IHSS Paramedical Services

Beyond personal care and domestic services, IHSS also covers a category called paramedical services — specialized health-related tasks that a recipient cannot safely perform independently due to their medical condition. These services are authorized when a physician or licensed healthcare provider certifies the need.

What Are Paramedical Services?

Paramedical services under IHSS include tasks such as bowel and bladder care, wound care and dressing changes, catheter care, colostomy care, tracheotomy care, ventilator management, and other medically necessary tasks that require specific training or oversight. These are distinct from basic personal care tasks and often require documentation from a physician.

Physician Authorization Required

Unlike personal care tasks, paramedical services must be authorized by a licensed healthcare provider. The provider must certify that the task is medically necessary, that the IHSS provider can safely perform it with proper training, and that the service cannot be provided through another program or source. A signed SOC 321 form (Request for Order and Consent — Paramedical Services) is required, completed and signed by a physician, podiatrist, or dentist.

Bowel and Bladder Care

Bowel and bladder care is one of the most commonly authorized paramedical services and is often the highest-hour task for recipients with severe physical disabilities or incontinence. It is assessed on the same Rank 1–5 scale as other tasks, with a Rank 5 range of 4:05–8:00 per week under the CDSS HTG — 17:40 to 34:38 a month. Note that bowel and bladder care is itself a personal care service under MPP 30-757.14(a), not a paramedical one. Only the medical tasks sometimes performed alongside it — inserting enemas, catheters or suppositories, digital stimulation as part of a bowel program, and colostomy irrigation — are assessed as paramedical services under MPP 30-757.19.

Training for Providers

IHSS providers performing paramedical services are typically required to receive training from a licensed healthcare professional before performing the task. The county or the recipient's physician can arrange this training. Documentation of completed training may be required by the county before hours are authorized.

If Paramedical Services Are Denied

If you have a documented medical need for paramedical services and the county denies authorization, you have the right to appeal through the State Hearing process. A physician letter specifically supporting the need for the denied service is essential for a successful appeal.

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