Policy on fraud investigation requests for school records

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CDSS has issued a policy about when a county welfare department or fraud investigator can request school records as part of an investigation. Welf. & Inst. Code Section 11484 requires state and local agencies to cooperate with welfare fraud investigations. However, the Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. Section 1232g, protects the privacy of student education records.

CDSS stated that because of FERPA, county welfare departments and welfare fraud investigators can only request what is defined as directory information from a school absent written consent from the student’s parents, a court order or a subpena. CDSS directed county welfare department staff and welfare fraud investigators to cease requesting information from schools other than directory information without parental consent, a court order or a subpoena. ACL 15-47 (6/17/15).

Revised regulations on parents as IHSS providers for children under age 18

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Following a decision of the CDSS director that invalidated CDSS’ prior regulations, CDSS issued revised regulations about eligibility for parents to be IHSS providers for their children. The revised regulations are at MPP Sections 30-763.44 and .45.

The revised regulation continues the rule that a child under age 18 is eligible for IHSS when the no parent is available to provide IHSS, which is defined as when the parent(s) is employed or enrolled in an education or vocational training program, or physically or mentally unable to provide IHSS services. A parent is considered unavailable only if unavailability occurs during the time the child must receive a specific service.

In addition, IHSS is available from a non-parent provider for up to 8 hours per week when parents are unavailable in order to do shopping or errands necessary for the family, to search for employment or to care for the recipient’s minor siblings. The regulations continue the rule that a parent who is required to leave or cannot obtain full-time employment because of the need to provide care for a child can be an eligible IHSS provider. The regulations also continue the rule that a parent cannot be the IHSS provider when a second parent who is in the home is available to provide care. The new regulations clarify that the restrictions who can be a provider for children under age 18 apply only to natural or adoptive parents. CDSS also included several questions and answers about the revised regulations.
ACL 15-45 (5/1/15).

MBSAC cost of living increase

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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

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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

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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).