Your child has been receiving In-Home Supportive Services (IHSS), and now their 18th birthday is approaching.
Does IHSS stop? Do you have to submit a new application? Will your child lose hours? Can you continue as their provider?
For most families, turning 18 does not end an existing IHSS case or require the family to start the application process over.
However, your child's 18th birthday marks an important transition. IHSS now considers your child an adult, and that change can affect how the county calculates services, communicates with your family, and determines authorized hours.
Generally, no. An existing IHSS recipient does not need to submit a completely new application simply because they turn 18.
IHSS serves both children and adults with disabilities. Recipients must continue to meet the program's eligibility requirements, including California residency, Medi-Cal eligibility, an eligible living arrangement, and a need for IHSS services.
When your child turns 18, IHSS changes their status from a minor recipient to an adult recipient. The birthday itself does not end their need for IHSS or cancel their case.
However, the county may need to review the case because some IHSS rules for adults differ from the rules for children.
California applies certain IHSS rules specifically to children under age 18.
For example, the state considers a parent's legal responsibility to care for a minor child when it determines certain IHSS services and hours.
Once your child turns 18, those minor-child rules no longer apply in the same way.
Because of this change, parents should make sure the county evaluates their child's needs under the correct adult IHSS rules.
Possibly.
Turning 18 does not automatically increase IHSS hours. However, the move from minor to adult status can change how the county calculates certain services.
Parental responsibility provides one important example. IHSS may limit certain services for a minor because parents normally provide some care to their children. Once the recipient becomes an adult, the county can no longer apply those minor-child rules in the same way.
California IHSS training materials provide an example involving a recipient who received 195 monthly IHSS hours at age 17. After the recipient turned 18, the rules changed, and the same underlying care needs could qualify the recipient for as many as 260 monthly hours.
Not every recipient will receive more hours after turning 18.
IHSS still bases authorized hours on the individual's functional limitations and need for assistance. However, families should not assume that the hours their child received at age 17 represent the maximum available at age 18.
When your child turns 18, review the entire IHSS assessment instead of simply accepting the same services and hours from the previous year.
A county social worker evaluates what your child can safely do without assistance and how much help they need.
Depending on your child's disability and circumstances, IHSS may authorize assistance with:
The county may need to calculate some of these services differently once your child becomes an adult.
Turning 18 does not automatically end protective supervision.
IHSS may authorize protective supervision for certain recipients who cannot recognize or avoid hazards because of a mental impairment or mental illness and require observation to prevent injury, hazards, or accidents.
If your child already receives protective supervision, pay close attention to the hours the county authorizes after their 18th birthday.
The rules that apply to adult recipients can change the total number of hours available. California's IHSS materials specifically show how a recipient's potential maximum hours can change after turning 18.
Review the new Notice of Action carefully and compare it with the previous authorization.
Generally, yes.
A parent can usually continue working as the IHSS provider for an adult child as long as the parent remains an eligible, enrolled provider and the adult recipient chooses the parent as their provider.
IHSS allows recipients to hire eligible family members, friends, neighbors, and other enrolled providers.
In some ways, turning 18 can simplify the parent-provider issue because the special IHSS rules that apply specifically to parents of minor children no longer apply in the same way.
SSI follows a separate process.
If your child receives Supplemental Security Income (SSI), Social Security generally conducts an age-18 redetermination and applies the adult disability standard.
This SSI review is not a new IHSS application.
However, families should pay close attention to SSI and Medi-Cal notices because IHSS recipients must maintain qualifying Medi-Cal eligibility.
Do not assume that an SSI notice and an IHSS notice mean the same thing. The programs interact, but each program follows different eligibility rules and procedures.
This issue catches many parents by surprise.
At age 18, your child becomes a legal adult.
Being the parent does not automatically give you authority to make every decision or communicate with every agency on your adult child's behalf.
Some adults with disabilities can manage their own IHSS services. Others may use an authorized representative or another legally recognized decision-maker depending on their circumstances.
Families should address this issue before or around the 18th birthday so they know who can communicate with the county, sign forms, approve providers, and participate in assessments.
You can ask the county to review your child's IHSS services if turning 18 changes how the county should calculate those services or if your child's needs have changed.
A reassessment is not the same as submitting a new IHSS application.
During a reassessment, the county reviews the previous assessment along with the recipient's current condition, functional limitations, living situation, and care needs.
Consider asking the social worker:
“Now that my child is 18, did you assess all of their services under the adult IHSS rules?”
That question can matter much more than simply asking whether your child's existing hours will continue.
When IHSS changes your child's authorized services or hours, the county should issue a Notice of Action.
Read it carefully.
Compare the new authorization with the previous one and look for:
Do not assume that a reduction is correct simply because your child turned 18.
At the same time, do not assume the county will automatically identify every additional service or hour your child may qualify for as an adult.
You can challenge an IHSS decision if the county reduces or terminates services.
Pay close attention to the appeal deadlines listed on the Notice of Action. Timing can become particularly important if you want to request that existing benefits continue while the state decides the appeal.
If your child's hours drop around their 18th birthday, review whether the county:
A major change in hours deserves a careful review.
If your child already receives IHSS, their 18th birthday generally does not require you to start the entire application process again.
But you should not treat the birthday as a routine administrative change either.
Your child now qualifies as an adult recipient. The county must apply the appropriate adult IHSS rules, and some limitations connected to parental responsibility may change. Your child's SSI may also undergo a separate age-18 review.
For some families, these changes can lead to additional IHSS services or hours.
If the county reduces your child's hours, denies services, or continues applying rules intended for minors, an IHSS attorney or advocate can review the assessment and Notice of Action and determine whether the county correctly evaluated your child's case.
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].