Highlighting “the momentous collaborative effort” (that started 5 years ago!) between DSS and the County Adult Protective Services (APS) program staff to revise the SOC 242 form, which will collect statistical information related to statewide APS data.  A training module was also developed for working with the new form.  [Download]

Passing on the emergency regulations on Non-Minor Dependents (NMDs), as well as some CalWORKs changes. (The CalWORKs changes include exempting NMD’s from: Statewide Fingerprint Imaging System requirements; state residency requirement when placed with an approved relative who resides out-of-state;  referral to the local child support agency for child support payments (for NMD’s over age 19 and if living with their own minor children).  [Download]

The Notice provides the background on why the report was done, and releases the Fraud Integrity report.  (NOTE: The report doesn’t appear on-line at the link provided in the ACIN…but hopefully will soon!) [Download]

In an effort to reduce the backlog of pending Medi-Cal applications, DHCS has issued this guidance to the counties on using MAGI and Express Lane Enrollment (ELE) aid codes as a manual workaround.

These aid codes are to be used when at least one member of the household has an active Medi-Cal or CalFresh aid code in MEDS and SAWS, and only when:

  1. At least one household member has been determined eligible or contingently eligible in CalHEERS and the entire case cannot be accepted into SAWS/MEDS because others in the household are still pending.
  2. The county file clears and determines the case as MAGI eligible, and CalHEERS responds that the case is pending due to data and/or technology issues with CalHEERS.

Counties cannot use this process to manually grant Medi-Cal eligibility for non-MAGI cases, limited/restricted scope cases, cases where no household member is on an active Medi-Cal/CalFresh aid code in MEDS/SAWS, or when the only eligible case members are TLICP children.

The state will send NOAs to beneficiaries granted eligibility through ELE aid codes based on this process.  Counties will send NOAs to those granted eligibility under MAGI aid codes.  All of these beneficiaries will receive intake packets.

 

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.

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 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 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.

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]

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]