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In-Home Supportive Services: How to Apply, How to Survive, How to Push for Change

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IHSS in California: How to Get Help at Home

Overview

The In-Home Supportive Services (IHSS) program helps eligible Californians who are older, blind, or disabled live safely at home—rather than in a facility. IHSS can pay for help with daily activities (like bathing, dressing, cooking, cleaning, and more). Most people “self-direct” their care: you choose your provider (often a family member or friend), set the schedule, and approve timesheets.

Who Qualifies

  • California resident with Medi-Cal (or applying for Medi-Cal at the same time).
  • Lives at home (a house, apartment, hotel, or relative’s home)—not a hospital or licensed facility.
  • Needs help to stay safe at home due to age, blindness, or disability.
  • Sends a Health Care Certification (SOC 873) signed by a licensed health professional.

Good to know: Some people qualify for no-cost Medi-Cal; others have a “share of cost.” Either way, you can still be found eligible for IHSS if the care is necessary to remain safely at home.

Services Covered

  • Domestic & related services: light cleaning, laundry, shopping, meal prep & cleanup.
  • Personal care: bathing, dressing, grooming, toileting, feeding, mobility/transfer help.
  • Paramedical tasks: provider-performed care ordered by a clinician (e.g., catheter/colostomy care, injections, wound care).
  • Protective supervision: monitoring for people with cognitive impairments to prevent injury.
  • Accompaniment to medical appointments and other approved health-related trips.

What IHSS does not cover

  • Paying bills, pet care, gardening/repairs, moving furniture, social outings, or “sitter” time not tied to care needs.

How to Apply

Application Steps

  • Start your application (SOC 295). Contact your county IHSS office to apply by phone, online (if available), or in person.
  • Have your clinician complete SOC 873. This confirms you need IHSS to live safely at home.
  • Home visit & assessment. A county social worker reviews what help you need and how many hours fit those tasks.
  • Get your Notice of Action (NOA). If approved, it lists each authorized service and your monthly hours.
  • Choose a provider. Hire a family member/friend or request matches from the county Public Authority registry.
  • Set up timesheets. Providers submit time via the Electronic Services Portal (ESP) with Electronic Visit Verification (EVV); you approve.

Timing & tips

  • Approval timelines vary; missing documents (like SOC 873) are the most common delay—send them promptly.
  • Bring meds lists, recent visit notes, and a simple “day-in-the-life” summary to your home visit—this helps justify hours.

Caregiver Role

IHSS is consumer-directed. If you’re approved, you are the employer of your individual provider. That means you pick the person, set the schedule, train and supervise them, and approve timesheets. The State processes pay; some providers may qualify for benefits and overtime depending on county rules and hours worked.

  • Who can be a provider? Often a family member or friend; many counties also offer a Public Authority registry with pre-screened caregivers.
  • Enrollment matters. All providers must complete provider enrollment (background check, orientation, tax forms) before starting paid hours.
  • Timesheets & EVV. Providers clock in/out and submit time; you review and approve in ESP.

FAQ

How many IHSS hours can someone get?

It’s individualized. The county assesses your needs and authorizes tasks by minutes/hours. Statewide caps are roughly up to 195 hours/month (most recipients) or up to 283 hours/month for “severely impaired” recipients or when protective supervision is approved.

Can I choose a relative as my provider?

Often, yes. Many recipients hire a spouse, parent, adult child, or other relative who completes provider enrollment. (Rules can differ for minor children and certain program types, but most families can designate a relative provider.)

Does IHSS provide 24/7 coverage?

No. IHSS has monthly hour limits. If you need more support than IHSS hours cover, ask about other programs (for example, managed-care “Community Supports”) that may supplement short-term or overflow needs.

What if I’m denied or think my hours are too low?

You can request a state fair hearing. Check your Notice of Action for how to appeal and deadlines. You can also submit new information if your needs changed.

Can I apply before leaving a facility?

Yes. If you have a planned discharge back to the community, you can start the IHSS process so services are ready (or close) when you return home.

Do I need Medi-Cal first?

You can apply for Medi-Cal and IHSS at the same time. If you already have Medi-Cal, IHSS can move faster once your SOC 873 is submitted and your assessment is complete.

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