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STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCYCALIFORNIA DEPARTMENT OF SOCIAL SERVICESREQUEST TO APPEAL EXTRAORDINARY CIRCUMSTANCES EXEMPTION INELIGIBILITY DETERMINATION:This request for appeal.

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How to fill out the SOC 856.PDF online

The SOC 856.PDF form is designed for individuals seeking to appeal a determination of ineligibility for an Extraordinary Circumstances Exemption. This guide provides clear and supportive instructions on how to complete the form online, ensuring that users can navigate the process with ease.

Follow the steps to successfully complete the SOC 856.PDF form online.

  1. Click 'Get Form' button to access the SOC 856.PDF document and open it in your preferred editor.
  2. Begin by filling in your personal details in the fields for provider name, recipient name, and case numbers as applicable.
  3. In the section titled 'I want to appeal the determination of County about my ineligibility for an Extraordinary Circumstances Exemption,' articulate the reasons you believe the county's decision is incorrect. If more space is needed, check the box to attach an additional page.
  4. Complete the contact information for the Exemption 2 county contact person, including their phone number, street address, city, state, and ZIP code.
  5. Sign and date the form in the provided areas to validate your appeal.
  6. Before submitting, take a moment to review all fields for completeness and accuracy. Make copies of the form for your records and the supporting documentation.
  7. Once satisfied, save your changes, then download, print, or share your completed SOC 856.PDF form as required.

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The important thing is to explain why more time is needed. The best evidence is from the people who provide you care and who kept a diary record of the time it takes. Witnesses may include — in addition to the IHSS recipient — past and present IHSS providers, regional center counselor, friends and family, etc.

There are four IHSS programs: The IHSS Residual (IHSS-R) Program is for people who are not eligible for full-scope Medi-Cal. It provides a maximum of 283 hours of services per month for people with severe disabilities and a maximum of 195 hours for people with disabilities that are not severe.

Generally, applicants who are determined to have severe deficits in their mental functioning are more likely to qualify for protective supervision. Provide the doctor with specific examples of the applicant's dangerous behaviors and deficiencies in memory, orientation, and judgment.

A provider in the IHSS/WPCS program will be paid overtime if they work more than 40 hours a week, but providers shall not work more than 66 hours a week for IHSS and WPCS recipients combined.

Once an appeal is received by CDSS, a finding regarding the support or denial of an appeal will be completed within 180 days. CDSS will notify in writing the county IHSS office or IHSS Public Authority Office and provider of the findings of the appeal review.

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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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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