Previously the Program Review Section reviewed Counties’ application processing times using two different application samples, one for general applications and one for disability-based applications. This ACWDL changes the process and integrates the area of application processing into one application sample. The idea is that the new process will create samples that are more representative of the total application population; the old process was yielding low numbers of reviewable disability- based cases. The reviews will be based on the same time standards of 45 days for general applications and 90 days for disability-based applications; of course disability-based applications that cannot be processed within 90 days due to state agency delay will not be considered.   [Download]

Some term life insurance policies now have cash values. The face value of those with cash surrender value will be combined with the face value of other insurance policies. If the total combined face value is over $1,500 the net value will be included in the property reserve. Endowment life insurance contracts are treated as a legal instrument similar to a trust. Assets held in an ELIC are considered available property. [Download]

This ACWDL lays out the process county welfare departments need to follow to determine the Medi-Cal eligibility of youth prior to their release from county juvenile facilities, pursuant to SB 1469. Before a juvenile is released, the county juvenile facility provides the necessary information to determine the juvenile’s Medi-Cal eligibility to the county welfare department.  The date of release is the date of eligibility.  If the juvenile is eligible the county welfare department must supply the juvenile with a temporary paper Medi-Cal card that he or she can use immediately upon release. [Download]

Info on the process to allow reimbursement to a recipient for overpaid Medi-Cal Share of Cost (SOC) as the result of missing the State’s payment of medically recognized expenses (also known as Buy-Out) at the beginning of the month through no fault of the recipient.

The In-Home Supportive Services Plus Waiver (IPW) had an impact on the IHSS and Medi-Cal (MC) SOC processing. While IHSS allows “obligations” to count towards the SOC, Medi-Cal requires payments. IHSS recipients with a Medi-Cal SOC are now subject to the same SOC spend-down processing as all other Medi-Cal beneficiaries. To deal with this issue, people in the Personal Care Services Program (PCSP) or IPW, who get IHSS, will have a comparison of their Medi-Cal and IHSS SOCs, and must meet the lesser of the two SOCs. The State will “Buy-Out” the difference between the two SOCs.

Procedurally, the state runs a Buy-Out processing about 1 week prior to the end of the month. After this file is processed, DHCS will not accept any retroactive or subsequent Buy-Out payments.

Due to the timing of the MEDS Monthly Renewal File process, new IHSS recipients will rarely be included in the Buy-Out during their first month of eligibility. These recipients are responsible for their entire Medi-Cal SOC for the first month of IHSS eligibility. The letter also addresses problems when recipients are not in the MEDs file or found eligible retroactively (must meet MC SOC, but may be eligible for reimbursement.)

The letter also transmit a new form, the X-27 SPEC, to reimburse recipients who through no fault of their own have paid out-of-pocket SOC expenses in excess of their obligation after the SOC comparison. For those of you not already lost, there is a description of how Conlan retro MC coverage and handling SOC for couples. [Download]