Medicaid self-directed care
In-Home Supportive Services (IHSS)
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- Who qualifies
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Aged, blind and disabled people who are California residents, have a Medi-Cal eligibility determination, live at home or in a place of their own choosing (a hospital, long-term care facility or licensed community care facility does not count as your own home), and submit a completed Health Care Certification form.
If you are approved, you hire your own individual provider and are that provider's employer: you hire, train, supervise and, if needed, fire them.
Source: In-Home Supportive Services (IHSS) Program (California Department of Social Services)Checked
- Can a family member be paid
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Yes. Yes. Care providers may include, but are not limited to, family members, friends, neighbors, or registered providers through the county public authority.
Once your services are approved, the county social worker helps you find a provider, who must complete the IHSS provider enrollment process before being paid.
Source: IHSS Provider Resources (California Department of Social Services)Checked
- Can a spouse be paid
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Depends. Yes, for some services. California's IHSS rules say an able and available spouse may be paid for personal care services and paramedical services. When you live with an able and available spouse, IHSS pays no one, neither the spouse nor another provider, for domestic services, related services, yard hazard abatement, teaching and demonstration, or heavy cleaning. A spouse may also be paid for transportation and protective supervision if the spouse leaves full-time work, or cannot look for work, because no other suitable provider is available.
The county decides whether a spouse is able and available. A spouse who does not receive IHSS is presumed able to do these tasks unless the spouse gives medical verification that they cannot, and presumed available except when out of the home for work, health or other unavoidable reasons.
- Pay rate
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Set county by county. Unions negotiate wages with the employer of record in each county, so rates vary; the social worker assigned to your case can tell you the IHSS hourly rate in your county. The State issues the provider's paychecks.
Source: In-Home Supportive Services (IHSS) Program (California Department of Social Services)Checked
- Hours limit
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At most 283 hours a month for people assessed as severely impaired, and at most 195 hours a month for everyone else.
The county authorizes your hours based on its needs assessment; these are the maximums, not what every person receives.