Medi-Cal System Treatment of New Medicare Beneficiary Identifiers

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The Centers for Medicare and Medicaid Services (CMS) is planning to phase in Medicare Beneficiary Identifiers (MBIs) between April 2018 and April 2019 to replace the current Medicare Health Insurance Claim Number (HICN) based on beneficiary Social Security Numbers.  The MBI and HICN will be linked and used, with SSA generating HICNs and CMS generating MBIs.

Starting April 2018, the SAWS and MEDS systems, along with other statewide systems, are expected to be able to receive MBI information.  The transition period will run through December 2019.  During this time, when beneficiaries will only receive an MBI, Counties are not to share MBI with anyone.  County workers will continue to enter Medicare information as they receive it.  A new field for MBI has been added to MEDS.

DHCS MEDIL I 17-15 (September 18, 2017).

Blind FPL Medi-Cal Income Threshold/Disregards Update

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Effective April 1, 2017, the Blind Federal Poverty Level income limits are as follows:

  • For a blind individual, the monthly income threshold is $1235, the same as the Aged and Disabled FPL threshold.
  • For a couple where both individuals are blind, the monthly income threshold is $1751
  • For a couple where one individual is blind and the other is aged or disabled, the monthly income threshold is $1666

DHCS ACWDL 17-33 (September 14, 2017)

CalWORKs and financial aid

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The California Department of Social Services has issued a reminder to counties about counting financial aid as income for CalWORKs. Most education grants, scholarships and loans are exempt in their entirety from consideration as income for CalWORKs regardless of how they are used.  Loans and grants that are entirely exempt include loans and grants under Title IV of the Higher Education Act or the Bureau of Indian Affairs student assistance program, grants administered by the federal Department of Education, educational grants based on need, and loans or grants from community college extended opportunity services, the California Student Aid Commission or a college accredited by the Western Association of Schools and Colleges.

Applicants or recipients can choose to pay education expenses from their exempt financial aid.  However, they cannot be required to do so, and supportive services cannot be reduced if a participant chooses not to use financial aid for education expenses otherwise covered by supportive services.  The WTW 8 form is used to documents this choice.

In general, non-federal financial assistance that is based on merit instead of need, including grants from charitable organizations, private scholarships, and non-federally subsidized loans are exempt to the extent the proceeds are used to meet education expenses.  Any portion of non-exempt financial aid that is not used for education expenses counts for CalWORKs.  If the non-exempt financial aid is a recurring payment, it counts as income.  If it is a one-time payment, it is a non-recurring lump sum that counts as a resource in the month after it is received.  Recipients must provide the county with verification of the education expenses for which they used non-exempt financial aid.  (ACIN I-58-17, August 29, 2017.)

Updated Guidance on Medi-Cal Failure to Respond NOAs

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In response to the Korean Community Center of the East Bay settlement, DHCS has issued new guidance to clarify procedures for discontinuing Medi-Cal cases for failure to respond at annual redetermination for MAGI and Non-MAGI cases.

In both MAGI and Non-MAGI cases, the county should use ex-parte resources to confirm continued eligibility.  If information is missing, the county should send an appropriate request for only the information that could not be verified (MC 216 for MAGI, or an appropriate non-MAGI renewal form).  If the beneficiary does not respond (and not just providing incomplete or insufficient information), the county must discontinue with an appropriate notice.  Sample language for these notices is included in the guidance.  Beneficiaries continue to have a 90-day cure period.

DHCS ACWDL 17-32 (August 31, 2017).

HUD Lead Safe Housing Rule Guidance

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The United States Department of Housing and Urban Development (HUD) has issued guidance to public housing authorities (PHA), Housing Choice Voucher (HCV) property owners and Project-Based Voucher (PBV) property owners regarding required actions when a child in a family receiving public housing, HCV or PBV assistance is identified as having an elevated blood level (EBLL).

The guidance identifies various actions that must be taken when a child under age 6 is identified with an EBLL, including notifying HUD, notifying the local health department if necessary, verification of the case if necessary, environmental investigation, control of the lead hazard within 30 days, notifying other residents and ongoing monitoring.  For public housing, the PHA is the responsible party.  For PBV, the property owner is the responsible party.  For HCV, the PHA is the responsible party but the property owner is responsible for certain response activities.

The guidance also reminds owners of PBV properties that receive more than $5,000 annually per unit in assistance that they must ensure that units built prior to 1978 receive a lead risk assessment, regardless of whether there are children under age 6 in residence, that occupants are informed of the result of the risk assessment, that identified lead paint hazards receive interim controls and that there is clearance by a certified risk assessor before re-occupancy.  PBV owners must also monitor and maintain any remaining lead based paint and hazard controls with annual visual inspections and reinspections with testing every two years.  (PIH Notice 2017-13, August 10, 2017.)

 

Accessibility in Special Occupancy Parks

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The California Department of Housing and Community Development (HCD) has issued guidance about application of the Americans with Disabilities Act and other disability laws to Special Occupancy Parks, which include recreational vehicle parks, incidental camping areas and tent camps.  HCD states that Special Occupancy Parks that are open to the public “likely” qualify as public accommodations and “thereby may be subject to” the Americans with Disabilities Act, the California Building Code, the Unruh Act, and the California Disabled Persons Act.

This means that Special Occupancy Parks must comply with the 2010 Americans with Disabilities Act Standards for Accessible Design, including accessibility requirements for day use areas, nature trails, parking spaces, bathrooms and pools.  (Information Bulletin 2017-04, July 25, 2017.)