Attending therapy does not automatically reduce a child’s total IHSS hours. However, a parent provider generally may claim only the authorized services actually provided during the reported time.

Therapy can affect claimable hours when the therapist, clinic, school, or another program is meeting the child’s needs during the appointment. It may also affect whether travel, accompaniment, waiting, or Protective Supervision can be claimed.

The answer depends on:

• The services authorized in the child’s IHSS case
• The type and location of the therapy
• Whether the parent must remain and provide assistance
• Whether another person assumes responsibility for the child
• Whether medical accompaniment or wait time has been authorized
• Whether the therapy schedule changes the child’s ongoing care needs

Authorized Hours Are Not Automatically Reduced

A child’s monthly IHSS hours are established through an individual county assessment. The social worker determines which services the child needs and how much time should be authorized for each service.

Starting occupational therapy, speech therapy, physical therapy, behavioral therapy, or another service does not automatically remove hours from the child’s IHSS case.

The county must evaluate whether the therapy changes the child’s actual need for IHSS services. A reduction should ordinarily be communicated through a new Notice of Action rather than being made informally by telling the parent to claim fewer hours.

You May Claim Only Services You Actually Provide

Even when the child’s monthly authorization remains unchanged, the provider may claim only authorized IHSS services that were actually performed.

California’s provider notice states that IHSS pays only for authorized hours and services. A provider should not claim time merely because the hours appear on the child’s Notice of Action.

For example, a parent generally should not claim personal-care time during an appointment if the therapist or clinic staff performed the entire task and the parent provided no authorized assistance.

The parent may still perform other authorized services before, during, or after the appointment, such as:

• Dressing the child for the appointment
• Assisting with toileting
• Feeding the child
• Helping the child transfer into a wheelchair
• Providing assistance needed during travel
• Performing authorized paramedical services
• Helping the child safely enter or leave the facility

The provider’s timesheet should reflect the services actually performed, not simply the length of the therapy appointment.

Is Therapy an Alternative Resource?

A therapy program may be treated as an alternative resource when it provides services that would otherwise be provided through IHSS.

California requires social workers to identify services available through other agencies or programs and use those resources in place of IHSS-funded services when they meet the assessed need at no cost to the recipient or the IHSS program.

This does not mean that every therapy appointment replaces all IHSS services. The county should identify the specific service the therapy program provides and determine whether it actually duplicates an authorized IHSS service.

For example, a one-hour speech therapy appointment does not necessarily replace assistance with bathing, dressing, feeding, toileting, meal preparation, or other care required throughout the week.

How Therapy Can Affect Protective Supervision

Protective Supervision may be provided through IHSS, alternative resources, voluntary resources, or a combination of those arrangements. Alternative resources may include child day care centers, community programs, or respite centers.

A therapy program may function as an alternative resource during the period when its staff assumes responsibility for supervising the child. In that situation, the parent generally should not claim Protective Supervision for the same period merely because the parent remains nearby.

The facts may be different when:

• The therapist does not assume responsibility for the child’s safety
• The parent must remain in the treatment room
• The therapist requires the parent to provide continuous intervention
• The parent must prevent elopement or other dangerous activity
• The parent continues performing authorized personal-care or paramedical services
• The appointment cannot safely proceed without the parent’s assistance

Parents should document exactly what the therapist handles and what the parent must continue doing. Simply being required to remain at the facility does not always establish that the parent is providing a compensable IHSS service.

Can I Claim Travel Time?

IHSS may authorize accompaniment to appointments with physicians, dentists, and other health practitioners when the recipient requires assistance to accomplish the travel.

Medical accompaniment is not intended merely to pay for transportation. The child must need assistance with an authorized IHSS task while traveling or while getting to and from the destination.

Possible examples include assistance with:

• Entering and exiting the vehicle
• Transfers
• Ambulation
• Wheelchair mobility
• Toileting
• Other authorized personal-care needs

Do not assume that driving a child to therapy is automatically payable. Ask the social worker whether accompaniment has been assessed and included in the child’s authorized services.

Can I Claim Time While Waiting?

Whether wait time is compensable depends on whether the provider is “engaged to wait” or “waiting to be engaged.”

A provider may be engaged to wait when the appointment’s duration is unpredictable and the provider cannot leave or use the time for personal purposes because assistance may be required at any moment.

Wait time at an alternative-resource site is not typically compensable when the child can be dropped off and picked up later, allowing the provider to use the appointment time for personal activities.

Important questions include:

• Is the appointment length known in advance?
• Is the parent free to leave?
• Must the parent remain immediately available?
• Does the therapist require the parent’s participation?
• Is the parent performing another authorized service?
• Could the parent reasonably use the time for personal activities?

Remaining in the lobby by choice does not necessarily make the entire appointment payable.

What If the Therapist Requires Me to Participate?

Parent training and participation may be important parts of a child’s treatment, but not every activity required by a therapist is automatically an IHSS service.

The county should determine whether the parent is performing an authorized IHSS task or participating as part of the therapy program.

For example, a therapist may ask a parent to observe a session, learn behavioral techniques, or discuss the child’s progress. These activities may be valuable but are not necessarily covered IHSS services.

The analysis may be different when the parent must provide an already-authorized service during the appointment, such as toileting assistance, transfers, feeding, mobility assistance, or a paramedical procedure.

Ask the therapist to provide a written explanation of:

• Why the parent must remain
• What the parent is expected to do
• How frequently assistance is required
• Whether clinic staff can provide that assistance
• Whether the child could attend safely without the parent
• Whether the parent is free to leave during the session

This information can help the social worker decide whether accompaniment, wait time, or another IHSS service should be authorized.

What About Therapy Provided at Home?

The presence of a therapist in the home does not automatically suspend every IHSS service.

The relevant question is who is performing the authorized task. A parent may continue claiming an authorized service when the parent is actually providing it and the therapist is not.

However, the parent should not claim time for a task performed entirely by the therapist or another paid program. IHSS generally should not pay twice for the same service during the same period.

Keep a clear record showing:

• When the therapist arrived and left
• What service the therapist provided
• Which IHSS services the parent performed
• Whether the parent was required to assist
• Whether Protective Supervision remained necessary
• Whether responsibility for the child’s safety was transferred to the therapist

Can Therapy Improve My Child’s Skills and Reduce Hours?

Therapy may eventually improve a child’s ability to perform certain tasks. If the child becomes more independent, the county may reassess the time needed for those particular services.

Attendance alone does not prove improvement. The county should evaluate the child’s current functioning and the assistance still required.

For example, attending occupational therapy does not establish that a child can now dress independently. The assessment should consider whether the child can complete each part of dressing safely, reliably, and without unreasonable physical or emotional stress.

Parents should describe what the child can do independently, what still requires assistance, how often prompting is needed, and whether skills demonstrated in therapy carry over into everyday life.

Keep a Therapy and Care Log

Maintain records showing how therapy affects the child’s care.

Include:

• Type of therapy
• Location
• Appointment dates and times
• Travel time
• Length of each session
• Whether the parent could leave
• Services performed by the therapist
• Services performed by the parent
• Safety intervention required during the visit
• Toileting, feeding, mobility, or paramedical assistance provided
• Changes in the child’s functional abilities
• Cancellations or changes in the therapy schedule

Also keep appointment confirmations, treatment plans, therapist statements, attendance records, and the child’s IHSS Notices of Action.

Ask the County for a Clear Explanation

When a social worker says therapy will reduce IHSS hours, ask which specific service is being reduced and why.

Questions may include:

• Which authorized IHSS service does the therapy replace?
• Who is providing that service during therapy?
• Is the reduction limited to the appointment time?
• Is travel or accompaniment being assessed?
• Has wait time been considered?
• How was Protective Supervision calculated?
• What evidence shows that my child’s functional needs decreased?
• Will the county issue a written Notice of Action?

Do not voluntarily reduce the hours claimed based only on a vague verbal statement. At the same time, do not claim appointment time unless an authorized IHSS service was actually provided.

Talk to an IHSS Attorney or Advocate

Attending therapy does not automatically reduce a child’s IHSS authorization. Therapy may affect claimable time when another resource assumes responsibility for the child or provides the same service IHSS would otherwise cover.

An IHSS attorney or qualified advocate can review the child’s Notice of Action, therapy schedule, Protective Supervision calculation, and the services the parent performs during appointments. They can also help determine whether accompaniment or wait time should have been assessed.

Need help? In California, the In-Home Supportive Services (IHSS) program provides crucial financial help for families raising children with special needs. American Advocacy Group is on the front lines every day, making positive change happen for people diagnosed with autism, Down syndrome, and a range of diagnoses across the continuum. As a leading advocate for all people with intellectual and developmental disabilities and their families, and the premier provider of the support and services people want and need, we understand the system and know how to take action regarding your best interests.

CONTACT US FOR HELP. Dial (877) 762-0702 or email us at [email protected].

Yes, a parent may generally serve as the IHSS provider for more than one child who receives services. Each child must have an individual IHSS case, be authorized for services, and designate the parent as a provider.

The parent must also complete the IHSS provider-enrollment process and comply with the workweek, overtime, timesheet, and service-hour rules that apply when one provider works for multiple recipients.

Each Child Must Qualify Separately

Having one child who receives IHSS does not automatically make another child eligible. The county must separately assess each child’s disabilities, functional limitations, authorized services, and monthly hours.

The assessment may consider information from the parent, child, physicians, therapists, family members, and other professionals. After completing the assessment, the county issues a Notice of Action identifying the services and hours authorized for that particular child.

A parent providing services for two children will therefore have:

• A separate IHSS case for each child
• Separate authorized services and hours
• Separate provider assignments
• Separate timesheets
• Separate approvals for each timesheet

Hours authorized for one child cannot simply be transferred to the other child.

Can a Parent Be the Provider?

Current California rules allow minor recipients enrolled in the Community First Choice Option, IHSS Plus Option, or IHSS Residual program to select a parent as their provider, provided that the parent successfully completes provider enrollment.

The previous rules requiring a parent to leave or be prevented from obtaining full-time employment were eliminated. Minor recipients generally now have access to the provider of their choice in the same manner as adult recipients.

An important exception applies to minor recipients enrolled in the Personal Care Services Program, commonly called PCSP. Federal restrictions continue to prevent a parent from being the paid provider for a minor child enrolled in that program. Counties should consider the family’s preference for a parent provider when determining the appropriate IHSS subprogram.

Parents should tell the county that they want to serve as the provider for each child so the correct provider assignment and program funding can be established.

Provider Enrollment Is Still Required

Being the child’s parent does not eliminate the regular provider-enrollment requirements.

A parent who wants to receive payment must generally:

• Complete the Provider Enrollment Form
• Present the required identification and Social Security documentation
• Complete provider orientation
• Sign the Provider Enrollment Agreement
• Complete the required criminal background check
• Meet federal employment-authorization requirements

Once enrolled, the parent must be assigned as a provider to each child’s case. The provider-enrollment rules remain separate from the rules determining whether the parent may be selected as the child’s provider.

The 66-Hour Weekly Limit

When one provider works for two or more IHSS recipients, California generally limits that provider to a combined total of 66 hours per workweek.

This is a provider-level limit. It applies to the total hours the parent claims for all children and any other IHSS or Waiver Personal Care Services recipients for whom the parent works.

For example, suppose a parent is assigned:

• 35 weekly hours for one child
• 40 weekly hours for another child

The combined assignment is 75 hours. Unless an exemption applies, the parent generally cannot personally work and claim all 75 hours during the same workweek. The family may need another enrolled provider to perform the remaining authorized services.

An IHSS workweek begins at 12:00 a.m. on Sunday and ends at 11:59 p.m. on Saturday. Providers working for multiple recipients are responsible for keeping their combined hours within the applicable weekly limit.

Overtime After 40 Hours

An IHSS provider is generally paid overtime when the provider works more than 40 hours during a workweek.

A parent working for two children might therefore receive regular pay for the first 40 combined hours and overtime pay for additional authorized hours, subject to the 66-hour weekly limit.

Overtime eligibility does not authorize a provider to exceed:

• Either child’s authorized monthly hours
• Either child’s maximum weekly hours
• The provider’s combined 66-hour limit
• Any schedule or overtime restriction requiring county approval

Working unauthorized overtime or exceeding the workweek limits can result in program violations. Repeated violations may eventually affect the provider’s ability to continue working through IHSS.

What If the Children Have More Than 66 Combined Hours?

The children do not lose their remaining authorized hours merely because one parent reaches the provider limit. However, another enrolled provider may need to work the hours that the parent cannot claim.

Another provider might be:

• The other parent
• An adult sibling
• Another relative
• A trusted family friend
• A provider located through the county Public Authority registry

The additional person must complete provider enrollment and be formally assigned to the appropriate child’s case before receiving payment.

Families should not submit all of the hours under one parent’s name when the parent is not legally permitted to work that number of hours. The children’s authorized hours and the parent’s provider workweek limit are separate issues.

Are Exemptions Available?

Some providers who work for multiple recipients may qualify to exceed the usual 66-hour limit.

Live-In Family Care Provider Exemption

The Live-In Family Care Provider Exemption can permit qualifying providers to work up to 90 hours per week and 360 hours per month.

However, this exemption is largely grandfathered. The provider generally must have been serving two or more qualifying live-in family-member recipients on or before January 31, 2016. Providers assigned after that date generally cannot qualify for this exemption.

Extraordinary Circumstances Exemption

The Extraordinary Circumstances Exemption may permit a provider to work up to 90 hours per week and 360 hours per month for multiple recipients.

Each recipient served by the provider must generally satisfy at least one of the following conditions:

• The recipient has complex medical or behavioral needs that must be met by a provider living in the home
• The recipient lives in a rural or remote area where other providers are limited
• The recipient cannot locate a provider who speaks the language needed to direct their care

The recipients must also generally make reasonable attempts to locate and hire additional providers. Prior attempts that negatively affected a recipient’s health or safety may be considered. The provider or recipients may submit the SOC 2305 exemption request to the county IHSS office.

A parent caring for multiple children with complex medical or behavioral needs may want to ask the county whether the Extraordinary Circumstances Exemption could apply.

Protective Supervision May Be Prorated

Families with more than one child receiving Protective Supervision should understand the rules for shared supervision.

When two or more IHSS recipients live together and both require Protective Supervision, California generally treats the supervision as a common need and prorates it between the recipients. The county should still assess each child’s individual need, but it does not necessarily authorize a full, separate block of Protective Supervision for each child during the same period.

For example, a parent cannot ordinarily claim that they simultaneously provided one full hour of Protective Supervision to each child and receive payment for two hours during the same one-hour period.

However, personal care, paramedical services, transportation, and other individualized services should be assessed according to each child’s individual needs. One child may require substantially more hands-on care or intervention than the other.

Parents should carefully review how the county divided any shared Protective Supervision hours and whether each child’s individual needs were accurately documented.

Keep Each Child’s Hours Separate

A parent provider should maintain a clear record of which services were performed for each child.

Helpful records include:

• A separate daily care log for each child
• Each child’s Notice of Action
• Each child’s authorized-services notice
• Medical and therapy appointment records
• Paramedical-service documentation
• School and program schedules
• A weekly calendar showing hours worked for each child
• Copies of submitted and approved timesheets

Do not claim time for a service that was not authorized for that child. Do not claim the same period twice merely because both children were present.

Providers may only be paid for the authorized services actually provided to the recipient who assigned them. Timesheets should reflect the hours worked for that specific recipient.

Workweek Agreements for Multiple Recipients

The Provider Workweek and Travel Agreement, or SOC 2255, helps providers who work for multiple recipients organize their weekly schedule and remain within the workweek limit.

The agreement identifies the recipients served and the hours the provider expects to work for each one. If the provider travels directly from one recipient’s location to another recipient’s location on the same day, the form may also address compensable travel time.

Travel time is generally limited to seven hours per workweek. This issue may not arise when siblings live together, but it can matter when the children live in different households or the provider works for additional recipients elsewhere.

The schedule may need to be updated when there is a permanent change in the recipients served or the provider’s regular work schedule.

What Parents Should Do

A parent planning to provide IHSS for more than one child should:

1. Confirm that each child has been separately approved for IHSS.
2. Tell each child’s social worker that the parent wants to serve as the provider.
3. Confirm that each child is enrolled in a program that permits a parent provider.
4. Complete all provider-enrollment requirements.
5. Obtain each child’s authorized-hours and services notice.
6. Ask the county for the parent’s combined weekly work limit.
7. Complete any required workweek agreement.
8. Determine whether another provider is needed.
9. Ask about an Extraordinary Circumstances Exemption when the combined hours exceed 66.
10. Track and submit each child’s hours separately.

Talk to an IHSS Attorney or Advocate

A parent can generally serve as the IHSS provider for more than one child, but the arrangement may become complicated when the children have substantial authorized hours, shared Protective Supervision, paramedical needs, or different IHSS funding programs.

An IHSS attorney or qualified advocate can review the children’s Notices of Action, confirm whether hours were properly prorated, evaluate the provider’s combined workweek limit, and determine whether an overtime exemption may be available.

Need help? In California, the In-Home Supportive Services (IHSS) program provides crucial financial help for families raising children with special needs. American Advocacy Group is on the front lines every day, making positive change happen for people diagnosed with autism, Down syndrome, and a range of diagnoses across the continuum. As a leading advocate for all people with intellectual and developmental disabilities and their families, and the premier provider of the support and services people want and need, we understand the system and know how to take action regarding your best interests.

CONTACT US FOR HELP. Dial (877) 762-0702 or email us at [email protected].

For many parents of children with disabilities, nighttime is anything but restful. Some children experience seizures while sleeping, wander from their beds, attempt to leave the home, or engage in behaviors that place them at risk of serious injury. As a result, parents may spend the night checking on their child, responding to alarms, or staying awake to ensure their child's safety and provide supervision.

If your child requires supervision overnight because of seizures, wandering, or other disability-related behaviors, you may wonder whether those needs can be considered through the In-Home Supportive Services (IHSS) program.

The answer depends on your child's specific circumstances, the nature of the supervision required, and how those needs are evaluated under IHSS rules.

Why Overnight Supervision May Be Necessary

Some medical conditions and developmental disabilities create safety risks that do not stop when a child goes to bed.

Examples may include:

• Seizures during sleep.
• Sleepwalking or wandering from the home.
• Attempts to leave the bedroom unnoticed.
• Self-injurious behaviors.
• Difficulty recognizing dangerous situations after waking.
• Medical conditions requiring immediate intervention during the night.
• Frequent nighttime behavioral episodes.

When these situations occur regularly, parents often must remain alert throughout the night to respond quickly and prevent serious harm.

How IHSS Evaluates Supervision Needs

IHSS may consider supervision needs when a child requires significantly more care than another child of the same age without a disability.

The county generally evaluates whether the child's disability creates a need for ongoing assistance or supervision that exceeds typical parenting responsibilities.

For children who experience nighttime seizures, wandering, or other dangerous behaviors, the assessment may focus on the frequency of the incidents, the level of risk involved, and the amount of supervision necessary to keep the child safe.

Every case is evaluated based on its own facts.

What Evidence Can Support Your Case?

Because overnight supervision often occurs while others are asleep, it can be difficult to demonstrate how demanding it is without proper documentation.

Helpful evidence may include:

• Medical records.
• Neurologist or physician reports.
• Seizure action plans.
• Sleep study results, if applicable.
• Statements from treating providers.
• Behavioral assessments.
• Daily or nightly logs documenting incidents.
• Records showing emergency room visits or injuries related to nighttime events.

Keeping a journal of nighttime incidents—including the time, duration, and type of assistance provided—can help illustrate the level of care your child requires.

Why Nighttime Care Is Often Overlooked

During an IHSS assessment, much of the discussion focuses on daytime activities such as dressing, bathing, eating, and mobility. As a result, parents sometimes forget to explain the amount of care they provide overnight.

If you wake multiple times each night to monitor your child, respond to seizures, redirect wandering, or prevent unsafe behaviors, be sure to discuss these responsibilities during your assessment. Nighttime supervision can be a significant part of your child's overall care needs.

What if the County Does Not Consider Overnight Supervision?

If you believe the county overlooked or underestimated your child's nighttime care needs, you may have options.

Depending on your situation, you may be able to:

• Request a reassessment.
• Submit additional medical documentation.
• Provide detailed records of nighttime incidents.
• Appeal a reduction or denial of services.

Additional evidence can often help provide a clearer understanding of your child's supervision needs.

Speak With an IHSS Attorney

Providing overnight supervision can place an enormous physical and emotional burden on families, especially when a child faces ongoing risks from seizures, wandering, or other dangerous behaviors. If your child's disability requires you to monitor or assist them throughout the night, those care needs should be carefully documented and considered during the IHSS assessment process.

An experienced IHSS attorney can review your case, explain your rights, and help determine whether your child's supervision needs have been fully evaluated.

Need help? In California, the In-Home Supportive Services (IHSS) program provides crucial financial help for families raising children with special needs. American Advocacy Group is on the front lines every day, making positive change happen for people diagnosed with autism, Down syndrome, and a range of diagnoses across the continuum. As a leading advocate for all people with intellectual and developmental disabilities and their families, and the premier provider of the support and services people want and need, we understand the system and know how to take action regarding your best interests.

CONTACT US FOR HELP. Dial (877) 762-0702 or email us at [email protected].

If your family is planning to move, you may be wondering what will happen to your child's In-Home Supportive Services (IHSS) benefits. Many parents worry that moving to another county will cause their services to stop or require them to start the application process all over again.

While moving to a new county can affect how your case is managed, it does not automatically mean your child will lose IHSS benefits. Understanding the transfer process can help make the transition smoother and reduce interruptions in services.

What Happens When You Move?

IHSS is administered by individual counties, but it is part of a statewide program. When you move from one California county to another, your case generally transfers to the new county.

The receiving county will become responsible for managing your child's IHSS case, including future reassessments and ongoing case administration.

Although benefits often continue during the transfer process, it is important to notify both counties as soon as you know you will be moving.

Will My Child Need a New Assessment?

In many cases, the new county will conduct its own assessment after your move. A county social worker may visit your home to evaluate your child's current needs and verify that the authorized services remain appropriate.

This reassessment does not automatically mean your child's hours will increase or decrease. However, because each county reviews cases independently, the new assessment may result in changes if the county determines that your child's care needs differ from the previous evaluation.

Being prepared for the assessment can help ensure your child's needs are accurately documented.

How Can You Prepare for the Transfer?

Before moving, it is helpful to gather important records related to your child's IHSS case.

These may include:

• Your most recent Notice of Action (NOA).
• Medical records.
• Physician certifications.
• Therapy evaluations.
• Behavioral assessments.
• Individualized Education Program (IEP) documents.
• Daily care logs.
• Any records that explain your child's functional limitations and supervision needs.

Having these documents readily available can help the new county better understand your child's ongoing care requirements.

Can My Child's Hours Change?

A move alone does not automatically change the number of authorized IHSS hours. However, if the new county determines that your child's needs have changed—or reaches a different conclusion during its assessment—the authorized hours could increase, decrease, or remain the same.

If you disagree with any changes made after the reassessment, you may have the right to appeal the county's decision.

Carefully reviewing your new Notice of Action is important so you understand any changes and applicable appeal deadlines.

What Should You Do Before Moving?

To help avoid delays or interruptions in services, consider taking these steps:

• Notify your current county about your planned move.
• Inform the receiving county as soon as possible.
• Keep copies of all IHSS paperwork.
• Update your address and contact information promptly.
• Continue documenting your child's daily care needs.
• Attend any scheduled reassessment appointments.

Staying organized can help make the transfer process as smooth as possible.

Speak With an IHSS Attorney

Moving to another county can feel overwhelming, especially when your child depends on IHSS services. While your case will typically transfer rather than start over, questions or disagreements may arise during the new county's assessment process.

If your child's benefits are reduced, delayed, or denied after moving, an experienced IHSS attorney can review your case, explain your rights, and help you determine whether an appeal or other action may be appropriate.

Need help? In California, the In-Home Supportive Services (IHSS) program provides crucial financial help for families raising children with special needs. American Advocacy Group is on the front lines every day, making positive change happen for people diagnosed with autism, Down syndrome, and a range of diagnoses across the continuum. As a leading advocate for all people with intellectual and developmental disabilities and their families, and the premier provider of the support and services people want and need, we understand the system and know how to take action regarding your best interests.

CONTACT US FOR HELP. Dial (877) 762-0702 or email us at [email protected].

One of the most frustrating things a parent can hear during an IHSS assessment is that their child's behaviors are "typical for their age." While it's true that all children need some level of supervision and assistance, children with disabilities often require care that goes far beyond what is expected for their peers.

If the county determines that your child's behaviors are typical, it may reduce or deny IHSS services. However, that does not necessarily mean the decision is correct or that you have no options.

How IHSS Evaluates Children's Needs

When determining eligibility for IHSS services, the county generally compares a child with a disability to another child of the same age who does not have a disability.

The question is not whether your child needs help. Instead, the county looks at whether your child requires substantially more care, supervision, or assistance because of a disability or medical condition.

For example, many young children need reminders to brush their teeth or get dressed. However, a child with autism, developmental disabilities, or other medical conditions may require constant prompting, physical assistance, behavioral intervention, or one-on-one supervision to complete the same task.

Those additional care needs may be relevant when determining IHSS services.

When Behaviors May Be More Than Age-Appropriate

Certain behaviors may appear common at first glance but are actually much more severe or frequent because of a disability.

Examples include:

• Frequent wandering or elopement.
• Aggressive behaviors toward others.
• Self-injurious behaviors.
• Running into traffic or unsafe areas.
• Repeatedly placing dangerous objects in the mouth.
• Severe sensory-related meltdowns.
• Inability to recognize dangerous situations.
• Constant supervision needed to prevent injury.

The key issue is often the intensity, frequency, and level of supervision required—not simply whether another child occasionally displays similar behavior.

Why Documentation Matters

Parents often see their child's daily struggles in ways that cannot be captured during a brief home visit.

Strong documentation can help demonstrate that your child's care needs exceed what is typical for their age.

Helpful evidence may include:

• Medical records.
• Diagnostic evaluations.
• Occupational, physical, or speech therapy reports.
• Behavioral assessments.
• School records and Individualized Education Programs (IEPs).
• Statements from treating providers.
• Daily logs documenting behaviors and the supervision required.

Detailed records can help provide a more complete picture of your child's functional limitations.

What if You Disagree With the County's Assessment?

If you believe the county underestimated your child's needs or incorrectly described their behaviors as age-appropriate, you may have options.

Depending on your circumstances, you may be able to:

• Request a reassessment.
• Submit additional medical or educational documentation.
• Correct factual errors in the assessment.
• Appeal the county's decision within the applicable deadlines.

Many successful appeals involve providing additional evidence that better explains the child's daily care needs and the amount of supervision actually required.

Every Child Is Different

No two children are exactly alike, even if they share the same diagnosis. Autism, developmental disabilities, epilepsy, cerebral palsy, and many other conditions affect children differently.

For that reason, IHSS decisions should be based on your child's individual functional limitations rather than assumptions about a diagnosis or general statements about age-appropriate behavior.

Speak With an IHSS Attorney

If your county has denied or reduced services because it believes your child's behaviors are "typical for their age," don't assume the decision is final. If your child requires significantly more supervision, assistance, or personal care than another child of the same age, those needs should be carefully documented and evaluated.

An experienced IHSS attorney can review your case, explain your rights, and help determine whether additional evidence or an appeal may be appropriate.

Need help? In California, the In-Home Supportive Services (IHSS) program provides crucial financial help for families raising children with special needs. American Advocacy Group is on the front lines every day, making positive change happen for people diagnosed with autism, Down syndrome, and a range of diagnoses across the continuum. As a leading advocate for all people with intellectual and developmental disabilities and their families, and the premier provider of the support and services people want and need, we understand the system and know how to take action regarding your best interests.

CONTACT US FOR HELP. Dial (877) 762-0702 or email us at [email protected].