If you work with elderly Medi-Cal members, you’re probably familiar with IHSS. But what does it mean for the members you serve every day? IHSS approval can take weeks or months, authorized hours do not always cover the full extent of a member’s needs, and when a family caregiver burns out, care can stop abruptly.
This blog covers:
- What is the IHSS program?
- Who qualifies for IHSS in California?
- How the IHSS application process works
- How 24 Hour Home Care bridges gaps in IHSS care
What is the IHSS program?
California’s In-Home Supportive Services (IHSS) program is a Medi-Cal benefit that provides non-medical, in-home care to eligible members who need assistance with daily living activities due to age, disability, or blindness. The goal of the California IHSS program is straightforward: help people remain safely at home rather than entering a nursing facility or other institutional care setting.
IHSS in-home care covers a range of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) under Personal Care and Homemaker Services, including:
- Bathing, dressing, and grooming
- Toileting and incontinence care
- Meal preparation and cleanup
- Medication reminders
- Light housekeeping
For elderly members, these are often the exact services that determine whether living at home remains possible. When they go unmet, the consequences are predictable: falls, emergency room visits, hospitalizations, and facility placements that could have been prevented. The cost to the Medi-Cal system, and to the member’s quality of life, increases significantly with every gap in care.
Who qualifies for IHSS in California?
To qualify for the California IHSS program, a member must meet all of the following criteria:
- Be a California resident
- Be enrolled in Medi-Cal
- Receive a Medi-Cal eligibility determination that requires functional need for assistance with ADLs/IADLs
- Live at home (members residing in acute care hospitals, nursing facilities, or licensed community care facilities are not eligible)
- Have a completed Health Care Certification form submitted by a licensed health care provider
Once these criteria are met, a county social worker conducts an in-home assessment to determine the number of authorized hours based on the member’s level of need. This can take weeks or even months. Any delay in care increases the risk of hospitalization or emergency room visits, as well as the need for more expensive skilled nursing.
For a detailed breakdown of eligibility requirements, read our blog, IHSS Eligibility Requirements: Who Qualifies? >
While waiting for IHSS approval, 24 Hour Home Care can facilitate non-medical, in-home care through a family-selected care provider.
How the IHSS Application Process Works
The IHSS application process typically follows these steps:
- Application submitted: The member or their authorized representative submits an application to the county IHSS office.
- Health Care Certification: A licensed health care provider completes and submits the required certification form confirming the member’s functional need.
- In-home assessment: A county social worker visits the member at home to evaluate their care needs and determine authorized hours.
- Notice of Action: The county issues a decision approving or denying IHSS and specifying the number of authorized hours.
- Provider enrollment: The member selects a caregiver, who must complete the IHSS provider enrollment process before paid care can begin.
For a step-by-step walkthrough of the application process, see How to Apply for IHSS in California >
From application to first paid care session, this process can take anywhere from several weeks to several months. For elderly members with immediate care needs, that gap is not just an inconvenience — it is a genuine health risk. Without support in place, members are more likely to fall, miss medications, skip meals, and end up in an emergency room or nursing facility before their IHSS hours ever begin.
IHSS assessment and approval can take weeks or even months. While waiting for IHSS approval, 24 Hour Home Care can facilitate non-medical, in-home care.
How 24 Hour Home Care Bridges Gaps in IHSS Care
Medi-Cal managed care plans can authorize Community Supports, such as Personal Care and Homemaker Services and Respite Care, as a complement to IHSS, at no cost to the member. These Community Supports can fill care gaps that IHSS cannot.
If your member is in any of the following situations, 24 Hour Home Care can help get care in place quickly:
- Pending IHSS approval: IHSS assessment and approval can take weeks, even months. 24 Hour Home Care can provide services during that waiting period, eliminating care gaps and ensuring your member has in-home support before IHSS hours begin.
- Maxed out of IHSS hours: When a member’s care needs exceed their authorized IHSS hours, Community Supports can supplement the difference. Rather than leaving a gap in coverage, 24 Hour Home Care can step in to provide the additional hours your member needs.
- Primary caregiver needs a break: Caregiver burnout is a common and preventable reason elderly members end up in a nursing facility. Respite Care gives family caregivers temporary, flexible relief so they can continue providing care without reaching a breaking point. Respite Care does not require an IHSS connection — any member who meets program criteria may be eligible regardless of their IHSS status.
The impact is measurable. DHCS data shows that Respite Care members experience 43.4% lower inpatient costs, and Personal Care and Homemaker members show 28.9% lower rates of avoidable institutionalization. Addressing daily living needs consistently and early reduces the gaps that too often lead to preventable hospitalizations and facility placements.
Learn more about 24 Hour Home Care CalAIM Community Supports >
How 24 Hour Home Care Delivers Community Supports
24 Hour Home Care is one of California’s leading providers of CalAIM Community Supports, partnering with every major Medi-Cal health plan to deliver in-home personal care and respite services to members across the state.
Rated 4.65 out of 5 stars by members. We partner with California’s leading Medi-Cal health plans across 58 counties.
For community partners, working with 24 Hour Home Care means:
- Referrals processed quickly: We verify eligibility and manage authorization directly with the health plan
- Consistent communication: We work directly with your members, walking them through every step to get care started quickly.
- A trusted, established partner: We have years of experience navigating the CalAIM system alongside health plans, care coordinators, members, and families.
How to Refer
Referring your member to 24 Hour Home Care for Personal Care and Homemaker Services or Respite Care takes just a few minutes. Here is how it works:
- Referral is submitted: A care coordinator, social worker, or health plan submits a referral on the member’s behalf
- Authorization: Our team works directly with the health plan to verify eligibility and secure authorization
- Onboarding: We handle hiring, training, background checks, and payroll for the caregiver the family has chosen
- Care starts: Care can begin with someone the member already knows and trusts, familiar and consistent from day one
