 | | Deadline Extended for Some Providers |  The 2009 Budget Act implemented several changes to the In-Home Supportive Services (IHSS) Program designed to combat fraud and abuse within the system, including the development of a provider enrollment process that was put into effect on November 1, 2009. Since that time, all IHSS providers have had to complete the following requirements in order to receive payment for services provided through the IHSS program. - Complete a new Provider Enrollment Form (SOC 426) and submit it to the county in person
- Present, in person, an original government-issued photo ID (must be current) and Social Security card, along with photocopies of both documents
- Attend a provider orientation meeting
- Complete a Provider Enrollment Agreement (SOC 846) stating that they understand and agree to the IHSS Program rules and requirements
- Submit to and clear a Criminal Background Investigation (CBI) as administered by the state Department of Justice at their own expense
Providers who started providing services after November 1st (new providers) must meet all of the new requirements before being paid as an IHSS provider. Providers who were providing services prior to November 1st (current providers) were given until June 30, 2010 to meet the new requirements and continue receiving payment. The California Department of Social Service (CDSS) has recently extended the deadline for current providers who have met at least one of the requirements, to December 31, 2010. However, current providers who have not met any of the new requirements by June 30th will no longer be eligible for payment and will have to meet all of the requirements before their eligibility can be reinstated.
Current providers who have not met the new enrollment requirements should contact the IHSS office that handles their consumer's case to schedule an orientation. New providers who need to begin the enrollment process should contact the PASC New Provider Enrollment Hotline at 877-565-4482. For more information on the requirements for IHSS providers, visit the PASC website at www.pascla.org.
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| Budget Update: Governor Proposes to Cut $750 Million from IHSS |
 Faced with an estimated $19 billion budget deficit for the upcoming fiscal year, Governor Schwarzenegger released a budget proposal in January that included cuts and changes to many programs that are utilized by the senior and disability communities, including the IHSS Program. Specifically, the governor proposed to 1) eliminate all IHSS services for consumers who have a functional index of less than 4, 2) reduce state participation in IHSS worker wages to the minimum wage of $8.00/hour, 3) reduce funding for county administration of the IHSS Program, and 4) eliminate the IHSS Program if a specified amount of additional funding was not received from the federal government by June 15th.
On May 14th, the governor released a set of revisions and additions to his state budget proposal that rescinded all of the cuts to IHSS proposed in January. However, the governor is now proposing to reduce funding for the program by $637.1 million in the 2010-2011 fiscal year and $750 million in subsequent years (an estimated 42% of the state's share of the program's cost). The revised proposal does not specify how the reductions would be made, but establishes a stakeholder group to develop a plan to acheive the savings.
Budget subcommittees in both the Assembly and Senate have rejected the governor's proposed cuts to IHSS, and both houses have proposed a more modest 10% reduction in program funding. It is not known if any of the proposals made will remain in the final budget, but it is important to note that any proposed changes require passage by both the state Senate and Assembly, as well a signature by the governor, before being enacted.
More information on the governor's proposals and the budget process will be posted on PASC's website, and in future editions of PASC E-News as it becomes available. To subscribe to PASC E-News, click here.
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| Budget Update: Additional Cuts and Changes to Medi-Cal Proposed |
In addition to the cuts mentioned in the article above, the governor has proposed several key changes to Medi-Cal that could affect the IHSS community including:
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Eliminating Adult Day Health Care Programs
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Eliminating full scope Medi-Cal for certain immigrants
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Increasing anti-fraud measures within the Medi-Cal Program
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Eliminating coverage for over-the-counter drugs
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Establishing maximum benefit dollar caps on medical supplies and durable medical equipment
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Limiting visits to physicians or clinics to 10 per year
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Limiting prescription drugs to six per month, except for life-saving drugs
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Imposing copayments for medical services (i.e., $5 for physician, clinic, dental, and certain pharmacy services, and $3 for lower-cost drugs)
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Imposing a $50 copayment for emergency room visits
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Imposing a $100 per day copayment, up to a maximum of $200, for hospital stays
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Requiring seniors and persons with disabilities to enroll in managed care
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Ending payments of Medicare Part B premiums for recipients whose incomes exceed the Medi-Cal eligibility threshold by less than $500 per month
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Reducing payments to radiologists to 80 percent of Medicare rates
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Freezing payments to hospitals at the current level for state savings of $64.9 million
As with the proposed cuts to IHSS, budget subcommittees in both the Assembly and Senate have rejected the majority of the governor's proposed cuts to Medi-Cal. It is not known if any of the governor's proposals will remain in the final budget.
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Legislation Watch
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AB 1763 (Lieu) - In-Home Supportive Services: This bill would, among other things, require counties and public authorities to accept clearances of Criminal Background Investigations (CBIs) conducted on IHSS providers in other counties for the purpose of provider eligibility. This would allow providers to work in more then one county, or transfer counties without having to pay for a separate criminal background check.
AB 2274 (Beall) - IHSS: This bill would allow a person who receives IHSS from either a contract or managed care organization authorized through a federal waiver, to select any qualified person to be their care provider.
AB 2374 (Nestande) - IHSS Pilot Project: Existing state law authorizes the establishment of a pilot project in five counties that will allow persons with significant disabilities or impairments to choose between receiving IHSS either through a public authority or a contracting voluntary nonprofit or proprietary agency. This bill would delay implementation of the pilot project to January 1, 2011.
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