What Services Does IHSS Cover? Complete 2026 California Guide

By the Unified Savers Editorial Team

This information is based on official California DSS guidelines and is reviewed for accuracy. For case-specific legal advice, consult a qualified attorney or your local legal aid organization.

IHSS covers five broad categories of in-home services: personal care (bathing, dressing, mobility), domestic services (cleaning, cooking, laundry), paramedical services (medication administration, wound care), protective supervision for recipients with cognitive impairments, and transportation to medical appointments. Not every recipient is authorized for every service — authorization is based on individual functional limitations assessed by a county social worker using the Uniform Assessment Tool (UAT). Total monthly authorized hours vary from under 20 hours to over 200 hours depending on need.

How IHSS Services Are Authorized

The county IHSS social worker conducts an in-home assessment using the Uniform Assessment Tool (UAT) to determine which services you need and how many hours to authorize. The UAT scores each task on a 1–5 scale:

1 = Independent — no assistance needed; no hours authorized
2 = Setup or supervision only — minimal hours may be authorized
3 = Some assistance needed — hours authorized based on task complexity
4 = Substantial assistance needed — higher hours authorized
5 = Fully dependent — maximum hours for that task are authorized

Services are only authorized for tasks the recipient genuinely cannot perform safely due to their disability or medical condition — not based on preference or convenience. The total authorized hours are the legal limit your provider can be paid for each month.

Category 1: Personal Care Services

Personal care is the largest IHSS service category and covers hands-on assistance with activities of daily living (ADLs) that the recipient cannot safely perform alone.

What personal care services include:

Bathing and grooming: Assistance with showering, bathing, hair washing, shaving, oral hygiene, and nail care
Dressing and undressing: Help putting on and removing clothing, adaptive equipment, prosthetics, or braces
Ambulation and repositioning: Assisting the recipient to walk safely, transfer between positions (bed to chair, etc.), and reposition in bed to prevent pressure sores
Feeding: Assisting the recipient with eating when they cannot self-feed
Toileting and bowel/bladder care: Assistance with using the toilet, bedpan, catheter care, or colostomy care
Respiration: Assistance with prescribed respiratory treatments (such as nebulizer use)
Assistance with self-catheterization (treated as a paramedical service when a physician prescribes it)

Personal care hours are typically the largest component of total authorized IHSS hours for recipients with significant physical disabilities.

Category 2: Domestic Services

Domestic services cover the household tasks the recipient cannot perform due to their disability.

What domestic services include:

Housecleaning: Sweeping, vacuuming, mopping, cleaning bathroom and kitchen surfaces, dusting — only in rooms the recipient uses
Laundry: Washing, drying, and folding the recipient’s clothing and linens (not other household members’ laundry)
Meal preparation: Planning and cooking nutritionally adequate meals for the recipient, including modified diets required by medical conditions
Meal cleanup: Washing dishes and cleaning the kitchen after meals
Grocery shopping and errands: Purchasing food, medications, and household necessities for the recipient

Domestic service hours are limited to the recipient’s actual needs and living space. Providers are not authorized to perform domestic tasks that benefit other household members who are not themselves IHSS recipients.

Category 3: Paramedical Services

Paramedical services cover health-related tasks that require training or are typically performed by medical professionals but that the recipient can direct and the provider can safely perform with instruction.

What paramedical services include:

Medication administration: Assisting with or administering prescribed medications, including oral medications, eye drops, ear drops, and topical creams (a physician’s written order is required)
Wound care: Dressing wounds or applying prescribed topical treatments as directed by a physician
Catheter care: Assisting with indwelling or external catheters per physician orders
Range of motion exercises: Performing prescribed exercises to maintain joint mobility (requires a physical therapist’s written instructions)
Enemas and suppositories: When prescribed by a physician
Tube feeding: Assisting with gastrostomy tube feeding per physician orders

Paramedical services require written physician orders or therapist instructions for most tasks. The county social worker will review these orders and authorize hours accordingly.

Category 4: Protective Supervision

Protective supervision is a specialized IHSS service for recipients who cannot be left alone safely due to a cognitive, behavioral, or mental health condition — even though they may not require hands-on physical assistance.

Who qualifies for protective supervision:

Recipients who, due to mental illness, developmental disability, traumatic brain injury, or severe cognitive impairment:

Are at risk of injuring themselves or others if left alone
Cannot recognize safety hazards in the home
Cannot call for help in an emergency
Are prone to wandering or elopement

Authorization for protective supervision requires documentation from a treating physician or mental health professional. It is one of the most heavily scrutinized IHSS service categories and often requires a county supervisor or senior social worker review.

Protective supervision can authorize up to the number of hours the recipient actually requires oversight — in some cases, this means 24-hour supervision is authorized. However, recipients generally cannot live alone without assistance if protective supervision is their primary authorized service.

Category 5: Accompaniment to Medical Appointments

IHSS authorizes providers to accompany recipients to medical appointments when the recipient cannot safely travel to or navigate appointments independently.

What is covered:

Travel time to and from the appointment
Time at the appointment itself (to assist with communication, physical support, etc.)
Accompaniment to specialist appointments, labs, pharmacies, and related medical visits

What is not covered:

Transportation to non-medical appointments (groceries, social activities) under this category — those are covered under Domestic/Errand services if authorized separately
Providers’ mileage or vehicle costs (IHSS does not reimburse provider transportation costs; mileage reimbursement is a separate negotiation between provider and recipient if the provider uses their own vehicle)

What IHSS Does NOT Cover

Understanding the limits is as important as knowing what is included:

Home repairs and modifications (painting, plumbing, installing grab bars) — these may be covered by other state programs such as HICAP
Companion care and socialization (IHSS does not pay for companionship as a service)
Services for other household members — all IHSS services are exclusively for the recipient’s own care
Services the recipient can perform safely — if the social worker determines you can do a task independently, those hours will not be authorized
Residential facility care — IHSS serves recipients living in private homes, not in nursing facilities or licensed residential care settings
Transportation costs — IHSS pays providers for their time accompanying recipients but does not cover vehicle expenses or gas

How to Request Services That Were Not Authorized

If you believe you need a service that wasn’t authorized at your last assessment, you have options:

Request an interim reassessment: Contact your county IHSS office and ask for an updated assessment if your condition has changed since your last evaluation
Provide supporting documentation: Ask your doctor, therapist, or specialist to write a letter explaining your functional limitations related to the uncovered service
Appeal a denial: If hours were denied at assessment and you disagree, you may request a State Fair Hearing within 90 days of receiving the Notice of Action

Frequently Asked Questions

Q: Can IHSS pay for multiple services in the same visit? Yes. A provider can perform personal care, domestic services, and meal preparation in the same visit and log the total hours for all tasks on a single timesheet entry for that day. There is no requirement to log each service category separately unless your county specifically requires it.

Q: Does IHSS cover mental health counseling or therapy? No. Mental health therapy is not an IHSS service — it is a medical service covered separately through Medi-Cal. However, IHSS does cover protective supervision for recipients whose mental health condition creates safety risks when left alone, and accompaniment to mental health appointments.

Q: What happens if my provider performs a service that was not authorized? The county can only pay for authorized services. If a provider performs unauthorized services and logs them on the timesheet, that constitutes fraud — both the provider and recipient could face repayment demands and possible disqualification. If you need additional services, the correct path is a reassessment, not logging unauthorized tasks.

For complete guides on IHSS service authorization, appeals, and provider enrollment, visit Unified Savers — California’s trusted resource for IHSS recipients and caregivers.

See also: What Services Does IHSS Cover? Complete Service Category Guide — the authoritative breakdown of all IHSS service categories and what each covers.