HCBS waiver budgets of enrollees who used to receive residual IHSS will not be reduced by the Independence Plus Demonstration Waiver.

The California Department of Health Services (DHS) authorized “Grandfather” protection for persons who were enrolled on December 1, 2004, in one of the Home and Community Based Services (HCBS) waivers administered by the DHS’ In-Home Operations (IHO) and who were also receiving In-Home Supportive Services (IHSS).  Waiver enrollees are subject to an individual cost-effective cap that counts all Medi-Cal services including HCBS waiver Medi-Cal services.  Not counted against the individual cost effectiveness budget were IHSS services not covered under Medi-Cal:  advance pay, parent or spouse provider services, protective supervision.  Under the Independence Plus Demonstration Waiver and clarification of services coverable under Medi-Cal outside the demonstration waiver, all of these services are now covered under Medi-Cal.  So that HCBS waiver enrollees would not have their IHSS services count against their individual budgets thereby reducing what could be covered as waiver services, DHS agreed to “grandfather” or freeze HCBS enrollees’ budgets.