5 Steps to Get IHSS for Kids Under Age 5

Many parents are told that their child is too young to qualify for In-Home Supportive Services (IHSS) under age 5, but your IHSS application can’t be denied simply based on your child’s age!

We sat down with Undivided’s Public Benefits Specialist Lisa Concoff Kronbeck for a breakdown of what’s involved in the application process and tips for how to make the most of this program.

IHSS is a Medi-Cal program, meaning your child must be enrolled in Medi-Cal before you can apply for IHSS. (If your child already has primary health care coverage, you can enroll them in Medi-Cal as secondary coverage!)

The most straightforward way your child may qualify for Medi-Cal is based on household income. The threshold for children is different for adults than for children, so even if you don’t qualify for Medi-Cal, your child might. You can use this Covered California chart to see if your child would qualify based on your household income. For children, the threshold for Medi-Cal eligibility is 266% of the federal poverty level.

If your household income is still too high to qualify your child for Medi-Cal, the other way to enroll is via a waiver program. The HCBS-DD waiver for Regional Center clients lets Medi-Cal look at only your child’s income (which probably isn’t much!), not the whole household, to determine eligibility. Learn more about Medi-Cal waivers in this clip:

Once your child is enrolled in Medi-Cal, you can apply for IHSS by phone or by submitting a paper application to your local IHSS office. If you don't know the contact information for your county's office, there is a complete list of IHSS offices on the CDSS website.

Check out our article How to Apply for In-Home Supportive Services (IHSS) for more information on what the application process entails — or if you’re an Undivided member, use the step-by-step guide in the Undivided app for an easy walkthrough.

During the application process, you may be required to have your child’s doctor complete forms indicating that your child needs certain services at home. The two main IHSS services Lisa addressed in this live event are paramedical services and protective supervision, which is where most of the IHSS hours are assigned for children under age 5.

Paramedical Services

Paramedical services, Lisa says, are “services that are ordered and directed by the doctor or another licensed medical provider,” such as g-tube feeds, injections, monitoring vital signs, “anything where you have to be trained in order to to know how to do that thing.” IHSS will want to see form SOC 321, signed by your child’s doctor(s), that details the services your child needs, how long each service takes, and how often they need it.

Here are Lisa’s tips for filling out this form:

Lisa says, “I also suggest that if your physical therapist or occupational therapist has a home plan for you to reinforce what's happening during sessions, that they write out a home treatment plan to quantify what you're doing, how often you should be doing it, and for how long. And then on the paramedical services form, have the doctor write ‘home therapy plan as directed by the therapist’ and attach a copy of the home plan.” Following the home therapy plan takes time, so make sure IHSS knows how long you’re spending on all your child’s care.

Protective Supervision

Protection supervision hours can be assigned to IHSS recipients who need 24/7 monitoring so that they don’t accidentally injure themselves or others. As Lisa explains, a key part of protective supervision is that due to the child’s disability, they don’t understand that their actions could be harmful. She says, “In order to get protective supervision for a young child, you need to show that they need more supervision and more close supervision than a typically developing child of the same age.”

Form SOC 821, which needs to be signed by your child’s doctor, is used to document this need. Ideally, you’ll keep a behavior log showing specific times when your child has been injured or when you’ve had to intervene to prevent injury. However, if don’t have time to create a detailed log because your appointment is so soon, Lisa says, “make a running list of all the different things you can think of that your child has done at random times when they've been injured or when you stopped them from getting injured because of their impaired judgment, orientation, or memory. Another thing you can do is write out a schedule of your typical day and at each point along the way, talk about the different ways that your child, if unsupervised, would encounter danger.” Here’s a sample hazard log to get you started!

Lisa addressed this commonly asked parent question during our live event: If you’re a parent provider, can you claim IHSS hours when you’re transporting your child to a medical appointment? The answer has to do with whether you’re providing paramedical or protective supervision services during that transportation and appointment.

Thank you to Lisa for covering a topic that’s often difficult for families to navigate! You can watch the full replay of our event here, where Lisa goes in detail about the application process and also answers some questions that parents asked in the chat during our livestream. We highly recommend revisiting the full video because it’s packed with helpful tips!

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