Stepsibling or half-sibling opt-out of CalWORKs Assistance Unit

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CDSS has issued instructions regarding SB 380.  Effective November 1, 2018, a CalWORKs assistance unit can receive full child support payments for a stepsibling or half-sibling of an eligible child instead of cash aid for the step/half sibling.  Those child support payments will not be considered in determining CalWORKs eligibility or grant amount.

Current law requires that most CalWORKs applicants and recipients assign their right to collect child support to the county. Current law also requires that the income of the sibling of an eligible child living in the same home as the eligible child be counted as income for CalWORKs.

The new rule allows CalWORKs applicants or recipients to exclude the needs of stepsiblings or half-siblings when determining the amount of CalWORKs the family will receive and allows such families to keep all current child support payments made on behalf of that child if: (1) The stepsibling or half-sibling lives with at least one eligible child; (2) He or she is a child for whom child support payments are received; (3) The amount of current child support received for that child is greater than the cash aid amount for that child and (4) The parent or caretaker relative requests in writing that the child not be included in determining the CalWORKs grant amount.

The stepsibling or half-sibling is considered when determining the maximum amount of income the family can have and be eligible for CalWORKs.  The stepsibling or half-sibling will be eligible for CalFresh, Medi-Cal, child care and special needs.  All other eligible members of the household will continue to receive CalWORKs.

The designation of whether to exclude a step/half-sibling can only be reevaluated at redetermination or semi-annual reporting.  The parent or caretaker relative can also ask to end the exclusion of the step/half-sibling mid-period if the child support payments decrease or end. Parents or caretaker relatives will need to provide all necessary verifications for the child in order to end the exclusion mid-period.

When the stepsibling or half-sibling ages out of CalWORKs, any child support arrears collected will count as income for CalWORKs.

When a stepsibling or half-sibling receiving child support is excluded, all of that child’s income does not count for the Assistance Unit.  For example, if the child is receiving both child support and Social Security Disability, the Social Security Disability will also not count as income for CalWORKs.

Social Security dependent’s benefits are considered child support when determining whether a stepsibling or half-sibling can be excluded.

When determining if the child support amount a stepsibling or half-sibling exceeds the CalWORKs grant, only child support directed to that child is considered.  This means that if a child support order is unallocated among multiple children, that child support is not a basis for excluding the child.  In that situation, the family needs to seek a modification of the child support order to have it expressly allocated.

Counties must notify applicants and recipients in writing at application and at each retermination. (ACL 18-82, August 1, 2018.)

Errata to EBT surcharge free ATM network

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CDSS has issued an errata to its ACIN regarding the surcharge free ATM network.

The ACIN stated that MoneyPass would be surcharge free only until September 30, 2018. The errata states that the MoneyPass Network will remain surcharge free until at least September 30, 2018.

The ACIN stated that Bank of American ATMs would be surcharge free.The errata states that cardholders withdrawing from Bank of America ATMs will incur a surcharge which will be refunded within 24 to 48 hours with no action required by the cardholder.  (ACIN I-39-18E, August 3, 2018.)

Implementation of the Intensive Services Foster Care Program

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The California Department of Social Services (CDSS) has issued instructions regarding the implementation of the Intensive Treatment Foster Care (ISFC) program.

The ISFC program is intended to serve children who require intensive treatment and behavioral supports, as well as children with specialized health care needs (including those served under ITFC). The program is designed to ensure that foster youth receive the services they need in a home-based family care setting and that they do not remain or enter a short-term residential program or Group Home.

To achieve this, the ISFC program provides core services and supports, including arranging access to mental health treatment, providing trauma-informed care, and providing transitional support during placement in a permanent home. ISFC program participants who meet the eligibility criteria of other publicly funded programs including mental health, education, and health services will have these services arranged for them by the Foster Family Agency (FFA) or the county.

Children eligible to receive help from the ISFC program are children or nonminor dependents in foster care who require higher level of supervision, as is determined by the Level of Care (LOC) Rate Determination Protocol.

An ISFC resource family includes a licensed foster family home or a certified family home of a licensed Foster Family Agency. An ISFC resource parent is a committed member of the youth’s team who has the ability to meet the individual’s intensive care needs. Non-related legal guardians and Kinship Guardianship Assistance Payment (Kin-GAP) Facilities are not eligible for the ISFC program.

To deliver these services, the ISFC program may either use a licensed FFA or a county licensed to run a FFA, or they may be operated directly by the county as a government program.  In either case, the ISFC program includes Therapeutic Foster Care (TFC) for youth under the age of 21 who are Medi-Cal eligible and meet medical necessity criteria. Each of the involved parties have several responsibilities. FFAs and Counties operating an ISFC must identify and train IFSC foster parents, placement matching, providing core services, and coordination of the appropriate professional and para-professional staff.

TFC parents and caregivers are specially trained and work under the supervision of the TFC agency and in conjunction with the ISFC staff (unless the youth is on probation or child welfare).

ISFC resource parents must complete participate in the development of the child’s plan ensure the well-being of the child, and be in the Resource Family Approval (RFA) program. They must also complete 40 hours of training prior to placement covering topics such as trauma, behavior de-escalation techniques, and cardiopulmonary resuscitation, and is described in depth in ACIN I-28-18.

For child placement, if a child requires immediate placement based on criteria behavioral identifiers, the Social Worker/Probation Officers may make immediate placement at the ISFC level to ensure safety pending an LOC rate determination. If a child has experienced any of the criteria behavioral identifiers within the last twelve (12) months, the placing agency may pay the ISFC rate for up to sixty (60) days, which may be extended pending local county manager approval. This extension should only be granted in the event that an HBFC setting cannot be found.

An ISFC level placement may be made before pre-placement training is completed if certain criteria are met depending on circumstance and those involved.

The ISFC does not allow more than two children in foster care and/or one ISFC eligible child placed in each resource family home, except in sibling group placements where the total number of children in a single resource family home is five (5).

FFA’s that have transitioned or are interested in transitioning to an ISFC program must submit an amended FFA Program Statement Template that is updated to reflect the new ISFC requirements to the Foster Care Rates Bureau. New ISFC programs that were not ITFC providers will receive a rate approval and issued rate letter, as well as a program letter from FCRB with a date effective. Counties not operating as an FFA that intend to opt-in to ISFC public delivery of benefits must submit an ISFC Program Description to the department pending approval.  (ACL 18-25, March 13, 2018.)

 

Processing Medi-Cal cases with no potential MAGI eligibility

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DHCS has issue guidance on not running CalHEERS business rules for certain household with no potential MAGI Medi-Cal eligibility.  These include Mega-Mandatory beneficiaries in programs required by federal law or categorical programs (e.g., foster care, Pickle, SSI/SSP) and cases where the entire household is potentially non-MAGI eligible (aged/disabled, receiving Medicare, no dependent children or pregnant persons).

Currently, if an applicant is Mega Mandatory and CalHEERS returns a MAGI eligibility result, counties must not accept the MAGI result and must retain or establish eligibility under the Mega Mandatory aid code.  In some cases, the county is unable to grant Mega Mandatory eligibility without running the case through CalHEERS rules, which requires information that is unnecessary for aged or Mega Mandatory individuals.  SAWS will be making changes to address these workarounds for Mega Mandatory and non-mixed MAGI/Non-MAGI households.  Otherwise, counties must run the CalHEERS rules for other individuals.

DHCS ACWDL 18-16 (July 11, 2018).

Medi-Cal for Unaccompanied Refugee Minors (URMs)

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DHCS issued a letter with information and guidance to counties regarding cases for Unaccompanied Refugee Minors (URMs)  URMs who are otherwise eligible get no share of cost full scope Medi-Cal benefits, and are to be treated like foster care children for Medi-Cal eligibility purposes.

Three state-designated URM program service providers should submit applications to the county of residence on behalf of URMs placed with the agency.  Social workers will provide verification letters as proof of eligibility for refugees.  County welfare departments must not delay or deny services for failure to provide the SSN or verification of immigration status, though counties should work to verify status in order to maximize federal financial participation.

URM individuals are eligible for full scope Medi-Cal regardless of immigration status.  Those who meet former foster youth (FFY) eligibility requirements are eligible to continue receiving full scope Medi-Cal under the FFY program.  Counties must follow the appropriate rules on annual redetermination and inter-county transfers.

DHCS ACWDL 18-14 (July 3, 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.)