GuidesWhat IHSS can cover
What IHSS can cover
Using IHSS and Home Health at the Same Time
Updated September 16, 2026. Reviewed September 16, 2026 against public CDSS, DHCS, Medicare.gov, VA, and CareScout 2025 California tables. County wages, hours, and wait times still change. Official .gov pages decide.
How personal care hours and skilled home health can appear together, and how to keep the two benefits from being confused at the assessment.
About 5 minutes to read. Based on CDSS and DHCS public program pages retrieved 2026-09-16. County offices apply these rules. Hourly rates, hour totals, and wait times are local and change.
Short answer
IHSS personal care and skilled home health can appear in the same home. IHSS is authorized personal and household help, plus other listed categories. Home health is usually the skilled nursing or therapy benefit. Tell the social worker which person already does which task so the two programs are not confused.
Who decides
The county IHSS office authorizes IHSS tasks. Home health is authorized through Medi-Cal, Medicare, or the home health agency’s own process, not by the IHSS notice alone.
What to do next
Write down who currently helps with personal care and who already visits for skilled care, then take that list to the IHSS assessment and to the home health intake.
Two benefits, one home
Adult children often meet both programs after a hospital discharge. A home health nurse or therapist may visit for a skilled need. In-Home Supportive Services may later pay a family member or another provider for authorized personal care and household help. Those can exist together. They are not the same application and not the same notice.
IHSS builds on Medi-Cal and a county assessment. Home health builds on a clinician order and a home health authorization under Medi-Cal, Medicare, or another payer. Confusing them at the IHSS visit can hide personal care need, or it can sound like you are asking IHSS to become the nurse. The coverage page keeps skilled nursing on the “different benefit” list for that reason.
What each program is for
IHSS, under WIC 12300 and MPP 30-757, may authorize personal care, domestic and related tasks, accompaniment to health-related appointments or alternative resource sites, protective supervision, paramedical services when ordered and authorized, limited heavy cleaning or yard hazard abatement, and teaching and demonstration. The social worker ranks function in the home. The Notice of Action is the IHSS list that counts.
Home health is skilled care in the home: nursing and therapy that licensed staff must do. It is not companionship. It is not ordinary landscaping. It is not routine childcare. It is also not a substitute for living in a facility. If your parent is still in a hospital or nursing facility, neither program is “the facility.” Plan the home they will return to, then file SOC 295 for that home.
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Questions people ask
- If a nurse visits, can we still have IHSS?
- Often yes. A skilled visit does not automatically cancel personal care. The county still assesses IHSS tasks. Home health still follows its own authorization.
- Can IHSS replace home health nursing?
- No. Skilled nursing and therapy that licensed staff must do usually stay on the home health side. IHSS is not facility care and not skilled nursing by another name.
- Are paramedical services the same as home health?
- No. IHSS paramedical services require an order and county authorization. They are a listed IHSS category, not a substitute for a home health episode.
Official sources for this guide
Related pages on California Home Help
Reviewed against CDSS, DHCS, Medicare.gov, and CareScout public pages. We do not quote IHSS wages. County IHSS offices and Medi-Cal decide eligibility, hours, and pay. For current county wage rates, use the official CDSS wage page. CDSS county IHSS wage rates.
Official program pages: CDSS: In-Home Supportive Services, CDSS: IHSS for children, County IHSS offices, CDSS: IHSS providers, CDSS: county IHSS wage rates, CDSS: provider orientation, CDSS: Electronic Visit Verification, CDSS: Electronic Services Portal, DHCS: Medi-Cal, Apply for Medi-Cal, BenefitsCal, CDSS: hearing requests, CDSS: forms catalog, CDSS: IHSS overtime and workweek, DDS: regional centers.