The In-Home Supportive Services (IHSS) program is administered, for the most part, by the county welfare office, often known as the Department of Social Services. This program provides assistance to eligible persons with disabilities who are unable to remain safely in their homes without assistance.
Eligibility An individual is eligible for IHSS, if he or she receives SSI/SSP, or similar types of assistance, and if IHSS is needed to live safely in his or her home.
In determining need for IHSS, county workers must determine that (1) the services needed are not available through alternative resources, and (2) the individual is unable to remain safely at home without the services.
Services The primary services are: (1) domestic and related (e.g., cooking, cleaning, laundry, shopping); (2) personal care services (e.g., bathrooming, dressing, helping the person eat); (3) essential transportation (e.g., to doctor's appointments); (4) protective supervision (e.g., watching and intervening if someone would walk into the street, etc.); and (5) paramedical services, including giving injections, under the supervision of a licensed professional. Limited yard hazard clean-up and, under the condition that the person will become more self-sufficient, some teaching and demonstration can be included.
Assessment of need The county worker will do an initial assessment of need, and annually reevaluate that need. In some service areas, the county worker will write down 'standard norms' unless you can support a need for more services. If there are special circumstances, be sure to bring these to the county worker's attention. Be sure to ask for a paramedical form if you need help with injections, tracheotomy suctioning, range-of-motion, or other assistance.
The county worker will fill out forms known as "SOC 293" and "SOC 293a," which will set out how much time per week you have been allowed for service. Your county worker must give you a copy of these forms if you ask for them. The maximum hours for people with significant needs is 283 hours of service per month. For all others who are eligible, the monthly maximum is 195 hours.
Protective Supervision Under IHSS regulations, protective supervision is only available to "safeguard the recipient against injury, hazard or accident." Regulations further stipulate that the need (1) may not be caused by a medical condition and the form of supervision is medical; or (2) be in anticipation of a medical emergency; or (3) be to prevent or to control anti-social or aggressive behavior.
How are IHSS organized, delivered, and paid for? The County will typically pay $5.75 per hour (sometime slightly more in unusual circumstances), when the IHSS person is hired by the person with a disability. IHSS workers paid by contract agencies typically earn more. IHSS workers are covered by workers' compensation if hurt on the job, and have state disability and unemployment insurance coverage.
Sometimes, the person with a disability will supplement the worker's pay, or pay for additional services. Likewise, a family member or friend may supplement the hourly rate or pay for extra services. As long as the money goes directly to the IHSS worker, and does not go through the SSI recipient's hands, it will not be counted as income to the person with a disability.
If the person receiving IHSS services is not in a position to be a good employer, there may be several options to consider. If the person is receiving supported living services, a community support facilitator may be able to assist the person to be [or learn to be] a better employer. In some cases, a personal advocate, parent, or close family member or friend may be able to help.
For an excellent overview, see In-Home Supportive Services, which can be ordered from Protection and Advocacy, 100 Howe Avenue, Suite 185 North, Sacramento, CA 95825. Call (800) 776-5746. Suggested donation $14.00.
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