Public Benefits Guide
IHSS for Regional Center adults, explained clearly.
In-Home Supportive Services pays for help at home so an adult with a disability can keep living in their own home or with family. This guide explains who qualifies, how the county decides hours, who can be the provider, and how IHSS fits with Regional Center services.
This guide provides general educational information. The county IHSS office makes the eligibility and hours decision after a home assessment of the applicant's complete situation.
IHSS is a Medi-Cal benefit. Regional Center eligibility does not create it.
To receive IHSS, a person must live in California, live in their own home or a family home (not a licensed facility), have a Medi-Cal eligibility determination, and need help with daily tasks because of age, blindness, or disability. The county IHSS office decides eligibility and hours. The Regional Center does not, and being a Regional Center client does not approve or deny IHSS on its own.
Where to begin
Start with your current situation
Choose the option closest to your situation. Each one changes what you should do first and what to say to the county.
Already has full scope Medi-Cal or SSI
You can apply for IHSS right away. Submit the SOC 295 application to the county IHSS office. The date the county receives it protects the start date, so if IHSS is approved, hours can be paid back to that date.
The county will mail a Health Care Certification form (SOC 873) for a licensed health care provider to complete. Return it within 45 days of the application date, then the county schedules the home assessment.
Does not have Medi-Cal yet
IHSS requires a Medi-Cal eligibility determination, so Medi-Cal comes first. You can submit the IHSS application at the same time to protect the start date, and the county will review Medi-Cal eligibility as part of the IHSS intake.
Read our companion guide on how adults who receive Regional Center services apply for Medi-Cal, including the parent income rules and the 250% Working Disabled Program.
Needs someone nearby to stay safe
Ask the county to assess Protective Supervision. This IHSS service is for people whose judgment, memory, or orientation is impaired in a way that could lead to injury without someone observing them. It is assessed separately from personal care tasks and can add a large block of hours.
Bring documentation: the IPP, psychological or behavioral assessments, and specific examples of unsafe behavior. The county may ask for a 24 Hour Coverage Plan (SOC 825) showing how supervision is covered around the clock, since IHSS does not pay for 24 hours a day.
Lives with family, and a family member wants to be the provider
For an adult age 18 or older, a parent, sibling, or other relative can be the paid IHSS provider. The adult recipient is the employer: the adult chooses the provider, signs the timesheets, and can change providers at any time. Spouses have separate rules.
The provider must complete county enrollment: a provider orientation, a Live Scan criminal background check, and the SOC 426 enrollment form. Enrollment can take several weeks, so start it as soon as IHSS is approved. A family member who is not enrolled cannot be paid.
Already receives Regional Center services at home
IHSS and Regional Center services work side by side. Under the Lanterman Act, Regional Centers use generic public resources like IHSS first for the needs IHSS covers, then fund what IHSS does not. Your service coordinator may ask whether you have applied.
Tell the IHSS social worker which Regional Center services you receive and when they happen, and tell your service coordinator how many IHSS hours were authorized. Neither agency should count the other's hours as covering a need it does not actually cover.
Not sure whether IHSS fits
If the adult needs hands on help or supervision with daily tasks such as bathing, dressing, meals, medication, housework, or getting to appointments, it is worth applying. The county decides after the home assessment, and applying costs nothing.
You do not have to know which IHSS program or how many hours before you apply. Describe the need accurately and let the social worker assess it.
Services and hours
What IHSS pays for
The county assesses each task the person cannot safely do alone and assigns time to it. The total becomes the monthly hours a provider can be paid for.
Types of service
- Domestic services: housework, laundry, shopping, errands
- Related services: meal preparation and cleanup
- Personal care: bathing, grooming, dressing, toileting, feeding, moving around, medication reminders
- Paramedical services ordered by a licensed provider, such as certain injections or tube feeding
- Protective Supervision for people at risk of injury without observation
- Accompaniment to medical appointments and other places IHSS services are received
Monthly hour limits
283
Maximum hours per month for a person assessed as severely impaired: 20 or more hours per week of personal care, meal preparation and cleanup, and paramedical services combined
195
Maximum hours per month for a person assessed as non severely impaired
Hours are not automatic
Nobody receives the maximum by default. Hours are built task by task from the assessment and from state hourly task guidelines. If the assessed need is higher than the cap, ask the social worker to record the unmet need on the Notice of Action. That record matters for Regional Center coordination and for any appeal.
Providers
Who can be the IHSS provider?
The adult recipient chooses. A parent, relative, friend, or a person from the county Public Authority registry can be hired. The recipient is the employer.
- 1The provider completes enrollment with the county: orientation, Live Scan fingerprinting, a criminal background check, and the SOC 426 form signed by both the recipient and the provider.
- 2Wages are set county by county and change when a county's agreement is renewed. Check the current rate for your county on the official CDSS wage table linked below rather than relying on a number in an article.
- 3Providers record time in the Electronic Services Portal or by telephone timesheet. The recipient approves each timesheet. The State pays providers twice a month.
- 4Overtime and weekly hour limits apply to providers. A provider who works for more than 1 recipient, or who would go over the weekly limit, needs to check the rules with the county before working the hours.
- 5A recipient can have more than 1 provider and can split the authorized hours between them. The total across all providers cannot exceed the monthly authorization.
- 6If the recipient needs help finding someone, the county Public Authority registry can provide a list of screened providers.
Documents
What to prepare before applying
Check items off as you gather them. Only the checkmarks are saved in this browser. This page never asks you to type personal information.
Application basics
Medical and disability records
Regional Center
For the home assessment
Application
How to apply
You can apply at any time of year. Several counties advise allowing up to 90 days for the full process, from application to authorized hours.
Submit the SOC 295 to the county IHSS office
Apply by phone, mail, fax, or online, depending on the county. Write down the date the county received the application. That date protects retroactive payment if IHSS is approved.
Confirm Medi-Cal
If the adult already has full scope Medi-Cal or SSI, the county verifies it. If not, the county reviews Medi-Cal eligibility as part of intake, which can add time.
Return the Health Care Certification (SOC 873)
A licensed health care provider completes it. Return it within 45 days of the application date. Health care providers may not charge a fee for completing this form.
Complete the home assessment
A county social worker visits the home, interviews the adult and, with permission, family or providers, and rates the adult's ability on each task. Describe the hardest days, not the best ones, and ask for Protective Supervision or paramedical services if they apply.
Read the Notice of Action
The county mails a written Notice of Action listing each service, the hours assigned, the total monthly hours, and any share of cost. Keep it. If anything looks wrong, see the appeals section below.
Hire and enroll the provider
The adult chooses the provider. The provider completes orientation, Live Scan, and the SOC 426 with the county. Payment starts after enrollment is complete and timesheets are submitted.
The visit that decides hours
Preparing for the home assessment
Most under authorizations happen because the family described a good day, or did not mention a need because it felt normal. The assessment is about what the adult cannot safely do alone, task by task.
- 1Walk through a full day and night before the visit. Note every task where someone prompts, supervises, or does part of it.
- 2Say how long tasks take on a difficult day. The social worker assigns time to each task, so minutes matter.
- 3Explain what happens without help: refusals, incomplete tasks, falls, wandering, or health risks. Specific recent examples are more useful than general statements.
- 4The adult can speak for themselves and can also ask a family member or advocate to be present. Both can share information.
- 5Share the IPP and any assessments, and name the Regional Center services already in place so the social worker understands the whole picture.
- 6Ask the social worker to state, in writing, which tasks were assessed and which were not, and to note any unmet need above the monthly cap.
Person centered, not minimized
Describing needs accurately is not the same as speaking negatively about the adult. It is how the county sees the real level of support that makes life at home work. The adult's strengths still count. The assessment simply needs the whole picture.
What to say
Scripts you can copy and use
Read these aloud on the phone, paste them into a message, or bring them to an appointment. Replace the bracketed age.
Calling the county IHSS office
Hello. I want to apply for In-Home Supportive Services for an adult age [age] who has a developmental disability and receives Regional Center services. Please record today as the application date and tell me how to submit the SOC 295. The applicant needs help with personal care and daily tasks, and I would like the assessment to also consider Protective Supervision and paramedical services. Please tell me which forms are needed, when the SOC 873 is due, and please send all requests in writing.
Asking the Regional Center service coordinator
I am applying for IHSS. Can you provide a current Regional Center eligibility letter, the most recent IPP, and any assessments that document the need for support at home? Once the county issues the Notice of Action, I would like to review with you how the IHSS hours and the Regional Center funded services fit together, and whether any need remains unmet.
After approval
What happens next?
45 days
Deadline to return the Health Care Certification (SOC 873) after applying.
1 year
IHSS cases are reassessed at least annually. You can request a reassessment sooner if needs change.
Once the Notice of Action arrives with approved hours, work through this list.
- 1Check every service line and the total monthly hours against what was discussed at the assessment.
- 2Check whether there is a share of cost. A Medi-Cal share of cost also applies to IHSS.
- 3Start provider enrollment immediately if the provider is not already enrolled.
- 4Set up the Electronic Services Portal so timesheets can be submitted and approved online.
- 5Give the Regional Center service coordinator the authorized hours so the IPP reflects them.
- 6Keep a simple record of which hours each provider works so the monthly total is never exceeded.
- 7Report changes in address, living situation, hospital stays, or Medi-Cal status to the county promptly.
- 8Watch for the annual reassessment notice and prepare for it the same way as the first visit.
Regional Center and IHSS
IHSS and Regional Center services do different jobs.
IHSS pays a provider for hands on help and supervision with daily living tasks. Regional Centers coordinate and fund developmental disability services through the IPP, such as Independent Living Services, Supported Living Services, respite, day programs, and Coordinated Family Support.
The Lanterman Act requires Regional Centers to use generic public resources first. IHSS is the main generic resource for personal care and supervision at home, so a service coordinator will usually expect that IHSS has been applied for before the Regional Center funds a similar support.
The 2 systems should not overlap for the same task at the same time, and neither should assume the other has a need covered. An adult with Supported Living Services, for example, typically has IHSS hours for personal care and Regional Center funded hours for the parts of supported living that IHSS does not pay for. The IPP should show how they fit together.
The Regional Center cannot change an IHSS decision, and the county cannot change an IPP. If IHSS denies or limits hours, tell the service coordinator, because a documented unmet need can be relevant to the IPP.
Denials, low hours, and delays
If the decision does not look right
A denial, fewer hours than expected, or a Protective Supervision refusal is common at first assessment and is often changed on review or at hearing.
- 1Read the complete Notice of Action, including the pages that list each task and its assigned time.
- 2Compare the assigned time on each task with what actually happens at home.
- 3Ask the social worker for a written explanation of any task rated as needing no help.
- 4Gather new evidence: assessments, doctor's statements, incident notes, the IPP.
- 5Ask the county for a reassessment if circumstances changed or were missed.
- 6Request a State Hearing. The general deadline is 90 days from the date on the Notice of Action.
- 7If hours are being reduced, request the hearing before the change takes effect to ask that current hours continue during the appeal. Read the notice for the exact date.
- 8Consider free help from Disability Rights California or a legal aid office before the hearing.
Get it in writing
Do not rely on a verbal decision or a phone explanation. Ask for the written Notice of Action and the task by task breakdown.
Request a State Hearing by phone at (800) 743-8525, online through the CDSS State Hearings Division, or in writing to the address on the notice. Disability Rights California: (800) 776-5746.
Special situations
Situations that need a closer look
Turning 18
At 18 the recipient becomes the employer of record and signs their own timesheets, or appoints someone to help. The parent provider rules for minors no longer apply, and a parent can continue as the paid provider for an adult child. Medi-Cal eligibility may be redetermined around this age, which affects IHSS, so keep Medi-Cal active.
Protective Supervision
This service is for people who need observation to prevent injury because of impaired judgment, memory, or orientation, not for behavior alone or for physical conditions alone. It is the most frequently denied and most frequently reversed IHSS service. Document specific unsafe events and be ready to show how supervision is covered 24 hours a day.
Share of cost
If the adult's Medi-Cal has a share of cost, it applies to IHSS too, and the recipient pays that amount toward the provider's wages before Medi-Cal pays the rest. If income is from work, ask the county whether the 250% Working Disabled Program would remove the share of cost.
Living situation
IHSS is only available in the person's own home, including a family home or a home they rent with support. It is not available in a licensed residential facility, a hospital, or a nursing facility. Moving between settings changes IHSS eligibility, so tell the county before a move.
Immigration status
IHSS follows Medi-Cal. Since January 1, 2026, some adults age 19 and older without a qualifying immigration category can no longer newly enroll in full scope Medi-Cal, which limits access to IHSS. Rules are detailed and change; review the official DHCS page and get advice before deciding not to apply.
DHCS: immigration status and changes to Medi-Cal eligibility
Roles
Who can help with what?
| Organization | What they do | What they do not do |
|---|---|---|
| County IHSS office | Accepts the application, verifies Medi-Cal, completes the home assessment, authorizes hours, issues the Notice of Action, and reassesses annually. | Choose the provider, or decide Regional Center eligibility or IPP services. |
| County Public Authority | Enrolls providers, runs the provider registry, offers provider training, and is the employer of record for bargaining. | Decide eligibility or hours. |
| Regional Center | Coordinates developmental disability services through the IPP, provides eligibility records, and funds supports IHSS does not cover. | Make or change the county's IHSS decision, or pay for tasks IHSS already covers. |
| bttr Living | For approved CFS clients, may help organize documents, prepare for the assessment, coordinate with the Regional Center team, track deadlines, and follow up on identified needs. | Determine IHSS eligibility or hours, act as the IHSS provider through CFS, provide legal advice, or act as an authorized representative without formal permission. |
Bay Area directory
IHSS offices in the RCEB and GGRC counties
IHSS applications in Alameda County, Contra Costa County, San Francisco, San Mateo County, and Marin County go to the county IHSS office, not to Medi-Cal and not to the Regional Center.
IHSS Service Desk (timesheets and portal)
(866) 376-7066State Hearings
(800) 743-8525Disability Rights California
(800) 776-5746Coordinated Family Support
IHSS goes better when someone is tracking the moving parts.
For approved CFS clients through RCEB or GGRC, bttr Living may help the adult and family gather records, prepare for the home assessment, understand the Notice of Action, coordinate IHSS hours with the IPP, track reassessment and appeal deadlines, and follow up on identified needs.
What to know
- bttr does not determine IHSS eligibility or hours.
- CFS is coordination and support. It is not the IHSS provider role, and CFS hours are not IHSS hours.
- bttr does not provide legal advice and does not represent families at State Hearings.
- bttr only communicates as an authorized representative when the adult has formally granted that authority.
- Regional Center funded referrals must go through the service coordinator. CFS is not automatically authorized.
Questions families ask
Frequently asked questions
No. IHSS is a Medi-Cal benefit decided by the county after a home assessment. Regional Center eligibility is decided separately. Regional Center records can help document the need, but the county makes the IHSS decision.
A Medi-Cal eligibility determination is required for IHSS. You can submit the IHSS application before Medi-Cal is finished to protect the application date, and the county will review Medi-Cal as part of intake. Services are not authorized until Medi-Cal is in place.
Yes. For a recipient age 18 or older, a parent or other relative can be hired as the IHSS provider after completing county enrollment, including Live Scan and the SOC 426. The adult recipient remains the employer and approves the timesheets. Spouse providers have separate rules.
It depends on the assessment. The monthly maximum is 283 hours for a person assessed as severely impaired and 195 hours for a person assessed as non severely impaired. Most people receive less than the maximum. Hours are built task by task from the home assessment.
An IHSS service for people who need someone observing them to prevent injury because of impaired judgment, memory, or orientation. It can add a large block of hours, up to the monthly cap. The county requires specific evidence and may ask for a 24 hour coverage plan, because IHSS does not pay for 24 hours a day.
Yes, and most adults living at home with significant support needs have both. IHSS covers personal care and supervision tasks. The Regional Center funds services IHSS does not cover. The IPP should show how the 2 fit together, and the same task should not be paid twice at the same time.
Wages are set by each county through bargaining and change when agreements renew, sometimes more than once a year. Bay Area counties are among the highest in the state. Check the official CDSS county wage table linked in the sources for the current rate where the recipient lives.
Ask for the written Notice of Action and the task by task breakdown, gather evidence, and request a reassessment or a State Hearing. The general hearing deadline is 90 days from the notice date. If hours are being reduced, request the hearing before the change takes effect to ask that current hours continue. Disability Rights California offers free help.
No. The adult, or someone the adult authorizes, applies to the county IHSS office. The service coordinator can provide eligibility records and the IPP, and can help think through how IHSS hours and Regional Center services fit together.
No. CFS is a Regional Center funded coordination service, not IHSS provider hours. For approved CFS clients, bttr may help gather documents, prepare for the assessment, understand the notice, coordinate with the Regional Center team, and track deadlines. bttr does not determine eligibility or hours, does not give legal advice, and only acts as an authorized representative when the adult formally grants that authority. CFS must be authorized by the Regional Center through the service coordinator.
Official sources
Where this guide comes from
- CDSSIn-Home Supportive Services program overview and eligibility
- CDSSSOC 295 Application for In-Home Supportive Services (PDF)
- CDSSCounty IHSS offices
- CDSSCounty IHSS provider wage rates
- CDSSHow to become an IHSS provider
- CDSSIHSS recipient resources
- CDSSState Hearing requests
- Disability Rights CaliforniaIn-Home Supportive Services Protective Supervision
- Disability Rights CaliforniaUnderstanding the maximum hours available and calculating hours
- DDSHome and Community Based Services
- DHCSImmigration status and changes to Medi-Cal eligibility
Information reviewed August 28, 2026. Program rules, hour limits, and county wages may change. Verify current information with the linked agency before making a decision.