Omid Saatsaz
Founder, Red Hill Home Care
If you've started researching how to pay for home care in California, you've probably run into the term IHSS. It's one of the most important, and most misunderstood, programs available — worth understanding clearly, including how it's different from what an agency like Red Hill provides.
What IHSS Is
In-Home Supportive Services (IHSS) is a Medi-Cal-funded program that pays for personal care and household support so eligible seniors and people with disabilities can stay safely at home instead of moving into a care facility. It's administered county by county through your local county social services or IHSS office, not through a private company.
What It Covers
Depending on the assessed need, IHSS can cover: personal care (bathing, dressing, grooming, bowel/bladder care, feeding), domestic services (housecleaning, laundry, meal preparation, shopping for food and necessities), accompaniment to medical appointments, and protective supervision for people with cognitive impairments who can't be safely left alone. The exact number of authorized hours is set by a county social worker after an in-home needs assessment — it's not a flat amount for everyone.
Who Qualifies
Eligibility generally requires being enrolled in Medi-Cal and having a documented need for assistance confirmed through that in-home assessment. Income and asset rules apply and have changed over the years, so the most current, accurate answer for your specific situation comes from your county IHSS office directly — not a general article like this one.
How IHSS Caregiving Actually Works
This is the part that trips people up: IHSS isn't an agency that sends you a caregiver. In most cases, you (or your family member) find and hire your own IHSS provider — often a family member, sometimes a friend or someone you already trust — and that person is paid directly by the state through the IHSS payroll system. It's a fundamentally different model from hiring a private-pay agency, where the agency employs, trains, schedules, and backs up the caregiver.
Where an Agency Fits Alongside IHSS
Plenty of families use both: IHSS hours cover a baseline amount of support (especially if a family member is already serving as the paid IHSS provider), and a private-pay agency like Red Hill fills in additional hours, covers nights/weekends IHSS doesn't reach, provides trained backup when the regular caregiver is sick or on vacation, or handles specialized needs like dementia care. If you're not sure how the two could work together for your situation, that's exactly the kind of thing worth a phone call rather than guessing alone.
Frequently Asked Questions
Does Red Hill Home Care accept IHSS payments directly?
No — IHSS pays its own designated provider (often a family member) directly through the state payroll system. Red Hill is a separate, private-pay agency that many families use alongside IHSS to cover additional hours.
Can a family member get paid through IHSS and also use a private-pay agency?
Yes, this is actually one of the most common setups — a family member serves as the paid IHSS provider for baseline hours, and a private-pay agency fills in nights, weekends, or hours the family member can't cover.
About Omid Saatsaz
Founder, Red Hill Home Care
Omid founded Red Hill Home Care after watching his grandfather receive home care firsthand, and after a close family friend with disabilities struggled to get the daily support they needed. Before starting Red Hill, he spent several years consulting for home care agencies on operations, marketing, and M&A, and three years at Medtronic in Irvine, CA working on neurovascular stroke-prevention devices (aneurysm treatment and blood clot retrieval). He holds a degree in Industrial Engineering from Cal Poly Pomona (2016).