DHCS issued clarification about the CalHEERS issues regarding scope of services for certain immigrants. The new release of CalHEERS uses two data fields for scope of services. If both fields (Citizen and Eligible Immigrant) are marked “no” or left blank, CalHEERS will grant restricted scope benefits. Counties have been instructed to ensure that workers do the appropriate verifications. Counties also must assess how much of a problem has occurred and fix problems as appropriate, including providing a proper notice. DHCS MEDIL I 15-20 (8/11/15).
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Medi-Cal applicants pending Accelerated Enrollment
DHCS has issued clarification in cases where individuals are pending AE and the County doesn’t deny the application. Counties are reminded that they must ensure that the individuals excluded from the 45-day AE process due to pending negative action should be included in county exclusion lists. These applicants should still receive Rivera notices unless the denial action will be completed before the NOI would otherwise be mailed. DHCS ACWDL 15-28 (8/6/15).
CalWORKs and CalFresh verification requests
In response to a request submitted by Legal Services of Northern California in 2009, CDSS has reiterated that counties must assist clients in obtaining information, including assistance in obtaining a Social Security Number and card. CDSS stated that if an application is unable to obtain a Social Security Number and card within 30 days of application, CDSS must evaluate the circumstances for good cause. In addition, CDSS stated that counties cannot require a printout from the Social Security Administration as proof of an applicant’s Social Security Number
CDSS also stated that the CW2200 Request for Verification form is a mandated form and must be used by counties. The CW2200 lists information that an applicant must provide and lists types of proof that an applicant can submit to verify particular information. The CW2200 also states that clients can request help from the county in obtaining verification and that counties can pay costs of obtaining verification when necessary. ACIN I-24-15 (4/13/15) and I-24-15E (5/5/15)
Guidance on pregnancy and young child exemptions
CDSS has clarified that temporary illness from pregnancy is good cause for non-participation in Welfare-to-Work. If a pregnant participant is unable to participate in Welfare-to-Work activities for at least half of her participation requirement in a month, that month does not count toward the 24 month time clock. If pregnancy significantly impairs a woman’s ability to participate in
Welfare-to-Work for at least 30 days, she can be exempt from Welfare-to-Work for disability.
CDSS has also reminded counties of the one-time young child exemption that allows an exemption for a parent or caretaker relative caring for a child under age 23 months to be exempt from Welfare-to-Work. In addition, a parent caring for a child under age six months can be exempt from Welfare-to-Work once and exempt for 12 weeks for subsequent children.
In addition, CDSS reminded counties that Civ. Code Section 43.3 and SB 252 allow a mother to breast feed her child in any public or private location, including a county welfare department office. ACIN I-38-15 (6/3/15).
New CalHEERS Functionality for Medi-Cal
The State is implementing a new CalHEERS release. In this letter, DHCS provides an overview of new major functionalities of this release. Counties will now be able to initiate negative actions (denials/discontinuances). Additionally, CalHEERS is supposed to reduce the number of MAGI Medi-Cal NOAs at application and change of circumstance. DHCS MEDIL I 15-19 (8/3/15).
Medi-Cal benefits through the Trafficking and Crime Victims Assistance Program
DHCS has issued guidance on Medi-Cal benefits for TCVAP beneficiaries. The letter reviews eligibility for TCVAP and documentation requirements for Medi-Cal eligibility purposes. DHCS ACWDL 15-25 (7/22/15).