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  • (ihss) Program Health Care Certification Form - California Department ... - Pascla

Get (ihss) Program Health Care Certification Form - California Department ... - Pascla

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM HEALTH CARE CERTIFICATION FORM A. APPLICANT/RECIPIENT INFORMATION.

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Toll Free Number (888) 944 – IHSS (4477) Local Number (213) 744 – IHSS (4477) OR....Print and mail to: DPSS In-Home Supportive Services. PO Box 93730. City of Industry, CA 91715-9608.

You must have a physician or other licensed health care professional fill out a Health Care Certification (SOC 873) form and you must return it to the county before care services can be authorized.

You must have a physician or other licensed health care professional fill out a Health Care Certification (SOC 873) form and you must return it to the county before care services can be authorized. You will be notified if your application for IHSS has been approved or denied.

Generally, misdemeanor crimes involving violence or threats of violence would disqualify a person from being an IHSS provider. Minor infractions, such as traffic violations, would not disqualify a person from being an IHSS provider. 10. WHAT HAPPENS IF I'M CONVICTED OF A CRIME AFTER I'M ENROLLED AS AN IHSS PROVIDER?

The IHSS Program will help pay for services provided to you so that you can remain safely in your own home. To be eligible, you must be 65 year of age and over, or disabled, or blind. Disabled children are also potentially eligible for IHSS.

ing to state regulations, a parent can be an IHSS provider if “The parent has left full-time employment or is prevented from obtaining full-time employment because no other suitable provider is available and the inability of the parent to perform supportive services may result in inappropriate placement or ...

You (or your authorized representative) must complete PART A of this form to let the county know who you have chosen to provide your authorized services. If you have multiple providers, you must fill out a separate form for each person who will be providing authorized services for you.

What Is Form SOC 873? Form SOC 873, In-Home Supportive Services (IHSS) Program Health Care Certification Form, is a medical certification form filled out by a licensed health care professional to enable disabled, blind, or elderly individuals to receive services from the In-Home Supportive Services (IHSS) program.

IHSS is a program intended to enable aged, blind, and disabled individuals who are most at risk of being placed in out-of-home care to remain safely in their own home by providing domestic/related and personal care services.

The In-Home Supportive Services (IHSS) program provides in-home assistance to eligible aged, blind and disabled individuals as an alternative to out-of-home care and enables recipients to remain safely in their own homes.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232