CDSS has made available a new online video, available in English, Spanish, Armenian and Chinese, that demonstrates how providers are to document overtime and travel time that will be compensable beginning January 1, 2015. The video explains the compensation and reimbursement changes related to SB 855 and SB 873 and explains proper use of several new related forms, including the revised time sheet and the new travel claim form. ACIN I-65-14.
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
Changes to how counties will calculate CalWORKs participation hours
Beginning July 1, 2014, counties must determine whether or not a CalWORKs recipient has met his or her hourly participation obligations by using a weekly average per month rather than a weekly minimum number of hours. Workers should (1) add up the total number of participation hours in all CalWORKs activities for the month, (2) divide by 4.33 and (3) round to the nearest whole number. Counties should no longer use weekly minimums, thus allowing recipients more flexibility in a given month to reach the required participation hours total. ACL 14-80.
DHCS MEDIL I 14-52: Translation of the Qualified Medicare Beneficiary, Specified Low-Income Medicare Beneficiary, and Qualifying Individuals Application (MC 14A) (10/24/14)
The Department issued this letter informing counties that the updated application for the Medicare Savings Programs has been translated in the 12 threshold languages.
DHCS ACWDL 14-39: Every Woman Counts (EWC) Program Offers Free Breast and Cervical Cancer Screening Services to Uninsured Women (10/24/14)
This letter informs counties about the Every Woman Counts program. The letter includes a brochure and flyer about the program, and it encourages counties to provide this information to those ineligible for other programs.
DHCS ACWDL 14-38: Annual Redetermination Process for Medi-Cal and Covered California Mixed Households (10/23/14)
DHCS issued this letter focusing on annual redeterminations for MAGI Medi-Cal and Covered California mixed coverage household. Since different annual redetermination periods and processes are involved, there will be two different annual redetermination dates for mixed coverage household members based on program: any time during the year for Medi-Cal, and before January 1 for Covered California.
Medi-Cal annual redeterminations are set for 12 months after the initial application date or most recent redetermination. Covered California redeterminations start processing in early October (for 2014) via CalHEERS. Covered California beneficiaries will be defaulted into their current plans if they don’t make an affirmative change, but they will have the option to switch plans during open enrollment.
When a mixed household population has the same annual redetermination date for Medi-Cal and Covered California, the Medi-Cal redetermination process will initiate the annual redetermination process. That means the county will go through the ex parte process and request of verifications to confirm Medi-Cal eligibility.
When a mixed household population has different redetermination dates for Medi-Cal and Covered California cases, the redetermination for one will be processed as a change of circumstances for the other, unless the county receives beneficiary information that does not change the information currently on file.
Counties are responsible for Medi-Cal eligibility determinations and ongoing case management of Medi-Cal cases with regards to cases that may have contact with the Exchange. The counties are required to assist with renewals for mixed households where changes are reported for Covered California that may impact Medi-Cal eligibility.
CMSP ACL 14-08: CMSP Policy on Determination of Other Health Coverage Under Covered California (10/15/14)
The CMSP Governing Board issued this letter to update its current policy regarding Covered California eligibility to reflect Open Enrollment dates of November 15, 2014, to February 15, 2015.
The policy is largely unchanged. If a CMSP application is received during the period between the first day of Covered California open enrollment and 15 days before the end of open enrollment, that application is considered “subject to the Covered California open enrollment period.” As such, CMSP applicants who are not eligible for Medi-Cal must provide evidence of application for and first month’s premium payment of Covered California participation. Those applicants not subject to the open enrollment period (here, starting 2/1/15) must provide evidence of termination from Covered California for lack of monthly premium payment and lack of eligibility for a special enrollment period.