Medi-Cal

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.)

Changes to federal Public Charge rule

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The Department of Homeland Security will not enforce the 2019 public charge rule. As a result, the 1999 interim field guidance on the public charge inadmissibility provision will now apply.  Under the 1999 Interim Guidance, the Department of Homeland Security and United States Citizenship and Immigration Services will not consider receipt of Medi-Cal (except for long-term care, public housing or CalFresh as part of determining public charge inadmissibility.  Public cash assistance for income maintenance, including CalWORKs, Supplemental Security Income (SSI), Cash Assistance Program for Immigrants and general assistance/general relief.

However, receipt of benefits alone will not automatically cause a public charge determination.  Receipt of benefits is only one factor among several considered as part of the totality of circumstances determination for whether someone is likely to become a public charge.  Receipt of benefits by family or household members is not considered for public charge purposes.

Medical testing, treatment, and preventative services for COVID-19, including vaccines, is not considered for public charge purposes. (ACL 21-32, March 15, 2021.)