What Documentation or Evidence Helps Increase IHSS Hours?

Parents and caregivers who receive In-Home Supportive Services (IHSS) for a child or family member with disabilities often find that the number of approved hours doesn’t reflect the true level of care needed. Fortunately, you can request a reassessment or appeal an IHSS decision—but success often depends on providing strong documentation and evidence.

The more clearly you can show how your child’s condition affects daily living and safety, the better your chances of securing additional hours.

Understanding How IHSS Hours Are Decided

IHSS social workers determine the number of hours a recipient receives based on an in-home assessment. They evaluate how much time is needed each day for activities such as bathing, dressing, feeding, toileting, mobility, and supervision.

If your child or family member has significant physical, developmental, or behavioral challenges, it’s your responsibility to demonstrate those needs with detailed and credible evidence.

1. Medical Records and Doctor’s Letters

Medical documentation is one of the strongest forms of evidence in an IHSS reassessment.
Ask your child’s doctor or specialist to write a letter that includes:

• Diagnoses and how they impact your child’s daily functioning.
• A description of the level of assistance needed for personal care, mobility, and safety.
• Specific recommendations for supervision, especially if your child is at risk of self-harm, injury, or wandering.

Be sure the letter uses clear, factual language that connects your child’s medical condition to their care needs—for example, “Due to uncontrolled seizures, [child’s name] requires continuous supervision to prevent injury.”

2. School and Therapy Reports

Reports from your child’s school or therapists can help verify how much support your child needs throughout the day. Useful examples include:

• Individualized Education Program (IEP) or 504 Plan documents that describe assistance required for self-care, mobility, or behavior regulation.
• Behavioral therapy progress notes that show the level of monitoring or redirection needed.
• Occupational or physical therapy evaluations outlining challenges with fine or gross motor skills.

These records demonstrate that your child’s support needs are consistent across multiple settings—not just at home.

3. Behavioral or Psychological Evaluations

If your child’s IHSS request involves protective supervision (for children who require constant monitoring due to safety risks), behavioral and psychological evaluations are essential.
Professional assessments can document:

• Impulsivity or poor safety awareness.
• Aggression or self-injurious behavior.
• Cognitive impairments that increase the risk of harm without supervision.

Evaluations should clearly link your child’s behaviors to the need for 24-hour or near-constant monitoring.

4. Personal Logs and Daily Care Notes

Your own notes can be powerful evidence. Keep a daily care log that tracks:

• The time you spend helping your child with meals, hygiene, dressing, or medical tasks.
• How often your child needs redirection, assistance, or supervision.
• Specific incidents showing why constant attention is necessary (for example, attempts to run into the street or self-harming behaviors).

Detailed logs show the social worker that your requests are based on real, consistent daily needs—not general estimates.

5. Photographs or Video Evidence (When Appropriate)

Visual evidence can help demonstrate safety concerns or physical limitations. For example:

• Photos of safety modifications in your home, such as locks or gates.
• Video (used respectfully and privately) showing mobility challenges or the need for hands-on assistance.

Always prioritize your child’s privacy and dignity when using photos or video as supporting documentation.

6. Statements from Care Providers or Witnesses

Letters or declarations from teachers, aides, therapists, or respite providers can help confirm your child’s needs. These statements should describe what kind of assistance or supervision they observe your child requiring in other settings.

7. Prior IHSS Assessments or Notices

Keep copies of all IHSS assessments, notices of action, and previous hour allocations. Comparing past and current documentation can help show that your child’s needs have increased or that prior assessments underestimated the care required.

Key Takeaway

The strongest IHSS cases are supported by clear, consistent documentation from multiple sources—medical, educational, behavioral, and personal. Each piece of evidence should directly connect your child’s condition to the specific time and care required to keep them safe and supported at home.

Need help? In California, the In-Home Supportive Services (IHSS) program provides crucial financial help for families raising children with special needs. American Advocacy Group is on the front lines every day, making positive change happen for people diagnosed with autism, Down syndrome, and a range of diagnoses across the continuum. As a leading advocate for all people with intellectual and developmental disabilities and their families, and the premier provider of the support and services people want and need, we understand the system and know how to take action regarding your best interests.

CONTACT US FOR HELP. Dial (877) 762-0702 or email us at [email protected].