Supportive Services Ihss Program Provider Enrollment Agreement
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InHome Supportive Services (IHSS) Program Provider ...
cdss.ca.govINHOME SUPPORTIVE SERVICES (IHSS) PROGRAM PROVIDER ENROLLMENT AGREEMENT. PROVIDER NUMBER PROVIDER NAME (FIRST, MIDDLE, LAST) 1. I attended the required provider enrollment orientation for IHSS providers and I understand and agree to the following: • I was given information about being a provider in the IHSS program.
SOC 846 (10/19) - In-Home Supportive Services (IHSS ...
www.pascc.orgIN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM PROVIDER ENROLLMENT AGREEMENT SOC 846 (10/19) Page 1 of 6. 1. I attended the required provider enrollment orientation for IHSS providers and I understand and agree to the following: • I was given information about being a provider in the IHSS program. • I was informed of my …
IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM …
www.cdss.ca.govcompleting a provider orientation, and returning a signed Provider Enrollment Agreement (SOC 846). • The county will send me a notice telling me if the person I have chosen as my provider does not complete the provider enrollment requirements or if he/she is not eligible to be an IHSS provider.
Waiver Personal Care Services - California
www.dhcs.ca.govPlan PCS via the In-Home Supportive Services (IHSS) program • Exhaust their current authorized PCS benefits ... they must complete the IHSS provider orientation and enrollment process first; or • Be employed directly by a Personal Care Agency. ... they will need to fill out a WPCS Provider Agreement form. • A provider agreement form can ...
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