In-Home Supportive Services
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
The In-Home Supportive Services (IHSS) program provides in-home care to seniors and persons with disabilities (SPD) allowing them to remain safely in their homes with as much independence as possible. IHSS include, but are not limited to:
- domestic and related services (housecleaning, meal preparation and clean up, laundry, and grocery shopping)
- personal care services (bathing, dressing, grooming)
- paramedical services (wound care, catheter care, injections)
- family and caregiver training
- accompaniment to medical appointments
- protective supervision for the mentally impaired
Members who may benefit from IHSS are those with complex chronic medical, cognitive or psychological conditions and functional limitations who require regular health monitoring and social supports to maintain function in the community and prevent avoidable emergency department or hospital admissions, or short- or long-term nursing facility admission.
Members have the right to hire, fire and supervise the work of IHSS personnel rendering services to them.
IHSS, for Medi-Cal in Los Angeles and San Diego counties, is not a managed care benefit, and services are carved out to county departments of social services. For Medi-Cal members in all other counties, the benefit is provided by the county.
To qualify for enrollment in the In-Home Supportive Services (IHSS) program, Medi-Cal members must meet all of the following criteria:
- Be a resident of California and United States citizen and live in their own home.
- Be age 65 or older, legally blind or disabled.
- Current Supplemental Security Income/State Supplementary Payment (SSI/SSP) recipient or be eligible to receive SSI/SSP.
- Be able to obtain a Health Care Certification form (SOC 873) from a licensed health care professional that indicates inability to independently perform some activity of daily living, and without IHSS, would be at risk of placement in out-of-home care.
Health Net public programs administrators provide information and assist in the referral of members who have complaints, grievances or appeals related In-Home Supportive Services (IHSS), to the grievance and appeal process established by the California Department of Social Services (CDSS) and local county agencies responsible for IHSS.
Participating providers, case managers, community-based organizations, and family members who believe a member in Los Angeles or San Diego County may benefit from in-home supportive services (IHSS) can contact the Health Net Member Services Department to coordinate referrals for members needing IHSS assessments. Members potentially eligible for IHSS may also be identified through emergency room/urgent care usage, inpatient admissions, authorizations, claims, and encounter data. For additional assistance or to obtain county-specific information, providers can also contact the Health Net Public Programs Department.
Providers must supply the completed health care certification form (SOC 873) required by the IHSS program in order to have a referral processed. If the referral comes from a source other than the member's provider, the IHSS social worker mails the SOC 873 to the member to have his or her PCP complete and return the form in order to complete the referral.
Health Net PCPs and other providers continue to render medically necessary care while the member participates in the IHSS program.