IHSS, or In-Home Supportive Services, is an alternative to out-of-home care such as a nursing home or group home. It covers the following types of services: Personal care (bathing, grooming, feeding, bladder/bowel etc.), light housework (cleaning, meal preparation, laundry etc.) and for individuals with mental impairment, also covers protective supervision.
To be eligible for IHSS, the applicant must reside in California and have a Social Security Number. They must be receiving Medi-Cal (the Medicaid program in California), be disabled, and be unable to live at home safely without help.
The process is to obtain Medi-Cal waiver (aka Institutional Deeming) and then apply for IHSS. For Regional center clients, the Case Manager can make the referral to initiate the Medi-Cal waiver process. Only the child’s income is considered in determining eligibility, though the application asks for financial details of the parent or primary caregiver. Regional Center Services (respite, daycare etc.) are not affected by the Medi-Cal application.
After obtaining Medi-Cal waiver you can contact the County’s Social Service Agency to begin the IHSS application process. Once paperwork is submitted a Social Worker visits the home to assess the child’s functioning level and determine the amount of time to be allotted for the performance of routine daily-living tasks. Hours are authorized based on the additional time the child needs to perform these tasks, as compared to a typical (non special-needs) individual of the same age. Children with major behavior issues may also qualify for protective supervision, i.e. additional hours. Before the Social Worker’s home visit it will be a good idea for the parent to observe and document the time taken for various tasks (brushing, bathing, dressing, feeding etc.).
Once IHSS services are approved the county agency can provide referrals to providers, or the family can hire individuals known to them. A family member (e.g. grandparent) can be an IHSS provider. They need to have SSN and should be authorized to work legally in the US. All providers have to undergo background check and drug screening, and attend orientation training. The pay is $12.20 an hour. The provider has to submit timesheets twice a month, and is paid via Check or Direct Deposit. The income is subject to applicable tax rules.
CA Department of Healthcare Services
In-Home Supportive Services
IHSS Public Authority – for Santa Clara County: 408-350-3206
Alameda Social Services – for Alameda County: 510.577.1800