If your family relies on IHSS to keep a senior or loved one at home in Orange County, the next few months could bring the biggest disruptions to the program in years. Governor Newsom’s proposed 2026–27 state budget includes three distinct changes that could reduce — or abruptly end — your loved one’s in-home support. And the story isn’t over: the May Revision drops mid-month, meaning more changes could follow.
This isn’t abstract policy. In Orange County alone, 55,000 people depend on IHSS for daily tasks like bathing, meal preparation, medication reminders, and mobility assistance. Most are seniors and adults with disabilities who cannot safely remain at home without that help. Cutting or disrupting IHSS isn’t an inconvenience — for many families, it means choosing between nursing home placement and an unpaid caregiving crisis.
Here’s exactly what’s being proposed, what it means for OC families, and what you can do right now to protect your loved one’s care.
The 3 Budget Changes That Could Affect Your Family
The Governor’s January budget proposal includes three distinct changes to IHSS. Each targets a different group — and together they could affect tens of thousands of OC families either immediately or within the next two years.
Immediate IHSS Termination When Medi-Cal Lapses
Under current rules, if your loved one temporarily loses Medi-Cal — even due to a paperwork error, a missed renewal deadline, or a processing delay — their IHSS hours shift to the IHSS-Residual program, preserving care while the issue is resolved. Under the proposal, IHSS ends the same day Medi-Cal lapses. If Medi-Cal is cut off on a Monday due to an administrative error, care stops on Monday.
State saves: $86 million/yearIHSS Backup Provider System Eliminated
California’s Backup Provider System (BUPS) provides up to 80 hours per year of emergency in-home care when a recipient’s regular provider is sick, unavailable, or unable to make a shift. BUPS pays providers $2 above the standard hourly rate, acknowledging the urgency. The proposal eliminates this safety net entirely — meaning if your loved one’s caregiver doesn’t show, there is no official backup system to call.
State saves: $3.5 million/yearState Stops Paying for County-Approved Hour Increases (2027–28)
Starting in fiscal year 2027–28, when counties authorize additional IHSS hours because a recipient’s care needs have grown, the state will no longer fund those additional hours. Counties must bear the full cost. Since counties are already financially strained, this creates a powerful incentive to deny hour increases even when a senior’s needs are genuinely growing.
State saves: $233.6 million/yearWhat This Means for Orange County Families
OC’s IHSS program is already under strain even before these cuts take effect. In Orange County, 48,000 caregivers — many of them family members of the people they care for — earn $18.90 per hour, according to United Domestic Workers (UDW) data. MIT’s Living Wage Calculator estimates a single adult in OC needs at least $36.53 per hour to meet basic expenses. The MOU between the county and UDW expires on June 30, 2026 — putting wage negotiations and state budget changes on a direct collision course this summer.
The Backup Provider elimination hits hardest in cities like Santa Ana, Anaheim, and Garden Grove, which have high concentrations of IHSS recipients who often rely on a single provider with no backup network of their own. When that caregiver misses a shift today, a county call to BUPS can provide same-day coverage. If the elimination passes, that option disappears.
The Medi-Cal immediate termination provision is the most broadly dangerous change. Annual Medi-Cal redeterminations — restarted in 2023 after federal pandemic pauses — have resulted in widespread administrative lapses statewide, including in OC. Under current law, those lapses are a hassle. Under the proposal, each one triggers an immediate end to in-home care. Families managing complex medical and bureaucratic situations for elderly or disabled loved ones face a new single point of failure.
Approximately 55,000 Orange County residents depend on IHSS to remain safely at home.
Current Rules vs. What’s Proposed
| Situation | Current Rule | Proposed Change |
|---|---|---|
| Medi-Cal lapses due to paperwork error | IHSS continues via Residual program during resolution | IHSS ends immediately on the day of lapse |
| Regular caregiver can’t make a shift | Up to 80 hrs/year emergency backup care (BUPS) | No official backup system — family is on their own |
| Care needs grow; county authorizes more hours | State funds the additional authorized hours | County pays (2027–28); incentive to deny increases |
| Existing authorized IHSS hours | Based on assessed care needs | No direct cut proposed (but downstream pressure is real) |
What Advocates and Researchers Are Saying
Disability Rights California has warned that the immediate Medi-Cal termination provision “will make it harder to access care” and that the county cost-shift “creates an incentive to lower the amount of IHSS authorized for individual recipients.” Their analysis was published shortly after the Governor’s January budget release.
Hand in Hand: The Domestic Employers Network described the budget as one that “sacrifices Medi-Cal and home care as federal cuts loom” — noting that California is cutting programs at the same moment Congress is debating significant Medicaid reductions under the federal “One Big Beautiful Bill.” For OC families navigating both state and federal uncertainty, the risk of a compounding disruption is real.
In OC, over 250 community members rallied in Westminster in late April, urging the Orange County Board of Supervisors to invest in care workers and reject proposals that would leave IHSS recipients without coverage. The energy around this issue is significant — and families making their voices heard during the May Revision process may still shape the outcome.
Experts advise OC families to have a documented backup care plan before state changes take effect.
The May Revision: Three Things to Watch
California’s May Revision typically releases around May 14 and gives the clearest picture of the final budget direction. In past years, some January proposals have been softened after advocates applied pressure. This is the window to act.
Watch for three specific signals in the May Revise:
- Whether the immediate termination provision is modified to preserve a grace period for administrative lapses
- Whether the Backup Provider elimination is maintained or rolled back under advocacy pressure
- Whether the county cost-shift start date of 2027–28 is delayed or conditioned on county fiscal health assessments
For broader context on what the state budget means for OC in-home care, see our earlier coverage: 2025–26 IHSS Budget Pressures, IHSS Backup Provider Elimination Deep Dive, and the OC IHSS Wage Crisis.
IHSS Protection Checklist: 10 Steps OC Families Should Take Now
Quiz: How Well Do You Know the 2026–27 IHSS Budget Proposals?
1. Under the proposal, what happens to IHSS the moment someone’s Medi-Cal lapses?
2. How many hours per year does California’s Backup Provider System currently allow?
3. When does the county cost-shift for IHSS hour increases begin?
4. Approximately how many Orange County residents currently receive IHSS?
5. When is California’s May Revision expected to be released?
Frequently Asked Questions About the Proposed IHSS Changes
Don’t Wait for Budget Cuts to Have a Plan
At Home VA Staffing provides compassionate in-home care for Orange County seniors and adults with disabilities. We can fill gaps when IHSS hours are reduced — and be your family’s plan B when a caregiver can’t make it. Call us at (213) 326-7452.
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