How Can California Seniors Get Nursing Care in Their Own Home?

In-home Care Options vs Out-of-Home Care


Medi-Cal Planning guidance for familiesSenior Citizens who are California residents and are in need of nursing care may qualify for one of four different county-administered programs called In-Home Support Services (IHSS) which allows Seniors to stay in the comfort of their own homes rather than relocate to a nursing home or assisted living facility.  IHSS is a Medi-Cal program and is funded by money from federal, state, and county governments.

The types of Senior home care services provided can range from meal preparation, feeding, cleaning, laundry, bathing, dressing, grooming, help with medications, injections, bowel and bladder care, protective supervision, and transportation and accompaniment to medical appointments. Having help with tasks around the house not only makes the lives of Seniors and the disabled easier but can also make it possible for the person to remain in his or her home.

how to pay for in-home nursing care for seniors in CaliforniaThe eligibility requirements of In-home Senior Care from the IHSS Program are different depending on which program is best suited for the applicant who has already been qualified for Medi-Cal or is currently applying for Medi-Cal, or who is receiving Supplemental Security Income (SSI) or State Supplementary Payment (SSP).  California residents who may qualify are typically enrolled in Medi-Cal, blind, disabled, incapacitated, or 65 years of age or older, living at home, and who are unable to safely live at home without care.  Seniors who are already living at a long-term care facility may apply for IHSS if they are planning on returning home soon, but cannot receive IHSS benefits until they do return home.

There are financial requirements that must be met as well. Many applicants have benefited from the services of a Medi-Cal Planning Attorney at Elder Law Services of California for help in qualifying for Medi-Cal and determining their eligibility for In-Home Care through the IHSS Program.

California Seniors who apply for In-Home Senior Care are responsible for deciding what type of service they need from their caregiver.  The most common practice is for the client who needs the care to hire, fire, and supervise caregivers who are either Independent Providers (IP) or who work for an In-Home Care Agency.  An Independent Provider can be a relative, friend, or even a neighbor of the recipient. If you do not know somebody who you would like to hire, then a social worker will make arrangements for an In-Home Care agency to provide your services.

In light of senior citizens being more vulnerable to being taken advantage of, background checks and caregiver training are important considerations before hiring an in-home care provider.

paying for in-home nursing care for Seniors in CaliforniaAfter an application for In-Home Support Services for Seniors has been received and processed, an appointment will be made for a social worker to visit the applicant at home for a “needs assessment”.  The social worker will ask the applicant questions about their physical and mental capacity to best determine what services are needed, and how many hours are needed for each service on a daily or weekly schedule.  In addition, the applicant’s primary care physician or health care provider will need to fill out a medical certification form stating that the applicant is unable to perform certain activities to take care of themselves without In-Home care assistance.  These activities are called “Activities of Daily Living” or ADLs.  After the Needs Assessment has been processed, the IHSS social worker will send the applicant a letter called a ‘Notice of Action’ to let them know if they have been approved for the IHSS program, and for how many hours have been authorized for the needed services.

What Are the Maximum Hours Per Month for Senior In-Home Care Services?

For Seniors who are not severely impaired, the maximum number of hours authorized per month is 195 hours, which works out to about 6.5 hours per day.  For applicants who are severely impaired, the maximum number of authorized hours is 283 hours per month or about 9.5 hours per day.

What are the Next Steps?

The eligibility requirements and necessary paperwork to apply for In-Home Care services can be complicated and burdensome for many people.  If you or a family member prefer to remain in your own home then call a Medi-Cal Planning Attorney at Elder Law Services of California for a free consultation to discuss the specifics of your situation. The Elder Law professionals at ELS can help you or your family member with Long-term Care Planning, Medi-Cal Planning, Asset Protection, qualifying for Medi-Cal, and help determine whether eligibility requirements for your county’s IHSS In-Home Care program can also be met.  The call is free and there is no obligation. The IHSS In-home Supportive Services program is an alternative to out-of-home care like nursing homes, assisted living facilities, and other board and care options. IHSS may appeal to people who are more vulnerable or concerned about Coronavirus (COVID-19) issues.  IHSS also appeals to people who prefer to have more choice and more control over their personal health care.

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Common Questions and Answers About In-Home Care for Seniors in California

Q: Who pays for the In-Home Care Services?
A: Medi-Cal, which is the California Medicaid program, pays for IHSS benefits.

Q: Who provides elderly care for In-Home Supportive Services (IHSS)?
A: Caregivers can be contracted through an agency or Independent Providers (IPs) who can be an independent contractor, a family member, friend, or neighbor.

Q: What types of services for Seniors are provided through the IHSS In-Home Care Services program?
A: Services that are covered may include personal care, homemaker services, and health maintenance services which are typically provided by a nurse or certified nursing assistant (CAN).

Q: Who can qualify for in-home care services?
A: Seniors who have qualified for Medi-Cal, children or adults with disabilities, people who have a long-term illness.

Q: Does Medi-Cal cover in-home care for Senior Citizens in California?
A:  The IHSS Program is available to California residents who are 65 and over or younger individuals who are officially disabled or blind and qualify for Medi-Cal (California Medicaid). The in-home care services covered by IHSS include personal care, homemaker services, and health maintenance services which are typically provided by a registered nurse (RN) or certified nursing assistant (CAN).

Q: How do I get Medicare to pay for in-home care?
A: Qualified applicants can have up to 283 hours of in-home care paid for each month through the IHSS program.

Q:  Can I own my own home and qualify for IHSS services?
A: Yes. However, your personal property cannot exceed $2,000 to qualify for IHSS. This does not include the home you live in, one car to get to and from medical appointments, and life insurance with a combined face value of less than $1,500. Personal property includes items such as savings, investments, certain types of property and personal possessions.

Q: Can I hire a family member to provide my IHSS services for in-home care?
A: Yes. You can hire relatives, friends, neighbors, and other caregivers to provide you with IHSS. In some cases, even a spouse can be paid as an IHSS caregiver.

Los Angeles County IHSS, Orange County IHSS, Riverside County IHSS, San Bernardino County IHSS, San Diego County IHSS, Santa Barbara County IHSS, and Ventura County IHSS each have their own IHSS Program. Call Elder Law Services of California at 800 403-6078 to discuss eligibility requirements for in-home care benefits in your county, and how Medi-Cal Planning can help you qualify for California Medicaid that pays for in-home support services, including nursing care, through the IHSS Program.

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