Case Study

Ensuring Safety: IHSS Caregiver Back-up System (BUS)

Riverside County, Calif.

The In-Home Supportive Services (IHSS) Caregiver Back-Up System (BUS) is an innovative, 24- hour, in-home emergency caregiver program designed to provide stabilization services and support to elderly and disabled individuals who are assessed to be at risk of harm due to caregiver absence and serious safety concerns. It is an enhancement to In-home Supportive Services, a statewide Medi-Cal benefit program that addresses crises and unmet needs (gap). The goal of the BUS is to allow elderly and disabled individuals to remain safely in their homes until the crisis situation is resolved and/or permanent care solutions are developed. The BUS system consist of a complex partnership between an identified pool of in-home caregivers who have agreed to respond to emergency situations on a 24-hour basis, Adult Protective Services (APS), the IHSS Public Authority (PA), and two local health plans; Molina and Inland Empire Health Plan. As emergencies arise which may be mitigated by dispatching a caregiver, the BUS system is activated. The activation of the BUS triggers a series of activities consisting of: the dispatch of an emergency in-home caregiver to address the immediate need; a coordinated multidisciplinary case review; health plan involvement; assessments and coordination with critical local partners, and the fiscal administration of additional pay incentives for the emergency caregivers. This complex partnership and care affords the time necessary to develop a plan to maintain residents in the least restrictive, but safe setting. The BUS system achieved a 96% and 93% successful immediate dispatch rate in 2015 and 2016, respectively.

Ms. Barbara Ann Kuhn 
Buyer Assistant, Department of Public Social Services

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