Resources for families
IHSS and hospice: can you have both?
Yes. In-Home Supportive Services (IHSS) is a county-run Medi-Cal program that pays for hours of help at home with bathing, dressing, meals, housework and similar tasks, for people who qualify. Hospice is a Medicare and Medi-Cal benefit that brings the nurse, aide, social worker and chaplain, the medicines and the equipment. They do different jobs, and a person can have both at the same time: hospice does not reduce IHSS hours, and IHSS does not change what hospice provides.
Medically reviewed by Oscar Chien, MD, Medical Director, October 19, 2026
On this page (6 sections)
What IHSS does and what hospice does
| IHSS | Hospice | |
|---|---|---|
| What it pays for | Hours of a caregiver's help with daily tasks: bathing, dressing, toileting, meals, housework, shopping, some paramedical tasks | The hospice team's visits, medicines for symptoms, equipment and supplies, short inpatient stays, respite, grief support |
| Who provides it | A caregiver the person chooses and the county enrolls, often a family member | The hospice's nurse, aide, social worker, chaplain and doctor |
| Who runs it | The county IHSS office, under the California Department of Social Services | The hospice, under Medicare and Medi-Cal rules |
| Who qualifies | People with Medi-Cal who are 65 or older, blind or disabled and need help to stay safely at home | People certified by a doctor as having six months or less to live if the illness runs its usual course |
| Can they overlap | Yes | Yes |
IHSS hours are set by the county's assessment of need, not by whether the person is on hospice.
Why families on hospice ask about IHSS
Hospice does not provide a caregiver who stays in the home. The aide visits for bathing a few times a week, and the daily care between visits is the family's. IHSS is one of the few programs that pays for those hours, and a family member can be the paid provider. Read what hospice does and does not provide.
How do you apply for IHSS?
Through the county IHSS office where the person lives: San Bernardino County, Riverside County, Los Angeles County or Orange County each has its own intake line. The person needs Medi-Cal, or to apply for it at the same time. A county social worker visits the home, assesses what help is needed and sets the monthly hours. The person then chooses a provider, who is enrolled by the county. It can take several weeks; apply as soon as the need is clear, and tell the county the person is on hospice so that the assessment is scheduled promptly.
What does the hospice social worker help with?
Our social worker can help you start the IHSS application, gather what the county asks for, and explain the assessment. The hospice does not decide IHSS hours and does not pay IHSS providers; that is the county's role. If a person already has IHSS when hospice begins, nothing has to change: tell the IHSS social worker that hospice has started, and tell the hospice nurse who the IHSS provider is so that the plan of care names them.
Common questions about IHSS and hospice
Will IHSS hours be cut because hospice is visiting?
No. IHSS hours are based on the county's assessment of the person's need for help with daily tasks. Hospice visits do not replace those hours.
Can my daughter be paid through IHSS while Mom is on hospice?
Yes, if the person qualifies for IHSS and the daughter enrolls as the provider through the county. The hospice has no part in that enrollment.
Does the IHSS provider give the hospice medicines?
The IHSS provider can help with tasks the county authorizes, including some paramedical tasks when ordered. The hospice nurse teaches whoever gives the comfort medicines, family or provider, and the plan of care names them.
What if the person does not have Medi-Cal?
IHSS requires Medi-Cal. Our social worker can help with the Medi-Cal application; many people with a terminal illness and limited income qualify. Read Medi-Cal and hospice.
Read more
24-hour care, respite care, Medi-Cal and hospice and paying for care.
About this page
- Written by
- Beta Hospice care team
- Medically reviewed by
- Oscar Chien, MD, Medical Director
- Last reviewed
- October 19, 2026
- Next review
- April 19, 2027
How we write and review this site
Sources
- California Department of Social Services: In-Home Supportive Services (IHSS) (opens in a new tab)
- Medicare.gov: Hospice care coverage (opens in a new tab)
- 42 CFR 418.202: Covered hospice services (opens in a new tab)
These sources support the general information on this page. For one personās care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (877) 258-7129 any time, or leave your number and someone from Beta's hospice team will call you. No decision is needed to call. Most families start with a question.
Only a hospice doctor, together with the personās own doctor, can confirm hospice eligibility. A website cannot.
- A nurse answers 24 hours a day, 7 days a week
- You can stop hospice at any time
- You have the right to choose your hospice