Form SOC2310 "Notice to Provider of Ineligibility for Exemption From the in-Home Supportive Services Program Workweek Limits for Extraordinary Circumstances - in-Home Supportive Services (Ihss) Program" - California

What Is Form SOC2310?

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 SOC2310 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 SOC2310 "Notice to Provider of Ineligibility for 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 INELIGIBILITY FOR 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
The ________________________ gathered information from you and the recipients
you work for to evaluate your need for an Extraordinary Circumstance Exemption
(Exemption 2). Based on our evaluation of this information, the requirements for
granting an Exemption 2 have not been met. You have been determined ineligible for
the following reasons:
… Does not meet basic Exemption 2 criteria:
… You do not provide services for two or more IHSS recipients.
… One or all of the recipients applying under Criteria A do not live in the same home
as the provider.
… The total number of authorized hours for all of your active recipients does not
exceed 264 hours per month; therefore, an exemption is not needed.
… One or all of the recipients applying under Criteria C do not speak a primary
language other than English.
… You were evaluated for an Exemption 2 and it was determined that:
… The recipients/authorized representatives (AR) you work for have not explored
the following options for finding an additional provider(s) so that all of their
authorized services can be provided within the IHSS program workweek limits:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
SOC 2310 (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 INELIGIBILITY FOR 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
The ________________________ gathered information from you and the recipients
you work for to evaluate your need for an Extraordinary Circumstance Exemption
(Exemption 2). Based on our evaluation of this information, the requirements for
granting an Exemption 2 have not been met. You have been determined ineligible for
the following reasons:
… Does not meet basic Exemption 2 criteria:
… You do not provide services for two or more IHSS recipients.
… One or all of the recipients applying under Criteria A do not live in the same home
as the provider.
… The total number of authorized hours for all of your active recipients does not
exceed 264 hours per month; therefore, an exemption is not needed.
… One or all of the recipients applying under Criteria C do not speak a primary
language other than English.
… You were evaluated for an Exemption 2 and it was determined that:
… The recipients/authorized representatives (AR) you work for have not explored
the following options for finding an additional provider(s) so that all of their
authorized services can be provided within the IHSS program workweek limits:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
SOC 2310 (2/18)
Page 1 of 2
State of California – Health and Human Services Agency
California Department of Social Services
… Recipient(s) do not have complex medical and/or behavioral needs.
… Recipient(s) do not live in a rural/remote area.
… Recipient(s) do not meet Language/Communication Barrier criteria.
… Recipient(s) did not demonstrate that services could not be provided with initial
interpretive assistance.
… Recipient(s) failed to provide sufficient justification as to why all the authorized
service hours of the recipients could not be worked by additional providers when
there are other providers associated with the case.
… Recipient(s) have exhibited an ability to work with other providers.
… The authorized hours for all recipients have been assigned to active providers;
therefore, an exemption is not needed.
Because you have been determined ineligible for an exemption, you will be subject to
the existing workweek limitations. Therefore, the maximum number of hours you may
work in a workweek for two or more recipients combined is 66 hours. The recipients
you work for will need to hire another IHSS provider(s) to work any remaining
authorized IHSS hours.
If you have received any violations for submitting timesheets reporting working more
hours than the workweek limits, the county will rescind those violations that you
received from the date the exemption request was submitted up to the date of this
letter.
Pursuant to Welfare and Institutions Code section 12300.4 (d)(3)(E)(iii)(I), the provider
and recipients may request an independent review of this determination within 30
calendar days of this notice date. An administrative review request form has been
attached to this notice for your convenience.
If you have any questions, please contact your recipient’s IHSS County Social Worker
at the IHSS office telephone number above.
SOC 2310 (2/18)
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