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Protective Supervision, part of the IHSS program, can be of great value for children with special needs like autism or Down syndrome, who need to be observed 24 hours per day to protect them from injuries, hazards, or accidents. But if you’ve had your IHSS hours cut or taken away completely by your social worker, it can lead to a lot of financial stress in your family. Fortunately, there’s a step-by-step approach to help you appeal and win your case so you can get your IHSS hours back.
The challenges arise with the service assessment process – the yearly home visit made by a social worker to evaluate the need for in-home care. The process relies extensively on the estimations made by your social worker, whether they have the proper training or medical knowledge or not. The state must use an unbiased functional index ranking to assess your child’s ability to perform various tasks and time for task guidelines to calculate your IHSS hours.
These rankings are centered on the social worker’s opinion of your child’s abilities, and sometimes their evaluation can contradict the medical documentation or your own statements about your child’s daily routine. Also, time-for-task guidelines do not account for differences in medical conditions and needs, and while social workers can override them, they rarely do so. As a result, people with the greatest needs are often denied adequate IHSS hours.
Because of this, there have been many instances when IHSS stated that as a parent, you should not be paid to take care of your own child. Other IHSS denials have stated that the parents took preventative measures to ensure their child’s safety, and therefore, they do not meet their guidelines.
You can still appeal these IHSS decisions and get back your IHSS hours. An appeal system known as a due process hearing is an excellent tool for parents who have been denied benefits for their children with autism, Down syndrome, cerebral palsy, or another disability. This process provides you with another chance to prove that your family qualifies for financial assistance.
But the process for challenging a denial can be daunting because there are timelines and a hearing involved. The matter can also involve the courts.
A request for hearing MUST be filed within 90 calendar days after the date of the county action or inaction. A written request for a rehearing must be filed within 30 calendar days of receipt after the decision is received. A request for a state hearing may be written or oral and there is a request form on the back of the Notice of Action. The request for a state hearing should include: the aid program involved (i.e., IHSS), the reason for the disagreement with the county action, if an interpreter is needed and what kind, and a copy of the applicable Notice of Action.
The hearing will involve the presentation of evidence (testimony by witnesses, letters, diary log, medical reports) about your needs in the service category areas where you and the county disagree. The evidence should explain what you need, how long it takes to provide the service, the reason you need more time than that set out in the assessment or the county guidelines, and what risks you may be exposed to if you do not receive the level of services requested. IHSS fair hearings are informal. The important thing is to explain why more time is needed. The best evidence is from the people who provide you care and who kept a diary record of the time it takes.
Witnesses may include — in addition to the IHSS recipient — past and present IHSS providers, regional center counselor, friends and family, etc. For each witness, list the points you want that witness to make and cross off each point as it is made.
If this process sounds overwhelming and you feel you need help, you can always reach out to us.
American Advocacy Group is on the front lines every day, making positive change happen for people diagnosed with autism, Down syndrome and a range of diagnoses across the continuum. As a leading advocate for all people with intellectual and developmental disabilities and their families, and the premier provider of the support and services people want and need, we understand the system and know how to take action in regard to your best interests.
CONTACT US FOR HELP.
Dial (877) 762-0702 or email us at [email protected].
