A Sample IHSS Notice of Action, Explained
Published by IHSSHours.com ·
Every decision about IHSS hours arrives the same way: a Notice of Action (NOA) in the mail. It is the most important letter the program sends, and almost nobody explains how to read it. Below is a sample change notice (form NA 1253, the one counties use when hours go up or down) for a fictional recipient, followed by what each part means and the two deadlines that start the day it is dated.
Everything on the sample is invented. Eleanor Vasquez, her case number, her social worker and her hours do not exist. The layout and the column headings follow the real CDSS form; the figures are illustrative only.
California Department of Social Services
This notice relates ONLY to your In-Home Supportive Services.
As of 07/01/2026 2 the services you can get and/or the amount of time you can get for services has changed.
Total Hours:Minutes of IHSS you can get each month is now: 101:59 3. This is a decrease of 16:46.
The “Authorized Amount of Service You Can Get” column shows what you got before (WAS), what you get now (NOW), and the difference (+/–). A zero, or an amount lower than “Total Amount of Service Needed,” is explained on the following page(s). Not Needed means the social worker found no need for help with that task (MPP 30-756.11). Pending means the county is waiting for more information. 4
On a phone, three middle columns (proration, need, refused) are hidden. Turn the phone sideways to see them.
| Service (hours:minutes) | Total amount of service needed | Adjustment for others who share the home (proration) | Amount of service you need | Services you refused or get from others | Authorized — NOW 5 | WAS | +/– |
|---|---|---|---|---|---|---|---|
| Domestic Services (per MONTH) | |||||||
| Domestic (housework) | 6:00 | 0:00 | 6:00 | 0:00 | 6:00 | 6:00 | 0:00 |
| Related Services (per WEEK) | |||||||
| Prepare meals | 7:00 | 0:00 | 7:00 | 0:00 | 4:30 | 7:00 | –2:30 |
| Meal clean-up | 1:45 | 0:00 | 1:45 | 0:00 | 1:45 | 1:45 | 0:00 |
| Routine laundry | 1:00 | 0:00 | 1:00 | 0:00 | 1:00 | 1:00 | 0:00 |
| Shopping for food | 1:00 | 0:00 | 1:00 | 0:00 | 1:00 | 1:00 | 0:00 |
| Other shopping / errands | 0:30 | 0:00 | 0:30 | 0:00 | 0:30 | 0:30 | 0:00 |
| Non-Medical Personal Services (per WEEK) | |||||||
| Respiration assistance | Not Needed | 0:00 | 0:00 | 0:00 | |||
| Bowel, bladder care | Not Needed | 0:00 | 2:20 | –2:20 | |||
| Feeding | Not Needed | 0:00 | 0:00 | 0:00 | |||
| Routine bed bath | Not Needed | 0:00 | 0:00 | 0:00 | |||
| Dressing | 1:45 | 0:00 | 1:45 | 0:00 | 1:45 | 1:45 | 0:00 |
| Menstrual care | Not Needed | 0:00 | 0:00 | 0:00 | |||
| Ambulation (help walking, in/out of vehicles) | 5:50 | 0:00 | 5:50 | 0:00 | 4:00 | 5:50 | –1:50 |
| Transferring (in/out of bed, on/off seats) | 1:10 | 0:00 | 1:10 | 0:00 | 1:10 | 1:10 | 0:00 |
| Bathing, oral hygiene, grooming | 4:40 | 0:00 | 4:40 | 0:00 | 3:30 | 4:40 | –1:10 |
| Rubbing skin, repositioning | 2:00 | 0:00 | 2:00 | 0:00 | 2:00 | 2:00 | 0:00 |
| Help with prosthesis / setting up medications | Not Needed | 0:00 | 0:00 | 0:00 | |||
| Accompaniment (per WEEK) | |||||||
| To/from medical appointments | 1:00 | 0:00 | 1:00 | 0:00 | 1:00 | 1:00 | 0:00 |
| To/from places you get services in place of IHSS | Not Needed | 0:00 | 0:00 | 0:00 | |||
| Protective Supervision (per WEEK) 6 | Not Needed | 0:00 | 0:00 | 0:00 | |||
| Paramedical Services (per WEEK) | Not Needed | 0:00 | 0:00 | 0:00 | |||
| Total weekly hours:minutes of service you can get | 22:10 | 26:00 | –3:50 | ||||
| Multiply by 4.33 (average weeks per month) to convert to monthly hours:minutes 7 | 95:59 | 112:35 | |||||
| Add monthly domestic hours:minutes (from above) | 6:00 | 6:00 | |||||
| TOTAL HOURS:MINUTES OF SERVICE YOU CAN GET PER MONTH | 101:59 | 118:45 | –16:46 | ||||
Time-limited services (heavy cleaning, yard hazard abatement, removal of ice or snow, teaching and demonstration): 0:00 per month.
Reasons for this change (page 2 of the real notice, summarized here): Prepare meals reduced because the recipient can now sit and assist with simple preparation (MPP 30-757.13). Bowel and bladder care found not needed; recipient reports independence with toileting (MPP 30-757.14(a)). Ambulation and bathing reduced after reassessment of the time needed (MPP 30-757.14). Protective Supervision not needed: no finding of a mental impairment requiring 24-hour supervision (MPP 30-757.17). 8
If you think this action is wrong, you can ask for a hearing. The back of this page tells how. 9
Your hearing rights (back of the notice, “NA Back 9”)
You have 90 days from the date of this notice to ask for a state hearing. If you ask within 10 days of the notice date, or before the date the change takes effect, whichever is later, your services stay at the old level until the hearing decision (“aid paid pending”). If you then lose, you may have to pay back the difference. To ask: call the State Hearings Division at 1-800-743-8525 (TDD 1-800-952-8349), file online, or mail the request form on this page. You may bring a friend, relative, advocate or lawyer; free legal help may be available from your local legal aid office.
NA 1253 (11/12) · IHSS CHANGE · Page 1 of 2 — Sample layout prepared by IHSSHours.com. Not an official document. Figures are fictional.
Reading it, callout by callout
- 1
Notice dateBoth deadlines count from this date, not from the day the envelope arrived. Write it on the front of the envelope the day you open it. A notice dated May 28 gives you until August 26 to request a hearing.
- 2
Effective dateThe day the new hours start. Counties must give advance notice of a reduction, so this is usually at least 10 days out, often the first of the next month. It is also the second half of the aid-paid-pending rule: if you request a hearing before this date, your old hours continue.
- 3
Total monthly hoursThe one number everyone looks for. It is what the recipient can use in a month and what the provider's timesheets are measured against. Divided by four, it is the provider's weekly maximum (the number on the provider's SOC 2271 and in our Provider Toolkit). It is not the recipient's assessed need; that is the first column of the table.
- 4
Not Needed vs. Pending“Not Needed” is a finding that the task takes no help at all, and it is appealable like any other line. “Pending” means the county is still waiting for something, usually a medical form such as the SOC 821, and the line will be decided later. Pending lines are not a denial yet, so ask the social worker what is missing.
- 5
The three authorized columnsNOW is what you get from the effective date. WAS is what you had. The +/– column is where the reduction hides: a notice can say “decrease of 16:46” at the top while the real story is four separate lines, each cut a little. Appeal the lines, not the total.
- 6
Protective SupervisionA “Not Needed” here is the single largest swing on any notice, because PS is authorized in large weekly blocks when it applies. If the recipient has a cognitive condition such as dementia and cannot be left alone safely, this line is the one to appeal first. Our guide: Protective Supervision.
- 7
The 4.33 conversionWeekly services are multiplied by 4.33 (the average number of weeks in a month), then domestic hours, which are assessed monthly, are added. This is why a weekly cut of 3:50 becomes a monthly cut of 16:46. The Hours Estimate (14-day money-back guarantee) does the same arithmetic.
- 8
The reasons pageThe real notice puts the reasons on page 2, each with a regulation number (MPP 30-757.xx). Those citations are the shape of the appeal: a State Hearing is about whether the county applied that rule correctly to the facts. Keep page 2; it is the part the county will argue from.
- 9
The back pageThe hearing rights are printed on the back of page 1. Nothing on the front says how long you have, so people throw the notice away without turning it over. 90 days to request a hearing; 10 days (or before the effective date) to keep the old hours while you wait.
What to do with yours
If the hours went up or stayed the same: file it with your assessment paperwork and give the provider the new total. Providers: update the number in your timesheet planner; your county will send you a SOC 2271 with the same figure.
If the hours went down or a line says Not Needed: you have 90 days, and 10 days matter most. Our appeal guide walks through the hearing request; the sample Appeal Package is built around this very notice, so you can see what a line-by-line dispute of the cuts above looks like. If the notice is a surprise, the Hours Estimate (14-day money-back guarantee) gives you an independent read on what the assessment should have found.
If a line says Pending: call the social worker at the number in the header and ask exactly what document is outstanding. A pending line decided later comes with its own notice and its own deadlines.
Keep every notice. The WAS column on the next one is only as useful as your copy of this one.
- CDSS form NA 1253 (11/12), Notice of Action, IHSS Change — the layout, column headings, service rows and the Not Needed / Pending definitions above are taken from it.
- Aid Paid Pending and the State Hearing process on IHSSHours.com, for the 10-day and 90-day rules (MPP 22-009, WIC 10951).
Educational information, not legal advice. The sample is fictional; your notice may differ in layout by county and revision. Official program information: cdss.ca.gov.