DPSS ePolicy

Converted document, no content change 

 Revision of existing policy and/or form(s)

What changed?

1. Revises policy to state that the proration of Protective Supervision (PS) service hours for PS companion cases is no longer applied.
   
   
2. Advises In-Home Supportive Services (IHSS) staff that the Manual of Policies and Procedures Section (MPP) 30-763.331 is no longer being enforced.
   
   
3. Removes the procedures for prorating PS services hours from this Administrative Release.
   
   
4. Informs IHSS staff the modification(s) made on the Case Management, Information and Payrolling System (CMIPS) as a result of the elimination of the proration of PS.
   
   
5. Provides both revised and new Notice of Action (NOA) messages that will further assist the IHSS applicant/recipient/legal representative in understanding why PS was approved or denied.
   
   
6. Provides guidance to IHSS staff on how to use the informational PS brochures created by California Department of Social Services (CDSS) for both adults and minor children.

Note: Changes are shown highlighted in gray throughout the document

The IHSS Social Worker (SW) must assess every IHSS applicant/recipient for PS services at the initial assessment, annual assessment, or interim assessment based on whether the applicant/recipient is:

1. Mentally ill/mentally impaired and non-self-directing;
   
   
2. Physically able to engage in potentially dangerous activities; and
   
   
3. In need of 24-hours-a-day supervision.

PS is not authorized:

1. For friendly visiting or other social activities;
   
   
2. When the need is caused by a medical condition and the type of the supervision required is medical;
   
   
3. In anticipation of a medical emergency;
   
   
4. To prevent or control anti-social or aggressive applicant/recipient behavior directed to harm another;
   
   
5. To guard against deliberate self-destructive behavior, such as suicide, or when an individual knowingly intends to harm himself/herself;
   
   
6.  For routine childcare or supervision; or
   
   
7. When environmental modifications are already in place and has eliminated the hazard that placed the applicant/recipient at risk;

Note: Environmental modifications are not required to eliminate the need for PS, but may be discussed as a possible means to eliminate the need for PS.

Effective July 1, 2020, the proration of PS service hours for PS companion cases was no longer applied and MPP Section 30-763.331 was no longer enforced.

In addition to verbally explaining PS to the applicant/recipient/legal representative, IHSS SWs shall:

1. Use the PS brochures in conjunction with the conversation about PS as a tool to further inform and educate the adult applicant/recipient/legal representative, and parents of minor applicant/recipient; and
   
   
2. Leave a copy of the PS brochure in applicant’s/recipient’s preferred written language as a reference for them to use after the assessment.

CDSS released All-County Letter (ACL) No. 15-25, Protective Supervision Clarifications, dated March 19, 2015, to provide guidance to counties on the existing PS policy and regulations. ACL 15-25 also explains PS policy resulting from the rulings of the following relevant court cases:

Marshall v. McMahon and Calderon v. Anderson (1996):

1. PS is not available merely to provide constant oversight in anticipation of environmental or medical emergencies; and
   
   
2. The individual must be mentally ill/mentally impaired and non-self-directing.

Lam v. Anderson and Garrett v. Anderson (1998):

1. Assess all IHSS eligible minors for a mental illness/mental impairment, and request the parent or guardian to obtain available information and documentation about the existence of a minor’s mental illness/mental impairment;
   
   
2. Evaluate a mentally ill/mentally impaired minor in the functions of memory, orientation, and judgment on an individualized basis;
   
   
3. Evaluate a mentally ill/mentally impaired minor even if there are no previous injuries;
   
   
4. Evaluate a mentally ill/mentally impaired minor regardless of age;
   
   
5. Assess whether the minor needs more supervision because of his/her mental impairment than a minor of the same age without such an impairment;
   
   
6. Evaluate a mentally ill/mentally impaired minor even if the minor can be left home alone for a fixed period;
   
   
7. Review any relevant information provided by the parent;
   
   
8. Advise parent or guardian of the availability of, and the conditions for receiving PS; and
   
   
9. Do not presume that services, which are otherwise compensable, will be provided voluntarily by a parent, guardian, or anyone else.

Included in the budget for the fiscal year 2020–2021, the Governor eliminated the proration of PS hours for PS recipients living in shared living arrangements, i.e., companion cases. CDSS released ACL No. 20-111, IHSS Protective Supervision Proration Changes, dated October 13, 2020, to advise counties of this change and the associated procedural changes in the Case Management, Information, and Payrolling System (CMIPS).

CDSS also released All County Information Notice (ACIN) No. I-76-21, Release of Revised In-Home Supportive Services Protective Supervision Notice of Action Messages and Informational Materials, dated September 29, 2021, and ACIN No. I-96-21, Modifications to CMIPS for IHSS, dated December 8, 2021, to release revised NOA messages and informational materials relating to PS policy. The PS NOA messages were revised to be more user friendly for applicants and recipients. In addition, a new PS NOA message was created to provide calculation information regarding the number of hours a recipient is authorized for PS.

Companion cases

Two or more individuals living in the same household and receiving IHSS.

 Garrett v. Anderson Criteria

Eligible minors must meet all four of the following criteria to be eligible for PS:

1. Is non-self-directing due to a mental illness/mental impairment;
   
   
2. Is likely to engage in potentially dangerous activities;
   
   
3. Needs more supervision than a minor of the same age who is not mentally ill/mentally impaired; and
   
   
4. Needs 24-hours-a-day supervision to remain at home safely.

Non-Self-Directing

Individual who lacks:

1. Ability to make decisions so as not to put himself/herself in danger;
   
   
2. Capacity to respond to changes in his/her environment;
   
   
3. Ability to understand alternatives and risks involved; and/or
   
   
4. Ability to accept the consequences of his/her decisions.

PS

1. Service which is available to monitor the behavior of a non-self-directing, mentally ill or mentally impaired recipient to safeguard him/her against injury, hazard, or accident; and
   
   
2. Provided through the following, or combination of the following arrangements:
   1. IHSS;
   2. Alternative resources such as community-based adult services or child day care centers; and/or
   3. Voluntary resources.

Self-Directing

Individual who has the:

1. Ability to make decisions so as not to put himself/herself in danger;
   
   
2. Capacity to respond to changes in his/her environment;
   
   
3. Ability to understand alternatives and risks involved; and/or
   
   
4. Ability to accept the consequences of his/her decisions.

 Component and Requirement

PS for adults

An adult applicant/recipient may be authorized PS if the applicant/recipient:

1. Has a mental illness/mental impairment; and
   
   
2. Is non-self-directing; and
   
   
3. Is physically able to engage in potentially dangerous activities; and
   
   
4. Has a need of 24-hours-a-day supervision.

PS for children

A minor child applicant/recipient may be authorized for PS, if the minor child:

1. Has a mental illness/mental impairment; and
   
   
2. Is non-self-directing due to a mental illness/mental impairment; and
   
   
3. Is likely to engage in potentially dangerous activities; and
   
   
4. Needs more supervision than a minor of the same age who is not mentally ill/mentally impaired; and
   
   
5. Has a need of 24-hours-a-day supervision.

The SOC 821, Assessment of Need for Protective Supervision for In-Home Supportive Services Program, if received, must be used in conjunction with other pertinent information, such as an interview or report by the social service staff or a Public Health Nurse (PHN), to assess the person’s need for PS. The completed SOC 821 must not be the sole source used to consider the need for PS. If the SOC 821 is not returned, or is returned incomplete, the SW must make the determination of need for PS based on other available information. The other available information includes, but is not limited to:

1. A PHN interview;
   
   
2. A Licensed Health Care Professional’s (LHCP) report(s);
   
   
3. Police report(s);
   
   
4. Collaboration with Adult Protective Services, Linkages, and/or other social service agencies; and
   
   
5. The social service staff’s own observations.

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