Overtime, Travel, Work Week, and Timesheet Changes

As of January 1, 2015, changes in State law went into effect to allow IHSS Providers to receive overtime pay and paid travel time, within certain limits. The forms below were sent to all Santa Cruz County IHSS Recipients and Providers to explain the basic rules and changes affecting work weeks, overtime, paid travel time.

Use the links below to open and carefully read the following information provided by CDSS:

• Important Information for IHSS Recipient Form TEMP3002 (PDF, 186 KB)
• Important Information for IHSS Providers Form TEMP3001 (PDF, 184 KB)

Recipients

• IHSS Overtime and Work Week Requirements - Recipient Declaration Form Temp 3000 (PDF, 39 KB) and
• IHSS Recipient and Provider Work Week and Travel Time Agreement Form SOC 2255 (PDF, 83 KB), if you are a recipient which has more than one (1) provider, you will need to complete this form to tell us:
  • what hours are being worked by each of your providers
• print and have all providers sign the form.
• Important: Make sure your Full Name and IHSS Case Number are clearly written on all forms.

Providers

• IHSS Provider Enrollment Agreement Form SOC 846 (PDF, 51 KB)
• IHSS Provider Workweek and Travel Time Agreement Form SOC 2255 (PDF, 83 KB), if you are a provider and work for multiple recipients, you will need to complete this form to let us know: what hours you work for each recipient and
  • when you will work during the week, and
  • when you work for more than one recipient during the day - how much time you spend traveling between recipients which is required to be eligible for paid travel time.
• Important: Make sure your Full Name and IHSS Provider Number are clearly written on all forms.

Mailing Address

• Make sure your Full Name, IHSS Case Number, or Provider Numbers are clearly written on all forms. 
• Mail to: In-Home Supportive Services P.O. Box 1320 Santa Cruz, CA 95060-9964