Medi-Cal

Treatment of Racial Equity Implicit Bias Initiative focus group payments

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The California Department of Social Services (CDSS) has provided guidance to County Welfare Departments regarding treatment of the Racial Equity and Implicit Bias (REIB) Initiative focus group payments. The focus groups will provide a unique client perspective and equity challenges.

CDSS is working with community partners to develop a trauma-informed, anti-racist, anti-stigma county training framework for the CalWORKs and CalFresh programs. This framework will promote positive outcomes for child and family health and well-being.

Community partner Parent Voices is working with consultant Anavo Solutions to convene a Community Advisory Committee comprised of nine community members. Participants in the Parent Voices Community Advisory Committee (PV-CAC) will receive a $1,000 stipend. The PV-CAC will operate and support a focus group of CalWORKs and CalFresh recipients.  Members of this focus group will receive $75 gift cards.

The $1,000 stipend is considered a lump sum payment and not income for CalWORKs or CalFresh.  The $1,000 stipend is a resource in the month received.  The $75 gift card is exempt from being considered a resource.

For CalFresh households subject to a resource test, both the $1,000 stipend and the $75 gift card count as a resource in the month received.

The PV Focus Group $75 Visa gift card is not countable as income for Modified Adjusted Gross Income (MAGI) Medi-Cal and Non-MAGI Medi-Cal. The $1,000 stipend would be counted as taxable income for MAGI Medi-Cal, which means it is counted in the month received as a one-time lump sum payment. (September 20, 2022)  For Non-MAGI Medi-Cal, the $1,000 payment is income in the month received and property in the month following the month of receipt.  (ACWDL, September 20, 2022.)

Treatment of CalKIDS accounts

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In 2019, the passage of SB 77 provided one-time state funding to create CalKIDS, a qualified scholarship program. It opens a college savings account for every newborn child in California regardless of income. CalKIDS will provide an initial seed deposit of at least $25 in each savings account and other potential financial awards to participants. In 2021, the passage of the American Rescue Plan Act significantly expanded the program to include an additional 3.7 million low-income public school students in grades 1 through 12 who qualify for free or reduced lunch, are homeless, or are in foster care. Eligible students receive an initial seed deposit of $500. Later in 2021, CalKIDS clarified eligibility to include students attending state special schools.  The CalKIDS expansion was implemented on July 1, 2022. 

College Savings and CalKIDS Accounts allow families to save and invest money for their children’s future higher education expenses. Savings withdrawn from a CSA program that utilizes a 529 college savings account, such as CalKIDS, are not subject to federal or state taxes if they are used for qualified higher education expenses. 

Because CalKIDS Accounts are owned by the State and are not available to the Assistance Unit (AU) are not counted as income or resources for CalWORKs purposes. Any funds, including funds deposited and investment returns, originating from a CalKIDS account will not be considered in the eligibility determination or grant calculation for CalWORKs applicants or recipients. 

CalKIDS Accounts are entirely excluded as income or resources for the CalFresh and California Food Assistance Program CalKIDS shows accounts must be excluded from income and resources entirely. 

CalKIDS does not count as income for CalWORKs Homeless Assistance Program (HA) and the CalWORKs Housing Support Program (HSP) because they are CalWORKs programs.  CalKIDS also does not count as income when determining eligibility for assistance provided by other Housing and Homelessness Programs, including Project Roomkey/Homelessness COVID Response, Bringing Families Home, and the Housing and Disability Advocacy Program.

CalKIDS accounts do not count as income for CalWORKs Stage 1 Child Care.  For other child care programs,  CalKIDS accounts are not considered countable income because they are owned by the state.. CalKIDS funds that are withdrawn and not utilized for educational purposes may be considered countable income if not excluded on some other basis.

The impact of CalKIDS on RCA/ECA and TCVAP follows the income and assets eligibility and administration rules of the CalWORKs program unless specifically superseded by RCA regulations. The eligibility criteria for ECA and TCVAP Cash Assistance states benefits shall be the same as those for RCA, with certain exceptions. These CalWORKs regulations regarding the treatment of CalKIDS accounts and funds also apply to RCA, ECA, and TCVAP recipients.

CalKIDS accounts are not counted as a resource for SSI/SSP or CAPI because they are owned by the state.  Distributions that are used for educational expenses of the designated beneficiary are excluded as a resource in the month received, and if retained beyond the month of receipt, they are excluded for 9 months beginning with the month of receipt. However, since the funds will be distributed directly to the higher education institutions on behalf of the participants to pay for qualifying higher education expenses and not retained by the beneficiary, the distributions will likewise not be considered a resource to the beneficiary.  (ACL 22-79, October 4, 2022.)

Duties regarding county Statement of Position to Limited English Proficient claimants

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County hearings representative for both California Department of Social Services (CDSS) and Department of Health Care Services (DHCS) programs must enclose the GEN 1365 Notice of Language Services form with the Statement of Position.  For non-county administered DHCS programs, county hearings representatives must enclose the DHCS Non-Discrimination Policy and Language Access Process document.

CDSS is working on a new version of the GEN 1365 specifically for fair hearings that will be released soon.

When the applicant or recipient indicates their preference for communication in a language other than English, counties must provide forms in that language when the translation is provided by CDSS or DHCS in that language.  Counties must provide oral interpretation services of any document on request, including non-standardized forms and individually tailored documents.  If requested, the county or agency must provide an oral interpretation of the Statement of Position, including any exhibits attached to the Statement of Position, at least two days before the hearing.

When the county is aware of the need for assistance in a language that is not listed in the GEN 1365, the county or agency should attempt to inform the claimant of how to get a free oral interpretation of the Statement of Position in the claimant’s preferred language.  (ACL 22-56, July 8, 2022.)

Eligibility of Ukranian nationals for federal and state benefits

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THIS LETTER HAS BEEN SUPERCEEDED FOR FEDERAL BENEFITS.  SEE ACWDL, July 6, 2022, summarized here.

The California Department of Social Services (CDSS) has provided guidance regarding eligibility of Ukranian nationals for various public benefits programs.

Ukranian arrivals who have refugee or asylee status qualify for CalWORKs, CalFresh, SSI, and Refugee Cash Assistance (RCA).

Ukranian refugees and asylees are eligible for RCA. Persons with Temporary Protected Status are not eligible for RCA.  Counties must accept a declaration under penalty of perjury of the applicant’s immigration status while documentary verification is pending.

Ukranian nationals who have Temporary Protected Status are not eligible for most federal or state public benefits.

Ukranian humanitarian parolees can be eligible for CalWORKs with state funds.  This is because humanitarian parolees have Permanent Residence Under Color of Law (PRUCOL).  This includes eligibility for Homeless Assistance and Housing Support Program, both of which can supplement federal refugee resettlement funding.

Ukranian humanitarian parolees are eligible for the Cash Assistance Program for Immigrants (CAPI).  They are not eligible for SSI.

Ukranian humanitarian parolees are eligible for CalFresh or California Food Assistance Program (CFAP) if they have been paroled into the United States for at least one year.  Paroled for at least one year means the duration of parole.  A humanitarian parolee is eligible for CalFresh or CFAP from the day they are paroled into the United States if their parole will last at least one year.  Ukranian humanitarian parolees for less than one year are not eligible for CalFresh or CFAP.

Public interest parolees must be admitted to the United States for at least one year and must meet two additional criteria to be eligible for CalFresh, including five years of residence, working 40 quarters, children under age 18, elderly or disabled as defined.  People who do not meet two of the additional criteria can be eligible for CFAP.

Ukranians with refugee, asylee or humanitarian parolee status are eligible for Project Roomkey, Bringing Families Home, Housing and Disability Advocacy Program, and Home Safe.

Ukranian arrivals, including humanitarian parolees, can be eligible for Medi-Cal.

Regardless of the documentation presented, counties must verify immigration status with the SAVE system.  (ACIN I-40-22, April 22, 2022, ACIN I-40-22E, May 24, 2022.)

COVID-19 Treatment of Pandemic Emergency Assistance Fund payments in various programs

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The California Department of Social Services has provided guidance regarding treatment of the one-time payment issued to CalWORKs recipients pursuant to the Pandemic Emergency Assistance Fund (PEAF) for CalWORKs, CalFresh and Medi-Cal.  The PEAF payment was a $640 payment to CalWORKs recipients that was issued on July 10, 2021.  PEAF is to assist low income families impacted by COVID-19.

PEAF does not count as income for CalWORKs and CalFresh and does not count as a resource for 12 months after receipt.  Both MAGI and non-MAGI Medi-Cal treat the PEAF payment as a disaster payment which does not count as income.

Families who received the PEAF payment were informed of the payment by phone and email message during the week of July 12, 2021.

The PEAF payment does not tick either the CalWORKs or federal TANF time-on-aid clocks.

The PEAF payment will not impact the amount of the CalWORKs unreimbursed assistance pool for purposes of child support distribution.

Lost PEAF payments can only be replaced if the assistance unit incurs skimming or scamming of their benefits.  (ACL 21-65, July 22, 2021.)

Increasing dual enrollment between CalFresh and Medi-Cal

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The California Department of Social Services (CDSS) now requires counties to provide additional outreach to help bridge the gap between Medi-Cal and CalFresh enrollment. Effective on January 1, 2022, county staff must verbally screen new and renewing Medi-Cal applicants for CalFresh and provide the opportunity to apply for CalFresh if eligible. All CalFresh applicants must also be screened for entitlement to expedited service.

Medi-Cal beneficiaries eligible for CalFresh include (but are not limited to) beneficiaries with Modified Adjusted Gross Income (MAGI) income less than or equal to 200% of the Federal Poverty Level (FPL), non-MAGI income less than or equal to 200% of the FPL, and non-MAGI Aged, Blind, and Disabled (ABD) FPL less than or equal to 138%. If the beneficiary is not interested in CalFresh, then the county must inform them of an online and paper application for the program.

Online Medi-Cal applications (SAWS and CalHEERS) already offer eligible beneficiaries applications to additional benefits programs at the same time. County staff are encouraged, but not required to verbally ask online applicants if they are interested in CalFresh.

Counties must cross-train staff who process Medi-Cal applications to perform CalFresh eligibility determinations.

Counties must designate a CalFresh liaison to establish CalFresh application referral procedures and establish outreach procedures to increase CalFresh enrollment among Medi-Cal applicants and beneficiaries. Counties must provide CDSS with contact information of these liaisons by January 1, 2022.  (ACL 21-52, April 30, 2021.)