IHSS: Medical Care or Daily Tasks?

If you or a loved one receives In-Home Supportive Services (IHSS), you may be wondering exactly what types of help the program covers. A common question is: Can IHSS pay for medical care, or does it only cover basic daily tasks?

The short answer is: IHSS does not cover skilled medical care—but it does cover a range of non-medical tasks, including some that support health and safety.

Let’s break down what IHSS can and cannot pay for.

What IHSS Does Cover

IHSS is designed to help eligible people stay safely in their own homes instead of being placed in institutional care. The program covers non-medical personal care and daily living tasks, including:

Personal Care Services:

Bathing and grooming
Dressing
Toileting and incontinence care
Feeding assistance
Assistance with mobility and transfers

Domestic Services:

Housecleaning
Laundry
Meal preparation and cleanup
Grocery shopping
Accompaniment to medical appointments (not the medical care itself)

Protective Supervision:

For individuals with mental impairments or developmental disabilities who need constant supervision to stay safe.

Paramedical Services (Limited Exception):

IHSS can cover certain medical-like tasks called “paramedical services” if:

A doctor prescribes them,
The tasks are necessary to keep the recipient safely at home, and
The caregiver (often a family member) is trained to do them.

Examples of approved paramedical services:

Administering medications
Catheter care
Colostomy/ileostomy care
Tube feeding
Blood sugar monitoring

These services must be authorized by IHSS and supported by documentation from a medical professional.

What IHSS Does Not Cover

IHSS does not pay for:

Skilled nursing care (e.g., IV therapy, wound care by an RN)
Services provided by a home health nurse or therapist
Medical procedures requiring licensed healthcare professionals
Physical therapy, occupational therapy, or speech therapy

Those types of care are typically handled by Medi-Cal home health benefits, private insurance, or separate care providers.

Can IHSS and Medical Services Work Together?

Yes! Many families use IHSS for personal and daily care, while receiving medical care separately through Medi-Cal, private insurance, or regional center programs. IHSS can even complement medical care by supporting recovery or daily functioning at home.

Bottom Line

IHSS mainly covers non-medical, daily living tasks—not skilled medical care. However, some doctor-prescribed paramedical services can be included with proper authorization. To ensure you or your loved one is receiving all the services you're eligible for, it’s essential to communicate with your social worker and healthcare provider.

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].

What Documents Do I Need for the IHSS Application?

If you’re applying for In-Home Supportive Services (IHSS) in California to help care for your child with special needs, one of the first questions that comes up is: “What documents do I need to submit with the application?” The IHSS application process can feel overwhelming, but being prepared with the right paperwork can make a big difference. Here's a breakdown of what you’ll need—and what can strengthen your case.

Basic Required Documents

When you apply for IHSS, your county social worker will need to confirm your child’s eligibility. That starts with:

1. Proof of Identity and Residence

Parent’s ID (driver’s license or state ID)
Proof of address (utility bill, lease agreement, etc.)
Child’s birth certificate or proof of guardianship, if applicable

2. Proof of Medi-Cal Eligibility

IHSS is a Medi-Cal program, so your child must be on Medi-Cal.
If you haven’t already applied, you’ll need to do that first.

3. Completed IHSS Application (SOC 295)

This is the standard IHSS application form. You can get it from your county office or download it online.

Supporting Medical & Educational Documents

The more documentation you provide about your child’s needs, the better. These records help justify the level of care you’re requesting:

4. Medical Records or Doctor’s Letters

Diagnosis or treatment summaries from pediatricians or specialists
Letters explaining your child’s daily care needs and limitations
If applying for protective supervision, have the doctor complete SOC 821

5. Therapy Reports

Reports from occupational therapists, physical therapists, speech therapists, or ABA providers
Any recent evaluations describing delays or behavioral concerns

6. IEP or School Reports

Your child’s Individualized Education Program (IEP), if they have one
Behavioral incident reports or safety concerns documented by the school

Optional but Helpful Documents

These aren’t required, but can strengthen your case, especially if you're requesting protective supervision or a higher number of hours.

7. Daily Care Log

A written log or schedule showing what care you provide every day
Include bathing, feeding, diapering, supervision, and behavioral support

8. Incident Logs or Photos

Notes or photos showing injuries, accidents, or risky behavior due to your child’s condition
Documentation of wandering, self-harm, or medical emergencies

9. Letters from Care Providers or Case Workers

Letters from regional center workers, social workers, or in-home therapists can help explain your child’s needs from a third-party perspective

Final Tips

Be specific: Vague statements like “my child needs help” won’t get the same results as detailed documentation.
Keep copies of everything you submit.
Organize your documents before the social worker’s in-home visit so you’re ready to show them.

The Bottom Line

The IHSS application isn’t just about filling out a form—it’s about showing the state that your child needs extra care to stay safe and healthy at home. With the right documents in hand, you’ll be in a much stronger position to get the hours and services your child deserves.

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

What Is Protective Supervision and How Do I Get It?

If you're caring for a child with special needs through California's In-Home Supportive Services (IHSS) program, you may have heard of something called protective supervision—but what is it, exactly? And how do you qualify?

Let’s break it down in simple terms, so you know what to expect and how to apply if your child needs this essential benefit.

What Is Protective Supervision?

Protective supervision is an IHSS service for individuals—including children—who need 24/7, non-medical supervision to stay safe in their own homes.

This benefit is designed for people who:

Have mental impairments or cognitive disabilities (such as autism, intellectual disability, or certain neurological conditions)
Are at risk of injury to themselves or others
Require constant monitoring, even if they are physically capable

It’s not about hands-on care like feeding or bathing. Instead, it’s about watching over your child to prevent dangerous behaviors or accidents.

What Are Examples of Behaviors That Might Qualify?

To qualify for protective supervision, you need to show that your child has unsafe behaviors due to a mental condition. Common examples include:

Wandering or running into the street
Putting objects in their mouth
Climbing furniture or windows
Self-injury (like head-banging or biting)
Aggression toward others
Lack of awareness about danger (like touching hot surfaces or leaving the house alone)

How Do I Apply for Protective Supervision?

Here are the basic steps:

Request it from your IHSS social worker
You must specifically ask for “protective supervision” during your IHSS assessment or reassessment.
Gather documentation
This is critical. You’ll need written support from:
- Your child’s doctor
- Therapists or behavioral specialists
- IEPs or school incident reports
- Any other documentation showing your child’s mental condition and unsafe behaviors
Complete the SOC 821 form
This is the official IHSS “Request for Protective Supervision” form. Your child’s doctor will need to complete part of it, confirming the need for 24-hour supervision.
Describe specific incidents
During the assessment, be prepared to explain:
- What behaviors put your child at risk
- How often they occur
- What could happen without supervision
- Any past injuries or near-misses

Be honest and specific. Downplaying the severity of your child’s needs can result in a denial.

What If I’m Denied?

Many parents are initially denied protective supervision, but go on to win on appeal. If you receive a denial:

Request a state hearing within 90 days
Gather additional evidence
Consider working with an advocate or legal representative who specializes in IHSS cases

Final Thoughts

Protective supervision is one of the most misunderstood—and often underutilized—services under IHSS. But for families caring for children with cognitive disabilities and behavioral challenges, it can be a vital source of both financial supportand validation of the care you provide every day.

If you think your child qualifies, don’t wait. Start gathering documentation and request an assessment or reassessment. With the right preparation, you can get the support your family needs.

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

Disputing Your IHSS Hours Decision

If you’ve been approved for California’s In-Home Supportive Services (IHSS) but feel the number of hours awarded isn’t enough to meet your needs—or the needs of someone you're caring for—you are not stuck with that decision. You have the right to appeal your IHSS hours.

Whether you’re a recipient or a caregiver helping someone navigate the process, here’s what you need to know about appealing IHSS hour determinations.

Understanding IHSS Hours

IHSS hours are based on an assessment by a county social worker, who evaluates what tasks a person needs help with and how much time those tasks should reasonably take.

These tasks include:

Personal care (bathing, dressing, grooming)
Domestic chores (cleaning, cooking, laundry)
Medical-related assistance
Protective supervision (for individuals who need 24-hour monitoring for safety)

After the assessment, the county issues a Notice of Action (NOA) stating how many hours per month have been approved.

What If You Disagree?

If you believe the hours are too low, don’t cover your actual needs, or were based on incorrect information, you can appeal the decision.

Common reasons to appeal:

You believe the county underestimated your needs
Your condition has worsened or wasn’t fully understood
The social worker missed or misclassified certain tasks
You were denied protective supervision, which you believe is necessary

How to File an Appeal

You can appeal by requesting a State Hearing. Here's how:

Look at your Notice of Action (NOA)
You must appeal within 90 days of the date on the NOA.
Complete the back of the NOA or use form SOC 295
This is the IHSS Appeal Request Form.
Mail or fax your appeal to:California Department of Social Services
State Hearings Division
P.O. Box 944243
Mail Station 9-17-37
Sacramento, CA 94244-2430
Fax: (916) 651-5210
Request an “Aid Paid Pending” hearing if needed
If your hours are being reduced, and you appeal within 10 days of the NOA date, you can request to keep your current hours during the appeal process.

What Happens Next?

After you file:

You’ll get a notice with the date and time of your hearing (usually within 30–60 days).
The hearing is typically done by phone, but you can request in-person if needed.
You’ll present your side to an administrative law judge.
You can bring evidence, doctors’ letters, or even witnesses.
The judge will issue a decision—often within a few weeks.

Tips for a Strong Appeal

Gather medical records that show your physical or mental health conditions
Document your daily needs, including how long tasks actually take
Ask your doctor or therapist to write a letter of support
Be specific about safety concerns if requesting protective supervision

You can also get free help from:

Legal Aid offices
IHSS advocacy organizations
Disability rights groups

Final Thoughts

Yes, you absolutely can appeal if you don’t agree with the number of IHSS hours awarded. The appeal process is a powerful tool to ensure your needs—or the needs of a loved one—are fully recognized and supported. Don’t be afraid to speak up about this decision, especially if your health or safety is at risk.

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

Does IHSS Income Affect My Other Public Benefits?

If you’re receiving income through California’s In-Home Supportive Services (IHSS) program—whether as a provider or a recipient—it’s important to understand how that income may impact your eligibility for other public benefits like Supplemental Security Income (SSI), Medi-Cal, CalFresh (food stamps), or Section 8 housing. The answer is not always straightforward, but we’ll break it down for you here.

What Is IHSS Income?

IHSS pays individuals to care for elderly or disabled people (including family members) in their own homes. The goal is to allow people to remain safely in their communities rather than being institutionalized. IHSS payments are considered income to the provider, but how they’re treated by other benefit programs depends on your role and your relationship to the recipient.

1. Does IHSS Income Affect SSI?

It depends on who you're caring for.

Parent caring for a minor child OR spouse caring for a spouse: If you’re living in the same home and caring for your own child or spouse through IHSS, that income is excluded from your countable income for SSI purposes. This means it will not reduce your SSI benefits.
Caring for someone else (not your child or spouse): If you’re an IHSS provider for someone other than your own minor child or spouse, then the IHSS income is counted and can reduce your SSI benefit.

Why? This special rule comes from a Social Security policy exception (often referred to as the “In-Home Parent/Spouse Provider Exclusion”).

2. Does IHSS Income Affect Medi-Cal?

Again, it depends on the situation:

If your only income is IHSS payments for caring for your child or spouse, and you live together, then that income is not counted for Medi-Cal eligibility in most cases.
However, if you have other income or are paid to care for someone else, that income may count and could affect Medi-Cal eligibility depending on your income limits.

Good news: Medi-Cal offers several programs with different income limits, so even if some income is counted, you may still qualify.

3. Does IHSS Income Affect CalFresh (Food Stamps)?

CalFresh usually does count IHSS income, unless it qualifies for the spouse/parent provider exclusion.

If you're caring for your own child or spouse and live with them, your IHSS income may be excluded and won’t impact your CalFresh benefits.
If you're caring for someone else, that income is counted and could reduce your food stamp amount.

4. Does IHSS Income Affect Housing Benefits (like Section 8)?

Section 8 housing authorities typically count IHSS income when calculating rent and eligibility, even if other programs exclude it. However, you should report all income and let your local housing authority determine how they treat IHSS pay, as policies can vary slightly.

Key Takeaways:

IHSS income is sometimes excluded, sometimes counted—it depends on your relationship to the person you care for and the benefit program.
For SSI and Medi-Cal, if you’re caring for your own child or spouse and live with them, IHSS income is generally not counted.
For CalFresh and Section 8, IHSS income is usually counted, but there are exceptions.
Always report all income, and ask about special exclusions based on your caregiving relationship.

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