InHome Supportive Services Department of Health and Human

In-Home Supportive Services Department of Health and Human Services Senior and Adult Services Dr. Sherri Z. Heller, Director March 2016

WHAT IS IHSS The In-Home Supportive Services (IHSS) Program provides domestic, related and personal care services to eligible aged, blind, and disabled individuals who are unable to perform the services themselves and who cannot remain safely in their own home unless the services are provided. IHSS is considered an alternative to out -of-home care. Most recipients receive IHSS as a benefit of Medi-Cal. 2 March 2016 Sacramento County In-Home Supportive Services

WHO IS ELIGIBLE California Resident Financial Eligibility – FFP Medi-Cal or meet IHSS -R requirements Live in Own Home Health Care Certification Form (SOC 873) Have Assessed Need for Services 3 March 2016 Sacramento County In-Home Supportive Services

APPLICATION PROCESS Call (916) 874 -9471 (Monday-Friday, 9 am-4 pm) Please refer to IHSS Application Process flowchart for detail 4 March 2016 Sacramento County In-Home Supportive Services

IHSS NEEDS ASSESSMENT 5 Assessment based on functional ability to perform ADLs/IADLs Functional Ranking Hourly Task Guidelines – Range of Hours Corresponds with Functional Ranking March 2016 Sacramento County In-Home Supportive Services

IHSS AUTHORIZED TASKS 6 March 2016 Sacramento County In-Home Supportive Services

WHO PROVIDES IHSS care providers can be: o A family member o A friend o A neighbor o A care provider selected from the Sacramento County IHSS Caregiver Registry 7 March 2016 Sacramento County In-Home Supportive Services

PROVIDER ENROLLMENT PROCESS Attend IHSS new provider orientation at the IHSS Public Authority (Tuesday, Wednesday, & Thursday @ 9 am) Bring valid U. S. government-issued photo ID and original Social Security card Submit the completed and signed IHSS Recipient Designation of Provider (SOC 426 A) form Complete and pass a California Department of Justice criminal background check http: //www. pubauth. saccounty. net/Pages/GI_Provider_Enrollment. as px 8 March 2016 Sacramento County In-Home Supportive Services

RECIPIENT ROLE AS EMPLOYER Ø Find, hire, train, supervise, and if necessary fire the provider Ø Set schedule for provider(s) and track the number of hours worked Ø 9 Review and Sign timesheets March 2016 Sacramento County In-Home Supportive Services

SACRAMENTO IHSS STATISTICS Recipient characteristics as of February 2016: • 24006 active IHSS cases • 50% are 65+ (oldest 106) • 42% non-English speaking • 24% (~5800 recipients) living alone • 13% assessed with severe impairments in memory, orientation, and/or judgement 10 March 2016 Sacramento County In-Home Supportive Services

SACRAMENTO IHSS STATISTICS 22959 active Care Providers average 700~800 applications received each month average 2000 annual caseload growth from 2013 to 2015 11 current average caseload per social worker is 350 March 2016 Sacramento County In-Home Supportive Services

ORGANIZATIONAL STRUCTURE Eligibility Unit o 7 Eligibility Specialist (ES), 1 Sr. ES, and 1 Supervisor Social Worker Units o 30 Intake Social Workers, 69 Continuing Social Workers, and 13 Supervisors Quality Assurance Unit o 4 Quality Assurance Social Worker and 1 Supervisor 12 March 2016 Sacramento County In-Home Supportive Services

ORGANIZATIONAL STRUCTURE Payroll Unit o 14 Account Clerks, 2 Lead Clerks, 1 Senior Account Clerk, and 1 Supervisor Family Service Worker Unit o 6 Family Service Workers and 1 Supervisor Public Health Nurses o 7 Public Health Nurses and 1 Supervisor 13 March 2016 Sacramento County In-Home Supportive Services

ACTIVITIES AND STAFF RESPONSIBILITIES Eligibility Specialist Process IHSS referrals and applications Identify priority cases Handle Health Care Certification (SOC 873) Process Health Care Certification related Denials 14 March 2016 Sacramento County In-Home Supportive Services

ACTIVITIES AND STAFF RESPONSIBILITIES Social Workers: Intake Social Worker Conduct initial intake assessment Continuing Social Worker Conduct annual reassessment, handle ongoing case related issues 15 March 2016 Sacramento County In-Home Supportive Services

ACTIVITIES AND STAFF RESPONSIBILITIES Quality Assurance Social Worker Quality assurance reviews Program integrity activities: o unannounced home visits o directed mailings o fraud detection and prevention - data match, paid claims, death match Data reports - out of county provider, 60 days no timesheet, etc. QA Driven Specific Areas – QA support referrals, PS reviews 16 March 2016 Sacramento County In-Home Supportive Services

ACTIVITIES AND STAFF RESPONSIBILITIES Payroll Staff Enroll providers into payrolling system Resolve provider timesheet issues Respond to 800 to 1200 provider calls daily Handle provider Worker Compensation claims Provide staff support to the Adult and Aging Commission 17 March 2016 Sacramento County In-Home Supportive Services

ACTIVITIES AND STAFF RESPONSIBILITIES Family Service Workers assist recipients in obtaining care providers provide education services to both recipient/provider including responsibilities/duties, resources, timesheet completion assess heavy cleaning needs 18 March 2016 Sacramento County In-Home Supportive Services

ACTIVITIES AND STAFF RESPONSIBILITIES Public Health Nurses Provide health teachings such as nutrition, disease management Assist recipients linking to physicians Assist with durable medical equipment supply requests Liaison with doctor’s to ensure accurate completion of medical forms (paramedical/HCC) PHN assessment 19 March 2016 Sacramento County In-Home Supportive Services

RECENT PROGRAM CHANGES Implementation of Fair Labor Standards Act (FLSA) 20 March 2016 Sacramento County In-Home Supportive Services

FLSA Impact of New Federal Rules to IHSS: Provider Overtime Pay Provider Travel Time Pay Wait Time New and Revised Forms Weekly Service Hour Adjustment Requests Provider Violations 21 March 2016 Sacramento County In-Home Supportive Services

FLSA Activities: ◦ Timesheet Workshops - February 1, 2016 through March 15, 2016 ◦ FLSA Related Forms Payroll – handle form entry, scan, mailing and follow-up activities FSW – assisting recipients with completing required forms ◦ Recipient Questions/Weekly Hour Adjustment Requests Designated FLSA Social Workers ◦ Provider Violation Appeals FLSA Supervisor 22 March 2016 Sacramento County In-Home Supportive Services