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In-Home Supportive Services (IHSS) (paid in-home care for aged, blind and disabled Californians on Medi-Cal): who qualifies, what you get, how to apply, and what happens next

IHSS pays a provider, who can be a family member, to help aged, blind and disabled people on Medi-Cal with daily tasks at home, up to 283 hours a month for the most impaired. The county assesses need at a home visit. Apply with form SOC 295 at the county IHSS office.

What IHSS is, in one paragraph

In-Home Supportive Services (IHSS) pays for help at home for people who are aged, blind or disabled, so they can stay home instead of moving to a care facility (rule:who). The county assesses which tasks a person needs help with, such as bathing, dressing, meals, cleaning, shopping and getting to medical appointments, and authorizes a number of hours each month. The person hires the provider, who can be a relative, and the state pays the provider. It is a Medi-Cal program run by each county.

283 hours
the most IHSS hours a severely impaired person can be authorized each month; 195 if not severely impaired (CDSS regulation, rule:max_hours)

Who may qualify

A person may qualify who meets all of:

  • lives in California (rule:resident);
  • has a Medi-Cal eligibility determination (rule:medi_cal);
  • lives at home or a place of their own choosing, not a hospital or care facility (rule:own_home);
  • is aged, blind or disabled and needs help to stay safely at home (rule:who);
  • returns a Health Care Certification (SOC 873) from a licensed health care professional (rule:health_care_certification).

Hours. The county social worker sets the hours at a home visit (rule:home_assessment). Monthly limits through an individual provider:

RecipientMaximum hours per month
Severely impaired283
Not severely impaired195

(rule:max_hours, rule:absolute_max). Pay. The provider's hourly wage is set county by county (rule:provider_wage).

How to apply, and what happens after

Submit an application (SOC 295) to your county IHSS office (rule:apply_where). The doctor's Health Care Certification must reach the county before any hours are authorized (rule:health_care_certification).

StageWhat happensDeadlineWhat loses people their hours
ScreenResidence, Medi-Cal, own home, daily needsMinutesNo Medi-Cal determination yet
ApplySOC 295 to the county IHSS officeSame dayWaiting for a Medi-Cal decision before applying
CertificationSOC 873 from a health care professionalBefore authorizationForm never returned
Home visitSocial worker assesses each taskUNKNOWNUnderreporting needs
DecisionNotice with services and monthly hours (rule:hours_notice)UNKNOWNAccepting hours below need
HireRecipient hires and supervises the provider (rule:hire_provider)Before work startsProvider not enrolled
ReassessEvery year, or on request (rule:annual_reassessment, rule:reassess_on_request)YearlyHours cut at reassessment
AppealState hearing90 days from the notice (rule:hearing_90)Missing the window
The procedure, stage by stage, as data
JSONThe procedure, stage by stage, as data
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"who_acts""Person / family / doctor"
"timeline""No deadline"
"evidence""None"
"failure_mode""Families providing unpaid care without knowing it can be paid"
"model_role""Screen from Medi-Cal status and daily needs"
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10 keys
"id""stage:screen_eligibility"
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"failure_mode""No Medi-Cal determination yet"
"model_role""Route to Medi-Cal first when there is no determination"
"automation_class""A"
10 keys
"id""stage:complete_application"
"order"3
"name""Complete application"
"what_happens""SOC 295 application to the county IHSS office"
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"model_role""Pre-fill from canonical facts"
"automation_class""A"
10 keys
"id""stage:submit"
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"name""Submit"
"what_happens""Application to the county IHSS office"
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"failure_mode""No proof of filing"
"model_role""Record the date"
"automation_class""B"
10 keys
"id""stage:health_care_certification"
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"name""Health care certification"
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"evidence""SOC 873"
"failure_mode""Form never returned; services cannot start"
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"id""stage:home_assessment"
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"name""Home assessment"
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"evidence""Medical information, list of tasks and times"
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"model_role""Prepare a task-by-task list with the time each takes"
"automation_class""C - the assessment is human"
10 keys
"id""stage:decision"
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"what_happens""Notice of Action with authorized services and monthly hours"
"who_acts""County"
"timeline""UNKNOWN"
"evidence""Notice of Action"
"failure_mode""Hours below need accepted"
"model_role""Compare hours with the task list and the 195/283 limits"
"automation_class""A"
10 keys
"id""stage:hire_provider"
"order"8
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"automation_class""B"
10 keys
"id""stage:issuance_use"
"order"9
"name""Services and pay"
"what_happens""Provider works authorized hours; the state pays the provider"
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"timeline""Each pay period"
"evidence""Timesheets"
"failure_mode""Hours not recorded"
"model_role""Track hours against the authorization"
"automation_class""D"
10 keys
"id""stage:renew_recertify"
"order"10
"name""Reassess"
"what_happens""Annual home reassessment; reassessment on request when needs change"
"who_acts""County + recipient"
"timeline""Every year, or on request"
"evidence""Updated medical information"
"failure_mode""Hours cut at reassessment"
"model_role""Request reassessment when needs grow"
"automation_class""B"
10 keys
"id""stage:denial_response"
"order"11
"name""Denial response"
"what_happens""Read the notice: services, hours, reason"
"who_acts""Model + recipient"
"timeline""Immediately"
"evidence""Notice of Action"
"failure_mode""Accepting a cut"
"model_role""Compare with the prior notice"
"automation_class""A"
10 keys
"id""stage:appeal_fair_hearing"
"order"12
"name""Appeal / fair hearing"
"what_happens""State hearing before an administrative law judge; a request before the effective date keeps services unchanged until the decision"
"who_acts""Recipient (legal aid can represent)"
"timeline""90 days from the notice; before the effective date to keep services"
"evidence""Notice, task list, medical evidence"
"failure_mode""Missing the effective date"
"model_role""Draft the request; calendar both dates"
"automation_class""B"

The same facts open other programs

Age, disability and Medi-Cal status open:

Those connections are read from the California benefits graph.

What this article shares with the graph
JSONWhat this article shares with the graph
6 keys
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"B011"
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"B016"
"B073"
"B013"
"B063"
"B001"
"related_programs" 8 keys
"B011""Medi-Cal (Medicaid)"
"B023""SSI + California SSP"
"B024""CAPI (Cash Assistance Program for Immigrants)"
"B016""Multipurpose Senior Services Program (MSSP) + CBAS"
"B073""PACE (Program of All-Inclusive Care for the Elderly)"
"B013""Medicare Savings Programs (QMB / SLMB / QI / QDWI)"
"B063""Older Americans Act meals (Meals on Wheels / congregate)"
"B001""CalFresh (SNAP)"
"triggered_by_events" 2 items
"event:disability_becomes_long_term_permanent"
"event:senior_needs_care_at_home_aging_parent_own_decline"
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"person.address.residential.state" 6 items
"B001"
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"person.identity.date_of_birth" 5 items
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"B001"
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Official addresses

  • Apply: your county IHSS office, with form SOC 295
  • The program, from the state: CDSS IHSS
  • IHSS Service Desk: (866) 376-7066
  • Hour limits explained: Disability Rights California
  • State hearings: CDSS hearing requests, (800) 743-8525; California Department of Social Services, State Hearings Division, P.O. Box 944243, Mail Station 9-17-442, Sacramento, California 94244-2430
Related pages
Beside
Medi-Cal (California Medicaid health coverage): who qualifies, what you get, how to apply, and what happens nextSSI and California SSP (monthly cash for people 65 or older, blind or disabled with very low income): who qualifies, what you get, how to apply, and what happens nextCAPI (California cash aid for aged, blind and disabled immigrants denied SSI): who qualifies, what you get, how to apply, and what happens nextMSSP and CBAS (Medi-Cal care management for seniors and adult day health centers that keep people out of nursing homes): who qualifies, what you get, how to apply, and what happens nextPACE (Program of All-Inclusive Care for the Elderly: all medical and social care from one team, at home instead of a nursing home): who qualifies, what you get, how to apply, and what happens nextMedicare Savings Programs (the state pays Medicare premiums: QMB, SLMB, QI, QDWI): who qualifies, what you get, how to apply, and what happens nextOlder Americans Act meals (Meals on Wheels / congregate) (free group meals and home-delivered meals for Californians 60 and older): who qualifies, what you get, how to apply, and what happens nextCalFresh (California food benefits): who qualifies, what you get, how to apply, and what happens next
References (18)
  1. In-Home Supportive Services (IHSS) Program — California Department of Social Services“The In-Home Supportive Services (IHSS) program provides in-home assistance to eligible aged, blind, and disabled individuals as an alternative to out-of-home care and enables recipients to remain safely in their own homes.”
  2. IHSS: residence — California Department of Social Services“You must be a California resident.”
  3. IHSS: Medi-Cal — California Department of Social Services“You must have a Medi-Cal eligibility determination.”
  4. IHSS: own home — California Department of Social Services“You must live at home or an abode of your own choosing”
  5. IHSS: Health Care Certification — California Department of Social Services“A completed Health Care Certification (SOC 873) must be received by the county prior to authorization of services.”
  6. IHSS: home interview — California Department of Social Services“A county social worker will interview you at your home to determine your eligibility and need for IHSS.”
  7. IHSS: notice — California Department of Social Services“If approved, you will be notified of the services and the number of hours per month which have been authorized for you.”
  8. IHSS: hiring a provider — California Department of Social Services“You are considered your provider's employer and, therefore, it is your responsibility to hire, train, supervise, and fire this individual.”
  9. IHSS: provider pay — California Department of Social Services“Because unions negotiate with the employer of record in each county, the wage rates may vary from county to county.”
  10. IHSS: reassessments — California Department of Social Services“IHSS assessments are completed during home visits at the initial intake assessment and annual reassessments.”
  11. IHSS: reassessment on request — California Department of Social Services“Recipients may request for a reassessment of need at any time if their needs or circumstances change.”
  12. IHSS: how to apply — California Department of Social Services“To apply for IHSS, complete an application and submit it to your county IHSS Office”
  13. MPP Division 30: IHSS hour limits (severely impaired) — California Department of Social Services“The IHSS service hours for a severely impaired recipient receiving services through the individual provider mode of delivery shall not exceed 283 hours per month effective July 8, 1988.”
  14. MPP Division 30: IHSS hour limits (not severely impaired) — California Department of Social Services“shall not exceed 195 hours per month effective July 8, 1988”
  15. Understanding the Maximum Amount of Hours Available and Calculating Hours — Disability Rights California“The maximum amount of IHSS hours an individual can get is 283 hours per month.”
  16. Overview of the IHSS Program (fact sheet) — California Department of Social Services“A friend or relative may serve as your care provider”
  17. IHSS Recipient Resources: contact — California Department of Social Services“IHSS Service Desk (866) 376-7066”
  18. State Hearing Requests — California Department of Social Services“you have 90 days to request a state hearing.”