In-Home Care for Adults With Disabilities Under 65: Services, Funding and Finding Help

Home care isn’t only for seniors. Adults under 65 living with physical disabilities, chronic illness, brain injury, multiple sclerosis, or recovering from an accident or surgery often use in-home caregivers for personal care, household help, transportation and supervision. In California, funding may come from IHSS (for Medi-Cal members of any age with a qualifying disability), regional centers (for people with developmental disabilities), Medi-Cal waivers, workers’ compensation or personal injury settlements, long-term care insurance, or private pay. The right caregiver respects independence and supports the person’s own goals.

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.

This guide explains who uses in-home care, the services available, how it’s funded in California, and how to find the right help.

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.

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.

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.

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.

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.

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 for disabled adults on Medi-Cal, 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.