DPSS ePolicy

Converted document, no content change

Revision of existing policy and/or form(s).

Provides a revised comprehensive listing of brochures, forms and notices used in the administration of the In-Home Supportive Services (IHSS) Program.

What changed?

1. The Administrative Release title was shortened to comply with formatting standards;
   
   
2. IHSS social work staff must no longer accept an affidavit as medical verification of a spouse's inability to perform specific IHSS tasks;
   
   
3. Reinstates PA 115, Physician's Certification of Spousal Disability, for use in verifying spousal disability; and
   
   
4. Includes a comprehensive listing of brochures, forms and notices to include:
   • Revised County and State forms;
   • Provider Eligibility forms; and
   • Federal Labor Standards Act forms.

Effective with this release, IHSS staff must use:

• Los Angeles County, i.e., PA brochures, forms and notices listed in this release in the administration of the IHSS Program;
• State, i.e., DHCS, PUB, SOC or STD, brochures, forms and notices listed in this release in the administration of the IHSS Program; and
• Brochures, forms and notices authorized by the Department or IHSS Program Section.

IHSS staff must not:

• Create or use unauthorized brochures, forms and notices;
• Distribute unauthorized brochures, forms and notices to IHSS applicants, recipients, providers, or other stakeholders;
• Modify or alter brochures, forms and notices authorized by the Department or IHSS Program Section, unless specifically permitted by IHSS Program Section; or
• Use brochures, forms and notices that have been cancelled by IHSS Program Section.

All brochures, forms and notices used in the administration of the IHSS Program must be provided to the applicant, recipient and provider in his/her designated written language.

If a brochure, form or notice is not available in the applicant's, recipient's, or provider's designated written language, then provide the English version along with the GEN 1365, Notice of Language Services, and verbally translate the brochure, form or notice.

County and State brochures, forms and notices released by the Department or IHSS Program Section may be retrieved from the:

• Department's Document Forms Library;
• IHSS district office supply room;
• IHSS district office shared drive;
• Case Management, Information and Payrolling System (CMIPS); or
• CMIPS Global shared drive.

IHSS Social Services Supervisors or Deputy Regional Services Administrators are available to assist IHSS line staff with locating, accessing, and navigating the:

• Department's Document Forms Library;
• IHSS district office shared drive;
• CMIPS; or
• CMIPS Global shared drive.

California Department of Social Services (CDSS)

The State agency responsible for oversight of the IHSS Program.

CMIPS

A web-based, comprehensive case management system used to:

• Record and track IHSS recipient and provider information;
• Determine eligibility for IHSS; and
• Manage payroll for IHSS providers.

Department of Health Care Services (DHCS) form

A DHCS developed and implemented form. Also known as a State form.

PA form

A Los Angeles County developed and implemented form.

PUB brochure

A CDSS developed and implemented brochure. Also known as a State brochure.

SOC form

A CDSS developed and implemented form. Also known as a State form.

STD form

A State of California Controller's Office developed and implemented form. Also known as a State form.

N/A

N/A

N/A