Q. Our 91 year-old mother is frail but wishes to remain at home. She has limited financial resources, so my sister is living with her and providing care without pay.  Are there any government programs that might help us hire a caregiver and give my sister some relief?

A.  Yes. There are a number of programs, but one that may be of special interest is the In-Home Supportive Services Program (“IHSS”). It is designed for persons of limited income who are blind, disabled or over age 65, and who are unable to live safely at home without assistance.  For qualifying individuals, it provides nonmedical services such as meal preparation, cleaning, laundry, bathing, feeding, dressing, grooming, toileting, and monitoring for persons with cognitive impairments who are at risk of injury at home.

It works like this: following an application, an in-home assessment is made by a social worker to determine the number of hours of care needed. This can be up to 195 hours per month for a non-severely impaired applicant and up to 283 hours per month for one who is severely impaired.  Upon approval, the beneficiary then selects and hires a caregiver and the IHSS program pays the worker for the number of approved hours per month, currently at the rate of $19.05 per hour in Alameda County (in 2024).

Resource Limits:  The program is designed for persons who are eligible for Medi-Cal or Supplemental Security Income (“SSI”).  With the recent lifting of the Medi-Cal resource caps (as of 01/01/2024), many more folks will now qualify for Medi-Cal, thereby making themselves eligible for IHSS upon a showing of need for care. Note: SSI still retains the very modest resource caps of no more than $2,000 in savings for a single individual or $3,000 for a couple. However, the Medi-Cal door has now swung widely open in 2024, and will be the easier route to eligibility.

Income Limits:  For persons with low monthly incomes, the benefit is available without a share of cost (“co-pay”).  However, for persons whose monthly income is above certain levels (currently, above $1,677 for a single person and $2,269 for a married couple, in 2023), the applicant will have a share of cost that must be paid to the worker before the IHSS program pays the balance.  Thus, the program only works well for persons with low incomes, or persons with great need who are awarded many hours of care.

In many cases, the caregiver may hire a family member, whether a spouse or an adult child.  Also, for the caregiver who works at least 80 hours per month, the program in Alameda County makes healthcare available at a nominal monthly premium, a valuable benefit to the worker.

If your mother qualifies for IHSS, she could hire your sister, so that your sister could then receive both a salary and health insurance.  Also, to give your sister some relief each month, your mother could split care hours, hiring your sister for some of the hours, and another caregiver for the balance of approved hours.

To find out more, call the Alameda County Area Agency on Aging at 510-639-1090, or go to www.AlamedaCountySocialServices.org. Alternatively, you may contact our firm for assistance.