CalWORKs overpayment collection threshold and discharge

The California Department of Social Services (CDSS) has issued guidance regarding the CalWORKs overpayment collection threshold and discharge policies.  This guidance supersedes ACL 19-19.

Effective July 1, 2019, the overpayment collection threshold for closed CalWORKs cases is increased from $35 to $250. Counties cannot demand collection of any non-fraudulent overpayments with a balance of $249 or less if the liable individual is no longer receiving CalWORKs.  The $250 threshold includes claims related to Welfare-to-Work supportive services.  The overpayment collection threshold applies to each individual claim, not to the total of multiple overpayment claims.

There is also a new discharge process for CalWORKs overpayments.  If the liable individual has not received CalWORKs for 36 consecutive months or longer, the county must deem a non-fraudulent CalWORKs overpayment uncollectable and must discharge it.  This rule applies even when there is a repayment agreement or a civil judgment if the overpayment is non-fraudulent.  This discharge rule applies to each individual overpayment claim, not to the total of multiple overpayment claims.  Counties must send a notice of action informing individuals when they are no longer liable for the overpayment.

The discharge policy does not apply to cases where fraud is alleged.  If a fraud investigation is pending when the 36 month timeframe occurs, collection is placed in suspense until the result of the investigation.  Collection can restart if the investigation determines there was fraud.

The discharge policy is not effective until it is programmed into the new single statewide computer system CalSAWS. However, when the discharge policy is programmed into CalSAWS, counties must apply it retroactively to any outstanding non-fraudulent CalWORKs overpayments established on or after December 1, 1996.

In addition, effective July 1, 2019, counties must now report any mass overpayment of CalWORKs benefits to CDSS.  A mass overpayment is an overpayment caused by the same action or inaction that impacts either eight percent of the county’s CalWORKs caseload or more than 1,000 CalWORKs recipients, whichever is greater.

Also effective July 1, 2019, a civil or criminal welfare fraud action cannot be commenced if case record, or any consumer credit report used in the civil or criminal case for the purpose of determining the overpayment, has not been made available or has been destroyed after the three year retention period.

These policies also apply to Refugee Cash Assistance, Entrant Cash Assistance and Trafficking and Crime Victims Assistance Programs.  (ACL 19-102, November 12, 2019.)

Fiscal year 2020 Income Reporting Threshold

The California Department of Social Services (CDSS) has issued the new Income Reporting Threshold (IRT) amounts for federal fiscal year 2020.  The IRT is the amount that triggers reporting requirements mid-period.  The new IRT levels are effective October 1, 2019.

Assistance Units are required to report when their total combined earned and unearned income exceeds the IRT amount.  Assistance Units with only unearned income are not required to report when that income by itself exceeds the IRT mid-period.

When a family receives income over the IRT amount and reports it to the county, the county must determine of the reported income is reasonably anticipated to continue.  If the income over the IRT will continue but not at a level that will result in ineligibility, the county must use the new reasonably anticipated income to recalculate the grant.

Counties must send an informing notice to recipients that is individualized for each assistance unit.  Counties must inform recipients of their IRT at least one per semi-annual reporting period or whenever their IRT changes.  The IRT level in which the recipient was last notified is used for reporting purposes until the county has informed the recipient of a change to their IRT.

These instructions also apply to Refugee Case Assistance, Entrant Cash Assistance and Trafficking and Crime Victim Assistance Programs.  (ACL 19-85, August 15, 2019.)

CalWORKs grant cost of living increase

Effective July 1, 2019, the Minimum Basic Standard of Care (MBSAC) that used to determine CalWORKs grants will increase by 4.15 percent.  This increase is annual cost of living increase.  The Income In Kind level will also increase by 4.15 percent.

If county computer systems are unable to implement the new MBSAC level by July 1, counties must take immediate steps to review and correct any applications denied on or after July 1 if the only reason for the denial was failure to pass the financial eligibility income test because of the MBSAC or Income In Kind amounts used.

This change is a county initiated mid-period change and should be used prospectively as soon as timely and adequate notice can be provided.

This change also applies to Refugee Cash Assistance, Entrant Cash Assistance and Trafficking and Crime Victims Assistance Program benefits.  (ACL 19-47, May 15, 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.)

SOGI self-identification

The California Department of Social Services has issued instructions implementing voluntary self-identification of sexual orientation and gender identity (SOGI).  Although counties must ask about SOGI, applicant or recipient responses are voluntary.  CDSS has created form CW 2223 for this purpose.  Counties must use the CW 2223 for applications and redetermination/recertifications.  All primary caretaker relatives, including minor parents/caretaker relatives, who elect to disclose this information complete their own CW 2223 form.  Applicants and recipients must be given the opportunity to complete the form regardless of whether the application or redetermination/recertification is done by phone, in person or on line.  For example, if the interview is done by phone, the form should be mailed to the client.

The CW 2223 is not programmed into the county computer systems.  The letter contains instructions for how county workers need to enter the information into the computer systems. 

For CAPI only cases, the CAPI application includes optional SOGI questions so the CW 2223 form does not need to be used.

Counties should do periodic training of front line staff on SOGI sensitivity and best practices.  According to CDSS, some best practices include explaining why the questions are being asked and that the responses are confidential, and using gender-neutral language such as partner or significant other.  (ACL 18-133, November 8, 2018.)

Hearing representative responsibilities and privileges process

The California Department of Social Services (CDSS) has issued clarification about county hearing representative responsibilities before a hearing.  The county hearing representative initially impartially reviews the hearing request.  After the review, the hearings representative either orders the county to take corrective action or defends the action at hearing.  The county hearings representative also provides claimants with information about the hearing process, including preparing a position statement.

The county hearings representative ensues that aid paid pending is paid when appropriate, identifies the issues raised in the hearing request, reviewed the disputed action(s) based on available evidence and regulations, and determines whether the case can be resolved or should proceed to hearing.

The county hearings representative also must provide reasonable accommodations for claimant’s disabilities, and services for limited English proficient claimants, including using forms that have been translated and using an interpreter for communication with the claimant at no cost to the claimant.

If the hearings representative cannot identify the issues from the hearing request, the hearings representative should attempt to contact the claimant to discuss the case.  If the hearings representative cannot reach the claimant, the hearings representative should review the case file for 90 days prior to the hearing request to determine issues.  If the hearings representative still cannot determine the issues, the hearings representative should write a limited position statement for the hearing. If the issues are identified on the day of the hearing and the hearings representative and claimant cannot reach a resolution, the hearings representative can request postponement of the hearing.

If the hearings representative determines the county action is correct, the county hearings representative should contact the claimant to explain the basis for the county action.  The hearings representative cannot imply that the claimant cannot or should not proceed with the hearing.  The hearings representative can explain the claimant’s right to withdraw if the claimant states they do not want to proceed with the hearing, but the county hearings representative cannot request a withdrawal.

If the hearings representative determines the county action is incorrect, the county representative must contact the case worker to take corrective action.  The county hearings representative must also contact the claimant to resolve the case without a hearing.  If that resolution is a conditional withdrawal, the language of the conditional withdrawal must be specific regarding the duties of the county and claimant for the action to be corrected.  A conditional withdrawal that states the county will re-review its action is insufficient. Conditional withdrawals should be in writing.  The county must ensure that corrective action is completed within 30 days.  If the claimant still chooses to attend the hearing, the hearings representative must be prepared for the hearing.

The hearings representative should inform the claimant of their right to review the case file and provide that access in two business days.  If the hearings representative withholds documents from the claimant pursuant to a claim of privilege, the hearings representative must prepare and give to the claimant a form identifying the withheld documents and the basis of the claim of privilege or confidentiality.  Welfare fraud investigation information from an active investigation is confidential unless that information has been used or relied on by the county in making its decision to take administrative action.  When the claimant challenges a county claim of privilege or confidentiality, the administrative law judge will convene an in camera proceeding to adjudicate that claim.

Finally, CDSS has issued guidelines for the content and format of county position statements for hearings.  (ACL 17-102, September 29, 2017.)