"How do you get approved for IHSS in California"

California IHSS Program – Eligibility and How to Apply

If you have questions about the California IHSS Program program, you’ve come to the right place. The IHSS Program can help pay for services provided to you so that you can remain safely in your own home. In this post, we are going to walk you through everything you need to know about the IHSS program.

First, we will describe what the program is about and how it works.

Next, we will walk you through the eligibility requirements and how to apply.

Also, we will explain in detail the services that IHSS covers.

Lastly, we will answer the most frequently asked questions about the California IHSS Program, including how much caregivers are paid and how to hire one.

"California IHSS Program"

What is the California IHSS Program?

IHSS stands for In-Home Supportive Services.  It is a program that provides those with limited income who are disabled, blind, or over the age of 65 with in-home care services to help them remain safely at home.

It is a statewide program in the state of California administered by each county under the direction of the California Department of Social Services.

The IHSS program provides non-medical assistance services.

It is considered an alternative to out-of-home care, such as nursing homes or board and care facilities.

Who is Eligible for IHSS in California?

To be eligible for IHSS, the person must meet certain requirements, including:

  • Be a citizen of the United States or have “qualified immigration” status and physically reside in the United States.
  • Be a resident of California
  • Live in your own home, such as the family home or your own apartment. (Long term care facilities and group homes are not considered to be your “own home”)
  • Be Medi-Cal eligible
  • Be over age 65, blind and/or disabled
  • Your doctor or licensed clinical provider must complete the IHSS Health Care Certification (SOC 873) form to certify that you/your family member needs IHSS services to remain safely in the home.

What is covered by the California IHSS Program?

The IHSS program covers a range of services, which, but are not limited to:

  • Domestic and Related Services: meal preparation, cleaning, laundry, and taking out the garbage.
  • Personal Care Services/Non–Medical Care: bathing, feeding, dressing, grooming, and toileting.
  • Paramedical Tasks: assistance with medications, injections, bowel and bladder care.
  • Protective Supervision: monitoring persons with cognitive or mental impairments to prevent injury.
  • Transportation and accompaniment to medical appointments.

How the IHSS Program Works

Here’s how the California IHSS program works:

A county social worker will interview to determine your eligibility and need for IHSS.

Next, you must have a physician or other licensed healthcare professional fill out a Health Care Certification (SOC 873) form and you must return it to the county before care services can be authorized.

You will be notified if your application for IHSS has been approved or denied.

If denied, you will be notified of the reason for the denial.

However, if approved, you will be notified of the service authorizations including, the number of hours per month that have been authorized for you.

If you are approved for IHSS, you must hire someone (your individual provider) to perform the authorized services.

You are considered your provider’s employer and, therefore, it is your responsibility to hire, train, supervise, and fire your provider.

Care providers may be family members, friends, neighbors, or registered providers through the Public Authority.

You can contact the PASC for assistance in locating a provider to interview for hire.

How do I apply for IHSS?

Here’s how to apply for IHSS in your county:

Step 1 – Visit your County IHSS Office

If you already have Medi-Cal or once you are approved for it, call or visit your county In-Home Supportive Services (IHSS) office to complete an IHSS application.

You will be required to complete an Application for In-Home Supportive Services (SOC 295).

Once IHSS gets the application, a caseworker will contact you and schedule a time to visit your home and understand your needs.

Step 2 – Needs Assessment

Your caseworker will come to your home and do a needs assessment to figure out if you are eligible for IHSS and what services you will get.

During this assessment, the caseworker will:

  • Ask about your mental and physical abilities and limitations;
  • Identify the tasks you can perform safely on your own;
  • Identify the tasks you might need help with;
  • Evaluate your living and social situation.

Step 3 – Complete Health Care Certification

You must have a physician or other licensed healthcare professional fill out a Health Care Certification (SOC 873) form and you must return it to the county before care services can be authorized.

Click here to download the Health Care Certification form.

Step 4 – IHSS Application Decision

After the needs assessment, IHSS will contact you to let you know if you have been approved or denied.

If you are approved, IHSS will also let you know the kinds of services and the number of hours you will get.

If services are denied or you think that you need more IHSS hours than were approved, you have the right to appeal.

The appeals procedure is outlined on the back of the notice you get.

Here are detailed guides on how to apply for IHSS by County:

IHSS phone number California

Here are the phone numbers for IHSS:

  • Timesheet Issues/Questions: Provider Help Line, (866) 376-7066
  • Program Integrity: (916) 653-3850
  • Program policy: (916) 651-5350
  • Quality Assurance: (916) 651-3494
  • Training: IHSS-Training@dss.ca.gov (916) 651-5362

If you have IHSS questions or comments for a county, please contact your County IHSS Office

Suspect Fraud?
IHSS Fraud Hotline: 1-(800)-822-6222

Help Stop Medi-Cal Fraud and Abuse

Provider Fraud and Elder Abuse complaint line: 1-(800)-722-0432

What IHSS Program do I Qualify for?

There are four different types of IHSS programs you can be approved for. They are”

The IHSS Residual (IHSS-R)

This program is for people who are not eligible for full-scope Medi-Cal.

It provides a maximum of 283 hours of services per month for people with severe disabilities and a maximum of 195 hours for people with disabilities that are not severe.

The Personal Care Services Program (PCSP)

This program is for people with full-scope Medi-Cal who are:

  • Adults who get care services from a parent, or
  • Adults who don’t have a spouse to provide services, or
  • Children under 18 who don’t have a parent to provide services.

Severely and non-severely disabled people can get up to 283 hours of services per month, including protective supervision.

The IHSS Plus Option (IPO)

This program is for people who get services from a spouse or parent (for people under age 18), or who get restaurant meal allowance or advance pay.

The program provides a maximum of 195 to 283 hours of services per month, depending on the severity of the impairment.

The Community First Choice Option (CFCO)

This program is an alternative for PCSP and IPO recipients.

CFCO provides home and community-based attendant services and supports, including help with household chores, personal care services, paramedical services, and protective supervision.

Severely and non-severely disabled people can get up to 283 hours of services per month, including protective supervision.

IHSS Program in California FAQs

Here are the most frequently asked questions about the California IHSS Program:

How much does IHSS pay in California?

IHSS Service providers are paid an hourly rate set by Medi-Cal for their county.

As of 2021, these rates are between $14.00 and $17.50 / hour.

In general, the value of the services provided through the IHSS program will not exceed $3,500 per month.

On average, an IHSS provider is paid closer to $2,200 per month.

Can I use IHSS hours in the workplace?

Yes. You can use IHSS hours to help you get, keep, or return to work.

To do this, you need to transfer hours that were for in-home services to the workplace. IHSS will not give you more hours than you originally were getting before you started using IHSS in the workplace.

To transfer hours to the workplace, contact your IHSS caseworker and say which services you need and the number of hours you wish to transfer.

Why do I Need Medi-Cal to be Eligible for IHSS?

Your IHSS funding comes through the California Medi-Cal program.

If you do not have Medi-Cal, here’s how to apply.

If you get SSI/SSP payments, the Social Security administration office automatically establishes Medi-Cal for you. No separate application for Medi-Cal is needed.

You should receive your Medi-Cal card (BIC) through the mail.

Note that once you’ve been approved for IHSS benefits, you must maintain your Medi-Cal eligibility going forward, or you will also forfeit your IHSS services.

How do I find an IHSS Caregiver?

Once you are approved for IHSS and your services needs determined, you must hire someone, known as an independent provider, to provide those services.

That person can be a family member or friend.

Each county IHSS office maintains a registry list to help people find workers for their needs.

What services are covered under IHSS?

IHSS chores are assessed according to the needs of the individual. They may include, but are not limited to:

  • Housekeeping
  • Grocery shopping
  • Meal preparation and clean up
  • Transportation to medical appointments
  • Spoon feeding
  • Help with breathing equipment
  • Toileting or incontinence-related needs
  • Bathing and hygiene tasks
  • Dressing assistance
  • Medication management
  • Tooth, nail, and hair care

California IHSS Program Summary

We hope this post on the California IHSS Program was helpful.

Questions?

If you have further questions about California IHSS Program or Medi-Cal, please let us know in the comments section below.

Be sure to check out our other articles about Medi-Cal in California, including:

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