What is IHSS?
In-Home Supportive Services (IHSS) is a California statewide program that helps seniors, people with disabilities, or those who are blind continue living safely at home. Run by each county under the California Department of Social Services, IHSS offers critical in-home care for those with limited income—making independence possible for thousands every year.
The Four IHSS Program Types
IHSS includes four program types, all offering similar services but with different eligibility requirements:
- CFCO: For Medi-Cal recipients who need nursing-home-level care. Most IHSS recipients qualify under this program.
- PCS: For those eligible for Medi-Cal based on age, blindness, or disability, but who don’t qualify for CFCO.
- IPO: For Medi-Cal recipients who are parent providers for minor children, spouse providers, advance pay, or meal allowance cases.
- IHSS-R: For those who don’t meet other requirements—typically individuals with Satisfactory Immigration Status and no federal reimbursement.
What Services Does IHSS Provide?
- Domestic Services: Meal preparation, cleaning, laundry, garbage removal
- Personal Care: Bathing, dressing, grooming, feeding, toileting
- Paramedical Tasks: Help with medications, injections, bowel/bladder care
- Protective Supervision: Monitoring for those with cognitive/mental impairments
- Medical Transportation: Rides and accompaniment to appointments
IHSS Eligibility—Who Can Apply?
- California resident receiving SSI/SSP or Medi–Cal
- Blind, disabled, or age 65+
- Living at home, apartment, or non-institutional setting
- Unable to live safely at home without help
Note: Residents of care facilities can apply if they’re planning to move home and need IHSS services in place.
IHSS Financial Requirements
To qualify for IHSS, you must have Medi-Cal. Those with no “share of cost” get full coverage. Higher-income individuals may qualify with a share of cost (SOC) through the Blind-Disabled Medically Needy Program (ABD-MN), and pay their SOC before receiving IHSS-covered care. You’ll receive Notices of Action (NOA) for your SOC amount and IHSS approval.
How to Calculate Share of Cost (SOC)
- Start with all earned (wages, tips) and unearned income (Social Security, disability, etc.)
- Deduct a $600 Maintenance Needs Allowance (MNA) for single adults
- Subtract $20 from unearned income
- Deduct health insurance premiums
- Subtract $65 from earned income (plus another $20 if no unearned income)
- Deduct approved work expenses for disabilities
- Subtract half of the remaining earned income
Who Provides IHSS Services?
Service delivery varies by county. Options include:
- Contract: County contracts with outside agencies
- County Homemaker: County trains and employs caregivers
- Independent Provider (IP): Client hires, supervises, and can select their own provider (often a family member)
Public Authorities in many counties help improve IP service quality and negotiate wages/benefits. IHSS payments are made directly to the provider by the State Controller’s Office.
How to Apply for IHSS: Step-by-Step
- Contact Your Local Department of Social Services: Find your county IHSS office to start your application.
- Submit Your Application: A social worker will visit your home for a needs assessment and review your ability to perform daily living activities.
- Medical Certification: Have your doctor complete the SOC 873 form to confirm you need IHSS services.
- Needs Assessment: The social worker evaluates your situation and determines service needs and hours.
- Approval & Service Hours: If approved, you’ll be notified of your authorized monthly hours.
Helpful Resources
How Does IHSS Decide How Many Hours I Get?
The State limits hours to 195/month for non-severely impaired and 283/month for severely impaired. Each client’s needs are reassessed annually or if health/care needs change.
- Physical/mental condition and daily living skills
- Statement of need
- Physician’s records
- Other relevant info gathered by the case manager
Need Help Applying or Understanding IHSS?
We offer free support and guidance! If you’re unsure how to apply, calculate share of cost, or maximize your hours, contact our team for a free senior care consultation. Let All Seniors Foundation help you get the care and benefits you deserve.
