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Medi-Cal Update #19-05 Page 11-1 General Assistance 11. Director’s Exceptions 11. Director’s Exceptions 11.1 Director’s Exception Overview 11.1.1 Policy Director’s Exception GA Policy [113] The Director of the Department may grant exceptions to the General Assistance (GA) policies to alleviate extreme hardship in emergency and unusual situations. A record of such exceptions shall be maintained by the Department. A decision by the Director on a request shall be final and not subject to appeal. 11.1.2 Evaluation of Extreme Hardship An Eligibility Worker (EW) or a Social Worker (SW) must evaluate the individual or family circumstances to determine if an extreme hardship exists. An extreme hardship exists when an individual or family does not qualify for any state or federal program and has no other income, resources or means of support. The Director’s Exception must be re-evaluated at least every six months. BUT most Categories have different re-evaluation periods, therefore, it is important to review the re-evaluation for the category the client falls under. In addition to evaluating the circumstances to determine if hardship exists, the EW must evaluate each family case to determine if a Vocational Service (VS) exemption is appropriate for either parent. [Refer to “Sponsored Noncitizen Families,” page 11-7]] and [Refer to “Non-Fed Families,” page 11-9], for specifics.] 11.1.3 Categories The Director of the Agency (or designee) may approve a Director's Exception request if one of the following conditions exists: A sponsored noncitizen family is denied or discontinued from CalWORKs and the sponsor is not able to provide support An undocumented individual(s) is gravely physically, mentally handicapped (such as paraplegic, quadriplegic, or comatose), or faces other exigent circumstances. An individual receiving GA Interim Assistance who requires psychiatric, psychological, and/or medical testing in order to establish disability for SSI.

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Page 1: 11.Director’s Exceptions · page 11-4 General Assistance 11. Director’s Exceptions Page 11-4 Update #19-05 11.2.3 Intake Process. After receiving the approved GA 5 or GA 5F, the

Medi-CalGeneral Assistance 11. Director’s Exceptions

11. Director’s Exceptions

11.1 Director’s Exception Overview

11.1.1 Policy

Director’s Exception GA Policy [113]

The Director of the Department may grant exceptions to the General Assistance (GA) policies to alleviate extreme hardship in emergency and unusual situations. A record of such exceptions shall be maintained by the Department. A decision by the Director on a request shall be final and not subject to appeal.

11.1.2 Evaluation of Extreme Hardship

An Eligibility Worker (EW) or a Social Worker (SW) must evaluate the individual or family circumstances to determine if an extreme hardship exists. An extreme hardship exists when an individual or family does not qualify for any state or federal program and has no other income, resources or means of support. The Director’s Exception must be re-evaluated at least every six months. BUT most Categories have different re-evaluation periods, therefore, it is important to review the re-evaluation for the category the client falls under.

In addition to evaluating the circumstances to determine if hardship exists, the EW must evaluate each family case to determine if a Vocational Service (VS) exemption is appropriate for either parent. [Refer to “Sponsored Noncitizen Families,” page 11-7]] and [Refer to “Non-Fed Families,” page 11-9], for specifics.]

11.1.3 Categories

The Director of the Agency (or designee) may approve a Director's Exception request if one of the following conditions exists:

• A sponsored noncitizen family is denied or discontinued from CalWORKs and the sponsor is not able to provide support

• An undocumented individual(s) is gravely physically, mentally handicapped (such as paraplegic, quadriplegic, or comatose), or faces other exigent circumstances.

• An individual receiving GA Interim Assistance who requires psychiatric, psychological, and/or medical testing in order to establish disability for SSI.

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• A person who is Permanently Residing In The United States Under Color Of Law (PRUCOL)

• A CalWORKs individual or family who is a participant in the Family Reunification Program (AB 429).

• A sponsored noncitizen who is abused or abandoned by his or her sponsor.

If none of the categories listed above are met there is NO GA eligibility under Director’s Exception.

11.2 Director’s Exception Process

11.2.1 Forms

When processing Director's Exception, the EW must complete either the:

• “Request for Director’s Exception — Individual” (GA 5), OR

• “Request for Director’s Exception — Family” (GA 5F).

• All forms required for GA application or redetermination processing must also be completed. [Refer to “Application Process,” page 6-2 for more details.]

Important:Other forms may be required. Staff must assess the Director’s Exception’ category and complete all necessary forms.

IDM

All forms necessary for processing Director’s Exception must be scanned into the Integrated Document Management (IDM) system under Benefits, F1 - Application.

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11.2.2 Referral Process

When the Eligibility Worker determines that the client meets one of the categories of Director’s Exception, the referral process below is followed:

STEP WHO ACTION

1. EW • Completes GA 5 or GA 5F as appropriate using DocuSign templates:• Sets signing order• Includes client’s Last Name, First Name, and Case # on the

Email Subject, after “Director’s Exception.”•

• Attaches all necessary documents/verifications relevant to the DE category.

• Submits the DocuSign folder to the unit supervisor.

Note:DocuSign Web Demo instructions may be accessed at the SCCLearn website and at the Program Reference Materials Page under Miscellaneous.

2. EW Supervisor • Reviews forms and documentation for completeness/accuracy. • DocuSigns the GA 5 or GA 5F. • Forwards the DocuSign folder to the GA SSPM for approval.

3. GA SSPM • Reviews and signs the GA 5 or GA 5F. • Forwards the DocuSign folder to SSPM Administrative Assistant.

4. GA Bureau Administrative Assistant (AA)

• Logs the Director’s Exception request following internal business procedures.• Forwards the DocuSign folder to the GA Program Coordinator.

5. GA Program Coordinator

• Reviews all forms and supporting verification to ensure the client meets the requested DE category.

• Completes DE Recommendation Slip in the Docusign folder. • Forwards the DocuSign folder to DEBS Director.

6. DEBS Director • DocuSigns GA 5 or GA 5F with Approval or Denial.• Forwards the DocuSign folder to the SSA Director’s Administrative Assistant.

7. SSA Director’s Administrative Assistant

• Ensures all information needed by the Agency Director is completed. • Forwards the DocuSign folder to Agency Director.

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11.2.3 Intake Process

After receiving the approved GA 5 or GA 5F, the GA EWs must set up the “Director’s Exception” cases as they would for a regular GA application with the exception of the “Authorization” process and Benefit Issuance. This is performed via “Bottom Line Override” (BLO) and “Non-System Determine Issuance” (NSDI) through designated staff with appropriate security access.

STEP EW Actions

1. Arranges a face-to-face interview with the applicant and/or the applicant’s representative, if necessary to gather any additional information or verification.

2. Enters all appropriate information into CalWIN (including Special Indicators). See [11.2.6]

3. Clears all “Alerts” and IEVS matches associated to the case.

4. Processes all reports associated to the case.

5. Runs EDBC.

6. Reviews the Display Eligibility Summary window in Wrap Up and the results will be “Fail.”

7. Prepares the case for Wrap-up Overrides results from “Fail” to “Pass” via Bottom Line Override and to issue the correct benefit amount via Non System Determine Issuance. Refer to [11.2.4] for more information.

NOTE: With bottom line override the only process that continues to be automated by CalWIN is the Benefit Issuance. All other necessary processes and requirements must be completed manually. Example: Generating required NOAs, sending relevant information to MEDS, aligning RRR date to the DE approved period, etc.

8. Documents thoroughly and appropriately in the Maintain Case Comments window for each “Override” that is processed in the case.

8. Agency Director/ Designee

• DocuSigns GA 5 or GA 5F with approval or denial.

9. Intake EW • Receives a Completed-DocuSign email with copies of all documents submitted.

• Takes appropriate action based on the decision received. • Extracts and converts DocuSign documents into PDF files and forwards for

IDM process.

10. GA Bureau AA • Receives a copy of Completed- DocuSign via email. • Completes internal procedures.

11. Program Bureau Administrative Assistant.

• Receives a copy of Completed-DocuSign via email.• Extracts and converts DocuSign documents into PDF files.• Saves all PDF files in the S drive: Director’s Exception Cases.• Completes Director’s Exception log.

STEP WHO ACTION

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11.2.4 CalWIN Entries

Bottom Line Override (BLO)

The following forms and print-outs are required for a BLO to take place:

• Approved GA 5 or GA 5F,• All required attachments, • Print-out of the Authorize Eligibility Program Benefit window, and • NSDI screen print out

The designated person performing “Bottom Line Override” process must take the following actions:

• Go to the Authorize Eligibility Program Benefit window. Select all the required benefit months and authorize the benefits as appropriate.

• Document all information appropriately on the Maintain Case Comments window.

Refer to CalWIN Online User Manual (OLUM) for detailed BLO instructions.

Non System Determined Issuance (NSDI)

The correct benefit amount is issued via NSDI. If this is a recurring benefit the following CalWIN entries are needed in the Capture Non-System Determined Issuance window:

Enter “Y” in the Recurring Benefit [Y/N] field. Enter the Valid From Date and Valid to Date (Approved DE period).

If it is indicated that the benefit is a recurring benefit, NSDI sets issuance triggers for future months during the “From and To” period, which must be manually canceled if benefits are either discontinued or subsequently authorized through CalWIN. For more information refer to System Announcement CA-8.2 and OLUM instructions.

11.2.5 Continuing Cases Process

The General Assistance Continuing EW must:

STEP ACTION

1. Monitor continuing GA eligibility.

2. Re-evaluate the Director's Exception every six months or at the expiration of the Director’s approval, whichever is earlier.

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11.2.6 Special Indicator

Each Director’s Exception category has a different time limit to receive General Assistance. A Batch-AU Exception-GA indicator must be set with an “Effective Begin and End Date” so GA does not continue beyond the time limit. In addition, the Special Indicator “Director’s Exception - GA” must also be entered for the DE period.

3. Reinvestigate eligibility at the beginning of the month in which the reevaluation is due in order to allow enough time to process the GA 5 or GA 5F. Refer to [“Reinvestigations,” page 14-1].

4. Gather all appropriate forms and documents (e.g., medical information, sponsorship forms, CalWORKs/DFCS referrals or SCZ 1812, etc.) in preparation for the reevaluation.

Note:For Family Reunification cases, if the client continues to participate in AB 429 services beyond the first 3 months and continues to be in need of General Assistance benefits, DFCS EW sends to the continuing EW an updated referral (SCZ 1812) by the first week of the expiration month of the GA Director's Exemption. If a referral is not received, the EW may contact DFCS by email at [email protected].

Under no circumstances Directors Exception can be approved without proper verification.

5. Complete a new GA 5 or GA 5F and submit it along with the appropriate attachments and budget information. Refer to [“Referral Process,” page 11-3]

6. Prepare the case for Wrap-up Overrides results from “Fail” to “Pass” via Bottom Line Override and to issue the correct benefit amount via Non System Determine Issuance. Refer to [11.2.4] for more information.

NOTE: With bottom line override the only process that continues to be automated by CalWIN is the Benefit Issuance. All other necessary processes and requirements must be completed manually. Example: Generating required NOAs, sending relevant information to MEDS, aligning RRR date to the DE approved period, etc.

7. Document thoroughly and appropriately in the Maintain Case Comments window for each “Override” that is processed in the case.

STEP ACTION

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11.3 Sponsored Noncitizen Families

11.3.1 Director’s Exception

Sponsored noncitizen families are only eligible for GA as a Director’s Exception. The EW must evaluate each sponsored noncitizen family, on a case by case basis to determine if GA is necessary to “alleviate extreme hardship in emergency and unusual situations.” If it is determined that GA is necessary in accordance with the above, all GA requirements (including sponsored noncitizen requirements) must be met. [Refer to “Evaluation of Extreme Hardship,” page 11-1] for more details.

11.3.2 Requirement for CalWORKs Application

All families applying for GA, MUST APPLY FOR CalWORKs prior to having their eligibility determined for GA. The CalWORKs Denial Notice of Action (NOA) must be provided to the GA EW prior to submitting the request for approval of the Director’s Exception. A copy of the CalWORKs NOA must be scanned into IDM GA case record.

Refer to GA Handbook Chapter 6 - [“CalWORKs Eligibility,” page 6-7.]

11.3.3 Sponsorship Information Requirements

After eligibility has been cleared, the EW must complete a “Request for Director’s Exception — Family” (GA 5F). The following forms (if appropriate to the case) must be attached to the GA 5F:

• I-134 or I-864 Affidavit of Support (as appropriate).

• GA 24 Sponsor’s Statement of Facts.

• GA 25 Sponsor Deeming Budget (if applicable).

• GA 54 Sponsorship Questionnaire.

• GA 55 General Assistance Requirements for Sponsored Noncitizens.

• GA 56) Notification to Sponsor.

• GA 59) Referral of Sponsor to Collections.

• SCD 355 - S/A Agreement to Reimburse — Sponsor.

Note:

If the Affidavit of Support (I-134 or I-864) is not available, the EW must initiate an Online SAVE request.

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11.3.4 Eligibility Worker (EW) Requirements

The EW MUST complete a “Request for Director’s Exception — Family” (GA 5F) for all family Director’s Exceptions. This referral must be completed after GA eligibility has been determined, but prior to referring to GA Vocational Services (VS).

11.3.5 GA Vocational Services (VS) Requirement

All non-exempt employable adults must comply with all VS requirements. [Refer to “Persons Exempt from GA Vocational Services,” page 11-8]] for exemption criteria.

Note:

If either of the parents does not comply with VS requirements, the entire family is ineligible.

To meet VS requirements, the EW must:

STEP ACTION

1. Enter all employment information for each nonexempt employable adult into CalWIN.

2. Refer the employable adult(s) for a VS orientation meeting, in accordance with normal procedures

3. Forward the GA 5F to VS. The GA 5F must be returned to the EW with the “General Assistance Cooperation Agreement” (SCD 523).

11.3.6 Persons Exempt from GA Vocational Services

One parent may be exempt from VS requirements, provided that ALL of the following conditions are met:

• The parent is not the primary wage earner, AND• There is a child under 1 year of age in the household, AND• The EW determines that there is NO other child care option available.

If all children are 1 year of age or older, BOTH parents must register with VS and comply with VS requirements.

11.3.7 Grant Calculation

The GA grant is to be calculated based on the number of persons who share housing with the family.

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Example:

If a family of three shares housing with four other individuals or a family of four, the basic grant level to be used is for three persons “Shared with 3 or More Other Persons.”

11.3.8 Completion of Budget Information

The information entered into the CalWIN system must clearly indicate whether housing is shared with individuals who are not a part of the applicant family’s household, AND, if so, the number of other persons with whom housing is shared.

11.4 Non-Fed Families

11.4.1 Director’s Exception

Since families are only eligible for GA as a Director’s Exception, the EW must evaluate each family, on a case by case basis to determine if GA is necessary to “alleviate an extreme hardship in emergency and unusual situations.” If it is determined that GA is necessary in accordance with the above, all GA requirements (including sponsored noncitizen requirements) must be met. [Refer to “Evaluation of Extreme Hardship,” page 11-1].]

11.4.2 Requirement for CalWORKs Application

All families applying for GA MUST APPLY FOR CalWORKs prior to having their eligibility determined for GA. The CalWORKs Denial Notice of Action (NOA) must be provided to the GA EW prior to submitting the request for approval of the Director’s Exception. A copy of the CalWORKs NOA must be scanned into IDM.

Refer to GA Handbook Chapter 6 - [“CalWORKs Eligibility,” page 6-7].

11.4.3 EW Requirements

The EW MUST complete a “Request for Director’s Exception — Family” (GA 5F) for all family Director’s Exceptions. This referral must be completed after GA eligibility has been determined, but prior to referring to VS. The EW must do the following:

• Determine if an extreme hardship exists because the family does not qualify for any state or federal program and has no other income, resources or means of support; AND

• Determine if a parent is to be exempted from VS requirements; AND

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• Complete a referral to VS for the development of a plan that will lead the family to self-sufficiency and no longer dependent on GA.

11.4.4 VS Requirements

All non-exempt employable adults must comply with all VS requirements. [Refer to “Persons Exempt from GA Vocational Services,” page 11-8] for exemption criteria.

Note:

If either of the parents does not comply with VS requirements, the entire family is ineligible.

To meet VS requirements, the EW must:

STEP ACTION

1. Enter all employment information for each nonexempt employable adult into CalWIN.

2. Refer the employable adult(s) for a VS orientation meeting, in accordance with normal procedures.

3. Forward a copy of the GA 5F to VS. The GA 5F must be returned to the EW with the “General Assistance Cooperation Agreement” (SCD 523).

11.4.5 Persons Exempt from VS

One parent may be exempt from VS requirements, provided that ALL of the following conditions are met:

• The parent is not the primary wage earner, AND• There is a child under 1 year of age in the household, AND• The EW determines that there is NO other child care option available.

If all children are 1 year of age or older, BOTH parents must register with VS and comply with VS requirements.

11.4.6 Grant Calculation

The GA grant is calculated by the system based on the number of persons who share housing.

Example:

If a family of three shares housing with four other individuals or a family of four, the basic grant level to be used is the one for three persons “Shared with 3 or More Other Persons.”

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11.4.7 Completion of Budget Information

The information entered into system must clearly indicate whether housing is shared with individuals who are not a part of the applicant family’s household, AND, if so, the number of other persons with whom housing is shared.

11.4.8 Completion of Director’s Exception Request

After eligibility has been cleared, the GA Intake EW must complete a “Request for Director’s Exception — Family” (GA 5F). All pertinent verification must be attached to the GA 5F, including the CalWORKs/RCA Notice of Action.

11.5 Undocumented Individual(s) Gravely Disabled or Facing Exigent Circumstances

11.5.1 Director’s Exception

Undocumented individual(s) who suffer a grave disability such as paraplegia, quadriplegia, coma, severe mental illness, or faces other exigent circumstances, may qualify for a Director's Exception payment. The request may be initiated by an EW, SW, or anyone having knowledge of the individual’s need or situation as indicated above.

11.6 Interim Assistance Testing

11.6.1 Determination

The need for psychiatric, psychological, and/or medical testing for a General Assistance Interim Assistance (“SSI pending”) recipient is determined only by an SSI Advocacy Unit Social Worker (SW). This usually occurs when a client has been denied SSI at the Hearing Level.

If the Social Worker determines that an evaluation of disabilities is essential for approval of SSI, a one-time vendor payment may be approved as a Director's Exception for psychiatric, psychological and or medical testing. [Refer to GA Handbook Chapter 11 [Refer to “Approval Process,” page 11-12].]

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Note:

Approval must be obtained before the testing can be performed. An estimate of the cost for the evaluation, may be used ONLY for the initial request. The Social Worker receives the name of the clinic and the cost estimate from the client’s attorney.

11.6.2 Approval Process

Approval for a Director's Exception for psychiatric, psychological, and/or medical testing may be obtained by the following process:

STAGE WHO ACTION

1. SSI Advocacy Social Worker

• Completes the GA 5.

• Documents the reason and justification for the request.

• Submits the GA 5 with attached copy of the cost estimate to the SW Supervisor.

2. SSI Advocacy Supervisor

• Reviews the GA 5 for completeness.

• Signs the GA 5.

• Forwards GA 5 with attached cost estimate to GA SSPM for approval.

3. GA SSPM • Reviews packet and signs the GA 5, and

• Gives packet to the GA Bureau Administrative Assistant.

4. GA Bureau Administrative Assistant

• Emails the complete DE packet to the Program Bureau (GA program coordinator).

• Files original in binder to await decision from Director/Designee.

• When decision received from Director/Designee, returns original copy of GA5 to the SSI SW along with a copy of the decision email received from the Director/Designee.

5. SSI Advocacy Social Worker

Takes appropriate action according to decision received.

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11.6.3 Attachment of Bill

When the final bill is received from the vendor/provider the following procedures must be followed:

STEP ACTION

1. The SSI Advocacy Social Worker must:

• Attach the final bill received from the vendor/provider to the GA 5.

• Submit the original GA 5 and the final bill to the assigned EW along with the decision from Director/Designee.

Note: The final bill for medical services rendered MUST indicate total ACTUAL amount owed. Estimates are not accepted.

2. The EW will:

• Enter all appropriate information into CalWIN.• Clear all “Alerts” associated to the case. • Process all reports associated to the case. • Run EDBC. • Review the Display Eligibility Summary window in Wrap Up and the results will be “Fail.”• Hand-Carry the paperwork to the designated staff in the office who is authorized to complete

“Bottom Line Override” process.

3. Designated staff will:

• “Perform a “Bottom Line Override” (BLO) process per the OLUM instructions to process the “Director’s Exception.”

• Document appropriately on the Maintain Case Comments window for each “Override” that’s processed.

• Complete any remaining blanks on the GA 5, such as “Monthly Amount” and “Total Amount Requested.”

• Submit original and one copy of the GA 5 along with all attachments to the unit supervisor for approval of the (BLO).

Attachments must include:

• Medical report/information• Screen print of the Authorize Eligibility Program Benefit window.

Note: Director's Exceptions must be re-evaluated at least every six months. A “Case Alert” must be set so that a timely alert is received for the re-evaluation of the case.

11.6.4 Payment

After the final approval is received from the Unit Supervisor and upon receipt of the approved GA 5 with the final bill for the testing attached; the designated staff assigned to complete “Bottom Line

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Override” process must:

STEP ACTION

1. • Go to the Authorize Eligibility Program Benefit window and select all required benefit months and authorize benefits as appropriate.

• Document information appropriately on the Maintain Case Comments window.

• If necessary, set appropriate “Case Alert” for re-evaluation of the case.

• Insure that the vendor is named as payee “FOR” client under “PM” (Payee Modifier).

2. Write “PAID” on bill, with initials and date.

3. Have the GA 5 and paid bill scanned into the IDM under Benefits F1.

11.7 PRUCOL

11.7.1 Definition

“PRUCOL” is defined as persons who are Permanently Residing Under the Color of the Law and refers to non-citizens residing in the United States with the knowledge and permission of the United States Citizenship and Immigration Services (USCIS), and the USCIS does not contemplate enforcing their departure.

11.7.2 Residence of a Non-Citizen

As stated in GA policy GA 141, “a non-citizen who has been lawfully admitted into the United States as an immigrant with the right to remain permanently or indefinitely, and a non-citizen granted temporary legal residence under the Immigration Reform and Control Act of 1986 (PL 99-603) or Violence Against Women Act of 1994 (PL 103-322) and its subsequent amendments, may establish residence as required by these policies. All other non-citizens, being unable to establish residence, are not entitled to aid.

However, noncitizens who qualify as PRUCOL can be eligible for GA under the Director’s Exception rule.

11.7.3 Director’s Exception PRUCOL Categories

The following PRUCOL categories may be eligible to General Assistance under Director’ Exception:

• Persons granted an indefinite stay of deportation• Persons granted indefinite voluntary departure in lieu of deportation

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• Parolees lawfully in the U.S. for an indefinite period• Refugees lawfully in the U.S.• Asylees lawfully in the U.S. for an indefinite period• Battered noncitizen who have been abused/battered or subjected to extreme cruelty within the

U.S. by their spouse, parent, or member of the family residing in the same household, • Noncitizen being processed through USCIS as a permanent resident noncitizen, • Persons in deferred action status• Cuban/Haitian Entrants lawfully in the U.S., or• Persons under an order of supervision.

Clients who fall under one of the PRUCOL categories must have a valid and current verification of their PRUCOL status BEFORE Director’s Exception is explored. GA benefits must be discontinued at the end of month when the client’s PRUCOL status has expired; unless the client submits a new document verifying the extension of his or her PRUCOL status.

Note:

The PRUCOL status is no longer recognized by the United States Citizenship and Immigration Service (USCIS). Submitting a secondary Online SAVE will NOT verify a client’s PRUCOL status.

[Refer to “PRUCOL,” page 11-14] on the Common Place Handbook and to GA Handbook, [Refer to “Citizenship/Noncitizen/Sponsored Noncitizens,” page 19-1] for more information on acceptable verification.

11.7.4 Re-Evaluation for PRUCOL - Order of Supervision

The Department of Homeland Security (DHS) provides individuals under Order of Supervision with form I-220B. This form serves as a personal report record and indicates the date that the individual must report to DHS. GA can only be approved for the period listed on the I-220B.

Example:

The I-220B states that the individual must “report in person “beginning March 08, 2011, to the ICE ERO Office located at 630 Sansome St., San Francisco, CA 94111 (415) 844-5512, every 3 months until further notice, unless you are granted written permission to report on a different date.”

Example:

Mr. Phan Nguyen comes in to apply for GA on June 1, he is not eligible for regular GA due to his immigration status, but found to be eligible for a Director’s Exception under the PRUCOL category. Mr. Nguyen presents his Order of Supervision forms I-220B which indicate he is to

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report every three months. His Personal Report Record shows his next report date is July 5. Therefore, Mr. Nguyen is approved for only two months covering June and up to July 30. The EW explains to Mr. Nguyen he will only be approved for the 2 months and will have to come in for a re-evaluation to show he has reported to the ICE ERO office and provide his “Personal Report Record indicating his next new report date. This should occur prior to the end of July to prevent termination of GA. The EW gives Mr. Nguyen an approval and discontinuance Notice of Action and a “Case Alert” is set so that a timely alert is received for the re-evaluation of the case. Verification of the extension of PRUCOL (Order of Supervision) status is a continuous action for continued eligibility.

NOTE: The correct PRUCOL Category must be selected in CalWIN.

11.8 Family Reunification Cases in Child Welfare

11.8.1 Family Reunification Program Overview

Assembly Bill 429, (Chapter 111, Statutes of 2001), provides for the continuation of CalWORKs Employment Services (CWES) for the parents of children who have been removed from the home and are receiving out-of-home care. These cases are known as Family Reunification (FR) cases.

Any biological or adoptive parent whose eligible child or children has been removed from the home and placed in out-of-home care is potentially eligible to continue receiving CWES.

Although CalWORKs reunification families are eligible for CWES, they no longer receive a cash grant when all the children have been removed from the home or if the remaining Assistance Unit (AU) members become financially ineligible.

Refer to Common Place Handbook, [“Family Reunification (AB 429) Program Overview,” page 27-16] for more information.

11.8.2 Director’s Exception

CalWORKs Reunification families are eligible to receive General Assistance under Director’s Exception (DE) for up to three (3) months. While under this type of Director’s Exception, financial eligibility (income and property) will be waived.

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Important:Parents or families who are NOT eligible for Family Reunification Services (AB 429) must go through the regular GA eligibility determination. They are NOT eligible for this type of GA Director’s Exception.

11.8.3 Family Reunification Procedures

The following procedures must be followed:

Step Who Tasks

1. DFCS EW • Identifies the parent(s) as Family Reunification (FR) client(s).

• Assesses the case to establish the current level of benefits.

• Determines if the child(ren) are not in the home. If the child(ren) are in the home, CalWORKs eligibility must be explored.

If the CalWORKs case is closed because the children were removed, contacts the Social Worker to determine if the client is potentially eligible for Family Reunification Services (AB 429 services).

If there was no CalWORKs case open prior to the child(ren)’s removal, proceed to Step 5.

REMINDER: Parents or families who are NOT eligible for Family Reunification Services (AB 429) must go through the regular GA eligibility determination. When referring clients to the GA Office, the General Assistance (GA) box in Part I of the “CalWORKs/DFCS Intake Referral” (SCZ 1812), must be checked.

2. Social Worker- Common Case EC

Makes the appropriate referral if parent(s) are eligible for AB 429 services, as follows:

If... Then...

CW has been discontinued for more than 30 days,

Sends a completed copy of the “CalWORKs/DFCS Intake Referral” (SCZ 1812) to the client to apply for CalWORKs.

CW has been discontinued for less than 30 days,

Sends a completed "CalWORKs/DFCS Common Case Communication/Alert” (SCD/SCZ 1811) to the DFCS EW

3. DFCS EW Creates AB 429 TMT Request.

4. DEBS EW/ Common Case EC

Refers to Common Place Handbook, [“Family Reunification (AB 429) Program Overview,” page 27-16], for policy information on establishing AB 429 services.

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5. DFCS EW/ Common Case EC

Contacts the client and or the Social Worker to determine if the client is potentially eligible for CalFresh (F/S) and/or GA-DE.

If the client is potentially eligible for CalFresh/GA-DE, completes a “CalWORKs/DFCS Intake Referral” (SCZ 1812) and instruct the client to apply at the appropriate Intake Office.

Note: Informs client that GA benefits will be denied if the SCZ 1812 referral form is not presented at intake.

6. Client • Applies for GA/CF benefits.

NOTE: If an intake appointment is not available within three to five working days, DFCS referrals must be given priority assignment.

• Provides SCZ 1812 to the intake EW.

7. DEBS GA Intake

• Makes GA (DE) and/or CalFresh eligibility determination.• Completes the “Director’s Exception Request-Family “

(GA 5F), and forwards it for required signatures. See [“Referral Process” on page 11-3].

• Determines application disposition according to outcome of the referral.

If parent(s) are... Then GA EW must...

NOT eligible for GA Director’s Exception- AB 429 criteria

• Determines if they are eligible for regular GA and, explores Vocational Services (VS) requirements.

• Completes a referral to VS as appropriate, for the development of a plan that will lead the family to self-sufficiency.

Eligible for GA Director’s Exception - AB 429 criteria,

• DO NOT refer the parent(s) to VS as they are registered with CalWORKs Employment Services (CWES)

• Completes Part II of the SCZ 1812, upon eligibility determination. • Emails the completed SCZ 1812 form to the DFCS-CalWORKs Liaison at

[email protected]:

If client requests GA DE but does not provide an updated SCZ 1812 signed by DFCS, the EW must sent an email to DFCS-CalWORKS inbox, above to confirm AB 429 participation and to request a current SCZ 1812. At this point DFCS can confirm client’s active participation or discontinuance of AB 429 services.

Step Who Tasks

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11.8.4 VS Requirements

Since Family Reunification - AB 429 parent(s) are already fulfilling the CWES work requirements, they must not be referred to Vocational Services.

11.8.5 Grant Calculation

The GA grant is calculated by the system based on the number of persons who share housing.

Example:

If a family of three shares housing with four other individuals or a family of four, the basic grant level to be used is the one for three persons “Shared with 3 or More Other Persons.” [Refer to “Process for CalWIN to Calculate the Shared Housing,” page 27-10] of the GA handbook for more information.

11.8.6 Completion of Budget Information

The information entered into system must clearly indicate whether housing is shared with individuals who are not a part of the applicant family’s household, AND, if so, the number of other persons with whom housing is shared.

11.8.7 Completion of Director’s Exception Request

After eligibility has been cleared, the GA Intake EW must complete a “Request for Director’s Exception — Family” (GA 5F).

The following forms (if appropriate to the case) must be attached to the GA 5F prior to submission:

8. DFCS EW • Records and tracks approved GA referrals• If an AB429 client continues to need General Assistance beyond the first 3

months, DFCS EW sends to the continuing EW an updated referral by the first week of the expiration month of the GA Director's Exemption.

Note:Clients no longer eligible for AB429 services and who are referred to apply for regular GA benefits will be provided with an SCZ 1812 indicating a referral for General Assistance (GA). Do not check AB429 box.

Step Who Tasks

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• CalWORKs/DFCS Intake Referral (SCZ 1812) • CalWORKs/RCA Notice of Action, and• Copy of the Authorize Eligibility Program Benefit window for the CalWORKS case.

11.9 Abused/Abandoned Sponsored Noncitizens

11.9.1 Definition of Sponsored Noncitizens

Sponsored noncitizens are lawful permanent residents (LPRs) who have been admitted into the United States because another person or group has agreed to support them. That individual or group is known as the noncitizen’s sponsor, and as such, have completed an affidavit of support substantiating that they have sufficient income and resources to meet the needs of the noncitizen.

11.9.2 Director’s Exception for Abused/Abandoned Sponsored Noncitizens

GA regulations require for the sponsor of the non-citizen to sign an “Agreement to Reimburse - Sponsor (SCD 355 S/A),” to repay any aid provided to the noncitizen during the period of time which the sponsor has agreed, in writing to provide for the noncitizen.

However, to protect the confidentiality of an applicant or recipient being abused/abandoned by the sponsor, this requirement does not apply to sponsored cases under this category.

The Eligibility Worker must NOT:

• Request a signed Agreement to Reimburse - Sponsor (SCD 355 S/A).

• Apply income deeming rules

• Refer the sponsored case to Collections. The total obligation from the sponsor and sponsor’s spouse is canceled.

Note:

Abused/abandonment information must be entered in CalWIN Collect Non-Citizen Detail window under Good Cause for Not Living with Sponsor and Abandoned by Sponsor [Y/N] fields, and documented thoroughly in Maintain Case Comments window.

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11.9.3 Eligibility

To be eligible for Director’s Exception, the abused/abandoned sponsored noncitizen must meet the following requirements:

• There must be supporting documentation of sponsor abuse or abandonment.

• The noncitizen must no longer reside with the abusive sponsor.

11.9.4 Affidavit of Support

Applicants/recipients must provide supporting verification that the abused/abandonment was caused by the sponsor(s), before Director’s Exception is explored. The processes stated on [Refer to “Client Unable to Provide Information,” page 19-24 must be followed when client is unable to obtain the affidavit of support or provide sponsor’s information.

11.9.5 Verification of Abuse or Abandonment

Supporting documentation of abuse or abandonment must be provided, which may include the following:

• Police, government agency or court records or files.

• Documentation from a domestic abuse program.

• Documentation from legal, clerical, medical or other professional from whom the client has sought assistance in dealing with the abuse.

• Physical evidence of abuse.

• A report from Adult Protective Services (APS) indicating there is abuse.

Note:

A sworn statement from the client will NOT suffice. Additional verification must also be provided along with the client’s statement.

Reminder:

If a dependent adult/elder person is applying on the basis of abusive sponsor and/or sponsor’s spouse, a referral to Adult Protective Services (APS) is MANDATORY. See. [“Mandatory Referral” on page 11-22].

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Verification of abandonment may be demonstrated by an applicant/recipient Sworn Statement (SCD 101) and a Collateral Contact Affidavit (SCD 193) from an acceptable source such as, migrant service agencies, landlords, community partners and neighbors.

11.9.6 Residing with the Sponsor

The sponsored noncitizen must no longer reside with the sponsor. The Eligibility Worker (EW) must determine that the client is no longer living with the sponsor or in one of the sponsor’s properties.

If client is unable to provide the sponsor address or his/her other real properties, follow the steps provided in [Refer to “Client Unable to Provide Information,” page 19-24. A rental or lease agreement with the owner’s name may also be provided to prove the client is not living with the sponsor.

11.9.7 Mandatory Referral

All Social Services Agency employees are mandated by law to report instances of physical abuse of dependent and elder adults.

EWs must refer the abused or abandoned elder or dependent sponsored noncitizen adults to Adult Protective Services by calling (408) 975-4900 or 1-800-414-2002 or submitting the “Report of Suspected Dependent Adult/Elder Abuse” (SOC 341). [Refer to “Protective Services for Adults,” page 26-1]] of the Common Place Handbook.

Reminder:

The sponsored noncitizen may call the National Domestic Violence Hotline at 1-800-799-7233 for more information or the local legal aid office or an immigration attorney. Santa Clara County’s Domestic Violence Crisis Line is (408) 279-2962 and the Elder Abuse Hotline number is 1-800-414-2002.

11.9.8 Definition of Dependent Adult or Elder

The term “dependent adult” means any person between the ages of 18 and 64 who has physical or mental limitations which restrict his or her ability to carry out normal activities or to protect his or her rights. “Elder” means a person 65 years or older.

The client may provide doctor’s verification or the “GA Request for Medical Verification” (SCD 1400) to establish his or her physical or mental limitations.

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11.10 Public Administrator/Guardian/Conservator (PAGC) Cases

In the following situations, the PAGC may request a Director's Exception. This is initiated by completing the “General Assistance Director's Exception Request” (GA 5). The GA 5 will be completed by the PAGC’s office and submitted to the General Assistance Social Services Program Manager (GA SSPM).

• If a conserved applicant/recipient is in a nursing home and has been denied Medi-Cal (usually due to trust property), a Director's Exception may be requested to pay the nursing home the current monthly long term care (LTC) Medi-Cal rate. The PAGC must reimburse the total amount paid when the trust property becomes available.

• In emergency situations, a Director's Exception may be requested for conserved applicants who have been approved SSI but have not yet received their check. In these situations, the PAGC must repay the GA upon receipt of the initial SSI check.

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