IHSS Intake Form

How to Apply for IHSS

In-Home Supportive Services (IHSS) is a California benefits program designed to assist residents of all ages perform activities of daily living and live safely at home. This guide aims to clarify the IHSS application process and facilitate a seamless transition for your loved ones to receive the support they deserve.

What is IHSS?

The IHSS program pays caregivers, known as IHSS providers, to assist aged, blind, and disabled recipients with various domestic services and activities of daily living.

The California Department of Social Services (CDSS) oversees the IHSS program while county welfare departments run its day-to-day administration, including accepting applications, conducting assessments, determining eligibility, paying providers, and more.

Parents, relatives, and other providers can earn more than $4,000 a month from the State for helping their loved one live safely at home. As an alternative to out-of-home care, the IHSS program enables recipients to choose their own provider while maintaining the dignity of living at home.

Ensure IHSS Eligibility

In order to qualify for IHSS, recipients must meet the following eligibility requirements:

  1. Reside in California or have a “qualified” immigration status;
  2. Either be at least 65 years old, blind, or disabled;
  3. Enrolled in Medi-Cal;
  4. Live at home.
  1. Residing in California or Possessing “Qualified” Immigrant Status

The IHSS program provides services to California residents or “qualified” immigrants. To qualify as a California resident, a person must live in California. Simply possessing property in California is not enough to establish residency. If a recipient leaves the State for 30 days or longer, the County determines whether the absence is temporary or permanent. Absences longer than 60 days are presumed to be permanent and would discontinue IHSS. Applicants apply for IHSS in their county of residence.

An immigrant who is not a California resident can still receive IHSS if he/she is considered a “qualified alien” under federal law.

  1. Aged, Blind, or Disabled

To qualify for IHSS, an applicant must be at least 65 years old, blind, or disabled. Each of these criteria would also qualify the applicant for Medi-Cal. An applicant is considered “blind” or “disabled” if he/she meets the Social Security Administration’s definition of those terms.

For an applicant to qualify as blind, he/she must have a “central visual acuity of 20/200 or less in the better eye with use of a correcting lens.” An eye with a “limitation in the field of vision so that the widest diameter of the visual field subtends an angle no greater than 20 degrees is considered to have a central visual acuity of 20/200 or less.”

A minor (under 18) is considered “disabled” if he/she has “a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.”

An adult is deemed “disabled” if he/she has an “inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”

  1. Enroll in Medi-Cal

Medi-Cal is California’s Medicaid program, which provides free or affordable medical services for children and adults with limited income and resources. Medi-Cal eligibility is based primarily on income.

If you want to apply for IHSS, but are not already enrolled in Medi-Cal, you can apply for both programs through your local county welfare department. There are separate applications for each program.

Although a detailed discussion of the Medi-Cal program and its application process are beyond the scope of this guide, extensive information can be found online, including the California Department of Health Care Service’s website.

  1. Living at Home

The IHSS program is intended for recipients who live at home or “abodes of their own choosing.” Someone living in a hospital or care facility would generally not qualify. However, alternative living situations are considered on an individual basis. For example, if an applicant lives in an RV, homeless shelter, or residence of a friend or family, the applicant may still qualify for IHSS if staying for a specified period of time and if the authorized services would be provided in a safe manner.

Determine Need for Services  

After ensuring your loved one is eligible for IHSS, the next step is to identify which in-home supportive services are needed and how much time should be authorized for each service.

The in-home supportive services include:

  • Domestic Services
  • Related Services
    • Meal Preparation
    • Meal Clean-up
    • Routine Laundry
    • Shopping for Food
    • Other Shopping/Errands
  • Non-Medical Personal Services
    • Respiration Assistance
    • Bowel and/or Bladder Care
    • Feeding
    • Routine Bed Bath
    • Dressing
    • Menstrual Care
    • Ambulation and Getting In/Out of Vehicles
    • Transfer
    • Bathing, Oral Hygiene, and/or Grooming
    • Rubbing Skin and Repositioning
    • Care of/Assistance with Prosthesis and Help Setting Up Medications
  • Accompaniment Services
  • Heavy Cleaning
  • Yard Hazard Abatement
  • Protective Supervision
  • Teaching and Demonstration Services
  • Paramedical Services:

See here for a description about each service.

Next, review CDSS’ Functional Index Rankings and Hourly Task Guidelines to help you estimate how much time your loved one requires for each service. For example, if your loved one can only prepare meals with substantial assistance, then your loved one’s need for meal preparation assistance would likely be rated as Rank 4. The Hourly Task Guidelines for Rank 4 in dressing provide a low of 5:15 hours per week and a high of 7 hours per week. If your loved one requires more time than the guidelines provide, you should request an exception, in which you will need to prove the extraordinary circumstances that warrant more time.

If your loved one is under 18 years old, be sure to review CDSS’ Age Appropriate Guideline Tool. This will tell you what age minors are eligible for the various IHSS services. CDSS expects neurotypical children to require assistance in most activities of daily living until a certain age. For example, CDSS expects all children under the age of five to require assistance with getting dressed. However, that doesn’t mean that it’s impossible for a child under five to qualify for dressing assistance; but you would need to demonstrate that the child has an extraordinary need for dressing assistance, well beyond that of a neurotypical child. For example, if a four-year-old child is wheelchair bound, then perhaps this would qualify as extraordinary need that requires much more time than dressing a neurotypical child.

Make a chart of each service your loved one requires and how much time is needed for each service. Here’s an example of a chart that will help you keep track of needed services:

In-Home Supportive Services Time Needed

Per Week

Explanation
Bowel and Bladder Care 2:15 Recipient can perform function with physical assistance

 

Ambulation 3:30 Recipient can only move around the home with substantial assistance
Bathing, Oral Hygiene, and Grooming 1:30 Recipient can perform function with verbal assistance

Gather Documentation

The IHSS application process entails gathering relevant documentation to validate your loved one’s eligibility. This includes personal identification, such as a state ID, driver’s license, or passport, to confirm the applicant’s identity.

An applicant must sign an IHSS Health Care Certification form (SOC 873), which authorizes the release of health care information. A licensed health care professional familiar with the applicant must also complete the IHSS Health Care Certification form. The county will assist an applicant with this form if the applicant requests assistance

A doctor’s note provides a professional testament for your loved one’s need for in-home care. To obtain this certification, applicants should request a detailed doctor’s note or medical report that specifies the need for in-home care. Below is a detailed table outlining examples of helpful information for your doctor’s note to include.

Helpful Content in Doctor’s Note Description
Patient’s Name and Date Full name and date of evaluation to ensure the document is current and accurately identifies the applicant.
Medical Diagnosis A clear statement of the age, medical condition(s), or disability necessitating in-home care.
Level of Care Needed Description of the applicant’s ability to perform activities of daily, explaining which tasks require assistance.
Types of Services Required A detailed list of recommended in home-supportive services, explaining why each service is needed.
Frequency and Duration of Care An estimation of how many hours per week each in-home care services are needed.
Doctor’s Contact Information Contact details for follow-up questions or verification purposes. Doctor should sign the letter and include license number.

If your loved one needs paramedical services or protective supervision, provide additional documentation. For paramedical services, a health care professional must complete the Request for Order and Consent – Paramedical Services (SOC 321).

For protective supervision, a health care professional must complete the Assessment of Need for Protective Supervision (SOC 821). Be sure to check out our 5 Tips For Your SOC 821. If your loved one needs protective supervision, it’s important to provide objective documentation. For example, an individualized education program (IEP), regional center documents, evaluations and reports regarding the applicant’s cognitive functioning, and letters from witnesses can all help support your loved one’s need for protective supervision.

Submit an IHSS Application

To initiate your IHSS application, complete the Application for In-Home Supportive Services (SOC 295). The application is also available in other languages, including, but not limited to: SOC 295 in Spanish; SOC 295 in Chinese; and SOC 295 in Armenian.

Once your application is completed, contact your local IHSS office and submit your application.

Schedule a Home Assessment

After you submit your IHSS application, a county social worker will contact you to schedule an initial assessment The purpose of the initial assessment, which usually occurs in the applicant’s home, is to determine the applicant’s need for services.

The home assessment is an important part of the application process because it forms the basis of the county’s decision to authorize or deny service hours. During the initial assessment, the county social worker makes observations and gathers information. The social worker assesses the applicant’s physical and mental conditions, living situation, and ability to perform activities of daily living.

The social worker will review all relevant documentation you provide. This is a valuable opportunity to support your need for services. Since initial assessments usually only take around an hour, county social workers don’t always have the opportunity to observe all of applicant’s needs during the short home assessment.

The social worker will also discuss whether you have access to alternative resources, such as adult and child day care centers, community resource centers, senior centers, etc. Note that regional centers are not alternative resources for IHSS purposes. If alternative resources address your needs for in-home support, then you may receive less IHSS hours or not qualify for IHSS at all.

Await Notification

The county must notify you of its decision whether to authorize in-home supportive services within 30 days from when you submit your application. Don’t hesitate to follow up with your local IHSS office if you haven’t received a response within 30 days.

The county will mail you a Notice of Action, which informs you of the county’s decision to authorize hours for each service. The Notice of Action must specify how many hours were offered for each service area and explain the basis for any denial of services.

The Notice of Action will also include information about your rights to appeal, in the event that you disagree with the county’s decision.

Select an IHSS Provider

If the County authorizes IHSS hours, the next step is for you to select an IHSS provider. The selection process is important, because it involves choosing your caregiver. You have the option to hire independently, which allows you to interview a caregiver of your choice who best fits your particular needs. Alternatively, you can utilize an IHSS registry, which offers a list of pre-screened providers, ensuring a level of safety and quality. This stage of the process is about establishing a trusted partnership between you and your caregiver, which helps build a successful and supportive in-home care relationship.

Hiring Independently

One option for choosing an IHSS provider is hiring independently. This approach offers you the flexibility to interview and select the caregiver of your choice, including a relative or friend. Hiring independently helps ensure a personal fit and a sense of comfort with your caregiver.

Using an IHSS Registry

Alternatively, you can opt for using an IHSS registry to select your IHSS provider. Your county provides access to a list of competent, pre-screened, independent providers, which helps make finding the right IHSS provider more efficient. Using an IHSS registry is a reliable option if you don’t want a relative or friend to serve as your IHSS provider.

The county IHSS registry operates as a helpful resource for connecting IHSS recipients with qualified caregivers. Below is a detailed table outlining how the registry works, the screening process for providers, and steps to take if a match is not satisfactory:

IHSS Registry Steps Description
Registry Function Serves as a database of caregivers who have been pre-screened and are seeking employment as IHSS providers.
Provider Screening Includes background checks, verification of qualifications, and training completion. Providers may also undergo an interview process by the registry staff.
Matching Process Recipients can access the registry to find caregivers meeting specific criteria (e.g., skills, availability). The registry may also recommend matches based on the recipient’s needs.
Interviewing Providers Recipients are encouraged to interview potential caregivers to assess compatibility. The registry can offer guidance on interview questions and what to look for.
Trial Period It’s advisable to have a trial period with a new caregiver to ensure a good fit. This period allows both parties to evaluate the working relationship.
Resolving Conflicts Recipients should contact the registry to report any issues and request additional matches. The registry can assist in resolving conflicts or finding a new provider.
Feedback Loop Recipients are encouraged to provide feedback to the registry about their experiences with providers, helping to improve the service for others.

Complete Provider Enrollment

After selecting an IHSS provider, the next step is to complete provider enrollment. This phase of the process formalizes the caregiver’s role and ensures the provider meets all program requirements. This step includes a provider orientation, where caregivers are briefed on IHSS policies, responsibilities, and the specific needs of their recipient. Additionally, a background check is conducted, including fingerprinting and a criminal history review, to ensure the safety and security of the IHSS recipient. This vetting process is designed to maintain the integrity of the IHSS program and provide peace of mind for recipients.

Provider orientation is a mandatory step in the enrollment process for IHSS providers. This includes training sessions designed to equip caregivers with the knowledge and skills necessary for their role, ensuring they understand the program’s policies and the specific care needs of their recipients.

A background check is required for all IHSS providers. This process involves fingerprinting and a criminal history check to safeguard the well-being of IHSS recipients. Below is a detailed table outlining the background check process, actions taken if a potential caregiver fails, and steps to ensure recipient safety:

Background Check Overview Description
Background Check Conducted Comprehensive review including fingerprinting, criminal history, and checks against abuse registries.
Criteria for Disqualification Convictions for certain crimes, such as violent offenses, theft, fraud, or abuse, result in automatic disqualification.
If a Potential Caregiver Fails The caregiver is notified of the disqualification and given information on how to appeal.
Appeal Process Caregivers have the right to appeal disqualification through a formal process, which may include a review of the background check or a hearing.
Steps for Recipient Safety IHSS periodically re-checks providers. Recipients are encouraged to report any concerns or incidents to IHSS immediately.
Replacing Disqualified Providers If a provider fails the background check, IHSS assists the recipient in finding another qualified provider.
Safety Training Providers undergo training on safety measures and emergency procedures to further ensure recipient well-being.

Begin Receiving Services

Once the provider enrollment is complete, the next step is to establish a schedule and care plan with your IHSS provider in order to begin receiving services. After your caregiver begins providing in-home support, the final and ongoing step involves monitoring your needs and adjusting your schedule, with regular reviews to assess the effectiveness of your care plan. This ongoing evaluation helps ensure that your caregiver continues to effectively implement your in-home supportive services.

Establishing a schedule involves recipients and caregivers agreeing how to implement the hours and services that the county authorized. For example, if the county authorized 25 hours a month for meal preparation, the recipient and caregiver should discuss when exactly these 25 hours per month should occur and how the caregiver can best assist with meal preparation.

After the county authorizes IHSS services, you should monitor your needs and adjust your schedule. You should regularly review your schedule and care plan with your provider, allowing for adjustments as your needs may evolve over time. This process helps ensure that your services remain effective and responsive to possible changes in circumstances. If you find that you require more hours than the county authorized, you should request a reassessment with the county.

Conclusion

In conclusion, the IHSS program provides a tremendous service to California residents who need assistance performing tasks of daily living. By paying caregivers to provide services and supervision, the IHSS program enables recipients to live safely at home with dignity.

Disclaimer

The information in this article is not legal advice, nor is it intended to be. The information provided may be inaccurate and outdated. You should consult an attorney for advice regarding your individual situation.

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