SLS vs IHSS: Understanding California's Two Main Disability Support Programs
If you are a family member of an adult with an intellectual or developmental disability (IDD) in California, you have probably encountered two acronyms repeatedly: IHSS and SLS. Both are government-funded programs that provide support services. Both can help your loved one live more independently. But they are fundamentally different in how they work, what they cover, and who they serve.
Understanding the difference matters because the right combination of services can dramatically improve your loved one's quality of life — and many families do not realize they can use both programs at the same time.
What Is IHSS?
In-Home Supportive Services (IHSS) is a Medi-Cal funded program administered by California's county social services departments. It provides funding for a caregiver to assist individuals with daily tasks so they can remain safely in their own home rather than moving to a facility.
IHSS covers specific tasks based on assessed need:
Domestic services like housecleaning, laundry, and meal preparation
Personal care including bathing, grooming, dressing, and toileting
Paramedical services such as medication management (with physician authorization)
Transportation to medical appointments
Protective supervision for individuals who are at risk of harm without constant oversight
A social worker visits the home, assesses your loved one's needs, and authorizes a specific number of hours per month. The individual (or their representative) then hires a caregiver — often a family member — who is paid through the IHSS program.
Key characteristics of IHSS:
Funded by Medi-Cal, not Regional Center
Available to anyone who qualifies for Medi-Cal, not limited to people with IDD
The individual or family hires and manages the caregiver
Hours are task-based and assessed by a county social worker
Family members (including parents) can be paid as IHSS providers
There is no matching process — you find your own caregiver
What Is SLS?
Supported Living Services (SLS) is a Regional Center-funded program designed specifically for individuals with intellectual and developmental disabilities. Unlike IHSS, which focuses on specific tasks, SLS focuses on helping the individual build the skills and supports they need to live as independently as possible in their own home or apartment.
SLS can include:
Daily living skills training — cooking, cleaning, budgeting, grocery shopping
Community integration — transportation, social activities, employment support
Health and safety support — medication reminders, emergency procedures, wellness routines
Overnight support — having someone present in the home during nighttime hours
Relationship and social skills — building friendships, navigating social situations
Life-sharing — being matched with a compatible supportive roommate who lives with you
SLS is coordinated through the Regional Center. A service coordinator works with the individual and family to develop an Individual Program Plan (IPP) that outlines goals and the services needed to achieve them. The Regional Center then contracts with an SLS vendor — like Homies — to provide those services.
Key characteristics of SLS:
Funded by Regional Center, not Medi-Cal
Only available to individuals with IDD who are Regional Center clients
The SLS vendor provides and manages the support staff
Services are goal-oriented and outlined in the IPP
Can include overnight and live-in support
Includes a matching process for life-sharing arrangements
Side-by-Side Comparison
| | IHSS | SLS |
|---|---|---|
| Funded by | Medi-Cal (county) | Regional Center (state) |
| Eligibility | Medi-Cal eligible individuals | Regional Center clients with IDD |
| Focus | Task-based personal care | Independence and skill-building |
| Who provides care | Individual hires their own caregiver | SLS vendor provides trained staff |
| Family as caregiver | Yes, family members can be paid providers | Depends on arrangement |
| Overnight support | Only if protective supervision is authorized | Yes, including live-in roommates |
| Matching | No matching process | Compatibility-based matching available |
| Supervision | County social worker reassessments | Ongoing program management and check-ins |
| Location | Individual's home | Individual's home or shared apartment |
Can You Use Both IHSS and SLS?
Yes — and many families do. IHSS and SLS are funded by different sources (Medi-Cal and Regional Center, respectively) and serve different purposes. They can complement each other.
For example, an individual in a life-sharing arrangement through SLS might also receive IHSS hours for specific personal care tasks that fall outside the scope of what the supportive roommate provides. The SLS services might cover overnight presence, community integration, and skill-building, while IHSS covers additional hours for paramedical services or protective supervision.
The key is coordination. Your Regional Center service coordinator and IHSS social worker should both be aware of the other program's involvement to avoid duplication and ensure all your loved one's needs are covered.
Which Program Is Right for Your Family?
The answer depends on your loved one's situation:
IHSS may be the better fit if:
Your loved one lives at home with family and needs help with specific daily tasks
A family member wants to be paid for the caregiving they are already providing
Your loved one does not need overnight support or a live-in arrangement
You want flexibility to hire and manage caregivers directly
SLS may be the better fit if:
Your loved one wants to live more independently, outside the family home
They would benefit from a compatible roommate and genuine peer relationship
You want professional oversight, screening, and ongoing program management
The goal is building independence and life skills, not just maintaining daily care
You want someone there overnight
Both together may be the best option if:
Your loved one has complex needs that span both personal care and independence goals
SLS covers the roommate and skill-building while IHSS covers specific care tasks
You want to maximize the total support hours available
How to Get Started
If your loved one is already a Regional Center client, start by talking to their service coordinator about SLS options. Ask specifically about life-sharing — many service coordinators are familiar with the model but may not bring it up unless you ask.
If your loved one receives IHSS but is not a Regional Center client, they may still qualify for Regional Center services. Eligibility is based on having a developmental disability that originated before age 18. Your local Regional Center can help determine eligibility.
For families exploring life-sharing specifically, visit our page for Regional Center clients or check out our FAQ for answers to common questions. You can also contact our team directly — we are happy to help you understand how SLS and IHSS might work together for your family.
The Bottom Line
IHSS and SLS are not competing programs — they are complementary tools in California's disability support system. IHSS helps with the daily tasks of living. SLS helps build a life worth living. For many families, using both together creates the most comprehensive support possible.
The most important step is understanding what is available and advocating for your loved one to receive everything they are entitled to. That starts with a conversation — with your service coordinator, with your IHSS social worker, or with our team.