Questions and Answers about Expanded Subsidized Employment

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CDSS has issued questions and answers about Expanded Subsidized Employment (ESE) for CalWORKs recipients.  Highlights of these questions and answers include

  • ESE funds cannot be used for dental services, glasses or tattoo removal, but non-prescription glasses and tattoo removal can be ancillary supportive services.
  • ESE funds cannot be used for the 25% match for federal work study placements, but can be used for CalWORKs work study placements.
  • ESE can be used for workers’ compensation costs and backgrounds checks but not for physicals or uniforms.
  • Counties can place a recipient in a second ESE placement if the first ESE placement does not use all six months of ESE eligibility, but counties must determine on a case-by-case basis if that placement is appropriate.
  • Youth can participate in ESE either as their welfare-to-work participation or as exempt volunteers, but Non-Minor Dependents are not eligible for ESE.

(ACL 17-03, January 25, 2017.)

Restoration of Acupuncture Services as a Medi-Cal Benefit

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As of July 1, 2016, the State has reinstated outpatient acupuncture services as a Medi-Cal managed care benefit.  Acupuncture will be covered as needed to prevent, modify, or alleviate the perception of severe, persistent chronic pain resulting from a generally recognized medical condition.  Services are limited to two sessions per month, though additional sessions may granted through medical necessity and prior authorization.

DHCS APL 16-015 (December 1, 2016).

Medi-Cal Coverage of Tobacco Prevention, Cessation Services

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DHCS issued an All Plan Letter providing instructions on what tobacco prevention and cessation services should be covered by managed care plans.  DHCS points to the US Preventive Services Task Force in setting coverage requirements for both pregnant and non-pregnant beneficiaries, including:

  1. Assessments of tobacco use for all adolescent and adult beneficiaries
  2. FDA-approved medications for non-pregnant adults, at least one of which must be available without prior authorization requirements
  3. Counseling services for tobacco user beneficiaries of any age
  4. Tailored counseling services for pregnant tobacco users
  5. Prevention of tobacco use for children and adolescents
  6. Training of managed care-contracted providers
  7. Systems to identify tobacco users for assessment and reporting purposes
  8. Systems to track utilization of tobacco cessation treatment

APL 16-014 (November 30, 2016).

CalFresh eligibility for people in SSI suspense status

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CDSS has issued instructions to counties implementing the decision and judgment in Riojas v. Vilsack and Lightbourne, 2016 WL 3566941.  Riojas held that people in SSI suspense status are eligible for CalFresh.

CDSS instructed counties that, effective immediately, people who are not receiving a SSI payment are eligible for CalFresh as long as all other CalFresh eligibility criteria are met. Within two months counties must identify applications that were filed after August 30, 2016 that were denied solely because the applicant was in SSI suspense status and issue retroactive benefits to those people.  Counties must also identify household members excluded solely because of their SSI suspense status on or after August 30, 2016, and, if otherwise eligible, issue retroactive benefits to those persons.

A change in SSI from active status to suspense status is not a mandatory mid-period report. However, if this change is reported, the county must add the household member effective the first day of the next month.  If SSI status changes to active status and that change is known to the county, then the county must increase or decrease benefits effective the first day of the next month, or as soon as 10-day notice can be given.  (ACL 17-09, January 27, 2017.)

CAPI PRUCOL Clarification

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CDSS has issued instructions about the definition of Permanent Resident Under Color of Law (PRUCOL) for purposes of eligibility for Cash Assistance Program for Immigrants (CAPI) benefits.  One way that people can be eligible for CAPI is if they are PRUCOL.  For CAPI purposes, PRUCOL refers to 12 categories of non-citizens.  The twelfth category is a general classification for people who can show that USCIS knows they are in the United States and USCIS does not intend to deport them.

A non-citizen can demonstrate that USCIS is aware of their presence in the United States by showing correspondence with USCIS. Individuals who are subject to an order of deportation or who overstay their visas cannot qualify.

A non-citizen can show that USCIS does not intend to deport them by showing it is USCIS’ policy or practice not to deport aliens in the same category.

The Systemic Alien Verification for Entitlements (SAVE) system for verifying immigration status does not identify people as PRUCOL.  Counties must determine whether people qualify as PRUCOL.  (ACIN I-79-16, November 30, 2016.)