Ihss doctor form 2025

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The document is a Health Care Certification Form for the In-Home Supportive Services (IHSS) program in California. It requires information from both the applicant/recipient and a licensed health care professional to assess eligibility for IHSS services, which assist aged, blind, and disabled individuals in performing daily living activities to prevent out-of-home care placement. The form includes sections for personal information, authorization to release health care information, and specific health care questions that must be answered by a licensed professional.

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What is the purpose of the In-Home Supportive Services (IHSS) Health Care Certification Form?

The form is used to authorize the release of health care information and to certify that an individual requires assistance with daily living activities, which is necessary for IHSS eligibility.

Who needs to complete the health care certification section of the form?

A licensed health care professional must complete the health care certification section to assess the individual's need for IHSS services.

What types of services does IHSS provide?

IHSS provides services such as housekeeping, meal preparation, personal care, assistance with daily living activities, and paramedical services.

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To edit the document on DocHub, upload the PDF file, use the editing tools available to fill in or modify information, and then save or export your changes.

What should I do if I answered 'NO' to questions #1 or #2 on the form?

If you answered 'NO' to either question #1 or #2, you should skip questions #3 and #4 and complete the rest of the form including the certification in PART D.

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Who can complete an SOC 821?

The form can only be signed by a medical professional with a medical specialty or scope of practice in the area of memory, orientation, and judgment. MPP 30-757.173(a)(1)(A). The SOC 821 form will ask the recipients doctor for information about the recipients function in the areas of memory, orientation and judgment.

What is a SOC 2298 form for IHSS?

You have the option to self-certify your living arrangements to exclude IHSS/WPCS wages from FIT and PIT by completing and submitting a Live-In Self-Certification Form for Federal and State Tax Wage Exclusion (SOC 2298).

What form do doctors fill out for IHSS?

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.

Which doctor is supposed to fill out my SOC 821?

Any medical professional specializing in memory, orientation, judgment can fill out the SOC 821. The more supporting documentation you provide, such as multiple SOC 821s indicating that the applicant has severe deficits in mental functioning, the stronger your case for protective supervision becomes.

How did I get approved for IHSS protective supervision?

Protective supervision is an IHSS service for people who, due to a mental impairment or mental illness, need to be observed 24 hours per day to protect them from injuries, hazards, or accidents.

Ihss doctor form 2025

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What is the purpose of the In-Home Supportive Services (IHSS) Health Care Certification Form?

Who needs to complete the health care certification section of the form?

What types of services does IHSS provide?

How can I edit the document on DocHub?

What should I do if I answered 'NO' to questions #1 or #2 on the form?

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Who can complete an SOC 821?

What is a SOC 2298 form for IHSS?

What form do doctors fill out for IHSS?

Which doctor is supposed to fill out my SOC 821?

How did I get approved for IHSS protective supervision?

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