multiple programs

EDD benefits eligibility for Covid-19

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The Employment Development Department (EDD) has issued a statement on its website about benefits eligibility for people impacted by Covid-19.   People certified by a medical professional as unable to work due to having or being exposed to COVID-19 are eligible for State Disability Insurance.

People unable to work because you are caring for an ill or quarantined family member with COVID-19  as certified by a medical professional are eligible for Paid Family Leave, which is up to 6 weeks of benefits.

People who have reduced work hours because the employer has reduced hours or shut down operations due to COVID-19, can file for Unemployment Insurance.

In addition, employers experiencing a slowdown in their businesses or services as a result of the coronavirus impact on the economy may apply for the UI Work Sharing Program which allows employers to retain their trained employees by reducing their hours and wages that can be partially offset with UI benefits.  (EDD Coronavirus-2019.)

 

CalWORKs overpayment collection threshold and discharge

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The California Department of Social Services (CDSS) has issued guidance regarding the CalWORKs overpayment collection threshold and discharge policies.  This guidance supersedes ACL 19-19.

Effective July 1, 2019, the overpayment collection threshold for closed CalWORKs cases is increased from $35 to $250. Counties cannot demand collection of any non-fraudulent overpayments with a balance of $249 or less if the liable individual is no longer receiving CalWORKs.  The $250 threshold includes claims related to Welfare-to-Work supportive services.  The overpayment collection threshold applies to each individual claim, not to the total of multiple overpayment claims.

There is also a new discharge process for CalWORKs overpayments.  If the liable individual has not received CalWORKs for 36 consecutive months or longer, the county must deem a non-fraudulent CalWORKs overpayment uncollectable and must discharge it.  This rule applies even when there is a repayment agreement or a civil judgment if the overpayment is non-fraudulent.  This discharge rule applies to each individual overpayment claim, not to the total of multiple overpayment claims.  Counties must send a notice of action informing individuals when they are no longer liable for the overpayment.

The discharge policy does not apply to cases where fraud is alleged.  If a fraud investigation is pending when the 36 month timeframe occurs, collection is placed in suspense until the result of the investigation.  Collection can restart if the investigation determines there was fraud.

The discharge policy is not effective until it is programmed into the new single statewide computer system CalSAWS. However, when the discharge policy is programmed into CalSAWS, counties must apply it retroactively to any outstanding non-fraudulent CalWORKs overpayments established on or after December 1, 1996.

In addition, effective July 1, 2019, counties must now report any mass overpayment of CalWORKs benefits to CDSS.  A mass overpayment is an overpayment caused by the same action or inaction that impacts either eight percent of the county’s CalWORKs caseload or more than 1,000 CalWORKs recipients, whichever is greater.

Also effective July 1, 2019, a civil or criminal welfare fraud action cannot be commenced if case record, or any consumer credit report used in the civil or criminal case for the purpose of determining the overpayment, has not been made available or has been destroyed after the three year retention period.

These policies also apply to Refugee Cash Assistance, Entrant Cash Assistance and Trafficking and Crime Victims Assistance Programs.  (ACL 19-102, November 12, 2019.)

Housing and Disability Advocacy Program guidance

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The California Department of Social Services (CDSS) has issued updated program guidance regarding the Housing and Disability Advocacy Program (HDAP).  HDAP offers funding to county agencies or tribal governments to assist homeless disabled individuals with applying for disability benefits programs while providing housing assistance.  39 counties currently have HDAP programs.  HDAP requires grantees to offer outreach, case management, advocacy and housing assistance concurrently.

Assistance should be provided until disability benefits are granted and the participant is stabilized in permanent housing. A dollar-for-dollar grantee match is also required.

There are several changes to the program because of legislation in 2019.  These changes include: 1) Funding is now available for federally recognized tribal governments; 2) Priority for assistance is for chronically homeless individuals or homeless persons who rely most heavily on government-funded services; 3) Programs can consider providing housing assistance after disability benefits are granted until housing placement is stable and affordable; 4) Case management staff must assist in developing a transition plan for housing support when disability benefits are granted or denied.

HDAP continues its principles of housing first, collaboration among programs and prioritizing assistance is for chronically homeless individuals or homeless persons who rely most heavily on government-funded services.  Providing services on first-come, first-served basis or by most likely to find housing is improper.

Required program components continue to be outreach, case management, benefits advocacy and housing assistance.  Limiting outreach to General Assistance/General Relief applicants or recipients is insufficient.

Additional program components include transition planning, workforce development for participants not likely to be eligible for disability benefits, interim assistance reimbursement, and data gathering.  (ACL 19-104, November 1, 2019.)

Guidance on discrimination complaint summary investigation letters

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The California Department of Social Services (CDSS) has issued instructions the content of letters from county civil rights coordinators that provide the county’s determination of complaints following their investigations.  An applicant for or recipient of benefits or services from a CDSS program can file a civil rights complaint with the county welfare department if they believe they have been discriminated against in violation of federal or state anti-discrimination laws.  An applicant or recipient has the right to appeal a county determination of a civil rights complaint to the CDSS Civil Rights Bureau.  The letters provided to complaintants provide a brief summary of the allegations and the reasons for the County’s determination. This is necessary to give the complaintant sufficient information to understand the basis for the decision, decide whether to appeal to CDSS and to present meaningful argument on appeal.

The County summary letter must contain: 1) a clear statement of the allegations, include the complaintant’s allegations of what happened, and on what basis discrimination is alleged; 2) The case specific facts that the county relied on to make its determination; and 3) the reasons for the County’s determination.

Any statements that the investigators attribute to the complaintant must be included verbatim in the summary letter.

Counties must include a draft of the summary letter to the complaintant with the final investigation report that is forwarded to CDSS for review.  The County must wait for CDSS’ approval before providing the summary letter to the claimant.  (ACL 18-111, September 10, 2018.)

Short Term Residential Therapeutic Programs Placement Criteria, Interagency Placement Committees, Second Level Review for Ongoing Placements

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The California Department of Social Services (CDSS) has recently provided guidance and instructions regarding Interagency Placement Committees (IPCs), Short-Term Residential Therapeutic Programs Placement (STRTP) Criteria, Child and Family Teams (CFTs), and Second Level Review requirements for children and nonminor dependents placed in STRTPs and group homes.

Assembly Bill 403 established new licensed children’s residential facilities called STRTPs, which are public agencies or private organizations licensed with CDSS to provide integrated, high-quality, therapeutic programs. The programs are intended for children whose behavioral and therapeutic need are not met by a home-based family setting, even with supportive services. The goal of the program is to provide trauma-informed therapeutic interventions and integrated programming to address barriers to the child’s ability to safely reside and transition into a home-based family setting. The county placing agency, the STRTP, the caregiver, and the child and their support system must work together to identify and coordinate necessary services.

STRTP homes must be cleared by IPCs and a second level of review which takes into account CFT’s opinions.

The IPC is made up of representatives from county placing agencies and the county Mental Health Plan (MHP). The IPC may work together with other jurisdictions to act as a multi-disciplinary committee for child care and treatment. The IPC must also review and approve placements for STRTPs, group homes with a level of care assessed at Rate Classification Level 13/14 and that have been granted extensions (as determined by ACL 16-65), as well as out-of-state residential programs. The IPC decision is to be made by reviewing all available assessments. To support partner agency compliance, county placing agencies must notify and coordinate needed services with the school of origin regarding educational stability and the case plan, the MHP, and the Regional Center currently serving the child immediately upon the child’s placement.

The child may be placed in a STRTP if the child does not require inpatient care in a licensed health facility and the child’s needs have been assessed and can be provided in a STRTP to maintain the health and well-being of the child. One of the following criteria must also be met:

  • the child meets medical necessity criteria as determined by a mental health professional
  • the child is assessed as Seriously Emotionally Disturbed
  • the child is assessed as requiring the level of services provided by the STRTP
  • OR the child meets the criteria for emergency placement into a STRTP.

Emergency placement determinations may be made prior to the IPC determination if:

  • A mental health professional has made a written determination that the child requires the level of care that STRTP services offer
  • The IPC makes a similar determination within thirty days of an emergency placement (or transmits their disapproval to the STRTP)
  • AND the STRTP is not acting as a temporary placement in the event that a home-based family setting cannot be found. The county placing agency must ensure there is commonality of need with the other children in the placement setting.

If counties decide to integrate the CFT and IPC into single meetings, they should do so via an Interagency Memorandum of Understanding.

STRTP providers are not required to accept any specific child for placement, though they are expected to have the capacity to serve individual children with complex needs. The intake process should be coordinated with the IPC to avoid non-admissions and 7-day notices of denial from an STRTP provider, and information should be conveyed to county placing agencies to allow for CFT meetings pending placement. If STRTP providers demonstrate a pattern of not accepting placements, a review may be conducted by CDSS to assess the technical assistance level of the STRTP in order to prevent unnecessary disruption.

Assembly Bill 1997 provided added requirements, and also requires that the Department of Health Care Services and CDSS develop a dispute resolution process in order to track the number of reported and resolved disputes. While this is developed, county placing agencies should inform the CDSS if there is an unresolved IPC dispute by emailing CDSS.

The Continuum of Care Reform (CCR) uses residential care as a short-term, therapeutic intervention until the child is able to transition into a home-based family setting.  The CCR includes additional requirements on case plan documentation and second level review. The former requires that the case plan for a child placed in a STRTP document that the placement is for the purposes of short-term, specialized and intensive treatment, the need for the placement, the plan for transitioning the child, and the projected timeline for future action. If the child is under 12 years of age of younger, prior approval from the director of the child welfare agency is needed.

The Placement Timeframes for Second Level Reviews are age-specific. For children ages 0-6, STRTP placements are extremely rare and not to exceed 120 days. For children ages 6-12, STRTP placements shall not exceed 6 months unless the county made progress toward implementation of the case plan (including the child’s future transition), circumstances beyond the county’s control have impeded the county from obtaining those services, and the need for additional time is documented by a caseworker and approved by the Child Welfare Deputy Director.  For children older than age 13 under the supervision of the dependency court, the placement shall not exceed 6 months unless the Child Welfare Deputy Director or Director has approved the case plan. For children older than age 13 under the supervision of the delinquency court, the placement shall not exceed 12 months unless the Chief Probation Officer of the county has approved the continued placement no less frequently than every 12 months thereafter.

County placing agencies should have established processed to ensure that these processes are followed immediately for children placed in STRTPs or group homes.  (ACL 17-122, January 9, 2018.)

 

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.)