How the Needs Assessment Determines Your IHSS Hours
The IHSS program provides personalized service hours based on each recipient's unique needs. A county social worker conducts an in-home assessment to evaluate the level of assistance required for various daily tasks. The authorized hours are detailed in a Notice of Action (NOA). Recipients can request a reassessment if their needs change. Documenting daily care needs is crucial for this process.
Key factors influencing your authorized hours
- Severity of Impairment: Impacts maximum potential hours, with "severely impaired" (SI) individuals needing 20 or more hours of specific non-medical personal services per week.
- IHSS Program Subtype: Different subprograms like PCSP, CFCO, IPO, and IHSS-R have varying rules and can influence maximum hours and service limits.
- Need for Protective Supervision: Can significantly impact total hours for individuals needing 24/7 supervision due to cognitive impairment.
- Proration and Alternative Resources: Hours may be reduced if services are shared or if free services are received from other sources.
Maximum Monthly IHSS Hours by Program and Impairment
Maximum hours depend on impairment level and program type. For PCSP and CFCO, both SI and NSI recipients can be authorized up to 283 hours per month. For IPO and IHSS-R, SI recipients can get up to 283 hours, while NSI recipients are limited to 195 hours. The overall maximum for IHSS is 283 hours per month.
Service-specific hour limits
IHSS also has specific limits for certain services. For example, domestic chores are typically capped at 6 hours per month, and laundry often at 1 hour per week. Documenting needs exceeding these limits during the assessment is important.
Calculating Your Monthly Hours
Monthly hours are calculated by multiplying authorized weekly hours (excluding domestic services) by 4.33, then adding the fixed monthly domestic service hours. For example, a non-severe recipient with 19.9 weekly non-domestic hours would have approximately 92 monthly hours after adding 6 domestic hours (19.9 x 4.33 + 6).
Comparison of IHSS Hour Calculations
| Factor | Severely Impaired Recipient (SI) | Non-Severely Impaired Recipient (NSI) |
|---|---|---|
| Weekly Assessment Threshold | 20 or more hours of specific services per week | Less than 20 hours of specific services per week |
| Max. Monthly Hours (PCSP/CFCO) | 283 hours per month | 283 hours per month |
| Max. Monthly Hours (IPO/IHSS-R) | 283 hours per month | 195 hours per month |
| Influence of Protective Supervision | Can be eligible for 283 hours/month with protective supervision | Can receive up to 195 hours for protective supervision, plus other needed services up to 283 hours/month (CFCO) or 195 hours (IPO/IHSS-R). |
| Maximum for IHSS Provider (Multiple Clients) | Same provider workweek limit of 66 hours across all clients, unless an exemption applies. | Same provider workweek limit of 66 hours across all clients, unless an exemption applies. |
What to Do If Your Hours Are Too Low
If your NOA shows insufficient hours, you can request a reassessment with updated documentation. You can also appeal the decision through a fair hearing, presenting evidence to support your claim. Resources like Disability Rights California's IHSS Self-Advocacy Resource Webpage can help with this process.
Conclusion: Personalized Needs, Personalized Hours
In conclusion, the number of hours you can claim for IHSS is a personalized figure based on a needs assessment. Program type, impairment level, and care requirements all contribute to the final monthly allocation. Understanding the process and your appeal options helps you advocate for necessary care hours.
