IHSS Paramedical Services
Published by IHSSHours.com · · Updated
🌐 Leer en Español →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 are medical tasks the recipient would do for themselves if they could, but which need judgment based on training from a licensed health care professional — such as injections, wound care and dressing changes, catheter insertion, colostomy irrigation, tracheostomy care and ventilator management. They are distinct from basic personal care tasks and always require an order from a licensed health care professional.
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 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.
Sources
- WIC 12300.1 — definition of paramedical services
- MPP 30-757.19 — paramedical services, provided under the direction of a licensed health care professional
- SOC 321 — Request for Order and Consent – Paramedical Services
- MPP 30-757.14 — personal care services, which include bowel and bladder care
- CDSS Hourly Task Guidelines — weekly time ranges by Functional Index rank, converted to monthly at 4.33 (MPP 30-763.2)
- WIC 10950 — the right to a State Hearing on a denial
Citations verified against the CDSS Manual of Policies and Procedures and All-County Letters. 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