Get the free In-Home Supportive Services Program Brochure (LARGE PRINT) - HS

CCI Updates Coordinated Care Initiative (CCI) CCI Phone Calls Department of Aging and Adult Services (DAYS) staff can use the following information to address phone calls about CCI and Cal Disconnect.

How to fill out in-home supportive services program

How to fill out in-home supportive services program?

1. Obtain an application form from your local social services agency or download it from their website.
2. Fill in your personal information such as your name, address, phone number, and date of birth.
3. Provide information about your marital status, household composition, and income details.
4. Indicate any disabilities or special needs that require in-home supportive services.
5. Attach any supporting documents or medical records that validate your need for in-home supportive services.
6. Submit the completed application form along with all the required documents to your local social services agency.

Who needs the in-home supportive services program?

1. Elderly individuals who have difficulty performing daily activities such as bathing, dressing, and eating due to aging-related limitations.
2. People with disabilities who require assistance with activities of daily living such as medication management, mobility, or meal preparation.
3. Individuals with chronic or temporary medical conditions that limit their ability to take care of themselves independently.
4. Family caregivers who need support and respite care to provide assistance to their loved ones in a home setting.
5. Low-income individuals or families who cannot afford private home care services but require assistance with daily activities and personal care.

For pdfFiller’s FAQs

What is in-home supportive services program?

The In-Home Supportive Services (IHSS) program provides assistance to eligible aged, blind, and disabled individuals who are unable to remain safely in their own homes without such assistance.

Who is required to file in-home supportive services program?

The individual receiving the in-home supportive services is required to file the program.

How to fill out in-home supportive services program?

To fill out the in-home supportive services program, the individual receiving the services must complete the necessary forms provided by the IHSS program.

What is the purpose of in-home supportive services program?

The purpose of the in-home supportive services program is to help eligible individuals remain safely in their own homes by providing necessary assistance with daily activities.

What information must be reported on in-home supportive services program?

The in-home supportive services program requires reporting information about the individual receiving the services, the type of services provided, and the hours of care needed.

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