Home Services Hearing Aid Coverage for Children Program Hearing Aid Coverage for Children 

Hearing Aid Coverage for Children 

HACCP home

Program Resources for Community Partners

HACCP Annual Eligibility Review (AER) Application

English | Instructions
Spanish | Instructions
Armenian | Instructions
Arabic | Instructions
Chinese | Instructions
Farsi | Instructions
Hindi | Instructions
Hmong | Instructions
Japanese | Instructions
Khmer (Cambodian) | Instructions
Korean | Instructions
Laotian | Instructions
Mien | Instructions
Punjabi | Instructions
Russian | Instructions
Tagalog | Instructions
Thai | Instructions
Ukrainian | Instructions
Vietnamese | Instructions

DHCS 8711 – HACCP Application (fillable PDF)

  • English
  • Spanish
  • Additionally, HACCP’s Online Application Portal is available in: English, Español, 繁體中文, 한국어, Tiếng Việt, Русский, Hmoob, Հայերեն, العربية, Tagalog, Українська, فارسی, ខ្មែរ, ລາວ, 日本語, हिंदी, ਪੰਜਾਬੀ, ภาษาไทย, and Mienh waac.

DHCS 8482 – HACCP Provider Referral for Patient Enrollment (fillable PDF)

  • Please note: We recommend printing this form on the reverse side of any flyer for families, to make it even easier for families to document their child’s referral for hearing aids and apply for coverage.

Handouts

HACCP Flyer for Families: How to Qualify for Hearing Aid Coverage

HACCP Application (fillable PDF)

HACCP application (English)
HACCP application (Spanish)
HACCP Provider Referral for Patient Enrollment 
(We recommend printing this form on the reverse side of any flyer for families, to make it even easier for families to document their child’s referral for hearing aids and apply for coverage.)

HACCP Overview Brochures

English
Spanish
Armenian
Arabic
Chinese
Farsi
Hindi
Hmong
Japanese
Khmer (Cambodian)
Korean
Laotian
Mien
Punjabi
Russian
Tagalog
Thai
Ukrainian
Vietnamese

HACCP Communications Toolkit

* To request a copy of the Communication Toolkit in any other threshold language, please contact HACCP by phone (multilingual, TTY/TTD) at 1 (833) 956-2878, or by email at HACCP@maximus.com. The call center is open Monday through Friday from 8 a.m. to 7 p.m., and Saturdays from 8 a.m. to 12 p.m.

Social Media 

Action Plan

Webinars Schedule

Future webinars are on hold at this time. If you have any HACCP-related questions, please contact HACCP@dhcs.ca.gov. 

Events Archive

Assistive Services

For individuals with disabilities, DHCS will provide assistive devices such as sign-language interpretation, real-time captioning, note takers, reading or writing assistance, and conversion of training or meeting materials into Braille, large print, audiocassette, or computer disk.

DHCS offers free alternative format and language services. Services available:

  • Language interpretation
  • Assistive devices
  • Sign-language
  • Real-time captioning
  • Note takers
  • Reading or writing assistance
  • Braille
  • Large print
  • Audio
  • Electronic format

To request these services contact:

Department of Health Care Services
Hearing Aid Coverage for Children Program
PO Box 138000, Sacramento, CA 95813
(833) 956-2878
haccp@maximus.com

Note: Some services may be unavailable if a request is made less than ten business days before the meeting or event