How I Got Approved for IHSS Protective Supervision

at-peace-robin-mead

Writing by Ronda Cook
Art by Robin Mead

My son has Autism Spectrum Disorder. I can tell you what I did that was successful in getting him Protective Supervision. He was approved in three and a half months without needing to appeal.  He got approved for 195 Protective Supervision hours.

About Protective Supervision

Protective Supervision is part of the IHSS program in California. It is for children and adults with a mental impairment that have self-harming and or dangerous behaviors that they engage in without regard to consequences. These behaviors must be regularly occurring and random. That is why they need someone to supervise them 24 hours a day 7 days a week to minimize injury to themselves.

If your child engages in any behaviors that put them at risk for harm or injury without awareness of consequences, you should pursue getting Protective Supervision.

You can learn more and meet other parents whose children have Protective Supervision in the Facebook Group IHSS Advocacy.

Examples of Self-Harming Behaviors

  • Eloping or wandering away
  • Climbing up high
  • Banging their head on the floors, walls or people
  • Punching or slapping themselves in the face
  • Scratching themselves until they bleed
  • Bolting out of an open door or gate
  • Running into the street
  • Chewing fingers
  • Talking to or following strangers

Step One: Applying for IHSS

If you are not already in the IHSS program, or if you want to learn how to appeal IHSS hours, please take a look at: IHSS Advocates Manual

Story from a reader who received 228 Hours Per Month from IHSS without Protective Supervision: How I Got Approved for 228 Hours Per Month in IHSS

Step Two: Applying for Medi-Cal

If you are having trouble qualifying for Med-cal, or you are given a high Share of Cost, please take a look at: IHSS Advocates Manual 

Step Three: Gathering Documents

Some people will qualify for IHSS, but not for Protective Supervision. Protective supervision is only for children or adults who have self-harming behaviors.

If you feel your family member might meet the qualifications, then call your IHSS Social Worker and ask for an assessment for protective supervision, or submit your request for this at the same time as you apply for IHSS.

You have to remember that Social Workers have lots and lots of cases. At a bare minimum you should be calling every single week and checking in if you have an open case waiting for a decision.

This is how my son got Protective Supervision quickly:

🌸 First I made a Dangerous Behavior Log which is a list of any self-harming behaviors he has done over the past six to 12 months. Here are some sample pages from my log: Sample Dangerous Behaviors Log for IHSS Protective Supervision

🌸 If your child is a client at a Regional Center, gather his Regional Center Individual Program Plan (IPP). And his Client Development Evaluation Report (CDER).  Regional Centers.

🌸 It may also help to collect letters, statements, files, or reports from any other program your child is part of, or any assessments your child has had.

🌸 Then I get a copy of the Individualized Education Program (IEP) from your child’s school. 

🌸 Now look through all these documents. See if they mention any self-harming behavior your child engages in. Look for any self-harming behaviors noted and highlight them.

🌸 If there are behaviors he engages in that are not noted, you could call a meeting and have them added to his school and/or Regional Center reports. Then collect copies of the updated files.

🌸 Once you have all of the above completed, call your Social Worker and tell them that you are applying for protective supervision.

🌸 Disability Rights California has a guidebook with information on this program: IHSS Advocates Manual

Tip: Keep track of every contact with IHSS that you have the date the time the person you spoke with and a summary of your conversation.

Step Five: Visiting Your Child’s Doctor

🌸 I printed the IHSS SOC 821 protective supervision form and took it to the doctor that treats him along with the hazard log.

🌸 It is helpful if you can sit with the doctor while he fills out the form and tell him to use the examples of self injurious behavior to write in the form. It’s best if your doctor marks most boxes “severe”.

🌸 Here’s where you can find a bunch of good Tips from Parents on Getting Doctor’s Forms

Step Five: Meeting the Social Worker

When I met the Social Worker for the home assessment, I handed her the following:

🌸 Dangerous Behavior Log

🌸 Completed SOC 821 form

🌸 IEP with the items highlighted

🌸 CDER with the items highlighted

🌸 IPP with the items highlighted

Tip: Always make a complete copy of everything that you give to IHSS so you know what information they are looking at.


APPEALING

We were approved at this point. If your family is not approved yet, keep appealing:

Appealing a Decision

🌸 If your case is denied, and you’re within the time frame to file an appeal, always try to do that first to preserve any back pay.

🌸 If you lose your appeal there’s another step beyond that you can try for. Otherwise you can always reapply– basically start a new case.

🌸 Generally though you would only want to reapply if you’ve exhausted all your other appeals first because if you reapply, then backpay would only be from your new application date.

🌸 The easiest way to appeal is online. Go to this link, create an account and state your reason for appeal as “Protective supervision incorrectly denied”. https://www.cdss.ca.gov/hearing-requests

🌸 You can request the hearing to be conducted by telephone, So you don’t have to worry about a babysitter.

🌸 You can upload any additional documents supporting your case. You can also submit more documentation while waiting for the hearing date. One important thing is the judges like documentation. They need paperwork that they can point to and say in their ruling: this document is why I approved this person’s request

🌸 If you have a strong case for protective supervision, you should definitely appeal. Even if the Social Worker ignored your documentation, the judge won’t ignore your paperwork.

Hiring an Advocate

🌸 You do not need to have a lawyer or advocate to appeal, however if you wish to hire one, this a business that provides advocates for families with children with developmental disabilities: IHSS Advocates.

🌸 When I first applied for IHSS, I read their website and I found it helpful. I spoke with one of their advocates and they told me I didn’t need to hire them because my son is so severely disabled he would be approved easily. I do believe they are honest people and I would recommend them.

🌸 Hiring an advocate can be expensive, but you do not pay upfront. It comes out of backpay when you win your case. I wouldn’t have hesitated to hire them if I needed it.


Tips from Gracie Fuentes

“Parents don’t need to tell doctor’s who is going to be their child’s provider. You can ask for the form to be filled out and, if you feel the need to explain, you can tell them it’s so the child can get hours for a provider to watch them…

“I get the feeling some doctors don’t like the fact that parents get paid to watch their own children. But they seem to ignore the fact that some of us gave up a good paying career to stay home with our children and make minimum wage. I gave up my career at a Law Firm.” 

Reader’s Tip

The same applies for Social Workers. Many readers report having trouble because their Social Workers were misinformed about the rules for parent providers, and told them they wouldn’t qualify or suggested withdrawing their application.

Keep in mind: Your child is applying for services. You are not applying. This is not your application. When your child is applying for services, it does not matter who the provider will be. After your child is approved, you can decide whether to hire a friend, family member, someone you don’t know, or to be a parent provider yourself.


Learn More

How to Survive on SSI

How I Got Approved for 228 Hours Per Month in IHSS

How Can I Get My IHSS Income Excluded from SSI? Medi-cal? CalFresh? Taxes? HUD? Housing Vouchers?

15 Secrets for People in IHSS or Medicaid Waiver Programs

10 Secrets for People with Live In Caregivers

IHSS Facebook Group

19 thoughts on “How I Got Approved for IHSS Protective Supervision”

  1. Hi,
    I’m in the process of getting my daughter IHSS, we were referred by one of her doctors and from the regional center. I have been advised to be the provider but unfortunately I don’t have anyone to sign off on my hours, I tried my daughters therapist etc but some are caregivers already so they cant sign and some said they would but then disappeared.

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    1. I asked about people in your situation when I first got approved and was doing the paperwork. The worker said there IS a way for YOU to sign off under your child’s name when push comes to shove. There are people who simply have no one else. So don’t let them tell you you can’t. She didn’t give me the details on how they do it, but just keep insisting you do not have anyone else, and they should get it pushed through for you. It might be as simple as creating a new/different email address that will receive the timesheet authorizations.

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  2. I am a regional center service coordinator and would like to have permission to use this article with my caseload and if possible have a PDF to make it easier to share

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  3. Thank you for your daily schedule, it is very helpful! I do have one question, are you the only one listed as her caregiver on the form, or do you have others? Thank you!

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  4. Thank you. Below is a 24-hour coverage plan I wrote for my daughter. Perhaps this template may help another parent.

    24-Hour Care Plan
    Megan is never left alone. She is always with her parent, sister, school staff, or daycare provider. At all times she is supervised because she does not have the ability to care for herself, recognize common dangers or know how to ask for help if she became injured. In other words, Megan doesn’t understand how to direct herself or keep herself out of harms way. Her care requires a level of vigilance and anticipation that’s hard to imagine and explain. At present Megan’s attention to task is limited to 3 minutes. Her behavior is often unpredictable. Additionally, her neurology is unique, so what drives her to act, as well as her perception of the world through her senses is not typical. For example, she does not have a reliable response to pain or thirst or hunger. Because she does not express bodily needs with consistency, it is up to her caregiver to anticipate her needs, dangers to her person, as well as to engage her meaningfully, to the best of her ability. Because Megan is unable to independently care for her bodily needs and is exceptionally impulsive, without supervision, she would attempt many acts of daily living (that she participates in with adult support), but are unsafe for her to do independently. She has many functional limitations due to impairments in her memory, orientation, and judgment.
    Below, please find instructions on the types of assistance and some of the common areas of safety concern typical to a 24-hour period of time during the school week. While caregivers and activities vary depending upon the day of the week or time of year, Megan is not ever without direct support and supervision.
    Morning 6:30AM through 8:30 AM
    Prepare breakfast and set out medications prior to waking Megan.
    Wake Megan.
    Help her to bathroom.
    Assist Megan with removing pajamas. Check to see if she’s wet and needs a quick rinse in tub prior to school. If she is wet, help Megan to tub, then rinse away nighttime urine. Please regulate water temperature because Megan does not understand how to adjust the faucet for water temperature. She could scald herself. Be sure to have hold of the handheld sprayer as soon as Megan is safely in the tub. It’s unsafe for Megan to use the hand sprayer because she will spray it in any direction creating a puddle on the bathroom floor, which in turn she may slip in.
    Help Megan get dressed. Please stand near the toilet seat ready to steady Megan or prevent Megan from falling off the toilet while she puts on her pull-up. Megan has some difficulty balancing and can sometimes fall over while trying to help herself get dressed.
    Assist Megan with breakfast. First off, make sure Megan is sitting in the middle of her stool. She has a tendency to sit crooked or toward one side or on the edge of the seat. You’ll decrease the potential of her falling, if you help her to reseat herself so she’s more stable. Particularly if there’s any type of meat or hard fruit like apples or melons at breakfast, watch her for choking. Megan does not chew her food thoroughly and will often overfill her mouth with food. Sometimes, she gags. Also, keep an eye out for spilled food under the kitchen counter breakfast bar. Usually our dog, Tibby, helps with this cleanup, but Megan will sometimes bolt for an item she wants in the frig or on the counter and slip on spilled food or trip over the dog. Keep her away from the stove. She’s interested in “helping” or “cooking” and will attempt to use different kitchen appliances. She is not capable of using any appliances independently, but she will try nonetheless. As you can imagine, there are risks here if she’s not supervised with the microwave or blender. Additionally, make sure you immediately dispose of any garbage or old food. She does not understand that raw eggs or yesterday’s school lunch may give her food poisoning. Pay great attention when other family members are leaving for work/school. Megan may decide she wants to ride with them in their cars and try to follow them out the door, try to get in their vehicles, or inadvertently stand behind them while they’re backing up.
    Help Megan rinse her breakfast dishes in the sink and place them in the dishwasher. Megan has a routine of helping with breakfast dishes, but she’s not able to coordinate this activity without assistance. If there’s breakage keep her away from the broken glass. She may want to try to help clean up, but she’s a danger to herself.
    Assist with Brushing teeth and other self-care.
    Please see our behaviorist’s task analysis and teaching goals for brushing teeth. Currently, Megan is not able to brush her teeth independently. Try to involve her in her own self-care (brushing teeth, brushing hair, putting on acne cream and sunscreen), but most likely these will be hand over hand type activities. Additionally, Megan will not differentiate the acne cream tube from the toothpaste tube.
    Walk to the car
    Megan sits in the front seat because she will unlatch her seatbelt when she’s riding in the back of the van. Megan is able to pull the handle to open the van door, but will sometimes smack herself with the door in the process of opening it, especially if the door sticks. Make sure you have the car keys in hand, because she can lock herself in the van but is unable to follow directions to pull up the door locks to open the van door. Over the years, we’ve made several calls to AAA to unlock the van because Megan has locked herself inside with the key. Also, place her backpack in the back compartment of the van. She’s inclined to get her feet tangled up in the backpack straps, a disaster waiting to happen when she reaches school and tries to leave the van. When you are driving, steer with your left hand. Be prepared for Megan to grab your right arm off the steering wheel if she wants your attention.

    8:30AM through 2:10 PM School Day
    Megan attends a Functional Skills Focused Special Day Class at Nordhoff High School. Her curriculum is driven by her IEP goals. Dee Ann Jenkins is her one-on-one classroom aide.
    2:10PM through 8:30PM Afterschool and Evening
    Pick up Megan at Nordhoff H.S.
    Located on the driver’s door compartment is a handicapped placard if SDC pick-up area is full. Upon returning home, help Megan to the restroom.
    Depending upon the day of the week, afternoons and evenings are filled with a variety of activities: Behavioral therapy, Social Skills Group at Sarazotti Park, Therapeutic Horseback Riding, Fit Kids at the athletic club. Megan requires your assistance with all outings and therapies. While it’s not possible to rule out the risk of accident completely (this would severely limit Megan’s independent movement, to try find a balance with helping her to develop skills for independence and a sense of freedom and choice while providing her with safety.
    Following afterschool therapies/activities, Megan can be engaged by taking her for a walk or in participating in making dinner and setting the table. After dinner preparation is often a good time to ask her about what she would like in her lunch for the next day. See if you can engage her or help her select some lunch items.
    Medications are given with her dinner.
    Help Megan take her bath and put on pajamas. (see AM)
    Help Megan brush teeth and pick out her clothes for AM.

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  5. Hello, I was wondering at what age your son got approved for PS? My son also has severe autism and I want to apple for it but I hear 3 year olds don’t get approved for PS because of their young age?

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  6. Hello… I was denied ps for my 3 year old son. I just had my hearing yesterday. How soon after hearing did you get your decision?

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  7. My son has cerebral palsy and he been diagnosis of sever of judgmental and moderate to sever of memory but no orientation. But he been attacked by a stranger in his apartment and he has ADD and 2 major depression and he has suicidal thought and he is living outside of the house 3 days a week.Is he has a chance to approve protective supervision?

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    1. Hi lydia,

      Thank you for writing. I have no way to know if they will approve his case. I hope if you follow some of the steps Rhonda suggests above that will help you. I hope things go well for your family. 💙💚💛

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  8. Hi! Fantastic info. We just received notice our son was determined eligible for the Institutional Deeming Waiver Medi-Cal. Do I need to wait to start the IHSS process? And when you say “social worker” do you mean the regional center case worker? Also, I have no idea what I’m supposed to do to transition him off of our private pay Kaiser & just onto the Medi-Cal properly (i.e. I don’t want to “owe” the private pay insurance anything). They made the Medi-Cal retroactive for three months (April – June) with a co-cost that is ridiculous; but then starting July 1st the deeming waiver coverage starts at no cost. Do I get to just pick a date? And when is it safe to cancel the private pay insurance? I’m so confused. Any help is much appreciated!

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