In-Home Supportive Services

Overview of Medi-Cal’s In-Home Supportive Services Program

The In-Home Supportive Services (IHSS) Program is a statewide Medi-Cal program that provides long-term services and supports for aged, blind or disabled California residents who are at risk of nursing home placement. Available benefits include personal care assistance and homemaker services to assist these individuals in living safely and independently in their home or the home of a loved one. Program participants have the option to self-direct their care, which allows them to choose and hire their own caregivers, including friends and relatives.

Within IHSS, there are 4 programs, the first two of which serve the majority of IHSS program beneficiaries.

  • Community First Choice Option (CFCO) – for Medi-Cal eligible persons who require a nursing home level of care.
  • Personal Care Services Program (PCSP) – for Medi-Cal eligible aged, blind or disabled individuals who require personal care assistance, but do not require the level of care that is provided in a nursing home.
  • IHSS Plus Option Program (IPO) – provides payment to spouses or parents of Medi-Cal eligible persons who do not need a nursing home level of care, but require care assistance, and receive it from a spouse or parent. Prior to becoming a Medi-Cal state plan option, this program was previously called the IHSS Plus Waiver.
  • IHSS Residual Program (IHSS-R) – provides a pathway of eligibility for persons who are not eligible for Medi-Cal but require IHSS care services.

The In-Home Supportive Services Program is available through California’s regular state Medicaid plan. In California, the Medicaid program is called Medi-Cal.

HCBS Medicaid Waivers versus HCBS State Plan Medicaid?
While home and community based services (HCBS) can be provided via a Medicaid waiver or a state’s regular Medicaid plan, HCBS through Medicaid state plans are an entitlement. Put differently, meeting the program’s eligibility requirements guarantees an applicant will receive benefits. On the other hand, HCBS via Medicaid waivers are not an entitlement. Waivers have a limited number of participant enrollment slots, and once they