California Medi-Cal programs that pay for care at home

In California, Medicaid is called Medi-Cal, and the program that most families mean when they ask who pays for care at home is In-Home Supportive Services, or IHSS. IHSS pays for help with daily tasks for people who qualify, and the person who receives care hires and directs the worker.

This page explains how the main California programs fit together, who runs each one, and where to start. Each fact comes from a California state agency page or from Medicaid.gov, listed under Sources with the date we read it.

How Medi-Cal and IHSS fit together

Medicaid.gov lists the California Department of Health Care Services as the state Medicaid agency, with a Medi-Cal helpline. Medi-Cal is the health coverage. IHSS is a separate program run by the California Department of Social Services (CDSS) that depends on Medi-Cal: one of its four eligibility conditions is a Medi-Cal eligibility determination.

CDSS describes IHSS as in-home assistance for eligible aged, blind and disabled people, as an alternative to out-of-home care. County social workers do the work on the ground. They interview you at home, decide your eligibility and need, and set the number of hours the county will authorize each month.

IHSS: California's self-directed option

Medicaid.gov describes self-directed services as a model where participants, or their representatives, choose and manage the people who provide their services. IHSS works this way. CDSS says that once you are approved, you hire your own individual provider and you are considered that provider's employer, so you hire, train, supervise and, if needed, fire them. If your county has contracted providers or county homemakers, you may use them instead.

Hours are set individually. CDSS does not publish one fixed maximum on its program page. The State issues the provider payment checks. Wage rates are negotiated county by county, so the hourly rate depends on where you live. CDSS tells recipients to ask their assigned social worker for the county rate.

For the full walk-through, see IHSS in California: who qualifies and how to apply.

MSSP: care management for adults 60 and older

The California Department of Aging runs the Multipurpose Senior Services Program (MSSP). The Department says MSSP provides social and health care management to help people stay in their own homes and communities. It is for people 60 or older who are eligible for Medi-Cal under a qualifying aid code and who are certified or certifiable for placement in a skilled nursing facility.

MSSP services listed on the Department's page include care management, adult day care, minor home repair, supplemental in-home chore, personal care and protective supervision, respite, transportation, counseling, meals and communication services. The Department says most participants also receive IHSS, and that MSSP pays for some needed services that are not otherwise available. You find an MSSP provider by choosing your county on the Department's Find Services in My County page.

Who can be the paid caregiver

CDSS says IHSS care providers may include family members, friends, neighbors or registered providers through the county public authority. Anyone who wants to be paid must finish the provider enrollment steps in CDSS form SOC 847 first. The rules for spouses and for parents of minor children are narrower, and CDSS handles children in a separate program page. Our paid family caregiver page for California covers who can and cannot be paid, as far as the state pages say.

How to apply

1. Contact Medi-Cal. IHSS requires a Medi-Cal eligibility determination, and Medicaid.gov's state agency list gives the Medi-Cal helpline.
2. Complete the IHSS application (SOC 295) and send it to your county IHSS office.
3. Get the Health Care Certification (SOC 873) completed. CDSS says the county must receive it before services are authorized.
4. Wait for the county social worker's home visit and written notice of approval or denial. If you are approved, the notice states the services and the monthly hours.
5. Hire a provider and have them enroll with the county.

CDSS also lists an Adult Protective Services hotline, 1-833-401-0832, for reporting abuse of an older adult or dependent adult.

What this page does not cover

California has other Medi-Cal waivers and community programs for adults with developmental disabilities, brain injury and other needs. We could not read the Department of Health Care Services waiver pages when we wrote this, so we have not described them. Ask the Medi-Cal helpline, or see intellectual and developmental disability services in California for providers.

Questions to ask when you call

• Does my county IHSS office have my SOC 295 application and my Health Care Certification (SOC 873)?
• When is my home visit with the social worker?
• Which IHSS sub-program am I in, and does that change who can be my provider?
• What is the hourly wage rate in my county?
• If I am 60 or older and could be placed in a skilled nursing facility, can I be referred to MSSP in my county?

Terms you will see

• Individual provider: the person you hire to do your authorized IHSS services. CDSS says you are their employer.
• Authorized hours: the monthly hours the county approves for each service after the home assessment.
• Public authority: the county body CDSS names as the source of registered providers.
• Health Care Certification (SOC 873): the form the county must receive before it authorizes services.
• Aid code: the Medi-Cal category that decides whether you meet MSSP's Medi-Cal condition.

What Carevo does and does not do

Carevo is a connection platform and directory. We do not run IHSS, decide who qualifies, or set anyone's hours, and we do not vouch for any provider. If you want private-pay help while your application is being processed, use the care-type links below to see providers that serve your area.

Programs in California

• In-Home Supportive Services (IHSS): In-Home Supportive Services (IHSS) pays a caregiver you choose to help with daily tasks at home. You must live in California, have a Medi-Cal eligibility determination and apply through your county.

Find providers in California

• Home care in California
• Home health care in California
• Nursing homes in California
• Intellectual and developmental disability services in California
• Paid family caregiver in California