IHSS helps people who are older, blind, or disabled live safely at home instead of in a facility. If you qualify, the program pays a caregiver (often a family member or friend) to help with day-to-day needs.
Contant the California Department of Social Services

who qualifies (the quick version)

You may be eligible if all of the following are true:

• You’re a California resident and live at home or an abode of your choosing (a house, apartment, hotel/motel, shelter, or a relative’s home). Hospitals, nursing homes, and licensed community care facilities do not count as “own home.” California Department of Social Services
• You’re Medi-Cal eligible (or become eligible through a waiver—see below). California Department of Social Services
• A health care professional confirms you need help with daily activities to remain safely at home (via the SOC 873 Health Care Certification). California Department of Social Services
• Friendly note: “Own home” is flexible—it can include shelters and other temporary living arrangements if services can be provided safely. Source: California Health Care Foundation.

financial eligibility (Medi-Cal basics + helpful waivers)

• Standard path: Most adults qualify for Medi-Cal if their income is at or below program limits (updated annually). IHSS requires a Medi-Cal determination first. Covered California
• For children and adults with developmental disabilities (through Regional Centers): Ask about the Home & Community-Based Services Developmental Disability (HCBS-DD) Waiver—often called “institutional deeming.” This lets eligible Regional Center clients get Medi-Cal without counting parental income, so IHSS can be authorized when medically needed. Regional Centers help start this process. DHCS and Department of Developmental Services
• Where to learn more: DHCS Medi-Cal Waivers overview and the DD Waiver page. DHCS

medical eligibility (what the county looks for)

After you apply, a county IHSS social worker visits your home to assess safety and your need for help with activities like bathing, dressing, meal prep, and more. Your clinician completes SOC 873 to confirm that without IHSS you’d be at risk of out-of-home placement. California Department of Social Services

home / habitat requirement

IHSS services are provided only in your own home (as defined above). They can’t be provided while you’re admitted to a hospital or living in a licensed facility. California Department of Social Services

what caregivers can be paid to do (examples)

IHSS authorizes specific tasks based on your needs. Common categories include:

• Domestic services: sweeping, mopping, cleaning the kitchen/bathroom, taking out trash, changing bed linens. pascc.org
• Related services: meal planning and preparation, grocery shopping (making a list, going to the store, unloading, storing), and laundry. California Department of Social Services
• Personal care services: bathing, dressing, grooming, toileting, feeding (including cutting food), help with mobility/transfer, help with self-administration of medications (reminding/handing meds). California Department of Social Services
• Accompaniment to medical appointments and some “alternative resource” visits (like county offices), including waiting time. pascc.org
• Protective Supervision (when needed for a person who cannot safely be left alone due to cognitive impairments). Disability Rights California
• Paramedical services (only when ordered by a licensed health professional on SOC 321 and the provider is trained): injections, catheter care, tube feeding, wound care, and other tasks that require sterile technique or clinical judgment. California Department of Social Services
• One-time “Yard Hazard Abatement” to remove weeds/grass/rubbish when it’s a safety/fire hazard (this is not general gardening). California Department of Social Services
• Heavy cleaning (limited; usually once) when needed to make the home safe. Justice in Aging

Not covered: Routine gardening, home repairs or improvements, services for other household members, and services while the recipient is in a hospital or facility. California Department of Social Services

Important clarification about injections & “nursing-level” care: IHSS does not pay for general nursing; however, if your clinician orders a paramedical service and trains the caregiver (documented on SOC 321), IHSS can cover it. California Department of Social Services

who can be the caregiver?

Many people choose someone they already know and trust.

• Family members and friends can be paid IHSS providers (they must pass background checks, complete orientation, and enroll). California Department of Social Services
• Parents of minor children and spouses can often be paid providers when program rules are met. California Department of Social Services
• Counties also have Public Authority registries to help match recipients with local caregivers, but most IHSS providers are relatives—over 70% statewide—which reflects both family preference and a broader caregiver shortage. Public Policy Institute of California

Reality check: Finding a non-family caregiver can be hard in many areas due to workforce shortages across home care. If you need help searching, ask your county Public Authority for its registry and backup system options. California Health Care Foundation

how to apply (step-by-step)

1. Start your application with the county IHSS office. You can call or submit the SOC 295 Application for In-Home Supportive Services. California Department of Social Services
2. Have your clinician complete the SOC 873 Health Care Certification. Counties generally need this within 45 days to proceed. California Department of Social Services
3. Home visit / assessment. A social worker will meet you at home to evaluate safety and the help you need with daily activities. California Department of Social Services
4. Approval notice (or denial with appeal rights). If approved, the county will list your authorized services and monthly hours. California Department of Social Services
5. Choose and enroll your caregiver. You (or your authorized representative) are the employer: you hire, train, supervise, and can change providers at any time. Use SOC 426A / SOC 847 for provider enrollment and SOC 426/429/2256 for timesheet/workweek forms, as directed by the county. California Department of Social Services

Helpful county “how to apply” pages (examples): Los Angeles DPSS (clear checklists & forms), San Francisco HSA (45-day SOC 873 tip), and Solano County (mail/fax option). Department of Public Social Services and SFHSA

what to expect before approval

While your application is processing, here’s what typically happens and how to get ready.

after you apply

• You’ll get a call or letter from the county to confirm your application and explain next steps. Keep your case number handy and save every notice you receive.
• The county will ask for your Health Care Certification (SOC 873). Many counties expect this within about 45 days, so let your clinician know it’s time-sensitive.
• The county will schedule a home visit. You can request an interpreter and have a support person or authorized representative present.
• If your Medi-Cal is still pending, the county will verify eligibility first. If you use Regional Center services, tell your worker in case waiver pathways apply.

prepare for the home visit (quick checklist)

• A daily schedule that shows when help is needed (good days and bad days). Be specific about safety risks and supervision needs.
• A current medication list, equipment used (like wheelchair, shower chair), and any recent hospital or clinic notes.
• The completed SOC 873 (if available) and any clinician notes describing why help at home is needed.
• A list of tasks you need help with: bathing, dressing, meal prep, mobility, laundry, shopping, cleaning, and transportation to medical visits.
• If paramedical tasks may be needed (like injections or tube care), draft a task list to review with your clinician for possible SOC 321 orders.
• For protective supervision, keep a brief incident log (wandering, falls, seizures, unsafe behaviors) to show why constant monitoring is needed.

during the home visit

• The social worker will ask questions, observe how you move around your home, and review your typical day and safety concerns.
• Be honest about difficult days and how fatigue, pain, or cognition changes your abilities. Demonstrate where help is needed.
• Mention any time-limited needs (heavy cleaning or yard hazard abatement) and any paramedical tasks a clinician may order.

while you wait for a decision

• You can start lining up a caregiver now and begin provider enrollment steps (orientation, background check), but payment only starts after approval.
• Respond quickly to county calls or letters asking for information. Missed calls can delay your case.
• If your condition changes before the decision, notify the county so the assessment reflects your current needs.

timelines and start date

• Processing times vary by county and workload. Many cases are decided within several weeks after the home visit and receipt of required forms.
• If approved, your authorized hours may be set based on your assessed needs and can sometimes apply back to your application date. Payment begins only after provider enrollment and timesheets.
• If you disagree with the decision, you’ll have the right to appeal within a set timeframe.

what to expect after approval

• You’ll get a service plan with your monthly hours. Average hours statewide are ~124 per month, but yours will be based on your individual needs. Legislative Analyst’s Office
• You and your provider submit electronic timesheets (or via telephone) for payment after hours are worked. California Department of Social Services
• If needs change, you can request a reassessment at any time.

guidance for friends who provide care

Friends can be paid IHSS caregivers when program rules are met. Use this quick list to set yourself up for success.

• Complete provider enrollment steps: orientation, background check, and timesheet setup. Payment starts only after approval and enrollment are finished.
• Work only on the tasks the county authorizes in the service plan (for example, personal care, domestic/related services, and accompaniment to appointments).
• Set clear expectations with the recipient about days, hours, transportation, and communication, and line up a backup plan for emergencies.
• Keep brief notes on what you did each day and any changes in condition or safety incidents, and share updates with the recipient or authorized representative.
• Only perform “nursing-type” tasks if a clinician orders them and trains you as paramedical services (for example, via SOC 321); otherwise, they are not covered.
• IHSS cannot pay for services while the person is in a hospital or licensed facility, but you can still coordinate plans and prepare supplies during that time.
• Ask the county Public Authority about registry resources, basic training, and any backup provider options that can support your role.
• Track hours accurately and submit timesheets on schedule. Be mindful of overtime rules, and note that special tax rules may apply for live-in arrangements.