California Home Care Medi-Cal

Last updated: August 21, 2026 Jurisdiction: California

IHSS is California's consumer-directed home-care program

In-Home Supportive Services (IHSS) provides in-home assistance to eligible aged, blind, and disabled people as an alternative to out-of-home care. CDSS requires California residency, a Medi-Cal eligibility determination, residence at home or another abode of the person's choosing, and a completed Health Care Certification; the recipient is responsible for hiring, training, supervising, and firing the provider (CDSS, In-Home Supportive Services).

The Legislative Analyst's Office projects IHSS will serve 875,344 recipients averaging 127 hours per month in 2026–27. Those are budget projections rather than completed actuals, but they show the program's scale (Legislative Analyst's Office, 2026–27 IHSS Budget).

IHSS has a distinct recovery and spousal context

CANHR states that IHSS personal-care payments are exempt from Medi-Cal estate recovery, a significant distinction from recoverable nursing-facility and qualifying HCBS services (CANHR Medi-Cal Recovery FAQ).

Program scale: the 875,344-recipient, 127-hours-per-month estimate is the LAO's FY 2026–27 projection, not a guarantee of individually authorized hours; IHSS authorizes tasks after a home assessment (LAO IHSS Budget; CDSS IHSS).

CBAS and the Assisted Living Waiver solve different problems

Community-Based Adult Services (CBAS) is a Medi-Cal managed-care benefit offering adult-day health services such as nursing, therapies, personal care, meals, and transportation. DHCS lists its CalAIM waiver authorization as running through December 31, 2026; renewal status beyond that date was not verified here, so confirm current status before relying on it (DHCS, Community-Based Adult Services).

The Assisted Living Waiver serves members age 21 or older with full-scope Medi-Cal and zero share of cost who meet its care and residence criteria. DHCS lists the waiver in 15 counties for a March 1, 2024–February 28, 2029 term and says slots are limited with a waitlist; participants must pay room and board from their own income (DHCS, Assisted Living Waiver).

Home care does not erase financial eligibility rules

IHSS, CBAS, and waiver pathways each have their own requirements. California's non-MAGI asset test was reinstated January 1, 2026, while the transfer-penalty rules are specifically tied to nursing-facility level of care (DHCS ACWDL 26-02; DHCS Asset Limit FAQ). Compare the different access structure on Florida's home-care Medicaid page.

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IHSS is California's consumer-directed home-care program

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