If you're caring for a parent, spouse, grandparent, or another loved one at home, you may have wondered: Can I get paid for the care I'm already providing?
In California, the answer may be yes—but the path depends on your loved one's situation, Medi-Cal eligibility, care needs, and the program available to them.
For San Diego families, two programs are especially important to understand: In-Home Supportive Services (IHSS) and CalAIM Community Supports.
While both can help eligible Medi-Cal members receive support at home, they work differently. IHSS can allow an eligible family member to become the paid caregiver. CalAIM Community Supports, on the other hand, provides authorized services through participating Medi-Cal managed care plans and contracted providers.
Understanding the difference can help your family determine which option may be worth exploring.
The Two Main Ways to Get Paid or Receive Covered Care in California
IHSS (In-Home Supportive Services)
In-Home Supportive Services (IHSS) is a California program that helps eligible older adults, people with disabilities, and blind individuals remain safely in their homes rather than needing out-of-home care.
For eligible recipients, IHSS can authorize assistance with everyday activities such as:
- Bathing and grooming
- Dressing
- Meal preparation
- Housekeeping
- Laundry
- Shopping
- Other authorized personal care and supportive services
The person receiving care must meet Medi-Cal and IHSS eligibility requirements, and a county social worker evaluates their needs to determine which services and how many hours may be authorized.
Can a family member be paid through IHSS?
Yes. A family member may be able to become an IHSS provider and receive payment for authorized caregiving services.
In San Diego County, the person receiving IHSS is considered the employer of their caregiver and is responsible for selecting and supervising their provider. Family members, friends, and other qualified individuals may serve as IHSS providers after completing the required enrollment process.
Certain rules apply to spouses and parents who want to provide IHSS services, so families should confirm their specific circumstances with the county.
Importantly, IHSS is not simply a program where anyone caring for a relative automatically receives a paycheck. The care recipient must qualify, the county must assess and authorize services, and the caregiver must complete the required provider enrollment process.
CalAIM Community Supports
CalAIM—California Advancing and Innovating Medi-Cal—is a statewide effort to make Medi-Cal more coordinated and focused on the needs of the whole person.
One part of CalAIM is Community Supports, which can provide certain services that help eligible Medi-Cal members remain safely at home and avoid higher levels of care.
One of these services is Personal Care and Homemaker Services, which may include assistance with activities such as:
- Bathing
- Dressing
- Feeding
- Mobility
- Meal preparation
- Grocery shopping
- Accompaniment to appointments
Availability depends on the member's Medi-Cal managed care plan, individual needs, and authorization.
In San Diego County, Coast Care is a provider of authorized CalAIM Community Supports services. Coast Care works with participating health plans and care teams to provide approved in-home services.
How is CalAIM different from IHSS?
The biggest difference is how care is arranged and delivered.
With IHSS, the eligible recipient can select an individual caregiver—including, in many circumstances, a family member—and that caregiver completes the IHSS provider enrollment process to receive payment for authorized services.
With CalAIM Community Supports, services are authorized through the member's Medi-Cal managed care plan and delivered by an approved provider such as Coast Care. The health plan—not Coast Care—determines whether Community Supports are authorized.
So if your goal is specifically to become a paid family caregiver, IHSS is the program you should investigate first. If your loved one needs in-home support through their Medi-Cal health plan, CalAIM may provide another path to covered care.
IHSS vs. CalAIM at a Glance
|
IHSS |
CalAIM Community Supports |
|
|
Who pays? |
IHSS program/provider payment system |
Medi-Cal managed care plan/provider arrangement |
|
Who provides the care? |
Individual IHSS provider |
Authorized Community Supports provider |
|
Can a family member provide care? |
Yes, in many circumstances |
Depends on the specific program/provider arrangement; not the same family-provider model as IHSS |
|
Who determines eligibility? |
County IHSS program |
Medi-Cal managed care plan |
|
What is assessed? |
Recipient's need for authorized IHSS services and hours |
Member's needs and eligibility for authorized Community Supports |
|
Where do you start? |
San Diego County IHSS |
Medi-Cal health plan, care team, or authorized provider |
|
Best fit for: |
Families seeking an individual paid caregiver arrangement |
Eligible Medi-Cal members who need covered in-home support |
Who Qualifies?
The exact requirements are different for IHSS and CalAIM, but Medi-Cal eligibility is an important starting point for both programs.
IHSS eligibility
California generally requires an IHSS applicant to:
- Be a California resident
- Have a Medi-Cal eligibility determination
- Live in their own home or another qualifying living arrangement
- Have a demonstrated need for assistance
- Complete the required health care certification
- Meet the program's other eligibility requirements
A county social worker evaluates the individual's condition, abilities, living situation, and need for assistance before determining which services and hours may be authorized.
CalAIM eligibility
CalAIM Community Supports are available to eligible Medi-Cal members, but not every Medi-Cal member automatically qualifies.
Eligibility and authorization depend on the member's Medi-Cal managed care plan, individual circumstances, identified needs, and the specific Community Supports available through the plan.
In San Diego County, Coast Care can help families understand whether their loved one's situation may be appropriate for CalAIM Community Supports. Coast Care offers a free phone screening, while the member's health plan ultimately makes eligibility and authorization decisions.
How to Get Started
If you're interested in IHSS
If your loved one may qualify for IHSS in San Diego County, the first step is to apply through San Diego County Aging & Independence Services.
You can call the IHSS Call Center at 800-339-4661 to begin the application process. After applying, an IHSS social worker will evaluate your loved one's needs and determine whether services are authorized.
If IHSS is approved and your family member wants you to provide their care, you will then need to complete the required IHSS provider enrollment process. San Diego County requires provider enrollment steps that include an enrollment session, proof of employment eligibility, and a Department of Justice background clearance.
If you're interested in CalAIM
If your loved one has Medi-Cal and needs help remaining safely at home, you can start by:
- Contacting their Medi-Cal managed care plan.
- Speaking with their care manager or healthcare team.
- Asking whether Community Supports may be appropriate.
- Contacting an authorized Community Supports provider such as Coast Care.
Coast Care offers a free phone screening to help San Diego families understand whether their loved one's situation may fit available CalAIM services. The health plan ultimately determines eligibility and authorization.
Frequently Asked Questions
Can I get paid to care for my parent in California?
Possibly. If your parent qualifies for IHSS, you may be able to become their IHSS provider and receive payment for authorized caregiving services.
Your parent must first qualify for IHSS, and you must complete the required provider enrollment process. The specific rules can vary depending on your relationship to the recipient and the circumstances of the case.
Can I get paid to care for my spouse?
In some circumstances, yes. California IHSS rules allow spouses to be paid providers under certain circumstances, but the rules regarding what services can be authorized are specific.
Because every IHSS case is evaluated individually, it's important to confirm your situation with the county before assuming that all caregiving tasks will be paid.
Can I get paid to care for my child?
Parents may be eligible to receive payment for certain authorized IHSS services provided to a minor child, but there are specific rules and limitations. IHSS does not generally pay a parent simply for providing the ordinary supervision and care expected of a parent.
Families should discuss their specific circumstances with their county IHSS worker.
Will getting paid through IHSS affect my other benefits?
It can depend on your individual circumstances, the benefit program involved, and how income is treated under that program.
Because benefit rules can vary, don't assume that IHSS income will or will not affect another benefit you receive. Check with the agency administering the benefit and with IHSS for guidance specific to your situation.
Does CalAIM pay me directly for caring for my family member?
Not in the same way IHSS does.
IHSS has an individual-provider model that can allow a qualified family member to become the paid caregiver.
CalAIM Community Supports work differently. Services are authorized through participating Medi-Cal managed care plans and delivered through contracted or authorized providers. In San Diego, Coast Care provides authorized Community Supports services for eligible members.
Can I use both IHSS and CalAIM?
Potentially, but this depends on the individual's circumstances, the services involved, and program rules. The programs are not simply interchangeable, and receiving one does not automatically mean you qualify for the other.
Talk with the appropriate program or care team before making decisions about your loved one's care.
What If I Need Help Figuring Out Which Program Is Right?
Trying to understand Medi-Cal, IHSS, CalAIM, authorizations, caregiver requirements, and eligibility can feel overwhelming, especially when you're already caring for someone you love.
The important thing is to start with the program that matches what your family actually needs.
If you're specifically looking for a way to become a paid family caregiver, start by exploring IHSS.
If your loved one has Medi-Cal and needs professional in-home support, CalAIM Community Supports may be another option worth exploring.
For San Diego families, Coast Care can help you understand whether your loved one may qualify for CalAIM Community Supports and what the next steps could look like. Coast Care's services may include personal care, homemaker assistance, mobility support, meal preparation, and other authorized in-home services.
Not sure which path fits your family?
Coast Care can check your CalAIM eligibility for free.
If your loved one has Medi-Cal and needs additional support at home, contact Coast Care to learn more about available CalAIM Community Supports and whether your family may be eligible.