Frequently Asked Questions about IHSS

• As part of the application process, you will have to provide IHSS with a Health Care Certification form completed by your physician.
• IHSS will also check to see if you already have Medi-Cal.  If you don't you will need to apply for Medi-Cal too.
• As part of the application process, a social worker may conduct a home visit to discuss your need for IHSS and determine if you are eligible. 
• Based on your ability to safely perform certain tasks for yourself, the social worker will assess the types of services IHSS pays for, your level of need and the number of hours that will be authorized for each service.
• This assessment will include information from you, your family, caregivers, physician or other licensed health care professional(s).
• You will be notified if IHSS has been approved or denied.  If denied, you will be notified of the reason for the denial.  If approved, you will be notified of the services and number of hours per month that have been authorized to you.
• If you are approved for IHSS, you must hire someone (care provider) to perform the authorized services.  You will be considered your care provider's employer and it is your responsibility to hire, train, supervise and fire your care providers.
• If you are not able to locate a care provider on your own, Fresno County IHSS Public Authority (PA) can give you a list of eligible providers to interview.  If you have difficulty interviewing potential providers, the PA may be able to assist you.  Call (559) 600-6666, select Option 4.
• The IHSS care providers are paid after completing timesheets which must be approved by the recipient or their authorized representative.  There are two pay periods a month - the 1st to 15th, and 16th to the end of the month. 

Authorized services are the tasks that have been approved by the Social Worker for your provider to help you.  It's important to remember that IHSS will only pay for services that are authorized. 

Services authorized by IHSS to help you remain safely in your home include:

• Domestic (housekeeping)
• Related Services (meal preparation, meal clean-up, laundry, shopping for food and errands)
• Personal Care (assistance with: ambulation, transfers, respiration, bathing/hygiene, dressing, eating, bowel and bladder, medications, repositioning and Paramedical)
• Accompaniment to medical appointments
• Protective Supervision for persons with cognitive impairments

Examples of services that IHSS does not authorize:

• Pet Care
• Reading or translation assistance
• Transportation (unless IHSS-related tasks are required to/from medical appointments)

• Applications are taken by IHSS over the phone or through an online application.  Your case number will be given to you when you apply by phone, or by mail after your online application is processed.
• If not already approved for Medi-Cal, applicants will be referred to apply.
• The Health Care Certification form will be mailed to you to take to your physician that must be returned within 45 days to the IHSS office.
• An IHSS Social Worker will visit you at your home to discuss your functional strengths and limitations to evaluate if IHSS will help you remain safely at home.  The Social Worker will also review information provided by your physician on the Health Care Certification form.
• The IHSS Social Worker will send you a Notice of Action to let you know if you have been approved or denied for IHSS.
  • If approved for IHSS, your Notice of Action lists the services and hours that you have been authorized.
  • If denied for IHSS, your Notice of Action will state why you were not approved.

If you do not agree with being denied for IHSS or were approved but disagree with the authorized services, you have the right to file for a State Hearing.

A share of cost is a dollar amount you are responsible to pay to the provider as part of their wages.  IHSS recipients that have Medi-Cal with a share of cost should not pay their IHSS provider any monies until they have received a letter from the California Department of Social Services (CDSS) instructing them to pay (a letter will arrive after each timesheet if a share of cost payment is required).

Refusing to pay your SOC to your provider could result in your IHSS case being terminated.

If you feel you should not have a Medi-Cal SOC, contact the Fresno County Medi-Cal program.

IHSS recipients are the employers of IHSS providers for the purpose of hiring, scheduling, supervising, firing and replacing them.  [Welfare & Institutions (WIC) 12302.5(b) and 12301.6]

While the California Department of Social Services (CDSS) performs payroll and other functions on the behalf of an IHSS recipient (the employer), it is necessary for IHSS applicants and recipients to have or apply for a Social Security Number (SSN) or a Individual Tax Identification Number (ITIN) for employment related purposes.

When establishing an employer of record and Employer Payroll Tax Account Number with the California Employment Development Department (EDD), CDSS also has to obtain a nine-digit Federal Employer Identification Number (FEIN) on behalf of the IHSS recipient/employer.  However, if the IHSS recipient/employer does not have a SSN, they must get an ITIN to complete this process.  Without a valid SSN or ITIN, CDSS cannot perform the functions on behalf of recipients that are required by the EDD.

It's important to understand you may still qualify to be eligible for services, and that you will not be denied because you don't have a SSN or ITIN.  The SSN/ITIN is a requirement for all employment related purposes. 

Applying for a SSN

Individuals must contact the Social Security Administration (SSA) in order to apply for a SSN.

• Apply Online at:  https://www.ssa.gov/ssnumber/
• Review the list of documents required to apply for a SSN at: https://www.ssa.gov/ssnumber/ss5doc.htm#work2
• Avoid lines by calling to schedule an in-person appointment.  Call 1(800) 772-1213 (8am-7pm)

What is an ITIN and What is it Used For?

An ITIN is a tax processing number issued by the Internal Revenue Service (IRS).  The IRS issues ITINs to individuals who are required to have a United States (US) taxpayer identification number, but who do not have and are not eligible to get a SSN from the SSA.

The IRS issues ITINs to help individuals comply with the US tax laws, and to provide a means to efficiently process and account for tax returns and payment for those not eligible for SSNs.  They are issued regardless of immigration status, because both resident and non-resident individuals may have a US filing or reporting requirement under the Internal Revenue Code.  ITINs do not serve any purpose other than federal tax reporting. 

How To Apply for a ITIN 

• Visit https://www.irs.gov/individuals/how-do-i-apply-for-an-itin to learn what documents are required to apply for an ITIN
• Have more questions?  Visit the IRS ITIN Frequently Asked Questions (FAQs) webpage at: https://www.irs.gov/individuals/international-taxpayers/itin-procedures-frequently-asked-questions
• To make an appointment to submit your documents in-person at an Acceptance Agents Office, find a location close to you (scroll to find an office near you):  https://www.irs.gov/individuals/international-taxpayers/acceptance-agents-california

Who Can I Call for Help?

You can call the IRS toll-free at 1-800-829-1040.  You can also contact one of the Acceptance Agents Offices near you for assistance (https://www.irs.gov/individuals/international-taxpayers/acceptance-agents-california).  Your IHSS Social Worker may also be able to assist you.

Where Can I Mail My ITIN application and documents?

Mail your application (W-7), tax return, proof of identity and original foreign status documents to: 

• Internal Revenue Service
• Austin Service Center
• ITIN Operation
• PO Box 149342
• Austin, TX 78714-9342

Helpful Tips When Filling Out the ITIN Application

• Reason you're submitting Form W-7, Box H - check "Other" and the reason for Other is because IHSS recipients are employers of their providers and must have a federal ID for tax reporting purposes.
• Name Section - Enter your full legal name
• Mailing Address Section - Enter your complete mailing address (this is the address the IRS will use to return your original documents and send written notification of your ITIN application status).
• Foreign (non-US) Address Section - Enter your complete foreign (non-US) address in the country where you permanently or normally reside.  If you no longer have a permanent foreign residence because you have relocated to the US, only enter the name of the foreign county you lasted resided.
• Birth Information Section - Enter your date of birth and related information.
• Other Information Section - Enter your information for the applicable questions.