IHSS and the State of California: Oversight, Funding, and Policy

While counties run the day-to-day operations of IHSS, the State of California sets the rules, funds the program, and negotiates policy. Every caregiver and recipient depends on decisions made at the state level — from the Governor’s annual budget to bills passed in the Legislature. The state’s role is less visible than the county office you call for payroll or reassessments, but it is just as important. Understanding how IHSS and the state interact helps explain why wages rise (or stall), how benefits are shaped, and why policy reforms matter for caregivers and clients alike.

How the state oversees IHSS

The California Department of Social Services (CDSS) administers IHSS statewide. It issues regulations, enforces rules, and provides funding streams that counties rely on. The Governor and Legislature control the IHSS budget, while courts sometimes step in on disputes over worker protections or program eligibility. Unions and advocacy groups also lobby the state for changes, making Sacramento a constant battleground for the future of home care.

• CDSS: Issues program regulations, guidance to counties, and oversees compliance.
• Budget: The Governor’s annual budget and legislative negotiations decide IHSS wages, hours, and funding priorities.
• Courts: Legal decisions can change how eligibility and labor protections are applied.
• Advocacy: Statewide unions (like SEIU 2015) and disability rights groups push for stronger funding and protections.

Where the state gets it right

When the state invests in IHSS, the benefits ripple across every county. Wage increases approved in the state budget set new minimums. Laws like paid sick leave or overtime protections come from Sacramento, not county boards. The state also funds training initiatives and caregiver registries that improve safety and quality of care. In short, strong state action creates consistency and raises the floor for everyone, regardless of where they live.

• Raising statewide wage floors through legislation or budget allocations.
• Funding caregiver training and safety programs.
• Creating labor protections like overtime pay and paid sick leave.

Where the state falls short

Even though the state has enormous power over IHSS, it often fails to act with urgency. Wage increases are limited by budget politics, leaving caregivers in many counties stuck near minimum wage. Structural problems — like the lack of Social Security contributions for live-in family providers — remain unfixed, despite years of advocacy. Bills like AB 283, which would shift bargaining to the state level, are promising but can stall in the Legislature. At times, the state’s approach has been more about controlling costs than supporting caregivers and clients.

• Delayed or stalled legislation that would improve wages and benefits.
• Budget fights where IHSS is used as a bargaining chip.
• Failure to resolve long-term issues like retirement security and health coverage.

Why the state matters

The state’s decisions touch every caregiver and recipient in California. Counties may handle payroll or assessments, but Sacramento sets the rules of the game. Whether it’s a new wage floor, a rule change in eligibility, or funding for caregiver support programs, state action shapes the everyday lives of hundreds of thousands of families. For advocates, this means that keeping pressure on the Governor and Legislature is just as important as pushing county boards.

Bottom line: IHSS is a state-run program delivered at the county level. Counties handle the mechanics, but the state decides the resources, protections, and policies that define the system. When the state leads boldly, IHSS grows stronger everywhere. When it hesitates, families and caregivers feel the strain. Understanding the state’s role is key to seeing the full picture of IHSS.