By the Unified Savers Editorial Team
AB 1453 is currently moving through the California Legislature and has not yet been signed into law. Provisions and effective dates may change. Check with your county IHSS office for current eligibility rules.
AB 1453, authored by Assemblymember Matt Haney (D-San Francisco), would require county IHSS offices to proactively assess adults diagnosed with serious mental illness (SMI) for IHSS eligibility when those individuals are transitioning out of inpatient psychiatric facilities or county mental health programs — a step advocates say could dramatically improve home support for a population currently underserved by the program.
The bill passed the Assembly on a 58-15 vote in May and cleared the Senate Health Committee in late June. It is awaiting a full Senate floor vote expected in August.
The Gap the Bill Addresses
IHSS currently covers individuals who need assistance with activities of daily living — bathing, dressing, meal preparation, housework — due to physical disability, cognitive impairment, or age. People with serious mental illness can qualify, but advocates say many never learn they may be eligible, particularly when they’re being discharged from acute psychiatric care.
A 2025 study commissioned by the California Hospital Association found that approximately 34 percent of adults discharged from inpatient psychiatric units in California had functional limitations that would likely qualify them for IHSS services — but only about 9 percent of those individuals were enrolled in the program at the time of discharge.
“People leaving psychiatric care often have nowhere stable to go and no support structure at home,” said Haney at an April press conference in San Francisco. “IHSS can be the difference between a successful transition and ending up back in the hospital or on the street. But providers and counties aren’t connecting these patients to the program.”
What AB 1453 Would Require
If signed into law, AB 1453 would:
- Require hospitals discharging Medi-Cal patients from inpatient psychiatric holds of 72 hours or more to provide written information about IHSS eligibility before discharge.
- Require county mental health departments to refer adults enrolled in Full Service Partnership (FSP) programs or other intensive outpatient mental health services to IHSS for evaluation when those individuals have documented functional limitations.
- Require county IHSS offices to complete an assessment within 30 days of receiving a referral from a mental health department — down from the current standard of 45 days.
- Require DHCS to develop a standardized IHSS referral form for use by psychiatric inpatient facilities by January 1, 2027.
The bill does not create a new IHSS eligibility category — it does not change who qualifies. It requires counties to actively identify and assess potentially eligible individuals rather than waiting for those individuals to self-refer.
County Opposition and Legislative Compromise
Several county welfare directors initially opposed the bill, citing administrative burden and the cost of processing additional IHSS assessments. The California State Association of Counties (CSAC) submitted a letter of opposition in March, arguing that counties lacked sufficient social worker staffing to absorb increased assessment referrals under the proposed 30-day timeline.
Haney’s office negotiated a compromise with CSAC in May that added a phased implementation schedule: the 30-day assessment timeline would not take effect until January 1, 2028, giving counties an 18-month preparation period. With that amendment, CSAC changed its position to neutral.
The Department of Finance estimated the bill would result in approximately $62 million in new IHSS costs to the state annually by full implementation, offset by reductions in emergency psychiatric hospitalization costs that DHCS estimated at approximately $45 million annually.
What This Means for Workers and Recipients
If AB 1453 becomes law, IHSS providers — particularly those in counties with large mental health populations like Los Angeles, Sacramento, and Alameda — should expect an increase in potential new recipients over the 2027-2028 enrollment period.
For adults with serious mental illness and their families, the bill provides a structured pathway into IHSS at a critical transition point. Individuals who have recently been discharged from psychiatric care and believe they may have functional limitations that qualify them for IHSS should contact their county IHSS office directly — current eligibility rules already cover SMI-related functional limitations, even before the bill takes effect.
County IHSS offices can be found through the CDSS county office locator at cdss.ca.gov.
Related IHSS Eligibility Resources
For a full overview of who qualifies for IHSS services in California, see IHSS Eligibility Requirements California: Who Qualifies. Adults with qualifying functional limitations can also check their eligibility using the Free IHSS Eligibility Checker.
For providers expecting an increase in new recipients under AB 1453, the IHSS Provider Enrollment Process 2026 Guide covers what new providers need to complete before their first shift.