2010 Notes from the Training Bureau

10-07-01A - Paraphrased Regulations

California Department of Social Services - State Hearings Division
Notes from the Training Bureau - July 1, 2010
Item 10-07-01A
Paraphrased Regulations

This version of the paraphrased regulations provides five additions and two revisions to the paraphrased regulations. There are also three deleted paraphrased regulations and there are additional corrections that are not substantive.

The major additions are as a result of changes in the federal stimulus package as set out in All County Letter 09-12. These changes have an impact on several food stamp rules such as the suspension of the ABAWD rule until October 2010 and disregarding the 13.6 percent increase in food stamps when computing food stamp overissuances, CAPI payments will be reduced in May 2009 and again in July 2009 because of SSP cuts resulting from the state budget.

This is the final paraphrased regulation package that Pat Coony worked on prior to his retirement. The paraphrased regulations would not exist without Pat’s efforts, creativity and technical abilities. Pat was the driving force behind the creation of the computerized decision system and has remained responsible for its ongoing maintenance and improvement. These are an invaluable tool and we at the Training Bureau want to thank Pat for his tireless efforts. He will be missed.

Revised417-1A

Refugees are eligible for Medi-Cal for eight months only under RMA/ECA; county must determine eligibility and send application 60 days before eight month period ends (ACWDL 08-43)

433-4 QI-1 program sunset extended to December 30, 2010 (ACWDL 09-11)

440-5 Basic Medi-Cal beginning date of aid rule (50193(c)); 50197(a))

444-6 Property is generally determined under FS rules for personal property and under 7/16/96 AFDC rules for real property, but exceptions exist in, e.g., automobile evaluation, and because certain Medi-Cal property rules and court cases are used in evaluating eligibility (ACWDL 98-43, Attachment 2; WIC 11155(b),(c)) 446-3 Refugees are eligible for Medi-Cal for eight months only under RMA/ECA; county must determine eligibility and send application 60 days before eight month period ends (ACWDL 08-43) 449-1 Persons discontinued from SSI must reapply; Craig v Bonta and SB 87 apply to discontinuance of SSI/SSP based Medi-Cal (50183, .5; ACWDL 07-24)

S449-2 Requirements when SSI/SSP is discontinued; Craig v Bonta and SB 87 apply to discontinuance of SSI/SSP based Medi-Cal (Ramos v. Myers; MEPM 5E; ACWDL 03-24, 07-24)

461-2A SDI is earned income for AFDC-MN and MI (ACWDL 96-09; Tinoco v. Belshé; AB1542)

462-3 TWC is earned income for AFDC-MN and MI (ACWDL 95-63; Sawyer v. Belshé; AB1542))

468-4 Dependent care deduction from earned income, $30 plus 1/3 deduction from earned income; deductions no longer available as of 5/1/98 (50553.3; AB 1542)

468-6 SDI is earned income for AFDC-MN and MI (ACWDL 96-09; Tinoco v. Belshé; AB1542))

468-7 TWC is earned income for AFDC-MN and MI (ACWDL 95-63; Sawyer v. Belshé; AB1542))

487-1A Policy in treatment of nonexempt property on or after 1/1/90 (ACWDL 90-01; 42 USC 1396p, 1396r-5). Counties must send cases to DCHCS property analyst if they conclude a potentially disqualifying property transfer took place. The property analyst will notify the county whether or not to send a NOA to restrict services due to a disqualifying transfer. (ACWDL 97-05)

487-6A Current and prior year Statewide APPR for Medi-Cal transfer of property period of ineligibility (ACWDLs 09-05 and 10-08)

Added:

201-5A Ninety day period to file hearing may be extended for good cause, but filing must be within 180 days (W&IC 10951)

248-2A State agencies must use consistent procedures to disqualify individuals whom law enforcement is seeking for purpose of holding criminal proceedings (7 U.S.C. 2015(k)(2))

266-16 Counties are to begin excluding income earned by census takers retroactive to January 2010 through September 2010 (ACL 10-18)

292-1E Any household member over the age of 18 through the age of 21 is considered be an “adult child” and shall be jointly and individually liable for the value of any overissuance (ACIN I-84-09)

461-5 The $25 weekly increase must not be considered income for purposes of determining eligibility or share-of-cost for all Medi-Cal programs. (ACWDL 10-10)

614-7 For purposes of W&IC §12300(e), full-time employment does not mean the fulltime provision of IHSS-funded care by a parent (Basden v Wagner)

616-5 New provider enrollment process; provider appeals with CDSS Adult Programs Division (ACL 09-52)

628-6 Counties do not need to continue to determine IHSS-R share of cost amounts for (PCSP or IPW) recipients who have Medi-Cal with zero share of cost (ACL 09-47)

State Hearings Division
California Department of Social Services
Item 10-5-1
May 10, 2010
FROM THE TRAINING BUREAU
ITEM 10-5-1: Paraphrased Regulations

In this version of the paraphrased regulations, there has been a reorganization of the older or obsolete

AFDC/CalWORKs pararegs. There are also additions and revisions to current pararegs in CalWORKs, Medi-Cal and IHSS.

This version of the paraphrased regulations provides 30 additions and four revisions to the paraphrased regulations. Nineteen paraphrased regulations have been deleted. Additionally, 28 pararegs have been renumbered from an “S” number to a non-S number such as S026-2 to 026-2. Seventeen pararegs have been renumbered from a non-S parareg to an S parareg such as 161-2 to S161-2. The “S” means “Superseded” and indicates that a regulation is no longer valid but was valid for an earlier period of time.

There are 124 paraphrased regulations in AFDC or CalWORKs beginning with “S” that have been moved to one of two obsolete AFDC/CalWORKs files and there is an accompanying obsolete AFDC/CalWORKs index.

Several pararegs beginning with “S” remain in the current parareg files. Those that remain are highlighted in yellow for easier reference and so to avoid the mistake of citing it for a period of time that is no longer valid.

Those that remain were selected because it was determined that it was more likely that a judge would need to access such a parareg such as in the case of S121-1A regarding an AFDC overpayment from September 1991 through December 1997.

The pararegs that were moved to the obsolete file were moved because it was believed that it was unlikely that they needed to be accessed. These pararegs can be accessed if necessary, however.

Other pararegs beginning with “S” were deleted altogether because they were duplicated elsewhere or because there was no chance that a judge would need to access them.

For those of you who use the cross-reference, the pararegs that are moved to the obsolete parareg files will remain in the cross-reference. If you find an “S” parareg in the cross-reference, but cannot locate that parareg in the regular parareg file, please look at the obsolete file.

Some of the additions to the pararegs include:

• A reference to IHSS-Residual eligibility for non-citizens in All County Information Notice I-18-08.

This includes a discussion of sponsor deeming rules for those non-citizens who are not eligible for federal full-scope Medi-Cal. Pararegs that reference ACIN I-18-08 are in the 561, 567 and 611 section of the paraphrased regulations.

• A reference to language access services for limited and non-English proficient individuals in All County Welfare Director’s Letter 10-03. References to this ACWDL can be found in section 413 of the paraphrased regulations. This ACWDL is very similar to All County Letter 03-56 found in the 013 section of the paraphrased regulations. It includes requirement for the county to provide among other things, “translated NOAs and/or other written translated material mailings that have been required and provided by DHCS.”

• A reference to the Conlan II process for IHSS in All County Information Notice I-10-03. In pertinent part, this ACIN states “In order to be considered for reimbursement, the recipient must have experienced an actual out-of-pocket expense for the excess share of cost.” This ACIN can be found at pararegs 527-6 and 628-5.

Renumbered

S026-2 to 026-2
S026-6 to 026-6
S026-7 to 026-7A
S026-7 to 026-7B
S026-7 to 026-7C
S026-7 to 026-7D
S026-7 to 026-7F
S026-8A to 026-8A
S026-10D to 026-10D
S026-10E to 026-10E
S026-12 to 026-12
S026-12B to 026-12B
S026-12E to 026-12E
S026-13 to 026-13
S053-7A to 053-7A
S075-1E to 075-1E (also revised)
S091-2 to 091-2 (also revised)
S096-1A to 096-1A (also revised)
S096-1B to 096-1B
S096-1D to 096-1D
S096-1E to 096-1E
S102-12 to 102-12 (also revised to delete ACL 97-72)
S129-1 to 129-1
S129-1A to 129-1A
S129-1C to 129-1C
S129-5 to 129-5
S152-2B to 152-2B
S153-3 to 153-3

Renumbered/Deleted

161-2 to S161-2
163-1 to S163-1
163-2 to S163-2
163-3 to S163-3
163-3A to S163-3A
163-3B to S163-3B
163-4 to S163-4
163-5 to S163-5
163-6 to S163-6
163-7 to S163-7
163-7A to S163-7A
163-8 to S163-8
163-9 to S163-9
196-3 to S196-3
S449-1
S449-2
567-8A to S567-8A

Deleted

S026-4A
S026-14
S026-16D
S026-16F
S054-5
S073-15
S085-7E
S092-5
S100-5
S103-9
S103-10
S103-12A
S104-7A
S109-25
S153-1
400-4
564-5

Revised

088-3 Property related overpayment/overissuance only determined based on information that should have been reported on the QR 7. (ACL 03-18; 44-352.111) 129-9G County must treat reported change in income from submit month as a mid-quarter report and also as income change in upcoming quarter if income from submit month continues into the next quarter (ACL 09-41; 10-10)

417-13A New State law reduced the CEC program period from 12 months to 6 months effective January 1, 2009; Reduction of CEC from 12 months to six is suspended until December 2010 (ACWDL 08-55; 09-15)

417-13B CEC continues for up to six months from initial eligibility to MSR or from MSR to annual redetermination: Reduction of CEC from 12 months to six is suspended until December 2010 (ACWDL 08-55; 09-15)

Additions

016-13A County must attempt contact with recipient before making fraud referral or taking action against grant for “whereabouts unknown” (ACL10-01)

026-6A Good cause may be established for failing to return a complete QR 7 in both CalWORKs and food stamps; time frames for counties to evaluate good cause claims (ACL 10-10)

043-4 Steps county must take if it learns recipient is absent from state for 30 days or longer (ACL 10-01)

086-3 Portion of payment for compensates for converted property is treated as property, remainder treated as income (44-105.3) 129-2B When county should and should not use weekly and bi-weekly multipliers (ACL 10-10)

413-1 DHCS policy on LEP clarifying county responsibility to provide efficient language services (ACWDL 10-03)

413-1A Guideposts for counties in providing effective language services to LEP individuals (ACWDL 10-03)

413-1B Counties must use translated forms/NOAs provided by DHCS and not English version for those preferring non-English version; counties must provide interpretation services to LEP individuals upon request to regardless of whether DHCS has translated notices/forms (ACWDL 10-03)

413-1C Counties required to ask applicants/beneficiaries their preferred language for oral and written communication (ACWDL 10-03)

422-7A Counties no longer required to verify the immigration status of immigrants who claim the last PRUCOL category on MC 13 (ACWDL 09-40)

422-7B For applicants who claim last PRUCOL category on MC13, there is no duty to complete G-845 or MC845 form; no county duty to verify PRUCOL at annual redetermination for those claiming last PRUCOL category on MC13 (ACWDL 09-40)

437-2A Disability income received after age 65 or person’s retirement age is not exempt for purposes of determining maximum amount allowed or premium payment (ACWDL 09-33)

446-4 RMA individuals are eligible for three-month retroactive Medi-Cal (ACWDL 09-40)

467-1A In-kind income amounts for clothing are eliminated from Medically Needy rules, but not for purposes of 1931(b) Medi-Cal (ACWDL 09-64)

527-6 IHSS recipients who paid their provider an excess share of cost can file a Conlan II claim to request reimbursement. (ACIN I-03-10)

561-9 Non-citizens who are not qualified aliens are not eligible for federal full scope Medi-Cal (ACIN I-18- 08)

561-9A To be eligible for PCSP/IPW, an individual must be eligible for federal full scope Medi-Cal (ACIN I- 18-08)

567-8C Non-citizens who are not qualified aliens are not eligible for federal full scope Medi-Cal (ACIN I-18- 08)

567-8D To be eligible for PCSP/IPW, an individual must be eligible for federal full scope Medi-Cal (ACIN I- 18-08)

567-11A Children meeting DDS institutional deeming criteria qualify for Medi-Cal regardless of parent’s income or resources (ACL 00-83)

567-15 IHSS Plus Waiver population transitioned to IHSS Plus Option (IPO) program effective October 1, 2009 (ACIN I-33-10)

611-6A Non-citizens who are not qualified aliens are not eligible for federal full scope Medi-Cal (ACIN I-18-08)

611-6B Recipients who remain in IHSS-R are those determined eligible for IHSS-R but not eligible for federal full scope Medi-Cal (ACIN I-28-06)

611-6C Counties must determine IHSS-R eligibility for those not eligible for federal full scope Medi-Cal (ACIN I-18-08)

611-6D Non-citizens who are LAPR or PRUCOL under former SSI/SSP rules are potentially eligible for IHSS-R (ACIN I-18-08)

611-6E For IHSS-R, non-citizens are subject to SSI/SSP sponsor deeming rules; rules reflected on state form SOC811 (ACIN I-18-08)

611-6F Institutionally deemed person do not qualify for IHSS-R program (ACL 00-83)