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This document notifies about the change in the form SOC 294C regarding IHSS Income Eligibility for children, updating the Department of Social Services County Forms Catalog.
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The County IHSS wage rate for providers is $18.50 per hour. The State Back-Up Provider System (BUPS) provider wage rate is $20.50 per hour. The Back-Up Attendant Program (BUAP) provider wage rate is $21.50 per hour.
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.
TIMESHEET AND/OR. OTHER PROVIDER-RELATED DOCUMENTS SIGNATORY. Completing this part of the form allows the Authorized Representative to sign IHSS provider timesheets and/or other provider related documents on the applicant/ recipient's behalf.
Timesheets and Other Provider-Related Documents (TPRD) (SOC 839A). In. addition to timesheets, an individual designated using the SOC 839A can. complete the following documents on behalf of the applicant/recipient: • IHSS Program Recipient Designation of Provider (SOC 426A)
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.

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NOTICE OF FORM CHANGE NO. 04-295 is a formal document used to report changes to previously submitted information or forms as per regulatory requirements.
Organizations or individuals who have previously submitted forms that are subject to change must file NOTICE OF FORM CHANGE NO. 04-295.
To fill out NOTICE OF FORM CHANGE NO. 04-295, provide the required identification information, detailed description of the changes, and any supporting documentation as specified in the guidelines.
The purpose of NOTICE OF FORM CHANGE NO. 04-295 is to ensure that all relevant authorities are informed of any updates or changes to previously filed information.
NOTICE OF FORM CHANGE NO. 04-295 must report identification details, a clear description of the changes, the effective date of the changes, and any other information required by the specific guidelines.
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