Under federal law, most home- and community-based services are optional benefits, meaning states can choose whether to include services like personal care in their Medicaid plans and how broadly to offer them.
In California, Medicaid covers in-home supportive services to Californians who are elderly, blind or disabled and would otherwise be at risk of nursing home placement. The federal government reimburses California for about half of the cost of IHSS.
Hagar Dickman, a senior attorney at Justice in Aging, said the risk to in-home services is not theoretical. During last year’s state budget negotiations, she said, Gov. Gavin Newsom’s administration initially looked to IHSS as one of the first areas to cut when facing a projected shortfall.
“In the May budget revision, home- and community-based services were immediately on the table,” Dickman said.
