Get the free In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873 - cdss ca

This document is used to obtain medical certification from licensed health care professionals for individuals applying for or receiving In-Home Supportive Services (IHSS), ensuring they are unable

How to fill out in-home supportive services ihss

How to fill out In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873

1. Obtain the In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873 from the IHSS website or your local IHSS office.
2. Read the instructions carefully to understand what information is required.
3. Complete the top section with your personal information including name, date of birth, and address.
4. Fill out the section that requires details about your medical condition, including diagnosis and the medical provider's information.
5. Provide information about the limitations or needs resulting from your condition that require in-home support.
6. Have your healthcare provider complete and sign the certification section to confirm the information submitted.
7. Review the form for completeness and accuracy.
8. Submit the completed form to your local IHSS office either by mail, fax, or in-person.

Who needs In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873?

1. Individuals who require assistance with daily living activities due to physical or mental health conditions.
2. Seniors who have difficulty performing everyday tasks and need support at home.
3. Persons with disabilities who require help to live independently.
4. Family members or legal representatives acting on behalf of eligible individuals.

People Also Ask about

Who qualifies as an IHSS recipient?

To qualify for IHSS you must: Be 65 years old or older, blind, and/or disabled as defined by Social Security Administration (SSA) standards.

Is it hard to get approved for IHSS in California?

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.

Who can fill out the IHSS form?

Under the law, you are ineligible to work in the IHSS program ONLY if you have been convicted within the last 10 years of: 1) fraud against a government health care or supportive services program; 2) child abuse; or 3) abuse of an elder or dependent adult.

Who fills out the IHSS form?

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.

What is the SOC for IHSS?

Eligibility criteria for all IHSS applicants and recipients: You must physically reside in the United States. You must be a California resident. You must apply for Medi-Cal if you are not already receiving.

Can family members be IHSS providers?

Upon approval of the recipient's service authorizations, the social worker will assist the recipient in obtaining an IHSS care provider. Care providers may include, but are not limited to, family members, friends, neighbors, or registered providers through the public authority.

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What is In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873?

The IHSS Program Medical Certification Form SOC 873 is a document used to certify an individual's medical condition and need for in-home supportive services to assist with daily activities.

Who is required to file In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873?

The form must be filled out by a qualified healthcare provider for individuals applying for or currently receiving IHSS benefits, to verify their medical needs.

How to fill out In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873?

To fill out the SOC 873 form, a healthcare provider needs to complete sections detailing the individual's medical condition, assistive needs, and provide their professional credentials and signature.

What is the purpose of In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873?

The purpose of this form is to establish the necessity of supportive services by validating the medical condition of the individual and defining the assistance required for their daily living.

What information must be reported on In-Home Supportive Services (IHSS) Program Medical Certification Form SOC 873?

The form requires information about the individual’s medical diagnosis, the level of impairment, specific tasks they need assistance with, and the healthcare provider's details.