Q. Our 85 year-old mother is frail but wishes to remain at home. She has limited financial resources, so my sister is living with her and providing care without pay. Are there any government programs that might help us hire a caregiver and give my sister some relief?
A. Yes. There are a number of programs, but one that may be of special interest is the In-Home Supportive Services Program (“IHSS”). It is designed for persons of limited financial means who are blind, disabled or over age 65, and who are unable to live safely at home without assistance. For qualifying individuals, it provides nonmedical services such as meal preparation, cleaning, laundry, bathing, feeding, dressing, grooming, toileting, and monitoring for persons with cognitive impairments who are at risk of injury at home.
It works like this: The applicant must first qualify for either SSI or Medi-Cal, and then submit an application for the IHSS program. An in-home assessment is then made by a social worker to determine the number of hours of care needed. This can be up to 195 hours per month for a non-severely impaired applicant and up to 283 hours per month for one who is severely impaired. Upon approval, the beneficiary then selects and hires a caregiver and the IHSS program pays the worker for the approved number of hours per month, currently at the rate of $18.10 per hour in Alameda County and $16.50 per hour in Contra Costa County (as of January 1, 2023). See this chart for rates in other California counties.
Resource Limits: The program is designed for persons of very modest resources who are either (1) eligible to receive Supplemental Security Income (“SSI”), or (2) eligible for Medi-Cal. Medi-Cal eligibility is now easier to achieve as the current resource caps have recently been dramatically expanded. To qualify for Medi-Cal, the applicant can now have up to $130,000 in savings if single, although more is allowed if married. Note: for those persons with excess assets, there may be lawful strategies to accelerate eligibility without the need to first spend down the excess.
Income Limits: For persons with low monthly incomes, the benefit is available without a share of cost (“co-pay”). However, for persons whose monthly income is above certain levels (currently, above $1,564 for a single person and $2,106 for a married person, as of December 2022), the applicant will have a share of cost that must be paid to the worker(s) before the IHSS program pays the balance. Thus, the program only works well for persons with low incomes, or persons with great need who are awarded hours close to the maximum.
In many cases, the caregiver may hire a family member, whether a spouse or an adult child. Also, for the caregiver who works at least 80 hours per month, the program makes healthcare available at a nominal monthly premium, a valuable benefit to the worker.
If your mother qualifies for IHSS, she could hire your sister so she could receive both a modest salary and health insurance. Also, to give your sister some relief each month, your mother could split care hours, hiring your sister part-time and another caregiver for the balance of approved hours.
To find out more, call the Alameda County Area Agency on Aging at 510-577-1800, or go to www.AlamedaSocialServices.org.