This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.
In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
Personal Care Policy In Los Angeles
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State:
Multi-State
County:
Los Angeles
Control #:
US-00458BG
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FAQ
L.A. Care is the health plan for Medi-Cal members in Los Angeles County. The California Department of Health Care Services (DHCS) works with L.A. Care to provide your Medi-Cal health care.
You May Be Eligible For IHSS If You: Are 65 years of age, disabled or blind. Have a functional impairment and are at risk for out of home care placement.
The Local Initiative Health Authority for Los Angeles County (L.A. Care) is a public agency that provides health insurance to Los Angeles County residents, particularly those who are low-income or uninsured, through four health coverage programs including Medi-Cal.
By Phone- Call the L.A. County Department of Public Social Services at 1-866-613-3777, Monday through Friday from a.m. to p.m., excluding holidays. By Mail- Print the Single Streamlined Application at Covered California and submit via mail to your local county office.
Examples of personal care service tasks Showering or bathing, including verbal or physical cueing or hands-on assistance. Dressing and undressing. Grooming tasks, including brushing teeth, denture care, shaving, hair styling, and makeup. Transferring, such as getting in and out of a chair or bed.
In Los Angeles County, you can apply by phone by calling (888) 944-IHSS (4477) or (213) 744-IHSS (4477) or complete the application SOC 295 - Application For In-Home Supportive Services, available at .
The applicant income limit is equivalent to 138% of the Federal Poverty Level (FPL). While this figure increases annually in January, for California Medicaid, the income limits increase each April. Effective 4/1/24, the monthly income limit for the IHSS program for a single applicant is $1,732.
You qualify for L.A. Care because you qualify for Medi-Cal and live in Los Angeles County. If you have questions about your Medi-Cal coverage or about when you need to renew your Medi-Cal, please call the Los Angeles Department of Public Social Services (DPSS) at 1-866-613-3777.
How to Become an IHSS Provider Go to an IHSS Provider Orientation given by the county. Complete, sign and return the IHSS Program Provider Enrollment Form (SOC 426) directly to the County IHSS Office or IHSS Public Authority. Complete and sign the IHSS Provider Enrollment Agreement (SOC 846) .
Under the law, you are ineligible to work in the IHSS program ONLY if you have been convicted within the last 10 years of: 1) fraud against a government health care or supportive services program; 2) child abuse; or 3) abuse of an elder or dependent adult.