The IHSS program employs more than 460,000 providers to deliver in‑home services to nearly 548,000 eligible individuals— low‑income people who are also aged, blind, or disabled located throughout the State and either qualify for Medi‑Cal or meet the program’s income and resource requirements—so they may remain in their own homes as an alternative to out‑of‑home care. Types of services that can be authorized through IHSS include housecleaning, meal preparation, laundry, grocery shopping, personal care services (such as bathing and grooming), accompaniment to medical appointments, and protective supervision for the mentally impaired.
Prospective Provider Enrollment Process
- Complete the IHSS Program Provider Enrollment Form and return it in person to the appropriate county office.
- Provide a U.S. government‑issued picture identification and an original Social Security card.
- Submit to fingerprinting and a criminal background check by the California Department of Justice.
- Attend an IHSS program provider orientation.
- Sign an IHSS Program Provider Enrollment Agreement Form
Source: Social Services’ Important Information for Prospective Providers About the In‑Home Supportive Services (IHSS) Program Provider Enrollment Process.
Note: If the applicant has been convicted of certain crimes within the past 10 years, he or she may not be eligible to be a provider.
To determine eligibility and need for services, a county social worker interviews a potential IHSS recipient at his or her home and assesses the types of services the recipient needs on a weekly basis and the number of hours the county will authorize for each service. The county then converts the weekly authorized service hours to a monthly allotment of hours. If approved for IHSS, the recipient can hire one or more approved providers to perform the services. Once hired, the recipient or his or her designee is responsible for training the provider to deliver services in the manner the recipient needs, supervising the provider, and, if necessary, firing the provider.
An IHSS provider is an individual who provides ongoing services to an eligible IHSS recipient and receives payment for these services. Before being eligible for work, the individual must complete the enrollment process outlined in the text box. Upon completing these steps and obtaining approval from the applicable local agency, the provider is eligible to perform services for any IHSS recipient as long as the provider remains active—by submitting at least one timesheet during a period of 12 consecutive months for services rendered—and his or her criminal background check remains clear.
State and Local Agencies’ Roles in IHSS Program Timesheets and Payments
The State and counties share administrative responsibilities for the IHSS program. Social Services administers the IHSS program at the state level. As the state entity responsible for the operation of IHSS, Social Services provides expertise to counties and assists them as needed in administering the program. Social Services is responsible for statewide oversight, administration, management, policy, and development of the IHSS program. To that end, Social Services’ staff have numerous responsibilities, such as creating training materials that address changes to the program and facilitating monthly meetings for stakeholders across the State. Social Services contracts with OSI to perform the majority of project management activities related to CMIPS II, the automated system used to process timesheets and payments. OSI manages large health and human services information technology projects for the State, and it contracts with Hewlett Packard Enterprise (HPE) to operate and maintain CMIPS II. However, Social Services has the final authority to make decisions on changes to CMIPS II.
Prospective Provider Enrollment Process
Social Services: Responsible for the statewide administration, management, oversight, policy, and development of the IHSS program.
OSI: Through an interagency agreement with Social Services, manages the contract with HPE to maintain and operate CMIPS II.
EDD: Through an interagency agreement with Social Services, prints and mails blank timesheets.
SCO: Through an interagency agreement with Social Services, processes and distributes paychecks.
Counties: Administer the IHSS program at the local level, including processing provider applications, conducting orientations for providers, resolving timesheet errors, and addressing payroll questions.
Sources: Interagency agreement between Social Services and OSI, interagency agreement between Social Services and SCO, interagency agreement between Social Services and EDD, and state regulations.
Social Services contracts with multiple state agencies to provide specific services related to IHSS timesheets and paychecks, as shown in the text box. As the CMIPS II project manager, OSI manages the contract to maintain and operate the system, through which IHSS services are managed and providers are paid. The Employment Development Department (EDD) is responsible for printing and mailing timesheets, and the State Controller’s Office (SCO) is responsible for processing payments. After receiving timesheet data from CMIPS II, EDD has two business days to print and mail blank timesheets to providers to use for their next pay period. SCO has one business day to print and mail paychecks or notices of electronic funds transfers after receiving payment information from CMIPS II.
Counties are responsible for administering the IHSS program at the local level. A county may establish a public authority, a public entity defined in state law, to delegate the performance of certain IHSS tasks, such as conducting background checks on prospective providers. At the five counties we visited—Los Angeles County, Sacramento County, San Bernardino County, San Diego County, and the City and County of San Francisco—the public authorities provide varying services depending on the relationship established with their respective county. For example, the public authority in the City and County of San Francisco maintains a provider registry and performs some of the hiring steps for providers, whereas the public authority in San Diego County conducts provider enrollment sessions and administers payment services for the providers.1
Counties are responsible for receiving and processing IHSS applications for recipients, as well as conducting orientations for providers. If providers have problems with their timesheets or paychecks, county staff help them resolve these issues using their access to CMIPS II. Counties also attend stakeholder meetings where they discuss the management of the IHSS program, provide feedback about the program and CMIPS II, and obtain information from state representatives on status updates and planned changes to CMIPS II.
The Case Management, Information and Payrolling System
In 1978 the Legislature enacted Assembly Bill 3028 (Chapter 463, Statutes of 1978), which mandated a payroll and payment system for the IHSS program. As a result of this legislation, Social Services developed the original Case Management, Information and Payrolling System (the original CMIPS). However, the number of recipients and providers participating in IHSS grew substantially over time, and the Legislature also added requirements to IHSS, resulting in the original CMIPS not being able to meet the needs of Social Services and the counties. In 2004 the Legislature passed Senate Bill 1104 (Chapter 229, Statutes of 2004), which required Social Services to implement a new system that would provide information to manage the IHSS caseload and monitor and evaluate IHSS. The law also required the system to incorporate technology that could readily be enhanced and modernized for the system’s expected life. Social Services, through OSI and its contractor HPE, developed the new system, CMIPS II, which was placed into initial operation at pilot counties in 2012 and achieved full statewide coverage in November 2013. CMIPS II is a web‑based system that Social Services and counties use to manage the IHSS program. Counties use the system to process recipient applications, determine eligibility for services, manage needs assessments, enroll providers, and link the recipients of services to their approved providers. CMIPS II calculates the pay for providers, including deductions, and produces various reports on payroll, quality assurance, and provider and recipient case management.
The original CMIPS required providers to submit timesheets to their respective county welfare departments to be paid. However, CMIPS II was designed to facilitate providers’ sending their timesheets to a single statewide location—referred to as the timesheet processing facility (TPF)—where timesheets are received and processed using a combination of automated processes with some human interaction, as shown in Figure 1. On average, the TPF receives more than 1 million timesheets each month from more than 460,000 providers. TPF employees receive and organize the incoming mail, and then machines open the envelopes and extract timesheets at a pace of approximately 3,000 timesheets per hour.
Process for Timesheets and Paychecks
Sources: CMIPS II detailed system design documents, CMIPS II User Manual, county policies, and contracts between the California Department of Social Services, SCO, and EDD.
* Providers may be ineligible to receive payment from the county, such as when they do not complete the enrollment process or when they are terminated. Providers who disagree with the county’s decision to not pay the hours claimed on their timesheets can seek payment from the recipient or county.
Scanners create electronic images of the timesheets, read the barcodes preprinted on the timesheets, and stamp the timesheets with a document number and date received. Optical character recognition (OCR) software reads the handwritten information on the timesheet, and the system flags timesheets that have entries that it cannot interpret, such as a numeral that appears to resemble both a 5 and a 6. Additional software checks the information as read by the OCR software against a number of readability rules, such as the presence of a single digit in each daily hour or minute box on the timesheet, and ensures that the total amount of time reported for each day does not exceed 24 hours. If the software is unable to interpret an entry, a TPF employee compares the scanned image of the timesheet to the information obtained by the OCR software, which provides an opportunity to enter the correct information.
The TPF then transmits the timesheet data to CMIPS II, which validates the data against additional timesheet rules to verify that the hours are authorized and properly claimed and makes the timesheet image and data available to the appropriate county. If the timesheet is valid, CMIPS II processes the timesheet data and then sends the payment information to SCO, which processes paychecks and electronic funds transfers. CMIPS II also sends a separate data file at the end of each business day to EDD to print and mail a new blank timesheet to the provider for the next pay period. As Figure 2 indicates, each timesheet has a similar format but is configured to identify the dates for that pay period.
Sample Blank Timesheet
Source: California Deparment of Social Services.
If a timesheet is invalid and the TPF employee cannot correct the issue, the timesheet is marked as having an exception. CMIPS II prepares a listing of all timesheet exceptions that it sends within four hours of discovery to counties. An exception that prevents the timesheet from being paid, such as an unreadable entry or a missing signature, requires the appropriate county to take action to resolve the error before the timesheet data can be processed and sent to SCO. CMIPS II also identifies timesheets with other exceptions that do not result in significant payment delays or in some cases do not result in any delay at all. Examples of these other exceptions, which pertain to specific IHSS program rules, include timesheets submitted early or timesheets claiming in the first half of the month more than 70 percent of the total hours authorized.
The State has made numerous updates to CMIPS II since its full implementation, due to legislative action, policy changes, and defects identified in the system. Several significant changes, which resulted in additional complexity to the system, have been a result of legislation requiring additional benefits or accommodations for recipients. For example, to comply with Americans with Disabilities Act regulations, and because of difficulties for blind or visually impaired (BVI) recipients in approving timesheets and reading IHSS notices, CMIPS II was updated in 2015 to add a BVI timesheet with larger fonts, a system for recipients to approve their providers’ timesheets by telephone, and a telephone line for obtaining audio notices. These changes resulted in an additional timesheet format, which counties were not able to print themselves, as well as modifications to the TPF and to CMIPS II to process the additional format.
However, the most significant series of updates to CMIPS II resulted from the implementation of overtime rules under the federal Fair Labor Standards Act (FLSA). In response to the FLSA regulations issued in October 2013, which effectively required overtime payments to IHSS providers, the Legislature passed Senate Bill 855 (SB 855), which was enacted as Chapter 29, Statutes of 2014, in June 2014 to implement this new federal requirement. This mandate required changes to the timesheets and to the CMIPS II software, as well as significant new procedures directed to providers to record and monitor hours worked in excess of 40 per week. Additionally, SCO, which had been printing and mailing timesheets and paychecks to providers, informed Social Services that it was unable to print the new timesheet format used for reporting overtime. As a result, in January 2015, Social Services contracted with EDD as its new partner for printing all types of IHSS timesheets, which resulted in the State’s current process of separately mailing timesheets and paychecks to providers. Due to delays caused by court challenges to the federal overtime rules, the state law was not implemented until February 2016.