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Commonly Asked Questions about Ihss provider Application Forms

Fill out SOC 295 Application for In-Home Supportive Services. The form is available in three languages.
Individuals who receive Medi-Cal with no share of cost (SOC) through SSI-linked Medi-Cal, the 250% Working Disabled Program, Aged and Disabled Program (income limit of $1,564 for an individual and $2,106 for a couple as of April 1, 2022), or expansion Medi-Cal, will also be entitled to IHSS with no SOC.
If you are an IHSS Provider who works and lives at the SAME address as your IHSS Recipient, you have the option to self-docHub your living arrangements to exclude Federal Income Tax (FIT) and State Income Tax (SIT) from your IHSS wages.
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.
The program is designed to help individuals stay in their homes and avoid institutionalization. However, it is hard to get approved for IHSS, and sometimes individuals may be denied services. If you have been denied IHSS in California, there are steps you can take to appeal the decision.
These requirements include completing, signing, and returning (in person) the Provider Enrollment Form (SOC 426), submitting fingerprints and being cleared of disqualifying crimes through a criminal background check, completing a provider orientation, and returning a signed Provider Enrollment Agreement (SOC 846).
Be 65 years old or older, blind, and/or disabled as defined by Social Security Administration (SSA) standards. Disabled children are also potentially eligible for IHSS; Be a California resident; Live in your own home.
PROVIDER ENROLLMENT PROCESS If you want to become an IHSS provider, you must complete all of the steps outlined below within 90 days from the date you began the process before you can be enrolled as a provider and receive payment from the IHSS Program for providing services.