How I Got Approved for 228 Hours Per Month in IHSS

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).

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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)

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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