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Home Care in California

by Aimee Hosler

Looking for home care services in California? Learn about the various services available, how much services costs, and how to pay for California home care.

Home care refers to the personal care services that occur in one's private home. These services may be medical in nature, or may include non-medical, hands-on support like patient transfer or personal care assistance. Home care may also include domestic tasks, such as cleaning or cooking.

As populations grow and medical advances extend life expectancy, demand for home care services is expected to rise. Who is using home care in California? The California Association for Health Services at Home (CAHSAH) reports that individuals receiving in-home care often have medical conditions that require constant monitoring, limited mobility, terminal illnesses, ventilator dependence or developmental challenges.

California Home Care Statistics

CAHSAH reports the following home care statistics. The organization expects demand for in-home care to grow in the coming decades:

  1. The number of Californians age 65 and older is projected to double between 2010 and 2030.
  2. A state survey counted 1,645 home health agencies and hospices in California in 2010. Among these were 1,286 home health agencies, 299 hospices and 47 home health agencies with hospice services.
  3. California home health agencies made 11,571,886 visits to 651,350 patients in 2010.

The Bureau of Labor Statistics calculated that California had 55,260 home health aides and 58,110 personal care aides in 2012 (BLS.gov, 2012).

What In-Home Care Services Are Available in California?

According to CAHSAH, home care in California can include the following services:

  1. Medicare-certified home health agencies providing in-home medical care (for example, physical therapy)
  2. Licensed home health agencies providing in-home medical care or home health aides
  3. Home care aide organizations providing non-medical care in-home
  4. Hospices providing medical and support services for the terminally ill and their families
  5. Home infusion pharmacies providing in-home pharmaceutical care
  6. Home medical equipment providers
  7. Interdisciplinary professional services such as in-home laboratory or x-ray

The different types of home care professionals in California include licensed homemakers and licensed home health aides:

  1. Homemaker services, often called companion services, include hands-off domestic tasks, like cooking or running errands.
  2. Home health aide services include hands-on personal care, like bathing, dressing and physically moving patients. While home health aides are not medical professionals, the BLS notes that some help administer patients' medications or check their vital signs under the direction of a nurse or health care provider.

How Are Home Care Services in California Licensed and Regulated?

The CAHSAH reports that in-home care in California is regulated as follows:

  • Licensed home health agencies are monitored by the California Department of Public Health (CDPH) to make sure they comply with state laws and regulations. They may obtain voluntary accreditation through the appropriate organizations.
  • Medicare and Medi-Cal certified agencies are surveyed regularly by the CDPH to make sure they comply with federal regulations and the conditions of program participation. Agencies can obtain voluntary accreditation.
  • Hospices are regularly surveyed by the CDPH. These services must comply with state laws and regulations.
  • Home care aide organizations must comply with OSHA standards and all applicable laws, regulations and wage orders. While they do not need to be professionally licensed, they must obtain a state business license.
  • Home medical equipment providers are required to obtain Home Medical Device Retailer licenses and employ competitive bidding practices. Accreditation is required for Medicare participation.
  • Home infusion pharmacies are regulated by the Board of Pharmacy and may obtain voluntary accreditation.

How Much Does Home Care in California Cost?

The cost of in-home care in California varies with the services and extent of care provided. The following approximate rates are based on the median cost of care as reported by the Genworth 2013 Cost of Care Survey.

Licensed homemaker services in California

National median for licensed homemaker services

Licensed home health aides in California

National median for licensed home health aides

Hourly rate

$22

$18

$23

$19

Daily rate (3 hours/day)

$66

$54

$69

$57

Weekly rate (20 hours/week)

$440

$360

$460

$380

Monthly rate (80 hours/month)

$1,760

$1,440

$1,840

$1,520

Yearly rate (20 hours/week)

$22,880

$18,720

$23,920

$19,760

Who Pays for Home Care Services in California?

There are a number of ways one can pay for home care in California. According to the CAHSAH, 64 percent of California home care services in 2010 were funded through Medicare, 14 percent through private insurance and 11 percent through Medi-Cal. The remaining methods of payment accounted for 11 percent of all home care in California in that year. Potential sources of payment include the following, as reported by the CAHSAH:

  • Medicare (within government coverage guidelines)
  • Workers' compensation
  • Managed-care
  • Long-term care insurance
  • Private payers
  • Veterans Health Administration (VHA)
  • Medi-Cal
  • TRICARE (CHAMPUS)
  • Medigap insurance
  • Self-pay

Medicare.gov notes that while Medicare benefits may be used for qualifying home health care services, round-the-clock services or full-time skilled nursing care are not covered. The VHA website states that homemaker and home health aide services may be included in medical benefits, and veterans should be eligible if they meet the clinical need for the service and it is available. The website for TRICARE (formerly CHAMPUS) reports that it does not generally cover long-term care. It's important to check with insurance companies and government agencies to find out the specifics about coverage.