Treatment of Same-Sex Spouses in Medi-Cal Post-Windsor and Obergefell

Posted on by

Post-Windsor (2013) and Obergefell (2015), counties must treat married same-sex spouses the same as married opposite-sex spouses for Medi-Cal eligibility purposes under both MAGI and Non-MAGI rules.  Rules applying to spouses for spousal impoverishment, undue hardship, long term care, and HCBS waiver programs shall apply the same to both same-sex and opposite-sex married spouses.  These changes are effective immediately.

DHCS will clarify rules regarding registered domestic partners, which were not affected by the Supreme Court decisions in Windsor or Obergefell.

DHCS ACWDL 17-27 (July 31, 2017).

IHSS electronic timesheets

Posted on by

The California Department of Social Services has issued instructions regarding electronic timesheets for In Home Supportive Services (IHSS) providers.  IHSS timesheets can now be submitted electronically using the Electronic Timesheet Service (ETS).  The ETS allows providers and recipients to enter time worked and submit timesheets, and view the previous three months of timesheet history.

ETS is optional.  To use it, both the provider and the recipient need to enroll.  After both the provider and the recipient are enrolled, the provider submits the timesheet and the recipient approves it.  Providers will not be able to submit their timesheets for recipient approval if the timesheet has errors.  Examples of errors that will block submitting the time sheet are hours claimed exceed remaining recipient authorized hours , hours claimed exceed remaining provider assigned hours,  no remaining recipient authorized hours , no remaining provider assigned hours, hours claimed exceed weekly maximum, and hours claimed exceed monthly overtime maximum and hours exceed overtime exemption limitation.

Providers and recipients can opt-out of ETS at any time.  (ACL 17-76, July 14, 2017.)

State AFDC-FC eligibility for registered non-California guardianship orders

Posted on by

The California Department of Social Services has issued instructions implementing the court order in Ramirez v. Lightbourne, Sacramento Superior Court No. 34-2015-80002216, regarding eligibility for State AFDC Foster Care (AFDC-FC) benefits for guardians with non-California guardianship orders.  The state AFDC-FC program provides cash aid to non-relative legal guardians.  (See Welf. & Inst. Code § 11405; MPP § 45-203.)  Previously, non-relative guardians with non-California guardianship orders could only be eligible for State AFDC-FC by obtaining a California guardianship order.  Ramirez held that non-relative legal guardians with non-California guardianship orders are eligible for State AFDC-FC if the guardianship order is registered with a California court.

Counties must inform applicants for State Only Foster Care benefits who have a guardianship order issued by another state that they may be eligible for benefits either by registering their non-California guardianship order with a California court or by obtaining a new guardianship order from a California court.  (ACL 17-82, July 27, 2017.)

Non-MAGI Medi-Cal Application Supplemental Forms

Posted on by

For Non-MAGI Medi-Cal determinations, DHCS has provided supplemental forms and a flow chart to help evaluate cases for proper eligibility.  Non-MAGI evaluations are required when an applicant requests such a determination, when MAGI does not apply, or when there is potential non-MAGI eligibility for those not income-eligible for MAGI.

If an ex parte review reveals the need for additional information, county eligibility workers need to send applicable supplemental forms to get that information.  Workers must attempt to contact the applicant at least twice.

DHCS ACWDL 17-26 (July 20, 2017).

Medi-Cal Standards for Dental Anesthesia Services

Posted on by

DHCS issued a Dental All Plan Letter to provide instructions on how to process TARs for intravenous sedation and general anesthesia services for dental procedures.  Providers must submit TARs or prior authorization requests for these services as of 11/1/15.  This letter includes six criteria and documentation requirements based on whether local anesthesia or conscious sedation had failed or was not feasible, as well as information about how the dental treatment plan affects what documentation must be submitted.

DHCS Dental APL 17-004 (June 28, 2017).

International child support enforcement

Posted on by

The Office of Child Support Enforcement (OCSE) of the United States Department of Health and Human Services has released instructions that 14 forms for international child support cases have been approved for use.

The United States ratified the Hague Convention on the International Recovery of Child Support and Other Forms of Family Maintenance on August 30, 2016.  The Hague Child Support Convention provides a legal framework and administrative procedures for international child support cases, speeds up the enforcement of U.S. orders by limiting the circumstances under which a court can review and object to an order those similar to grounds now allowed under United States law, recognizes United States due process requirements, and provides standardized time frames and procedures for international case processing.  (See OCSE DCL 16-11.)  31 countries have signed the Hague Child Support convention.

Child support agencies must use the approved forms for case processing with convention countries unless the responding countries has different form requirements.  (OCSE AT 17-06, July 11, 2017.)