Assembly Bill (AB) 1436 would authorize an applicant for, or recipient of, in-home supportive services to designate an individual to act as his or her authorized representative for purposes of the In-Home Supportive Services program.
STATUS:
Introduced: 02/27/2015
Disposition: Pending
Committee: Assembly Human Services Committee
Hearing: 04/28/2015 1:30 pm, State Capitol, Room 437
BACKGROUND:
Specifically, this bill:
1) Defines “authorized representative” to mean an individual who is appointed by an In-Home Supportive Services (IHSS) applicant or recipient in order to represent that applicant or recipient for purposes related to the IHSS program, as specified.
2) Allows an IHSS applicant or recipient to designate an authorized representative.
3) Specifies that an IHSS applicant or recipient shall determine the duties to be provided by the authorized representative and that these duties may be changed or revoked at any time by the applicant or recipient.
4) Requires the authorized representative to have a legal responsibility to act in the client’s best interest.
5) States that legal documentation of authority to act on behalf of the applicant or recipient under state law, including but not limited to a court order establishing legal guardianship or a valid power of attorney to make health care decisions, shall serve in place of an IHSS
applicant’s or recipient’s written appointment of an authorized representative.
6) Permits the authorized representative, if so instructed by the IHSS recipient, to sign timesheets for services rendered on behalf of the recipient, but disallows the authorized representative who is a care provider from signing his or her own timesheet unless the provider has legal custody over a minor recipient, as specified, or the provider is legally authorized to act on the applicant’s or recipient’s behalf per state law.
7) Specifies that an individual with legal authority to act on behalf of an IHSS applicant or recipient may designate someone other than him or herself to act on behalf of the applicant or recipient.
8) Prohibits anyone prevented from being an IHSS provider due to past criminal convictions, as well as individuals granted certain exemptions to serve as a provider despite past criminal convictions, as specified, from serving as an authorized representative.
9) Prohibits anyone found to have perpetuated a substantiated report of abuse or neglect against a child, elder, or dependent adult from serving as an authorized representative.
10) Directs the Department of Social Services, in consultation with stakeholders, as specified, to develop a standardized statewide form, as specified, and procedures related to the designation of an authorized representative.
EXISTING LAW:
1) Establishes the IHSS program to provide supportive services, including domestic, protective supervision, personal care, and paramedical services as specified, to individuals who are aged, blind, or living with disabilities, and who are unable to perform the services themselves or remain safely in their homes without receiving these services. (WIC 12300 et seq.)
2) Specifies requirements regarding IHSS provider timesheets, including that both provider and recipient must sign the timesheet to verify the accuracy of information. (WIC 12301.25)
3) States that counties may choose to contract with a nonprofit consortium or establish a public authority for the provision of IHSS services. Requires nonprofit consortia and public authorities to, among other things, establish a registry to assist recipients in locating IHSS providers, and to investigate the background and qualifications of potential providers, as specified. (WIC 12301.6)
4) Maintains an IHSS recipient’s right to hire, fire, and supervise the work of any IHSS provider, regardless of the employer responsibilities of a public authority or nonprofit consortium, as specified. (WIC 12301.6 and 12302.25)
5) Requires counties to perform a background check on individuals applying to become IHSS providers, and stipulates circumstances under which individuals shall be excluded from becoming an IHSS provider, as well as circumstances under which such an exclusion might
be waived, as specified. (WIC 12305.86 and 12305.87)
FISCAL EFFECT: Unknown
COMMENTS:
In-Home Supportive Services: The IHSS program enables low-income individuals who are at least 65 years old, living with disabilities, or blind to remain in their own homes by paying for care providers to assist with personal care services (such as toileting, bathing, and grooming),
domestic and related services (meal preparation, housecleaning, and the like), paramedical services, and protective supervision. Approximately 470,000 Californians receive IHSS, with approximately 99% receiving it as a Medicaid benefit.
When an individual is determined eligible for IHSS services by a county social worker, he or she is authorized for a certain number of hours of care. IHSS recipients are responsible for hiring, firing, directing, and supervising their IHSS workers. These responsibilities include some
administrative duties, such as scheduling and signing timesheets; however, the state handles payroll. There are currently about 409,000 IHSS providers in the state; approximately 73% are relatives and an estimated 52% are live-in. Providers must complete an enrollment process,
including submitting fingerprint images for a criminal background check and participating in a provider orientation prior to receiving payment for services.
Authorized representatives: A number of programs administered by the state allow for, and set forth definitions and designation procedures regarding, authorized representatives in order to facilitate recipients’ full participation in programs. These authorized representatives are
permitted, within specified limits, to act on behalf of program applicants and participants typically for purposes of applying for services and other required program activities.
For example, Welfare and Institutions Code 14014.5 defines “authorized representative” for purposes of the Medi-Cal program and directs the Department of Health Care Services and the California Health Benefit Exchange to implement policies and prescribe materials to ensure the
protection and privacy of applicants and recipients who appoint such a representative. Additionally, DSS Manual of Policies and Procedures Section 63.402-6 outlines rules and processes regarding the appointment of authorized representatives by applicants for and
recipients of CalFresh food stamp benefits.
Need for this bill: According to the author, the authorized representative function is critical in that it provides applicants and recipients with a self-directed pathway to receive needed assistance with complex rules and requirements of these programs. IHSS program applicants and recipients may struggle with increasingly complex and changing program rules; yet, while they may have family members and friends who are able to provide support, there is no formal process to designate these individuals as authorized representatives.
Additionally, the author points out, DSS has at times issued IHSS forms and All-County letters that reference “authorized representatives,” despite the lack of definition, explanation of duties and limitations, or formal designation process. As a result, counties have often developed ad hoc
internal processes for designating authorized representatives for purposes of the IHSS program.
The author states that, “IHSS program recipients are the employer of their care provider for purposes of hiring/firing, training, supervising, scheduling and signing their timesheet. Similarly, whether to designate an authorized representative and who to designate would be their
decision. For consumers who struggle with the maze of programmatic rules and complex paperwork, allowing them to designate an authorized representative to work on their behalf will give them the support they need to continue to direct services in their own homes and remain
independent.”
This bill, according to the author, provides flexibility for an IHSS applicant or recipient to determine the duties of the authorized representative, and makes it clear that the authorized representative has a legal responsibility to act in the client’s best interest.
According to the County Welfare Directors Association of California (CWDA), the sponsor of this bill, it creates “an authorized representative function for IHSS in statute. Whether to designate an authorized representative would be the decision of an individual recipient. Who to
designate would also be his or her choice, with a few exceptions that mirror other protections in current law. For example, the bill would provide that an individual who could not meet a criminal background check to become a provider of services in IHSS could not be named as an
authorized representative unless they were otherwise legally authorized to act on behalf of the recipient (such as the parent of a child recipient or a conservator.) Also, an individual found to have perpetrated abuse or neglect against a child or adult would be barred from serving as an
authorized representative. As the IHSS program continues to grow, it is vital to create a standardized structure for designating an authorized representative to assist an applicant for or recipient of these services.”
Recommended amendments: For purposes of clarity, committee staff recommends the following technical amendment to paragraph (b)(2) beginning on page 3 of the bill:
12 (2) For purposes of this section, an individual having legal
13 authority to act on behalf of an applicant or recipient may also
14 designate the authorized representative to specify an individual
15 other than himself or herself to act on behalf of the applicant or
16 recipient if that individual elects to do so.
REGISTERED SUPPORT / OPPOSITION:
Support
County Welfare Directors Association of CA (CWDA) –sponsor
California Association of Public Authorities (CAPA) – co-sponsor
American Federation of State, County and Municipal Employees (AFSCME)
California State Association of Counties (CSAC)
Ventura County Board of Supervisors
UDW/AFSCME Local 3930
Opposition
None on file |