By the Unified Savers Editorial Team
IHSS hours are determined by county social workers through in-home assessments based on the recipient’s documented functional needs. Additional hours must be justified by documented change in condition, increased need for specific services, or errors in the initial assessment. Contact your county IHSS office to initiate the process.
To request more IHSS hours, the recipient (or their authorized representative) should contact their IHSS county social worker and request a reassessment, explaining that their care needs have increased since the last assessment. The social worker will schedule an in-home visit to evaluate the recipient’s functional limitations across all covered service categories. The strongest requests are supported by written documentation from doctors, therapists, or other healthcare providers confirming the increased need.
Many IHSS recipients and their families accept their authorized hours as fixed — but they’re not. Hours are based on functional assessments that can and should be updated whenever the recipient’s needs change. If a recipient needs more care than their authorized hours allow, they have the right to request a reassessment and advocate for an appropriate increase.
When to Request a Hours Increase
You should request a reassessment for additional IHSS hours when:
- The recipient’s medical condition has worsened: A new diagnosis, disease progression, surgery recovery, or deteriorating chronic condition increases care needs.
- Previous functional limitations were underreported: During the original assessment, the recipient may have minimized their difficulties or the social worker may have missed important needs. This is extremely common — many recipients don’t realize they can mention all their challenges.
- A new service need has developed: The recipient now needs help with a service category they didn’t need before (for example, new incontinence care needs, or protective supervision needs that weren’t present at the last assessment).
- A prior error in the assessment: Hours in a specific service category seem too low based on the actual time required to perform that task.
- The authorized hours don’t cover the actual care time: If the provider consistently runs out of authorized hours before all necessary care is provided each month, this is direct evidence of insufficient authorization.
How IHSS Hours Are Calculated
Understanding how hours are determined helps you advocate effectively. IHSS hours are calculated separately for each covered service category. The social worker evaluates how much time per month the recipient needs help with each activity, based on their functional limitations.
Major service categories that contribute to total hours:
- Domestic services: Housework, laundry, meal preparation, shopping — typically 15–30 hours/month for recipients with moderate limitations
- Personal care services: Bathing, dressing, grooming, oral hygiene, mobility assistance — can be 40–120+ hours/month for recipients with significant physical limitations
- Paramedical services: Medications, wound care, medical equipment management — hours vary by medical complexity
- Protective supervision: For recipients with cognitive impairments who need supervision for safety even when not receiving direct care — can add 100–283 hours/month for recipients who need 24-hour oversight
- Accompaniment: Accompanying recipient to medical appointments, outings
The CDSS uses standardized time studies to estimate how long each task should take. These estimates are built into the assessment tool social workers use. If you believe the time estimate for a particular task is too low for your specific situation (due to behavioral challenges, medical complexity, or physical limitations that slow the process), document this specifically.
Step-by-Step: How to Request More Hours
Step 1: Contact your county IHSS social worker
Call your county IHSS office and ask to speak with the recipient’s assigned social worker. If you don’t know who the social worker is, the main IHSS line can look it up with the recipient’s case number or date of birth. Tell the social worker:
“I’d like to request a reassessment for [recipient name]. Their care needs have increased since the last assessment, and the current authorized hours are not sufficient to cover all necessary services.”
Ask for the reassessment to be scheduled as soon as possible and get a reference number for your call.
Step 2: Prepare documentation of increased need
Before the social worker arrives, gather written documentation from healthcare providers. This is the most powerful evidence you can bring to a reassessment:
- Doctor’s letters: Ask the recipient’s primary care physician or specialist to write a letter describing the recipient’s current functional limitations and why the IHSS services are medically necessary. Be specific — “patient requires assistance with all aspects of daily hygiene, including bathing, dressing, and oral care, estimated to take 2 hours daily” is far more useful than a general letter.
- Therapy notes: If the recipient works with physical therapy, occupational therapy, or speech therapy, request documentation of current functional limitations.
- Hospital discharge instructions: If the hours increase is needed following a hospitalization, the discharge paperwork often contains specific care instructions that support the need.
- Caregiver log: A written log kept by the provider showing how many hours each week are spent on each service category, with specific tasks listed. Keeping this log for 2–4 weeks before the assessment provides concrete evidence.
Step 3: The in-home reassessment visit
The social worker will schedule a visit to assess the recipient’s current functional abilities. During this visit:
- Be present: The recipient, provider (if a family member), and any additional support person should all be present if possible.
- Demonstrate actual limitations: The social worker needs to see what the recipient can and cannot do. Don’t have the recipient perform at their best — show their actual typical functioning. If they can walk 20 feet to the bathroom on a good day but need full transfer assistance on most days, explain this variability.
- Describe the complete picture: Mention all service needs, including ones you thought weren’t important. If the recipient needs help with medication management, mention it. If they need supervision for safety, mention it. Every service category counts toward total hours.
- Describe time requirements specifically: For each task, explain how long it actually takes given the recipient’s specific limitations. “It takes 45 minutes to help my mother bathe because she has limited mobility in her left arm and needs careful positioning” is stronger than “she needs bathing help.”
- Refer to your documentation: Have your caregiver log and doctor’s letters available and hand them to the social worker during the visit.
Step 4: After the assessment
Following the reassessment, the county will send a Notice of Action stating the new authorized hours. This notice will either:
- Increase hours as requested
- Keep hours the same with a written explanation
- Reduce hours (uncommon if you requested an increase, but possible if the social worker found services that are no longer needed)
If the hours are not increased and you believe they should have been, you have the right to appeal through a state fair hearing within 90 days of the notice date.
Common Reasons Reassessments Are Denied and How to Address Them
“The recipient’s condition doesn’t appear to have changed” Counter this with written medical documentation showing the progression or change in condition. A doctor’s letter is far harder to dismiss than a provider’s verbal statement.
“The recipient demonstrates the ability to perform this task” During assessments, recipients sometimes perform tasks they normally struggle with — adrenaline, wanting to appear capable, or a “good day” can distort the picture. Document the variability in your caregiver log and ask the social worker to note the recipient’s average ability, not peak performance.
“The time estimate for this service is based on state standards” The CDSS time studies provide averages, but individual recipients with specific medical or behavioral needs often require more time. Present your caregiver log showing actual time spent on specific tasks, with notes on why your situation requires more time than average.
Requesting an Emergency Hours Increase
If the recipient’s condition has changed suddenly and they need additional care immediately, you can request an emergency or temporary increase in IHSS hours while the formal reassessment is being processed. Contact your county IHSS office, explain the emergency situation, and ask about temporary authorization for additional hours.
Hospital discharge situations often qualify for emergency additional hours — if the recipient is being released from the hospital with new care needs, the hospital social worker and the IHSS county social worker can coordinate to ensure the necessary hours are in place before discharge.
What to Do If Your Request Is Denied
If the county denies your request for additional hours, you have the right to appeal at a state fair hearing. The appeal process allows an Administrative Law Judge to review the county’s determination and all your supporting documentation.
For a complete guide on preparing for and winning a state fair hearing, see our article on how to win an IHSS fair hearing.
Additionally, contact SEIU 2015 if you are a union member — your union representative can advise on the reassessment process and connect you with resources to support your appeal.
Frequently Asked Questions
Q: How often can I request a reassessment for more IHSS hours? A: You can request a reassessment at any time — there is no mandated waiting period between requests. IHSS regulations allow recipients to request reassessment whenever their condition or circumstances change. However, requesting a reassessment too frequently without documented change in condition may result in the county scheduling them less urgently. Time your request to coincide with a genuine documented change in need.
Q: Can the social worker reduce my hours when I request an increase? A: Yes — a reassessment evaluates all service categories, and the social worker could theoretically find that the recipient’s condition has improved in some area, resulting in a reduction. This is uncommon when the explicit purpose of the reassessment is to address increased needs, but it can happen. To minimize this risk, be prepared to document all current needs thoroughly and don’t suggest any services are no longer needed unless they genuinely aren’t.
Q: My IHSS provider is a family member — does that affect the hours we can request? A: No — the authorized hours are based entirely on the recipient’s functional needs, not on who the provider is. Family members and non-family providers are authorized the same number of hours for the same level of care need. The only exception is the provider exclusion rules, which prevent certain family members from providing certain types of services in certain situations — but the authorized hours themselves are recipient-based.
Related Resources on Unified Savers:
- How to Win an IHSS Fair Hearing — Complete guide to appealing IHSS decisions at a state hearing
- IHSS Authorized Hours Appeal — How to appeal when your hours are reduced
- IHSS Reassessment Process Guide — What to expect at your annual IHSS reassessment
- IHSS Social Worker Visit Tips — How to prepare for and navigate IHSS social worker visits