Home Care Benefits (IHSS)

SAN DIEGO SENIOR SURVIVAL GUIDE - PART I
Care at Home through In-Home Support Services

What is In-Home Supportive Services (IHSS)?

In-Home Supportive Services (IHSS) is a California state program that helps Seniors by paying for in home care services to help older adults remain safely in their homes.  Within San Diego County the program is administered by the County.  In Home Supportive Services provides personal care and household assistance.  IHSS services often include domestic chores, personal care, and accompanying clients to medical appointments.  Information about the program as it is run in San Diego County can be found at: http://www.sdcounty.ca.gov/hhsa/programs/ais/inhome_supportive_services/index.html

Three Prong Eligibility Test

In order to qualify individuals need to qualify for the program three ways.

• First, to qualify for help through the IHSS program an applicant must need help in order for them to live safely at home;
• Second, this program is only available to individuals who are blind, or disabled, or be at least 65 years of age; and,
• Third, to receive benefits an applicant must qualify under specific financial eligibility guidelines.  Individuals can either qualify for free in home care services under these guidelines or may qualify for subsidized services with a co-pay which is referred to as a share of cost.  Within financial guidelines Disabled individuals are not disqualified by working.  

The financial rules for qualification can seem complex.  All individuals who are recipients of Supplemental Security Income (SSI) automatically qualify.  Under the IHSS financial eligibility criteria, only qualifying individuals who have below a certain amount of non-exempt assets can participate in the program.  For those individuals their income determines their required share of cost.  The Attorneys in our office help families arrange their financial affairs so that they can qualify, and qualify with the least possible share of cost (co-pay).

Applying for Benefits

If is easy to start the qualification process. You start it with a phone call.  Seniors and their family members in San Diego can call (800) 510-2020 to apply over the phone.  If the program representative determines over the phone that you are potentially eligible, a Social Worker will be assigned to your request.  We feel that it is important for Seniors and their families to know what needs to be communicate over the phone in order to get the process rolling.  If you are successful in answering the Phone Screener's questions a Social Worker will make an appointment to visit you at your home.  Then you wait for the Social Worker's visit.  This is the biggest delay in accessing in home support services.  When the Social Worker visits they will talk with you about your medical condition and your ability to do different tasks of daily living without help.  They will ask you about your current living arrangements and what help you are receiving from friends and family.  Your Social Worker will brief you more fully on IHSS, determine which services they feel you need, and how often you need that help.  They may also contact your doctor to confirm your medical condition.  A separate specialist will calculate any share of cost which you must pay for the services you receive.

How much help can I get?

Three factors influence how much help is made available to each individual under the IHSS program. 

• The first factor is of course how much help is needed.  Services may include personal care (bathing, feeding, transferring, bowel/bladder care, etc.); domestic tasks (cleaning, shopping, laundry, etc.); and certain paramedical services.

• The second factor which determines the amount of in home help which is available to a senior are the California State guidelines.  The maximum amount of care which the State will provide under the IHSS program is 283 hours per month.  This means up to a little more than 51 1/2 hours a week or a little less than 9 1/2 hours a day.  Round the clock care is not available.  Although these limits seem generous, prior to our current budget crisis most benefit recipients received only about 20 hours a week.

• The final factor which limits how much help is available to seniors to let them stay in their homes safely is California's budget crisis.  Reduced funding has certainly slowed the IHSS's application processing time and it is believed that it has also reduced the numbers of hours of care made available to needy taxpayers.

How do I find and pay someone to take care of me?

Selecting someone to help you or your parent continue in their own household is not easy.  The first person you choose to provide help in your home may not be the right person.  In accepting someone into your home - even part time - is almost like a relative visiting for too many days, or a new spouse moving in, but without the romance.  Each individual quirk can be annoying.  Recognizing this, the IHSS system allows benefit recipients to select their own homecare worker.  Your are able to choose almost anyone you want including family members and friends.  You get to hire, supervise and if need be, fire them.

Realizing that many Seniors need help finding a homecare worker, the IHSS Public Authority maintains a registry of screened homecare workers.  Help through the Registry is available in both English and in Spanish and is available to both benefits recipients and for individuals who are paying their own costs out of pocket.  The Registry's services also extend to providing on call service for individuals in need of immediate personal care during any time when they don't have a regular worker, such as when they are new to IHSS, are newly coming home from the hospital, or have lost or terminated their homecare worker.

The Public Authority also provides free training for homecare workers in general homecare issues, first aid and CPR.  The San Diego Public Authority Registry Department can be reached at (866) 351-7722.  Several non-profit agencies also help individuals find homecare workers including Jewish Family Services (858) 637-3040 and Elderhelp (619) 284-9281

How do my homecare workers get paid?

At this time homecare workers are paid $11.50/hr by IHSS.  The IHSS system shoulders most of the paperwork burden which ordinarily falls on an employer.  The homecare worker and a Senior (or their family) fill out timesheets for submission twice a month.  The homecare worker then submits the timesheets to the County IHSS unit.  A government unit cuts the paychecks, and workers are issued paychecks from the State.