During a Center of Excellence Elder Abuse meeting last year, a psychiatrist from the Department of Mental Health highlighted an issue: Los Angeles County was not allowing nurse practitioners to sign the medical form certifying individuals for IHSS services. As a result, many eligible patients, particularly those under psychiatric care, were being denied much-needed IHSS services.
Following this, Bet Tzedek’s Medi-Cal and IHSS Policy Specialist Kim Selfon collaborated with the Association of Nurse Practitioners, who confirmed that this problem was extensive throughout L.A. County, but that it was also an issue in other counties. Bet Tzedek engaged with the L.A. County IHSS office, which clarified that this was indeed their policy.
Recognizing the urgency of this matter, we escalated the issue to the California Department of Social Services (CDSS). After review, CDSS determined that L.A. County’s policy was incorrect. As a result, CDSS issued an All-County Letter to all IHSS agencies statewide, ensuring that nurse practitioners are authorized to complete the medical certification form for IHSS services.
This outcome is a significant victory for our clients. It allows their healthcare providers — nurse practitioners who are often more accessible than physicians — to certify their eligibility for IHSS services. This change will help prevent unnecessary service denials and save clients from having to visit providers who are not actively involved in their care.
