Separation of SIU and eligibility determination functions

The California Department of Social Services (CDSS) has issued a reminder to counties that management of eligibility determination and program integrity investigation must be separate.

County Special Investigative Unit (SIU) staff is responsible for preventing and discovering fraud by applicants and recipients.  SIU staff must investigate fraud allegations.  County eligibility workers are responsible for referring cases to the SIU.

The SIU must be a separate organization, independent of organizations performing eligibility and benefit determination functions.  Counties must ensure separate and independent operation of eligibility and investigation activities.  SIU staff cannot dictate CalWORKs or CalFresh eligibility determinations but can make recommendations.  (All County Welfare Directors Letter May 1, 2019.)

Reasonable accommodations in CDSS and DHCS programs

The California Department of Social Services (CDSS) and the Department of Health Care Services (DHCS) have issued a joint letter reminding counties of their obligation to ensure equal access to persons with disabilities to state and federal funded programs.  This includes providing reasonable accommodations to qualified persons with disabilities and effective communication through auxiliary aids and services.  These obligations apply to all county administered programs, services and activities funded by, or with federal pass-through funds from CDSS and/or DHCS.  These obligations also apply to county contractors and vendors that provide program benefits or services.

Counties must adopt written policies detailing how they will comply with these requirements.  Counties must have a procedure for complaints regarding disability discrimination, including failure to provide a reasonable accommodation.  Counties must inform clients of the county complaint procedure and they may file discrimination complaints with the appropriate state or federal agency.

Title II of the Americans with Disabilities Act (ADA) prohibits counties from excluding from participation, denying benefits or services to, or discriminating against any qualified person with a disability.  A qualified person with a disability is a person with a disability who, with or without accommodation, meets the essential eligibility requirements for the program provided by the public entity.  Disability is a physical or mental impairment that substantially limits one or more major life functions, a record of such an impairment or being regarded as having such an impairment.  California law defines disability more broadly by removing the word “substantially” from the definition of disability, and counties are required to follow California law.  The ADA also guarantees equal access to individuals who have a relationship or association with a disabled person.

The ADA does not require public entities to allow a person with a disability to participate if that person poses a direct threat to health or safety of others.  However, the county must determine whether a person is a direct threat only evaluating whether reasonable accommodations can mitigate or eliminate the risk.  The determination of whether a person poses a direct threat must be made based on objective factual evidence and an individualized assessment.

The ADA requires counties to make reasonable accommodations by modifying their policies, practices, or procedures when necessary to provide equal access to persons with disabilities.   This includes waiving a program rule or policy to help a person with a disability, or a change in the way a county carries out a policy or practice affecting a person with a disability.

Counties must notify all clients of the right to request reasonable accommodations and the protection against discrimination on the basis of disability.

When the county has actual knowledge of a disability or when the need for an accommodation is obvious, county staff must offer to assist with appropriate disability specific accommodations.  Counties are encouraged to train staff to identify disabilities and offer to assist identifying accommodations.

When an individual asks for a change in county policies, practices, or procedures because a disability, this request should be treated as a reasonable accommodation request.  While counties can make a reasonable accommodation request form available, counties cannot require individual to use a specific form for a reasonable accommodation request.   Reasonable accommodation requests can be made in person, by telephone or in writing by the individual or someone acting on the individual’s behalf.  It is not necessary that a person be an authorized representative to request a reasonable accommodation.  There is no limit to the number of accommodation requests a person can make, and each request must be individually evaluated.  Counties cannot impose an arbitrary limit on the duration of a reasonable accommodation.

County staff must document all reasonable accommodation requests and subsequent county actions in the individual’s case file.

If an accommodation is not immediately agreed upon, or if there is a disagreement about the appropriateness of a requested accommodation, county staff must engage in an interactive process with the individual requesting the accommodation or a person acting on their behalf.

A county can deny a reasonable accommodation request only when the accommodation would  fundamentally alter the nature of the program, service or activity, or would impose an undue financial or administrative burden taking into account all resources available to the program, service or activity.  The determination that an accommodation request would be a fundamental alternation or an undue burden must be made by the county welfare department director or designee and must be accompanied by a written statement of the reason for the decision.  If such a decision is made, the county must take alternative action to ensure that the person with a disability can access relevant benefits or services while avoiding a fundamental alteration or undue burden.

Counties cannot impose eligibility criteria that exclude or tend to screen out individuals with disabilities unless such criteria are shown to be necessary for the operation of the program.  Counties must provide programs, activities and services in the most integrated manner possible.  Counties cannot change individuals with disabilities for the cost of reasonable accommodations.

Counties must ensure effective communication with individuals who have vision, hearing or speech disabilities.   Communication with these individuals must be equally effective as communication with people who do not have these disabilities.  This requirement extends to companions of applicants or recipients.  For persons who are blind, have vision loss, or are deaf-blind, this requirement includes providing individuals with disabilities with auxiliary aids and services when necessary to communicate effectively. This can include providing written communication in large print, braille, accessible electronic format for use with a screen reader or via audio recording or a qualified reader.  For persons who are deaf, have hearing loss, or are deaf-blind, this requirement also includes providing a note taker, qualified sign language, oral, cued-speech or tactile interpreter, real-time captioning, telecommunication devices, or written materials.  For persons who have speech disabilities, this requirement includes providing a qualified transliterator.  Counties cannot require persons with communication disabilities to provide their own interpreter.  Counties may allow another adult accompanying an individual with a disability to interpret only in emergency situations or when requested by the persons with a disability.  Counties cannot rely on minors to interpret except in emergency situations when no other interpreter is available.

If counties choose to use Video Remote Interpreting, the service must meet specific technical performance standards.

Counties must consider how the individual normally communicates and must give primary consideration to a request for a particular auxiliary aid or service.

Counties must modify their policies, practices and procedures to allow individual with disabilities to use service animals on their premises.  Counties may not require certification or other proof that an animal has been trained or licensed as a service animal.  When it is not obvious what service an animal performs, county staff may only ask if the animal is required because of a disability and what work or tasks the animal is trained to perform.  (ACL 19-45, May 16, 2019.)

Use of the Work Number

The California Department of Social Services (CDSS) has issued guidance regarding use of the Work Number consumer credit report in determining initial and ongoing eligibility for various programs. 

For CalFresh, if documentary evidence of income is unavailable, for example because a household member did not provide or does not have access to necessary documentation at the time of the application or interview, the Work Number can be used to verify income in real time at application, during the certification period, at recertification, or for a Quality Control review.

Information obtained through the Work Number is not considered verified upon receipt which means the applicant or recipient must be consulted before the county can use the information.  If the information provided by the Work Number is consistent with information provided by the applicant or recipient, consultation is not necessary.  If the household confirms the information from the Work Number is accurate or there is no discrepancy, the Work Number can be used to verify income.

The Work number can be used in conjunction with, but not instead of existing required income and eligibility sources including IEVS.

Counties cannot require the household to submit additional documentation that is duplicative of information received through the Work Number.  Counties can request additional documentation only if the household states that the information is inaccurate or the Work Number does not verify all income sources.

If the county takes adverse action based on information from the Work Number, the notice of action must state the name, address and telephone number of the Work Number, a statement that the Work Number did not make the adverse decision, a statement of the right to obtain free disclosure of the consumer’s file within 60 days, and a statement of the consumer’s right to dispute the accuracy or completeness of any information provided by the Work Number.

Counties can use the Work Number to verify information received at initial application or recertification.  This can allow same day service when documentary evidence is not available on the day the application is submitted.

Counties can use the Work Number to verify a voluntary report of a change in income or to verify income information provided at periodic report.

For Quality Control reviews, counties can use the Work Number to substantiate information provided by the household or if the household refuses to cooperate.

For CalWORKs, counties can use the Work Number to verify information at application, redetermination and to determine ongoing eligibility.  The Work Number can be used to verify welfare-to-work information for Work Participation Rate purposes.  Counties can use the Work Number to verify income when transitioning clients from State One to Stage Two child care.

The Work Number cannot be used to verify a missing mandatory report of income over the Income Reporting Threshold.

For IEVS matches, if the client does not respond to the verification letter, the county can use the Work Number as the independent verification source.

The Special Investigations Unit can use the Work Number to verify information from IEVS. (ACL 19-08, February 9, 2019.)

Disability and domestic violence questions computer system flags

The California Department of Social Services (CDSS) has issued directions regarding AB 2030.  AB 2030 requires CDSS to include in any amendments or revisions to standard application or semi-annual reporting forms after January 1, 2019 that allow applicants or recipients to disclose disabilities, the need for reasonable accommodations because of a disability and any experiences of domestic violence. 

CDSS states that initial application forms and semiannual report will capture the need for reasonable accommodations the next time they are revised.

The current welfare computer system vary in how they flag reasonable accommodations.  CalWIN has an icon for disability accommodations that is displayed in the upper-right side of the “Display Individual Demographics Summary” window.  CalACES North (formerly known as C-IV) can flag cases with an indicator type that county users can select (special accommodations, special circumstances etc.)  CalACES South (formerly known as LRS) allows any county user with access to falg a case to alert the first point of contact.  These flags are identified by a banner at the top of every page.  (ACL 19-13, February 21, 2019.)

Expulsion from California State Preschool Programs

Expulsion from California State Preschool Programs

The California Department of Education (CDE) has issued instructions regarding expulsion or disenrollment from California State Preschool Programs for behavior.  These instructions implement AB 752 (2017).

Prior to expulsion or disenrollment for a child’s persistent and serious challenging behavior, the California State Preschool Program (CSPP) contractor must, within 180 days, take the following steps:

  1. Consult with the child’s parents or legal guardians and teacher to maintain the child’s safe participation in the program.
  2. Inform the parents or legal guardians of a child exhibiting persistent and serious challenging behaviors of how the CSPP will assist the child in order to safely continue to participate in the program.
  3. If the child has an Individualized Education Plan (IEP) or Individualized Family Support Plan (IFSP), and with the parent or guardian’s written consent, consult with the local educational agency or the local regional center on how to serve the child.
  4. If the child does not have an IEP or IFSP, consider (a) completing a universal screening including social and emotional development, (b) referring the parent or guardian to local community resources, and (c) implementing behavior supports, before referring the child to the local educational agency to request an assessment to determine the child’s eligibility for special education support and services, including a behavior intervention plan.
  5. If after these steps concerns about safe participation remain, the contractor will consult with the child’s parents or legal guardians, the child’s teacher, and if applicable, the local educational agency providing special education services to the child.
  6. If the contractor determines that the child’s continued enrollment would present a continued serious safety threat to the child or other enrolled children the contractor shall refer the parents or legal guardians to other potentially appropriate placements such as Resource and Referral agencies and programs, or other local referral services available in their community.
  7. Once the reasonable steps outlined above have been completed, the contracting agency may then disenroll the child, subject to the due process requirements and procedures.

CDE identified several resources regarding children with challenging behavior.  (Management Bulletin 18-06, August, 2018.)

Transfer from Stage 1 to Stage 2 child care

The California Department of Education (CDE) has issued instructions regarding transition from Stage 1 child care to Stage 2 child care. Stage 1 is child care for CalWORKs recipients participating in welfare-to-work activities.  Stage 1 is administered by the California Department of Social Services through county welfare departments or Alternative Payment Programs (APP) under contract with county welfare departments.  Stage 2 is child care for CalWORKs recipients who are found to be stable on the program or former CalWORKs recipients.  Stage 2 is administered by CDE through contracts with APPs.

Stage 2 contractors must develop efficient coordinated systems for transferring families from Stage 1 to Stage 2 to ensure that families do not experience a break in child care services.  The sending Stage 1 program and the receiving Stage 2 program are responsible for data sharing and coordination to ensure the transfer of the nine data elements needed for child care eligibility and payment.  Only those nine data elements must be received to transfer the family to Stage 2.  If the nine data elements are incomplete or are missing information, the family should continue to receive Stage 1 child care until the nine data elements are transferred.  The Stage 2 contractor cannot require the family to provide documentation to transfer to Stage 2.

When the Stage 2 contractor receives all nine data elements and informs the Stage 1 contractor that the nine data elements are complete, the family’s enrollment is transferred to Stage 2.  The family’s 12 month eligibility period for Stage 2 begins on the date the nine data elements are received and confirmed.  There is no need to for the family to complete an application for Stage 2.  Starting on the date the nine data elements received and confirmed, the Stage 2 contractor must assume full responsibility for reimbursing the provider and provide written notice informing the parent of the transfer.

Current CalWORKs recipients are categorically eligible for Stage 2 until they are certified no sooner than 12 months after transfer.  If a CalWORKs family would have their child care terminated for violation of a child care contractor’s reasonable policies, the contractor must notify the county welfare department about possible actions including transfer to Stage 1.

Families who transfer to Stage 2 as former CalWORKs recipients must report if their income exceeds 85 percent of State Median Income.  (Management Bulletin 18-05, August, 2018.)