In-Home Supportive Services Program: Considering the State Costs and Benefits

The In-Home Supportive Services (IHSS) program is the fastest-growing major social services program, providing care for over 430,000 recipients, at an annual total cost of about $5.5 billion. The program, which is available to low-income elderly and disabled persons, provides various services to recipients in their own homes and can enhance the quality of life for recipients by making it easier to live at home. For many recipients, the program allows individuals to live at home rather than in an institutional setting (typically, a nursing home). By preventing-or at least delaying-the move to a nursing home, the program can save money for the state. In this report we look at the net fiscal impact of the IHSS program on the public sector and conclude that the state maximizes its net fiscal impact by targeting IHSS services to those recipients who are most likely to enter a nursing home in the absence of the program. Given the state's continuing fiscal problems, we offer additional options for the Legislature to consider that can achieve state savings through increased targeting.