STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM
LIVE-IN FAMILY CARE PROVIDER OVERTIME EXEMPTION
Provider Number__________________________
PROVIDER NAME:
Part A: PROVIDER REQUIREMENTS
Beginning February 1, 2016, state law (Welfare and Institutions Code section 12300.4) limits the maximum weekly
number of hours an IHSS/Waiver Personal Care Services (WPCS) provider can work in a workweek. A provider in
the IHSS/WPCS program will be paid overtime if they work more than 40 hours a week, but providers shall not work
more than 66 hours a week for IHSS and WPCS recipients combined.
The IHSS program has created a family-member exemption to the workweek maximum of 66 hours for IHSS providers
to allow them to work up to a maximum of 90 hours per workweek and up to a maximum of 360 hours a month. In
order to be eligible for this exemption, you must meet the three (3) following conditions on or before January 31, 2016:
• You must provide IHSS services to two or more IHSS recipients.
• You must currently live in the same home as the IHSS recipients that you provide services to.
• You must be related to the IHSS recipients to whom you provide services as his/her parent, stepparent, adoptive
parent or grandparent or be his/her legal guardian.
With this exemption, you cannot work more than 90 hours per workweek or more than 360 hours per month. If you
work up to these maximum hours for your recipients and your IHSS recipients still have IHSS hours left, then your
IHSS recipients will have to hire another IHSS provider to work the rest of their IHSS hours.
Please complete Part B of this form and provide all information to verify that you meet the three (3) requirements
above to qualify for this exemption as a Live-in Family Care Provider.
SOC 2279 (1/16)
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