DHCS clarified income levels for the Blind FPL Medi-Cal programs starting 4/1/15:
– Individuals: $1211
– Couples: $1751 where both are blind; $1666 where one individual is blind and the other is aged or disabled.
DHCS ACWDL 15-24 (7/15/15).
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
MBSAC cost of living increase
Effective July 1, 2015, the CalWORKs Minimum Basic Standard of Adequate Care (MBSAC) increased by 2.54%. The MBSAC is the maximum amount of income an assistance unit can have, after income deductions, and be eligible for CalWORKs. The increase is the cost of living increase required by Welf. & Inst. Code Section 11453. This cost of living increase also increased the Income-In-Kind (IIK) level by 2.54%. The IIK level is the value assigned to free housing, utilities, clothes or food.
These increases also apply to Refugee Cash Assistance, Entrant Cash Assistance and Trafficking and Crime Victims Assistance Program benefits. The California Department of Social Services issued a chart showing the new MBSAC and IIK amount. ACL 15-52 (6/5/15).
Priorities for Processing Medi-Cal Application Batches
DHCS has set priorities for counties to process Medi-Cal batch applications. Counties are to resolve batch transactions that DHCS has not batched in weekly 45-day accelerated enrollment (AE) batch runs. Then, counties need to review Rivera Notice of Inaction individuals. Next, counties would process applications within the required 45 day timeframe. Finally, counties should process full eligibility determinations for those batched in aid code 8E.
DHCS MEDIL I 15-15 (7/13/15).
Medi-Cal managed care coverage of wheelchairs
DHCS issued an All Plan Letter clarifying how Medi-Cal plans should determine medical need for wheelchairs and applicable seating and positioning components. The criteria for medical necessity must include a medical evaluation of the beneficiary and review of the equipment to ensure that the beneficiary has appropriate mobility in or out of the home.
Medi-Cal covers medically necessary equipment when it is appropriate for use in or out of the patient’s home, regardless of whether the needed equipment will be used inside or outside of the home. DHCS APL 15-018 (7/9/15).
OCAT released
CDSS has released its new Online CalWORKs Appraisal Tool (OCAT). OCAT guides county welfare department workers through the CalWORKs appraisal process and generates recommendations for welfare-to-work and supportive services. The OCAT appraisal includes a section to screen for learning disabilities.
OCAT is currently only available in English. Clients with limited English proficiency are to be referred for evaluation and services to address their language barrier. Counties have the option to reassess current welfare-to-work clients using OCAT if they believe doing do will identify barriers to self-sufficiency. Clients must be informed of their privacy rights at the beginning of the OCAT appraisal. Training on OCAT started in April, 2015. All counties must have fully implemented OCAT by October 1, 2015. ACL 15-43 (4/17/15).
Residency for Out-of-State Students for Medi-Cal Purposes
DHCS recently issued guidance around Medi-Cal residency requirements for students either from out-of-state who attend California schools or California residents who attend out-of-state schools. If otherwise eligible, those students who come to California to attend school may apply for Medi-Cal (all other eligibility rules apply). Similarly, Medi-Cal beneficiaries who leave California to attend school can continue their Medi-Cal eligibility assuming they are still otherwise eligible. These beneficiaries may also apply for Medicaid in the state in which they attend school.
Parents/caretakers and households would also retain Medi-Cal eligibility if the only child or one child attends school out of state. Medi-Cal will only cover emergency services as long as the provider agrees to accept Medi-Cal. DHCS ACWDL 15-23 (7/9/15).