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Click ‘Get Form’ to open the soc 838 in the editor.
Begin by entering the recipient's name in the designated fields, ensuring you include first, middle, and last names as required.
Next, input the provider's name following the same format. This is crucial for identifying who will receive the assigned hours.
Fill in the IHSS recipient case number and provider identification number accurately to avoid any processing delays.
Specify the hours assigned per month. Be clear about how many hours you wish to allocate to your provider.
Review the statement regarding understanding of hour assignments and ensure you check it before signing.
Sign and date the form where indicated. If applicable, have an authorized representative sign on behalf of the recipient.
Finally, complete any additional sections for county use if necessary, including comments or social worker details.

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What is a SOC 839 form?

This form allows the IHSS applicant/recipient or his/her legal representative to. choose an Authorized Representative for the IHSS program and identifies the functions the Authorized Representative may perform on his/her behalf. This form is only for the IHSS program.

What is SOC 838?

SOC 838 In-Home Supportive Services Recipient Request for Assignment of Authorized Hours to. Provider. SOC 839 In-Home Supportive Services Recipient Timesheet Signature Authorization. SOC 840 In-Home Supportive Services Program Provider or Recipient Change of Address and/or Telephone.

Who can fill out SOC 873?

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.

What is the maximum income to qualify for IHSS?

Effective 4/1/25, the monthly income limit for the IHSS program for a single applicant is $1,801. When both spouses are applicants, there is a couple income limit of $2,433 / month.