Alternatives to IHSS

Published by IHSSHours.com · October 7, 2026 · Updated October 11, 2026

IHSS is the largest program in California that pays for help at home, but it is not the only one. Some programs add to IHSS. A few replace it: once you enroll, the county ends your IHSS. Knowing which is which matters before you sign anything.

Programs That Add to IHSS

Waiver Personal Care Services (WPCS). WPCS is part of the Home and Community-Based Alternatives (HCBA) Waiver, for people on Medi-Cal who need the level of care of a nursing facility or hospital. It adds care hours on top of IHSS for people whose needs are greater than IHSS can authorize. When the waiver is full, applicants go on a waitlist. How WPCS works with IHSS.

Multipurpose Senior Services Program (MSSP). MSSP gives care management to people 65 or older on Medi-Cal who could be certified for a nursing facility and who live in an area an MSSP site serves. Along with a care manager, it can arrange things like respite, transportation, meals and housing assistance. Most MSSP participants also receive IHSS.

Community Supports through a Medi-Cal managed care plan. Under CalAIM, a plan may offer Personal Care and Homemaker Services, which can cover need that IHSS hours do not, and Caregiver Respite. Plans choose which of these to offer. How CalAIM and IHSS fit together.

Regional center services. For people with developmental disabilities, regional center services work alongside IHSS. IHSS and regional center services.

Programs That Replace IHSS

Program of All-Inclusive Care for the Elderly (PACE). PACE is a health plan built around a day center. It provides and coordinates all of a person's care, including long-term care at home. To join, you must be 55 or older, live in a PACE service area, be found by the state to need nursing-home level of care, and be able to live safely at home when you enroll. Because PACE provides all personal care, the state tells counties to end IHSS for anyone who enrolls. You cannot have both.

SCAN Connections and SCAN Connections at Home. Members of these two SCAN Health Plan plans get in-home care through SCAN and may not also receive IHSS. Other SCAN plans are different. IHSS and SCAN Health Plan.

Assisted Living Waiver (ALW). This waiver pays for care in an assisted living setting for people who would otherwise need a nursing facility. You must be 21 or older, have full Medi-Cal with no share of cost, and need nursing-facility level of care. Residents pay their own room and board. It operates in 15 counties: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma. Slots are limited and there is a waitlist. IHSS is for people living in their own home, so this is a different path, not an add-on.

Before you join anything that replaces IHSS, ask three things: how many hours of help at home the program will give you, and get the answer in writing; who the caregiver will be, and whether the person who helps you now, including a family member, can keep being paid; and what happens to your care if you later leave the program.

One Waiver at a Time

Several of these are Medi-Cal "waiver" programs: the HCBA Waiver, the Assisted Living Waiver, MSSP, and the waivers for people with developmental disabilities. A person can be enrolled in only one waiver at a time, so choosing one can rule out another.

Other Programs Worth Asking About

Community-Based Adult Services (CBAS). CBAS is a daytime health program at a licensed center, for adults 18 or older on Medi-Cal who meet its medical criteria. Centers offer nursing, therapies, personal care, a hot meal and transportation to and from home. It is a Medi-Cal managed care benefit, with centers in 28 counties. It is care at a center during the day, not care in your home.

Help at home for veterans. The VA has two programs for enrolled veterans who need help with daily activities. Homemaker and Home Health Aide Care sends a trained aide to the home. Veteran-Directed Care gives the veteran a budget to hire their own workers, who may include a family member or neighbor; it is not offered everywhere. A VA social worker can say what is available where you live.

Tell your IHSS social worker about any other program you use, so the services you get do not overlap.

Where to Start

Your county IHSS social worker can tell you which of these operate in your county and how they affect your IHSS.
Your Medi-Cal managed care plan. Call member services and ask about Community Supports, CBAS and care management by name.
HICAP, California's free Medicare counseling program, can explain a Medicare plan such as PACE or SCAN before you enroll: 1-800-434-0222.

Each program has its own eligibility rules, service areas and waitlists, and they change. Use this page to know what to ask about, then confirm the details with the program itself before you rely on them.

Sources

CDSS All County Letter 09-37 — counties end IHSS for Medi-Cal beneficiaries enrolled in PACE, because PACE provides all personal care services
DHCS, Program of All-Inclusive Care for the Elderly — PACE eligibility
DHCS, SCAN Connections and SCAN Connections at Home — members may not also receive IHSS
DHCS, Assisted Living Waiver — eligibility, the 15 participating counties, room and board, the waitlist
DHCS, Multipurpose Senior Services Program — eligibility and services
California Department of Aging, Community-Based Adult Services — eligibility, services, and the number of counties served
Disability Rights California, publication 5392.01, Medi-Cal Programs to Help You Stay in Your Own Home or Leave a Nursing Home — one waiver at a time; most MSSP participants also receive IHSS; IHSS and PACE cannot be received together
U.S. Department of Veterans Affairs, Geriatrics and Extended Care — Homemaker and Home Health Aide Care; Veteran-Directed Care
WIC 12300 et seq. — IHSS is for people living in their own home

Checked against the pages above on October 7, 2026. IHSSHours.com is independent and is not affiliated with any of these programs or plans. Educational information, not legal advice. More on our sources and method: How we calculate estimates.

Educational information, not legal advice. Only your county can authorize IHSS services, and only after an assessment. IHSSHours.com is an independent resource and is not affiliated with CDSS or any county IHSS office. · More IHSS guides