iho or hcba waiver

The care management team coordinates Waiver and State Plan services (e.g., medical, behavioral health, In-Home Supportive Services, etc. Providers or recipients may request a review by CDSS.21 During this process, overtime violations will be suppressed, regardless of the state’s decision.22. If you requested an independent review and were still denied an exemption, you will have to hire another provider to cover the remaining hours and ensure that your needs are being met. ��$����+� �?�rL��� Y��AD�g`�z` f�m At the time of each county assessment or reassessment, the county social worker must evaluate whether the recipient’s circumstances appear to indicate that the provider for that recipient maybe eligible for an exemption.

3.6. endstream endobj 507 0 obj <>/Metadata 54 0 R/Outlines 124 0 R/Pages 504 0 R/StructTreeRoot 254 0 R/Type/Catalog/ViewerPreferences<>>> endobj 508 0 obj <>/MediaBox[0 0 612 792]/Parent 504 0 R/Resources<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 509 0 obj <>stream Home and Community-Based Services (HCBS) Waivers allow states that participate in Medicaid, known as Medi-Cal in California, to develop creative alternatives for individuals who would otherwise require care in a nursing facility or hospital. Code § 12300.4(d)(3)(E)(iii)(I); All-County Letter 18-58 (“ACL 18-58”). Here, once mom reaches the 360 hours per month maximum, she is considered “unavailable.”  At that time, dad may provide the remaining 70 hours because he meets the parent provider requirements in MPP § 30-763.451 (i.e., he works less than 40 hours per week in order to provide IHSS to the children, no other suitable provider is available, and dad’s inability to provide IHSS may result in inappropriate placement or inadequate care). The ESAR will send you a notice setting a telephone conference within 10 business days of the date the ESAR request was received.

Code § 12300.4(d)(3)(E)(ii); ACL 18-31 at 3. & Inst.

16-22 (“ACL 16-22”), available at http://www.cdss.ca.gov/lettersnotices/EntRes/getinfo/acl/2016/16-22.pdf. Exemption 1 is available for providers who met ALL of the following conditions on or before January 31, 2016: Before Exemption 1 (formerly known as the Family Exemption) was codified in statute, CDSS sent a letter and form to providers who were identified as meeting the criteria. – (Return to main document), 33 Welf.

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In order to request an ESAR review, within 45 days of the county Notice of Ineligibility, you must mail a form SOC 2313 to: California Department of Social Services – (Return to main document), 28 Welf. )U!���$5�X�3/9�� �(�$5�j�%V*�'��&*���r" (,!��!�0b;�C��Ң2(��ɘ� � I�8/

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Providers for the Home and Community Based Alternatives (HCBA) Waiver (formerly known as the Nursing Facility/Acute Hospital Waiver) or In-Home Operations (IHO) Waiver participants or applicants, who were enrolled in either waiver on or before January 31, 2016, and whose medical or behavioral needs require that services be provided by the requested provider, are eligible for the WPCS exemption if ANY … Because the state will not pay a provider for more than 360 hours per month, DRC is not able to help you get an exemption above the maximum limit.

For all other purposes call 916-504-5800 (Northern CA); 213-213-8000 (Southern CA).
– (Return to main document), 25 See ACL 18-31 at 6-7 for an explanation of these rules.

916-504-5800 The Home and Community Based Alternatives (HCBA) Waiver used to be called the Nursing Facility/Acute Hospital (NF/AH) Waiver.


I am worried that I will lose my parent provider eligibility if my husband requests to be the additional provider. Code § 14132.99(d)(1)(B)(5)(B). A provider who works for more than one recipient cannot work more than 66 hours per week for IHSS and/or WPCS combined. How Do I Know If I Qualify for an IHSS Exemption? The provider lives in the same home as the waiver applicant or participant, even if the provider is not the family member; OR, The provider currently provides care to the waiver participant, and has done so for two or more years continuously; OR.

You will need to find additional providers to work the hours above those for which your provider is authorized. If your provider met the criteria but was not sent a notice, CDSS is advising counties and recipients to complete an Exemption 1 application and mail it to CDSS directly.

h�bbd```b``� "O�H� ��3X|�\Gb37��/�o�HV��\0y,���e] The regulation governing IHSS parent providers allows two parents to be paid providers for their two or more minor children, but both parents MUST meet the parent provider requirements in MPP § 30-763.451. %%EOF Code § 14132.99(d)(1)(B)(2). This publication contains information about how to request an exemption to the maximum number of hours that some providers may work each month in the IHSS and WPCS programs. 800-776-5746

At the same time, the state placed limits on the maximum weekly number of hours an IHSS or WPCS provider can work in a workweek. [Take the Survey]. 2y�.-;!���K�Z� ���^�i�"L��0���-�� @8(��r�;q��7�L��y��&�Q��q�4�j���|�9��

& Inst. ), and arranges for other available long … 794 0 obj <> endobj 819 0 obj <>/Filter/FlateDecode/ID[(\3218\312\243b?\263O\261\\\333\033\005\000\313&) (\224\232\024\0215LfH\273\301\320\273\004\276d\332)]/Index[794 26]/Info 791 0 R/Length 75/Prev 421755/Root 795 0 R/Size 820/Type/XRef/W[1 3 1]>> stream Such history may satisfy the requirement of searching for additional providers.19. – (Return to main document), 15 ACL 18-31 at 3-4. n�3ܣ�k�Gݯz=��[=��=�B�0FX'�+������t���G�,�}���/���Hh8�m�W�2p[����AiA��N�#8$X�?�A�KHI�{!7�. & Inst. The county should document identified barriers that limit the recipient’s ability to hire additional providers.17 Providers do not need to live in the same home as recipients.

�k�F�[�6�{���U���' 8T���ƥ��8�@����CϘ���H330H��eY7 )�N�bFQ� ʼO The county shall inform potentially qualifying recipients about the exemption(s) and the process by which you or your provider may apply.8.

Please note that a provider of IHSS or WPCS (or both) who is granted an exemption may work up to a total of 12 hours per day, and up to 360 hours per month combined for the IHSS and WPCS that he or she provides, not to exceed each waiver participant’s monthly authorized hours.28, At the time of initial application, and at least annually, DHCS shall inform all waiver applicants or participants whose providers may be eligible for an exemption and their providers about the exemptions and the application process.29On a one-time basis, DHCS will mail an informational notice and exemption request application form to all providers who may be eligible for an exemption and to the waiver participants to whom those providers provide services.30, DHCS will review the exemption requests pursuant to a process developed with input from stakeholders.

You can mail your completed application to: CDSS – Adult Programs Division – (Return to main document), 16 ACL 18-31 at 4-5. The purpose of the HCBA Waiver is to provide Medi-Cal beneficiaries with long-term medical conditions who meet one of the designated "levels of care" (i.e., nursing facility (including intermediate care facility), subacute, acute hospital), described below, the …

WPCS –8 REV 03/2018 services in order to remain safely in his or her own home. You can also ask your county social worker for the application.

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