Most IHSS families only ever see two documents: the Notice of Action that started the disagreement, and, weeks or months later, a decision that arrives in the mail. In between, the case moves through a process that almost nobody outside the system gets to watch — a case gets assigned, a county worker reviews it, a settlement sometimes gets offered, paperwork the county owes you gets drafted, and a decision eventually gets enforced. None of that happens in front of the recipient or caregiver who filed the appeal.
This article walks through what actually happens after an IHSS fair hearing request is filed, using the state’s own regulations and the California Department of Social Services (CDSS) State Hearings Division as the source. It’s meant to demystify the process, not replace legal advice.
How a Case Gets Assigned
An IHSS appeal begins with a Notice of Action (NOA) — the county’s written notice that it is denying, reducing, or terminating a service, or the recipient’s written notice that the county failed to act on a request. A recipient (or a family member acting on their behalf) generally has 90 days from that notice to request a state fair hearing, by phone, mail, or through the state’s online Appeals Case Management System (ACMS).
Once a hearing request is filed, ACMS logs the case, and the claimant receives two separate notices from the CDSS State Hearings Division. The first simply confirms the hearing was requested and explains hearing rights. The second arrives at least ten days before the hearing itself and lists the date, time, and format — by default a telephone hearing, though claimants can ask for an in-person or video hearing instead. Around the same time, the county assigns an appeals worker, sometimes called a Hearing Specialist or Appeals Representative, who will represent the county’s position at the hearing and is usually the first point of contact for the case going forward.
Know Who You're Talking To
The appeals worker assigned to your case works for the county. They are not a neutral go-between, and their job is to represent the county's position at your hearing — even when a large part of that job involves trying to resolve your case before a hearing ever happens.
That doesn't make them dishonest, and many appeals workers are genuinely willing to fix a mistake if one exists. But anything you say to them, including in a casual or informal phone call, can end up shaping the county's written position statement against you. Treat these conversations the way you would any conversation with the other side in a dispute: be honest, stay factual, and don't assume they're advocating for you.
What the County Does Before Anyone Sees a Judge
The appeals worker’s job starts well before the hearing date. They review the case file, the original assessment, and the reason the disputed action was taken, and they typically reach out to the claimant to discuss the issue directly. Part of that outreach is exploring whether the dispute can be resolved without a hearing at all — through a corrected assessment, additional documentation, or a straightforward change in hours the county agrees to make.
Claimants have the right to review the case record the county used to make its decision, free of charge, before the hearing takes place. That review matters: it’s often the only way to see exactly which regulations, assessment notes, or medical documentation the county is relying on, and whether anything in that file is incomplete or incorrect.
Conditional Withdrawals: Settling Without a Hearing
If the appeals worker and the claimant reach an agreement, the case doesn’t go in front of an Administrative Law Judge (ALJ) at all. Instead, the claimant can sign a conditional withdrawal — a written agreement describing exactly what the county will do (for example, a reassessment or a specific change in authorized hours) in exchange for canceling the hearing. This is different from an unconditional withdrawal, in which a claimant simply cancels the hearing because they no longer dispute the county’s action, with no obligation on the county’s part in return.
A conditional withdrawal is a real commitment on the county’s side: once signed, the county has 30 days to carry out the terms it agreed to. Claimants are encouraged to read a conditional withdrawal carefully before signing it, since signing effectively closes the hearing. If the terms are unclear, or the claimant disagrees with the county’s proposal, the safer route is not to sign and to proceed with the scheduled hearing instead. If the county later issues a new NOA that the claimant still disagrees with — for instance, after a reassessment that was supposed to resolve the dispute — the claimant can request a hearing on that new action as well, typically with same effective date as original appeal.
The Position Statement: The County's Case, in Writing
Whether or not a case settles early, state regulations require the county to prepare a written County Statement of Position and deliver it to the claimant at least two business days before the scheduled hearing. This document lays out the county’s version of the facts, cites the specific regulations it relied on, summarizes the evidence in the case file, and lists the witnesses — usually the assigned social worker — the county intends to call.
This is one of the more consequential pieces of the process, because it is the closest thing to a preview of the county’s argument that a claimant will get. Claimants have the right to read it before the hearing and to flag anything they believe is factually wrong, either directly with the appeals worker or with the judge at the hearing itself. If the position statement doesn’t arrive on time, that alone can be grounds to request a postponement. Claimants are not required to submit a written statement of their own, but preparing one — describing, point by point, why the county’s action was wrong — is one of the few tools available to counter a document the claimant otherwise has no part in drafting.
Write Your Own Response
You don't have to wait for the hearing to make your case. Once you've reviewed the county's position statement, consider preparing a short written response of your own — a plain-language document that goes point by point through what you disagree with and why the requested hours or services are needed.
- Which specific facts, hours, or reasons in the county's statement you disagree with, and why
- The evidence behind your position — assessments, medical documentation, or caregiver logs
- Why the requested hours or service are necessary for safety or independence at home
This isn't a required filing and there's no official form for it — it's a preparation tool, not a substitute for bringing your actual supporting documents to the hearing or uploading them to the ACMS pre-hearing.
What Happens After the Decision: Compliance
At the hearing, the county generally presents its case first, since the burden is on the county to justify a reduction, denial, or termination. The Administrative Law Judge who hears the case does not always issue the final word alone. Under state regulations, an ALJ prepares a proposed decision that is routed for review by the Chief Administrative Law Judge and, in many cases, submitted to the CDSS Director for adoption — unless the ALJ has been delegated authority to issue a final decision directly. That internal review layer happens entirely behind the scenes, and it’s part of why a decision can take weeks to arrive even after the hearing has already concluded.
Once a decision is issued, it generally takes effect immediately. If the claimant wins in whole or in part, the county has 30 days to comply with the judge’s order and must notify the claimant once it has done so. If the county fails to act within that window, the claimant has a specific remedy: state regulations allow a claimant to file a new hearing request that raises a compliance issue directly — an allegation that the county did not carry out a decision that was already made in the claimant’s favor. This compliance mechanism exists precisely because a win on paper isn’t the same as a win in practice, and it is one of the least publicized parts of the entire process.
Either side — the claimant or the county — can also ask for a rehearing within 30 days of receiving the written decision, arguing that the hearing was unfair or that the decision was legally or factually wrong. The other party then has five days to respond, and the State Hearings Division is generally expected to decide the rehearing request within 35 business days, though it isn’t unusual for that to take longer in practice.
Why This Matters
None of this changes the substance of an individual case. But knowing the sequence — that a hearing specialist is assigned almost immediately, that a written position statement is owed to you on a specific timeline, that a settlement carries a real enforcement deadline, and that a compliance complaint is a legitimate next step if a county drags its feet — turns a process that otherwise feels like a black box into something a family can actually track. If a decision goes in your favor and the 30-day compliance window passes with nothing happening, that isn’t something to wait out. It’s grounds to go back to the State Hearings Division and ask for it to be enforced.
This article describes the general regulatory process for IHSS state hearings in California; specific timelines and procedures can vary by county and by the details of an individual case. For help with an active appeal, contact Disability Rights California, a local legal aid office, or the CDSS State Hearings Division directly.
Sources
- Disability Rights California, "IHSS Fair Hearings Guide: How to Prepare for IHSS Terminations or Reductions in Hours," disabilityrightsca.org.
- California Department of Social Services, State Hearings Division, cdss.ca.gov/inforesources/state-hearings.
- California Department of Social Services, Manual of Policies and Procedures, Division 22 (State Hearings), MPP §§22-045, 22-053, 22-060, 22-073.25, 22-078.
- California Department of Social Services, State Hearings Division, "Rehearing Protocol," cdss.ca.gov.
- County of Shasta, California, "Admin Hearing Process," shastacounty.gov.
- Legal Services of Northern California, "Representing Yourself at a State Hearing: Tips to Succeed," lsnc.net.
