On Behalf of the Tulare County Board of Supervisors, I write in support of SB 1245 by Senator Ochoa Bogh, which streamlines the process for In-Home Supportive Services (IHSS) clients to receive paramedical services.
California's population of adults aged 65 and older is projected to reach 25 percent of the population, or 8.6 million Californians, by 2030. IHSS is an important tool in meeting the goals set out in the Master Plan for Aging to enable this growing population to age with dignity and independence. Currently, nearly 600,000 IHSS providers deliver services to over 750,000 recipients in the state. This includes paramedical services such as the
administration of medications, wound care, or injections, among others.
While the California Department of Social Services (CDSS) allows any licensed healthcare professional to sign off on the initial SOC 873 form required for a client to obtain IHSS, the department only allows limited types of
healthcare professionals to sign the additional SOC 321 form required to authorize paramedical services. Specifically, only physicians, surgeons, podiatrists and dentists are authorized to sign this additional form.
The current requirements for authorizations of both the health care certification and paramedical forms can prevent timely delivery of services essential for the client's health. Counties cannot allow paramedical services without the second form, which can lead to significant delay for a client to obtain paramedical services from their IHSS provider. This delay can be exacerbated by overwhelmed healthcare systems.
SB 1245 allows the same licensed health care professionals who currently sign the IHSS health care certification form to also sign the paramedical form. This bill would also allow nurses and nurse practitioners working at the direction of the licensed health care practitioner to complete the forms. Aligning which licensed health care professionals may sign the paramedical and health care certification forms will reduce administrative barriers. By broadening the types of health care providers who are authorized to sign these forms, IHSS clients can have both forms signed at the same time by the same provider, thereby reducing delays, improving health outcomes and better fulfilling the goals of the IHSS program.
In Tulare County we average 7,850 IHSS cases with approximately 1,650 of those cases receiving paramedical services. Over 40,000 hours a month are dedicated to those paramedical services. The passage of this bill would significantly reduce the wait time for services, reduce the amount of time staff would have to dedicate to the approval process, and even increase the opportunity of paramedical services to more individuals who struggle to obtain the necessary authorizations.
The County of Tulare recognizes the need to improve the process for IHSS clients who need paramedical services. For this reason, the County of Tulare is pleased to support SB 1245 and respectfully urges your "AYE" vote on this bill.
Sincerely,
Larry Micari, Chair
Tulare County Board of Supervisors
cc: Member of the Senate Human Services Committee, Tulare County State Delegation, Shaw Yoder Antwih Schmelzer & Lange, County Welfare Directors Association (CWDA)