DHCS ACWDL 14-28: Elimination of the Deprivation Requirement for Medi -Cal Linkage for the Modified Adjusted Gross Income Parent/Caretaker Group and the Aid to Families with Dependent Children-Medically Needy Program (7/7/14)

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DHCS released this letter to clarify that the previous deprivation of requirement was eliminated as of January 1, 2014, as part of the implementation of the Affordable Care Act.  Prior to January 1st, family linkage to 1931(b) or AFDC-MN programs was established when a child was deprived through absence, death, incapacity or unemployment/underemployment of at least one parent in the child’s family.  With the ACA, Parent/Caretaker and AFDC-MN eligibility is established when the parent/caretaker lives with the child for whom s/he provides care.

The letter also discusses the effects of this rule change on pregnant women, stepparents, and Sneede v. Kizer cases.  DHCS provides 8 examples on determining program linkage.

DHCS APL 14-007: Dual-Eligible Special Needs Plans (6/26/14)

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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.

DHCS MEDIL I 14-38: Department of Health Care Services (DHCS) Waiver Change Information (6/25/14)

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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.

ACIN I-33-14: CalFresh Overissuances (6/27/14)

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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)

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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]