From the State
updated December 30, 2020

The Benefit

In-Home Supportive Services (IHSS) provide people with low-income who have disabilities or are 65 years old or older with in-home and personal care services to help them live safely in their own homes. Services you can get include:

• Domestic services, such as sweeping, vacuuming, taking out the garbage, wheelchair cleaning and battery recharging, and changing bed linens
• Related services, such as meal preparation and cleanup, laundry, and shopping
• Personal care services, such as feeding, bathing, grooming, dressing, bowel and bladder care, and help with medications
• Transportation to medical appointments or alternative sources of services like day programs
• Removal and cleanup of yard hazards
• Heavy cleaning
• Protective supervision for cognitively or mentally impaired persons to safeguard from self-injury or hazard
• Paramedical services, as ordered by a physician, such as injections, range of motion exercises, and catheter insertion
• Help with personal care services at a disabled person’s workplace, but not with job-related services.

IHSS is often seen as an alternative to out-of-home placement, such as assisted living or nursing facilities.

IHSS does not provide 24-hour care. If you need 24-hour care, you will need to make other arrangements for your non-IHSS hours, such as through a Home and Community-Based Waiver (HCBW). To learn more about HCBWs, contact the Department of Health Care Services In-Home Operations at 1-916-552-9105 (Northern California) or 1-213-897-6774 (Southern California).

Your Responsibilities with Your Care Provider

You are responsible for hiring, firing, and supervising your care provider. If your county has contracted IHSS providers, you can hire them to provide you with the necessary services. You can also hire a friend, relative, neighbor, or other care provider.

Wages for IHSS care providers vary from county to county. You and your care provider must submit timesheets for all authorized services provided. The state will handle payment of your care provider(s) unless you are getting advance pay.

The In-Home Supportive Services Consumer Training Handbook (PDF) offers detailed information about how to supervise a care provider, including issues like hiring, firing, communication, safety, and handling payment. There is more information about this on the California Department of Social Services’ website.

Advance Pay
Advance pay means the state sends you funds before your In-Home Supportive Services are performed, so you can pay your care provider directly. To get advance pay, you must be considered “severely disabled,” meaning you need at least 20 hours per week in personal care services, meal preparation and cleanup, and/or paramedical services.

What You Pay

Many people get In-Home Supportive Services free of charge. This includes anybody who gets one of the following types of Medi-Cal:

• SSI-linked Medi-Cal
• Medi-Cal through SSI 1619(b) for people who used to get SSI cash benefits and now make up to $37,994 per year ($39,350 for people who are blind).
• Medi-Cal’s Working Disabled Program (WDP), which lets people with disabilities make up to $64,820 per year and pay an affordable premium for coverage.

Read more about these types of Medi-Cal in DB101’s article on Medi-Cal. People who do not get their Medi-Cal in these ways may need to pay a share of cost, which means that each month, they would pay a portion of the expenses for their IHSS.

Do You Have to Pay a Share of Cost?

If you do not get one of the above types of Medi-Cal, you may still be able to get no-cost IHSS if your countable monthly income is less than the SSI monthly benefits rate in California — $954.72 for an individual or $1,598.14 for a couple in 2021. (We’ll explain more about how countable income is calculated below.)
If your countable monthly income is above the SSI benefits rate, you can still get IHSS if you meet all other eligibility criteria. You may, however, would have to pay a share of cost.

Here are the most common groups of people who have to pay a share of cost for IHSS:

• People who get Social Security Disability Insurance (SSDI) and do not work at all, if their SSDI benefits are high enough to put their countable income above the SSI monthly benefits rate.
• People who get veterans benefits or other unearned income and do not work at all, if their unearned benefits are high enough to put their countable income above the SSI monthly benefits rate. Note: Many veterans do not have a share of cost.
• People who get Social Security or other retirement benefits and do not work at all, if their retirement benefits are high enough to put their countable income above the SSI monthly benefits rate.

If you work, you may not have to pay a share of cost.

If you have a disability and you start working, you could probably qualify for no-cost IHSS, because you could sign up for Medi-Cal’s Working Disabled Program (WDP). Read more about WDP in DB101’s article about Medi-Cal.

How to Calculate Your Share of Cost

Your share of cost is based on your countable income. Here’s a brief intro to the 2 types of countable income you may have:

Unearned income includes monthly disability payments or other income you get without doing any work. Examples include disability benefits (SDI, SSDI, STD, LTD), income from a trust or investment, dividends, and profits or funds you get from any source other than work. Some unearned income is not counted, such as CalFresh (formerly Food Stamps).

Earned income includes your monthly salaries, wages, tips, professional fees, and other pay for physical or mental work you do.

Use the following steps to figure out your IHSS share of cost (if any).

1. If you have monthly unearned income, subtract a $20 general income exclusion from it. (If you do not have unearned income, this exclusion is applied to any earned income.) The resulting number is your countable unearned income. Example: If you get $1,000 per month in SSDI benefits, you would have $980 in countable unearned income.
2. If you have monthly earned income, subtract a $65 earned income exclusion from it. Also subtract $20 if you didn’t have unearned income during the month. If you had any Impairment Related Work Expenses (IRWEs), you can also subtract the cost of these expenses from your earned income. Once you’ve done all of that, divide the remaining number by 2. The resulting number is your countable earned income. Example: In addition to your SSDI benefit, you made $500 at your job last month. First you subtract $65, leaving $435. Then, you divide this number by 2. Once you’ve completed this, your countable earned income would be $217.50.Note: If you are blind and have Blind Work Expenses (BWEs), you would subtract the cost of your BWEs after you divide by 2.
3. Add up your countable unearned and countable earned income to find your total countable income. Example: If you had $980 in countable unearned income and $217.50 in countable earned income, your total countable income would be $1,197.50.
4. Compare your total countable income to the 2021 SSI monthly benefits rate. If your total countable income is less than that rate ($954.72 for an individual and $1,598.14 for a couple), you do not have a share of cost. If it is greater than the monthly benefits rate, you will have share of cost. Example: If you are an individual with $1,197.50 in countable income, you would have to pay a share of cost (unless you were able to sign up for Medi-Cal’s Working Disabled Program (WDP)). Your share of cost would be $1,197.50 – $954.72 = $242.78 per month. That means you’d have to pay $242.78 each month for the in-home support services you get and the IHSS program would pay the rest.

If you work, you probably do not need to pay a share of cost, even if your income exceeds $954.72!

If you are working and have a disability, you could probably qualify for no-cost IHSS, because you could sign up for Medi-Cal’s Working Disabled Program (WDP) as long as you make less than $64,820 per year. Read more about WDP in DB101’s article about Medi-Cal.

Eligibility and Application

If you are a California resident, live in your own home, and get Medi-Cal benefits, you may be eligible for IHSS if you need the services it provides to stay safely in your own home as an alternative to out-of-home placement. To learn more about qualifying for Medi-Cal, see DB101’s Medi-Cal article.

Note: Starting in 2014, there is a new way to qualify for Medi-Cal with no resource limit. That means that even people with significant resources may qualify for IHSS.

Living in your own home

Your home is the place you choose to live. Some examples of places that could be your own home include a house, an apartment, a mobile home, or a room with board. For IHSS purposes, acute care hospitals, long-term care facilities, and community care facilities are not “your own home.” However, if you live in such a facility, you may be eligible for IHSS if you plan to live in your own home in the future. If you are in this situation, IHSS can do a preliminary needs assessment while you are still staying at the facility. Once you move out of the facility and into your own home, IHSS will do another assessment in your home.

Applying for IHSS

1. If you already have Medi-Cal or once you are approved for it, call or visit your county In-Home Supportive Services (IHSS) office to complete an IHSS application. Once IHSS gets the application, a caseworker will be assigned to do an in-home needs assessment as part of the application process.
2. Your caseworker will come to your home to complete the needs assessment: that’s an interview to decide if you qualify for IHSS. The caseworker will ask you a series of questions about your mental and physical abilities and limitations; figure out the tasks you can perform safely on your own and the ones you might need help with; and evaluate your living and social situation.
3. After the needs assessment, IHSS will contact you to let you know if you have been approved or denied. If you are approved, you will be notified of the services and number of hours authorized. If services are denied or you are not happy with the number of hours IHSS authorized, you have the right to appeal. The appeals procedure is outlined on the back of the notice you get.

The Benefit

In-Home Supportive Services (IHSS) provide people with low-income who have disabilities or are 65 years old or older with in-home and personal care services to help them live safely in their own homes. Services you can get include:

• Domestic services, such as sweeping, vacuuming, taking out the garbage, wheelchair cleaning and battery recharging, and changing bed linens
• Related services, such as meal preparation and cleanup, laundry, and shopping
• Personal care services, such as feeding, bathing, grooming, dressing, bowel and bladder care, and help with medications
• Transportation to medical appointments or alternative sources of services like day programs
• Removal and cleanup of yard hazards
• Heavy cleaning
• Protective supervision for cognitively or mentally impaired persons to safeguard from self-injury or hazard
• Paramedical services, as ordered by a physician, such as injections, range of motion exercises, and catheter insertion
• Help with personal care services at a disabled person’s workplace, but not with job-related services.

IHSS is often seen as an alternative to out-of-home placement, such as assisted living or nursing facilities.

IHSS does not provide 24-hour care. If you need 24-hour care, you will need to make other arrangements for your non-IHSS hours, such as through a Home and Community-Based Waiver (HCBW). To learn more about HCBWs, contact the Department of Health Care Services In-Home Operations at 1-916-552-9105 (Northern California) or 1-213-897-6774 (Southern California).

Your Responsibilities with Your Care Provider

You are responsible for hiring, firing, and supervising your care provider. If your county has contracted IHSS providers, you can hire them to provide you with the necessary services. You can also hire a friend, relative, neighbor, or other care provider.

Wages for IHSS care providers vary from county to county. You and your care provider must submit timesheets for all authorized services provided. The state will handle payment of your care provider(s) unless you are getting advance pay.

The In-Home Supportive Services Consumer Training Handbook (PDF) offers detailed information about how to supervise a care provider, including issues like hiring, firing, communication, safety, and handling payment. There is more information about this on the California Department of Social Services’ website.

Advance Pay
Advance pay means the state sends you funds before your In-Home Supportive Services are performed, so you can pay your care provider directly. To get advance pay, you must be considered “severely disabled,” meaning you need at least 20 hours per week in personal care services, meal preparation and cleanup, and/or paramedical services.

What You Pay

Many people get In-Home Supportive Services free of charge. This includes anybody who gets one of the following types of Medi-Cal:

• SSI-linked Medi-Cal
• Medi-Cal through SSI 1619(b) for people who used to get SSI cash benefits and now make up to $37,994 per year ($39,350 for people who are blind).
• Medi-Cal’s Working Disabled Program (WDP), which lets people with disabilities make up to $64,820 per year and pay an affordable premium for coverage.

Read more about these types of Medi-Cal in DB101’s article on Medi-Cal. People who do not get their Medi-Cal in these ways may need to pay a share of cost, which means that each month, they would pay a portion of the expenses for their IHSS.

Do You Have to Pay a Share of Cost?

If you do not get one of the above types of Medi-Cal, you may still be able to get no-cost IHSS if your countable monthly income is less than the SSI monthly benefits rate in California — $954.72 for an individual or $1,598.14 for a couple in 2021. (We’ll explain more about how countable income is calculated below.)

If your countable monthly income is above the SSI benefits rate, you can still get IHSS if you meet all other eligibility criteria. You may, however, would have to pay a share of cost.

Here are the most common groups of people who have to pay a share of cost for IHSS:

• People who get Social Security Disability Insurance (SSDI) and do not work at all, if their SSDI benefits are high enough to put their countable income above the SSI monthly benefits rate.
• People who get veterans benefits or other unearned income and do not work at all, if their unearned benefits are high enough to put their countable income above the SSI monthly benefits rate. Note: Many veterans do not have a share of cost.
• People who get Social Security or other retirement benefits and do not work at all, if their retirement benefits are high enough to put their countable income above the SSI monthly benefits rate.

If you work, you may not have to pay a share of cost.

If you have a disability and you start working, you could probably qualify for no-cost IHSS, because you could sign up for Medi-Cal’s Working Disabled Program (WDP). Read more about WDP in DB101’s article about Medi-Cal.

How to Calculate Your Share of Cost

Your share of cost is based on your countable income. Here’s a brief intro to the 2 types of countable income you may have:

• Unearned income includes monthly disability payments or other income you get without doing any work. Examples include disability benefits (SDI, SSDI, STD, LTD), income from a trust or investment, dividends, and profits or funds you get from any source other than work. Some unearned income is not counted, such as CalFresh (formerly Food Stamps).
• Earned income includes your monthly salaries, wages, tips, professional fees, and other pay for physical or mental work you do.

Use the following steps to figure out your IHSS share of cost (if any).

1. If you have monthly unearned income, subtract a $20 general income exclusion from it. (If you do not have unearned income, this exclusion is applied to any earned income.) The resulting number is your countable unearned income. Example: If you get $1,000 per month in SSDI benefits, you would have $980 in countable unearned income.
2. If you have monthly earned income, subtract a $65 earned income exclusion from it. Also subtract $20 if you didn’t have unearned income during the month. If you had any Impairment Related Work Expenses (IRWEs), you can also subtract the cost of these expenses from your earned income. Once you’ve done all of that, divide the remaining number by 2. The resulting number is your countable earned income. Example: In addition to your SSDI benefit, you made $500 at your job last month. First you subtract $65, leaving $435. Then, you divide this number by 2. Once you’ve completed this, your countable earned income would be $217.50. Note: If you are blind and have Blind Work Expenses (BWEs), you would subtract the cost of your BWEs after you divide by 2.
3. Add up your countable unearned and countable earned income to find your total countable income. Example: If you had $980 in countable unearned income and $217.50 in countable earned income, your total countable income would be $1,197.50.
4. Compare your total countable income to the 2021 SSI monthly benefits rate. If your total countable income is less than that rate ($954.72 for an individual and $1,598.14 for a couple), you do not have a share of cost. If it is greater than the monthly benefits rate, you will have share of cost. Example: If you are an individual with $1,197.50 in countable income, you would have to pay a share of cost (unless you were able to sign up for Medi-Cal’s Working Disabled Program (WDP)). Your share of cost would be $1,197.50 – $954.72 = $242.78 per month. That means you’d have to pay $242.78 each month for the in-home support services you get and the IHSS program would pay the rest.

If you work, you probably do not need to pay a share of cost, even if your income exceeds $954.72!

If you are working and have a disability, you could probably qualify for no-cost IHSS, because you could sign up for Medi-Cal’s Working Disabled Program (WDP) as long as you make less than $64,820 per year. Read more about WDP in DB101’s article about Medi-Cal.

IHSS Programs

There are 4 IHSS programs:

The IHSS Residual (IHSS-R) Program is for people who are not eligible for full-scope Medi-Cal. It provides a maximum of 283 hours of services per month for people with severe disabilities and a maximum of 195 hours for people with disabilities that are not severe.

The Personal Care Services Program (PCSP) is for people with full-scope Medi-Cal who are:

• Adults who get care services from a parent, or
• Adults who don’t have a spouse to provide services, or
• Children under 18 who don’t have a parent to provide services.

Severely and non-severely disabled people can get up to 283 hours of services per month, including protective supervision.

The IHSS Plus Option (IPO) Program is for people who get services from a spouse or parent (for people under age 18), or who get restaurant meal allowance or advance pay. The program provides a maximum of 195 to 283 hours of services per month, depending on the severity of the impairment.

The Community First Choice Option (CFCO) Program is an alternative for PCSP and IPO recipients. CFCO provides home and community-based attendant services and supports, including help with household chores, personal care services, paramedical services, and protective supervision. Severely and non-severely disabled people can get up to 283 hours of services per month, including protective supervision.

IHSS for Children

If you’re a child under age 18, you can get IHSS in different ways, depending on your living situation.

If you live with at least one parent, you can pay someone other than your parent to provide IHSS if:

• Your parents are absent because of employment, education, or training for vocational purposes.
• Your parents are physically or mentally unable to perform the needed services
• Your parents are absent because of ongoing medical, dental or other health-related treatment, or
• A combination of the above.

Note: If your parents must be absent to go shopping, do other essential errands, or take care of your siblings, you can pay another person for IHSS for up to 8 hours per week.

If you live with at least one parent, your parent can be paid to do IHSS if:

• Your parent has no full-time employment or can’t get full-time employment because of the need to provide you with IHSS; and
• No other suitable provider is available.

Note: If you don’t get the IHSS your parent is supposed to provide, you may require inappropriate out-of-home placement. That means you wouldn’t live in your own home with your parent anymore.

If you live with both parents, one of your parents can be paid to do IHSS only when:

• Your other parent cannot provide the services because they are working, getting an education, or are physically or mentally unable to provide the services. If your other parent cannot provide services because they are working or getting an education, the parent providing the services can only get paid for them during the hours when the other parent is working or studying.

IHSS in the Workplace

You can use IHSS personal care services to help you get, keep, or return to work. IHSS that can be performed in the workplace includes meal preparation and cleanup, personal care services (except routine bed baths), and paramedical services. IHSS hours cannot be used for assistance with college courses or vocational training.

To use IHSS personal assistance hours at the workplace, you must first contact your IHSS worker and specify the number of hours and services you need.

Note: You can request to transfer IHSS hours to the workplace but you cannot request additional hours specifically for use at the workplace.

Example: You currently get 80 hours of IHSS for use at your home. You request 20 hours of service for use at your workplace. Your caseworker may approve those 20 hours, but if that happens, you will only get 60 hours of IHSS at home.

In-Home Supportive Services (IHSS): Example

Jack’s Story

Jack is 56 years old and has cerebral palsy. He has been living alone for a number of years and is having an increasingly difficult time taking care of himself and his home. Tasks like cooking, bathing, and getting dressed in the morning take far more energy than they used to.

Jack has become depressed about the situation. He is very independent and has always prided himself on his ability to take care of his affairs on his own. The last thing he wants to do is move into an assisted care facility. He explains his situation to his friend Henry over lunch one day. Henry suggests that Jack look into In-Home Supportive Services (IHSS) as an alternative to moving into an assisted care facility.

“What’s In-Home Supportive Services?” asks Jack.

“Well, I don’t know a whole lot about it,” says Henry, “but I’ve heard it helps people with disabilities remain in their homes safely. I think they help you with the kinds of things you’re talking about — cooking, cleaning, getting in and out of bed.”

“How much does it cost?” asks Jack.

“I think it depends on your income level. If your income is low enough, I think it’s free. It’s a public program,” says Henry.

“Hmmmm. Sounds like it could be really helpful,” Jack says.

“Why don’t you call the county In-Home Supportive Services (IHSS) office,” says Henry. “I bet they’ll have information on it.”

So Henry and Jack search online to find the phone number of the nearest IHSS office. Jack calls and is transferred to an IHSS intake coordinator named Ms. Smith. Jack briefly explains his situation to her.

“I think the In-Home Supportive Services Program could be exactly what you need,” says Ms. Smith. “Let me ask you a few questions first. So you said you have cerebral palsy, correct?”

“Yes.”

“OK,” says Ms. Smith. “IHSS is available to people with disabilities, if they need it. I’ve got a few more questions. Are you a California resident?”

“Yep. I’ve lived here my whole life.”

“Good. Are you getting Medi-Cal?” asks Ms. Smith.

“Yes, ma’am. I am.” Jack says.

“Excellent!” says Ms. Smith. “That means you may qualify for IHSS if you need it. Are you on any other public benefits programs?”

“Nope, just Medi-Cal,” says Jack.

“OK,” says Ms. Smith. “Do you work?”

“I sure do,” Jack says. “Part-time as an accountant for a local manufacturing company. I make $1,600 per month,” says Jack.

“OK,” says Ms. Smith. “Do you have any other sources of income? Earned or unearned?”

“Nope. That’s it.”

“Well, you definitely qualify for the program,” Ms. Smith says. “Now we’ll check if it’s free of cost to you.”

“What do you mean?” asks Jack.

“Well, sometimes people with countable income above $954.72 per month might have to pay something for Medi-Cal and IHSS,” says Ms. Smith.

“$1,600 is more than $954.72, so I’m going to have to pay something, right?” asks Jack.

“Not necessarily – let me do the math here. So you have $1,600 per month in earned income. First, we’ll need to subtract $65 from that — that’s your earned income exclusion — and another $20 — that’s your general income exclusion. So that leaves us with $1,515. Do you have any impairment related work expenses?”

“Well, I couldn’t work if I wasn’t taking my medication. And I pay $40 a month in copayments for that. Does that count?” asks Jack.

“It sure does,” says Ms. Smith. “So let’s see, we subtract $40 from $1,515. That’s $1,475. $1,475 divided by 2 is $737.50. So actually, you only have $737.50 in countable income each month, which is lower than $954.72. That means, you qualify for no-cost In-Home Supportive Services,” says Ms. Smith.

“That’s some pretty weird math, but it’s great news for me!” exclaims Jack.

“It sure is,” says Ms. Smith. “Why don’t you come in tomorrow and fill out an application to get the process started.”

So the next day, Jack goes down to the county In-Home Supportive Services (IHSS) office and fills out an IHSS application. Several days later, a county worker named Ms. Jones comes to visit him at his home. She is there to do a needs assessment so she can figure out what Jack needs help with and how many hours of assistance IHSS will pay for. She asks him a series of questions about his physical and mental abilities and limitations to figure out which tasks he can safely perform on his own and which tasks he needs help with.

Clearly, Jack has a sharp mind but needs assistance with things like cooking, cleaning, getting dressed, and getting in and out of bed.

“How about work,” Ms. Jones asks Jack. “Do you need any assistance there?”

“Not currently. Why? Can I use IHSS there too?”

“Yes, you can. We’d have to transfer some of the hours assigned for in-home support to the workplace, but it can be done. You can use IHSS to help you get, keep, and return to work.”

“Well, that’s good to know,” says Jack. “I probably don’t need that now. But I’ll keep it in mind for the future.”

Ms. Jones completes the needs assessment and informs Jack that he will get a Notice of Action in the mail letting him know if he has been approved or denied In-Home Supportive Services. She also tells Jack that if he is approved for services, he will be responsible for hiring and supervising his care provider. He will need to complete a Provider Enrollment Agreement form with his provider and make sure all timesheets are done properly.

Two weeks later, Jack gets a Notice of Action in the mail with good news. He has been approved for 60 hours of IHSS each month. Jack won’t have to pay anything and all of his authorized services will be covered by IHSS. Jack is thrilled and hires Wendy, a retired neighbor and long-time friend, to provide the services. Wendy comes by every day to help Jack in and out of bed. She prepares meals for him, cleans, and does some of his laundry. She also provides personal care services like dressing, grooming, and bathing. When necessary, she drives Jack to his doctor’s appointments.

It turns out to be a great arrangement. Wendy enjoys the part-time work and Jack is extremely grateful for the help. His depression has lifted, he has more energy than he used to, and he is thrilled to be able to remain in his own home. It’s a win-win for everyone involved.

What are In-Home Supportive Services?
In-Home Supportive Services (IHSS) provide people with low income who are blind, disabled, or 65 years old or older with personal assistance and in-home services so they can safely stay in their homes or continue working. Services range from assistance with household chores to personal care and paramedical services. IHSS is often seen as an alternative to assisted living or nursing facilities.

Who is eligible?
All California residents living in their own homes who get Medi-Cal and need IHSS.

What services does In-Home Supportive Services provide?

IHSS includes:

• Household chores, such as cooking, cleaning, and laundry
• Personal care services, such as dressing, bathing, and feeding
• Transportation and accompaniment to medical appointments
• Protective supervision, and
• Paramedical services as ordered by a physician.

Who provides IHSS?
Some counties have contracted IHSS care providers. Community care providers, friends, neighbors, and relatives can provide services as well. You are responsible for hiring, firing, and supervising your IHSS caregiver.

Who pays for IHSS?
In-Home Supportive Services (IHSS) are financed by state, county, and federal funds. Depending on your countable income, you may have to pay for a portion of the cost of services. This is known as share of cost.

If you work, you may qualify for no-cost IHSS even if you think you have to pay a share of cost. That’s because if you have a disability, you could sign up for Medi-Cal’s Working Disabled Program (WDP). Read more about WDP in DB101’s article on Medi-Cal.

How many hours of IHSS will I get each month?
Depending upon your circumstances, you may be eligible to get up to 283 hours of IHSS each month. The county will do a needs assessment to figure out the services you need and how many hours you qualify for.

How do I apply for IHSS?
Call or visit the local county In-Home Supportive Services (IHSS) office to fill out an IHSS application and verify your eligibility for the program. Next, someone from the county IHSS office will come to your home to conduct a needs assessment to figure out the services you need and how many hours you qualify for.

How do I find out if I qualify?
After the needs assessment, IHSS will send you a letter called a Notice of Action that will let you know if you have been approved or denied services. If approved, you will be notified of the services and number of hours authorized for each service. If services are denied or you are not happy with the number of hours authorized, you have the right to appeal by requesting a State Hearing. The back of the Notice of Action has information about how to appeal.

Are there limitations on the number of hours provided per task?

Yes. For example, your care provider cannot spend more than 6 hours per month on domestic services or more than 1 hour per week shopping for food. If you can show that you need more time for a specific service, your county IHSS worker will see if additional hours can be authorized to meet your needs.

Are there medical eligibility requirements for IHSS?

People with disabilities must meet Social Security’s medical eligibility criteria to qualify for IHSS.

Can I use IHSS hours in the workplace?
Yes. You can use IHSS hours to help you get, keep, or return to work. To do this, you need to transfer hours that were for in-home services to the workplace. IHSS will not give you more hours than you originally were getting before you started using IHSS in the workplace.

To transfer hours to the workplace, contact your IHSS caseworker and say which services you need and the number of hours you wish to transfer.

I’m in college. Can I use IHSS hours to help me with my courses?

No. You cannot use IHSS hours to help you with college courses or vocational training.

I live in an assisted living facility. Can I use IHSS there?

No. If you live in a nursing home or other assisted living facility, you do not qualify for IHSS. If you plan to live in your own home in the future, you can apply for IHSS while you are in the facility. An IHSS employee can do a preliminary needs assessment while you are still residing at the facility. Once you move out of the facility and into your own home, IHSS will do another assessment in your home.

Who hires and supervises my caregiver?
You, the recipient of In-Home Supportive Services (IHSS), are responsible for hiring, firing, and supervising your caregiver.

Can I own my own home and qualify for IHSS services?

Yes. Your personal property cannot exceed $2,000 to qualify for IHSS. This does not, however, include the home you live in, one car to get to and from medical appointments, and life insurance with a combined face value of less than $1,500.

Can I hire family members to provide my IHSS?

Yes. You can hire relatives, friends, neighbors, and other caregivers to provide you with IHSS.

In-Home Supportive Services (IHSS): Pitfalls

Basing decisions on misinformation

Most of us usually rely on the experience of others to understand how to deal with similar situations. The real problem with this is that benefits are person-centered. Benefits programs fit each individual differently, based on a variety of facts and conditions, such as:

• Your work history
• How much you earn
• What you own
• How disabling your condition is
• How clearly you report the details of your condition to your medical provider
• How well your medical provider understands or documents these details
• What benefits an employer provides, and
• What benefits you have purchased individually.

Failing to share information with your medical provider
Many people do not clearly discuss their plans to apply for benefits with their medical provider(s). Ideally, you and your medical provider should share complete information to figure out how long your disabling condition may last. If this step is not included, you may end up with a Medi-Cal (or other benefits program) application that does not support your claim. This could be because the information you provided does not clearly reflect how long the disabling condition may last or how it affects your day to day activities.

Working more because you’ve transferred IHSS hours to the workplace
If you are enrolled in Medi-Cal’s IHSS program, you need to continue to meet income and resource requirements. Working additional hours, because you are able to transfer IHSS hours to the workplace, may put you above income or resource requirements. If this occurs, you may want to consider enrollment in the Working Disabled Program (WDP), which allows you to earn up to $64,820 annually and keep getting Medi-Cal and IHSS. If you enroll in WDP, you will not have to pay a share of cost for your IHSS

In-Home Supportive Services Resources
Call or visit your county In-Home Supportive Services (IHSS) office to complete an IHSS application. Once IHSS gets your application, a caseworker will conduct a needs assessment to figure out the services and number of hours IHSS may provide to assist you.

The California Department of Social Services provides a variety of resources and information on IHSS, including many fact sheets and videos.

The California Association for Public Authorities for IHSS helps consumers gain access to service providers in their local area.

The California Advocates for Nursing Reform provide a fact sheet and local phone numbers for information on IHSS.

Disability Rights California has articles on various topics related to IHSS, including a complete IHSS manual.

To learn more about Medi-Cal:

• Visit the Medi-Cal website, which has a helpful set of frequently asked questions.
• Visit or call your local county social services agency.
• Get local help from Covered California.
• If you have a disability, talk to a Benefits Planner to learn more about health programs for people with disabilities.

The Health Consumer Alliance website provides publications on many aspects of Medi-Cal.

The National Immigration Law Center has a section on immigrants and public benefits, including health care.

Getting Help with Your Benefits

If you get Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), or Childhood Disability Benefits (CDB) benefits, and you’re looking for a job, a trained Benefits Planner can help you avoid problems with your job plan. If you need help or have questions about your situation, you can call the Ticket to Work Help Line at 1-866-968-7842 or 1-866-833-2967 (TTY), Monday through Friday.

Community-Based Organizations
Various community-based organizations guide people through state, federal, public, and private health and income programs. Some organizations may work with specific populations while others work with people with any type of disability. Here are a few examples:

• Goodwill Industries services range from personal evaluation and office skills training to career counseling, childcare, and transportation. Some Goodwill Industries centers also do benefits planning for people who get SSI, SSDI, and Medicare. Find locations at www.Goodwill.org, or by calling (voice) 1-800-466-3945.
• The California Foundation for Independent Living Centers lists centers serving people with all disabilities. Many of these centers do benefits planning for people who get SSI, SSDI, and Medicare. If they don’t offer benefits planning themselves, Independent Living Centers can refer you to local benefits planners. Find the list of independent living centers at www.CFILC.org, or by calling (voice) 1-916-325-1690 or (TTY) 1-916-325-1695.
• The California Department of Public Health’s Office of AIDS lists 1,300 organizations offering HIV/AIDS services throughout California. Some of these organizations provide case management, benefits planning, and benefits counseling services that can include help with public and private benefits programs. You can search the list online, or call (voice) 1-800-367-AIDS (2437) or (TTY) 1-888-225-AIDS (2437).
• Disability Rights California provides representation for consumers of public programs who are disabled. Website publications include topics on health care, benefit programs, and In-Home Supportive Services.