In the wake of recent hurricanes and fires, counties have been reminded that they may accept written attestations from applicants to prove California residency. DHCS has issued talking points to help applicants and providers navigate issues of eligibility, enrollment, and billing for relocated (permanently or temporarily) Medi-Cal or Medicaid beneficiaries.
DHCS MEDIL I 17-16 (October 2, 2017).
The California Department of Social Services (CDSS) has issued instructions about changes to CalFresh income deducation and resource exclusion rules. Military combat pay is excluded from income when determining CalFresh eligibility and benefit level if the additional pay is the result of deployment to or service in a combat zone and was not received immediately prior to serving in a combat zone.
The CalFresh standard deduction increased to $144 per month effective fiscal year 2009, and for every year thereafter is indexed to inflation.
The cap on deduction for dependent care expenses is eliminated.
Funds in designated retirement accounts, in a Federal Thrift Savings Plan, in an ABLE account, in a myRA account or in an education savings account are excluded from resources. (ACL 17-98, October 12, 2017.)
CDSS has issued several directives regarding CalFresh for victims of the Northern California fires. These directives include issuance of mass replacement benefits, statewide access to CalFresh (and CalWORKs) services statewide, allowing purchase of hot food with CalFresh benefits and waiver of timely reporting requirements.
California has been approved to issue Disaster CalFresh. Current CalFresh recipients can request supplemental disaster benefits. New applicants affected by the disaster can be eligible for Disaster CalFresh if the household lived in the disaster area at the time of the disaster, and experienced either damage to their home or self-employment property, disaster-related expenses, disruption in income or inaccessible liquid resources.
CDSS also has links to the application for disaster CalFresh and the affidavit form for issuance of replacement CalFresh. Disaster CalFresh, October 2017.
Social Security has issued a ruling regarding the responsibilities of both the Social Security Administration and the claimant to develop evidence and other information in disability and blindness claims for both SSDI and SSI cases. The ruling applies at all levels of review, including administrative law judge hearings.
Social Security states that the claimant has the primary responsibility to provide evidence in support of disability or blindness claims. The Social Security Act also requires the Social Security Administration to make reasonable efforts to obtain all medical evidence from the claimant’s treating source that is necessary to properly evaluate the claim prior to evaluating medical evidence obtained from a consultative source. Social Security must also develop a complete 12-month medical history when making a disability determination. This means that Social Security will make an initial request for evidence from the medical source, and will follow up with the provider between 10 and 20 days after the request if it has not received the evidence.
Claimants must submit or inform Social Security of all evidence known to them that relates to the disability claim. Claimants must submit or inform Social Security of any written evidence no later than 5 business days before an administrative law judge (ALJ) hearing. The ALJ can ignore evidence submitted less than 5 business days before the hearing unless the claimant demonstrates good cause for late submission. To satisfy the duty to inform, the claimant must provide information specific enough to identify the source of the evidence and the relevance of the evidence.
Representatives have a duty to assist claimants in obtaining evidence. Representatives must also submit or inform Social Security of evidence as soon as they obtain or become aware of it. Representatives should not wait until 5 business days before the hearing to submit or inform Social Security of evidence unless they have a compelling reason for the delay. In addition, representatives cannot inform Social Security of evidence without submitting it unless the representative shows they could not obtain the evidence despite good faith efforts. Violation of these duties can result in referral to the Office of General Counsel for disciplinary action.
At the Appeal Council level, the Appeals Council will not obtain or evaluate additional evidence when deciding whether to grant review unless there is good cause for failure to previously submit it or the case is a SSI claim that is not based on an initial application for benefits (an age-18 redetermination for example). SSR 17-4p (October 4, 2017).
The Department of Child Support Services has issued statewide policy instructions regarding suspension of child support orders for incarcerated obligors. This policy implements revisions to Family Code 4007.5 in AB 610 (2015).
Child support obligations are suspended when a qualifying order is issued or modified after October 8, 2015 and the obligor has been incarcerated or involuntarily institutionalized for more than 90 consecutive days after the order was issued or modified. The suspension applies to payments on a current order and arrears payments.
Exceptions to child support obligation suspension are when the obligor has the means to pay while incarcerated or involuntarily institutionalized, the incarceration or involuntary institutionalization is for domestic violence, or the incarceration or involuntary institutionalization is for failure to comply with a child support order.
Local Child Support Agencies (LCSA) can administratively adjust orders at any time after the initial 90 days of incarceration or involuntary institutionalization provided that the LCSA sends notice of the intended adjustment to both the obligor and obligee and neither party has objected within 30 days of receipt of the notice. If either party objects, the LCSA must file a motion in court. The child support order suspends effective the first day of the first full month following incarceration or involuntary institutionalization.
If there is no evidence of ability to pay when the obligor is incarcerated or involuntarily institutionalized, the LCSA can ask the court to establish a $0 order when the order is initially established or when the LCSA determines based on its review of the case that the order should be modified.
These policies do not apply to orders established or modified prior to October 8, 2015. (CSSP Letter 17-03, October 10, 2017.)
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.)