Q. I recall reading your article some time back about seeking benefits for care in the home, but I did not save it. Could you address the issue again? Our 92 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. This is an update to the article you referenced. 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 with 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 or who is at risk of wandering. Upon approval, the beneficiary then selects and hires a caregiver and the IHSS program pays the worker for the approved hours per month, currently at the rate of $20.00 per hour in Alameda County and at the rate of $19.33/hour in Contra Costa County (in 2025).
Resource Limits: Good news: For those persons on Medi-Cal, the asset caps were eliminated in California as of January 1, 2024, and so the focus is now on monthly income. Income is counted after deduction for health insurance premiums, such as Medicare and other health care policies.
Income Limits: For persons with low monthly incomes and who are on Medi-Cal (but not receiving SSI), the IHSS benefit is now available regardless of how much they have in assets. However, for persons whose monthly income is above certain levels (currently, above $1,801 for a single person and $2,433 for a married couple, in 2025), the applicant will have a monthly share of cost (i.e. “co-pay”) 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 care assistance hours close to the maximum. However, note that where a couple is married, but only one spouse needs IHSS, the income of the “well spouse” is not counted for In Home Supportive Services; that said, we find that Medi-Cal often includes the well spouse’s income in the determination of eligibility, which is usually error and should be appealed.
SSI Recipients: Note that the resource (asset) caps for persons on SSI are still in effect and were not changed by California’s elimination of resource limits entirely, effective Jan. 1, 2024. So, be mindful if your loved one is also receiving SSI, the resource caps for non-exempt assets are still in place, i.e. $2,000 for a single individual, and $3,000 for married couple.
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 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 she could receive both a modest salary and health insurance. Also, to give your sister some relief each month, your mother could split care hours, hiring your sister part-time and another caregiver for the balance of approved hours. For caregivers who live in your mother’s home, the payments are not taxable income to the caregiver.
To find out more, call the Alameda County Area Agency on Aging at 510-577-1800, or go to www.AlamedaSocialServices.org, or you may contact our firm for assistance.