As of December 31, 2014, PE coverage begins on the date of the eligibility determination and ends at the end of the following month if no Medi-Cal application is submitted for full determination. Previously, presumptive eligibility went back to the first day of the month for a 60-day enrollment period. There is no change to the end date of eligibility. DHCS MEDIL I 15-31 (9/24/15)
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Making Changes to Beneficiary Information with a Health Plan
Managed care plans are to contact county office liaisons to provide updated contact information for Medi-Cal beneficiaries. If the plan has received the beneficiary’s approval, the counties must incorporate these changes immediately. If the plan does not have the beneficiary’s approval, a county worker must verify the changes before making them. DHCS ACWDL 15-30 (9/22/15).
Questions and answers regarding OCAT
CDSS has issued several questions and answers regarding the new Online CalWORKs Appraisal Tool (OCAT) (See ACL 15-43 for background about OCAT). Most importantly, the questions and answers state that an individual cannot be sanctioned for not answering particular OCAT questions. This should include questions about disability and domestic violence. An individual can be sanctioned for refusing to do the OCAT appraisal at all.
In addition, the questions and answers state that an OCAT appraisal can be done by telephone as a reasonable accommodation or when coming to the welfare department would interfere with work or class schedule. ACL 15-69 (9/17/15).
CalFresh student eligibility
AB 1930 required CDSS to identify and verify participation in programs that are exempt from the rule that students are generally ineligible for CalFresh. CDSS has identified that students enrolled in either a Workforce Innovation and Opportunity Act (WIOA) program or Extended Opportunity Programs and Services (EOPS) program are eligible for CalFresh. CDSS states it is developing a form to verify enrollment in these programs and is continuing to work on identifying other educational programs that are exempt from the CalFresh student rules. ACL 15-70 (9/17/15).
Medi-Cal backlog cases no longer batched for Accelerated Enrollment
DHCS has explained that the application batching process that allowed the state to mitigate some of the 2014 application backlog through Accelerated Enrollment (AE) has ended. DHCS is still required to send Rivera Notices of Inaction when an application is pending for 45 days or more. DHCS will continue to monitor how many applications remain pending after 45 days, with the possibility that AE batching may resume to help mitigate any further application delays. DHCS MEDIL I 15-27 (9/18/15).
Fixing Medi-Cal Aid Codes for Former Foster Youth
DHCS issued instructions to the counties to facilitate the appropriate Medi-Cal coverage of former foster youth through aid code 4M. Former foster youth are entitled to receive Medi-Cal through the age of 26. The current CalHEERS programming uses MAGI rules, resulting in some eligible former foster youth being assigned other aid codes or not at all.
The state is extracting data for the counties on affected former foster youth who should be assigned aid code 4M. Counties must use available information to verify former foster youth status, and then immediately enroll eligible individuals into the proper aid code and issue a NOA.
This letter applies to those currently receiving Medi-Cal with a different, non-cash aid linkage aid code, and those without an aid code but with eligibility for APTCs. The state will issue a separate letter for those former foster youth enrolled in a qualified health plan through Covered California. DHCS ACWDL 15-29 (9/16/15).