The In-Home Supportive Services (IHSS) program—administered at the state level by the Department of Social Services (DSS)—provides in-home care for persons who cannot safely remain in their own homes without such assistance. Since 2009-10, the IHSS program has experienced significant budget-related changes intended to achieve General Fund savings. As part of the 2012-13 budget, the Governor proposes significant changes to the IHSS program. First, the Governor proposes to transition IHSS from a fee-for-service benefit to a managed care benefit. In addition, the Governor proposes to eliminate domestic and related care services for most IHSS recipients who live with another person. We find that this reduction presents significant legal and implementation challenges, and we therefore offer the Legislature two savings alternatives for its consideration. The first alternative is to consider extending a 3.6 percent across-the-board reduction in service hours that is set to expire at the end of the current year. The second alternative is to consider reenacting a reduction in state participation in provider wages to a level, determined by a study, that does not impact recipient access to services.