Revision of SOC 473 CAPI form

The California Department of Social Services has issued a revised SOC 473 form for screening of Cash Assistance Program for Immigrants (CAPI) Household Expenses and Contributions form.

Among other things, the new SOC 473 form:

Defines key terms for the CAPI program.

Screens for the Medicaid Medical Facility payment standard.

Screens for the out of home payment standard.

Screens for separate household status of people living in the same household as a CAPI applicant.

CDSS also clarified its policy regarding when a CAPI applicant is unable to obtain third-party verification.  When the applicant or recipient is unable to obtain required documentation from a third party, the county should obtain a written statement under penalty of perjury from the claimant stating that he or she does not have the requested information, naming the third party who does have the information, and that the applicant or recipient asked the third party for the information and the third party did not provide it.  When third parties fail to provide documentation requested by the county to determine CAPI eligibility, the county must accept the claimant’s sworn statement regarding payment of rent and rental liability.  (ACL 22-12, February 16, 2022, ACL 22-12E, August 17, 2022.)