California pays for in-home care through its In-Home Supportive Services (IHSS) Program. IHSS allots a set number of hours to each approved beneficiary as part of the intake process. The beneficiary can then approve payment for those hours to a registered caregiver of their choice. Caregivers can be family members, spouses or friends, and payment authorization is at the discretion of the beneficiary.

Eligibility for IHSS

IHSS offers financial support to seniors aged 65 and over as well as blind and disabled beneficiaries, including children with qualifying disabilities. Applicants are required to be residents of California who legally reside in the United States and who have met Medi-Cal eligibility. Beneficiaries have to live in their own homes or in a private dwelling of their own choosing. Hospitals, nursing homes and community care homes are not considered to be a beneficiary’s own home, thus they are not eligible for IHSS support. 

Caregiver Requirements

Because IHSS benefits are paid at the discretion of the beneficiary, program participants can choose their own caregivers. The IHSS itself maintains a registry of authorized caregivers that beneficiaries can choose from, or they can ask a trusted friend or family member to register as a caregiver and provide IHSS-paid support services. In order to qualify as a caregiver, applicants must fill out an application and pass a background check, including fingerprint screening with the California Department of Justice. They must also attend an IHSS orientation session and sign the IHSS provider agreement.

How IHSS Pays for In-Home Care

New IHSS applicants must submit documentation verifying their disability to the program and agree to a home inspection by an intake worker. At the end of the intake process, the approved beneficiary receives an allotment of hours to pay for their caregiver, which must be documented and submitted with a bi-weekly time sheet. The time sheet must be approved and signed by the beneficiary, who certifies that the hours recorded are valid and accurate and that payment is authorized. After that, the IHSS office issues payment by mail or direct deposit to the caregiver.