IHSS Programs

There are three standard programs by which consumers receive IHSS services. Each program has a different maximum number of hours allowed. This maximum depends on whether or not you are determined “severely disabled.” Your caseworker will make this determination during your needs assessment.

1. Medi-Cal Personal Care Services Program

The Medi-Cal Personal Care Services Program (PCSP) is available to people with full-scope Medi-Cal who fit into one of the following categories:

• an adult child who receives care services from a parent, or
• an adult who doesn’t have a spouse to provide services, or
• a child who doesn’t have a parent to provide services.

Severely and non-severely disabled people can receive up to 283 hours of service per month under PCSP, including protective supervision. Individuals receiving care under this program and their provider(s) should be sure to fill out a PCSP Provider/Enrollment Agreement form.

2. Residual Program

Unlike PCSP, the Residual Program is for people who are not eligible for full-scope Medi-Cal. The program provides a maximum of 195 hours per month, including protective supervision for non-severely impaired people. If an individual is severely disabled, a maximum of 283 hours per month is available.

3. IHSS Plus Waiver Program

The IHSS Plus Waiver Program is available if your provider is going to be paid in advance or if there is a restaurant meal allowance. It is also available if your parent or spouse is your care provider or if you have both a spouse/parent care provider and a non-parent/non-spouse care provider.

The maximum number of hours allowed under the Plus Waiver Program varies from 195 to 283.

How Services are Authorized

New regulations established guidelines regarding the amount of time allocated for certain IHSS services.

Important: If you can prove that you need more hours than what is listed above, you can receive them. If you live with a roommate or attendant, your services will be pro-rated.

Protective supervision hours will be authorized at 195 hours per month for non-severely impaired people and 283 per month for severely impaired people. Whether a person receiving 195 hours per month is entitled to more (up to 283) will depend on which IHSS program they are on.

Children can receive IHSS services if:

A parent can be the IHSS provider if:

• the parent quit a job or can’t get a full-time job because they must care for the disabled child; and
• no other suitable care provider is available; and
• the child is at risk of out-of-home placement or inadequate care.

If both parents live in the home, one parent may get paid by the IHSS program when the other parent is working, in school, sleeping, or disabled.

IHSS in the Workplace

Assembly Bill (AB) 925, also known as the Workforce Inclusion Act, allows for the use of IHSS personal care services to help obtain, retain, or return to work (see All-County Letter Number 04-43 for details). You can request to transfer IHSS hours to the workplace under the law but you cannot request additional hours specifically for use at the workplace.

IHSS services that can be performed in the workplace include meal preparation/clean-up, personal care services with the exception of routine bed baths and paramedical services.

IHSS hours cannot be used for assistance with college courses or vocational training.

To transfer IHSS personal assistance hours to the workplace, you must first contact your caseworker and specify the number of hours and services needed. If you are on the Medi-Cal Medically Needy program with a share of cost/IHSS share of cost and go to work, you should consider the Medi-Cal California Working Disabled Program. This program allows you to earn up to $56,892 annually and still be eligible for full scope Medi-Cal. Rather than having a Medi-Cal share of cost, you will have a small premium to pay every month for your Medi-Cal and will not have an IHSS share of cost.

Sources

The following links are provided for those who want detailed information on Medi-Cal. For those looking for more general information, please go to DB101’s IHSS Resources Page.

The California Department of Social Services provides a variety of resources and information on IHSS. The Department’s All-County Directors Letter Number 04-43 provides details on the use of IHSS personal care services at the workplace.

The CSU Sacramento Institute for Social Research offers detailed information on IHSS in their IHSS Provider Handbook and Consumer Handbook.

The California Advocates for Nursing Reform provide a fact sheet and local phone numbers for information on IHSS services.

Protection & Advocacy, Inc. is a federally funded program that provides representation for consumers of public programs who are disabled. Their website includes information on IHSS and other benefit programs.