IHSS in California: who qualifies and how to apply

IHSS is California's program for paying a caregiver to help you with daily tasks at home. To qualify you must live in California, have a Medi-Cal eligibility determination, live in your own home, and submit a completed Health Care Certification. You apply through your county IHSS office.

What IHSS is

The California Department of Social Services (CDSS) says IHSS provides in-home assistance to eligible aged, blind and disabled people as an alternative to out-of-home care, so they can stay safely in their own homes. The county social worker decides what help you get. You decide who gives it.

CDSS says that if you are approved, you must hire someone, your individual provider, to do the authorized services. You are considered that provider's employer, which means you hire, train, supervise and, if needed, fire them. Where your county has contracted IHSS providers or county homemakers, you may use them instead.

Who qualifies for IHSS

CDSS lists four conditions that apply to every applicant and recipient.

• You are a California resident.
• You have a Medi-Cal eligibility determination.
• You live at home or in an abode of your own choosing. Acute care hospitals, long-term care facilities and licensed community care facilities are not counted as your own home.
• You submit a completed Health Care Certification form (SOC 873).

CDSS does not list an age minimum for adults on its program page. For children, see the section below.

How the county sets your hours

A county social worker interviews you at home. Based on your ability to do certain tasks safely for yourself, the worker assesses which types of services you need and how many hours the county will authorize for each. CDSS says the assessment uses information from you and, where appropriate, from family, friends, your physician or another licensed health care professional.

Assessments happen at intake and at each annual reassessment. You can request a reassessment at any time if your needs or circumstances change. CDSS says social workers decide hours using the Functional Index Rankings, the Annotated Assessment Criteria and the Hourly Task Guidelines. You are notified of approval or denial in writing. If you are denied, the notice gives the reason. If you are approved, it lists the services and the hours authorized per month.

How to apply for IHSS

1. Fill in the application, form SOC 295, which CDSS publishes in English and several other languages.
2. Send it to your county IHSS office.
3. Get the Health Care Certification (SOC 873) completed and make sure the county receives it. CDSS says the county must have it before it authorizes services.
4. Take part in the home visit and wait for the county's notice.

Health care providers and clinics may not charge a fee for filling out forms tied to an IHSS eligibility determination, according to CDSS. CDSS asks that prohibited fees be reported to its Adult Programs Division.

Can a family member be your IHSS provider

Yes, in many cases. CDSS says that once your services are authorized, the social worker helps you find a care provider, and care providers may include family members, friends, neighbors or registered providers through the county public authority. Before anyone is paid, they have to complete the enrollment steps in CDSS form SOC 847, and CDSS lists a set of exclusionary crimes that bar enrollment.

For spouses and parents, the state pages we read are less direct. CDSS's IHSS consumer handbook, published in 2006 and so dated, says IHSS pays spouses of consumers and parents of minor children to provide care under certain circumstances, that every case is evaluated separately, and that the county decides whether a spouse is able and available to do tasks. It also says a parent cannot be paid for age-appropriate supervision and care. Ask your county IHSS office what applies today.

Our paid family caregiver page for California gathers these points in one place.

IHSS for children

CDSS runs a separate page for children with disabilities. It says IHSS is funded through four sub-programs: the Community First Choice Option (CFCO), the Personal Care Services Program (PCSP), the IHSS Plus Option (IPO) and IHSS-Residual (IHSS-R). When a minor is enrolled in PCSP, a parent is not allowed to be the child's provider, because federal rules restrict it. CDSS says that, effective 60 days after publication of ACL 23-106, minors in CFCO, IPO or IHSS-R may hire any provider who completes enrollment, including a parent. Parents who want to be the provider should tell the county their preference. CDSS says this choice does not change IHSS eligibility, but it does decide which sub-program the child is placed in.

How IHSS providers are paid

The State issues all provider payment checks, and withholds disability insurance and Social Security taxes where the provider qualifies. Providers fill in electronic timesheets in the Electronic Services Portal. CDSS says the IHSS pay periods run from the 1st through the 15th and from the 16th through the end of the month.

The hourly rate depends on the county, because wages are negotiated with the employer of record in each county. We do not state a rate because CDSS does not publish one statewide. Ask your social worker.

CDSS also notes that, since January 2017, live-in providers can choose to self-certify their living arrangement to exclude IHSS wages from federal and state income tax. Read the CDSS live-in provider page and ask a tax professional before relying on it.

Questions to ask your county

• How many hours were authorized, and for which services?
• What is the hourly rate in this county?
• If my relative wants to be my provider, what steps and screening do they need to finish, and how long does it take?
• If I disagree with the hours, how do I appeal or ask for a reassessment?

How Carevo fits in

Carevo is a connection platform and directory. We do not run IHSS, assess eligibility or enroll anyone. If you need help before your hours start, or more hours than IHSS authorizes, you can look for home care providers in California.

More about care in California

• All California Medicaid programs for care at home
• Paid family caregiver in California
• Home care providers in California