>>Narrator: In Home Supportive Services is the largest publicly funded, non-medical service
to help people with disabilities remain in their homes.
Applying to the program can be daunting.
To start the application process, contact the IHSS program in your county.
A representative will gather information about your income, disability, and what services
you may need.
>>Elizabeth Zirker: Some people need a service called Protective Supervision.
This is an I-H-S-S service for people with cognitive or mental health disabilities in
need of 24-hour observation and monitoring to protect them from injuries, hazards or
accidents.
Make sure you tell the representative from IHSS that you want protective supervision
for your family member if you think they need the service.
>>Narrator: The county will give you a form called form S-O-C-821, also referred to as
assessment of need for protective supervision for in-home supportive services program.
The doctor will need to fill out this form.
Explain to the doctor that your family member needs constant supervision to keep him or
her safe.
Describe how your family member's memory, orientation, and judgment are impaired, and
how it affects his or her life.
It is helpful to provide the doctor with a copy of our publication called "In-Home
Supportive Services Protective Supervision" which is available on our website.
>>Elizabeth: Your family member's doctor should check the boxes on the form indicating
whether the person is severely impaired, moderately impaired, or unimpaired in memory, orientation,
or judgment.
The doctor should be as detailed as possible and include specific examples.
>>Narrator: If the doctor runs out of space, he/she may attach a letter to the form to
continue explaining your condition.
Return the form to your social worker and keep a copy for your own records once it is
complete.
Applying for protective supervision is not a guarantee of services.
If your application is denied, request a hearing to appeal the County's decision...
...or call Disability Rights California for assistance.
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