Waiver Personal Care Services Program

IN-HOME SUPPORTIVE SERVICES

Waiver Personal Care Services Program

Release Date

06/15/2022

Section Heading

Purpose

Converted document, no content change

What changed?

Changes the title from WPCS Provider Payment Processing to Waiver Personal Care Services Program to accurately reflect policy revision;
Changes references of the In-Home Operations (IHO) Waiver to the Medi-Cal Home and Community Based Alternatives (HCBA) Waiver;
Advises that the Waiver Personal Care Services (WPCS) Program is now administered via HCBA;
Clarifies the roles of In-Home Supportive Services (IHSS) Line and HCBA/WPCS staff;
Revises policy and procedures to include IHSS Social Worker (SW) responsibilities regarding IHSS eligibility determination and assessment, information sharing, and HCBA referrals;
Clarifies that WPCS hours are not alternative resources for the purpose of determining need for IHSS and authorizing IHSS hours; and
Includes updated images of related Case Management, Information and Payrolling System Version 2 (CMIPS) screens.

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

Policy

IHSS SW staff shall:
- Assess the IHSS applicant/recipient for IHSS eligibility and need for services and authorize IHSS as otherwise eligible per existing procedures;
  
  Note: WPCS eligibility is contingent upon the individual receiving IHSS. WPCS hours are not alternative resources for the purpose of determining need for IHSS and authorizing IHSS hours. IHSS services shall not be denied/removed, nor shall hours be reduced because an individual is receiving WPCS.
- Refer applicants/recipients to HCBA for a WPCS assessment upon request; and
- Share relevant case file information with HCBA Waiver staff upon request.
Designated IHSS Line staff shall enter WPCS provider enrollment information into CMIPS.
CMIPS is the designated payrolling system for WPCS Program providers.
WPCS providers must complete the IHSS provider enrollment requirements prior to being paid as a WPCS provider via CMIPS.
HCBA Waiver staff shall add the individual as a WPCS provider in CMIPS.

Background

In 2002, Assembly Bill 668 added Section 14132.97 to the Welfare and Institutions Code (WIC) that requires the Department of Health Care Services (DHCS) to provide WPCS to individuals eligible for services under the Nursing or Model Nursing Facility waivers.

IHO waivers for eligible physically disabled individuals receiving full-scope Medi-Cal allowed these individuals to remain safely in their own home as an alternative to hospitalization or nursing facility placement. The IHO waiver sunset on December 31, 2019, and all IHO waiver participants were transitioned to the HCBA waiver. The HCBA Waiver provides care management services to persons at risk for nursing home or institutional placement. DHCS administers the HCBA Waiver program. WPCS is now administered through HCBA.

Definitions

Assign Provider Screen

CMIPS screen used to assign a registered and eligible provider to a case.

California Department of Social Services (CDSS)

The State agency responsible for oversight of the IHSS Program and CMIPS.

CMIPS

The state’s web-based case management system that tracks case information and processes payments for the IHSS Program.

Criminal Background Investigation (CBI)

One of four IHSS provider enrollment requirements that calls for prospective providers to submit fingerprints to the Department of Justice to ensure that there are no crimes on file that may make them ineligible to be an IHSS provider.

HCBA (Formerly IHO)

The section within DHCS that administers the WPCS Program that provides care management services to persons at risk for nursing home or institutional placement. Care management services are provided by a multidisciplinary care team comprised of a registered nurse and a SW. The care management team coordinates waiver and state plan services, e.g., medical, behavioral health, IHSS, etc., and arranges for other available long-term services and supports available in the local community.

Tier 2 Crime

A violent or serious felony, as specified in PC Section 667.5(c), and PC section 1192.7(c);
A felony offense for which a person is required to register as a sex offender, pursuant to PC section 290(c); and
A felony offense for fraud against a public social services program, as defined in WIC section 10980(c)(2) and (g) (2).

WPCS

A program administered by HCBA in which individuals are either eligible for Nursing or Model Nursing Facility Waiver services. Both waivers provide personal care services to categorically needy and medically needy Medi-Cal recipients who would otherwise spend at least 90 days in a nursing facility. Individuals can receive both IHSS and WPCS Program services simultaneously.

Requirements

To receive WPCS

An individual must be enrolled in the HCBA Waiver and receiving IHSS.

To be paid as a WPCS provider

The prospective WPCS provider must complete the IHSS provider enrollment requirements.

Verification Docs

N/A

Attachments

N/A

DPSS ePolicy

NAVIGATION