Sanctioned adults are eligible for stage 1 child care

Posted on July 9, 2015 by Stephen Goldberg

Following substantial advocacy by the Child Care Law Center, CDSS has clarified that adults in CalWORKs sanction status can be eligible for Stage 1 child care. Under MPP Section 42-721.41, sanctioned adults are eligible for child care when the client is in the process of curing a sanction or during the months in sanction the client is working or participating in a county-approved program activity, which are activities in the assigned as part of the a welfare-to-work plan or activities necessary to accept or retain employment. Sanctioned adults in a cure plan remain in Stage 1 child care. Sanctioned adults performing an approvable activity should be assessed for transfer to Stage 2 child care.

CDSS also reiterated that clients in sanction status can request to cure the sanction by entering into a plan to cure the sanction and performing the activity stated on the cure plan up to a maximum of 30 days, whichever is shorter.

ACL 15-53

IHSS 7% reduction restored

Posted on July 7, 2015 by Stephen Goldberg

Effective July 1, 2015, the IHSS 7% reduction is restored. The 7% reduction was part of the settlement in the Oster v. Ligthbourne litigation and was codified in Welfare and Institutions Code Sections 12301.01 and 12031.02. In SB 97, (Budget Act, Section 57, Part 6) the legislature suspended the reduction for one year, from July 1, 2015 to June 30, 2016. In a special legislative session later this year, the legislature will attempt to determine funding sources for making the restoration of the 7% reduction permanent.

Notices of the possibility that the 7% reduction would be restored were scheduled to go out in mid-June. The notices say that restoration was a possibility because the restoration legislation had not yet passed.

The IHSS computer system called CMIPS II is supposed to automatically create a new IHSS authorization with the restored hours added, and to automatically updated provider hours. The ACL warns that there may be an issue assigning the hours when a recipient has multiple providers and if the recipient wants hours divided differently between multiple providers, the recipient needs to file a SOC 838 form with their county.

ACL 15-57

Medi-Cal plans must offer certified nurse midwife services

Posted on July 2, 2015 by John Tan

Medi-Cal managed care plans are required to provide access for certified nurse midwife services to Medi-Cal beneficiaries. Beneficiaries may seek out CNM services from outside the plan when the plan is unable to provide such services within network. DHCS APL 15-017 (6/30/15).

New Medi-Cal guidelines for Hepatitis C treatments

Posted on July 1, 2015 by John Tan

This week, DHCS issued new guidance to Medi-Cal managed care plans about new treatment guidelines for recent FDA-approved treatments for Hepatitis C. The updated policy, effective July 1, 2015, looked at recent medical evidence and practice guidelines to determine who would be eligible for treatment.

DHCS APL 15-016 (6/29/15); Treatment Policy for the Management of Chronic Hepatitis C

CDSS issues new instructions about Protective Supervision

Posted on June 29, 2015 by Stephen Goldberg

In this letter, CDSS states several policies about several aspects of eligibility for In Home Supportive Services Protective Supervision, which is 24 hour supervision to safeguard against injury, hazard or accident. (MPP § 30-757.17.) These policies include:

A person must be both mentally ill and non-selfdirecting to be eligible for Protective Supervision. CDSS states it will amend MPP Section 30-757.17 to reflect this policy.
A person must be physically able to harm themselves to be eligible for Protective Supervision. This can include observation of persons who are bedridden but who are able to harm themselves. CDSS gives the example of a bedridden person who can pull out a G-tube.
While Protective Supervision is not available to guard against deliberate self-destructive behavior, a recipient who engages in deliberate self-destructive behavior and other behavior that is a basis for Protective Supervision such as wandering can be eligible for Protective Supervision to prevent the wandering.
Environmental modifications such as removing knobs from stoves or adding safety latches can eliminate the need for Protective Supervision.
Fluctuating or episodic behavior can be a basis for Protective Supervision if the behavior is unpredictable. However, if the behavior is predictable, IHSS should only be authorized for the time when the behavior occurs.
Leaving a recipient for fixed short periods of time is not, by itself, a reason to deny Protective Supervision
Actual injury is not required for Protective Supervision eligibility. A history of a propensity for the recipient to place themselves in danger is sufficient for Protective Supervision eligibility.

The letter also restates criteria for assessing children for eligibility for Protective Supervision. ACL 15-25.

CDSS directs counties to discontinue use of promissory notes for overpayment collection

Posted on June 26, 2015 by Julie Aguilar Rogado

Acknowledging that inclusion of promissory notes along with CalWORKs overpayment notices of action constituted an unlawful demand in violation of its regulations (MPP Section 44-351.1), CDSS directed counties to stop sending such agreements to reimburse. Recipients may still voluntarily request a reimbursement agreement, which must be in writing and clearly indicate that repayment is voluntary. CDSS further instructed counties to begin using a new form, CW 2217 “CalWORKs Request for Voluntary Repayment,” which they may provide upon request as long as the recipient has asked if he or she may voluntarily repay, the overpayment was already explained to the recipient, the county did not initiate or request the repayment, and the recipient understands he or she may suspend the repayment at any time. ACL 15-13.

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