The Department issued this letter to Medi-Cal Managed Care plans providing guidance on D-SNPs as the state adopts the Coordinated Care Initiative and Cal MediConnect for dual eligibles. D-SNPs in non-CCI counties will continue to operate per contract. Contracts for D-SNPs in CCI counties depend on whether that D-SNP is also a Cal MediConnect plan.
Summaries of select CalWORKs, CalFresh, Health and Housing Regulations
DHCS MEDIL I 14-38: Department of Health Care Services (DHCS) Waiver Change Information (6/25/14)
DHCS released this letter to provide information about seven different DHCS Waivers constituting Home and Community-Based Services and Long-Term Care Services and Supports programs. Waivers coming up for renewal this year are being renewed for a five-year period. The letter describes each of the waiver programs and provides information on how to access Long Term Care services and how a client may apply for waiver services.
DHCS MEDIL I 14-37: All Counties Jurisdictional Change for Medi-Cal Disability Referrals and Applications (6/24/14)
DHCS issued this letter explaining that due to downsizing of the Oakland State Programs Branch, all Medi-Cal disability referrals and packets will be handled by the Los Angeles office effective June 1, 2014.
ACIN I-33-14: CalFresh Overissuances (6/27/14)
Some post-FNS clarification on establishment and collection of CalFresh overissuances. To determine whether an overissuance is cost-effective to collect, the thresholds is determined based on the amount as of the date the overissuance is calculated. Counties are to terminate any collections for OI’s that were above $35 when established. (SB 1391 raises the cost effectiveness threshold to above $125, but only for households no longer on CalFresh. If the OI is discovered and established, but before collection can start the family will no longer be on CalFresh, and the OI is 125 or less, no collection would occur. [Download]
ACIN I-31-14: Release Of The Statewide Report Of County Quality Assurance/Quality Improvement Activities In The IHSS For Fiscal Year 2012/13 (6/11/14)
SB 1104 required CDSS and county welfare departments to establish a dedicated QA function to conduct routine scheduled reviews of IHSS cases. This report is the first out after conducting the review. 17,621 case reviews, resulting in about 10 percent of QA case reviews resulted in a change in authorized service hours. Not listed in the executive summary is the discovery that 4% of the cases referred for fraud follow up were being underpaid. Overall, although there was a high level of achievement, not all counties did all required reviews, and data was inconsistent, and the review demonstrated that there needs to be improvements in QA data forms, instructions and training. The review (with the revised forms) does seem to detect “critical incidents” where an IHSS recipient may be at risk. [Download]
ACIN I-28-14: Collection Of CalFresh Overissuances (6/10/14)
A reminder to counties that when determining the amount of a CalFresh overissuance, the amount of the overissuance is based on the initial amount of the CalFresh benefit. In cases where there is an existing overissuance recouped by benefit reduction, the amount of a recoupment for another type of overissuance is based on the initial CalFresh benefit issued for the household, not from the adjusted benefit. Example provided. [Download]