In-Home Supportive Services (IHSS) is California's long-term in-home care program for Medi-Cal recipients. This guide walks you through every step — and explains how CalAIM PCHS bridges the gap while you wait.
PCHS bridges the gap: The IHSS application process typically takes 30–45 days. If you are enrolled in Medi-Cal Managed Care, CalAIM PCHS can be authorized to start immediately during the waiting period — so care doesn't have to wait for IHSS approval.
IHSS is a California state program that pays for in-home care services for eligible seniors, blind, and disabled Medi-Cal recipients — allowing them to remain safely at home rather than entering a care facility.
With IHSS, the member acts as the employer of record. They can hire a family member, friend, or agency caregiver as their IHSS provider.
IHSS covers personal care, domestic services, paramedical services, protective supervision, and accompaniment to medical appointments.
IHSS is managed by each county's Department of Social Services. Processing times, assessment practices, and available hours vary by county.
The IHSS application process has 8 key steps. Here's exactly what to expect at each one.
To qualify for IHSS you must: (1) be a California resident, (2) be aged 65 or older, blind, or have a disability, (3) have Medi-Cal coverage, and (4) demonstrate a need for in-home assistance to remain safely at home. There is no income limit for the service itself — only Medi-Cal eligibility is required.
You can apply by phone, mail, or in person at your county's Department of Social Services. The primary application form is SOC 295 — Application for In-Home Supportive Services. By law, your county must accept your application however you submit it. Find your county office at cdss.ca.gov.
You will need: your Social Security number, Medi-Cal ID number, date of birth, and contact information. You will also need your doctor to complete the Health Care Certification Form (SOC 873) — this confirms that you have a medical need for in-home services. Ask your doctor's office early, as this can take time.
Once your application is received, a county social worker will contact you to schedule a home visit assessment — typically within 10 business days. During the visit, the social worker evaluates your ability to perform daily tasks and determines how many IHSS hours you qualify for. Be honest and thorough about your daily limitations.
Tip: Have a family member or advocate present at the home visit to help describe needs the applicant may understate due to pride or nervousness.
Within 30–45 days of applying, you will receive a Notice of Action (NOA) stating whether you are approved or denied, and if approved, how many hours of IHSS you are authorized per month. If denied or if hours are insufficient, you have the right to request a State Hearing within 90 days.
Once approved, you hire your own IHSS provider. This can be a family member (with some exceptions), a friend, or a caregiver from your county's Public Authority Registry. Your county will provide an enrollment packet for your chosen provider. Note: a spouse or your minor children cannot be hired as your IHSS provider.
Your provider must complete enrollment with IHSS: fingerprinting, orientation, and signing the Provider Enrollment Agreement. Until enrollment is complete, they cannot be paid for services. Allow 2–4 weeks for this process.
Once services begin, your provider submits hours via the Electronic Services Portal (ESP) or by phone through the Telephone Timesheet System (TTS). You, as the recipient, must approve the timesheet. Timesheets are submitted twice monthly. Payments are processed by the State Controller's Office.
Main IHSS application form. Available from your county or CDSS website.
Must be completed and signed by your licensed physician.
Your Benefits Identification Card showing your Medi-Cal number.
Required for identity verification during the application process.
State-issued ID, driver's license, or passport for identification at home visit.
Utility bill, lease, or other document confirming your California home address.
While you wait for IHSS: If you are a Medi-Cal Managed Care member, ask your plan about CalAIM PCHS services. PCHS can be authorized during the IHSS waiting period — ensuring you have care in place while your application is processed. Contact Divine Agape and we can help coordinate this.