As California’s aging population continues to grow, so does the demand for in-home care. Families are often faced with two primary options: home health services and non-medical home care. While the terms sound similar, they refer to distinct services governed by different regulations, providers, and care goals. Understanding these differences is essential for making informed decisions about care for yourself or your loved ones.
What Is Home Health?
Home health care is medical in nature and prescribed by a physician. It is provided by licensed professionals such as registered nurses (RNs), licensed vocational nurses (LVNs), physical therapists, occupational therapists, speech therapists, and medical social workers. These services are regulated by the California Department of Public Health (CDPH) and may be covered by Medicare, Medi-Cal, Veteran Affairs, Regional Centers or private insurance if they meet qualifying criteria, or paid privately.
Typical home health services include:
- Wound care and post-surgical monitoring
- Medication administration and education
- Disease management for chronic illnesses (e.g., diabetes, COPD)
- Physical, occupational, or speech therapy
- Monitoring vitals and medical assessments
To receive home health services, a physician must order the care plan and a licensed Home Health Agency (HHA) must deliver it under clinical supervision.
What Is Non-Medical Home Care?
Non-medical home care, often referred to as personal care or companion care, supports individuals with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). These services are not medical and do not require a doctor’s order. Non-medical caregivers are not licensed medical professionals, but many receive specialized training and are registered with the state of California.
Non-medical home care services are regulated by the California Department of Social Services (DSS) and delivered by Home Care Organizations (HCOs). Unlike home health care, non-medical home care is generally paid out-of-pocket, although long-term care insurance or regional centers may provide support in some cases.
Common services include:
- Bathing, grooming, and toileting
- Dressing and mobility assistance
- Meal preparation and feeding
- Medication reminders (but not administration)
- Light housekeeping and laundry
- Transportation and errands
- Companionship and supervision
These services are crucial for seniors, people with disabilities, and those recovering from illness who need help staying independent at home.
Key Differences Between Home Health and Non-Medical Home Care
| Feature | Home Health Services | Non-Medical Home Care |
|---|---|---|
| Type of Care | Medical | Non-medical(personal and companion care) |
| Regulating Agency | California Department of Public Health (CDPH) | California Department of Social Services (DSS)Type of Care |
| Care Providers | RNs, LVNs, therapists, medical social workers | Caregivers, home care aides |
| Requires Physician's Order | Yes | No |
| Licensed Professionals | Yes | No |
| Covered by Insurance | Often covered by Medicare/Medi-Cal/private insurance/ Veteran Affairs | Usually private pay or long-term care insurance, and Veteran Affairs |
| Primary Goal | Recovery, clinical monitoring, disease management | Support with daily living, comfort, independence |
| Duration of Services | Typically short-term, episodic | Can be long-term, ongoing |
| Supervision | Clinical oversight | Agency oversight or family-directed |
Which Type of Care Is Right for You?
The right choice between home health and non-medical home care depends on the needs of the individual:
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Choose home health if the individual needs skilled medical services at home due to a surgery, illness, or chronic condition. It’s ideal when the person is homebound and under a physician’s care.
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Choose non-medical home care when assistance with daily activities is needed, but no medical interventions are required. It’s a great option for older adults who need help staying safe and independent at home.
In many cases, both services can work together to provide a continuum of care. For example, a patient recovering from surgery may initially receive skilled nursing care from a home health provider, followed by personal assistance from a non-medical caregiver once their medical condition stabilizes.
California's Oversight and Standards
California takes the safety and quality of in-home care seriously. Here's how regulation works:
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Home Health Agencies must be licensed by the CDPH and meet Medicare Conditions of Participation if they serve Medicare patients. Nurses and therapists are licensed by the Board of Registered Nursing (BRN) or Board of Behavioral Sciences (BBS), depending on their discipline.
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Home Care Organizations (HCOs) must be licensed and registered with the DSS. All Home Care Aides (HCAs) must undergo background checks, training, and be listed on the Home Care Aide Registry.
Families seeking services should always check a provider's license and registry status before hiring.
Conclusion
Choosing between home health and non-medical home care doesn’t have to be confusing. By understanding the differences in scope, regulation, and purpose, California families can tailor in-home support to match both short-term recovery needs and long-term quality of life goals. When in doubt, consult a care manager, physician, or social worker to help determine the most appropriate path forward.
