How to Fill Out the IHSS Paramedical Services Form (SOC 321)

To fill out the IHSS paramedical services form SOC 321, you complete the top with your name and IHSS case number, your licensed health care professional writes the medical order in the middle (listing each task, how long it takes, how often it’s needed, and how long the order should last), you sign the informed consent at the bottom, and the fully signed form goes to your county IHSS office. Both signatures — the professional’s on the order and yours on the consent — must be on the form before the county can add paramedical hours to your care plan.¹

The form is a free PDF from the California Department of Social Services.² You can also request a copy from your county IHSS social worker. Getting it to your doctor early moves things along.

What the Form Is Authorizing

Paramedical services are health-related tasks your IHSS provider performs at home that would normally be done by a licensed professional. Under MPP Section 30-757.191, they share three characteristics: you would do the task yourself if you were not functionally limited, the task is necessary to maintain your health, and it is complex enough to require training from a licensed professional.¹ The regulation covers activities such as administering medications, puncturing the skin, inserting a medical device into a body opening, and anything requiring sterile technique.

Common examples include injections of prescribed medication, catheter insertion or changes with drainage-bag emptying and output recording, colostomy or ostomy irrigation, and bowel programs including digital stimulation. Your regular IHSS provider performs these tasks at the same hourly rate as other IHSS care. The licensed professional who signs the SOC 321 is responsible for training the provider and directing how the services are carried out.³

Filling Out the Recipient Section

The top of the form asks for your identifying information. Write your full legal name and your IHSS case number, which appears on any Notice of Action or correspondence from your county IHSS office. If you can’t locate it, call your assigned social worker before submitting. A missing or wrong case number slows processing.

Do not fill in the medical details. Task descriptions, minutes per occurrence, and frequency all belong to the professional’s section. Your job on this form, beyond identifying yourself, is signing the informed consent at the bottom.

The Licensed Professional’s Order

Only a licensed health care professional can complete the order section. The form’s checkboxes list three practice categories: Physician/Surgeon, Podiatrist, and Dentist.² The underlying IHSS statute (Welfare and Institutions Code Section 12300) and MPP use broader language, referring to any licensed health care professional lawfully authorized to order the services, which can include registered nurses, physical therapists, and occupational therapists whose licenses cover the specific task.³ If your provider’s license category is not one of the three checkboxes, call your county social worker in advance to confirm how to submit the order.

You have the right to choose the professional who writes the order. They do not need to be a Medi-Cal provider, but if they aren’t, you pay any fee the office charges to complete the form.¹

For each paramedical task, the professional fills in four fields:

Type of service, described plainly (for example, “administer insulin injection” or “catheter change”)
Time required per occurrence, in minutes
Frequency, stated as a number of times per day, week, or month
Duration of the order (for example, “12 months” or “ongoing”)

Those time and frequency figures determine how many monthly hours the county adds to your care plan, so the numbers should reflect what the procedure actually takes.² Round estimates that don’t match real procedure times are among the fastest ways to trigger a county review or a reduced authorization.

The professional then signs a certification confirming they hold a current California license, that the ordered services fall within their scope of practice, and that they have informed you of the risks of having an unlicensed IHSS provider perform these tasks. The form warns the professional that IHSS providers are not licensed to practice a health care profession and will rarely be trained in health care services, and that the signing professional will be responsible for directing the paramedical services going forward.² There is no separate training verification box on the SOC 321; the signature is treated as acceptance of the training and supervision responsibility.³

Signing the Informed Consent

At the bottom of the form is the “Patient’s Informed Consent” section. You (or your guardian or conservator) sign here to acknowledge that the professional has explained the risks of an unlicensed provider performing these tasks and that you consent to the arrangement.² The county cannot authorize any paramedical hours without both signatures on the form.¹

Submitting the Form

Once both signatures are in place, deliver the SOC 321 to your county IHSS office. You can send it yourself or have the professional’s office send it. Keep a copy before handing it over.³ If you have an in-home reassessment coming up, bringing the completed form to that visit avoids any mailing delays.

There is no statewide fax number or online upload portal for the SOC 321. Contact your county IHSS office for their preferred submission method, which is typically mail, fax, or in-person drop-off.

What Happens After You Submit

The social worker reviews the professional’s order for completeness and compares the requested task times against program guidelines. The county must issue a Notice of Action approving or denying the request within 30 days of the date the application is signed.⁴ That notice tells you how many paramedical hours have been added to your monthly care plan.

Paramedical services should start as soon as the county receives the completed form.³ The regulations also allow retroactive reimbursement. If you received paramedical care after your application date but before the county formally authorized hours, those costs can be reimbursed as long as the care matches the eventual authorization.¹

How Long the Order Lasts

The SOC 321 has no printed expiration date. The duration is whatever the professional wrote in the “How Long Should This Service Be Provided?” field.² “12 months” means 12 months. “Indefinite” or “ongoing” keeps the order in effect until the county reassesses your case.

IHSS reassessments generally happen every 12 months, though counties can extend the interval up to 18 months for stable cases or shorten it when needs are expected to change.⁵ At reassessment, the social worker may ask for a new SOC 321 if the previous order has expired or your condition has changed. If a new procedure is prescribed between reassessments, or an existing task is no longer needed, file a new SOC 321 then rather than waiting for the annual review.

If the County Denies or Reduces Hours

If the county denies your paramedical request or authorizes fewer hours than the professional ordered, you can request a state hearing within 90 days of the date on the Notice of Action.⁶ Three ways to request one:

Online through the CDSS hearing request portal at acms.dss.ca.gov
By phone to the State Hearings Division at (800) 743-8525
By mail to the California Department of Social Services, State Hearings Division, P.O. Box 944243, Mail Station 9-17-442, Sacramento, CA 94244-2430

You can also complete the hearing request form printed on the back of the Notice of Action.⁶

If the county is reducing or terminating paramedical hours you already receive, timing matters. To keep your current hours in place while the appeal is pending (called “aid paid pending”), request the hearing before the effective date of the change on the Notice of Action. File after that date and your hours drop to the new level until the hearing decision comes back.⁷ Read the notice the day it arrives and count backward from the effective date. That deadline is not flexible.

1
California Department of Social Services. California Code of Regulations Social Services Standards 30-757
2
California Department of Social Services. Request for Order and Consent – Paramedical Services
3
Disability Rights California. Paramedical Services through the IHSS Program
4
California Department of Social Services. Paraphrased Regulations – Social Services
5
California Department of Social Services. All-County Information Notice No. I-69-04
6
California Department of Social Services. State Hearing Requests
7
Disability Rights California. How to Prepare for IHSS Terminations or Reductions in Hours