DHCS is not raising the community spouse resource allowance or the maximum spousal income allocation under the Medicare Catastrophic Coverage Act. These limits will remain at $119,200 and $2981, respectively. ACWDL 15-38 (12/18/15).
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Medi-Cal 1095-B forms issued
Beginning January 4, 2016, DHCS started to issue 1095-B forms to Medi-Cal beneficiaries as proof of minimum essential coverage for 2015 tax returns. Mailings were sent on a rolling basis on county and zip code. The MEDIL includes the mailing schedule and cover letter samples. MEDIL I 15-43 (12/31/15).
Bilingual and interpreter services at Local Child Support Agency offices
The California Department of Child Support Services (DCSS) issued instructions to Local Child Support Agencies (LCSAs) about providing bilingual and interpreter services. DCSS’ new policy is based on the Dymally-Alatorre Bilingual Services Act.
DCSS directed LCSAs to 1) provide interpreters for limited English proficient persons who speak a language spoken by five percent or more of the population served by the LCSA, 2) post notices in languages spoken by five percent or more of the population served by the LCSA about the availability of bilingual services upon request, 3) translate written materials, including forms, signs and literature, into languages spoken by five percent or more of the population served by the LCSA, and 4) determine and employ a sufficient number of bilingual staff in public contact positions.
DCSS included a chart of languages that are spoken by 5% of the population served by the LCSA based on the 2010 census and the American Communities Survey. CSS Letter 16-05 (February 9, 2016).
Extension of ABAWD time limit waiver
The federal government has granted California’s request for an extension of its waiver of the Able-Bodied Adults Without Dependant Children (ABAWD) time limit. The ABAWD rule limits receipt of federal Supplemental Nutrition Assistance Program (SNAP) benefits (CalFresh in California) by non-disabled adults without children to three months every three years unless they are meeting certain work requirements. Areas, including entire states, can request waiver of the ABAWD rule if their average unemployment rate is 20 percent over the national average for a recent 36 month period. California’s ABAWD waiver is now extended until December 31, 2017.
The result of the waiver is that there continues to be no time limit for receiving CalFresh benefits in California and participation on CalFresh Employment and Training Program is voluntary until January 1, 2018. ACIN I-11-16 (February 2, 2016).
Live-In family care exemption to IHSS workweek rules
CDSS has issued instructions for the live-in family care exemption from the new IHSS overtime rules. Instructions about the workweek rules are in ACL 16-01. There are two exemptions from these rules for IHSS providers. An IHSS provider who, on or before January 31, 2016, is providing services to two or more live-in family member, can work up to 12 hours per day or 90 hours per week, not to exceed 360 hours per month. The criteria for this exemption are: 1) The provider works for two or more IHSS recipients, 2) The provider lives in the same home as all of the IHSS recipients for whom services are provided and 3) The provider is related to all of the IHSS recipients for whom services are provided as parent, adoptive parent, step-parent, grandparent or legal guardian. This exemption does not apply to providers who do not meet these criteria prior to February 1, 2016.
This exemption does not change the rules regarding minor IHSS recipients living in two parent households. However, a non-parent provider can provide IHSS for any remaining hours that cannot be provided by the parent provider who is limited to 360 hours per month.
There is also an exemption from the workweek rules extraordinary circumstances which place the IHSS recipient at imminent risk of institutionalization. A potential example is where no other caregiver who speaks the recipients primary language can be located in the community. These exemptions will only be granted on a case by case basis. CDSS issued ACL 16-22 with criteria and requirements for the extraordinary circumstances exemption. ACL 16-07 (January 21, 2016).
CalWORKs and CalFresh file access rules
CDSS has issued instructions about access to county welfare department case files for CalWORKs, CalFresh, Trafficking and Crime Victim’s Assistance Program and Refugee Cash Assistance. The general rule is the client may inspect non-privileged, non-confidential documents in their case record, including the entire case narrative. Clients are not required to state why they want to inspect their case file. The only questions the county can ask are questions necessary to assist in identifying the information the client wants. The county cannot require a Public Records Act request for the client to see their case file.
Clients must be able to access their case file regardless of whether the file is maintained in paper or electronically, including documents stored separately from the county consortia automated systems. Documents can be provided by hard copy, read only access to systems with a hard copy of any requested documents, or by a pdf file. The county must provide if the client so requests.
If the client’s request includes documents that the county deems to be privileged or confidential, the county should redact the privileged or confidential information and provide the redacted documents to the client. If the documents cannot be redacted, the entire document can be withheld. Examples of potentially privileged or confidential information include whereabouts of an absent parent, child protective services information, and information about minor’s consent services. Medical records are also privileged, but as the holder of the privilege clients have access to their own medical records that are in the case file. The identity of an informant is also privileged, but must be disclosed if the informant will testify at a hearing.
If a document is redacted or withheld pursuant to a claim of privilege or confidentiality, the county must use the Response to Request to Inspect Case Record form to inform the client that documents are being withheld and why. CDSS recommends that counties establish an informal dispute resolution process to resolve these disputes. Case file access disputes can also be raised during administrative hearings.
For an administrative hearing, the county must allow a claimant to examine their case record during normal business hours. The county must provide the claimant with any and all information that can assist the claimant in preparing for the hearing. The county cannot charge for copies of CalFresh documents. For CalWORKs documents, the county can copy requested documents without charge or for a charge related to the cost of copying.
Claimants are entitled to access to fraud investigation files when the county has taken an administrative action based on the fraud investigation and the claimant has requested a hearing to challenge that action. The claimant can examine relevant, non-privileged, non-confidential documents from the fraud investigation file that the county used in making its decision to take the administrative action that is the subject of the hearing. ACL 16-02 (January 20, 2016).