DHCS provides an overview of backlog batch processes

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In this letter, DHCS walks through the various efforts the state has made to expedite processing and eligibility for applicants waiting for eligibility determinations throughout the ACA era.  Of the described batches, the state is still processing the following batches:

  • Processing applications for short term negative actions due to the absence of such functionality in CalHEERS;
  • Transition to Medi-Cal cases from Covered California annual redetermination period; and
  • Accelerated enrollment for cases that have not been processed within 45 days since the second open enrollment period.

The letter includes a graph describing each batch process and relevant state instruction letters.  DHCS MEDIL I 15-05 (3/5/15).

New CalWORKs immunization good cause request form in use beginning this month

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Coincidentally, given the recent outbreaks of measles and whooping cough in California, CDSS recently issued a revised form for CalWORKs recipient families who seek a good cause exception to the child immunization requirements.  As of March 1, 2015, counties must use the revised Immunization Good Cause Request Form (CW 2209) which allows families to explain why one or all eligible children in the assistance unit are not immunized or cannot show proof of immunization.  The form must be provided at the time of application, redetermination and whenever the county requests proof of immunization.  Families are still permitted to make a verbal good cause request.  ACL 14-98.

Upcoming Changes to CalHEERS online Single Stream Application

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As of March 2, 2015, the online CalHEERS application portal has been changed to be more consumer friendly and in line with the paper application.  This DHCS letter explains that changes were made to simplify language and improve applicant understanding by putting some information front and center and making links available in easier places.  The changes include:

  • Asking questions about whether applicant qualifies for subsidies up front;
  • Links to information about the Deemed Infant Program, the Former Foster Youth program, and programs for pregnant women;
  • Updating the household information section to clarify what documentation is required;
  • Preventing the entry of contradictory tax information; and
  • Offering the opportunity to register online to vote.

Paper applications are being reviewed and will be printed when approved.  DHCS MEDIL I 15-04 (3/4/15).

Eligibility criteria and instructions to counties on Approved Relative Caregiver program

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Relative caregivers of foster children who are not eligible for federal foster care payments may be eligible for an equivalent payment through the Approved Relative Caregiver (ARC) program if their counties elect to participate in the program.  While the households of relative caregivers might be eligible for CalWORKs benefits for non-federally eligible foster children, those payments are lower than the federal foster care payment rate.  This letter explains the eligibility requirements for the children and caregivers and instructs the counties on the requirements of the program and how to opt in or out, in accordance with Welf. & Inst. Code §11461.3.  ACL 14-89.

Change in Third Party Administrator for CMSP Benefits

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As of April 1, 2015, CMSP medical and dental benefits will be authorized by Advanced Medical Management, taking over for Anthem Blue Cross.  On March 3, 2015, beneficiaries were mailed notices regarding this transition.  CMSP ACL 15-02 (3/3/15).

AEVS responses and the Medi-Cal Provider Operations Manual will be updated to reflect this change as of April 1, 2015.  DHCS MEDIL I 15-06 (3/6/15).

Updates to SSI Allocations and MSP property limits

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DHCS has informed counties about the increase in the standard and parent allocations for SSI in 2015.  This DHCS letter also includes information about the decrease in Medicare Part A premiums, and the lack of change for Part B premiums and deductibles.  Similarly, the property levels for the various Medicare Savings Programs remain at $7,160 for an individual and $10,750 for a couple.  DHCS ACWDL 15-13 (3/3/15).