Makes note of the $30 Substantial Gainful Activity increase to $860 per month (effective January 1, 2006) and clarifies that, even where severe medical conditions exist, an applicant will not be considered disabled if he or she has average monthly earnings at or above the SGA level. [Download]
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Author: Brian Lawlor
ACWDL 05-32: Section 1115 Demonstration Application Template – Evacuees of Hurricane Katrina (10/5/05)
Reminds counties that, pursuant to the Lynch v. Rank lawsuit, every potentially eligible Pickle person must receive a Pickle Medi-Cal notice for three consecutive years. The letter also announces that individuals listed during years previous to the most recent three will be dropped from the Pickle Tickler report and a year’s worth of ineligibles will be purged each year. Lynch also requires that each person on the Pickle Tickler listing who has an active Medi-Cal case or who brings the Tickler notice into the county welfare department to apply under the Pickle Amendment shall have an eligibility determination completed.[Download]
ACWDL 05-28: Medi-Cal Changes Due to a Property Change in the SSI program (8/29/05)
Effective April 1, 2005, all Medi-Cal programs that use SSI property rules (Pickle, Disabled Adult Child, Disabled Widow(er), and 250% Working Disabled) are to adopt the following changes:
· The definitions of “Household goods” and “personal effects” have been broadened and, regardless of their dollar value, no longer count as resources.
· The $500 limit for items of unusual value has been eliminated. [Download]
ACWDL 05-24: Processing Qualified Medicare Beneficiary Cases When Eligibility Has been Erroneously Discontinued (8/5/05)
Directs counties how to reinstate eligibility for Qualified Medicare Beneficiary Program (QMB) cases that are erroneously discontinued through no fault of the beneficiary. Eligibility can be reinstated for months when the beneficiary should have been receiving benefits. Medi-Cal must retroactively pay for all past-due Medicare premiums. [Download]
Block Transfer Filings, 28 C.C.R. § 1300.67.1.3
This regulation, which became effective in August of 2005, establishes standards for redirecting enrollees to one or more contracting providers when their health plan terminates or does not renew the contract with their provider group or hospital. The regulation applies to transfers of 2,000 or more enrollees. Among other provisions, it requires health plans to file with the Department of Managed Health Care, no later than 75 days before the termination, a detailed transition plan to ensure continuity of care for enrollees. It also requires plans to mail notices of the transfer to affected enrollees at least 60 days prior to the proposed termination date. [Download]
HUD PIH Notice 2006-5(HA) – Implementation of the 2006 HUD Appropriations Act (Public Law 109-115); Funding Provisions for the Housing Choice Voucher Program (January 13, 2006)
“This Notice implements the Housing Choice Voucher (HCV) program funding provisions resulting from enactment of the Federal Fiscal Year (FFY) 2006 HUD Appropriations Act … signed into law on November 30, 2005.” Among other things, this Notice describes the method by which HUD will allocate funds for FFY 2006 to public housing authorities (PHAs) consistent with the HUD Appropriations Act. Most important for housing advocates and PHA directors and staff is the provision permitting a PHA to apply to HUD for funds to adjust (increase) its baseline funding allocation. Congress has appropriated $45 million dollars for such adjustments. The adjustments are available only to (1) adjust allocations for Calendar Year 2005 renewal funding that was based on leasing and cost data averaged for the months of May, June and July of 2004 which, due to temporarily low leasing levels during these months did not accurately reflect actual leasing levels and costs for such period; and (2) adjust allocations for PHAs that experienced a significant increase in renewal costs from unforeseen circumstances or portability.
Is that crystal clear? The bottom line is that the application deadline for adjustment funds is close of business (5:00 p.m. EST) January 31, 2006. So, advocates and PHAs in jurisdictions that may be eligible should take note and act quickly. Surprisingly, the application form which is attached to this Notice is short and simple. [Download]