Yearly Archives: 2017

IHSS overtime exemption for extraordinary circumstances

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CDSS has issued instructions about the IHSS overtime exemption for extraordinary circumstances.  The criteria and initial instructions for the IHSS overtime exemption for extraordinary circumstances are in ACL 16-22, summarized here.

CDSS’ new instructions address renewal of an extraordinary circumstances exemption.  All conditions on which the exemption was initially granted must remain the same for an exemption to be renewed.  If there has been any changes, the county must submit to CDSS a referral for a new exemption instead of renewal of the existing exemption.

Prior to submitting the renewal request, the recipients must explore and exhaust all options for hiring additional providers in the same manner as for the initial exemption request.  This includes contacting relatives, friends, neighbors or other people the recipient knows about their willingness to be a provider, contacting provider registries both in the county where the recipient lives and in neighboring counties, and utilizing alternative resources such a Regional Center services, to address issues with the recipient’s ability to tolerate an outside provider.

CDSS eliminated the requirement to perform a renewal at the next face-to-face reassessment when reassessment occurs before the end of the six month or one year period of the exemption.  However, requests for renewals must be submitted to CDSS by the county no less than 30 days before the exemption ends.

CDSS also clarified that counties determine when to submit exemption requests to CDSS and the county shall not submit either an initial referral or request to renew to CDSS if the county decides other resources are available.  (ACL 17-13, April 7, 2017.)

Medi-Cal Disregard Program for Unmarried Pregnant Women under 21

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Unmarried pregnant women under the age of 21 and not otherwise eligible for Medi-Cal can be eligible for full-scope or pregnancy-related Medi-Cal.  Such potential beneficiaries must either be living with parents and not filing a tax return for the year, or will be claimed as a tax dependent by parents for the tax year.  For this group, DHCS will disregard all household income.  Beneficiaries will be assigned to aid codes M7 or M8, depending on immigration status.

This program is effective August 1, 2016.

DHCS ACWDL 17-06 (March 1, 2017).

Confirmation number for IHSS applications

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CDSS has issued instructions implementing AB 1797 about confirmation numbers for IHSS applications.  AB 1797 added Welfare and Institutions Code Section 12301.16 that requires counties to provide HIS applicants with a confirmation number upon receipt of an IHSS application.

CDSS will use the case number that is randomly assigned by the CMIPS II computer system as the confirmation number.  CDSS developed a notice called “Notice of Application Confirmation Number (SOC 2300)” for IHSS agencies to use when providing notification of the application confirmation number.  Counties must provide the confirmation number either verbally before the end of a telephone call during which an IHSS application is taken or in writing when the application is entered into CMIPS II.  (ACL 17-18, February 16, 2017.)

County Welfare Department Use of Consumer Credit Reports

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NOTE — The section of this ACL regarding the Work Number being used in conjunction with, but not in lieu of, existing income and eligibility sources, is superseded by ACL 21-23.

CDSS has instructions to counties about SB 1232 regarding county welfare department use of consumer credit reports.  An example of a consumer credit report is a report from “The Work Number.”  These requirements are mandatory effective January 1, 2017.

Counties cannot obtain consumer credit reports without written authorization of the applicant or recipient.  Consumer credit reports can be used in conjunction with existing fraud detection resources.  Consumer credit reports cannot be used as the only means of verification.  The SAWS 2 Plus, CF 285 and CF 37 have been modified to include authorization for counties to obtain consumer credit reports.

If a county takes adverse action based on information in a consumer credit report, the county must provide an informing notice in addition to the notice of action.  The informing notice must include the name, address and telephone number of the consumer credit reporting agency, a statement that the consumer credit reporting agency did not make the decision, a statement of the right to free disclosure from the consumer credit reporting agency within 60 days and a statement of the right to dispute the accuracy of the information with the consumer credit reporting agency.

Information from a consumer credit report must be made available to an applicant or recipient who requests it from the county welfare department or if an applicant requests a fair hearing to regarding the information in the consumer credit report.  Note that information received from “The Work Number” is not considered verified upon receipt for CalFresh.  ACL 16-118 (December 30, 2016).

Changes to Rules Regarding the Evaluation of Medical Evidence in Social Security cases

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Social Security has finalized new regulations that dramatically change the way it evaluates evidence.  The new rules are effective for claims filed on or after March 27, 2017.  Most importantly, the new regulations eliminate the “treating physician rule” which required deference to doctors who have a treatment relationship with the claimant.   The new rule calls for evaluating opinions from acceptable medical sources by considering the supportability of the opinion and the consistency of the opinion with underlying medical records.  This evaluation is supposed to consider that the claimant has a longstanding treatment relationship with the treating source.

The new regulations add physician’s assistants, advance practice registered nurses, and, when consistent with scope of practice and state licensing rules, optometrists and audiologists.

The new regulations require express consideration of evidence from all medical sources, including evidence from sources that are not considered acceptable medical sources.  This is the only portion of the new regulations that is effective immediately for all claims.

The regulations expressly do not require a statement of how nonmedical evidence is evaluated.

The regulations state that disability evaluations from other agencies such as the Veterans Administration will no longer be given weight in Social Security’s evaluation.

The regulations repeal Social Security Rulings 96-2p, 96-5p and 96-6p.  The regulations also repeal Social Security Ruling 06-03p but state the substance of that ruling regarding evaluation of medical evidence from sources who are not considered acceptable medical sources is incorporated into the new regulations.

Revisions to Rules Regarding the Evaluation of Medical Evidence, 82 Fed. Reg. 5844 (January 18, 2017).

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Study Time for SIPS, teen participants and summer vacations

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In instructions about county data reporting, CDSS has changed its policy about counting homework time for welfare-to-work participants in Self Initiated Programs (SIPs).  A SIP is an education program started by the participant prior to welfare-to-work appraisal.  Previously, CDSS said that SIPs could not count homework time for their welfare-to-work hours.  In these data reporting instructions, CDSS states that SIPs can count homework time in the same way that any homework time is counted for any other education activity, which is actual hours spent doing homework up to one hour of unsupervised homework for each hour of class time.  Unsupervised homework time can be verified by a statement from the education program indicating the amount of homework required for the student’s course of study.  Counties can retain such statements from the education institution and use them for any student enrolled in that course of study.

CDSS also says that in a two parent household when one of the parents is a teen attending secondary school, the other parent must participate enough hours to total 35 average weekly hours.

In addition, CDSS says, for summer vacation, satisfactory progress and participation may count, regardless of the number of hours of participation, if the participant has not completed basic education requirements and is enrolled or intends to enroll as a full-time student after the school vacation.

(ACL 17-08, January 27, 2017.)