14 Myths about In-Home Supportive Services (IHSS) for Minors

Published: Dec. 5, 2023Updated: Apr. 24, 2024

In-Home Supportive Services (IHSS) can be a crucial program for families raising kids with disabilities, providing the specialized child care our kids need right at home. It's a lifeline for many families across California, but it can also be overwhelming and confusing for parents to navigate, like so many of these systems in which we operate. On a daily basis, Undivided Navigators receive questions about IHSS eligibility, how hours are calculated, whether young kids can qualify, how to demonstrate the need for more services, and more.

We want every eligible family to understand what IHSS can offer, how they can access these vital supports, and what to do when they disagree, so we sat down with Undivided Public Benefits Specialist Lisa Concoff Kronbeck to get answers to some common questions — and misconceptions — about IHSS.

Myth #1: IHSS is “just being paid to stay home and take care of your kids.”

At the core of In-Home Supportive Services is making sure our kids with significant care needs can grow up in their own communities. As Kronbeck explains, IHSS is “a Medi-Cal service designed to help elderly people and people with disabilities to stay safely in their homes by providing funding for home care for tasks that [they cannot] do on their own. Their inability to do that is potentially jeopardizing their risk of remaining at home instead of being institutionalized.”

She emphasizes that IHSS is not “just being paid to stay home and take care of your kids. What's happening is some of our children with disabilities are eligible under the IHSS regulations to qualify for home caregiving. And IHSS allows parents to be paid as that care provider in certain circumstances.” To learn more about becoming a parent provider, check out this article about IHSS providers.

Myth #2: IHSS is income based.

IHSS is a Medi-Cal program. While it’s true that Medi-Cal has income restrictions, Kronbeck explains, “There are several Medi-Cal programs that allow people with disabilities to access Medi-Cal, regardless of income.” One program that Undivided often helps families access is the institutional deeming waiver, which can allow Regional Center clients to receive full Medi-Cal benefits no matter their family’s income.

Myth #3: IHSS is only for kids of a certain age range.

Some families think their children don’t qualify for IHSS because they’re told over the phone, “Your child is too young,” or “Call back when your child is a certain age.” Kronbeck reminds us that IHSS hours are “tied to what kind of care a parent would be expected to provide to a typically developing child of the same age. So to the extent that your child has extraordinary care needs that exceed that, they can't deny based just on age.”

If you’re applying for IHSS for the first time and you’re told that your child is too young, Kronbeck recommends this response: “I understand. I would like to apply anyway. If my child is denied, they can send me a written notice of action.” The reason is because if you appeal the denial and your child is later found eligible, IHSS will pay retroactive benefits to the date you first applied, potentially up to 90 days prior to the application date. (We previously hosted a full event about applying for IHSS with a child under age 5, so be sure to check it out if this is your situation!)

Myth #4: IHSS is only for services at home.

While IHSS hours are primarily calculated based on at-home care needs, there are some exceptions for spending time in the community and attending medical and therapeutic appointments. For the details, listen to Kronbeck’s explanation in this clip:

If your family will be on vacation, Kronbeck says it can get “a little murky” as to whether you can bill for IHSS hours away from home. Ideally, you’ll let your case worker know beforehand so that you can get those hours approved, but it’s largely on a case-by-case basis.

Myth #5: You can’t be an IHSS parent provider if you work.

As of February 2024, IHSS has updated the rules on which parents can qualify as a paid provider, so even full-time working parents may now be eligible. You can check out this article for the full details.

Myth #6: You can’t be a paid parent provider for more than one child.

If you have two children who qualify for IHSS, you can be the paid provider for both of them. However, you’ll have to do more calculating when it comes to their maximum weekly hours, and you may have to apply for an exception to get more hours. Hear the details in this clip:

Myth #7: Your child can get IHSS hours based on their diagnosis.

It’s important not to make assumptions about the IHSS hours your child could qualify for based on their diagnosis alone. Kronbeck says simply, “Every child is assessed based on their individual needs. The hours will be awarded based on that particular child and not based on their diagnosis.” To learn more about who qualifies and how hours are calculated, see our article all about IHSS eligibility.

Myth #8: You can get protective supervision for your child’s aggressive behavior.

Protective supervision is a service provided by IHSS for children who need constant monitoring to prevent harm to themselves or others because they don’t understand the consequences of their actions. However, Kronbeck reminds us that the word “aggression” can mean something different to IHSS than it does to doctors and behaviorists. “Somebody will say, 'Oh, my child has aggressive behaviors. Can I apply for protective supervision?' My first question is, does the child know that he can hurt somebody by those behaviors? Is he trying to hurt somebody? Or is he just having sensory input issues? Is he just frustrated and lashing out and not understanding that he can hurt somebody? And if they say he doesn't understand that he can hurt someone, then I say then don't use the word aggression.”

Myth #9: You have to prove that your child injures themselves to get protective supervision hours.

IHSS will require you to submit a log of your child’s dangerous behaviors to assess the need for protective supervision. It’s important to document not just times when your child actually injured themselves but also times when you had to intervene to prevent injury. Kronbeck says, “Keep track of dangerous behavior, whether there's actual injury or not. Because if you have a child who needs protective supervision, you know that you are intervening to keep them safe multiple times per day, sometimes multiple times per hour. IHSS needs to be aware of how much supervision they require in order to not get injured. Make sure that your child's doctor is aware of these behaviors and the energy that you put into keeping your child safe because the doctor is the one who needs to fill out the forms. You want them filled out by somebody who knows your child and knows their history, their limitations, and their cognitive impairments.”

Undivided members have access to a step-by-step guide to applying for protective supervision in our app, including a dangerous behavior log template, so ask your Navigator if you need this!

Myth #10: Your child has to be a certain age to get protective supervision.

Kronbeck notes that young children may qualify for protective supervision if caregivers have to intervene to prevent them from removing life-saving equipment, such as a G tube or trach, because they don’t understand the consequences of their actions. Even toddlers who are not ambulatory might pull out their equipment and risk injury. Kronbeck reiterates that no matter how old your child is, IHSS will be comparing their care needs with a typically developing child of the same age, so “if your child needs more close supervision, you better be prepared to document it and substantiate that claim.”

However, not all medical issues qualify for extra hours. Hear Kronbeck’s explanation in this clip:

Myth #11: Once your child gets protective supervision or paramedical service hours, you’ll get them every year.

Kronbeck says renewal of protective supervision or paramedical services is not automatic. “They may not ask you to renew it every single year. But they usually will every couple of years. They'll let you know, when they send you the notification that you have your annual visit, they will include a new copy of the paramedical services form, and it will be checked on the form that you need to have an updated one.”

Myth #12: Your case worker will automatically assess your child for protective supervision or paramedical services

Kronbeck says, “If you don't request it, you are not going to get it.” Case workers are supposed to provide information about these services to families of children with developmental disabilities, but that does not always happen. Make sure you request the forms for protective supervision and/or paramedical services. You’ll also want to make copies of everything you submit in case anything gets lost in the bureaucratic shuffle. Hear more tips about the evaluation process in this clip:

Myth #13: If you get denied IHSS, that’s it.

You have the chance to appeal any IHSS decision, whether you receive a denial for your initial application or a reduction of services later down the road. For details about the appeal process and what to expect, check out this clip:

Myth #14: The Career Pathways incentive program ends in 2023.

The Career Pathways program has been extended until September 2024, so parent providers can continue to take paid training classes and claim the incentives. See our full article for more information about this program, the new deadlines, and the many ways Undivided can help parents find classes, stay organized, and get paid for their time!

Thank you to Lisa Concoff Kronbeck for answering so many of our questions! To see the full recording and transcript of this event, check out IHSS under age 18.

If you have further questions about IHSS, your Undivided Navigator can provide support and even set up a free consultation call with our Public Benefits Specialist for 1:1 help. (Get started here if you don’t have a Navigator yet!)

Be sure to sign up for our newsletter to learn more about upcoming free events, and join our private Facebook group to get your questions answered by fellow parents in our supportive community!

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