How to get paid to care for a family member in California: IHSS, VA, Paid Family Leave

Who pays family caregivers in California, and who does not

In California, Medicaid is Medi-Cal, and the "Medicaid program for family caregivers" people search for is IHSS. The sections below give the rules for each row.

IHSS: how a family member becomes the paid caregiver

IHSS works in two steps: the person who needs care qualifies and is assessed for hours, then they hire a provider, and the provider can be you.

• Who qualifies as a recipient. A California resident with a Medi-Cal eligibility determination who is 65 or older, blind or disabled and lives at home rather than in a hospital, nursing facility or licensed care home. A Health Care Certification (form SOC 873) from a medical professional must be returned within 45 days of the county's request.
• The assessment. A county social worker interviews the applicant at home and sets the services and the hours a month for each. The regulations require the county to process the application, including the needs assessment and the notice of action, within 30 days of a completed written application, unless a disability determination is still pending. Reassessment is annual.
• The recipient chooses the provider. The recipient hires an individual provider and is that provider's employer, responsible for hiring, training, supervising and dismissing; the state issues the pay. An adult child is the common choice; spouses and parents of minor children are allowed under the rules below.
• Enrolling as the provider. You sign the county's enrolment form under penalty of perjury, attend an in-person orientation and give fingerprints for a California Department of Justice background check at your own cost. You have 90 calendar days to finish, and once enrolled you can be paid for authorised hours worked up to 90 days earlier. The step-by-step version is in how to become an IHSS provider.

How much do family members get paid for caregiving through IHSS?

There is no salary. Monthly pay is the hours the county authorised for your relative multiplied by the county hourly wage. Two things cap it: the assessment, which pays authorised hours rather than every hour you spend, and the statutory maximums of 195 hours a month for a recipient who is not severely impaired and 283 for one who is. "Severely impaired" means an assessed need of 20 or more hours a week for personal care, meal preparation, meal clean-up or paramedical services.

In the CDSS wage workbook in force from 1 October 2026, San Diego County pays $20.40 an hour (effective 1 March 2026) and Imperial County $18.83 (effective 1 January 2026); the full county table is in IHSS provider pay by county.

Illustrative calculations: hours × the CDSS county wage, before payroll deductions. The 100-hour row is a round number, not an average. Inputs: the CDSS county wage workbook and the hour maximums in Welfare and Institutions Code section 12303.4 as set out in the CDSS regulations.

Can a spouse be a paid caregiver in California? The spouse and parent rules

California does pay spouse caregivers, with conditions. The IHSS regulations single out two relationships: a spouse, and a parent caring for a minor child. Every other relative, including an adult child caring for a parent, is treated like any other provider.

Spouses

• A spouse who does not receive IHSS is presumed able unless they provide medical verification otherwise, and available except when out of the home for work, health or other unavoidable reasons.
• While an able and available spouse lives in the home, no one, the spouse included, is paid for domestic services, related services, yard hazard abatement, teaching and demonstration or heavy cleaning.
• A spouse can be paid for personal care and paramedical services, and for transportation and protective supervision only when they leave full-time employment, or cannot seek work because no other suitable provider is available.
• When the spouse is out at work or unwell, another provider can be paid for meal preparation, transportation and protective supervision during that absence.

Parents of minor children

Under CDSS All County Letter 23-106, effective 60 days after publication, a minor recipient in the CFCO, IPO or IHSS-R subprogrammes "may hire any provider that successfully completes provider enrollment", including a parent. A parent still cannot be the provider for a child placed in the Personal Care Services Program (PCSP) because of federal rules; the county chooses the subprogramme, so tell the county at the outset that you want to be the provider. Providers for minors are paid only for the services in Welfare and Institutions Code section 12300(e): domestic services, personal care, accompaniment to health appointments, protective supervision needed because of the child's limitations, and paramedical services.

Is IHSS income taxable? Notice 2014-7 and the SOC 2298

IHSS wages are taxable unless you live with the person you care for. IRS Notice 2014-7 treats Medicaid waiver payments to an individual care provider as "difficulty of care" payments excludable from gross income, but only for care in the provider's own home where the recipient lives. CDSS applies it through the Live-In Self-Certification form SOC 2298:

• Once processed, your IHSS wages are excluded from federal and state income tax. Social Security and Medicare (FICA) withholding still applies.
• Processing takes up to 30 days and is not retroactive: wages paid before then stay taxable and earlier W-2s are not amended.
• No annual re-certification; one form per recipient; file SOC 2299 (and an SOC 840 change of address) if you move out but keep providing care.
• You may elect to count all of the excluded pay as earned income for the Earned Income Credit or Additional Child Tax Credit; since 2025 the excluded amount may appear in W-2 box 12, code II, rather than box 1.

VA caregiver program: stipend levels, Veteran Directed Care and Aid and Attendance

• Program of Comprehensive Assistance for Family Caregivers (PCAFC). The veteran needs a VA disability rating of 70 percent or higher, enrolment in VA health care and a need for at least six months of continuous in-person personal care. The caregiver must be 18 or over and a spouse, child, parent, step-family or extended family member, or live full time with the veteran. Only the Primary Family Caregiver receives the stipend, which is built from the Office of Personnel Management General Schedule annual rate for grade 4, step 1 in the veteran's locality, divided by 12: Level One pays that monthly rate multiplied by 0.625, Level Two multiplied by 1.00 where the VA finds the veteran "unable to self-sustain in the community"; the VA pages publish no dollar amounts. Primary caregivers also get CHAMPVA coverage if uninsured, at least 30 days of respite care a year, counselling and travel benefits. Apply jointly on VA Form 10-10CG.
• Veteran Directed Care. The veteran receives a budget, agrees a spending plan with a counsellor and hires their own workers, "which might include their own family member or neighbor"; availability varies by location, so ask the VA social worker.
• Aid and Attendance. A monthly addition to a VA pension for veterans and survivors who need help with daily self-care, are largely bedridden, live in a nursing home because of a disability or have severely limited eyesight. It is paid to the veteran, not the caregiver. Apply on VA Form 21-2680 with the examination section completed by a clinician.

California Paid Family Leave while you care for a seriously ill relative

If you have a job and need weeks rather than months, Paid Family Leave replaces part of your wages while you care for a seriously ill parent, child, spouse, registered domestic partner, sibling, parent-in-law, grandparent or grandchild. You need at least $300 of wages with State Disability Insurance (SDI) withheld in your base period, the 12 months roughly 5 to 18 months before the claim.

• Duration: up to eight weeks in a 12-month period.
• Amount: set by your highest-earning quarter in the base period. Earnings of $722.50 to $16,279.90 in that quarter give 90 percent of weekly wages; $20,931.31 or more gives 70 percent up to the maximum; the band between pays a flat $1,127 a week; $300 to $722.49 pays the $50 minimum.
• Maximum: $1,765 a week for claims in calendar year 2026, up from $1,681 in 2025.

Does Medicare pay for caregivers? No, and long-term care insurance only sometimes

Medicare does not pay family caregivers, and does not pay for personal care when that is the only care needed. It covers home health for a homebound patient: medically necessary part-time or intermittent skilled nursing, therapy, medical social services and equipment, with home health aide visits only while skilled care is also being given. Medicare.gov states it does not pay for 24-hour care at home, delivered meals, homemaker services unrelated to the care plan, or custodial care on its own.

Long-term care insurance can pay a relative only if the policy says so. One group policy outline filed with the California Department of Insurance states that "Care from Immediate Family members is covered only when specifically indicated" and offers an optional Informal Family Care Benefit for a relative who was not living with the insured when benefits first became payable. Check the outline of coverage for "informal" or "immediate family" wording.

Arizona: ALTCS and paid family caregivers

The Arizona Long Term Care System (ALTCS) is the AHCCCS Medicaid programme for people who need a nursing-facility level of care but can be served at home with attendant care, personal care and homemaker services. Apply through Health-e-Arizona Plus or form DE-828 (AHCCCS: 602-417-4000 or 1-800-654-8713). Unlike IHSS, the paid caregiver works for a contracted provider agency rather than directly for the member. A spouse can be that caregiver: the Spouse Attendant Care Acknowledgement (AHCCCS Exhibit 1620-12) records that the spouse "is employed with a provider agency", that the ALTCS case manager decides the paid hours, and that a spouse cannot be paid for more than 40 hours of attendant care in a seven-day period. Families in Yuma County can post uncovered hours on find caregivers in Yuma County; caregivers can browse caregiver jobs in Yuma County.

Where CaregiverConnect fits

IHSS pays for assessed tasks, not for a full week of company, overnight supervision or the evenings when the family provider is at another job. Families fill that gap by hiring a private caregiver directly, which is what CaregiverConnect is for: post the hours and tasks free of charge, independent caregivers in San Diego County, Imperial County and our other areas apply, and you hire and pay them directly as the household employer, with no commission. We do not run background checks; caregivers may upload proof of one, and how to hire a private caregiver covers the checks, taxes and written agreement; what in-home care costs in California gives rate reference points.

If you are the family provider and want more paid hours than the authorisation allows, other families nearby are looking for exactly your IHSS enrolment, background check and experience. A caregiver profile is free, you set your own rate and hours, and optional premium plans exist for more visibility.

Frequently asked questions

Sources

1. CDSS, In-Home Supportive Services programme overview (eligibility, assessment, provider choice)
2. CDSS, IHSS wages by county (workbook sheet "IP Effective 10-1-2026")
3. CDSS, Manual of Policies and Procedures Division 30, sections 30-700 to 30-764 (definitions, 30-day application processing, spouse rules)
4. CDSS, Manual of Policies and Procedures Division 30, sections 30-765 to 30-785 (hour maximums, aged definition, provider enrolment)
5. CDSS, IHSS for children (parent providers, ACL 23-106)
6. CDSS, Live-In Provider Self-Certification (SOC 2298)
7. IRS, Certain Medicaid waiver payments may be excludable from income (Notice 2014-7 Q&A)
8. VA, Program of Comprehensive Assistance for Family Caregivers
9. VA Caregiver Support Program, PCAFC stipend calculation
10. VA, Veteran Directed Care
11. VA, Aid and Attendance and Housebound benefits
12. EDD, Paid Family Leave eligibility FAQs (covered relatives)
13. EDD, Calculating Paid Family Leave benefit payment amounts
14. EDD, Disability Insurance and Paid Family Leave maximum weekly benefit amount, CY 2014-2026
15. Medicare.gov, Home health services
16. AHCCCS, Arizona Long Term Care System (ALTCS)
17. AHCCCS Medical Policy Manual, Exhibit 1620-12, Spouse Attendant Care Acknowledgement of Understanding
18. California Department of Insurance, filed long-term care outline of coverage (Genworth group policy 7053, Informal Family Care Benefit)