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TO: Dear Doctor: This patient has applied for In-Home Supportive Services (IHSS) and stated that he/she needs certain paramedical services in order for him/her to remain at home. You are asked to indicate on this form what specific services are needed and what specific condition necessitates the services. In-Home Supportive Services is authorized to fund the provision of paramedical services, if you order them for this patient. For the purpose of this program, paramedical services are activiti.

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ELIGIBILITY & CASE MANAGEMENT The In-Home Supportive Services (IHSS) authorized representative process is intended to ensure that IHSS recipients with cognitive impairments have the assistance needed to secure services from the IHSS program, allowing them to remain safely in their own homes.

SOC 839 - In-Home Supportive Services Designation of Authorized Representative.

The In-Home Supportive Services (IHSS) is California's largest in-home care program. The IHSS program helps low-income individuals with disabilities, including older adults, remain safely in their own homes. IHSS does this by paying someone chosen by the individual with a disability to provide the needed help.

Currently, the application process can be confusing, and at present only 10% of eligible families get approved for IHSS. Of those who do get approved, it can take anywhere from two weeks to several months to finally receive benefits.

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.

Effective April 2023 – March 2024, the monthly income limit for the IHSS program for a single applicant is $1,677. When both spouses are applicants, there is a couple income limit of $2,269 / month.

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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