Understanding the IHSS Program:
A Guide for Home-Based Care in California

The IHSS program is designed to offer in-home care for eligible elderly, visually impaired, and disabled persons, providing a preferable alternative to institutional care and helping beneficiaries live safely in their own residences.

Program Eligibility

• Key requirements for IHSS candidates and beneficiaries:
•  Residency in California is a must.
• Determination of Medi-Cal eligibility is required.
• Your residence should be your own home or a place of your choosing (settings like acute care hospitals, long-term care facilities, and licensed community care facilities don’t qualify).
• Submission of a complete Health Care Certification form is essential.

Program Mechanics

Your eligibility and need for IHSS services are determined through a home visit by a county social worker. The social worker evaluates your capacity to perform certain tasks independently and decides the necessary services and the hours allocated for each. This evaluation considers input from you and, if relevant, from your relatives, friends, doctor, or other licensed health care professionals.

• Before any service approval, the county must receive a filled-out Health Care Certification (SOC 873).
• Notifications will be sent regarding IHSS approval or denial. Denials will include reasons, while approvals will detail authorized services and monthly hours.
• Upon approval, it’s your responsibility to employ a provider for the approved services. As an employer, you’re responsible for hiring, training, supervising, and, if necessary, dismissing this provider.
• In some counties, contracted IHSS providers or county homemakers may be available as service options.

Payment Process for IHSS

Contact your assigned social worker to learn about the hourly pay rate in your county, which varies due to union negotiations. The State handles all payment checks to individual providers and deducts amounts for disability insurance and Social Security taxes where applicable.

Assessment of Needs

IHSS conducts initial and annual home visit assessments, and recipients can request reassessments whenever their needs or situations change. County social workers actively oversee recipient cases and maintain regular communication to ensure that program services meet their needs. These assessments are based on various criteria, including the Functional Index Rankings, Annotated Assessment Criteria, and Hourly Task Guidelines (HTGs).

Service Authorizations

Service authorizations are determined during a comprehensive needs assessment, which includes reviewing the recipient’s medical history, medication uses, emergency contacts, doctor information, household makeup, functional assessments, mini-mental health evaluations, necessary referrals (to Adult Protective Services, Child Protective Services, Fraud, community services, etc.), language needs, and a thorough biopsychosocial evaluation. Social workers are responsible for documenting and justifying all service requirements and authorizations in their case narratives.