FLSA Forms
Starting February 1, 2016 IHSS providers will be paid overtime at a rate of one and a half times their regular hourly pay rate for hours worked over 40 in a workweek, not to exceed 66 hours.
The following documents were sent to recipients and providers explaining the new rules.
1. Consumer’s-(Recipient’s)
TEMP 3002 – Recipient Important Information
SOC 2271A – Recipient Notice of Maximum Weekly Hours – Informs recipient of his/hers weekly maximum hours.
SOC 2256 – Recipient and Provider Workweek Agreement – To be completed by recipients to agree on a workweek assignment. (3 pages) To be mailed to the IHSS office.
2. Provider’s
TEMP 3001 – Provider Important Information
SOC 846 – Provider Enrollment Agreement – Provider Agreement includes Overtime and Maximum hours policy * DUE BY APRIL 29, 2017 to the Consumer’s IHSS office
In the case where the provider has not yet been assigned to a Recipient case, the return address will be the DOJ County address.
SOC 2271 – Provider Notification of Recipient Authorized Hours and Services and Maximum Weekly Hours
SOC 2255 – Provider Workweek and Travel Time Agreement (if applicable)
This is completed by Providers serving multiple IHSS Recipients. Return to recipient IHSS office (7 PAGES)