DPSS ePolicy

Converted document, no content change

 Revision of existing policy and/or form(s)

What changed?

1. Effective December 1, 2011, all In-Home Supportive Services (IHSS) recipients who were receiving IHSS through the Personal Care Services Program (PCSP) or the IHSS Plus Option (IPO) Program and met Community First Choice Option (CFCO) Program eligibility criteria, were transitioned into the CFCO Program. The transition to the CFCO Program was seamless to IHSS recipients and no notices were issued.
   
   
2. Effective September 1, 2014:
   
   
   • CFCO recipients are identified within Case Management, Information and Payrolling System (CMIPS) by the Funding Source Aid Code of 2K;
     
   • Actual CFCO data must be entered on the SOC 824, IHSS QA/QI Quarterly Activities Report; and
     
   • CFCO-eligible IPO Non-Severely Impaired (NSI) recipients receiving Protective Supervision (PS) hours, shall receive the 195 PS hours and the hours for other services, up to the Statutory Maximum of 283 hours per month.

Note: Changes are shown highlighted in gray throughout the document.

All IHSS CFCO recipients must be eligible for Full-Scope, Federal Financial Participation (FS FFP) Medi-Cal and meet one of the Nursing Facility Level of Care (NF LOC) eligibility criteria.

The federal Patient Protection and Affordable Care Act of 2010 (Public Law 111-148) was enacted March 23, 2010, and established CFCO as a new State Plan Option (SPO). This SPO allows states to provide Home and Community-Based Attendant Services and Supports.

In December 2011, the California Department of Social Services and the California Department of Health Care Services submitted a State Plan Amendment (SPA) for the CFCO Program to the Centers for Medicare & Medicaid Services (CMS). This SPA allowed California to receive an additional six percent (from 50% to 56%) in federal funding for services for CFCO-eligible PCSP and IPO program recipients, who were moved into CFCO, and for new CFCO-eligible applicants. This initial CFCO SPA was approved by CMS on August 31, 2012, retroactive to December 1, 2011.

The initial SPA was based on draft CFCO federal regulations and was approved with the understanding that a new SPA would be submitted for approval to include NF LOC eligibility criteria as required, per the final CFCO regulations. The new CFCO SPA was approved by CMS on July 31, 2013, with an effective date of July 1, 2013.

California was the first state in the nation to receive approval for implementing the CFCO Program. With this addition, California now operates four IHSS programs: IHSS‑Residual, PCSP, IPO and CFCO.

Activities of Daily Living (ADLs)

IHSS personal care services.

Instrumental Activities of Daily Living (IADLs)

IHSS domestic and related services, accompaniment to medical appointments, and care and assistance with prosthesis.

Requirement:

Services

Limit/Condition

1. Assistance with ADLs, IADLs, and health-related tasks that includes:
   
   
   • Domestic and Related Services;
     
   • Personal Care Services;
     
   • Accompaniment to Medical Appointments;
     
   • Paramedical Services;
     
   • Protective Supervision;
     
   • Heavy Cleaning;
     
   • Yard Hazard Abatement; and
     
   • Teaching and Demonstration that leads to the skills necessary to perform ADLs, IADLS, and health-related tasks.
     
     Note:  CFCO recipients may also receive:
     
     
     •  Restaurant Meal Allowance;
       
     •  Advance Pay;
       
     •  Services provided by a recipient’s spouse; and/or
       
     •  Services provided by a minor child/recipient’s parent.
        
2. A back-up system to ensure continuity of services and supports.
   
   
3. Voluntary recipient training on managing care providers.
    

SOC 864, IHSS Program Individualized Back-up Plan and Risk Assessment (6/25)