DPSS ePolicy

Converted document, no content change

Revision of existing policy and/or form(s)

What changed?

1. Provides guidance regarding Assembly Bill (AB) 135 as it relates to In-Home Supportive Services (IHSS) Program eligibility requirements;
   
   
2. Provides clarification regarding assessing an IHSS applicant’s/recipient’s eligibility under:
   
   
   1. IHSS-Residual (IHSS-R) Program rules; and
   2. Sponsor Deeming rules.
       
3. Includes new sponsor deeming specific Notice of Action (NOA) messages that inform IHSS applicants/recipients of how sponsor deeming rules affected the determination of their IHSS eligibility;
   
   
4. Directs IHSS Social Workers (SWs) to view the Medi-Cal Eligibility screen in Case Management, Information and Payrolling System Version 2 (CMIPS) to determine Medi-Cal eligibility and verify the immigration status of non-United States (U.S.) citizens; and
   
   
5. Advises IHSS SWs that they will receive a Task in CMIPS identifying cases that were denied Medi-Cal benefits due to non-compliance with the Medi-Cal eligibility determination.
   
   Note: Changes are shown highlighted in gray throughout the document

Blind

An individual with a central visual acuity of 20/200 or less in the better eye with use of a correcting lens. An eye which is accompanied by a limitation in the fields of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees shall be considered as having a central visual acuity of 20/200 or less.

CFCO

Federally funded program for FFP Medi-Cal eligible IHSS recipients who also meet one of the Nursing Facility Level of Care eligibility criteria.

Deeming

The term used for the process of considering another person’s income to belong to the applicant/recipient

Entry Date/Admission Date

Date the individual is admitted as a permanent resident into the U.S., or their status is adjusted to permanent resident.

FFP

Federal matching funds paid to states for allowable expenditures for services or administrative costs.

IHSS-R

State-funded program for IHSS recipients who are not eligible for FFP Medi-Cal and who meet the IHSS eligibility criteria as outlined in Manual of Policy and Procedures (MPP) 30-755.

IPO

Federally funded program for FFP Medi-Cal eligible IHSS recipients who are not eligible for PCSP due to one or more of the following:

1. Recipient has a spouse for a provider; or
   
   
2. Recipient is a minor child with a parent for a provider; or
   
   
3. Recipient receives Advance Pay; or
   
   
4. Recipient receives Restaurant Meal Allowance.
   

Lawful Permanent Resident (LPR)

Non-U.S. citizens who are lawfully admitted for permanent residence by the U.S. Citizenship and Immigration Services (USCIS). These noncitizens may have also entered the country with an immigrant visa or adjusted their status after entering as a non-immigrant, refugee, or asylee.

MPP

Regulations adopted by the California Department of Social Services (CDSS) for the purposes of administering programs governed by CDSS and pertain to State law.

PCSP

Federally funded program for FFP Medi-Cal eligible IHSS recipients. Services include:

1. Domestic and related services;
   
   
2. Personal care services; and
   
   
3. Protective supervision.

Permanently Residing Under Color of Law (PRUCOL)

A public benefits category created by the federal courts that grants full scope Medi-Cal eligibility to immigrants residing “under the color of law.” For a person to be residing “under the color of law”, the USCIS must know of the person’s presence in the U.S. and provide the person with written assurance that enforcement of deportation is not planned.

Presumptively Eligible

The determination of IHSS eligibility prior to the completion of the Medi-Cal eligibility determination for IHSS applicants as follows:

1. Disabled Applicant - Unemployed with no expectation of employment within the next 45 days due to mental and/or physical impairment that will last for at least one year or end in death in the County staff’s judgment; or
   
   
2. Blind Applicant - A central visual acuity of 20/200 or less in the better eye with use of a correcting lens, or defined as blind under the State plan approved under Title X.

Presumptive eligibility in the IHSS Program is not the same as presumptive disability in the Medi-Cal Program. County Medi-Cal eligibility staff make presumptive disability decisions by following the criteria outlined in the Medi-Cal Eligibility Procedures Manual, Section 22C-3.1 through 22C-3.6.

Share of Cost (SOC)

Net non-exempt income in excess of income standards that must be paid towards Medi-Cal benefits/services, including IHSS, prior to receiving no cost benefits/services.

SOC 294A, IHSS Income Eligibility – Adult

State of California form used to determine IHSS eligibility and SOC for an adult IHSS applicant/recipient.

SOC 294C, IHSS Income Eligibility – Child

State of California form used to determine IHSS eligibility and SOC for a minor child IHSS applicant/recipient.

 SOC 310, Statement of Facts for In Home Supportive Services

State of California form used only for applicants/recipients receiving services through the IHSS-R Program and who are subject to sponsor deeming rules.

SOC 811, In-Home Supportive Services Sponsor to Alien Deeming Worksheet

State of California form used to report a sponsor’s income and resources.

Sponsor

An individual who signs an affidavit of support agreeing to support a non-U.S. citizen as a condition of admission of the non-U.S. citizen for permanent residence in the U.S.

WIC

General statutory law of California.

Requirement and Limit/Condition

 CFCO Eligibility:

1. Be full scope FFP Medi-Cal eligible; and
   
   
2. Be linked to Medi-Cal as aged, blind, or disabled, or meet MPP 30-780.2 (b) criteria; and
   
   
3. Unable to remain safely at home without IHSS; and
   
   
4. Total assessed need of 195 or more IHSS hours per month, excluding heavy cleaning and hazard abatement; or
   
   
5. If under 195 IHSS hours per month, must have three or more services with a Functional Index Rank of three or above in eating; bowel and bladder/menstrual care; bathing/grooming; dressing; mobility inside; transfer; respiration; and paramedical services; or
   
   
6. A combined “Individual Assessed Need” total of 20 hours or more per week in one or more of the following: meal preparation; meal clean-up; respiration; bowel and bladder care; feeding; routine bed baths; dressing; menstrual care; ambulation; transfer; bathing/oral hygiene/grooming; repositioning and rubbing skin; care and assistance with prosthesis; and paramedical services.
   

IPO Eligibility:

1. Be full scope FFP Medi-Cal eligible; and
   
   
2. Be linked to Medi-Cal as aged, blind, or disabled, or meet MPP 30-780.2 (b) criteria; and
   
   
3. Unable to remain safely at home without IHSS; and
   
   
4. Has a spouse for a provider; or
   
   
5. Is a minor child with a parent for a provider; or
   
   
6. Receives Advance Pay; or
   
   
7. Receives Restaurant Meal Allowance.

PCSP Eligibility

1. Be full scope FFP Medi-Cal eligible; and
   
   
2. Be linked to Medi-Cal as aged, blind, or disabled, or meet
   MPP 30-780.2 (b) criteria; and
   
   
3. Unable to remain safely at home without IHSS.

IHSS-R Eligibility

1. Be full scope State-only Medi-Cal eligible; or
   
   
2. Denied/discontinued Medi-Cal for a reason other than non-compliance with Medi-Cal requirements.