Requiring use of the “Here’s Why” section of CalFresh overissuance notices

CDSS has issued instructions to counties about the content of CalFresh overissuance notices.  Counties must complete the free-form “Here’s Why” section of the overissuance notice.  The drop-down menu explanations in the “Here’s Why” section of the overissuance notice do not provide sufficient detail about the reason for the overissuance and must be accompanied by additional information that is specific to the case.  The free-form “Here’s Why” section must be completed even if the county consortia computer system allows the notice to be issued without completing the free-form section in order to meet state and federal due process requirements.

At a minimum, the free-form “Here’s Why” section must include: 1) the amount of benefits the household received, 2) the amount of benefits the household should have received, 3) the time period of the overissuance, 4) the specific reason that caused the overissuance, 5) the amount of benefits to be repaid, and 6) how the household can pay the claim.  ACL 16-71 (September 12, 2016).

CalWORKs Time Limit Exemption for Indian Country Residents

CalWORKs has a time limit exemption for Indian Country residents where at least 50 percent of adults are not employed.  The California Department of Social Services did a survey to determine which Indian Country areas qualify for this time limit exemption.  Based on the survey, CDSS identified and listed 25 Indian Country areas where at least 50 percent of adults are not employed.

If a CalWORKs recipient lives in an Indian Country area not identified by CDSS as having at least 50 percent of adults not employed, the recipient, county or Tribal-TANF program can get a written certification from a federally-recognized tribe that the recipient lived in where at least 50 percent of adults are unemployed to qualify for the time limit exemption. ACL 16-68 (August 26, 2016).

Preserving Medi-Cal eligibility for Foster Youth who run away from placements

DHCS has issued a letter to clarify eligibility guidelines for foster care youth who leave court-ordered placements.  While loss of contact with the youth may discontinue foster care payments, that youth may be in other Medi-Cal aid codes and must not be discontinued simply due to loss of contact.

During ex parte review of Medi-Cal cases, workers should determine if the foster care youth is still under jurisdiction of the court; if so, the youth should be placed in the appropriate Medi-Cal only aid code not associated with a foster care payment.  If the foster care youth is still under the court’s jurisdiction, that youth should stay in the appropriate aid code regardless of whether the youth is located.  Foster care youth are not required to enroll into managed care unless in a COHS county.

The letter runs down scenarios about whether a foster care youth is located, where that youth is located, and whether the youth is under jurisdiction of the court.

DHCS ACWDL 16-20 (September 1, 2016).

Adult Immunizations as a Medi-Cal Pharmacy Benefit

DHCS has issued a letter to Medi-Cal managed care plans to instruct plans to include adult immunizations on plan formularies.  A pharmacist may administer immunizations according to plan protocols as long as the pharmacist completes an immunization training, is certified in basic life support, and comply with all state and federal recordkeeping and reporting requirements.

DHCS APL 16-009 (August 31, 2016).

MFG Repeal

The California Department of Social Services has informed counties that the legislature has repealed the CalWORKs Maximum Family Grant (MFG) rule.  Effective January 1, 2017, no child will denied aid because the child was born into a family receiving CalWORKs.  Any child previously excluded by the MFG rule must be added to the assistance unit effective January 1, 2017.

Counties are required to review their caseloads to determine existing cases with children excluded by the MFG rule and inform those families that their CalWORKs grant will change to include the previously excluded children.  In addition, counties must send a mass mailing starting on November 1, 2016 to all CalWORKs recipients informing them of the repeal of the MFG rule.  CDSS encourages counties to display the informing notices in their offices and to discuss the MFG repeal at application and redetermination.

Children previously excluded by the MFG rule will be subject to child support assignment.  Children excluded by the MFG rule were able to keep all child support paid on their behalf.  Child support paid on behalf of these children will be assigned to the state the effective January 1, 2017 and the family will receive the first $50 of child support collected on behalf of the family.  Parents will need to complete the CW 2.1Q Child Support Questionnaire for children previously excluded by the MFG rule if those children are not already identified on an existing CW 2.1Q.  Parents will be required to cooperate with the local child support agency unless they have good cause, including that cooperation will put the family at risk.

Other benefits paid on behalf of children excluded by the MFG rule, such as Social Security dependant’s benefits, will be counted as income for CalWORKs effective January 1, 2017.  In addition, CalFresh benefits will be redetermined based on the new CalWORKs grant.  ACL 16-66 (August 26, 2016).

CalWORKs MAP increase

The CalWORKs Maximum Aid Payment (MAP) will increase by 1.43% effective October 1, 2016.  CDSS has directed counties to notify recipients of the change to their grant no later than September 20, 2016.  CDSS also directed the computer system consortia to automate the grant increase or ensure a workaround to ensure that CalWORKs recipients receive the MAP increase on October 1.

The MAP change may change the Income Reporting Threshold (IRT) for some CalWORKs assistance units.  CDSS directed counties to inform these recipients of their new IRT.

CDSS provided a chart of the new CalWORKs grant levels.  ACL 16-64 (August 16, 2016).