What You Need To Know To Receive Maximum Hours For IHSS

Navigating the IHSS (In-Home Supportive Services) system can be overwhelming, especially as a parent to an autistic child.

This is why understanding the Functional Index Ranking (FIR) and Hourly Task Guidelines, is CRUCIAL for securing the maximum hours for your child. It’s about understanding the system and then being able to give the case worker the information they need to categorize each or your child’s behavior in the right place (thus getting more hours).

I didn’t know anything about the system, how it worked, and had to go online to gather as much information as I could to try and make it make sense. So here is a very introductory explanation of what I was able to learn, and how I was able to get my 7 year old autistic son as many hours as possible. Let’s dive in.

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What Is the Functional Index Ranking (FIR)?

FUNCTIONAL INDEX RANKING FOR MINOR CHILDREN IN IHSS

The Functional Index Ranking (FIR) is a scoring system used by IHSS to evaluate how much help your child needs with daily living tasks. This ranking determines the number of hours allocated for specific services. Each activity your child requires help with—like eating, dressing, or mobility—is rated on a scale of 1 to 5:

Rank 1: Independent, no assistance needed.
Rank 2: Needs verbal reminders or prompts.
Rank 3: Requires some physical assistance.
Rank 4: Requires substantial physical assistance but the recipient can physically assist in some way (helpful movements, shifting weight, holding onto provider for support, etc.)
Rank 5: Complete physical dependence, unable to participate at all.
Rank 6: Paramedical. The recipient requires assistance that is considered invasive for the task to be completed. Example: tube feeding, ostomy bag, etc.

How FIR Works for Minor Children

The FIR compares your child’s abilities to age-appropriate developmental milestones.

For example, while a 3-year-old isn’t expected to cook independently, a 7-year-old should begin demonstrating basic self-care skills like dressing and identifying danger.

Every spot on the chart that has a 1 means that there are no hours given. It’s supposed to be “parental responsibility” to cover those needs or expected for the child to need assistance.

A spot on the chart with 1-5 means that you may qualify for hours.

For example: at age 7 a child is “expected” to still need assistance with bathing but would qualify for hours at age eight. But he does qualify for dressing and received a rank 4.

Of course there are exceptions, these are simply guidelines. This is why the home visit is important and why you have to be DETAILED with the information you give them.

If your autistic child struggles with these tasks due to communication or sensory challenges, it’s crucial to highlight these difficulties during the IHSS evaluation.

Qualifying for Each FIR Ranking (with Examples)

I’ll use my son as an example and hope it helps understand the system.

Since my son is 7 years old, according to the chart, he may qualify for:

Ambulation
Dressing
Bowel and Bladder
Transfer
Respiration

Since my son does not require respiration, he does not get any hours for that category. Nor did he receive hours for ambulation nor transportation.

He did qualify for Bowel and Bladder and Dressing as a Rank 4 since he needs to be physically assisted with getting dressed and needs physical assistance in the bathroom. Things that a child his age should be able to do by now on their own.

Hourly Task Guidelines: How They Work

What Are Hourly Task Guidelines?

The Hourly Task Guidelines determine how many hours IHSS can allocate for specific activities. Tasks like grooming, dressing, and protective supervision each have typical hourly ranges based on the child’s needs and FIR scores.

Examples of Hourly Allocations

Dressing: my son was given 1:30 hours. Rank 4 (Low).
Bowel and Bladder: he receives 2:55 hours. Rank 4 (Low).

Protective Supervision and Maximum Hours

Protective supervision focuses on preventing injury rather than training or teaching skills.

If your child requires constant supervision to stay safe, ensure this is documented clearly. For example, a child prone to wandering or climbing high surfaces may qualify for maximum protective supervision hours.

Read my blog post on the steps I took to get my son approved for Protective Supervision.

How to Increase Your Chances of Getting Maximum Hours

Provide Strong Documentation

Documentation is your strongest tool when applying for IHSS. This includes:

Medical Records: Include diagnoses like autism and related challenges (e.g., communication deficits, sensory processing issues).
IEPs: Highlight goals that demonstrate your child’s current limitations (e.g., learning to identify danger or express pain).
Therapist or Doctor Letters: Have professionals explain why constant supervision is essential for your child’s safety.

Use Real-Life Examples

Specific examples can paint a clearer picture of your child’s needs:

” I have to help my child get dressed because he cannot dress himself. He will put on pants inside out”.
OR maybe you child simply needs to be reminded to do things, like getting dressed and is not able to do it on his/her own.

The more detailed you are, the better for the case worker to understand what your child needs.

Be Thorough During the Home Visit

The home visit is a critical step in the IHSS evaluation. Be prepared to:

Discuss your child’s daily routine and supervision needs.
Demonstrate tasks or behaviors that require intervention (e.g., showing how your child needs physical assistance during meals).
Avoid being vague or talking about yourself. Focus on your child’s behaviors and what evidence you have to back up your claims.

Consistency in Records and Statements

Ensure all documentation aligns with the information you provide during the assessment. Contradictions, such as stating your child can perform tasks independently in one document but needs help in another, can result in reduced hours.

What to Do If Hours Are Denied or Reduced

Common Reasons for Denial

Insufficient documentation.
Misunderstanding of your child’s needs during the home visit.
It may also be an inexperienced case worker that does not understand disability and what it entails.
Evaluators deeming the supervision as “training” rather than preventive care.

Steps to Appeal

During the in-home visit you should receive information on your rights.

In my case it was a pamphlet: Your Rights Under California Public Benefits Program.

File an Appeal: Submit the appeal within the required timeline (typically 90 days). Include a written statement explaining why the decision was incorrect.
Gather Additional Evidence: Provide updated evaluations, medical records, and detailed behavioral logs.
Request a State Hearing: If the appeal isn’t resolved, you can request a hearing to present your case before an administrative law judge.

Who to Reach Out To for Help

Disability Advocates: Many nonprofits and Regional Centers offer free assistance.
IHSS Specialists: Social workers familiar with autism and IHSS can help strengthen your case.
Legal Aid Organizations: These groups often provide support for families navigating appeals.

Final Thoughts

Having an In-home visit can make anyone anxious, you are NOT alone!

The best thing to do is to be as prepared as possible. Securing maximum hours for IHSS requires preparation, documentation, and persistence.

By understanding the FIR and Hourly Task Guidelines and presenting a clear, consistent case for your child’s needs, you can advocate effectively.

Again, please remember, you’re not alone—many resources and professionals are available to support you. And you can ALWAYS APPEAL! A denial is not the end of the road.

With the right approach, you can ensure your child receives the care and supervision they deserve.

What You Need To Know To Receive Maximum Hours For IHSS