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Home Care vs.
Home Health Care
While the term “home care” often is used to describe both medical and non-medical care, home care typically refers to non-medical care such as housekeeping or personal care services provided by persons who are not nurses, doctors, or other licensed medical personnel. Home health care refers to skilled nursing care and other care such as speech, physical, or occupational therapy provided by licensed personnel.

Home care workers provide paramedical, personal care, domestic, and related tasks and are the employee of the IHSS recipients or a contract agency such as the Consortium.

Home health care workers are employed by public or private independent agencies and provide only medical care.

The key difference is that home health care workers are authorized under a medical model by doctors for short-term care and are generally paid by Medicare. Most home care workers are authorized through the Department of Human Services in San Francisco and paid for by Medicaid.

 
   

Contract Mode
In the contract mode of IHSS service provision, Home Care Providers are employees of an agency that has a contract with the Department of Aging and Adult Services IHSS Program. The IHSS Consortium operates under the Contact Mode.

Contract Worker
Contract workers are individuals assigned to provide the approved IHSS services by an agency (IHSS Consortium) under contract agreement with the Department of Human Services. The contract agency is responsible for the hiring, supervision, and firing of contract providers.

Domestic Tasks
Domestic Tasks (IADLs) include sweeping, cleaning bathroom, storing food and supplies, taking out garbage, dusting and picking up, changing bed linen, and miscellaneous domestic services. Related services include meal preparation, meal cleanup, laundry, shopping, and errands.

IHSS Home Care Worker
See Independent Provider and Contract Worker

In-Home Supportive Services (IHSS)
IHSS is a federal, state, and locally-funded program which provides services (see Domestic Tasks and Personal Care) to low-income aged, disabled, and blind individuals who are unable to remain safely in their own homes without the physical assistance of another person to accomplish domestic and personal care tasks. IHSS is an alternative to out-of-home care.

IHSS Public Authority
Although separate from the City and County, the Public Authority was established by San Francisco Ordinance No. 195-85 under California Welfare and Institutions Code section 12301.6. These laws outline major objectives for this public agency:

» Create and operate a central registry to provide lists of screened workers to IHSS consumers for potential in-home employment
» Arrange training and support services for both workers and IHSS consumers
» Become employer of record for IHSS Independent Providers, allowing worker organization and union representation
» Provide formal opportunities for consumer and worker leadership in program and policy development
» Participate in the overall improvement of personal assistance services.

San Francisco’s Public Authority brings together IHSS consumers and workers in partnership to foster the development of high-quality personal assistance services. The governing body of the Public Authority serves as a meeting ground for consumers, workers, and representatives of City government.

Independent Provider (IP)
Independent Providers are individuals selected by the IHSS recipient to provide the approved IHSS services. The IHSS recipient is responsible for the hiring, supervising, and firing of the IP.

Independent Provider (IP) Mode
Independent Providers are IHSS home care workers who are employed directly by a consumer. Independent Providers are often family members of the consumer being served. Independent Providers can also be found on the San Francisco IHSS Public Authority registry. For collective bargaining purposes, the IHSS Public Authority is the employer of record for Independent Providers.

Medicare
Medicare is the publicly-funded and administered health insurance program for persons over 65 years of age who qualify through their work history or contributions to Medicare. Medicare pays for doctors and hospital care when a person is recovering from an illness or accident.

Medicaid (Medi-Cal)
A federal- and state-funded program that provides comprehensive medical benefits (insurance) to low income families, seniors, children, disabled, people in skilled nursing facilities, pregnant women, and CalWORKS recipients

Paramedical Services
Paramedical Services include wound care and sterile procedures.

Personal Care
Personal care (ADLs) include dressing, bathing, grooming, oral hygiene, skin rubbing, reposition on/off seats, respiration, feeding/hydration, bed baths, menstrual care, ambulation, moving in/out of bed, assistance with medications, and assistance with maintenance exercises.

Share of Cost
Share-of-Cost means an individual’s net non-exempt income is in excess of the applicable SSI/SSP benefit level, which must be paid toward the cost of in-home supportive services authorized by the county.

 
 

Consumers
  
  In government parlance, recipients of IHSS are known as “consumers” and are referred to as such. Within agencies serving IHSS recipients, consumers may also be referred to as clients or recipients.

A recent study showed that 65% of IHSS consumers in California are women, 46% are 65 years of age or older, 3% are blind, and 51 % are people with a disability. The majority of IHSS consumers are over the age of 55. Approximately 41 % are Asian/Pacific Islanders, and 35% are white. In regard to language spoken, 32% of the consumer population speaks English, 31 % speak Chinese (Mandarin, Cantonese or another Chinese language), and 23% speak Russian.

 
             
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