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If you want to apply for health care only, you can ask the county for a health care only application. Health care includes: low-cost insurance for Medi-Cal; affordable private health insurance; or a tax credit that can help you
APPLICATION FOR IN-HOME SUPPORTIVE SERVICES. To the Applicant: All sections of this form must be completed. Information provided is subject to veriication. NOTE: Retain your copy of your completed application.
The In-Home Supportive Services (IHSS) program provides in-home assistance to eligible aged, blind, and disabled individuals as an alternative to out-of-home care and enables recipients to remain safely in their own homes.
Use this application if you are for applying for food assistance (CalFresh), cash aid (California Work Opportunity and Responsibility to Kids or Refugee Cash Assistance), Medi-Cal and/or other health care programs.
Blank Application Forms. The below forms may be dropped at a secure drop box, at one of our offices, during regular business hours, 8:30 a.m. to 5:00 p.m or submitted by fax to 510-670-5095 or by mail at P.O. Box 12941, Oakland, CA 94604.
Use this application if you are applying for food assistance (CalFresh), cash aid (California Work Opportunity and Responsibility to Kids or Refugee Cash Assistance), Medi-Cal and/or other health care programs.
The IHSS Program is a federal, state and locally funded program designed to help pay for services provided to you so that you can remain safely in your own home. You may be eligible if you are 65 years of age, disabled, or blind.
