CalHEERS glitch affects MAGI Medi-Cal individuals without SSNs

Posted on by

DHCS issued a letter to address a known CalHEERS system defect where individuals without a social security number go through the system and return with pending eligibility from CalHEERS.  The defect occurs when an individual is processed for an eligibility determination request at intake, renewal, or change of circumstances.  The impacted populations are newborn infants, undocumented individuals, and those without SSNs, both existing MAGI beneficiaries and new applicants.

The letter gives instructions on how to deal with affected cases.  DHCS MEDIL I 15-23 (8/13/15).

CalWORKs instructions on home county rules

Posted on by

CDSS has clarified that residence in California, but not in a particular county, is required for CalWORKs eligibility. Although recipients are required to report address changes within 10 days, failure to report an address change, by itself, is not a basis for adverse action against the recipient. For example, not reporting moving from a Region 1 (higher grant) county to a Region 2 (lower grant) county would cause an overpayment because of the difference in the grant level, but not because of the failure to report.  In addition, a recipient can temporarily reside in another county for up to four months without changing their home county as long as they intend to return. CDSS provided five examples to illustrate the CalWORKs home county rules. ACIN I-63-15 (7/27/15).

Questions and answers regarding Family Stabilization Program

Posted on by

CDSS has issued 15 questions and answers about the Family Stabilization Program (FSP). FSP provides intensive case management services to CalWORKs Welfare-to-Work (WTW) participants who are experiencing an identified situation or crises. The program is described in ACL 14-12 . Among other items, the questions and answers clarify that FSP services are available to adults who are exempt from WTW participation, and adults in the family who are not included in the assistance unit if there is at least one mandatory WTW participant in the family.

Regarding FSP plans, the questions and answers clarify that a client in sanction status can use an FSP plan to cure their sanction, and each adult in a household must have a separate FSP plan. CDSS also clarified that FSP is not mandatory. In addition, CDSS states that if a client has a crisis outside of the scope of a county’s FSP plan, the county should still assess such clients for WTW exemption and provide services for removal of barriers to WTW participation outside of the FSP program. ACIN I-64-15 (7/29/15)

CalHEERS issues with Medi-Cal scope of services for immigrants

Posted on by

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).

Medi-Cal applicants pending Accelerated Enrollment

Posted on by

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

Posted on by

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)