#231 Box 944243, Mail Station 6-16-50 IHSS is an alternative to out-of-home care and is administered by county welfare departments under the authority of the California Department of Social Services. duty to care for the child upon adoption. 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"). If approved for IHSS, you must hire someone (your individual provider) to perform the authorized services. Dangerous Behavior Log: The best way to show that your child qualifies for IHSS Protective Supervision is by examples of what your child does that may cause injuries. Your employer or the In-Home Supportive Services (IHSS) program may help you get personal assistance services at work. Severely and non-severely disabled people can get up to 283 hours of services per month, including protective supervision. P.O. An IPP identifies the goals for your child, who will provide services or support to reach these goals, and if there is a cost associated with the service or support, who will fund it. , , . <>
Please choose an optionAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming, Have you received a Notice of Action? The elimination of protective supervision proration may result in an increase in IHSS hours. WebThe IHSS Program will help pay for services provided to you so that you can remain safely in your own home. Tips for Using Adobe PDF Files, Notice of Action Documents(used by county governments), Copyright 2023 California Department of Social Services, NA Back9 (5/22) - Your Hearing Rights (Full Rights Are Listed in CDSS PUB 412), NA Description Of Services L (3/15) - Description Of services, NA IHSS Back L (3/15) - Your Hearing Rights, NA 200 (12/20) - Notice Of Action - Multipurpose - Include Budget, NA 200 (7/21) - Notice Of Action - Multipurpose - Include Budget, NA 210 (5/20) - Discontinue, Suspend Financial Eligibility, NA 213 (10/21) - Deny - Financial Eligibility, NA 213A (12/20) Notice Of Action Deny Financial Eligibility, NA 213A (7/21) Notice Of Action Deny Financial Eligibility, NA 214 (4/00) - Discontinue, Suspend Transfer of Property, NA 215 (1/00) - Continuation Page, Sponsor Non Citizens Deemed Income, NA 216 (11/99) - Sponsored Non Citizens Property, NA 271 (12/20) - Notice Of Action - Continuation Page - Family Income Computations - Cash Aid, NA 271 (7/21) - Notice Of Action - Continuation Page - Family Income Computations - Cash Aid, NA 274 (4/99) - Continuation Page Overpayment Computations (prior to 10-1-89), NA 274B (4/99) - Continuation Page Overpayment Computations (for 10/1/89 to 8/31/91), NA 274C (4/99) - Continuation Page - Overpayment Computations (for 9/1/91 to 8/31/95), NA 274D (1/00) - Continuation Page - Overpayment Computations (Ortega 9/1/95 to 12/31/97), NA 274E (6/11) - Notice Of Action Overpayment Computations For 1-1-98 to 6-30-2011, NA 274F (6/11) - Notice Of Action - Overpayment Amount Owed (For Overpayments Occurring On Or After 7/1/2011), NA 274G (7/19) - Notice Of Action - Continuation Page - Overpayment ComputationsOccurringOn Or After10/1/2013, NA 274H (12/20) - Notice Of Action - Continuation Page - Overpayment Computations Between 6/1/2020 and 05/31/2021, NA 274I (7/21) - Notice Of Action - Continued - Overpayment Amount Owed For Overpayments Occurring Between 6-1-2021 and 5-31-2022, NA 274J (7/21)-Notice of Action Continued - Overpayment Amount Owed For Overpayments Occurring On or after 6-1-2022, NA 275 (4/99) - Continuation Page - Overpayment Adjustment Computation - Cash Aid, NA 277 (1/00) - Continuation Page Optional Persons Transfer of Property, NA 278 (1/00) - Discontinue/Suspend Optional Persons Transfer of Property, NA 279 (1/00) - Excess Property (with Good Faith), NA 280 (1/00) - Excess Property (w/o Good Faith), NA 281 (6/11) - Notice Of Action - Underpayment Amount Owed (For Underpayments Occurring on or After 1-1-98 thru 6-30-2011), NA 281A (6/11) - Notice Of Action Underpayment Amount Owed (For Underpayments Occurring On Or After 7/1/2011), NA 281B (5/13) - Notice Of Action Continuation Page - Underpayment Computations On Or After 10/1/2, NA 281C (7/19) - Notice Of Action - Continuation Page - Underpayment Computations Occurring On Or After 6/1/2020, NA 281C (12/20) - Notice Of Action Continuation Page - Underpayment Amount Owed (For Underpayments Occurring Between 6-1-2020 and 5-31-2021), NA 281D (7/21) - Notice Of Action (Continued) Underpayment Amount Owed (For Underpayments Occurring Between 6-1-2021 and 5-31-2022), NA 281E(7/21) - Notice Of Action (Continued) Underpayment Amount Owed (For Underpayments Occurring On Or After 6-1-2022), NA 290 (2/14) -Notice Of Action - Multipurpose, NA 300 (7/19) - Notice Of Action - Continuation Page - Recipient Financial Eligibility Test, NA 300 (10/21) - Notice Of Action - Continuation Page - RecipientFinancial Eligibility Tests, NA 301 (10/21) - Continuation Page - Applicant Financial Eligibility Test, NA 403 (1/22)- Notice Of Action - For Resource Families, Including Homes Certified By AFoster Family Agency, County Approved Relative Homes, Non-Relative Extended Family Members, Foster Family Homes, Non-Related Legal Guardians, Intensive Treatment Foster Care and/or Intensive Services Foster Care, Group Homes and Short-Term Residential Therapeutic Programs, NA 403A (4/17) - Notice Of Action Approval, Change Or Discontinued For Kinship - Guardians Only, NA 421 (6/21) Assistance Dog Special Allowance (ADSA) - Notice Of Action - Approval, NA 422 (11/21) - Assistance Dog Special Allowance (ADSA), NA 422L (1/22) -Assistance Dog Special Allowance (ADSA) Notice of Action Denial, NA 530 (4/11) - Notice Of Action -48-Month Time Limit, NA 530 (4/21) - Notice Of Action - 60-Month Time Limit, NA 531 (12/20) - Notice Of Action - Continuation Page-48-Month Time Limit- Includes Budget, NA 531 (4/21) - Notice Of Action - Continuation Page - 60-Month Time Limit - Includes Budget, NA 531 (7/21) - Notice Of Action - Continuation Page - 60-Month Time Limit - Includes Budget, NA 532 (7/19) - Notice Of Action - Continuation Page - 48-Month Time Limit Discontinue, NA 532 (12/20) - Notice Of Action - Continuation Page - 48-Month Time Limit Discontinue - Includes Budget, NA 532 (4/21) - Notice Of Action - Continuation Page - 60-Month Time Limit Discontinue - Includes Budget, NA 532 (11/21) - Notice Of Action- Continuation Page - 60-Month Time Limit Discontinue - Includes Budget, NA 691 (3/18) - Notice Of Denial - Cash Assistance Program For Immigrants (CAPI), NA 692 (12/17) - Notice Of Change - Cash Assistance Program For Immigrants (CAPI), NA 693 (9/22) - Notice Of Approval - Cash Assistance Program For Immigrants (CAPI), NA 791 (9/18) - Notice Of Action - Approval/Denial/Change, NA 816 (3/14) - Notice Of Action - Sanction Of Other Parent After Failed Compliance Plan, NA 817 (3/14) - Notice Of Action - Sanction Of Participant After Failed Compliance Plan, NA 818 (3/14) - Notice Of Action - Taking You Out Of Welfare To Work, NA 820 (1/01) - Notice Of Action - Transportation Approval, NA 821 (1/01) - Notice Of Action - Transportation Approval/Denial, NA 822 (7/16) - Notice Of Action - Transportation Change, NA 823 (8/00) - Notice Of Action - Ancillary Expenses Approval/Denial, NA 825 (8/00) - Notice Of Action - Payment Adjust Transportation, NA 827 (7/99) - Notice Of Action - Recoupment Unused Advance Payment, NA 828 (7/99) - Notice Of Action - Transportation And Ancillary Exp Overpayment, NA 832 (3/20) - Notice of Action - Child Care Services, NA 833 (4/20) - Notice of Action - Child Care Services Change, NA 834 (3/20) - Notice of Action - Child Care Services Denial, NA 835 (3/20) - Notice of Action - Child Care Services Discontinuance, NA 840 (3/14) - Notice Of Action - Welfare To Work Plan, NA 840A (10/03) - Notice Of Action - Determination Of Good Cause/No Good Cause, NA 841 (3/14) - Notice Of Action - Welfare-To-Work Plan, NA 843 (6/99) - Notice Of Action - Ineligible, NA 844 (8/99) - Notice Of Action - Adequate Progress, NA 845 (3/14) - Notice Of Action - Sanction and Removal Of The Other Parent's Needs, NA 960X SAR (9/13) - Notice Of Action - Stop Aid;Report Not Received, NA 960Y SAR (10/14) - Notice Of Action - Stop Aid;Report Incomplete, NA 991 (10/03) - Notice Of Action - Refugee Cash Assistance (RCA)/Entrant Cash Assistance (ECA) MC-Decrease/Expiration (Time-Expiration), NA 992 (5/03) - Refugee Cash Assistance (RCA) Application Approval, NA 994 (11/00) - Food Stamp Notice Of Discontinuance (Failure to Meet Non-Assistance CFAP Work Requirement (Violation Prior To Three Consecutive Month Grace Period), NA 995 (5/13) - Food Stamp Notice of Denial/Disqualification For The California Food Assistance Program, NA 996 (11/00) - Food Stamp Notice Of Discontinuance (Failure to Meet Non-Assistance CFAP Work Rule (Violation After Receipt Of Three Consecutive Month Grace Period, NA 1209 (2/02) - Notice Of Action - Change In The Amount Of Kin-Gap Payment, NA 1210 (4/02) - Notice Of Action - Discontinue, NA 1211 (2/00) - Notice Of Action - Denial, NA 1212 (2/00) - Notice Of Action - Discontinue Property, NA 1213 (2/00) - Notice Of Action - Discontinue Restricted Account, NA 1214 (2/00) - Notice Of Action - Change Under/Overpayment, NA 1217 (9/22) - Notice Of Action - Cash Assistance Program For Immigrants - Notice of Overpayment, NA 1218 (9/22) - Notice Of Action - Cash Assistance Program For Immigrants - Notice Of Underpayment, NA 1230 (9/22) - Cash Assistance Program for Immigrants Notice of Overpayment - Waiver Approval, NA 1231 (9/22) - Cash Assistance Program for Immigrants Notice of Overpayment - Partial Waiver Approval, NA 1232 (2/21) - Cash Assistance Program for Immigrants Notice of Overpayment - Waiver Denial, NA 1233 (3/02) - Notice Of Action - Multipurpose, NA 1239 AR (12/20) - Notice Of Action - Continuation Page - Annual Reporting Budget, NA 1239 AR (8/21) - Notice Of Action - Continuation Page - Annual Reporting Budget, NA 1239 SAR (12/20) - Notice Of Action - Continuation Page - Semi-Annual Reporting Budget, NA 1239 SAR (8/21) - Notice Of Action - Continuation Page - Semi-Annual Reporting Budget, NA 1240 (4/13) -Notice Of Action - Food Stamp Overissuance & Dormant EBT Account, NA 1250 (11/12) - Notice Of Action In-Home Supportive Services (IHSS) Approval, NA 1250L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Approval, NA 1251 (5/09) -Notice Of Action In-Home Supportive Services (IHSS) Approval Continuation, NA 1251L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Approval Continuation, NA 1252 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Denial, NA 1252L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Denial, NA 1253 (11/12) - Notice Of Action In-Home Supportive Services (IHSS) Change, NA 1253L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Change, NA 1254 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Change Continuation, NA 1254L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Change Continuation, NA 1255 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Termination, NA 1255L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Termination, NA 1256 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Share Of Cost, NA 1256L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Share Of Cost, NA 1257 (5/09) - Notice Of Action In-Home Supportive Services (IHSS) Multi, NA 1257L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Multi, NA 1261 (1/16) - Notice Of Action - Form and Instructions - For Group Homes, Short-Term Residential Treatment Centers, Foster Family Agencies, Transitional Housing Placement-Plus Foster Care and Transitional Housing Placement Program, NA 1261A (3/20) - Notice Of Action For Approved Relatives, Non-Relative Extended Family Members, Foster Family Homes, Non-Related Legal Guardians or Non-Minor Dependents Residing In A Supervised Independent Living Setting, NA 1261B (1/16) - Notice Of Action - Form And Instructions - For Kinship-Guardians Only, NA 1263 (8/11) - Notice Of Action - Overissuance Budget Worksheet, NA 1267 (4/13) - CalFresh Informing Notice Of Receiving Intercounty Transfer, NA 1268 (4/13) - CalFresh Informing Notice Of Sending Intercounty Transfer, NA 1269 (11/11) - Notice Of Action - Approve Non-Minor Dependent, NA 1270 (11/11) - Notice Of Action - Discontinue Non-Minor Dependent, NA 1271 (5/14) - Notice Of Action - Denial Of Home Assessment/Approval, NA 1273 (7/13) - Electronic Notification Agreement, NA 1274 (7/13) - Electronic Notification Notice, NA 1275 (7/13) - Electronic Notification Cancellation Notice, NA 1276 (1/15) - Notice Of Action - Welfare-to-Work 24-Month Time Clock Limit Notice, NA 1277 (1/16) - Notice Of Action - Approved Relative Caregiver (ARC) Overpayment, NA 1278 (11/16) - Notice Of Action - Approve Approved Relative Caregiver (ARC) Payment, NA 1279 (5/22) Notice of Action Deny Approved Relative Caregiver (ARC) Payment, NA 1280 (5/22) Notice of Action Discontinue Approved Relative Caregiver (ARC) Payment, NA 1281 (11/16) - Notice Of Action - Change Approved Relative Caregiver (ARC) Payment, NA 1282 (12/19) - Notice Of Action In-Home Supportive Services (IHSS) Overpayment - Advance Pay, NA 1282L (12/19) - Notice Of Action In-Home Supportive Services (IHSS) Overpayment - Advance Pay, PI 2 (6/15) - IRS Office Of Safeguards Data Incident Report, PUB 13 (5/22) - Your Rights Under California Public Benefits Programs - For People Applying For Or Receiving Public Aid In California, PUB 56 (12/06) - The In-Home Supportive Services Program, PUB 69 (5/22) - County Forms Catalog2021-2022, PUB 104 (12/06) - In-Home Supportive Services Individual Provider Benefits and Services Information, PUB 179A (5/15) - A Manual Communication Guide For Field Officers, PUB 190 (8/06) - How To Hire And Supervise Your In-Home Supportive Services (IHSS) Provider, PUB 203 (1/04) - In-Home Supportive Services - Guide to Workers Compensation Benefits for Individual Providers. 21 Engel Injection Molding Machines (28 to 300 Ton Capacity), 9 new Rotary Engel Presses (85 Ton Capacity), Rotary and Horizontal Molding, Precision Insert Molding, Full Part Automation, Electric Testing, Hipot Testing, Welding. IHSS Service Desk for Providers and Recipients WebIHSS has personal care services, protective supervision, household chores, accompaniment and paramedical services. 2 0 obj
Upon receipt, the State Hearings Division must grant or deny your rehearing request within 35 working days. NA 1257L (3/15) - Notice Of Action In-Home Supportive Services (IHSS) Multi (18pt Font) NA 1261 (1/16) - Notice Of Action - Form and Instructions - For Group Note that there is no minimum age requirement for protective supervision. The home visit is an important part of the initial assessment, which forms the basis of the countys decision to authorize or deny protective supervision. If youre a child under age 18, you can get IHSS in different ways. If you have an authorized representative, the judge will ask if he/she would like to make the applicants opening statement. If your county has homemaker employees, you may receive services from a county homemaker. Go to http://www.americanadvocacygroup.com or call us directly at (877) 762-0702, and we will assist you in getting your child the funding he or she deserves. You are entitled to an interpreter at the hearing, free of charge. If there are any discrepancies or inaccurate information in the documentation, you should seek to get the documents corrected prior to submitting them to the county social worker, county hearing representative, or administrative law judge. Children usually are not eligible for IHSS domestic chores, 1.5 hours if you have to use a laundromat. considered to have left employment to care for their child and is ineligible to PO Box 944243, MS 21-36 Webo When assessing a child for protective supervision, the Social Worker will counsel the care provider that specialized parenting classes are available that teach the parent parents home. Do not mail in this form or drop it off at the doctors office. A directory of county social services offices can be found here: https://www.cdss.ca.gov/county-offices. Also, make sure to highlight any behavior and safety concerns. IHSS Protective Supervision consists of closely watching your childs behavior and intervening as appropriate to safeguard him or her against injury, hazard, or accident. You or your authorized representative will be given an opportunity to cross-examine the county social worker. The IHSS Plus Option (IPO) Program is for people who get services from a spouse or parent (for people under age 18), or who get restaurant meal allowance or advance pay. IHSS AssessmentIHSS AppealRehearing RequestState Court ReviewOther, Please attach any documentation (e.g. An applicant is never required to suffer an actual injury in order to be eligible for protective supervision. Typically, nonself-directing refers to a persons inability to make decisions without external control. The court agrees with you that the administrative law judge made some kind of error, but determines that there is not enough evidence for the court to decide the issue and sends (remands) the case back to CDSS for a rehearing. If you want to use IHSS personal assistance hours at the workplace, first contact your IHSS worker and specify the number of hours and services you need. Regional Center Individual Program Plan (IPP): This is a document created by the Regional Center. Sit in person with the doctor while she fills out the form, while telling her to use your list of dangerous behaviors from your log to write on the form. The court agrees with CDSS and denies your writ petition; The court agrees with you that the administrative law judge made some kind of error, and the court grants you protective supervision and/or other supportive services; and. Get free assistance with your personal care and daily chores from a qualified, IHSS Provider who comes to your home. Disability Rights California (DRC) is a nonprofit organization founded in 1978 that defends, advances, and strengthens the rights and opportunities of people with disabilities. For more information and resourcesvisit the In-Home Supportive Services Program website. The reasons to request a rehearing include: You can submit your rehearing request by: State Hearings Division However, laws are regularly changing. endstream
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