How I Got Approved for 228 Hours Per Month in IHSS

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Art: Robin Mead

IHSS is a program in California that provides free home aides for people with disabilities. IHSS can also provide a salary to a friend or family member who is caring for a loved one.

Bougainvillea was approved for IHSS in LA County in just two weeks and received 228 hours per month (54 hours per week). These hours will be used to pay her current caregiver who helps her with household tasks and personal care needs caused by Mast Cell Activation Disorder.

Bougainvillea kindly wanted to share her story to help others. If you are looking for more ideas on how to increase your care hours, take a look here:  The Self-Advocate’s Guide to State Home Aides

Bougainvillea’s Story

Good news! I was approved for IHSS at 228 hours a month. It took only 2 weeks from home visit to approval! A special thanks to everyone who encouraged me to pursue IHSS even though I felt overwhelmed and thought it would be hard.

It has not been hard. Much easier than applying for disability. This is what we did. It looks like a lot, but it wasn’t:

1) We called IHSS to apply (5 min, plus a bit of wait time). I procrastinated and avoided sending in my paperwork and scheduling my home visit for two months because I was scared of having a visitor ruin my safe home, but most people could finish that part in a few weeks.

2) I got a copy of the application form, filled out a draft, got my doctor’s signature, and sent it to my Social Worker.

3) Even though this was not requested, I attached key medical records that documented my illness and functioning.

4) I also attached doctor letters describing my functioning and limitations and how severely ill I am (Luckily, I already had these letters from my disability application). Sample disability letters from doctors.

5) If you don’t have a doctor’s letter documenting functioning, you can work with your doctor: How to Work with Your Doctor to Get a Great Letter. If your doctor doesn’t like writing letters or filling out forms: How To Get Your Doctor to Fill Out Paperwork

6) Next, I read the IHSS Advocates Manual 

7) We used the IHSS Manual to create a chart of my care needs.

  • In the first column, I copied and pasted the “Services” categories and subcategories (see list below). This lists everything my caregiver could be paid for doing.
  • In the second column, I wrote down in more detail what kind of care my caregiver provides in each category, using the guidance from the IHSS Manual to make sure I was as specific as possible, especially on services my caregiver provides that others have been approved for in the past.
  • In the third column, we recorded how many hours he spent doing each category for 6 weeks.

8) Before the home visit, my caregiver left a voicemail explaining how sick I was and the need for the worker to wear a Tyvek suit to the visit to protect me.

9) My caregiver met the social worker at the door the day of the visit. He showed the apartment for five minutes. The social worker was worried about impacting my health and asked to meet with my caregiver in another part of the building for the rest of the interview.

10) My caregiver sat with the Social Worker for 90 minutes and answered questions. He gave his answers directly from what was written on the chart we prepared. He also gave her a copy.

11) While we were waiting for the decision, my caregiver enrolled to be an IHSS provider: He went to a 3 hour orientation, signed paperwork, and got fingerprints done.

12) The case worker said my hours may be increased as high as 283 hours once my doctor sends in the paramedical forms. That is our next step.

If you’re on the fence, I strongly recommend applying, especially if you have a caregiver already (as this person can get paid for their care – my caregiver will earn more than my Social Security disability check each month).


IHSS Covered Services 

Here’s a list of what California covers. From the  IHSS Advocates Manual

Note: Every state is different. Some states will not cover yard hazard abatement, heavy cleaning, or some of the tasks listed under domestic services. Also, some states have a limit on number of hours for domestic services. For example: no more than one hour per day total for meal preparation, cleaning, shopping, chores and housekeeping.

1. DOMESTIC SERVICES *

  • a. Sweeping and Vacuuming *
  • b. Washing kitchen counters *
  • c. Cleaning oven and stove *
  • d. Cleaning and defrosting refrigerator *
  • e. Cleaning bathroom *
  • f. Storing food and supplies *
  • g. Taking out garbage *
  • h. Dusting and picking up *
  • i. Bringing in fuel for heating or cooking purposes from a fuel bin in yard, miscellaneous *
  • j. Changing bed linens *
  • k. Miscellaneous *

2. RELATED SERVICES

  • a. Preparing meals, serving meals, cutting up food *
  • 1. Breakfast
  • 2. Lunch
  • 3. Dinner
  • 4. Snacks
  • b. Meal clean up and menu planning *
  • 1. Breakfast
  • 2. Lunch
  • 3. Dinner
  • 4. Snacks
  • c. Laundry, mending, ironing, sorting, folding and putting away clothes
  • d. Shopping for food
  • e. Other errands

3. HEAVY CLEANING

4. NONMEDICAL PERSONAL SERVICES

  • a. Respiration
  • b. Bowel/bladder care (including help on/off commode) *
  • c. Feeding and drinking *
  • d. Bed baths *
  • e. Dressing *
  • f. Menstrual care *
  • g. Ambulation *
  • h. Moving into and out of bed *
  • i. Grooming, bathing, hair care, teeth and fingernails *
  • j. Rubbing skin to aid circulation, turning in bed, repositioning in wheelchair, help in and out of vehicles *
  • k. Care and help with prosthesis (including wheelchair) *

5. MEDICAL TRANSPORTATION

  • a. To medical appointments
  • b. To alternative resources

6. YARD HAZARD ABATEMENT

7. Protective Supervision

8. TEACHING AND DEMONSTRATION

9. PARAMEDICAL SERVICES * (i.e., catheterization, injections, range of motion exercises, etc., specify)


Learn More

IHSS also has a special program that provides additional hours for adults and children at risk for self-harm: How I Got Approved for IHSS Protective Supervision

Navigating Medicaid and Medi-cal home aide program: The Sleepy Girl Guide to State Home Aides

Good Facebook Groups: IHSS Advocates and IHSS Consumers and Providers 

20 thoughts on “How I Got Approved for 228 Hours Per Month in IHSS”

  1. What is the maximum number of hours a person can receive from IHSS. My sister who was on IHSS for 80 hrs/month suffered a stroke and has been hospitalized and put into a SNF. She has been out of her apartment for 6 months and wants to go home. She is basically bedridden, needs help getting into a wheelchair, and is diabetic as well as suffering from early dementia. All she wants is to go home. Is it possible to get IHSS for this type of situation?

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    1. There are several good IHSS Facebook groups. You might try asking this question there, as there are many knowledgeable families. You can try IHSS consumers and providers united.

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  2. my mom is so confused she is 77 years old she can not beget shorts her self neither check suger how we can get more hours she is getting only 165 thanks

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  3. I think people need to realize when you read the policies for IHSS the protective supervision is only for a severe mental illness. We’re talking dementia drinking chemicals illness that they need to be supervised.

    Reading more about the hours to get more than most you have to qualify for paramedical services (gtube, wound care, etc.) but if you don’t the state has a set of guidelines that you follow. It’s really rare that it goes over as I’ve been told speaking to the helpline and the different offices. Now of course it sounds like there was a different need for this illness but the most common range is 20-30 hours a week. This is not 24 hour full care and I don’t think most people realize this, this is assistance with tasks of daily living to remain safely in the home per the website (meals, meal clean up, laundry, etc).

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  4. My aunt worked a job then had to have a limb removed.. does she qualify for ihss well will she have to pay for help im confused because she worked and now she is bed ridden meaning she can’t work

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  5. My aunt worked a job then had to have a limb removed.. does she qualify for ihss well will she have to pay for help im confused because she worked and now she is bed ridden meaning she can’t work

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    1. They have to get An SOC 873 (health care certification form) done by their doctor and also have Medí-Cal. If the Medi-Cal has a share of cost, she’ll have to pay that before they pay for anyone to help take care of her. The best I could say if apply and see what happens.

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    2. She needs to be eligible for medi-cal before she could even apply to IHSS. IHSS does an assessment in real time- meaning that they go based on her needs at that specific time. Losing a limb does not necessarily prevent some people from being completely independent (there may be some assistive devices that could also help them regain full independence). So, it is really about your aunt and her specific needs at the time the home assessment is done.

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  6. Can a recipient of IHSS become a provider if the care involved is within the realm of what he is able to do? Ie: a specific care position that involves a supportive relationship and rides to drs appointments. Mentor related. Would this be acceptable?

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    1. I don’t know the answer to this, but some IHSS recipients do work. I assume this would be treated like any other job, and they can’t discriminate against hiring someone because that person is disabled.

      I wonder if it might cause IHSS to review the person’s hours more closely, just to make sure they really need care themselves.

      If the person is on disability, they would need to report to social security that they are working. If they are on SSI, it will lower their check. SSDI will not lower, but will still need to follow work rules. https://howtogeton.wordpress.com/2017/05/03/how-to-work-without-too-much-trouble/

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  7. its a great program. i wish they had it nationally. i used to be a provider before i got sick there. you can even have family or friends become your ihss worker. so they can get paid for their time caretaking!

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  8. what happens after you get fingerprints done and paid for? I have to pay for them next month. Let me know thanks.

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    1. I was on ihss and out of nowhere they denied me my ihss who has been taking care of me during the day and at night my spouse helps me out too. I’m beddridden and have tested positive for colon cancer. I am immobile and have tested positive for colon cancer and I have a DISEASE that there’s no cure for and it’s called Neurofibromatosis type 1 and I suffer everyday life and need help with everything I do. I need to get BACK my ihss worker. We are not rich by any means whatsoever. Please don’t call me back. You can TEXT ME BACK. The social worker gave my provider hour’s and approved me since 2008 at least. I desperately need my provider back to me as soon as possible so I live in my home.

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      1. My brother also has nf1 and has malignant peripheral nerve sheath tumor and we just got a letter he was only approved 40 hours a MONTH!!!! I take care of him every single day! He’s starting radiation soon 5 days a week 35 mins one way from us. Ugh the case worker seems like a joke!

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