DHCS provided this updated information on processing state residency verifications for pending and current applications through SAWS and CalHEERS. Previously, the paper verification of state residency status had been suspended until 8/1/14. That suspension is now extended until further notice. Attestation by verbal contact or listing of California address is sufficient.
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
DHCS MEDIL I 14-43: Information Concerning the Future Implementation of the Full-Scope Medi-Cal Coverage and Affordability and Benefit Program for Low-Income Pregnant Women and Newly Qualified Immigrants (NQIs) (7/30/14)
DHCS issued this letter to the counties about the implementation of the new Full-scope Medi-Cal coverage and affordability benefits program for low-income women and non-qualifying immigrants, to be operational no sooner than 1/1/15.
Currently, Medi-Cal limits full-scope benefits to pregnant women under 60% FPL and pregnancy-only Medi-Cal to those between 60%-208% FPL. Recent legislation established an affordability wrap between Medi-Cal and QHPs purchased through Covered California where pregnant women and non-qualifying (5 year bar) immigrants in a Covered California plan could have out-of-pocket expenses (including copays, premiums and deductibles) paid for by Medi-Cal.
Once these programs are fully implemented, pregnant women under 138% FPL will qualify for full-scope Medi-Cal. Pregnant women between 138-213% FPL who are enrolled in a Covered California QHP will have the option to enroll in the wrap. NQIs who would have been eligible for Medi-Cal due to MAGI expansion rules would enroll in a QHP with automatic enrollment in the wrap.
The letter also discusses the implementation process to be followed leading up to January 2015.
ACIN I-40-14: Child Welfare Services Reviews (7/15/14)
Information to counties about the benefits of conducting qualitative reviews of programs across the entire continuum of child and family services. [Download]
ACIN I-43-14: Assessments To Determine The Appropriateness Of The Group Home Placement For Children And Youth In Group Home Care Over One Year In Duration And Plans For Transitioning Into A Family-Based Setting (7/25/14)
Instructions to counties regarding assessing children in group homes. [Download]
DHCS APL 14-008: Standards for Determining Threshold Languages (7/15/14)
DHCS issued this letter to inform managed care plans of the updated dataset for threshold languages and language concentration standards. Included is the dataset and identified threshold languages for each county.
DHCS has revised MCP contracts to include the following language about threshold languages:
A population group of mandatory Medi-Cal beneficiaries residing in the service area who indicate their primary language as other than English, and that meet a numeric threshold of 3,000 or five-percent (5%) of the beneficiary population, whichever is lower.
DHCS MEDIL I 14-42: Denying Pending Applications from both the California Health Eligibility, Enrollment and Retention System (CalHEERS) and the Statewide Automated Welfare System (SAWS) Access Channels (7/25/14)
This DHCS letter instructs counties to follow the procedures outlined previous in MEDILs I 14-23 and 14-30 when counties need to deny pending applications after ex parte reviews and two ten-day letters while CalHEERS functionality is pending. SAWS will issue interim procedures on denying pending applications.