In-Home Care for Disabled Adults Under 65: Services, Funding and Finding the Right Caregiver

Home care for disabled adults gives younger people with physical, developmental or chronic conditions the daily support they need to live at home, work, study and stay connected. In California, disability home care is often funded through IHSS or a regional center, then filled out with private hours from a licensed agency. This guide explains what a special needs caregiver does, how funding works for adults under 65, what care costs, and how to choose a caregiver who fits a younger adult’s goals and routines.

Younger adults with disabilities often want the same things older adults do: to live at home, keep their routines, work or volunteer, and stay connected to friends and family. In-home care can make that possible, and it often looks different than elder care, with more focus on supporting independence, work and community life. Home care for adults with disabilities is not just for seniors, and in-home support for disabled adults under 65 can make independence possible.

Who uses in-home care under 65?

• Adults with physical disabilities such as spinal cord injury or cerebral palsy
• People with neurological conditions like multiple sclerosis, ALS or Parkinson’s
• People with traumatic brain injury
• Adults recovering from major surgery, accidents or serious illness
• People with chronic illnesses that limit daily activities
• Adults with developmental disabilities
• Family caregivers who need respite

What services can in-home caregivers provide?

• Personal care: Bathing, dressing, grooming, toileting
• Mobility: Transfers, standby assistance, help with mobility equipment
• Household help: Meal prep, laundry, light housekeeping, errands
• Transportation: Rides to work, school, appointments and activities
• Community participation: Support at events, classes, volunteering
• Medication reminders: On-schedule reminders
• Respite: Relief for family caregivers

Skilled nursing tasks require licensed nurses or home health. See personal care assistance and senior transportation services.

What does a special needs caregiver do?

A special needs caregiver supports an adult with a disability in the routines that make independence possible. The focus is less on “taking care of” someone and more on helping them do what they want to do, safely.

Typical support ranges from companion care to hands-on help, and includes:

• Morning and evening routines: bathing, dressing, grooming, toileting and help getting in and out of bed or a wheelchair.
• Meals and nutrition: planning, shopping and cooking, including texture-modified or special diets the care team has set.
• Household help: laundry, light cleaning and keeping the home organized and accessible.
• Getting out: rides and escorts to work, classes, therapy, appointments, the gym or social activities.
• Structure and coaching: keeping a predictable schedule, using visual checklists, and practicing daily living skills.
• Communication with family and the care team: short notes after each shift so everyone knows how the day went.

Caregivers at a licensed Home Care Organization are non-medical. They give medication reminders but do not handle injections, wound care, tube feedings or other skilled tasks. If those are needed, a home health nurse or therapist covers them, and the caregiver works alongside that plan.

How is in-home care funded for adults with disabilities?

• IHSS: Medi-Cal members of any age who are blind or disabled and need help at home; see IHSS in California
• Regional centers: People with developmental disabilities, under California’s Lanterman Act
• Medi-Cal HCBA Waiver: People at a nursing-facility level of care
• CalAIM Community Supports: Eligible Medi-Cal managed care members
• Workers’ compensation or injury settlements: People injured at work or in accidents
• Long-term care or disability insurance: Policyholders who meet benefit triggers
• Private pay: Anyone

People receiving Social Security Disability Insurance generally become eligible for Medicare after a waiting period, but Medicare still doesn’t cover ongoing non-medical home care.

Home care for adults with developmental disabilities

Adults with developmental disabilities such as autism, cerebral palsy, Down syndrome or an intellectual disability may qualify for services through one of California’s 21 regional centers. The regional center works with the adult and family on an Individual Program Plan (IPP), which can include day programs, supported living, respite and in-home support.

Private home care often fills the gaps around that plan:

• Hours the plan doesn’t cover, such as evenings, weekends or while a family caregiver works.
• Backup coverage when a regular worker is sick or a vendor can’t staff a shift.
• Transition periods, such as after a hospital stay, a move, or the loss of a parent who provided most of the care.

When families use both, it helps to share the IPP goals with the agency so the caregiver reinforces the same skills and routines the regional center team is working on.

Caregiver for disabled adults: how many hours, and what does it cost?

Hours depend on what the person can do on their own, what other support they have, and their goals. Common patterns look like this:

• A few hours a day, several days a week: help with morning routines, meals and errands for someone who is mostly independent. About 12 to 20 hours a week.
• Daily support around work or school: a caregiver for the morning routine and a second visit in the evening. About 20 to 35 hours a week.
• Most of the day: for someone who needs help with most daily activities or can’t safely be alone for long. 8 to 12 hours a day.
• 24-hour or live-in care: for complex needs or after a major change in health.

At Nona’s, home care costs $40 to $50 an hour depending on the level of care, with no deposits or weekly minimums. 24-hour and live-in care run $850 to $1,100 a day. Many families combine private hours with hours from IHSS in California, so the private share is smaller than the total schedule suggests.

What should you look for in a caregiver?

• Respect for independence and self-direction
• Experience with the specific disability or condition
• Training in safe transfers and equipment
• Reliability for work or school schedules
• Personality and interest fit, including age compatibility
• Flexibility for changing needs

What other resources help?

• Independent living centers offer advocacy, peer support, and help with housing, benefits and assistive technology.
• Disability-specific organizations for MS, spinal cord injury, brain injury and others offer education and support.
• Assistive technology programs can help with devices and home modifications.

How does Nona’s help adults under 65?

Nona’s provides licensed, non-medical in-home care for adults who need help at home, with no minimums. Care plans are built around each client’s goals and routines. Care is $40 to $50 per hour, depending on the level of care. See how many hours of home care you actually need.
Nona’s can usually start care quickly, and you can change the schedule with 24 hours’ notice.

How do you build a care plan that supports independence?

For adults under 65 with disabilities, care should support independence, work, school, and community life, not only safety. A good care plan starts with the person’s own goals.

• Start with goals. Ask what the person wants to do, such as working, volunteering, attending classes, or living on their own.
• Identify specific supports. Note exactly which tasks need help and when.
• Respect preferences. Include preferred routines, communication style, and how the person likes help to be offered.
• Plan for flexibility. Schedules may change with work, school, or health.
• Review regularly. Adjust the plan as goals and needs change.

When the person directs their own care, they are more likely to feel in control and satisfied with it.

How do you coordinate home care with other services?

Adults with disabilities may receive services from several sources, such as regional centers, IHSS, independent living centers, therapists, and private caregivers. Coordination helps prevent gaps and overlap.

Keep a shared calendar and contact list, and make sure each provider knows what others are doing. Home care for adults with disabilities works best when everyone is working toward the same goals.

How do you plan for long-term needs?

Families of younger adults with disabilities often need to think about long-term planning, including what happens if a parent caregiver can no longer provide care. Special needs trusts, legal documents, and housing plans can help.

Talk with an attorney or financial planner who works with families of people with disabilities.

How do you choose the right caregiver for a younger adult?

Younger adults with disabilities often have different priorities than older clients, such as work schedules, school, social activities, and independent living goals. Look for a caregiver who respects the person’s autonomy, communicates directly with them, and is comfortable supporting activities outside the home.

Ask agencies about caregivers’ experience with younger clients and with specific disabilities, such as spinal cord injury, multiple sclerosis, cerebral palsy, or brain injury. Personality fit matters a great deal, since the caregiver may be part of daily life for years.

Involve the person receiving care in interviews and decisions whenever possible.

How do you find a special needs caregiver who’s the right fit?

Skills matter, but fit matters just as much for a younger adult. Look for a caregiver who treats the person as an adult, respects their choices, and is comfortable with their interests and pace.

Questions worth asking an agency:

• Has the caregiver supported adults with this kind of disability before?
• How do you match caregivers by age, personality and interests?
• Can we meet the caregiver before the first shift?
• Who covers shifts when the regular caregiver is out?
• How will we hear about each shift?

A licensed agency should also confirm the caregiver is listed on the California Home Care Aide Registry, has cleared a background check, and is covered by the agency’s workers’ compensation and liability insurance. Here is how to verify a caregiver in California yourself.

Frequently asked questions

Can adults under 65 get in-home care?
Yes. In-home care serves adults of any age who need help at home.

Does IHSS cover adults with disabilities under 65?
Yes, if they’re eligible for Medi-Cal and have a qualifying disability.

What is a regional center in California?
A nonprofit agency that coordinates services for people with developmental disabilities.

Can a caregiver help me get to work?
Yes. Caregivers can provide rides and support for work, school and activities.

Does Medicare cover home care for disabled adults?
Medicare covers skilled home health in some cases, not ongoing non-medical care.

What is a special needs caregiver?
A special needs caregiver supports a child or adult with a disability in daily life: personal care, meals, household tasks, rides, routines and community outings. In California, caregivers from a licensed home care agency provide non-medical support and work alongside any nurses or therapists the person already has. The goal is to help the person live as independently as possible.

Can a family member be paid through IHSS to care for a disabled adult?
Often, yes. California’s In-Home Supportive Services program lets eligible Medi-Cal recipients choose their own provider, and that can include many family members. The county sets the number of authorized hours after an assessment. Families often add private agency hours for evenings, weekends or backup when the family provider needs a break.

How much does home care for disabled adults cost in California?
Licensed agency care typically costs $40 to $50 an hour, depending on the level of care. At Nona’s there are no deposits or weekly minimums, and 24-hour or live-in care runs $850 to $1,100 a day. IHSS and regional center services can cover part of the schedule for those who qualify.

Home care for adults with disabilities: summary

Home care for adults with disabilities helps people under 65 with personal care, household help, transportation, and supervision. Disability home care in California can be funded through IHSS, making home care for disabled adults on Medi-Cal more affordable, regional center services for adults with developmental disabilities, private pay, or other programs.

When choosing a caregiver for a disabled adult, look for experience with the specific condition, respect for the person’s independence, and reliable backup coverage. Build the care plan around the person’s goals, not just tasks. Licensed in-home care costs $40 to $50 per hour depending on the level of care, and 24-hour care runs $850 to $1,100 per day. See how to pay for home care in California and our personal care services.