According to state law, counties are supposed to stop accepting older, non-single streamlined applications for Medi-Cal after January 1, 2016. However, DHCS is requiring counties to continue to accept these older applications (including the SAWS 2 PLUS) and request any additional information necessary to make MAGI and non-MAGI determinations as appropriate until any remaining supplies are exhausted. DHCS ACWDL 15-34 (10/28/15).
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Notices for 1095-B at Initial Medi-Cal Application
Counties must offer a 1095-B beneficiary notice to all households at application for insurance affordability programs including Medi-Cal. The Notice will provide information about the Form 1095-B and remind all applicants to report all changes that may affect program eligibility to their county worker. DHCS included English and Spanish language versions of the Notice. DHCS MEDIL I 15-35 (10/26/15).
CalFresh COLA
CDSS has issued the CalFresh cost of living increase for Federal Fiscal Year 2016. Effective October 1, 2015, the maximum CalFresh grants increases to $194 per month for a one person household with similar increases for larger households. The maximum shelter deduction increases to $504. The standard deduction increases to $155 for a one to three person household with similar increases for larger households. The standard utility allowance increases to $385, the limited utility allowance increases to $118 and the telephone utility allowance decreases to $19.
CDSS included a chart of new income eligibility standards, maximum allotments, and deductions. ACIN I-75-15 (9/4/15).
Counties must review Share of Cost cases for MAGI eligibility
The State issued an urgent reminder to counties to review caseloads for share of cost cases (or potential share of cost cases denied due to assets) for MAGI eligibility. These cases should be appropriately determined back to January 1, 2014, so that the state can issue proper 1095-B forms and get individuals signed up for Covered California where appropriate. DHCS MEDIL I 15-29 (10/22/15).
Welfare-to-work satisfactory progress determination
CDSS has issued guidance on determining satisfactory progress in an assigned welfare-to-work (WTW) activity. The guidance states that the satisfactory progress standard for each activity must be stated in the WTW plan. If an individual is not making satisfactory progress, the county should offer learning disability screening and determine whether the client has a learning or physical disability.
If a student does not make satisfactory progress in an education program despite regular attendance and participation, the county should consider alternative classes for the classes that are causing trouble or doing a new assessment and modifying the WTW plan accordingly.
If an individual loses a job because of inability to meet job requirements despite regular attendance and participation, the individual should not be sanctioned and instead the individual should be reassessed to determine a new appropriate WTW activity. ACL 15-80 (10/20/15).
Medi-Cal Benefits for Students Attending College Out of County
When a student attends college in a different county, the family needs to inform the county of this change. The county will update only the student’s address in SAWS and MEDS. This change will trigger change in health plans where applicable, and the student can pick a new health plan based on the student’s college address. Until the student enrolls in a new plan, Medi-Cal benefits will be administered on a fee for service basis. If a student returns home for a school break and needs services, the student will need to update the address of record.
DHCS has issued this guidance along with a Frequently Asked Questions. DHCS MEDIL I 15-32 (10/20/15).