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IHSS Fresno County Guide (2026): Get Approved for Hours + Get Paid as a Family Caregiver

IHSS (In-Home Supportive Services) can help seniors and disabled adults stay safely at home by providing authorized care hours. This page explains the process and links you to the official Fresno County and State tools.

Important: Modern Medicine Group is not the County IHSS office. This is a physician-led guide that organizes official resources into a clear step-by-step roadmap.

Quick Start

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Apply for IHSS Online 

Apply for IHSS Online (Fresno County): Open Application Form

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ESP Login 

ESP Login (Timesheets / eHire / Pay Stubs / W-2): Go to ESP

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Secure Document Upload

Secure Document Upload (Fresno County): Secure Submission Page • Upload Portal

Track A — Seniors / Care Recipients (How to Enroll + Get Approved for Hours)

What is IHSS?

IHSS (In-Home Supportive Services) is a California program that may provide in-home care hours so an eligible senior or disabled person can stay safely at home. IHSS can pay for a caregiver, which can sometimes be a family member (if requirements are met).

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Official Fresno County IHSS overview: Fresno County IHSS Program Page

Eligibility (Simple Checklist)

  • Lives in California (Fresno County for this guide)

  • Needs help with daily activities (bathing, dressing, meals, mobility, etc.)

  • Generally: age 65+, blind, or disabled

  • Often has (or qualifies for) Medi-Cal

If you’re not sure, apply anyway — the County decides eligibility during the process.

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 Apply

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County follow-up + assessment

After you apply, the County typically follows up and schedules an assessment to understand what help is needed.

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Decision + authorized monthly hours

If approved, the County assigns authorized service hours.

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Choose a caregiver (family or hired caregiver)

Once approved, you can hire a family caregiver (if they enroll) or request a list of Registry Providers.

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How seniors get approved for IHSS hours (step-by-step)

Medical Team Discussion

Hire a family member

  1. The senior is approved for IHSS hours

  2. The family member enrolls as an IHSS provider

  3. The senior hires the provider (eHire online or paper agreement)

Hiring options (family vs. Registry Provider)

Request a Registry Provider list

To request a list of Registry Providers to interview:

How to Hire a Provider Quickly (eHire)

Apply for IHSS Online 

Electronic Services Portal

Paper option

IHSS Provider Hiring Agreement (PDF)

Securely Upload Documents

Avoid faxing sensitive paperwork.

Timesheets, Pay & Account Management

All managed through ESP:

Common tasks:

  • Submit/approve timesheets

  • View pay status

  • Download pay stubs

  • Update address

  • Download W-2

When IHSS May Not Be Enough (24/7 Care)

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Signs higher-level care may be needed:

  • Frequent falls or unsafe wandering

  • Missed medications

  • Overnight supervision required

  • Unsafe cooking or door safety issues

  • Advanced memory loss or confusion

  • Caregiver burnout with no backup

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Next step: A full care evaluation and long-term plan.
 

Track B — Family Members / Caregivers (How to Get Paid as an IHSS Provider)

 Can I get paid to care for my parent or loved one?

Often, yes — if your loved one is approved for IHSS hours, and you complete provider enrollment requirements, and the recipient officially hires you as their provider.

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Make sure your loved one applies (or is already approved)

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Enroll as an IHSS Provider (Fresno County)

Provider enrollment & orientation page: Fresno County — Provider Online Enrollment & Orientation

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Get hired by your loved one (Recipient)

  • ESP: Login

  • TTS (Telephone Timesheet System): 1-833-342-5388

Timesheets & getting paid

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Fast Path: 4 Steps to Become a Paid IHSS Caregiver

Elderly Group Gathering

Provider forms

Fresno County — IHSS Care Provider Forms

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SOC 840 (Change of Address / Phone) PDF: Download

Employment verification

Fresno County — Verify Employment as an IHSS Care Provider

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IHSS 0177 Employment & Wage Verification Request Form (DOCX): Download

Provider help lines

Links :

Video 5: How to Download Your IHSS W-2

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Links:

Video 4: How to Upload IHSS Documents (Fresno County)

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Links:

Video 3: How a Recipient Hires a Provider (eHire vs Paper)

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Link : ESP Login

  • Logging in / registering

  • Where to find timesheets

  • Where to download pay stubs / W-2

Video 2: How to Create Your ESP Account (Timesheets + Hiring)

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Link: IHSS Application Form

  • What info you need before you start

  • How to submit

  • What happens next (County follow-up + assessment)

Video 1: How to Apply for IHSS in Fresno County (Online)

Helpful How-To Videos 

Official Resource Links (Fresno County + State)

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How Modern Medicine Group Can Help Seniors While You Navigate IHSS

If you’re a senior (or caring for one), a strong primary care relationship makes this whole process easier—especially when medical conditions, medications, fall risk, memory concerns, and chronic disease management are involved.

  • Senior-focused primary care

  • Preventive care + chronic condition management

  • Care plan coordination (family + caregivers)

  • Bigger-picture planning (home safety, fall prevention, memory concerns, transitions to higher levels of care)

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