As an IHSS Care Provider, you can now request certain changes without having to come in to the office or call us!
Please see below for form submission instructions
Effective February 1st, 2019
We will no longer be accepting the following forms in our Public Authority Office Lobby:
Direct Deposit (do not submit to county office; see form for return instructions)
As not all forms are submitted to the County Office, please see below for specific submission instructions
IHSS Existing Provider Packet
If you are an active IHSS Care Provider, and will be caring for a new Recipient, you will not need to enroll as a new provider again. Simply complete the IHSS Existing Provider Packet.
Once completed and signed by the Recipient, the form can be submitted by
County of Fresno Department of Social Services
P.O. Box 1912
Fresno, CA 93718-9889
or by fax to:
After you have submitted your packet, please allow 2 weeks processing time to you receive your first set of timesheets.
IHSS Recipient & Care Provider Request Form
Please complete the IHSS Recipient & Care Provider Request Form to make the following requests:
Change of Address or Telephone Number
As an IHSS Care Provider you are required to inform us of any change in your contact information by completing and signing the IHSS Change of Address and/or Telephone within ten (10) days.
Employment & Wage Verification
It is important to remember that the County of Fresno and Department of Social Services In-Home Supportive Services (IHSS) ARE NOT THE EMPLOYER. However, verification that the care provider is and/or has been employed by one or more recipients of the IHSS program can be provided.
Workweek & Travel Time Agreement
Providers who work for multiple recipients will need to complete and sign a Workweek & Travel Time Agreement. This agreement explains the workweek and travel time limitations, and includes areas for you to plan your workweek schedule and record the estimated travel time between recipients’ locations each week. Completing the SOC 2255 will help make sure that you do not work more or travel more than you are allowed to each workweek.
Once completed and signed, forms can be submitted by:
USPS mail to:
Department of Social Services
IHSS - Public Authority
P.O. Box 1912
Fresno, CA 93718-1912
IHSS - Public Authority
As an IHSS Care Provider, you can request that your payments are automatically deposited into your checking or savings account instead of being sent to you through the mail. What are the advantages of direct deposit? Your payroll checks can't get lost in the mail or stolen from your mailbox, purse or pocket. You may have access to your money sooner because you don't have to wait for the check to arrive through the mail.
If you would like to enroll via paper form you can Download Direct Deposit Forms. Please remember that you must submit a separate form for each IHSS Recipient that you want payments to be directly deposited for. If there are no timesheets submitted for 60 days, you will be dis-enrolled from direct deposit and will have to re-enroll. Once all sections of the form are complete please sign, date and mail to:
Provider Forms Processing Center
PO Box 1697
West Sacramento, CA 95691-6697
NEW! Direct Deposit Online Enrollment Service is Now Available!
Beginning February 12th, 2018, IHSS Care Providers now have the option of enrolling for Direct Deposit Online! The new Online Direct Deposit Enrollment Service allows current, active IHSS/WPCS providers in all California counties the ability to electronically enroll, change or dis-enroll by using the website, instead of using a paper form.
1. You must be registered on the ESP Website
2. You must be actively working for an IHSS and/or WPCS recipient
3. Have an open checking or savings account
4. Have your Bank Name, Account Number and the Routing Number
5. IHSS Providers are eligible for direct deposit if they meet the following requirements:
If you have questions about IHSS Direct Deposit, you can call the Provider Direct Deposit Help Desk during business hours at 1-866-376-7066 (select option 2 for Direct Deposit assistance).
As an IHSS Care Provider, you have the option to complete a W-4 and DE 4 to have Federal & State taxes withheld from your wages.
Once completed and signed, W-4/DE 4 forms should be submitted by mail to:
IHSS Payroll Management Unit
PO Box 1660
West Sacramento, CA 95961-6660
Instructions for completing your W-4 & DE-4. Unfortunately, we cannot provide any tax advice, please contact the IRS or your tax preparer for questions regarding withholdings or exclusions. For more information, please visit the IRS website (www.irs.gov).