California Home Help

Compare care options

Home, licensed agency, or a facility path

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.

Mark what is going on for a parent. The table below is an educational comparison of common California settings. Highlighted rows are paths families often look at with those notes. Highlighting is not a recommendation, not a qualification, and not a county decision.

This page is educational. It is not county advice, a Medi-Cal determination, an hours authorization, or a wage quote. Your county IHSS office and Medi-Cal decide eligibility, hours, and who can be paid. Licensed facilities and home care agencies decide their own admissions and private-pay terms. County IHSS staff decide whether a home-care file is complete and which tasks to authorize. County Medi-Cal staff decide Medi-Cal eligibility and share of cost. A facility or agency is a separate conversation. Highlighted rows are paths families often look at with the notes you checked. That is not a recommendation and not a statement that anyone qualifies.

What is going on at home right now?

Check anything that is true enough to discuss. Leave the rest unchecked. This does not score the case.

Every row stays visible until you check a note. Then some rows are marked “often discussed for these notes.” That mark is educational. It does not mean anyone qualifies.

Stay home with IHSS / family caregiver

Where care happens
The parent’s own house or apartment, or another abode of their choosing. A hospital, nursing facility, or licensed community care facility is not that home.
Who typically pays
Medi-Cal funds authorized IHSS tasks after the county notice. The recipient is generally the employer of an enrolled individual provider, often an adult child. This is not a private-pay wage quote and not a promised hour total.
What it is often used for
Listed personal care and household tasks so an eligible person can remain at home. A relative who can enroll as the provider. Families who can be present for the parts of the day the notice does not cover.
Where it usually falls short
A licensed facility stay. Companionship-only sitting. A guaranteed around-the-clock roster. Skilled nursing that belongs in a facility or a Medicare home-health plan.

Related pages

Private home care (licensed HCO)

Where care happens
The parent’s home, through a California-licensed Home Care Organization. Confirm the license. The registry on this site lists licensed agencies.
Who typically pays
Usually private pay by the family or another private payer. Medi-Cal does not automatically pay a home care organization the way it pays IHSS. Medicare home health is a different skilled benefit.
What it is often used for
Flexible private hours at home while IHSS is pending, or when the family wants help the IHSS notice does not cover. A licensed employer of caregivers instead of the family running payroll.
Where it usually falls short
A substitute for Medi-Cal eligibility work. A promise that an agency will be reimbursed by IHSS. Facility room and board.

Related pages

Mix: IHSS plus private top-up

Where care happens
Still the parent’s own home. IHSS listed tasks on one calendar. Extra privately paid hours from a licensed agency or another arranged helper on another calendar.
Who typically pays
IHSS covers only authorized tasks in the notice, through Medi-Cal. Extra agency hours are usually private pay. Do not add the two in your head and treat the sum as a county promise.
What it is often used for
Households that can stay home if some hours are authorized and some hours are purchased. Families who already know IHSS is not a facility staffing pattern.
Where it usually falls short
A way to force around-the-clock IHSS. A single blended timesheet. A facility placement.

Related pages

Assisted living

Where care happens
A licensed residential care setting (often an RCFE). Meals, housekeeping, and on-site staff. This is not “own home” for IHSS.
Who typically pays
Usually private pay for room, board, and care. Medicare does not typically pay for long-term assisted living. Ask the community and Medi-Cal about any other payer that might apply. The cost of care hub shows CareScout 2025 statewide medians as a planning estimate, not a community quote.
What it is often used for
A parent who needs a residential setting with meals and staff nearby, and who does not need a skilled nursing facility. Families who cannot safely cover nights at home.
Where it usually falls short
An IHSS individual-provider plan in that building. Skilled nursing, IV therapy, or other care the license does not allow. A way to keep the IHSS case as if the parent were still in a house.

Related pages

Memory care

Where care happens
Usually a licensed residential unit or community with dementia programming and secured or closely supervised space. Not a hospital. Not own home for IHSS.
Who typically pays
Usually private pay. Ask the community about any other payer. This page does not quote a rate and does not decide whether a specific person should move.
What it is often used for
Wandering, severe confusion, or a need for dementia-specific staffing that a house cannot safely hold. Families comparing a residential memory setting with staying home.
Where it usually falls short
A short skilled rehab stay. An IHSS protective-supervision substitute inside a facility. A medical crisis that belongs in a hospital or skilled nursing facility.

Related pages

Nursing home / skilled nursing facility

Where care happens
A licensed skilled nursing facility. Staff, room, and nursing services. Not own home. IHSS does not pay this bed.
Who typically pays
A short skilled stay after a qualifying hospital period may involve Medicare. A longer nursing-facility stay may involve Medi-Cal if the person is eligible. Facility billing staff and Medi-Cal decide how a stay is billed. This page is not a coverage determination.
What it is often used for
Skilled nursing, rehab after a hospital stay, or medical complexity a house cannot safely hold.
Where it usually falls short
An IHSS plan for that bed. A memory-care apartment that is not skilled. A way to collect IHSS wages inside the facility.

Related pages

Hours, monthly planning dollars, who pays, and IHSS

Monthly figures are midpoints at 20 hours/week for hourly rows, and published or labeled medians for facility rows. Move the live calculator below to change hours. Facility fees do not change with the slider.

SettingHow billedHoursMonthly midpointWho typically paysWhen IHSS may apply
Private home care (licensed HCO)Hourly20 hrs/week$3,467$3,033 to $3,900Usually the family or another private payer. Medicare home health is a different skilled benefit.IHSS may cover authorized tasks in the same house on a separate calendar. It does not pay the agency invoice.
Live-in home care (hourly framing)Modeled as 12 billed hours/day84 hrs/week$14,560$12,740 to $16,380Private pay. Agencies often quote a daily package instead of 24 times the hourly rate.IHSS is not a live-in staffing pattern. Authorized tasks may still run in the home. The county sets those hours.
Assisted living (RCFE)Monthly community feeFacility staffing, not hourly$7,000$5,600 to $8,400Usually private pay or long-term care insurance. Medi-Cal rarely pays the room.IHSS does not follow someone into a licensed residential care facility. Own-home rules still apply.
Memory careMonthly community feeSecured unit staffing$9,100$8,400 to $9,800Usually private pay. CareScout does not publish a separate California memory-care median.A licensed memory-care unit is not the IHSS own-home setting. Ask the county before assuming hours continue.
Nursing home / SNFMonthly room and boardFacility nursing roster$13,673$12,167 to $15,178Private pay or Medi-Cal long-term care after a stay qualifies. Medicare may cover a limited skilled stay, not custodial long-stay care.A nursing facility is not own home. IHSS stops while someone lives there. A return-home plan can restart the county file.
IHSS / Medi-Cal pathCounty-authorized tasksSet on the Notice of ActionNot estimatedCounty wage pageMedi-Cal funds authorized tasks. The recipient is generally the employer of an enrolled individual provider. The State issues the warrant.May apply when the person lives in their own home, has a Medi-Cal determination, and the county authorizes listed tasks.

Planning estimate only. Not a quote, not a facility admission, not a Medi-Cal or IHSS eligibility result, and not an hours authorization. Rates vary by county, agency, and facility. IHSS hours and provider pay are county and Medi-Cal decisions. We do not calculate IHSS paycheck amounts. Licensed agencies and facilities set their own private-pay terms. County IHSS staff authorize tasks. County Medi-Cal staff decide coverage and any share of cost. Ask those offices and providers for the number that counts.

Illustrative cost planner

Live dollar totals for private-pay settings, using CareScout 2025 California medians. IHSS is shown as a program path, not as a household paycheck.

Hours of help per week

Private home care is billed by the hour. CareScout publishes its California home-care median on a 44 hour/week basis. Facility rows stay monthly fees even if you change hours.

About 2.9 hours/day across 7 days

Days per week (optional)

Used to show hours/day and to model live-in framing as 12 billed hours times the days you choose. Facility fees do not change with this number.

Which setting are you pricing?

Estimated private-pay cost

Private home care (licensed HCO)

$3,033 to $3,900monthly

Low
$3,033
Midpoint
$3,467
High
$3,900

Annual: $36,400 to $46,800Midpoint $41,600 per year

How this number was calculated

20 hours/week × $40/hour × (52 ÷ 12) weeks = $3,467/month at the midpoint. Low uses $35/hour. High uses $45/hour. 52 ÷ 12 is about 4.33 weeks.

Compare settings at these hours

Private home care (licensed HCO)

$3,467/month mid

$3,033 to $3,900 monthly · $41,600 per year at midpoint · 20 hours/week

Live-in home care (hourly framing)

$14,560/month mid

$12,740 to $16,380 monthly · $174,720 per year at midpoint · 84 hours/week

Assisted living (RCFE)

$7,000/month mid

$5,600 to $8,400 monthly · $84,000 per year at midpoint

Memory care

$9,100/month mid

$8,400 to $9,800 monthly · $109,200 per year at midpoint

Nursing home

$13,673/month mid

$12,167 to $15,178 monthly · $164,076 per year at midpoint

IHSS / Medi-Cal path

Wage set by county

Private-pay alternative: $3,033 to $3,900 per month for the same hours.

Paying for care and official pages

Official California sources

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.

Want help lining up the next packet?

A coordinator can walk through Medi-Cal, county forms, and the home-versus-facility conversation with you. The county still decides any IHSS case. A facility or agency still decides its own admissions.

For example: starting an IHSS application, provider enrollment, or county forms. Keep medical records and diagnoses for the county packet.