This DHCS letter instructs counties to follow the procedures outlined previous in MEDILs I 14-23 and 14-30 when counties need to deny pending applications after ex parte reviews and two ten-day letters while CalHEERS functionality is pending. SAWS will issue interim procedures on denying pending applications.
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Affordable Care Act
DHCS MEDIL I 14-41: Immigration Documents Commonly Used by Lawfully Present Immigrants (7/21/14)
In this update letter, DHCS provides a non-exhaustive desk reference for the different examples of immigration documents that applicants may use for verification purposes. The letter includes illustrations of these documents.
DHCS MEDIL I 14-36: Using Modified Adjusted Gross Income and Express Lane Enrollment Aid Codes for Applications in the Pending Backlog (7/8/14)
In an effort to reduce the backlog of pending Medi-Cal applications, DHCS has issued this guidance to the counties on using MAGI and Express Lane Enrollment (ELE) aid codes as a manual workaround.
These aid codes are to be used when at least one member of the household has an active Medi-Cal or CalFresh aid code in MEDS and SAWS, and only when:
- At least one household member has been determined eligible or contingently eligible in CalHEERS and the entire case cannot be accepted into SAWS/MEDS because others in the household are still pending.
- The county file clears and determines the case as MAGI eligible, and CalHEERS responds that the case is pending due to data and/or technology issues with CalHEERS.
Counties cannot use this process to manually grant Medi-Cal eligibility for non-MAGI cases, limited/restricted scope cases, cases where no household member is on an active Medi-Cal/CalFresh aid code in MEDS/SAWS, or when the only eligible case members are TLICP children.
The state will send NOAs to beneficiaries granted eligibility through ELE aid codes based on this process. Counties will send NOAs to those granted eligibility under MAGI aid codes. All of these beneficiaries will receive intake packets.
DHCS ACWDL 14-28: Elimination of the Deprivation Requirement for Medi -Cal Linkage for the Modified Adjusted Gross Income Parent/Caretaker Group and the Aid to Families with Dependent Children-Medically Needy Program (7/7/14)
DHCS released this letter to clarify that the previous deprivation of requirement was eliminated as of January 1, 2014, as part of the implementation of the Affordable Care Act. Prior to January 1st, family linkage to 1931(b) or AFDC-MN programs was established when a child was deprived through absence, death, incapacity or unemployment/underemployment of at least one parent in the child’s family. With the ACA, Parent/Caretaker and AFDC-MN eligibility is established when the parent/caretaker lives with the child for whom s/he provides care.
The letter also discusses the effects of this rule change on pregnant women, stepparents, and Sneede v. Kizer cases. DHCS provides 8 examples on determining program linkage.
DHCS APL 14-007: Dual-Eligible Special Needs Plans (6/26/14)
The Department issued this letter to Medi-Cal Managed Care plans providing guidance on D-SNPs as the state adopts the Coordinated Care Initiative and Cal MediConnect for dual eligibles. D-SNPs in non-CCI counties will continue to operate per contract. Contracts for D-SNPs in CCI counties depend on whether that D-SNP is also a Cal MediConnect plan.
DHCS MEDIL I 14-38: Department of Health Care Services (DHCS) Waiver Change Information (6/25/14)
DHCS released this letter to provide information about seven different DHCS Waivers constituting Home and Community-Based Services and Long-Term Care Services and Supports programs. Waivers coming up for renewal this year are being renewed for a five-year period. The letter describes each of the waiver programs and provides information on how to access Long Term Care services and how a client may apply for waiver services.