ENROLLMENT

For persons interested in working as an IHSS Individual Provider:

In order for you to work as an In-Home Supportive Services (IHSS) Individual Provider and receive payment from IHSS for your services, you must complete several steps in the enrollment process.

Please do the following:
• Attend an enrollment session to submit your completed paperwork
• Complete and sign the SOC 426 Provider Enrollment Form
• Bring a copy of form SOC 426A signed by the IHSS Consumer you plan to work for
• Submit fingerprints and undergo a criminal background check by the California Department of Justice (DOJ) (This
step will occur at the enrollment session, the fee is $40.)
• Provide a current government issued photo identification card
• Provide your original Social Security card
• Sign a provider agreement stating that you understand and agree to the rules of the program and the responsibilities of being an Individual Provider
• Not be convicted within the last 10 years of the crimes listed on the SOC 426C (attachment below)

Please note:
• The name on your identification and Social Security card must match in order to be accepted
• Copies of identification or Social Security cards will not be accepted- all originals must be present
• Do not attend an enrollment session unless you were mailed a complete packet from Public Authority
• Please arrive 30 minutes before your enrollment session begins
• Space is limited and applicants will be taken on a first come-first served basis

Information and Forms

• SOC 426C (summary of disqualifying crimes)
• Enrollment Checklist
• Important Phone Numbers
• Universal Precautions
• SOC 426A Form
• Tips for avoiding fraud
• Mandated Reporter
• SOC 426

Please contact IHSS Public Authority at 866-351-7722 for questions regarding Provider Enrollment.

If you want to learn more about the history of the Public Authority, please go to the following link: PA History

 

Quality Service = Quality Care