Jack has become depressed about the situation. He is very independent and has always prided himself on his ability to take care of his affairs on his own. The last thing he wants to do is move into an assisted care facility. He explains his situation to his friend Henry over lunch one day. Henry suggests he look into the In-Home Supportive Services (IHSS) Program as an alternative to moving into an assisted care facility.

“What’s the In-Home Supportive Services Program,” asks Jack.

“Well, I don’t know a whole lot about it,” says Henry. “But I’ve heard it’s a publicly funded program to help people with disabilities remain in their homes safely. I think they provide assistance with the kinds of things you’re talking about—cooking, cleaning, getting in and out of bed.”

“How much does it cost?” asks Jack.

“I think it depends on your income level. If your income is low enough, I think it’s free. It’s a publicly funded program,” says Henry.

“Hmmmm. Sounds like it could be really helpful,” Jack says.

“Why don’t you call the county welfare office,” says Henry. “I bet they’ll have information on it.”

So Henry and Jack log onto Internet to find the phone number of their nearest county welfare office. Jack calls and is transferred to an IHSS intake coordinator named Darlene. Jack briefly explains his situation to Darlene.

“I think the In-Home Supportive Services Program could be exactly what you need,” says Darlene. “Let me ask you a few questions first to make sure you qualify. So you said you have cerebral palsy, correct?”

“Yes.”

“OK,” says Darlene. “IHSS is available to people with disabilities so you meet the criteria there. Are you a California resident?”

“Yep. I’ve lived here my whole life.”

“Good. Are you on Medi-Cal?” asks Darlene.

“Yes, ma’am. I am.” Jack says.

“Excellent” says Darlene. “That means you qualify for IHSS. Are you on any other public benefits programs?”

“Nope.”

“No, just Medi-Cal,” says Jack.

“OK,” says Darlene. “Do you work?”

“I sure do,” Jack says. “Part-time as an accountant for a local manufacturing company. I make $1,800 per month,” says Jack.

“OK,” says Darlene. “Do you have any other sources of income? Earned or unearned?”

“Nope. That’s it.”

“OK,” Darlene says. “Well you definitely qualify for the program. Now we have to determine if you’re going to have any share of cost.”

“What’s that?” asks Jack.

“Well, if your countable income is above $870 per month, you would have to pay for a portion of the cost of your IHSS services. The portion you pay is called your ‘share of cost,’” says Darlene.

“I see,” says Jack.

“But let me do the math here. You may not have to pay anything. OK. So you have $1,800 per month in earned income. We need to subtract $65 from that—that’s your earned income exclusion—and another $20—that’s your general income exclusion. So that leaves us with $1,715. Do you have any impairment related work expenses (IRWE)?”

“Well, I couldn’t work if I wasn’t taking my medication. And I pay $40 a month in co-payments for that. Does that count?” asks Jack.

“It sure does,” says Darlene. “So let’s see, we subtract $40 from $1,715. That’s $1,675. $1,675 divided by 2 is $837.50. You have $837.50 in countable income. That means, you qualify for no-cost In-Home Supportive Services,” says Darlene.

“Well, that’s good news,” says Jack.

“It sure is,” says Darlene. “Why don’t you come in tomorrow and fill out an application to get the process started.”

So the next day, Jack goes down to the local welfare office and fills out an IHSS application. Several days later, a county social worker named Louise comes to visit him at his home. She is there to conduct a needs assessment, an in-home interview to determine what Jack needs help with and how many hours of assistance IHSS will pay for. She asks him a series of questions about his physical and mental abilities to determine which tasks he can safely perform on his own and which he needs help with.

Clearly Jack has a sharp mind but needs assistance with things like cooking, cleaning, getting dressed and getting in and out of bed.

“How about work,” Louise asks Jack. “Do you need any assistance there?”

“Not currently. Why? Can I use IHSS services there too?”

“Yes, you can. We’d have to transfer some of the hours assigned for in-home support to the workplace, but it can be done. IHSS can be used to help obtain, retain, and return to work.”

“Well, that’s good to know,” says Jack. “I probably don’t need that now. But I’ll keep it in mind for the future.”

Shortly after his needs assessment, Jack receives more good news. He has been approved for 60 hours of IHSS services each month. And because his countable income is below the $870 limit, he won’t have to pay anything for the care he receives. He and his care provider will have to fill out a timesheet and he’ll be responsible for hiring, firing (if necessary), and supervising that person. But he doesn’t have to pay anything.

Jack is thrilled. He hires Wendy, a retired neighbor and long-time friend to provide the services. Wendy comes by everyday to help Jack in and out of bed. She prepares meals for him, clean, and does some of his laundry. She also provides personal care services like dressing, grooming, and bathing. When necessary, she drives Jack to his doctor’s appointments.

It turns out to be a great arrangement. Wendy enjoys the part-time work and Jack is extremely grateful for the help. His depression has lifted, he has more energy than he used to, and he is thrilled to be able to remain in his own home. It’s a win-win for everyone involved.