In July 2014, the Social Security Administration (SSA) announced the availability of SSA benefit verification letters and other SSA verification processes, via its My Social Security site. CDSS has now issued updated instructions (along with a few pointed reminders) to counties about the changes in the SSA processes for verification of Social Security account information, and how they relate to largely unchanged CDSS requirements for a client’s submission of Social Security numbers and income information. The specifics for verification of Social Security account information vary somewhat in the CalWORKs, Medi-Cal and and CalFresh programs, highlighted here. There is language here that is horatory but still helpful to the client’s cause, where CDSS reminds counties that “the CWD shall make every effort to assist the individual in obtaining the documents necessary to submit a complete application for a SSN card” and “strongly recommends that counties ensure that the forms they are using are adequate in providing all necessary information to clients.” ACIN I-24-15 (April 13, 2015).
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Counties must accept updated Medi-Cal beneficiary address information from health plans
DHCS has instructed counties that they must accept updated beneficiary contact information from managed care plans. If the beneficiary approves of the plan doing this, the county must update within 2 days. If the beneficiary has not approved, the county must contact the beneficiary to get an update within 5 days. DHCS ACWDL 15-19 (4/16/15).
Counties should also accept this information from Health Care Options immediately, with consent from the enrollee. DHCS ACWDL 15-20 (4/27/15).
Counties must send back ALJ decisions retroactively terminating Medi-Cal eligibility
The Chief ALJ has determined that hearing decisions that order retroactive termination of Medi-Cal eligibility were issued in error and should be returned to CDSS for correction. Should beneficiaries disagree with the corrected order, due process rights still exist. DHCS MEDIL I 15-12 (4/7/15).
New Medi-Cal noticing requirements under Rivera
DHCS issued guidance about notice requirements for Medi-Cal applicants whose applications have not been processed within 45 days per the Rivera decision. These beneficiaries have a right to file an appeal and request a hearing when the Medi-Cal determination has not been made within 45 days of application.
To comply with these requirements, DHCS has implemented in two phases a Rivera notice that foregoes the 90 day deadline to file for a hearing (applicable only for Rivera notices). Notices are available only in English and Spanish; samples are available with the letter.
DHCS MEDIL I 15-11 (4/7/15)
Approximately 120,000 current and former CMSP/P2H beneficiaries affected by data breach
Anthem Blue Cross’s January data breach may have affected 120,000 beneficiaries of the CMSP and Path2Health programs. These beneficiaries were sent notices at their last known address, but counties are to post information in county offices. CMSP ACL 15-04 (4/7/15).
Welfare to Work’s altered “flow”
Beginning in 2014, CDSS implemented AB 74, which changed the sequence of activities for CalWORKs Welfare to Work (WTW) participants provided in Welf. & Inst. Code Section 11320.1 in order to better serve individuals who face significant barriers to employment in light of the WTW 24-month clock. AB 74 permits participants to bypass the job search (job market test) when the participant is identified as having potential barriers to employment, such as mental health, substance abuse or domestic abuse, which warrant further assessment during the appraisal process. AB 74 also provides for a standardized appraisal tool to identify such individuals. That tool, the Online CalWORKs Appraisal Tool (OCAT), is to be implemented in Spring 2015. When significant barriers are identified during appraisal, the participant should be evaluated for a WTW exemption and referred for barrier evaluation and related services when appropriate. ACL 15-09.