San Mateo County IHSS — in-home support

You must be a California resident. You must have a Medi-Cal eligibility determination. You must live at home or an abode of your own choosing (acute care hospital, long-term care facilities, and licensed community care facilities are not considered "own home"). You must submit a completed Health Care Certification form.

A county social worker will interview you at your home to determine your eligibility and need for IHSS. Based on your ability to safely perform certain tasks for yourself, the social worker will assess the types of services you need and the number of hours the county will authorize for each of these services. This assessment will include information given by you and, if appropriate, by your family, friends, physician, or other licensed health care professional.

A completed Health Care Certification (SOC 873) must be received by the county prior to authorization of services.

You will be notified if IHSS has been approved or denied. If denied, you will be notified of the reason for the denial. If approved, you will be notified of the services and the number of hours per month which have been authorized for you.

You have the right to free and timely oral interpretation, sign language services, and written translations of English-language content.

Health care providers and clinics shall not charge a fee to a patient for filling out any forms related to an IHSS applicant’s eligibility determination or providing information responsive to forms that support a claim or appeal regarding eligibility for a public benefit program (Health and Safety Code Section 123114).

If you are approved for IHSS, you must hire someone (your individual provider) to perform the authorized services. You are considered your provider's employer and, therefore, it is your responsibility to hire, train, supervise, and fire this individual.

IHSS assessments are completed during home visits at the initial intake assessment and annual reassessments. Recipients may request for a reassessment of need at any time if their needs or circumstances change.

You may contact the social worker assigned to your case to determine the IHSS hourly rate in your county. Because unions negotiate with the employer of record in each county, the wage rates may vary from county to county.

Go to an IHSS Provider Orientation given by the county. Here you will learn important information about the program and the requirements for you to follow as a provider. Complete, sign and return the IHSS Program Provider Enrollment Form (SOC 426) directly to the County IHSS Office or IHSS Public Authority. For additional guidance, contact your County IHSS Office or IHSS Public Authority. Do not send the form to CDSS. Translations: Armenian | Chinese | Spanish Complete and sign the IHSS Provider Enrollment Agreement (SOC 846) . This is the agreement that ALL IHSS providers are required to sign. Translations: Armenian | Chinese | Spanish Get fingerprinted and go through a criminal background check by the California Department of Justice.

If you want to become an IHSS provider, you must complete all the steps outlined in the document linked below before you can be enrolled as a provider and receive payment from the IHSS program for providing services.

I am responsible for paying the costs of fingerprinting and the background check.

Recipients have the ability to approve/reject timesheets online and providers have the ability to complete and submit their electronic timesheets, view their payment status and history, sign-up for and make changes to Direct Deposit and submit Sick Leave Claims.

Non-Live-In Providers are required to check-in and out and select if services are provided in the recipient’s “home” or in the “community.” This must be completed using either the Electronic Services Portal (ESP), Telephone Timesheet System (TTS) using the recipient’s landline telephone, or IHSS EVV Mobile Application (App).

Providers will be paid based on their reported “hours worked” and not the time between check-in/check-out.

Effective July 1, 2022, all IHSS and WPCS providers are required to use Direct Deposit to have their paychecks automatically deposited into a checking or saving account or loaded onto a pay card of their choice.

It takes approximately 30 days for provider(s) to start receiving Direct Deposit after they successfully submit their Online Direct Deposit enrollment request. The provider should continue to submit their timesheets as they wait for their Direct Deposit to begin.

When a minor is enrolled in the IHSS sub program, PCSP, a parent is not permitted to be their minor child’s provider as this is restricted by federal program rules. However, effective 60 days after the publication of ACL 23-106, minor recipients, who are in CFCO, IPO, or IHSS-R, may hire any provider that successfully completes provider enrollment. Parents who wish to provide IHSS to their minor child should inform the county of their provider preference so this information may be taken into account when determining IHSS Program eligibility. Choosing to have a parent as a provider will not impact IHSS eligibility; however, it will determine which IHSS program the minor is placed.

A completed Health Care Certification (SOC 873) or acceptable alternative documentation must be received by the county prior to authorization of services.

If their income is too high for SSI, they may qualify with a share of cost.

However, parents with minor recipients in the Personal Care Services Program (PCSP) continue to be ineligible to be paid parent providers pursuant to WIC section 14132.95(f) and MPP section 30-763.457.

If you disagree with an action taken by the County or the Department of Health Care Services, or you disagree with an eligibility determination made by Covered California, you have 90 days to request a state hearing. After 90 days, you must prove you had a good reason for asking late.

In-Home Supportive Services (IHSS) Program

IHSS Provider Orientation

Electronic Services Portal

Electronic Visit Verification (EVV) for Recipients and Providers

ONLINE DIRECT DEPOSIT SERVICE

IHSS for Children

State Hearing Requests

California Health and Human Services Agency California Department of Social Services APPLICATION FOR IN-HOME SUPPORTIVE SERVICES To the Applicant: All sections of this form must be completed. Information provided is subject to verification. NOTE: Retain your copy of your completed application. Regarding your Social Security Number, it is

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM HEALTH CARE CERTIFICATION FORM A. APPLICANT/RECIPIENT INFORMATION (To be completed by the county) Applicant/Recipient Name: Date of Birth: Address: County of Residence: IHSS Case #: IHSS Worker Name: I

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM PROVIDER ENROLLMENT FORM INSTRUCTIONS: • Use black or blue ink to fill out. Print information clearly. • Fill out, sign and return this form in person to the office or location designated by the county

State of California ­– Health and Human Services Agency California Department of Social Services IN-HOME SUPPORTIVE SERVICES (IHSS) PROVIDER NUMBER PROGRAM PROVIDER ENROLLMENT AGREEMENT PROVIDER NAME (FIRST, MIDDLE, LAST) 1. I attended the required provider enrollment orientation for IHSS providers and I understand and agree to the follow

STATE OF CALIFORNIA ­ HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES IMPORTANT INFORMATION FOR PROSPECTIVE PROVIDERS ABOUT THE IN­HOME SUPPORTIVE SERVICES (IHSS) PROGRAM PROVIDER ENROLLMENT PROCESS An IHSS provider is someone who gets paid to provide services to a person who receives in­home supportive services

In-Home Supportive Services (IHSS)

In-Home Supportive Services (IHSS)

ill out our online Referral Form. If you need assistance completing the form, please call 650-573-3900. Step 2: Complete the IHSS Health Care Certification Form (SOC 873) After submitting your online referral: You will receive a confirmation

one of the following methods: eFax: 833-808-0937 email: SMCIHSSInfo@smcgov.org In-Person: 2000 Alameda de las Pulgas Ave., Suite 200, San Mateo, CA 94403 US Postal Mail: San Mateo County IHSS PO Box 5892, San Mateo, CA 94402 IMPORTANT INFORMATION: The SOC 873 form must be completed and submit

mpleted SOC 873 Form Submit using one of the following methods: eFax: 833-808-0937 email: SMCIHSSInfo@smcgov.org In-Person: 2000 Alameda de las Pulgas Ave., Suite 200, San Mateo, CA 94403 US Postal Mail: San Mateo County IHSS PO Box 5892, San Mateo, CA

n-Person: 2000 Alameda de las Pulgas Ave., Suite 200, San Mateo, CA 94403 US Postal Mail: San Mateo County IHSS PO Box 5892, San Mateo, CA 94402 IMPORTANT INFORMATION: The SOC 873 form must be completed and submitted within 45 days of application. IHSS FAQs What Happens Next? After t

can hire a caregiver to provide you with IHSS services. To enroll a provider, please call (833) 650-2272 and leave a voicemail with the following information: Client name and case number Provider’s full legal name and start date of service Plea

Please contact the IHSS Service Desk at (866) 376-7066 during normal business hours of 8am- 5pm Monday through Friday, excluding major holidays.