How IHSS Works for Family Caregivers
California's In-Home Supportive Services (IHSS) program allows eligible individuals who are elderly, blind, or disabled to receive care in their homes. This Medi-Cal-funded program enables recipients to hire and pay caregivers, including family members. The payment amount is based on authorized care hours and the hourly wage set by the specific county.
To qualify, the care recipient must be eligible for Medi-Cal and have a county social worker assess their need for assistance with daily activities. Services can cover a range of needs, from personal care to meal preparation.
County-based IHSS pay rates
IHSS hourly wages are determined at the county level and can vary significantly. These rates are influenced by union negotiations and minimum wage laws. For example, in early to mid-2025, rates vary across counties:
- Los Angeles County: $18.50 per hour
- San Diego County: $19.00 per hour
- San Francisco County: $22.00 per hour
- Santa Clara County: $20.04 per hour
- Riverside County: $18.50 per hour
Caregivers should contact their county's IHSS office for the most current wage details.
The IHSS application process for family caregivers
The process involves the care recipient applying for Medi-Cal and IHSS, a social worker conducting an in-home assessment to determine care hours, and the family member completing provider enrollment, which includes a background check. Once approved, caregivers submit timesheets for payment.
Other avenues for getting paid as a family caregiver
Additional options for financial assistance for family caregivers exist outside of the IHSS program.
Veteran-directed care programs
The U.S. Department of Veterans Affairs (VA) offers programs that can help pay family caregivers of eligible veterans. The Aid & Attendance Pension can help veterans pay for care, and in some cases, an adult child caregiver may be compensated. The Veteran-Directed Home and Community Based Care (VDC) program provides veterans with a budget they can use to hire and pay a family member, including a spouse. VDC availability can vary by location.
California Paid Family Leave (PFL)
California's PFL program provides eligible employees with up to eight weeks of partial wage replacement to care for a seriously ill family member. As of January 2025, this benefit replaces 70% to 90% of wages and applies to care for a child, parent, spouse, registered domestic partner, sibling, grandparent, or grandchild.
Private options: Long-Term Care Insurance and Personal Care Agreements
Some long-term care (LTC) insurance policies may reimburse family members for care, depending on the policy terms. Families can also create a legal personal care agreement with an elder law attorney. This formal contract outlines the care services and compensation and requires careful documentation for tax purposes and to avoid potential issues with Medi-Cal eligibility.
Comparison of Caregiver Payment Options in California
| Feature | In-Home Supportive Services (IHSS) | CA Paid Family Leave (PFL) | Veteran-Directed Programs (VDC) | Long-Term Care Insurance | Private Personal Care Agreement |
|---|---|---|---|---|---|
| Funding Source | State Medi-Cal program | State Disability Insurance contributions | U.S. Department of Veterans Affairs | Private insurance policy | Out-of-pocket family funds |
| Typical Compensation | Hourly wage, varies by county ($17-$22+ in 2025) | Percentage of regular salary (70-90% as of 2025) | Monthly stipend or flexible budget | Reimbursement based on policy coverage | Hourly rate set by family, based on market rate |
| Caregiver Eligibility | Must pass background check, be 18+, and complete orientation | Must have paid into SDI, relationship must be with qualified relative | Must pass background check; spouse can be paid in VDC | Varies by policy; may require training | No formal requirements, but training is helpful |
| Care Recipient Eligibility | Must be Medi-Cal eligible, age 65+, blind, or disabled | Recipient must have a serious health condition | Veteran must meet specific service-connected disability requirements | Must meet policy's trigger for care benefits | Anyone in need of care, typically elderly or disabled |
| Key Limitations | Recipient must be low-income; limited monthly hours | Temporary only (8 weeks) and based on past earnings | Not all VA Medical Centers offer VDC; eligibility is complex | Coverage can be restrictive and costly; not all policies allow family pay | Can affect Medi-Cal eligibility; requires proper legal documentation |
Conclusion
When considering how much do caregivers get paid in California for family members, the primary source of compensation is the In-Home Supportive Services (IHSS) program. Payment is an hourly rate that varies by county, typically ranging from $17 to over $22 per hour as of 2025. Eligibility is based on the care recipient's Medi-Cal status and assessed need for care. Other options include California's Paid Family Leave for temporary income replacement, VA benefits for eligible veterans, and potential reimbursement through long-term care insurance policies or personal care agreements. Understanding the specifics of each program is essential for families seeking financial support for caregiving.
