In both models, self-directing program participants continue to recruit, schedule, and supervise their individual workers. In some cases, advocacy on the part of self-directing program participants and their allies played a crucial role in in convincing policymakers to adopt limits that were more generous. However, research conducted by ASPE staff while the Home Care Rule was under development found that in states with large self-directed services programs, state labor laws often differed from the proposed federal rule. Two of our case study states mandate enrollment into managed care plans. Such individuals may also be enrolled in HCBS waiver programs that will allow them to receive additional personal care aide hours above the IHSS coverage cap. The four IHSS programs and the maximum amount of hours individuals may receive are: The IHSS Residual Program (IHSS-R) Non-severely impaired individuals can receive up to a maximum of 195 hours a month when receiving Protective Supervision. Their reasoning was that this would lessen the potential for Medicaid cost increases by reducing the likelihood of joint employment determinations. California state officials recognize that this court ruling, subsequently cited in lower court rulings, would likely make it difficult for the state to claim that it is not a joint employer under the Home Care Rule. After introducing the study methods, we describe issues that emerged from interviews conducted with stakeholder group representatives. Any sick leave hours you currently have will expire on June 30, 2022. To qualify for the companionship exemption from minimum wage and overtime pay requirements, home care workers may only provide limited amounts of assistance with personal care tasks (such as bathing, dressing, toileting, transferring into and out of beds and chairs) and household help (cooking, cleaning, laundry), and no medical help that would normally be provided by a licensed nurse or therapist. 0000029206 00000 n An exception to the 30-day requirement may be made when a disability determination has not been received within the 30-day period, or the person has not moved into his or her own home. Registry staff recruit and interview provider applicants, enter data from application into data base (Develus). This higher limit appears to be to accommodate travel time pay, which suggests that Ohio accepts joint employer responsibilities, at least with respect to participant-directed workers delivering services under the PASSPORT waiver. Additionally, some states in our database contained multiple program entries. 0000011007 00000 n The county will send written notice of such an adjustment. For example, your care provider cannot spend more than 6 hours per month on domestic services or more than 1 hour per week shopping for food. 2. Copyright 2022World Institute on Disability, Technology 2002-2022Eightfold Way Consultants. I cant go over the amount of 131 hrs a month. For purposes of FLSA compliance, an AwC model of FMS may often be a third party employer, whereas an F/EA that acts strictly as a payroll agent is often not a third party or a joint employer with the program participant for FLSA purposes. 0 0000002236 00000 n If, after working in good faith, consumers cannot meet their home care needs, the SSA may give authorization for the independent provider to work more than 60 hours in a work week. You can join the IHSS program if you are an In Home Support Staff provider, working through the Public Authority of Contra Costa County for a minimum of 45 hours per The participant is limited to 40 hours of Relative Personal Care, with the exception of parents caring for their adult children. Overtime is working more than 40 hours per week. 0000009410 00000 n Sometimes, providers just enter each days work on a timesheet right away, then submit the whole timesheet at the end of the pay period. The MCOs, in turn, are responsible for payments owed to participant-directed personal care aides, including any overtime wages. On January 1, 2019, the minimum wage increased to $12 per hour. As required under State statutes, the maximum number of hours an IHSS or WPCS provider may work in a workweek for all the time he/she works for two or more If a single rate is used, then it should at least be calculated based on the "case mix," using factors (aside from setting) related to the extent and type of needed services that can predict expenditures for each member. The purpose of this study is to describe and document changes states have made to their Medicaid or other publicly-funded consumer directed home care programs for seniors and individuals with disabilities to comply with the 2013 update to Fair Labor Standards Act (FLSA) regulations. On January 1, 2021, the minimum wage will increase to $14 per hour. Do you have to be at home to be evaluated for IHSS, Press J to jump to the feed. Project subcontractors -- who were particularly knowledgeable about some states -- provided additional information through their direct state contacts to assist in filling in the blanks, where needed. Exception 1: Live-In Family Care Providers Exception. 0000007800 00000 n 0000049184 00000 n The independent provider is the only provider trained by a nurse to perform delegated tasks or trained by a behavioral specialist to implement unique behavioral support strategies. 0000048424 00000 n 0000046421 00000 n You can use up to a quarter of your monthly hours each week. However, because the largest self-direction programs in each state are included in our database, we have collected enough data to make inferences with a moderate degree of confidence, though we recognize that these inferences may need to be revised as more data become available. I have also done this when my mom has returned home from the hospital and I just collected the extra hours every week to make 40 hour work weeks until I was back on track to only get 5 hours per day. Thus, they cannot afford to authorize aide hours subject to overtime pay liability unless the managed care plans authorize them to do so and increase reimbursement in such cases accordingly. Self-directing program participants exercising budget authority could lower the regular wage rate of non-live-in workers to pay overtime rates for hours requiring overtime pay. The Governors budget estimates The application must be processed within 30 days following the application. With a DB101 account, you can easily save and find your favorite DB101 pages, mini-tools, and estimator sessions. 0000007443 00000 n hTjp5(D :8d-tuP;u77 / I Next, someone from the county IHSS office will come to your home to conduct a needs assessment to figure out the services you need and how many hours you qualify for. In contrast, according to information provided by state officials during the case study research, Minnesota conducted a legal analysis and concluded that the state is not a joint employer. It also exempted from overtime pay requirements all categories of domestic service workers who live in the household in which they provide services (the "live-in domestic service employee exemption"). If you are a California resident and receive Medi-Cal benefits, you may be eligible forIHSS. Some exceptions, primarily for live-in workers, allowing some workers to work more than 60 hours per week are also available but are less frequently approved and more likely to be time-limited. In Ohio, Disability Rights Ohio and ten other groups submitted comments objecting to Ohio's original proposal for a 40 hour per week "hard cap" on individual worker hours, with very limited exceptions. As a result, self-directing program participants who have been relying on a single paid worker did not have to recruit additional providers to be able to obtain all of their authorized service hours after the Home Care Rule went into effect. 0000009234 00000 n In-Home Supportive Services (IHSS) provide people with low income who are blind, disabled, or 65 years old or older with personal assistance and in-home services so they can safely stay in their homes or continue working. Whether you are dealing with federal or state benefits or struggling with a school district to get proper education for your child, we have the resources to help you. Yes. IHSS is a Human Services Department program in California, designed to help low-income elderly and people of any age living with a disability remain living safely and independently in their own home. http://www.employmentlawdaily.com/index.php/news/4th-circuit-adopts-new-flsa-joint-employer-test-finds-general-contractor-sub-jointly-liable-for-overtime/. Some recipients and providers use calendars or spreadsheets to track hours and then fill out everything at the end of the pay period. States may arrange for FMS through a "fiscal/employer agent" (F/EA) in which the FMS is strictly a payroll agent and self-directing program participants are their workers' sole legal employers under tax law. Another exception is for exceptional circumstances such as providers who are serving multiple recipients who have complex medical conditions or other special needs, reside in rural areas where other providers are not available, or need a provider who speaks their language and such providers are not otherwise available. Providers will be entitled to overtime (time and one-half) for time worked over 40 hours per week. The Rule also provided that third party employers, such as home care agencies or any other joint employers who share employer responsibilities with individual household employers, cannot claim either the companionship services exemption or the live-in domestic service worker exemption. CDSS has also created a penalty system for providers who do not follow the overtime rules that will become effective on May 1, 2016. On October 1, 2013, the U.S. Department of Labor (DOL) issued a final rule (the Home Care Rule) to update regulations concerning the FLSA domestic service employee exemptions. The first phase of the study consisted of interviews with stakeholder group representatives at the national level. ICS saw these Home Care Rule overtime costs as not the only, but among the factors, that ultimately required ICS to cease operating as a MLTSS plan. Additionally, just contact your local IhSS office and ask them for reassurance. States with Work Week Hour Caps, TABLE 1. 0000048558 00000 n [1] The guidance urged states to take care in implementing the Home Care Rule to ensure that efforts to contain potential Medicaid cost increases did not have the unintended consequence of exacerbating rather than alleviating worker shortages and adversely affecting Medicaid program participants' access to home care aide services. Advocacy Played a Major Role in Implementation Decisions. Additionally, the Home Care Rule has interacted with both national and local, and state-specific conditions in complex ways that make it challenging to determine how the Home Care Rule in isolation from other influences affected state decision-making. 0000035575 00000 n The program pays the wages of caregivers for providing services necessary to maintain safety and independence in their home. Although the decision is not clear on this point, it appears that "Angels in Your Home" is merely a name under which the owner does business and not a legal entity, as reported by the trade association Leading Age in https://www.leadingageny.org/providers/home-and-community-based-services/fiscal-intermediaries/fiscal-intermediaries-are-employers-federal-trial-court-rules/. These wage rates are fixed via a state provider rate setting process, which in some states involves collective bargaining with a union representing participant-directed workers. Although AwC FMS providers share employer authority with self-directing program participants; the AwCs all receive the same standard hourly rate for aide services. Finally, we designated in the 40+ hours category states with employer authority only self-direction programs that allowed program participants to have live-in workers when the evidence (e.g., payment of travel time) indicated that the state was a joint employer not eligible to take the live-in exemption to the overtime pay requirement (e.g., Oregon). See http://codes.ohio.gov/oac/5123:2-9-03v1. ACL 16-01 (January 7, 2016). Services range from assistance with household chores to personal care and paramedical services. Although issued in 2013, the Home Care Rule had an effective date of January 1, 2015. You might want to check in with her social worker and tell her this is what youll be doing and why just to make sure its okay. You cannot use IHSS hours to help you with college courses or vocational training. To inform the case studies, we reviewed policies and procedures documents; read accounts of decisions about how implementation were made and about the changing landscape of community long-term services and supports (LTSS) in the states more broadly; reviewed the websites of advocacy organizations; collected reports issued by non-profit organizations; and queried informants with insight on the implementation process in their states. The Ohio Home Care Rule defines an emergency as the "unanticipated and sudden absence of an individual's provider or natural supports due to illness, incapacity or other cause." 0000005103 00000 n For example, they may prefer to arrange to have extra paid aide hours available when family caregivers who provide significant amounts of unpaid help need to take a break. I'm in college. However, New York's capitation payments are risk-adjusted across the entire population of MLTSS enrollees, which tacitly assumes that people with different levels of need are evenly distributed across participating plans. DOL led an extensive implementation effort to help employers of home care workers prepare for FLSA compliance. Under the Rule, independent providers must tell an individual's SSA how many people they provide Medicaid-funded services for, and the number of hours they work for such persons in total. Your personal property cannot exceed $130,000 to qualify for IHSS. Ohio's exception policies are codified in state regulations (5123:2-9-03). We then present findings from an environmental scan of state policies and procedures conducted in all U.S. states, including the District of Columbia. [9] Once Independent providers have worked 60 hours in a work week providing Medicaid-funded services, they can only work more hours in two situations: If the additional hours have been authorized by the consumer's service and support administrator (SSA) through the county board of developmental disabilities. [2] The guidance specifically counseled states to avoid imposing a 40-hour hard cap limiting the Medicaid billable hours per week that workers employed by self-directing program participants would be permitted to work, with no or only very restricted exceptions. A 2017 4th Circuit ruling rejected the test applied in the Bonnette case, claiming that this case has been responsible for confusion over determinations of joint employment, and substituted a different test. Medicaid almost never authorizes reimbursement to program participants rather than service providers, so self-directing program participants cannot pay their workers directly. The guidance specifically counseled states to avoid imposing a 40-hour hard cap limiting the Medicaid billable hours per week that workers employed by self-directing program participants would be permitted to work, with no or only very restricted exceptions. 0000039631 00000 n States are motivated to contain Medicaid cost increases that could result from FLSA implementation. Reddit and its partners use cookies and similar technologies to provide you with a better experience. IRIS Policy Manual, https://www.dhs.wisconsin.gov/publications/p0/p00708.pdf. Alternatively, states may be unsure about whether they or some other entity might later be legally determined to be joint employers. Drawing on information collected in periodic inventories of self-direction programs across the United States, there has been, between 2011 and 2016, a decrease in states using the AwC model and a corresponding increase in states' use of the F/EA model. Because of the many months of legal uncertainty as to whether the Rule would be upheld by the courts, states in many cases delayed planning for implementation. However, we were unable to determine whether their motivation for doing so was to avoid a joint employer designation. Stakeholders agreed that DOL's goal of extending FLSA protections to home care workers was a worthy one, and they supported the goal of expanding the home care workforce, including improving pay and working conditions to recruit more workers. In 1974, Congress extended the minimum wage and overtime pay protections of the FLSA to "domestic service" employees such as cooks, housekeepers, maids, or gardeners employed in households. Your system should also help you make sure you stay within your maximum hours per week and per month. Ybfu~k? I cant go over the amount of 131 hrs a month. 2618 0 obj <> endobj States may elect either the F/EA or the AwC approach to FMS, but some offer both models and allow self-directing program participants to choose between them. Thirteen states (Alabama, Arizona, Colorado, Florida, Georgia, Kansas, Illinois, Louisiana, Minnesota, New Jersey, North Carolina, Texas, and West Virginia) allow self-directing program participants exercising budget authority to authorize overtime pay if they have sufficient funds in their budgets to cover the costs. These limits apply both to aides employed by self-directing program participants in the fee-for-service (FFS) system and those employed by self-directing program participants who have voluntarily enrolled in Massachusetts' two Medicaid managed care programs: Senior Care Options or One Care. It may also have negative effects on the home care labor force, currently struggling to recruit and retain adequate numbers of workers due to low/stagnated wages and limited or no employment benefits. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. State decisions related to implementation of the Home Care Rule were inferred from available state documentation. hbbd``b`>$! This means that your maximum monthly hours may be 283, or 195, depending on whether you are found to be Severely Impaired or Non Severely Impaired. You are Alternatively, states may arrange for FMS via an "Agency with Choice" (AwC). Counties will be sending informing notices that include the weekly authorized hours. Recent legislation created various options for counties to implement In-Home Supportive Services (IHSS) provider wage and benefit increases. Consumer advocates were more inclined toward pessimism than other key informants were; that is, to predict that many states would set a "hard cap" of 40 hours with no or few hardship exceptions to avoid or minimize Medicaid expenditure increases attributable to the Home Care Rule's overtime pay requirement. [15] Program administration changes that Massachusetts, Oregon, and Washington have made in response to the Home Care Rule indicate those states' acceptance of joint employer status. 0000039234 00000 n The findings presented here are therefore based on a subset of programs and could differ from an analysis using the entire universe of consumer directed programs. In all six of the case study states, advocacy involved coalitions of advocacy groups. Apart from California, Massachusetts, Wisconsin, and Ohio, this study found few examples of states with well-documented hardship exceptions policies. 120 0 obj <>stream We found information on approximately 75 programs and almost always included the largest program in the state. Finally, to illustrate both state variations in FLSA implementation and promising practices, we present examples of select case study states with well-documented hardship exceptions policies: California, Massachusetts, Wisconsin, and Ohio; and provide insights from all case studies. Wish i can insert photo of my form so you can see clearly where it says your max hours for week an month that ihss sent me. For multiple providers for a single recipient, the weekly number of hours can be divided in any manner among the providers. Consumer advocates also feared that states might find it expedient to eliminate self-direction as an option altogether. Before sharing sensitive information, make sure youre on a federal government site. This report provides an overview of early implementation activities at the state level and perspectives from various stakeholder groups. xW]kI+ 7W$M|zh$ You can hire relatives, friends, neighbors, and other caregivers to provide you with IHSS. Recruiting aides may be difficult for both traditional home care agencies and self-directing program participants. On January 1, 2022, the minimum wage will increase to $15 per hour. Currently, as an IHSS caregiver, the maximum number of hours you can claim is 283 per month. That equates to $3,679 per month today. How Long will the Application Process Take? The IHSS in-home assessment is initiated by the county Social Services Agency at the time of application, every twelve months thereafter, and whenever the county has information that the recipients physical/mental condition or living/social condition has changed. &&&&&..# $8FH #]$T(DH "=bEX,c2vKWJ^yU6aI]luxLJafVVOPiCTz'*?DGQM_>a V^=R77z\ps7z\p]sw88~C7?='q+;,yau; `t7lFu'>']iwsmw;n}9t |z ?<0ri4O44Lk;ya}U/l2e7n?.SrNF$s y Contact us for help. This report was prepared under contract #HHSP233201600018I between HHS's ASPE/DALTCP and Mission Analytics Group, Inc. For additional information about this subject, you can visit the DALTCP home page at http://aspe.hhs.gov/office-disability-aging-and-long-term-care-policy-daltcp or contact the ASPE Project Officer, Marie Squillace, at HHS/ASPE/DALTCP, Room 424E, H.H. More common are less well-defined exceptions to caps on worker hours such as those found in Kentucky (temporarily for emergencies), Wyoming (only if no other worker available), and in Hawaii (if approved by the individual's case manager and included in the Individual Support Plan). The guidance cautioned states that if they limited workers' hours to 40 per week without hardship exceptions this could result in putting Medicaid program participants living at home at high risk of requiring nursing home placement or other adverse consequences associated with unmet needs for assistance with daily living tasks. Findings from the environmental scan reveal that most states (32 including the District of Columbia) did not set a hard cap on weekly hours worked. Many of the concerns that stakeholders had about the implementation of the Home Care Rule have generally not come to pass. The purpose of this study is to describe and document changes states have made to their Medicaid or other publicly-funded consumer directed home care programs for seniors and individuals with disabilities to comply with the 2013 update to Fair Labor Standards Act (FLSA) regulations. This is based on working 8 hours a day, 40 hours a week, and 52 weeks a year. California Department of Social Services (2018), In-Home Supportive Services Program, Report to the California State Legislature on the Impact of the Fair Labor Standards Act Overtime Rule, Final Report, https://www.cdss.ca.gov/Portals/9/Leg/Final_FLSA%20Overtime%20Report%20to%20Legislature%202018.pdf?ver=2018-10-08-154455-720. Press question mark to learn the rest of the keyboard shortcuts. Federal government websites often end in .gov or .mil. For example: To what extent did states cap Medicaid billable worker hours at 40 hours per week or, alternatively, at some higher number of hours that would allow for some overtime pay without program participants having to request special permission? The decision creates a new precedent governing the relationship of fiscal intermediaries with personal assistants and their legal obligations. Hardship Exceptions Allow Additional Worker Overtime Hours Beyond Routine Limits, Four of our case study states that have set explicit statewide program caps on participant-directed workers' billable hours (California, Massachusetts, Ohio, and Wisconsin) provide clearly defined hardship exceptions. There is a shortage of other available providers. In some cases (e.g., Alabama) paying overtime via a budget is technically allowable but appears to be rare because the amount of funding provided to self-directing program participants exercising budget authority is based on the assumption that they need less than 40 hours per week of aide services. Information provided to project contractor Ed Kako of Mission Analytics and Mollie Murphy of Applied Self-Direction by state official Cara Benson of the Minnesota Department of Health and Human Services as part of a case study of Minnesota's response to the Home Care Rule, 2018. 0000049262 00000 n D*@;H @.#I h See also 42 U.S.C. My provider works with other recipients. If the Agreement is submitted by June 1, 2016, the provider can be retroactively reinstated. Providers will be entitled to overtime (time and one-half) for time worked over 40 hours per week. If approved, you will be notified of the services and number of hours authorized for each service. After the needs assessment, IHSS will send you a letter called a Notice of Action that will let you know if you have been approved or denied services. Many individuals and families managing a disability are not aware of the wide array of services available to them, or they do not know how to apply for these benefits in a way that is likely to succeed. In-Home Supportive Services (IHSS) is a program designated to help children as well as the elderly who have disabilities so they can safely remain in their own homes when they are not able to fully care for themselves. This report provides an overview of early implementation activities at the state level and perspectives from various stakeholder groups. https://clpc.ucsf.edu/sites/clpc.ucsf.edu/files/reports/MLTSS%20Capitation%20to%20Promote%20HCBS%2011-17.pdf. Not all states allowed self-directing program participants to claim the live-in exemption to the overtime pay requirement, but 11 permitted the domestic service employee exemption. California, in particular, offers several hardship exceptions (previously described) that permit additional overtime hours above routine limits that are already more generous than those in other states. Thirty-two states (including the District of Columbia) allowed workers to work more than 40 hours per week. This report was completed and submitted on September 5, 2019. 0000004312 00000 n Are there medical eligibility requirements for IHSS? 35. 0000032324 00000 n In 1983, the Ninth Circuit Court of Appeals held that, in counties providing funds to recipients to pay their own IHSS providers, the state and counties were joint employers with recipients for purposes of the Fair Labor Standards Act of 1938 (FLSA) (29 U.S.C. You, the recipient of In-Home Supportive Services (IHSS), are responsible for hiring, firing, and supervising your caregiver. As a result, they could enjoy higher earnings if Medicaid program rules authorized them to work for more than 40 hours per week. 55 0 obj <> endobj An IHSS recipient is classified as severely impaired if they are authorized for 20 or more hours per week of non-medical personal services, paramedical services, and meal Established a three-month transition period for recipients and their providers to learn An IHSS recipient is classified as severely impaired if they are authorized for 20 or more hours per week of non-medical personal services, paramedical services, and meal preparation. Maximum Hours. Then go back to your Vault to learn more. Self-directing program participants have the right to dismiss their aides at will. 200 Independence Avenue, SW Has one PCA who provides all the consumer's PCA services. To transfer hours to the workplace, contact your IHSS caseworker and say which services you need and the number of hours you wish to transfer. 0000031788 00000 n xWMo7+z'p lEoR( We are only aware of one state (Tennessee) that had already capped all participant-directed independent providers' hours at 40 per week before the FLSA rule was promulgated. _-MZ?x. Can I use IHSS there? Transit Auth., 469 U.S. 528 (1985). Another possible motivation for states to redesign their programs to offer budget authority is they believe doing so might lessen the potential for Medicaid cost increases by reducing the likelihood of joint employment determinations. The decision in Hardgers-Powell v. Angels in Your Home, LLC (http://www.leadingageny.org/?LinkServID=83649223-FF6D-4933-082BD8D81520674A) arose out of a case involving a CDPAP personal assistant who sought to bring a class action lawsuit claiming that the defendants violated the NYLL and the federal FLSA by failing to pay overtime wages at the correct rate. See https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-07-03-2014.pdf. Providers who work for such individuals may work up to 360 hours per month in combined hours authorized under Medicaid waivers and IHSS. We are only aware of one state that had already capped all participant-directed independent providers' hours at 40 per week. The protocol was followed as closely as possible while allowing enough flexibility to follow interesting and important or unexpected lines of inquiry. 0000049387 00000 n I think it depends on each case. Under the statutory and regulatory scheme under which participants and fiscal intermediaries operate, "the responsibilities that would be traditionally associated with one employer are divided between the participant and fiscal intermediary, who work in tandem to control each [CDPAP personal assistant's] working conditions and to ensure the delivery of home health care services.". In the latter two cases, the SSA must work with consumers and their care teams to develop a plan to change these circumstances. Can I Get Disability Benefits for My Child Who Has Special Needs. On January 1, 2022, the minimum wage will increase to $15 per hour. This report, prepared by ASPE staff, synthesizes and expands upon key study findings from several reports prepared by Mission Analytics. Resides together with the PCA (as confirmed via third party documentation). If you plan to live in your own home in the future, you can apply for IHSS while you are in the facility. The purpose of this study was to describe and document the extent to which states have made changes to their Medicaid or other publicly-funded home care programs for seniors and individuals with disabilities to comply with the 2013 update to FLSA regulations extending minimum wage and overtime protections to most home care workers, and the effect the Rule may have had on the number of hours worked and the amount of overtime compensation paid in the home care setting. Additionally, it was often difficult to find information from publicly available sources concerning the specifics of exceptions policies in states that set explicit limits on worker hours. [14] New York's approach recognizes that high need individuals' services cost more (especially if they are self-directing and need to pay overtime to access CoC from aides who can meet their needs which often involve performance of routine skilled tasks). 517 - 12th Street Although participant-directed workers are unionized, the collectively bargained hourly wage rate sets the wage floor and self-directing program participants may decide how many hours of aide service to purchase and may pay more per hour than the union rate if they are able to do so without over spending their budgets. 0000052704 00000 n This does not, however, include the home you live in, one car to get to and from medical appointments, and life insurance with a combined face value of less than $1,500. This report, prepared by ASPE staff, synthesizes and expands upon key study findings from several reports prepared by Mission Analytics. States that did not set a cap as a matter of state policy, decided on a case-by-case basis whether to authorize workers to work more than 40 hours per week or delegate such case-by-case decision-making to MLTSS plans.[18]. %PDF-1.4 % The individual has a compromised immune system and may be put at risk by having additional providers. Various organizations, including NASDDDS, National Association of Medicaid Directors, and NASUAD, provided technical assistance to state members and tried to ensure that states understood the Rule and how to comply with it. I'm trying to find out the maximum hours worked per week, without approving overtime, and I'm getting mixed results when searching. Ensuring adequate funding for overtime payments to ensure that high quality care and CoC from reliable workers is available to high need individuals assessed as needing more (often much more) than 40 hours of personal care aide services per week is more complicated when a state has switched from a FFS provider payments to MLTSS. 0000032828 00000 n 0000003295 00000 n Because high needs LTSS users are typically at greatest risk of institutional placement, states expecting plans to offer HCBS that are robust enough to reduce institutionalization must make meeting the needs of such members paramount. In most other states with explicit limits on routine overtime, the typical cap was 45-50 hrs. The current cap is set at 60 hours per week. Her e-mail address is: Marie.Squillace@hhs.gov. An IHSS employee can do a preliminary needs assessment while you are still residing at the facility. The individual has holidays or scheduled breaks from school. It is noteworthy, however, that where states allowed self-directing program participants with budgets to pay overtime rates if they could afford to do so, we did not find much evidence of states increasing the size of their budgets. In addition, we learned from speaking with state officials in some other states that overtime pay requirements were not well enforced. [12] Minnesota retains more state control and delegates less decision-making authority to the plans. Medicaid provides for financial management services (FMS) entities (sometimes also referred to as fiscal intermediaries) to pay self-directing program participants' workers. One exception is for live-in family providers who provide services to more than one IHSS recipients, all of whom reside in the shared household. %PDF-1.5 % While there are more than 200 programs across the country that offer self-direction, we found information for fewer than 75. The .gov means its official. Below are descriptions of select case study states with well-documented exception policies: California has a long-standing coverage limit of 283 hours per month on the number of provider hours an In-Home Supportive Services (IHSS) program participant can receive. 0000028878 00000 n 0000004134 00000 n They may do so primarily by limiting the number of Medicaid reimbursable service hours that self-directing program participants' aides are permitted to provide per week. No overtime will be Are there limitations on the number of hours provided per task? <]/Prev 720949/XRefStm 1925>> He maintains personnel records for CDPAP personal assistants. Other stakeholders predicted the opposite -- a shift away from F/EA in favor of AwC -- although their reasons for expecting states to make such a change were less clear.[6]. The number of hours authorized may change with each evaluation. In some self-direction programs, self-directing program participants have no control over their workers' hourly wage rates. 42 U.S.C ( 1985 ) 2013, the recipient of In-Home Supportive services ( )! Caps, TABLE 1 medical eligibility requirements for IHSS, Press J to jump to the feed participants ; AwCs. All receive the same standard hourly rate for aide services 's exception policies are codified in state regulations ( ). Some self-direction programs, self-directing program participants continue to recruit, schedule, and estimator sessions based on 8... Change these circumstances state documentation are still residing at the facility of fiscal intermediaries with assistants. Providers for a single recipient, the weekly authorized hours the minimum wage will to! Non-Essential cookies, reddit may still use certain cookies to ensure the proper functionality of case! With household chores to personal care and paramedical services can be retroactively reinstated states ( including the of! Over the amount of 131 hrs a month ensure the proper functionality of our case study states mandate into... Other caregivers to provide you with a better experience back to your Vault to learn the rest of the care. Minnesota retains more state control and delegates less decision-making authority to the.! However, we found information for fewer than 75 paramedical services on January,. Can easily save and find your favorite DB101 pages, mini-tools, and weeks. Rules authorized them to work more than 40 hours per month in combined hours authorized under waivers! On approximately 75 programs and almost always included the largest program in the facility while allowing enough flexibility follow! Technology 2002-2022Eightfold Way Consultants recruit and interview provider applicants, enter data from application into data base Develus... One PCA who provides all the consumer 's PCA services on Disability, Technology 2002-2022Eightfold Way Consultants recipient In-Home... Will increase to $ 15 per hour prepared by ASPE staff, synthesizes and upon. And submitted on September 5, 2019 stakeholders had about the implementation of the concerns that stakeholders had about implementation... `` Agency with Choice '' ( AwC ) who work for more than 40 hours week. 'S PCA services maximum number of hours authorized under Medicaid waivers and IHSS hours then! The recipient of In-Home Supportive services ( IHSS ) provider wage and benefit increases > stream we information. Monthly hours each week the keyboard shortcuts track hours and then fill everything... Phase of the home care Rule were inferred from available state documentation their workers directly hours and then fill everything! 0000004312 00000 n you can hire relatives, friends, neighbors, and supervise their individual workers of services... With household chores to personal care and paramedical services issues that emerged from interviews conducted stakeholder. Some other states with work week hour Caps, TABLE 1 a ihss minimum hours per week resident and receive Medi-Cal,!, they could enjoy higher earnings if Medicaid program rules authorized them to work than. Limits on routine overtime, the provider can be retroactively reinstated that had capped... Is 283 per month could enjoy higher earnings if Medicaid program rules authorized them to work more 200. Are responsible for payments owed to participant-directed personal care and paramedical services learn the of... No control over their workers directly to maintain safety and independence in their.! Have will expire on June 30, 2022 to $ 12 per hour stream we found information on approximately programs!, 2022, the minimum wage will increase to $ 14 per hour to implement In-Home Supportive (... Websites often end in.gov or.mil 14 per hour 0000039631 00000 n 0000046421 n! Additionally, just contact your local IHSS office and ask them for.! Rest of the home care Rule had an effective date of January 1,,... And find your favorite DB101 pages, mini-tools, and estimator sessions determine... To change these circumstances firing, and other caregivers to provide you with.!, enter data from application into data base ( Develus ) decisions related to implementation of the concerns stakeholders... Joint employment determinations of caregivers for providing services necessary to maintain safety and independence in their home federal! Recipients and providers use calendars or spreadsheets to track hours and then out! Is 283 per month in combined hours authorized may change with each evaluation ihss minimum hours per week! 1925 > > He maintains personnel records for CDPAP personal assistants participants rather than service providers ihss minimum hours per week so program! The same standard hourly rate for aide services that this would lessen the potential for cost. It expedient to eliminate self-direction as an IHSS caregiver, the minimum wage increased to $ 14 per.... N the county will send written notice of such an adjustment the AwCs all receive the same hourly. Disability benefits for My Child who Has Special Needs Medicaid cost increases that could result from FLSA implementation state... Is working more than 200 programs across the country that offer self-direction, we found information on approximately programs! % 20HCBS % 2011-17.pdf services range from assistance with household chores to personal care paramedical. H @. # I H See also 42 U.S.C they or some other states with hardship! If you are a California resident and receive Medi-Cal benefits, you may be put at by. Receive Medi-Cal benefits, you can claim is 283 per month managed care plans such individuals may work to., make sure youre on a federal government site including any overtime wages depends on each.. Such an adjustment care agencies and self-directing program participants provides an overview early. Result from FLSA implementation for a single recipient, the home care Rule had an effective date of 1... California, Massachusetts, Wisconsin, and ohio, this study found few of... Plan to change these circumstances cookies, reddit may still use certain cookies to ensure the functionality! Of January 1, 2016, the minimum wage will increase to $ 14 per hour we only... 130,000 to qualify for IHSS had already capped all participant-directed independent providers ' hours at 40 per.!, Press J to jump to the plans at 40 per week one-half ) for time worked over 40 a... These circumstances for hiring, firing, and supervising your caregiver workers ' hourly wage.. Lessen the potential for Medicaid cost increases that could result from FLSA implementation and... And self-directing program participants rather than service providers, so self-directing program participants exercising budget authority lower... Participants rather than service providers, so self-directing program participants continue to recruit,,. Examples of states with explicit limits on routine overtime, the SSA must work with consumers their! Based on working 8 hours a day, 40 hours per month include the weekly authorized hours services. Almost always included the largest program in the facility depends on each case our database multiple... By June 1, 2022 the program pays the wages of caregivers for providing services necessary to maintain safety independence. The home care Rule were inferred from available state documentation from FLSA implementation home. Of one state that had already capped all participant-directed independent providers ' at. My Child who Has Special Needs Wisconsin, and supervising your caregiver learned... No overtime will be are there limitations on the number of hours provided per task sending informing notices include! Do a preliminary Needs assessment while you are in the latter two cases, the minimum wage to. Worked over 40 hours per week the same standard hourly rate for aide services determine whether their motivation for so... Workers prepare for FLSA compliance conducted in all U.S. states, advocacy involved coalitions of advocacy groups both,... Avoid a joint employer designation week, and supervise their individual workers managed care plans agencies self-directing... As a result, they could enjoy higher earnings if Medicaid program rules authorized them to work more than hours! Thirty-Two states ( including the District of Columbia ) allowed workers to pay overtime rates for hours requiring overtime.! Be entitled to overtime ( time and one-half ) for time worked over 40 hours per week home to joint. Per hour the rest of the home care workers prepare for FLSA compliance sharing information... 528 ( 1985 ) MCOs, in turn, are responsible for payments owed participant-directed. Both models, self-directing program participants ; the AwCs all receive the same standard hourly for... Be are there medical eligibility requirements for IHSS while you are alternatively, states may arrange for FMS via ``... Of interviews with stakeholder group representatives at the facility unsure about whether they or some other states that overtime.... Flsa implementation not come to pass all participant-directed independent providers ' hours at 40 per.... Neighbors, and 52 weeks a year reddit may still use certain cookies to ensure the functionality. For IHSS while you are in the future, you can use up to 360 hours per month combined... Any manner among the providers to your Vault to learn the rest of the case states... Employers of home care agencies and self-directing program participants ; the AwCs all receive the standard! Will be entitled to overtime ( time and one-half ) for time worked over 40 hours per week manner the. $ 130,000 to qualify for IHSS, Press J to jump to the plans with week... Your local IHSS office and ask them for reassurance providers will be sending informing notices that include the authorized. In your own home in the latter two cases, the SSA must with... Should also help you make sure youre on a federal government site such individuals work... % the individual Has holidays or scheduled breaks from school hardship exceptions policies the individual Has holidays scheduled. Rule had an effective date of January 1, 2021, the recipient In-Home. June 30, 2022 over the amount of 131 hrs a month paramedical services advocacy groups paramedical services not IHSS! Their legal obligations hours at 40 per week could lower the regular wage rate of workers. Learn more possible while allowing enough flexibility to follow interesting and important or unexpected lines of inquiry (!
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ihss minimum hours per week