Form SOC2309A "Notice to Recipient of Approval of Exemption From the in-Home Supportive Services Program Workweek Limits for Extraordinary Circumstances - in-Home Supportive Services (Ihss) Program" - California

What Is Form SOC2309A?

This is a legal form that was released by the California Department of Social Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2018;
  • The latest edition provided by the California Department of Social Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form SOC2309A by clicking the link below or browse more documents and templates provided by the California Department of Social Services.

ADVERTISEMENT
ADVERTISEMENT

Download Form SOC2309A "Notice to Recipient of Approval of Exemption From the in-Home Supportive Services Program Workweek Limits for Extraordinary Circumstances - in-Home Supportive Services (Ihss) Program" - California

945 times
Rate (4.4 / 5) 66 votes
State of California – Health and Human Services Agency
California Department of Social Services
IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM
NOTICE TO RECIPIENT OF APPROVAL OF EXEMPTION FROM THE
IN-HOME SUPPORTIVE SERVICES PROGRAM WORKWEEK LIMITS FOR
EXTRAORDINARY CIRCUMSTANCES
County of:
(ADDRESSEE)
Notice Date:
IHSS Office Address:
IHSS Office Telephone:
Provider Name:
… Initial Exemption
Provider Number:
… Exemption Renewal
As of the date of this notice, the request for an exemption is approved for
_____________________________________. Your provider will also receive a notice
that the exemption request has been approved.
The approval of the exemption means that, while it remains in effect, your provider may
work up to a combined total of 360 hours per month for you and the other recipients
he/she currently works for.
Your provider may not work more than your monthly authorized hours. If the recipients
your provider works for, including you, have combined authorized hours that total
more than 360 per month, you or one of the other recipients will need to hire another
provider(s) to work the hours above 360 per month. If your provider works more than
360 hours per month, it could lead to his/her being ineligible to be a provider in the
IHSS program.
The exemption will be in effect until ____________________. Within 30 days from
the date of expiration, the county will review the cases of all active recipients receiving
care from your provider to determine whether the circumstances the exemption was
based on continue to exist and, if so, the county will initiate a renewal of the exemption
on your provider’s behalf.
If you have any questions, please contact your IHSS County Social Worker at the IHSS
office telephone number above.
SOC 2309A (2/18)
Page 1 of 1
State of California – Health and Human Services Agency
California Department of Social Services
IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM
NOTICE TO RECIPIENT OF APPROVAL OF EXEMPTION FROM THE
IN-HOME SUPPORTIVE SERVICES PROGRAM WORKWEEK LIMITS FOR
EXTRAORDINARY CIRCUMSTANCES
County of:
(ADDRESSEE)
Notice Date:
IHSS Office Address:
IHSS Office Telephone:
Provider Name:
… Initial Exemption
Provider Number:
… Exemption Renewal
As of the date of this notice, the request for an exemption is approved for
_____________________________________. Your provider will also receive a notice
that the exemption request has been approved.
The approval of the exemption means that, while it remains in effect, your provider may
work up to a combined total of 360 hours per month for you and the other recipients
he/she currently works for.
Your provider may not work more than your monthly authorized hours. If the recipients
your provider works for, including you, have combined authorized hours that total
more than 360 per month, you or one of the other recipients will need to hire another
provider(s) to work the hours above 360 per month. If your provider works more than
360 hours per month, it could lead to his/her being ineligible to be a provider in the
IHSS program.
The exemption will be in effect until ____________________. Within 30 days from
the date of expiration, the county will review the cases of all active recipients receiving
care from your provider to determine whether the circumstances the exemption was
based on continue to exist and, if so, the county will initiate a renewal of the exemption
on your provider’s behalf.
If you have any questions, please contact your IHSS County Social Worker at the IHSS
office telephone number above.
SOC 2309A (2/18)
Page 1 of 1