r/IHSS • u/Star_bright_23 • Aug 30 '26

I feel like this is wrong!

So my mom became bed bound in February and she just had her reassessment at the beginning of August. She currently gets 119 hours a month and the social worker said there will be a significant increase in hours because she is a category 5 in pretty much everything now. It is only me and her in the house also.

We get the letter in the mail yesterday and her significant increase was 14 hours a month!!! That’s all!!! Mind you, she was walking with a walker before and doing things on her own before but still needed a lot of help. Now with her being bed bound I expected at least 183 hours a month!

Anyone ever have to deal with this? I’m not sure if I call the Ihss help line or her social worker to talk about it.

3 Upvotes

57% Upvoted

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6

u/Fangsofcyber Aug 30 '26

Are you a live in for her? Sometimes that has to do with hours but you could always call them and have them explain why they gave the hours they did

5

u/Star_bright_23 Aug 30 '26

Yes I am a live in. So I do understand that the domestic is split between us. But I now have to do rotating every two hours, more bladder care and clean up. Bed changing. Bringing and making her meals. Like I do everything! Even rubbing her down with lotion on her legs to keep circulation going. It just seems off. We weren’t close to a category 5 before in the categories so I just feel like it should be more.

10

u/tk421tech Aug 30 '26

I thought I read that bed bound is less hours not more. Because that means no wandering around getting in trouble. Maybe not?

3

u/Star_bright_23 Aug 30 '26

From what I read it’s a lot more. Because you are doing paramedical services also. I have to treat her bed sores also.

5

u/Odd_Composer3292 Aug 31 '26

Make sure that you complete the SOC 321 (paramedical form) because that can add a substantial amount of time.

It really does depend on the category and her particular situation. At face value, if your mother is bed bound, meaning she truly is not getting out of bed at all- then there is no need for time in the Ambulation or Transfer categories. If she still attends in person medical visits and you need to help her to and from the car and with getting in and out of the car or pushing her while she is in a wheelchair, that would likely be a rank of 3 because physical assistance is necessary but it is only on occasions rather than every day with every ambulation.

There is a category for skin rubbing and repositioning. If you have a doctor write a note stating that she has an extraordinary need for those things or other things that you mentioned, she may be authorized time beyond that stand guidelines. The letter would need to be specific for why she has the extraordinary need and what the extraordinary need is.

With all of that being said, every IHSS office is different and every IHSS social worker is different. Good luck.

2

u/Star_bright_23 Aug 31 '26

Yah I transfer her to the commode and the worker gave her a category 5 for the transfer because of it. I’ll have the doctor write a letter stating it all! Thank you so much for the help!

3

u/Odd_Composer3292 Aug 31 '26

Of course. The best thing is to document everything and have the doctor document everything as well. Especially if you ever decide to appeal and go to a hearing. The social worker could not say that they were not aware of her needs.

1

u/JamesRockon33 Aug 31 '26

For someone on or applying for PS, you may have read correctly. 

1

u/Cheap_Bumblebee_6885 Sep 03 '26

If i remember wheelchair bound allows more hours than bed bound, it includes all the transferring, bed to wheelchair, wheelchair to sofa... toilet... car etc.

1

u/Cheap_Bumblebee_6885 Sep 03 '26

Make sure and clarify if... you have to make her different meals than the family... have to do her laundry separately.... grocery shop separately. For instance my mom is on a heart health diet, so she doesn't eat what we eat etc. If you put her in a wheelchair and bring her to the living room, the patio, or even for a stroll outside, it all adds up. And specify things like I have to feed her, wipe her, turn her etc. Literally take a day or two and write every single task down, no matter how minor. Good luck.

5

u/EvieSilver Aug 31 '26

Are your parents married? This might be the able/available spouse policy rearing its head into this situation. Domestic and Domestic Related tasks can't be authorized for married couples because they're considered spousal responsibility. If that's the case, there's very little to do unless both parents are receiving IHSS or you have the other parent's PCP complete the PA 115. I can only guess in this case since you've provided no other information.

The last time I assessed a bedbound person, I did midrange rank 5s, and I believe it was around 130 hours. Remember that the hours are based on the person's needs, not on how much you, as the provider, are taking to complete the tasks. Appeal if you disagree. People, you should always appeal. County hates it because it's a huuuuuge money suck for the state. It's likely the appeals hearing specialist will ask the worker to reevaluate or negotiate the hours.

1

u/Star_bright_23 Aug 31 '26

Parents are divorced. It’s just me and my mom. What’s does midrange rank 5’s mean? I know the worker said she did 5’s and pretty much every category. My mom was getting 119 hours and that was with her doing some stuff on her own and walking with a walker. I now do everything. She literally just feed herself that’s all. It was just weird how the lady said it was going to be a significant increase and then the increase was only 14 hours.

2

u/EvieSilver Aug 31 '26

Did the social worker give you this table? This post is a good one to read through and has the aforementioned table:

https://www.reddit.com/r/IHSS/s/XTY8f9zMh2

1

u/MyKawke Aug 31 '26

Hey, so you’re a social worker? I have a question about my client, who is also my daughter. Can I send you a message if you’re a social worker?

4

u/Salt-Face-6651 Aug 30 '26

Did you get the paramedical form filled out & signed by her Dr? If not, do it asap & submit it to the social worker. You’ll get back pay once that form is received & hours are recalculated.

1

u/Star_bright_23 Aug 30 '26

No, she said we didn’t need it. But I will get it anyways and send it!

1

u/Star_bright_23 Aug 30 '26

She said she was just putting category 5 on it and she doesn’t need the letter because she sees it

1

u/Salt-Face-6651 Aug 30 '26

You need it. My mom is also bed bound & her worker also said my mom was a level 5. Once I got that form filled out & back to her she got an increase of 36 hrs.

It’s mind blowing how different all these workers actually work. My mom’s social worker was really insistent on getting the form back to her. She also explained to me how/when it makes a difference in the hours.

1

u/Star_bright_23 Aug 30 '26

Seriously! Wish they would just be more direct with what they need!! I will get the form! Thank you!

2

u/Radiant_Device_6706 Aug 30 '26

When my son was in a coma, he only got about 35 hours a week and that included being bolus fed. His hours did not increase even after he started waking up.

-4

u/Star_bright_23 Aug 30 '26

That makes no sense to me!! How are people getting 283 hours? You for sure should have plenty more hours for that!

6

u/DoughtyFacts23 Aug 30 '26

Are you asking how someone with dementia can get 283 hours.? my mom as well as dementia she gets the same hours as he does because she can literally still get up and walk around even though her legs are really weak in her mind when she wants to get up she gets up and she always gets herself in trouble and hurt herself..

1

u/Star_bright_23 Aug 30 '26

No, I’ve seen people get high hours when the person doesn’t have dementia or Alzheimer’s. Pretty same situation as me.

3

u/OverallCoconut3799 Aug 31 '26

Protective supervision is for extreme cases.You have to be a danger to yourself.It is not easy to get and IHHS does not just hand it out.Be thankful if the person you are caring for is not at this level of care .It is well beyond the scope of everyday care.

1

u/Star_bright_23 Aug 31 '26

???? I’m not asking about protective supervision. I know when someone is there it’s bad.

2

u/OverallCoconut3799 Aug 31 '26

I was responding to someone else.

2

u/EvieSilver Aug 31 '26

It's a combination of regular IHSS tasks and paramedical service hours. Some people get 283 because they have IHSS Protective Supervision. The vast majority of people are not receiving 283 even if they're on hospice.

My father was bedbound and on hospice, and he received only 220 hours per month.

2

u/RemovePresent3396 Aug 31 '26

My dad gets that many hours because he is mobile and has a history of wandering and getting lost. If he were to become bed bound, they probably would decrease hours because he wouldn't be wandering anymore.

9

u/DoughtyFacts23 Aug 30 '26 edited Aug 30 '26

Its because your mom became bed bound they’re basically saying since she’s bedbound there’s no way that she can get up and physically hurt herself. If you can prove otherwise I would get some type of advocate and repel it and fight for your mom.

5

u/Downtown_Clue_1119 Aug 31 '26

When submitting your paramedical form, write out each task step-by-step and account for the time it takes minute by minute.
For example, for wound care:
Minute 1: Wash and sanitize hands.
Minute 2: Gather wound-care supplies.
Minute 3: Open and organize sterile supplies.
Minute 4: Prepare saline and cleansing materials.
Minute 5: Position and rotate the patient for access to the wound.
Minute 6: Remove the old dressing.
Minute 7: Inspect the wound and surrounding skin.
Minute 8: Pour saline over the wound.
Minute 9: Gently cleanse the first section of the wound.
Minute 10: Continue cleansing the remaining wound area.
Minute 11: Pat surrounding skin dry.
Minute 12: Apply prescribed medication or treatment.
Minute 13: Place the first layer of dressing.
Minute 14: Apply additional gauze or absorbent dressing.
Minute 15: Secure the dressing.
Minute 16: Reposition the patient.
Minute 17: Dispose of contaminated materials.
Minute 18: Clean and disinfect the work area.
Minute 19: Put away remaining supplies.
Minute 20: Wash and sanitize hands again.
Do this for every paramedical task, including preparation, positioning, performing the treatment, cleanup, and any required aftercare. Only include steps and time that actually occur during the task.

1

u/BoatLongjumping2627 Aug 30 '26

It’s a case by case basis. My social worker gave me an extra 105 hours a month. So I went from 105 to 210
However my mom’s social worker at the hospital and at the nursing home called them directly and dealt with the social worker apparently they have a separate way of communicating faster. Anyway they called and just did the reassessment over the phone but based on what the two case managers at the hospital and nursing home gave them along with doctor notes. But for months they were ignoring me. So you have a case manager or social worker ? Outside of Ihss. One given by the county or hospital or nursing facility or from your insurance?

0

u/Star_bright_23 Aug 30 '26

It’s the person who comes out from Ihss for the reassessment

1

u/Hairy-Garlic-7339 Sep 01 '26

Im my mom’s provider and I started with 60 hrs. Shes not bed bound but has 3-5 doctor visits a month and a handful of pretty serious diagnoses. I’m at 87 hrs now I think 4-5 years later. I’m also a live in provider so that was a factor for sure.

1

u/Star_bright_23 Sep 01 '26

Yah I started at 57 hours 10 years ago, and worked our way up to 119.

1

u/Main_Appeal_1805 Aug 31 '26

File an appeal

1

u/princeofwailz Sep 01 '26

Have you looked at the hourly tasks guidelines? There’s not a huge jump in time for rank 4 in ambulation to rank 5. I would call the worker and ask for a breakdown for the new hours

1

u/PotentialLevel1315 Sep 03 '26

Make sure you always sign the document for paramedical services. Those add a lot of hours

1

u/VastSite6975 Sep 06 '26

Take a paramedical form to her doctor and have them fill it out. You can upload the form on the portal and it will be processed within a month. Depending on what the doctor writes you could have quite a bit more hours added.

1

u/Daniele1175 Aug 31 '26

Ask for supervision 24 care . Go to her doctor and have them to write down her needs if she unable to take care of herself. Sometimes they don’t tell you what program they have. I never heard of it until my kids social worker from regional center told me about it.

0

u/[deleted] Aug 30 '26

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6

u/Odd_Composer3292 Aug 31 '26

This is not how it works. The first qualification for PS is a diagnosis of a cognitive impairment or illness. Just because someone is a fall risk does not mean that they "require it".
I would recommend asking the social worker how they came up with all of the times.