California pays home health aides through the In-Home Support Services (IHSS) waiver program. This waiver is comprehensive, and it offers many different types of in-home support based on beneficiaries’ needs. The program has relatively complex eligibility requirements for participants who need different levels of care and meet different financial limitations.

In-Home Support Services (IHSS) Waivers in California

California has created a one-stop waiver program that offers comprehensive in-home services and supports for participants of all need levels and many tiers of income and assets. Seniors in California who meet the IHSS income and asset limitations can get support for home health and paramedical assistance, which can include blood tests, medication management, non-medical caregiver support, chore assistance, transportation aid, respite care, adult day health services, transition services and medical supplies. Social events are organized by local community and senior centers that participate in the program.

How the IHSS Program Works

When seniors apply for the IHSS program, a case worker performs an eligibility and needs assessment. This may include going over financial statements, checking for enrollment in other state low-income programs, requesting information from the applicant’s doctor and performing a home visit to check that the senior’s needs can all be met with support the IHSS program offers. After approval is granted for participation in the program, the IHSS authorizes a set number of hours it will compensate caregivers of all types. Some hours are reserved for home health aides, while others are reserved for other types of support and cannot be used for home health. The maximum number of hours that can be allotted is 268 per month, though it is extremely rare for the maximum to be approved. Beneficiaries are subject to periodic recertification and verification that their financial and medical needs have not changed, which may affect their authorized hours.

IHSS Eligibility Guidelines

Seniors in California can establish financial eligibility for IHSS by showing they already participate in CalFresh, the state’s EBT/SNAP program, receive cash aid, SSI/SSDI or Medicaid. Because these programs all share similar income and asset limitations for participants, it is presumed that approval from one establishes eligibility for all. Medical need for IHSS can be established with a doctor’s note or by a home visit from a program intake worker. IHSS is an almost entirely beneficiary-directed program, which puts the seniors who participate in control of hiring, training, scheduling and retention for all of the workers paid under the program, including home health and paramedical professionals.