To receive the FMAP increase under ARRA states cannot have more restrictive policies then were in place on July 1, 2008. Since July 1, 2008 California had reduced the continuous eligibility for children (CEC) period from one year to six months as well as added a Mid-Year Status report requirement for some children. The 6 month CEC and the MSR requirement will be suspended until the Director of DHCS issues a declaration specifying that the increased FMAP is no longer available through the ARRA. Upon such a declaration, the CEC time period will be restored to six months and MSR requirements for children will be required. The letter includes instructions to reinstate any child who was discontinued because of the 6 month CEC or the MSR. [Download]

This letter rescinds 09-08 and 09-08E. Everything looks the same as those letters except they changed the typo “2008” to the correct “2009”. An A&D FPL refresher: $1133 is the limit for an individual beginning April 1st, 2009. The couple’s income limit is $1579 as of January 1, 2009. [Download]

TMC, which provides an additional six to twelve months of Medi-Cal eligibility to beneficiaries discontinued from the Section 1931(b) program due to earnings from employment, has a new sunset date of December 31, 2010. Counties will continue to do eligibility determinations for TMC until DHCS notifies them that the program has been discontinued. [Download]

This letter clarifies and modifies the Medi-Cal to Healthy Families bridging performance standards originally laid out in ACWDL 07-03. [Download]

The QI1 program is a Medicare savings program that pays the Medicare Part B premium for people under 135% of the FPL. The program’s sunset date has been extended until December 31, 2010. Counties will continue to accept applications until DHCS notifies them that the program has been discontinued. [Download]

AB 1512 requires that foster care children that have moved to a new county be disenrolled from the County Organized Health System (COHS) in the previous county within two working days of a request from certain entities. Foster care kids and kids in the adoption assistance program are not required to be in managed care in most counties, in COHS counties they do have to be in the COHS. In the past when FC and AAP kids moved out a COHS county they either were unable to disenroll right away or were disenrolled only to be automatically reenrolled at the beginning of the next month. This new letter lays out a process that implements AB 1512 and is designed to correct the past disenrollment problems. Counties will immediately enter in the county system the child’s new residence address and where necessary the residence county code and counties will contact the Medi-Cal Managed Care Ombudsman’s office to disenroll the child. When the ombudsman’s office is contacted not by the county but by an authorized medical decision maker the ombudsman’s office will disenroll the child and instruct the decision maker to contact the FC or AAP worker in the county of responsibility to ensure that the new residence address is updates in the county system. The letter also contains information regarding access to mental health services and instructions for when a Foster Child moves out of state. [Download]