The 1115 waiver for In-Home Supportive Services (IHSS) Plus ends July 31, 2009.  This demonstration waiver provides aged, blind and disabled individuals an array of self-directed personal care assistance through delivery options that are not available under the State Plan Personal Care Services Program.  There is no cap on the number of people who can be served through this demonstration waiver.

CMS has indicated that renewal of the program as an 1115 waiver is problematic because 1115 demonstration waivers are meant to test out new concepts, services, delivery systems, etc. From CMS’ viewpoint, self-directed personal care services are no longer demonstration services, now that the 1915(j) State Plan option is available to states.  DHCS and California Department of Social Services (CDSS) staff discussed converting the IHSS Plus 1115 waiver to the 1915(j) State Plan option with CMS and have consensus that, on the conceptual level, this is the appropriate course of action to pursue. This is based upon CMS' verbal assurance that CDSS' CMIPS system meets the federal requirements for financial management. 

Conversion to the 1915(j) State Plan option will involve:

1. Developing the financial management training and support systems that need to be  provided to Advanced Pay participants; and
2. Making the case that restaurant meal allowances meet the self-directed services construct.
3. Developing and implementing a transition plan that is virtually transparent to current waiver participants.  

The Department plans on sending the draft 1915(j) State Plan option to CMS at least six months prior to the July 31, 2009, expiration of the 1115 waiver.

Materials for the Meeting

• Directions to Meeting
• Meeting Notice
• Meeting Agenda
• Do's and Don'ts for this meeting