Form SOC2309 "Notice to Provider 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 SOC2309?

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 SOC2309 by clicking the link below or browse more documents and templates provided by the California Department of Social Services.

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Download Form SOC2309 "Notice to Provider of Approval of Exemption From the in-Home Supportive Services Program Workweek Limits for Extraordinary Circumstances - in-Home Supportive Services (Ihss) Program" - California

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State of California – Health and Human Services Agency
California Department of Social Services
IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM
NOTICE TO PROVIDER 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
You are receiving this letter because you are the IHSS provider for the following
recipients:
Recipient Name #1: _________________ Case Number: _________________
Recipient Name #2: _________________ Case Number: _________________
Recipient Name #3: _________________ Case Number: _________________
Recipient Name #4: _________________ Case Number: _________________
As of the date of this notice, the request for an exemption is approved for
_____________________________________. The approved exemption applies only
for work you perform for the recipients listed above. The recipients will also receive a
notice that the exemption request has been approved.
The following recipient(s) you were a provider for do not meet the criteria of the
approved exemption and should be assisted in hiring a provider:
… None
… Recipient Name: _________________ Case Number: _________________
… Recipient Name: _________________ Case Number: _________________
SOC 2309 (2/18)
Page 1 of 2
State of California – Health and Human Services Agency
California Department of Social Services
IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM
NOTICE TO PROVIDER 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
You are receiving this letter because you are the IHSS provider for the following
recipients:
Recipient Name #1: _________________ Case Number: _________________
Recipient Name #2: _________________ Case Number: _________________
Recipient Name #3: _________________ Case Number: _________________
Recipient Name #4: _________________ Case Number: _________________
As of the date of this notice, the request for an exemption is approved for
_____________________________________. The approved exemption applies only
for work you perform for the recipients listed above. The recipients will also receive a
notice that the exemption request has been approved.
The following recipient(s) you were a provider for do not meet the criteria of the
approved exemption and should be assisted in hiring a provider:
… None
… Recipient Name: _________________ Case Number: _________________
… Recipient Name: _________________ Case Number: _________________
SOC 2309 (2/18)
Page 1 of 2
State of California – Health and Human Services Agency
California Department of Social Services
In the future, if your employment arrangements change and you no longer work for the
above-named recipients who were approved under the exemption, the exemption will
be ended and you will be subject to the standard workweek limits. In that case, the
maximum number of hours you would be able to work in a workweek for two or more
recipients combined would be 66 hours.
As a condition of being granted an exemption, you must sign the enclosed IHSS
Program Exemption from Workweek Limits for Extraordinary Circumstances Approved
Exemption Provider Agreement (SOC 2308) and return it to the county. Note: This
does not apply to providers who have been approved for an exemption renewal.
The approval of the exemption means that, while it remains in effect, you may work up
to a combined total of 360 hours per month. You may not work more than the monthly
authorized hours for any one recipient. If your recipients’ combined authorized hours
total more than 360 per month, one or more of the recipients will need to hire another
provider to work the hours above 360 per month. If you work more than 360 hours per
month, it could lead to being ineligible to be a provider in the IHSS program.
The exemption will be in effect until ____________________. Within 30 days prior to
the expiration of your exemption period, the county will review the recipients’ cases to
determine whether the circumstances the exemption was based on continue to exist
and, if so, the county will request a renewal of the exemption on your behalf.
If you have any questions, please contact your recipient’s IHSS County Social Worker
at the IHSS office telephone number above.
SOC 2309 (2/18)
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