How to Get Paid as a Family Caregiver in California: IHSS and Other Options

If you spend hours helping a parent with bathing, meals, shopping, appointments, mobility, supervision, or other daily needs, it is natural to wonder whether California has a program that can pay you for some of that work.

In some situations, the answer is yes. One of the most important programs to understand is In-Home Supportive Services, usually called IHSS. But being a family caregiver does not automatically mean that you will qualify for payment.

What is IHSS?

California's In-Home Supportive Services program is designed to help eligible people remain safely in their own homes rather than requiring out-of-home care.

According to the California Department of Social Services, an IHSS applicant must be a California resident, have a Medi-Cal eligibility determination, live at home or in an abode of their own choosing, and submit the required health care certification.

A county social worker conducts an in-home assessment to determine eligibility and the person's need for assistance. The assessment is used to determine which services are authorized and how many hours are approved.

Can a family member be the paid caregiver?

IHSS uses individual providers to perform authorized services. In many family situations, the person providing that care may be a relative. However, there are rules and enrollment requirements, and some situations can be more complicated than others.

The important point is that payment does not simply begin because a son, daughter, spouse, or other relative is already helping at home. The person receiving care first needs to qualify for IHSS, services and hours must be authorized, and the person who will provide the paid services must satisfy the applicable provider requirements.

The person receiving IHSS is generally the provider's employer

This distinction is easy to misunderstand.

California's IHSS guidance states that when a person is approved for IHSS and hires an individual provider, the IHSS recipient is considered the provider's employer. The recipient is responsible for hiring, training, supervising, and, when necessary, firing the individual provider.

A family caregiver who becomes a paid provider should not be confused with the recipient's role as the person receiving IHSS.

How does someone become an IHSS provider?

The California Department of Social Services states that a prospective IHSS provider must complete the required provider enrollment steps before being enrolled and receiving payment from the program.

The exact process is handled locally. California directs prospective providers to their county IHSS office or IHSS Public Authority for questions about enrollment and requirements.

That means it is usually better to think of this as two connected processes: first establishing the care recipient's IHSS eligibility and authorized needs, and then making sure the person who will provide the paid care is properly enrolled.

How many hours can a family caregiver be paid for?

There is no single number that applies to every family.

The county assessment looks at the recipient's ability to safely perform particular tasks and determines the types of services and number of hours that may be authorized. The amount of unpaid care a family member is already providing does not, by itself, establish the number of paid IHSS hours.

This is why describing what actually happens during the day can matter: bathing, dressing, toileting, meal preparation, mobility, housework, accompaniment, supervision, and other needs may raise different issues during an assessment.

How much does IHSS pay?

IHSS wage rates can vary by county. California advises recipients and providers to contact the social worker assigned to the case for the applicable hourly rate. The State issues payments to individual providers.

Because rates and individual circumstances can change, it is better to verify the current rate for your county rather than relying on an old statewide number found online.

What if your parent does not qualify for IHSS?

IHSS is important, but it is not the only form of support available to California families. A family that does not qualify for IHSS may still have other paths worth exploring.

These programs do different things. Some may support the caregiver, some may provide services directly to the person receiving care, and some may help build a broader care plan. They should not all be treated as substitutes for IHSS.

Where should you start?

If you think IHSS may fit your family's situation, start with the county IHSS process for the person who needs care. If that person already has IHSS, ask the county IHSS office or Public Authority what is required for the family caregiver to enroll as a provider.

Before making the call, write down the care tasks you perform and how often they happen. A concrete description of the person's needs is more useful than simply saying, “I take care of my mother every day.”

If IHSS does not fit, the next step may be a different county, aging, caregiver, health, or long-term care program.

You can also read our guide to respite care for California family caregivers if what you need most is relief from the day-to-day caregiving load.