CAPI

The end of SSI cash-out

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The California Department of Social Services has issued instructions implementing the end of SSI cash-out.  SSI/SSP recipients are ineligible for CalFresh.  Instead, SSI/SSP recipients receive an extra $10 per month in SSP benefits.  AB 1811 Sections 38-41 end the SSI cash-out.  When implemented, this change will make SSI/SSP recipients eligible for CalFresh. The change will be implemented on June 1, 2019.  If automation cannot be completed implementation can be delayed until August 1, 2019. Newly eligible households, that is new applicants in which all members are SSI/SSP recipients, will be eligible for CalFresh as of the implementation date.  If a newly-eligible SSI/SSP only household submits an application within the calendar month prior to implementation, the county must process the application but will not issue benefits until the implementation date.

SSI/SSP recipients in ongoing households will be eligible for CalFresh at the household’s next periodic report, annual recertification, or when voluntarily requested by the household.  A new application will not be required to add an SSI/SSP recipient to an ongoing household.

Grants under the Cash Assistance Program for Immigrants increase by $10 per individual and $20 per couple.  SSI/SSP recipients will be eligible for the Food Distribution Program on Indian Reservations.

All SSI/SSP recipients will be considered elderly and/or disabled household members for CalFresh purposes.

Income, resources and deductions of the SSI/SSP recipient will be considered when determining CalFresh eligibility.  Households in which all members of household receive SSI/SSP will be considered categorically eligible for CalFresh. This means that no additional verification is needed for resources, gross or net income, Social Security Number, sponsored immigrant information or residency.

Households will not be required to report termination of SSI/SSP mid-period.  However, if termination of SSI/SSP becomes known to the county it must take action mid-period.

Transitional CalFresh cases will be treated like other ongoing CalFresh cases.

Counties must provide reasonable accommodations for the disabilities of newly eligible SSI/SSP recipients. (ACL 18-90, July 31, 2018)

Expiration of indigence exception for CAPI

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CDSS has provided clarification about the process for renewal of an indigence exception in the Cash Assistance Program for Immigrants (CAPI) program.  For CAPI, if an immigrant’s sponsor has signed the New Affidavit of Support (I-864 form), the sponsor’s income and resources are deemed to the immigrant for 10 years (extended CAPI cases).  If the sponsor becomes disabled, deeming continues indefinitely (basic CAPI cases).  Counties determine the sponsor’s income and resources using the SOC 860 form.  Sponsor deeming can be suspended under the indigence exception.  When the immigrant is no longer being provided with support by their sponsor, and as a result the immigrant is no longer able to provide themselves with food and shelter, the immigrant may be eligible for the indigence exception to sponsor deeming.

The indigence exception applies 12 months after it is granted.  After 12 months, the application for the indigence exception must be completely redone.  CDSS recommends that the CAPI redetermination process begin no later than 10 months after the previous redetermination to have enough time to receive the redetermination paperwork.

For renewal of the indigence exception, the recipient must complete the SOC 809 CAPI Indigence Exception Statement.  The sponsor must complete the SOC 860 form.  The county must then complete the SOC 813 CAPI Indigence Exception Determination form.

The SOC 860 sponsor income and resources form must be redone at each annual redetermination, regardless of whether the recipient requests the indigence exception unless the sponsor’s whereabouts are unknown.  The form is sent to the sponsor and the recipient.  If it is not returned, CAPI is suspended and benefits stopped.  (ACL 17-33, summarized here.)[1]

The initial clarification incorrectly stated that counties could redetermine the indigence exception if the county becomes aware of a change in circumstances.  In fact, the CAPI indigence exception applies for a full 12 month period.  CDSS issued an errata correcting this error.  (ACL 17-70, July 21, 2017 and ACL 17-70E, December 21, 2017.)

[1] Two lawsuits have been filed challenging the policy in ACL 17-33 to suspend CAPI benefits if the sponsor does not return the SOC 860 form.

Suspension, reinstatement, termination and reapplication for CAPI benefits

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CDSS has issued instructions suspension, reinstatement and termination of Cash Assistance Program for Immigrants (CAPI) benefits and reapplication for CAPI.

Suspension is an interruption of CAPI benefits because of the recipient’s failure to satisfy one or more CAPI eligibility requirements.  CAPI benefits can be reinstated without a new application if they re-qualify for benefits within 12 months of the date of suspension.  Suspension is effective the first day of the month in which the recipient no longer meets all CAPI eligibility requirements.  The county sends a notice of change of benefits (NA 692) form when suspending CAPI benefits.

Examples of events that can cause suspension of benefits include: income in the budget month exceeding the payment standard in the payment month, resources exceeding the allowable limit, failing to provide proof of applying for SSI, being outside the United States for 30 consecutive days, being a resident of a public institution for an entire calendar month, and failing to cooperate in providing requested information.

CAPI benefits can be reinstated when the recipient submits evidence requested by the county to reestablish eligibility during the suspension period.  A recipient does not need to file a new application to request reinstatement within the 12 month suspension period.  Benefits are reinstated effective the first day the recipient meets all eligibility requirements, even when that day is in the middle of the month.  This may require counties to make partial month payments.

Termination occurs when benefits have been suspended for 12 consecutive months and cannot be reinstated without filing a new application.  The county sends a second NA 692 notice when terminating benefits.  After this notice, the former recipient must reapply for benefits.  This is treated as a new application with a new protected application date.  (ACL 18-07, January 19, 2018.)

CAPI Indigents Exception form and policy

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CDSS has issued clarification regarding county completion of the Cash Assistance Program for Indigents (CAPI) indigence exception form.  Included in this clarification are several policy statements about evaluating eligibility for the indigence exception from sponsor deeming.

CDSS states that an applicant for the CAPI indigence exception is considered homeless if he or she has no permanent living arrangement, that is, no fixed place of residence.  Examples include persons who sleep in doorways, homeless shelters or parks, and persons who are couch surfing and have no permanent living arrangement at the beginning of the month.

CDSS states that monthly income for purposes of determining eligibility for the CAPI indigence exception include any in-kind contributions from either a sponsor or anyone else.  In addition, monthly income includes the cash value of any other public benefits that the applicant receives.  If the applicant resides with their spouse, the spouse’s earned or unearned income is included.

CDSS states that if an applicant for the indigence exception claims to be living independently or living with others and paying rent (as opposed to claiming to be homeless), there is a contradiction with claiming the indigence exception.  In those cases, CDSS requires the applicant to submit a written statement from anyone who has given the applicant a loan, and failure to submit that statement means the indigence exception is denied.

Based on the written statement, the county determines whether the loan is genuine.  A loan is considered genuine if it must be repaid under any circumstances (for example repayment from CAPI benefits if received is considered conditional and the loan is not genuine) and the applicant currently (before a decision on the CAPI application) has sufficient income such that there is a reasonable likelihood of repayment of the loan.

If the loan is genuine, it does not count as income for purposes of the CAPI income standard, but its value is considered for in determining eligibility for the indigence exception by counting it towards the CAPI applicant’s ability to purchase shelter and food.  If the loan is not genuine, it is considered a gift, and the applicant is ineligible for the indigence exception because the applicant’s needs for shelter and food are satisfied by gifts.  (ACL 17-100, September 20, 2017.)

Hearing representative responsibilities and privileges process

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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.)

CAPI application procedures

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The California Department of Social Services has issued instructions regarding applications for the Cash Assistance Program for Immigrants (CAPI).  Any person can apply for CAPI by telephone, in writing to the county social services agency or in person at the county social services agency office.  For individuals applying by telephone, the county must complete the CAPI application form over the phone.  Counties must have a face-to-face contact with the applicant as part of the application process.  The county should begin the application process and follow up by making an in person appointment.  If the applicant cannot travel to the local social services agency office for a face-to-face contact because of a disability or other good reason, the county must make alternative arrangements.

Counties cannot refer applicants or recipients to apply for SSI before evaluating immigration status.  Counties cannot refer applicants or recipients to apply to SSI if the county determines the applicant is not a qualified immigrant or the applicant or recipient has applied for SSI in the last six months and was denied solely because of immigration status.  When the county refers an applicant or recipient to apply for CAPI, the applicant or recipient must do so within 30 days.

Counties must make all CAPI forms available in each of the threshold languages in the county.  CDSS has translated the CAPI forms into the state threshold languages.  When the client’s primary language is other than one of the state’s or county’s threshold languages, the county must provide an in person interpreter or use a telephone interpreter service to communicate in the client’s primary language.

Counties must make a decision to approve or deny CAPI as soon as possible but no later than 30 days following the date of application.  The county cannot delay making a decision to wait for a decision on a SSI application.  The date of application is the date an individual expresses the desire to apply for CAPI by telephone or in person, or the date the county receives a written request.

CDSS policy is to make an exception to the 30 day period for applicants under age 65 claiming disability and a Medi-Cal disability determination has not been made.  In those cases, counties have 30 days from the date the county obtains a disability determination from the Disability Determination Services Division (DDSD) to make a determination.

When benefits are granted, the applicant is entitled to benefits retroactive to the first day of the month following approval.  In cases delayed by waiting for a DDSD determination, benefits are granted retroactive to the first day of the month following the application date.  (ACL 17-31, May 18, 2017.)