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IHSS Advocacy Guide

These are the four functional categories that lead to hours:

1
1

Domestic Services

(cleaning, laundry)

2
2

Related Services

(meal prep, shopping)

3
3

Personal Care Services

(bathing, dressing, feeding, toileting)

4
4

Protective Supervision

(constant oversight for safety)

5
5

Paramedical Services

(giving treatments, tube feeding)

Document Everything Daily

Keep a care log/journal showing:

Every task you do for your child.

The minutes spent each time.

Any safety incidents or near-incidents.


Be specific:

  • Don't say: "Helped with feeding"
  • Do say: "Fed child by hand for 30 mins; prevented choking on food twice."
  • Include nighttime interruptions if you are up for safety-related reasons.

Prepare Evidence Before the Needs Assessment

Collect:

  • Doctor's letters describing:
  • Constant need for supervision.
  • Safety risks (wandering, choking, seizures, self-harm, aggression, etc.).
  • Cognitive/mental impairments that require redirection or protection.
  • School reports showing need for a 1:1 aide or behavioral plan.
  • Therapist/ABA reports describing unsafe behaviors.

Use IHSS Language

Ask medical providers to use language IHSS understands:

  • "Unable to self-direct"
  • "Requires continuous, 24-hour monitoring to prevent injury to self or others."

Maximize Protective Supervision Hours

Key criteria:

Child must have a mental impairment or mental illness AND require 24-hour supervision to prevent injury.

Show that:

  • Dangerous behaviors are frequent and unpredictable.
  • Injury would likely happen without your immediate intervention.

Example advocacy framing:

"My child cannot recognize dangers such as traffic, sharp objects, or strangers, and has run into the street multiple times without warning."

During the Home Assessment Interview

Don't minimize needs

Describe the worst days, not the best.

Be consistent

Your answers, doctor's reports, and care logs must align.

Avoid vague answers

Don't say "sometimes." Instead say: "Four times in the past week, my child climbed furniture and nearly fell."

Key Tips to Maximize Hours

Use specific safety risk examples

(wandering, choking, falls, aggression)

Log every incident

More incidents = stronger case

Use video or photo evidence

If safe and appropriate

Get multiple supporting letters

From different providers (doctor, therapist, school)

Never say your child can be left alone

Even briefly, if you are pursuing protective supervision

Paramedical Services

Any specialized treatments, Requires Doctors order

Additional info here

After the Award Notice

If hours are less than what's needed:

File an appeal within 90 days

(form SOC 295)

Continue documenting needs

Until the hearing

Request aid paid pending

So hours stay the same during appeal