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  1. 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.

  2. 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.

  3. I am applying to participate in the Multipurpose Senior Services Program (MSSP). I agree to cooperate with the MSSP staff that will determine my eligibility for the program and, if I am accepted, will work with me to obtain the social and health services that I need.

  4. The Senior Community Service Employment Program (SCSEP) provides job training to low-income, unemployed adults age 55 and over. Participants gain part-time work experience in non-profit and government agencies and are paid the highest of state or local minimum wages.

  5. The mission of the California Department of Health Care Services (DHCS) is to provide Californians with access to affordable, high-quality health care, including medical, dental, mental health, substance use disorder services, and long-term services and supports. Our vision is to preserve and improve the physical and mental health of all Californians. DHCS works closely with federal officials ...

  6. How do I apply? Use this application if you are applying for food assistance (CalFresh), cash aid (California Work Opportunity and Responsibility to Kids, Refugee Cash Assistance, General Assistance or General Relief), Medi-Cal and/or other. health care programs.

  7. The Multipurpose Senior Services Program (MSSP) provides both social and health care management services to assist individuals remain in their own homes and communities.

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