IHSS & Pub Auth Caregiver Handbook_7-8-22_tn

RIVERSIDE COUNTY IN-HOME SUPPORTIVE SERVICES (IHSS) & PUBLIC AUTHORITY CAREGIVER HANDBOOK

TABLE OF CONTENTS

02 What is In-Home Supportive Services and the IHSS Public Authority?

03

Your Responsibilities as a Caregiver 07

05

Tips for Registry Caregivers: Preparing for the Interview

IHSS Payroll and Benefits

10

13

Resources for Caregivers

Maintaining Good Work Practices

The In-Home Supportive Services (IHSS) program provides in-home assistance to eligible aged, blind and disabled individuals as an alternative to out-of-home care and enables recipients to remain safely in their own homes. WHAT IS IN-HOME SUPPORTIVE SERVICES?

INTRODUCTION

We are happy to have you on board as a Riverside County IHSS caregiver. Many elderly and disabled individuals prefer to stay independent for as long as possible. They want to stay in control of their lives and live in their own home among familiar surroundings and people they know. To accomplish this, the IHSS program pays family members, friends, and neighbors to provide care to eligible recipients. When an eligible recipient does not have someone that can become their caregiver, but they still want to remain living at home, they can be referred to the IHSS Public Authority who can connect registry caregivers to IHSS recipients in need of assistance. Whether you are a family caregiver or a registry caregiver, this guide will give you information to help you feel more comfortable about your role. You will also find detailed information about questions to ask your IHSS recipient regarding hiring, supervising and dismissing caregivers.

01

WHAT IS THE IHSS PUBLIC AUTHORITY?

According to the California Association of Public Authorities (CAPA), The Public Authority was established to protect and enhance the quality of IHSS and provide seniors and people with disabilities access to personal assistance to meet their needs and support the choice to live independently. Public Authorities are responsible for maintaining caregiver registries, providing IHSS consumers (recipients) with caregiver referrals, and providing for consumer and caregiver training. In addition to these services, Public Authorities are the employer of record for purposes of collective bargaining. Public Authorities are required to have an IHSS consumer-majority advisory committee. Recruits caregivers to join the registry. Screens registry applicants through background checks and drug & alcohol screenings. Maintains a computer database of IHSS recipients and caregivers location and availability preferences, among others. Matches IHSS recipient needs with the skills and availability of caregivers. Provides IHSS recipients a list of names of potential caregivers from which they can hire. Provides free and optional training to IHSS recipients and caregivers The Riverside County Public Authority operates a registry that: Assisting the IHSS recipient and caregiver in understanding employer/employee roles, rights, and responsibilities. Assisting the IHSS recipient with the hiring of caregivers. Assisting with conflict resolution between an IHSS recipients and caregiver. The Registry provides support services to IHSS recipients as needed. These services may include: IN-HOME SUPPORTIVE SERVICES ADVISORY COMMITTEE

The Riverside County IHSS Advisory Committee is comprised of current and former IHSS recipients and caregivers who are committed to meeting once every other month to advocate for their peers. IHSS caregivers and recipients can also join the IHSS Advisory Committee as a member when a vacant seat becomes available. If you are interested in joining, please visit: https://rivcodpss.org/disabled-adults-seniors/ihss-advisory- committee

02

YOUR RESPONSIBILITIES AS A CAREGIVER

Be on time to work every time (no excuses). Provide quality service by using the authorized hours in an efficient and effective manner. Know what services are authorized by reviewing the “Notice of Action” with the IHSS recipient and provide authorized services only. Remember you are only to do work needed by the IHSS recipient, not others in the household. Help the IHSS recipient maintain or increase self-sufficiency. Promptly report any changes in the IHSS recipient’s health, abilities, environment, or need for services to the IHSS HOME (Helping Others Manage Efficiently) Call Center at 1-888-960-4477 Complete electronic timesheets, work schedules and other forms as required. Maintain strict confidentiality about the IHSS recipient for whom you work. Report suspected abuse or neglect. Give at least a two-week notice if you need to resign from working for an IHSS recipient. As an IHSS caregiver the recipient you work for is your employer. As the employer the recipient will provide instructions to you on how to complete your authorized tasks. You have the responsibility and obligation to: WHAT IS THE IHSS NOTICE OF ACTION? All tasks are authorized by the IHSS social worker as shown on the IHSS recipient’s “Notice of Action.” The recipient's Notice of Action will list the services that you are authorized to perform for a particular recipient. As an IHSS caregiver, you may perform a variety of household management tasks including meal planning, shopping, food preparation, house cleaning, personal care, accompaniment to medical appointments, paramedical services, and laundry. Each IHSS recipient's Notice of Action is unique. You are only authorized to perform tasks that are listed on your IHSS recipient's Notice of Action, which are instructed by the recipient. A description of authorized IHSS tasks can be found on page 14. DRIVING YOUR IHSS RECIPIENT Transportation services (accompaniment to medical appointments) may be authorized for you to take the IHSS recipient to medical appointments. The purpose is to make sure the person receives the transportation to and from the doctor’s office. Accompanying the IHSS recipient to medical appointments is permitted when the IHSS recipient requires assistance at the appointment and cannot go alone. Assisting an IHSS recipient in and out of a vehicle or an office building is allowed when the IHSS recipient is unable to perform these activities independently. IHSS does not pay for gasoline or reimburse caregivers for mileage. IHSS does not pay for automobile insurance, but you must have insurance to transport the IHSS recipient in your own vehicle. For safety reasons, turn off your cell phone when transporting an IHSS recipient to avoid an automobile accident.

03

YOUR RESPONSIBILITIES AS A CAREGIVER

INJURIES AND ACCIDENTS

Workers Compensation covers caregivers for injuries they may incur while doing services specifically authorized by an IHSS social worker. If you are injured while performing a task that is not authorized by IHSS, you will not be covered. Refer to your Provider Letter (SOC2271) for your list of authorized tasks. The IHSS recipient could be held responsible if the IHSS recipient asked you to perform the task. Report injuries immediately to the IHSS HOME Call Center at 1- 888-960-4477. Per the State of California, all caregivers that are not living with or caring for a family member must be vaccinated and boosted against coronavirus (COVID-19). You are required to maintain your own records of vaccination, or COVID-19 test results if applicable, and must provide them if asked by your recipient. If your recipient tests positive for COVID-19, you are not required to continue caring for the recipient during that time. Additionally, if you test positive for COVID-19 you should not be providing IHSS services for any recipient. You should contact your IHSS recipient(s) immediately and let them know you are unavailable. If you are a registry caregiver, you will need to contact the Public Authority's Registry Dispatch Unit at 1-800-915-1777. Upon request, while supplies remain available, the IHSS Public Authority can provide you with essential protective gear (EPG), such as masks and gloves. Call 1-888-960-4477 to request EPG equipment. COVID- 19 PRECAUTIONS

04

Once you have become active on the registry, you will be eligible to be hired to work for an IHSS recipient. Any time that you are looking to work for a new IHSS recipient you will need to contact the Public Authority's Registry Dispatch Unit at 1-800-915-1777. A representative will review your work preferences with you and add you to the list of caregivers who are ready to be paired with a new recipient. TIPS FOR REGISTRY CAREGIVERS: PREPARING FOR THE INTERVIEW

INTERVIEWING IN PERSON

TELEPHONE SCREENING

Be friendly. Give a brief description of your skills and experience. Specify the days and hours you are available to work. Ask if the IHSS recipient needs you to accompany him/her to medical appointments. If so, how often and what is the distance? Offer to provide the IHSS recipient with a list of references at the time of the interview. Thank the recipient for calling, even if you do not get the offer of a personal interview. IHSS recipients will take the time to interview applicants, but first they will want to screen them by phone. The IHSS recipient may or may not choose to set up an in person interview following the telephone conversation. It is very important that you respect and maintain confidentiality. Do not ask the IHSS recipient for any personal information such as name, address, or phone number prior to being offered an interview. Remember to:

Arrive at your interview on time. Be prepared to show a photo ID to identify yourself. The IHSS recipient may wish to have a registry social worker or someone they know present during the interview to help them feel more comfortable. The accompanying person may assist in identifying additional questions to ask. Become acquainted with the IHSS recipient by letting them tell you about themselves. This also shows the recipient that you have an interest in them as a person. Review with the IHSS recipient their “Notice of Action” which they received from their IHSS social worker. This will tell you how many hours and which tasks they are authorized to receive. The IHSS program will only pay for tasks that you have been authorized to complete in the Notice of Action.

05

TIPS FOR REGISTRY CAREGIVERS: PREPARING FOR THE INTERVIEW

POSSIBLE INTERVIEW QUESTIONS

SPECIAL NEEDS INTERVIEW QUESTIONS

What kind of work have you done? What kind training, if any, have you had? Why are you in this line of work? Do you mind being around someone who smokes or drinks? Are you allergic to cats, dogs or other animals? Would you be willing to take me to my doctor’s appointments? Do you have a Driver’s License and car insurance? Would you be willing to work together with me on some tasks? Will you cook according to my needs and plan menus with me? Is there anything on the “Notice of Action” that you cannot or would not do? Do you have any problem understanding written or oral directions? What days and hours are you available? 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Have you had any experience in caring for a person with severe memory loss? How would you handle a person who wanders? How would you deal with a person who refuses to eat? How would you handle aggressive or abusive behavior? How would you handle a medical emergency? Have you ever been certified to give First Aid and/or CPR? Can you perform wound care? Would you be willing to learn how? Can you measure and document changes in someone's behavior? Do you know how to operate a lift to transfer someone? Can you change a bed with someone in it? The IHSS recipient may have special needs. The following is a list of questions that provides the IHSS recipient information about your experience working with a recipient who has special needs. If you have experience or special knowledge in these areas, let the IHSS recipient know. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

06

IHSS PAYROLL & BENEFITS

ELECTRONIC TIMESHEETS

1st to 15th 16th to the last day of the month. There are two pay periods each month:

Any private arrangement made between the IHSS recipient and the provider to do work other than that which is authorized by the IHSS social worker is strictly between the IHSS recipient and the caregiver and will not be paid for by IHSS. If the IHSS recipient has a Share of Cost (SOC), he or she is responsible for paying the SOC amount directly to the caregiver during the first pay period of the month. The county is not responsible for a recipient's SOC. An IHSS recipient who refuses to pay the SOC can lose his/her IHSS eligibility and services. Caregivers should not work or claim more than the authorized hours. They will not be paid for working extra hours unless pre-approved for overtime. Claiming more hours is considered fraud.

ELECTRONIC SERVICES PORTAL (ESP)

Having an Electronic Services Portal (ESP) account is required for all caregivers to receive payment. The ESP is where you as a caregiver can take care of any payroll needs. You may access this website using any electronic device. On the ESP you will be able to submit your electronic timesheets, view your payment status, download payment history, submit sick leave claims, and enroll for direct deposit. Your IHSS recipient(s) will have access to ESP or Telephonic Timesheet System (TTS) to approve or reject your electronic timesheets.

To access the ESP visit: www.etimesheets.ihss.ca.gov

07

IHSS PAYROLL & BENEFITS

DIRECT DEPOSIT

IHSS caregivers will be required to use Direct Deposit or a pay card. Your paycheck will automatically be deposited into a bank account or the pay card of your choice.

There are several advantages of using direct deposit

You will receive your paycheck faster. You don’t need to worry about your paper check being lost or stolen. No need to wait for a paper check to be mailed to you.

You must be already registered in the ESP at www.etimesheets.ihss.ca.gov to enroll for Direct Deposit.

TAXES

Social Security contributions will be withheld unless you are caring for your spouse, or are a minor child working for your parent. Income taxes will not be withheld unless you request it. If you want taxes withheld, fill out the W-4 form and send to County of Riverside Department of Public Social Services, In-Home Supportive Services Public Authority, PO Box 7300, Moreno Valley, CA 92552-9901 . Caregivers may be eligible for the Earned Income Tax Credit. Be sure to speak to a tax professional about this. BENEFITS Depending on the amount of time worked, you may be eligible for State Disability and/or unemployment benefits if you are laid off. Caregivers who work more than 80 hours per month for three consecutive months may be eligible for health benefits. REGULAR WORK HOURS AND TIME OFF IHSS does not pay for vacation. If the caregiver does not work the hours authorized, the IHSS recipient may give that time to another caregiver. Requests for time off/sick time must be directly coordinated with the IHSS recipient. Always call the IHSS recipient if you will be arriving late or are unable to work. If planned time off is needed, call the social worker, and give the IHSS recipient plenty of advanced notice so there will be time to arrange for a replacement through the Public Authority Registry (if the recipient has confirmed willingness to accept registry provider). Registry Caregivers should call the Public Authority's Registry Dispatch Unit at 1-800-915-

1777 to update your availability when time off is needed. Never send a substitute to work for the IHSS recipient. Submit timesheets promptly and accurately at the end of each pay period.

SICK LEAVE

There are one-time requirements that must be completed by caregivers to accrue and use paid sick leave. For the latest sick leave eligibility information visit the California Department of Social Services website: https://www.cdss.ca.gov/inforesources/ihss- providers/resources/sick-leave 08

IHSS PAYROLL & BENEFITS

VIOLATIONS

Working more than 40 hours in a workweek without your recipient getting approval from the county when your recipient is authorized less than 40 hours in a workweek. Working more hours for your recipient than the recipient’s maximum weekly hours which causes you to work more overtime hours in a month than you normally would without receiving county approval. Working more than 66 hours in a workweek when working for more than one recipient. Violations are given when guidelines for overtime and travel time limitations are not followed. Some of the actions that will cause you to get a violation are:

Caregivers will not be paid for any time spent performing tasks while an IHSS recipient is hospitalized or goes on vacation. Vacation exceptions may be made if a recipient goes on vacation and needs the caregiver to accompany them for assistance, in which case the trip must be in the United States and be approved by the IHSS social worker. UNPAID TIME

Claiming more than 7 hours for travel time in a workweek.

More information regarding violations can be found on page 18 and on the CDSS website: https://www.cdss.ca.gov/inforesources/ihss /ihss-providers/resources

09

MAINTAINING GOOD WORK PRACTICES

HANDLING THE IHSS RECIPIENT’S MONEY

Do not bring friends or children to the workplace. Do not tell the IHSS recipient your personal problems. Keep discussions of personal life to a minimum. Do not eat the IHSS recipient’s food or accept gifts or loans from the IHSS recipient. Do not borrow money from the IHSS recipient even if they offer it. Never discuss controversial subjects such as religion or politics. Never ask the IHSS recipient to contribute to join or buy anything. Turn off your cell phone or put it on vibrate while you are working for the IHSS recipient. Always remember that this is a job. Just because the work is in someone’s home or working for a relative or friend does not mean it can be treated as any less of a job. BE PROFESSIONAL ON THE JOB CONFIDENTIALITY Never tell anyone personal information about the IHSS recipient. This information is considered confidential and was included in your signed Participant's Rights, Responsibilities, and Release Agreement (DPSS 3492). Never discuss the IHSS recipient’s personal or private affairs with anyone other than the IHSS social worker or the IHSS Public Authority staff.

WORKING ALONE IN THE IHSS RECIPIENT'S HOME Never work in the IHSS recipient’s home when the IHSS recipient is temporarily absent, such as at a doctor’s appointment. Only work while the IHSS recipient is present to reduce the likelihood of complaints regarding theft or damage to the IHSS recipient’s personal property and to reduce questions about the completion of tasks. Upon returning, verify the amount spent and the amount of change, and have the IHSS recipient initial the piece of paper. This is for the protection of the caregiver and the IHSS recipient. Provide receipts for all expenditures. Obtain a note with permission from the IHSS recipient for anything that is handled and/or taken out of their home. Before leaving the IHSS recipient’s house, count the money in front of the IHSS recipient and verify the amount taken. Make a note of the amounts on a piece of paper. When you handle money, personal checks, and other types of checks, credit cards, or Medi-Cal cards that belong to the IHSS recipient:

10

MAINTAINING GOOD WORK PRACTICES

GOOD COMMUNICATION Communication is the key to being a good caregiver. When the IHSS recipient explains the task, ask questions to make sure there is an understanding of exactly what is needed to be done and how the IHSS recipient wants it done. Ask the IHSS recipient to write down how they want tasks to be done. Try to do the tasks as the IHSS recipient asks. Remember, this is their home and their body, and they know what will work. Listen to the IHSS recipient’s wishes and do everything you can to meet them within reason and the Notice of Action. Respect their knowledge. If you are unclear about something, ask the IHSS recipient. Please do not argue with the IHSS recipient. If problems arise in communicating with the IHSS recipient, the IHSS social worker can help with mediation.

Discuss problems as they arise, don’t bottle them up. Discuss them fairly and calmly. When being offered correction, first listen to the IHSS recipient, then ask them how they want the task done. Blaming the IHSS recipient or making them feel ashamed is not helpful to the situation. If you find it difficult to be corrected by your IHSS recipient, ask for help from the IHSS social worker. They can assist in mediating problems. Supervision includes accountability, good communication and recordkeeping. It is important to encourage the IHSS recipient to do as much as they can. Ask the IHSS recipient to post the main list of their needs and the job description on the refrigerator. If they want certain things done in a specific way, it is important to write them down. This makes communication and supervision easier. Remember, there are many ways to do things. This should be a collaborative effort. SUPERVISION ACCEPTING CORRECTION Be careful in the IHSS recipient’s home to avoid damaging any of the IHSS recipient’s possessions. If something is damaged, tell the IHSS recipient immediately to avoid being liable for payment or replacement. Remember, the IHSS recipient may terminate you if items are routinely damaged. ACCIDENTAL DAMAGE TO AN IHSS RECIPIENT'S PROPERTY

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MAINTAINING GOOD WORK PRACTICES

MAINTAIN RESPONSIBILITY

IHSS recipients should not leave valuables lying around. They should keep their jewelry, cash, checkbook, and credit cards put away safely and securely. If valuables are left out, ask the IHSS recipient to put them away. Do not move any valuables without their permission. Ask for a receipt every time when shopping for the IHSS recipient. Be sure to give all receipts to the IHSS recipient. Do not add your name to the IHSS recipient’s savings, checking, charge account, Social Security Income (SSI) or any other documents. This could result in allegations of financial abuse. Try not to get involved with the IHSS recipient’s private life. Do not lend the IHSS recipient money, household furnishings or clothing. If the IHSS recipient is abusive, for example: hitting or endangering health and safety, contact their IHSS social worker or the Public Authority social worker. Call the police (911) or Adult Protective Services at 1-800-491-7123. Always report problems to the IHSS social worker by calling the IHSS HOME Call Center at 1-888-960-4477.

TERMINATION OF EMPLOYMENT

There are many reasons for letting someone go. It may be that the IHSS recipient just does not feel comfortable, the caregiver is uncooperative, is not doing what they agreed upon, is arriving late for work or is missing days without notice. Remember, the IHSS recipient is the employer and has the right to terminate you for any reason.

Examples of reasons for dismissal may include but are not limited to:

Abuse of drugs and/or alcohol. Excessive use of the telephone. Theft or financial abuse.

The IHSS recipient may ask for an explanation if they suspect theft or misuse of bank accounts. If they really believe something of value is missing, they may call the police. ENDING AN ASSIGNMENT WITH AN IHSS RECIPIENT Make sure you give the IHSS recipient timely notice so they can find a new caregiver. A two- week notice is preferred. Call the IHSS HOME Call Center at 1-888-960-4477 to advise that you are no longer working for the IHSS recipient.

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RESOURCES FOR CAREGIVERS

Visit www.RiversideIHSS.org for helpful information regarding the IHSS program. You will find that many of the resources you need are available online. RIVERSIDEIHSS.ORG WEBSITE On the RiversideIHSS.org website, caregivers can request services electronically and will receive a ticket confirmation to check the status of their requests. SELF-TICKETING PORTAL

IHSS HOME CALL CENTER

1-888-960-4477 The IHSS HOME Call Center can assist you with most concerns related to your IHSS case, including enrollment, linking you to your recipients, questions about timesheets, verifications of employment, and workers' compensation, among others. 1-800-915-1777 The Registry Dispatch Unit can assist registry caregivers with requesting new clients and updating their status and availability to provide care. Registry caregivers can also update their availability online on at REGISTRY DISPATCH UNIT

CAREGIVER TRAINING

The Public Authority collaborates with other community organizations to offer free trainings opportunities that will likely help you on your journey as a caregiver. These trainings are optional and available for all Riverside County In Home Supportive Services caregivers. A range of different topics are offered from Caregiver Basics to Understanding Alzheimer's and Dementia. Many trainings are offered in English and Spanish. To get more information about available trainings and to register visit: https://rivcoihsspatrainings.eventbrite.com

13

SERVICES COVERED BY IHSS

How to use this list: 1. Review your IHSS Provider Notification (Notice of Action) which lists the services that are authorized for your consumer by the IHSS program. Ask your consumer/employer how many hours you are authorized to work each month. If they are unable to tell you, contact the county and ask about the services and hours authorized. 2. Once you find out about the services and hours authorized, look at the list below to determine which tasks are included. Remember, most consumers will not have all of these services authorized, and you can only be paid for the services and tasks that are authorized to your recipient. Also keep in mind the amount of time authorized for each service.

IHSS Service

Tasks

Helping the consumer get to and from alternative resources where the IHSS recipient receives services instead of IHSS. Helping the consumer get to and from the doctor, dentist, or other health related appointments. Wait-time is included if the consumer needs assistance with specific IHSS tasks during transportation and/or to and from the destination. Wait-time is also included when the recipient is able to drive himself/herself to appointments but needs assistance at the destination. Wait time (or “Wait Time-On Duty”) is only authorized when the provider is not performing work duties but unable to use time effectively for his/her own purposes. Generally, “Wait Time-On Duty” is unpredictable and short duration. “Wait Time-On Duty” is compensable. Wait time (or “Wait Time-Off Duty”) is not authorized when the provider is completely relieved from work duties and has enough time to use effectively for his/her purposes such as take a meal break, run a personal errand or read a book. The provider must be informed in advance and will not have to resume work until a specified time. “Wait Time-Off Duty” is not compensable. Assisting the consumer with walking or moving from place to place inside the home, including: to and from the bathroom; climbing or descending stairs; moving and retrieving assistive devices such as a cane, walker, or wheelchair, etc.; and washing/drying hands before and after performing these tasks. Ambulation also includes assistance to and from the front door to the car, including (getting in and out of the car) for medical accompaniment and/or alternative resource travel.

Accompaniment to Alternative Resources

Accompaniment to Medical Appointments

Ambulation

IHSS Provider Orientation, May 2017

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IHSS Service

Tasks

Helping the consumer take a bath or shower; bringing a washcloth, soap, and towel to the consumer and putting them away; turning on and off faucets and adjusting water temperature; assisting the consumer with getting in and out of the tub or shower; washing, rinsing, and drying the parts of the consumer’s body he/she can’t do; and applying lotion, powder, and deodorant. Brushing teeth, rinsing mouth, caring for dentures, and flossing. Hair combing/ brushing; hair trimming when the consumer cannot get to the barber/salon; shampooing, applying conditioner, and drying hair; shaving; and washing and drying your hands. Assisting the consumer with getting on and off the toilet or commode; wiping and cleaning the consumer; helping the consumer with using, emptying, and cleaning bed pans/bedside commodes, urinals, ostomy, enema and/or catheter receptacles; application of diapers; positioning for diaper changes; managing clothing; changing disposable gloves; and washing/drying consumer’s and provider’s hands. This service does not include insertion of enemas, catheters, suppositories, digital stimulation as part of a bowel program for a person with paralysis, or colostomy irrigation. All of those tasks are part of “Paramedical Services.” Assistance with taking off or putting on, maintaining, or cleaning prosthetic devices such as an artificial limb and glasses/hearing aids as well as washing and drying hands before and after performing these tasks. This service area also includes assisting the consumer with self-administration of medication, i.e., reminding the consumer to take prescribed and/or over-the-counter medications at appropriate times and/or setting up the medications. Limited to sweeping, vacuuming, and washing floors, kitchen counters, and sinks; cleaning the bathroom; storing food and supplies; taking out garbage; dusting and picking up; changing bed linen; cleaning oven and stovetop; cleaning and defrosting refrigerator; bringing in wood for cooking for those who only have a wood stove; changing light bulbs; and wheelchair cleaning or recharging wheelchair batteries. Washing/drying hands; helping the consumer put on and take off clothes, corsets, elastic stockings, and braces and/or fastening/ unfastening, buttoning/unbuttoning, zipping/unzipping, and tying/untying of garments and undergarments; changing soiled clothing; and bringing tools to the consumer to assist with independent dressing such as a sock aid. Helping the consumer eat and drink liquids; assisting the consumer reach for, pick up, and grasp utensils and cups; and washing and drying your hands before and after feeding. This does not include tube feeding, which is part of “Paramedical Services.” It also does not include cutting food into bite-sized pieces or pureeing food, which is part of “Prepare Meals.”

Bathing, Oral Hygiene/ Grooming

Bowel and/or Bladder Care

Care and Assistance with Prosthesis

Domestic (Housework)

Dressing

Feeding

IHSS Provider Orientation, May 2017

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IHSS Service

Tasks

Thorough cleaning of the home to remove hazardous debris or dirt. This is a one-time service that usually involves throwing away large amounts of clutter into a dumpster. It is rarely needed or approved. You will be expected to keep the home clean with Domestic services (if approved) after the heavy cleaning is done. Washing, rinsing, drying dishes, pots, pans, utensils, and appliances, and putting them away; loading and unloading the dishwasher; storing/putting away leftovers; wiping up spills from the table, counter, stove, and sink; and washing and drying your hands. Limited to external application and changing of sanitary napkins and external cleaning; and wiping and drying hands before and after performing these tasks. You should not insert a tampon, even if that is the consumer’s preference. If the consumer wears a diaper, time for menstrual care should not be necessary as the time would be assessed as part of “Bowel and/or Bladder Care.” Helping the consumer from a standing, sitting, or lying down position to another position and/or from one piece of equipment or furniture to another. This includes transfer from a bed, chair, couch, wheelchair, walker, or assistive device generally occurring within the same room. This may include using a Hoyer lift or similar device or a transfer belt. This service does not include turning a consumer who is bedbound to prevent skin breakdown or pressure sores. That is part of “Rub Skin and Repositioning.” Picking up prescriptions and shopping for non-food items the consumer needs. This includes making a shopping list, traveling to/from the store, shopping, loading, unloading, storing supplies purchased, and performing reasonable errands such as delivering a delinquent payment to prevent a utility shutoff or picking up a prescription. This does not include time to pay monthly bills. Paramedical services are skilled tasks that the consumer’s doctor or a nurse has taught you to do such as the administration of medications, puncturing the skin to give the consumer a shot, inserting a medical device into a body orifice such as tube feeding, inserting a catheter or irrigating a colostomy, activities requiring sterile procedures such as caring for an open bed sore, or activities requiring judgment based on training given by a licensed health care professional such as putting a person who has paralysis into a standing frame.

Heavy Cleaning

Meal Cleanup

Menstrual Care

Move In/Out of Bed (Transfer)

Other Shopping and Errands

Paramedical Services

IHSS Provider Orientation, May 2017

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IHSS Service

Tasks

Planning meals; removing food from the refrigerator or pantry; washing/drying hands before meal preparation; washing, peeling, and slicing vegetables; opening packages, cans, and bags; measuring and mixing ingredients; lifting pots and pans; trimming meat; reheating food; cooking and safely operating the stove; setting the table; serving the meals; pureeing food; and cutting the food into bite-sized pieces. When the food is cooking and doesn’t need your attention, you are expected to be doing other services. Observing the behavior of a consumer who is confused, mentally impaired or mentally ill in order to safeguard him/her against injury, hazard, or accident. Removal of ice and snow from entrances and essential walkways when access to the home is hazardous. Rubbing of skin to promote circulation; turning in bed and other types of repositioning; and range of motion exercises. This does not include care of pressure sores if they have developed. That care would be part of “Paramedical Services.” Limited to non-medical services such as assistance with self-administration of oxygen, assistance with setting up CPAP machine, and cleaning IPPB and CPAP machines. Bringing soap, washcloth, and towel to the consumer; filling a basin with water and bringing it to the consumer; washing, rinsing, and drying body; applying lotion, powder, and deodorant; cleaning basin or other materials used for bed sponge baths and putting them away; and washing and drying your hands before and after bathing. Washing and drying laundry, mending, ironing, folding, and storing clothes in closets, on shelves, or in drawers. You are expected to do other IHSS services while the clothes are in the washer and dryer. Grocery shopping at the nearest grocery store. No additional time is allowed for the consumer to go to the store with you. Shopping for food includes making a grocery list, travel to/from the store, shopping, loading, unloading, and storing groceries. Teaching the consumer how to perform certain tasks when they could learn to become independent if taught. Teaching and Demonstration is only allowed for a short period of time. Removal of grass, weeds, rubbish, or other hazardous items when they are a fire hazard. This is not gardening.

Prepare Meals

Protective Supervision

Removal of Ice and Snow

Rub Skin and Repositioning

Respiration Assistance

Routine Bed Baths

Routine Laundry

Shopping for Food

Teaching and Demonstration

Yard Hazard Abatement

IHSS Provider Orientation, May 2017

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IHSS IN-HOME SUPPORTIVE SERVICES TRAINING ACADEMY A PROJECT OF THE SAN DIEGO STATE UNIVERSITY SCHOOL OF SOCIAL WORK

Violations

A violation is the consequence of not following overtime and travel time limitations, and could cause you to be suspended from the program or terminated as an IHSS provider. It is important that you follow the overtime and travel time limitations to prevent getting a violation. Some of the actions that will cause you to get a violation are: 1. Working more than 40 hours in a workweek without your recipient getting approval from the county when your recipient is authorized less than 40 hours in a workweek. 2. Working more hours for your recipient than the recipient’s maximum weekly hours which causes you to work more overtime hours in a month than you normally would without receiving county approval. 3. Working more than 66 hours in a workweek when working for more than one recipient. 4. Claiming more than 7 hours for travel time in a workweek. If the county determines that you have violated the weekly overtime and/or travel time limitations, you will be paid the overtime and/or travel time that exceeded the workweek and/or travel time limitations but you will also receive a violation notice from the county. In addition to the violation notice, you will receive an IHSS Program Notice to Provider of Right to Dispute Violation for Exceeding Workweek and/or Travel Time Limits form, SOC 2272, with information on how to request a county review of the violation. A notice will also be sent to all of your recipients informing them of your violation and explaining why you received it.

Violations can also be issued due to administrative or processing errors such as timesheets being misread in scanning or timesheets processed out of order. If this is the case, it can be overridden by the county during the dispute review process.

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

Consequences for violations vary depending on if it is your first, second, third or fourth violation:

NOTE: If your actions result in more than one violation during a calendar month, it will only count as one violation. For example, if a timesheet or travel claim form triggers an error during the first pay period of May and another during the second pay period of May, the first error will result in a violation and the second error will be tracked by the system. A second violation will not be issued within the same calendar month.

1ST VIOLATION

2ND VIOLATION

3RD VIOLATION If a third violation occurs, you will be suspended as an IHSS provider for 90 days.

4TH VIOLATION If a fourth violation occurs, you will be ineligible to work as an IHSS provider for 365 days.

If a second violation occurs, you will have an opportunity to complete a one- time training to avoid receiving a second violation. If you do not complete the training within 14 calendar days of the date of the notice, you will receive a second violation.

For the first violation, you and each of your recipients will get a notice of the violation with information on how to request a county review.

If you receive a violation, the violation will remain on your IHSS record, except for the first time you receive a second violation. (The second violation may be removed by completing a one-time training, but this may be done only once). However, after one year, if you don’t receive another violation, the number of violations you have received will be reduced by one. As long as you don’t receive any additional violations, each year after the last violation was removed, the number of violations will be reduced by one.

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

If you receive a fourth violation and are ineligible to be an IHSS provider for one year, when the year is up you must re-enroll if you wish to work in the IHSS program. This means you must: • Re-submit an application; and • Complete all of the provider enrollment requirements, including the criminal background check, provider orientation and all required forms. • Also, your violations count will be reset to zero. County Review Process If you receive a violation, you have ten calendar days from the date of the violation notice to request a county review by submitting the Notice to Provider of Right to Dispute Violation for Exceeding Workweek and/or Travel Time Limits (form SOC 2272) . Once the county receives the request for review, it has ten business days to review and investigate the violation and send you a notice stating whether the violation will remain or if it will be removed. If you do not submit an SOC 2272 form within the ten calendar days, the violation remains in effect. For the third and fourth violations, if the county doesn’t remove the violation, you may request a review by CDSS, within ten business days of the date of receiving the county notice. The county notice will explain how you may request a review by CDSS.

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

For questions about In-Home Supportive Services or IHSS Public Authority, call the IHSS HOME Call Center at 1-888-960-4477.

For caregiver referrals to the Public Authority Registry, contact the Registry Dispatch Unit at 1-800-915-1777.

To report elder or dependent adult abuse or neglect, please call Adult Protective Services at 1-800-491-7123.