In-Home Supportive Services (IHSS) 101

In-Home Supportive Services (IHSS) is a Medi-Cal program that provides home-based personal care and related services so that people with disabilities can remain safely in their communities instead of institutions. Part of a broader network of Medi-Cal-funded supports, the IHSS program will help pay for certain services for an eligible child with a disability to remain safely in their own home.

Your child must be enrolled in Medi-Cal before you apply for IHSS. If your family's income exceeds the Medi-Cal threshold, you may be able to enroll in Medi-Cal using the institutional deeming waiver.

Authorized services may include:

• Personal care services
• Meal preparation
• Accompaniment to your child’s disability-related medical appointments
• Paramedical services: These are services prescribed and supervised by a medical professional, such as the administration of meds, home therapy programs, tube-feeding, blood sugar monitoring, and wound care.
• Protective supervision: This is for children whose severely impaired judgment, orientation and/or memory puts them at risk of self-injury or injuring others.

IHSS services generally must be provided in the recipient’s home (aside from exceptions such as accompaniment to doctor visits). However, IHSS recipients are not required to remain in their homes at all times. If your child is allotted a certain amount of time for diapering or g-tube feeding, for example, that doesn’t mean that every single diaper change or tube-feeding you carry out must take place in the home.

IHSS providers cannot be paid for services rendered at the recipient’s home while the recipient is away on vacation, out of the country, or in the hospital. IHSS providers also cannot be paid for providing direct care to the recipient during a hospitalization. If your child is hospitalized, you should notify your child’s caseworker. You cannot bill for IHSS services on a day that your child spent fully inpatient, but you can bill for services performed at home on the day of admission and for services performed at home on the day of discharge.

If your child is out of the state or country for more than 30 days, their eligibility for IHSS may be impacted due to state residency rules. If your family is traveling out of state, you may wish to speak with your service coordinator ahead of time and get written approval to bill hours during this time, and, if you will be traveling for an extended period, to make sure that IHSS eligibility itself is not disrupted. You can review the Manual of Policy and Procedures, sections 30-770 for further details.

If your child’s extensive disability-related needs at home require more care than a typically developing child of the same age, and you currently provide that care, you may be paid to serve as your child's IHSS provider. You can also hire a third party, such as another family member, a friend, or a trained professional found through an agency. For more information, see our article on finding or acting as an IHSS provider.

All IHSS providers must be eligible to work in the United States and are required to complete a background check and fingerprinting (there is a LiveScan fee for this requirement) as well as an orientation session.

Your parent provider income is tax exempt and cannot be deemed to your child due to their income-based eligibility assessments for other benefits like SSI or Regional Center co-pay assistance.

For more information about IHSS, see our articles about how to apply, how to choose a provider, and how to appeal a denied application. You can also learn more about accessing IHSS with this advocacy guide published by Disability Rights California (it’s available in sixteen languages!).

If you're in LA County, you can access the IHSS Helpline chat or call (888) 822-9622.