Caring for a Family Member: The Rules for Spouse and Parent Providers

Most IHSS providers are related to the person they care for, and the program treats two relationships differently: a spouse, and a parent of a minor child. Everyone else (adult children, siblings, grandparents, friends) enrolls and is paid like any other provider. Here is what changes for those two, and the rules that work in a live-in relative's favor.

If you are the recipient's spouse

The law treats a spouse who lives in the home as an "able and available" resource for some tasks, so a spouse provider is paid for some service categories and not others:

• Paid at any time: personal care services (bathing, dressing, feeding, transferring, bowel and bladder care and so on) and paramedical services.
• Paid only in limited cases: protective supervision and accompaniment to medical appointments, when the spouse has had to leave full-time work, or cannot take full-time work, because no other suitable provider is available.
• Not paid to the spouse: domestic services (housework, laundry), related services such as shopping and meal preparation, heavy cleaning and yard hazard abatement. The county counts those as met by the spouse.

Exceptions exist when the spouse is medically unable, or unavailable for reasons such as work schedules, incarceration, deployment, or a restraining order; the county assesses these case by case. If the spouse is away 24 hours or more, a non-spouse provider can be authorized for that period.

If you are the parent of a minor recipient

This is the rule that changed most recently. Until February 2024, a parent could be paid only after showing they had left or could not take full-time work and that no other suitable provider was available. AB 120 ended those requirements effective February 19, 2024 (ACL 23-106): a parent now enrolls like any other provider, with the SOC 426, orientation, SOC 846 and background check.

• Funding source matters. Parents can be paid providers when the child's case is under CFCO, IPO or IHSS-Residual. A minor in the PCSP program cannot choose a parent as the provider; ask the county which program the case is in if you are unsure.
• What is payable for a minor (parent or not): personal care, related services, accompaniment to medical appointments, protective supervision and paramedical services. Domestic services, heavy cleaning and yard work are not payable for minors, and nothing is authorized for ordinary childcare a child of that age would need anyway.
• Shared custody: both parents can be providers, with hours split by the time the child spends in each home. If the parents live in different counties, the county with the active Medi-Cal case leads.
• Work authorization and Tier 1: a parent who is not authorized to work in the U.S., or who has a Tier 1 conviction, cannot be the paid provider, but can hire a non-parent provider for the child.

Three rules that favor live-in relatives

1. No income tax on your IHSS wages. Live with the recipient and file SOC 2298; those wages are excluded from federal and state income tax. Our tax guide covers it.
2. No Social Security or Medicare withholding for a spouse provider, a parent providing for a minor child, or a child under 18 providing for a parent, under the IRS family-employee rules; ask the county about the exemption form if it is still being withheld.
3. A higher weekly cap. The Live-In Family Care Provider exemption lets a provider who lives with and cares for two or more recipients, and is their parent, stepparent, adoptive parent, grandparent or legal guardian, work up to 90 hours a week and 360 a month instead of 66. Apply through the county.

What does not change

Timesheets still have to match hours actually worked; EVV check-in is waived for live-in providers but not the timesheet itself. Paid sick leave, the backup system and the violation ladder apply to relatives exactly as to anyone else. And being family does not make you the recipient's authorized representative: that is a separate designation the recipient makes.