Table of Contents4.3 Summary Abstract.....4-7 4.3.1 Reviewing the Summary Abstract.....4-7 4.4...

Common-Place Handbook page TC-1

Table of Contents

1. Statewide Fingerprint Imaging System (SFIS) ...............................................1-1

1.1 Overview ........................................................................................................1-11.1.1 Background .....................................................................................1-11.1.2 Definition .........................................................................................1-11.1.3 Purpose...........................................................................................1-11.1.4 Confidentiality..................................................................................1-11.1.5 Mandated Programs........................................................................1-21.1.6 Fingerprint Imaging [MPP 40-105.3 and MPP 63-505.14] ..............1-21.1.7 Photographing Clients [MPP 40-105.31] .........................................1-21.1.8 Informing Requirements..................................................................1-3

1.2 Cash Aid SFIS Rules [40-105.3] ....................................................................1-31.2.1 Who.................................................................................................1-3

Cash Aid SFIS Decision Chart ...................................................1-41.2.2 When...............................................................................................1-41.2.3 Immediate Need..............................................................................1-51.2.4 Permanent Exemption.....................................................................1-51.2.5 Temporarily Excused ......................................................................1-51.2.6 Victims of Domestic Abuse .............................................................1-61.2.7 Failure or Refusal to Cooperate ......................................................1-6

1.3 CalFresh SFIS Rules [63-601, 63-505] ..........................................................1-7

1.4 Technical SFIS Information ............................................................................1-71.4.1 SFIS Central Site ............................................................................1-71.4.2 SFIS Database................................................................................1-71.4.3 File Clearance for SFIS...................................................................1-81.4.4 SFIS Search Results Timeframes...................................................1-91.4.5 Types of Searches ..........................................................................1-9

Open Search ..............................................................................1-9Closed Search ...........................................................................1-9

1.4.6 Types of Results .............................................................................1-9Expected Results .......................................................................1-9Unexpected Results .................................................................1-10

1.4.7 Administrative Cause Chart ..........................................................1-11

1.5 Resolution Screen ........................................................................................1-11Administrative Situation ...........................................................1-12Administrative Situation Correction ..........................................1-12Possible Fraud .........................................................................1-13

Update # 13-17 Revised: 10/04/13

Common-Place Handbook

2. Social Security..................................................................................................2-1

2.1 Social Security Contact Persons....................................................................2-1

2.2 Wire to Wire Third Party Query (WTPY) ........................................................2-12.2.1 Use of SCD 169 and SCD 1955 .....................................................2-2

3. Income Eligibility Verification System (IEVS) ................................................3-1

3.1 Applicant System ...........................................................................................3-13.1.1 Frequency of Matches ....................................................................3-13.1.2 Current Matches .............................................................................3-13.1.3 Abstracts .........................................................................................3-23.1.4 Wire to Wire Third Party Query System (WTPY) ............................3-23.1.5 Federal Employer Identification Number (FEIN) .............................3-3

3.2 Recipient System ...........................................................................................3-3

3.3 Confidentiality.................................................................................................3-33.3.1 IEVS Regulations............................................................................3-43.3.2 Federal Tax Information..................................................................3-4

Email ..........................................................................................3-4Fax .............................................................................................3-5Identification ...............................................................................3-5

3.4 Informing Requirements.................................................................................3-53.4.1 Informing Regulations .....................................................................3-53.4.2 "Notice of Use of Computer Systems" (SCD 1504) ........................3-63.4.3 SSN Not Provided...........................................................................3-6

3.5 IEVS as a Verification ....................................................................................3-63.5.1 Primary Source Verification ............................................................3-6

4. IEVS Applicant System ....................................................................................4-1

4.1 Overview ........................................................................................................4-14.1.1 Requirements..................................................................................4-14.1.2 Applicants .......................................................................................4-24.1.3 Disqualified or Excluded Persons ...................................................4-24.1.4 Procedures for Generating IEVS Abstracts ....................................4-24.1.5 Processing Applicant IEVS Reports................................................4-3

For Hard Copy IEVS Abstract Reports: .....................................4-34.1.6 EW Responsibility Processing Applicant IEVS Reports..................4-54.1.7 Case Transfer .................................................................................4-54.1.8 Scanning .........................................................................................4-5

Revised: 10/04/13 Update # 13-17


4.2 CalWIN IEVS Applicant Reports ....................................................................4-64.2.1 CalWIN Structure ............................................................................4-6

4.3 Summary Abstract..........................................................................................4-74.3.1 Reviewing the Summary Abstract ...................................................4-7

4.4 Processing IEVS CalWIN Abstracts ...............................................................4-8

4.5 Resolving Abstract Report Discrepancies ......................................................4-94.5.1 EW Responsibility in Resolving Discrepancies ...............................4-94.5.2 Client Responsibility ........................................................................4-94.5.3 Denial/Discontinuance ..................................................................4-10

4.6 UIB/DIB Match..............................................................................................4-104.6.1 UIB Claim ......................................................................................4-114.6.2 CalWIN Abstract Report as Verification ........................................4-114.6.3 Information on the UIB Abstract ....................................................4-114.6.4 DIB Abstract Information ...............................................................4-13

4.7 EDD Wage Match.........................................................................................4-144.7.1 Processing the EDD Wage Abstract .............................................4-14

4.8 EDD Wage Match Information......................................................................4-16

4.9 EDD Real-Time Match .................................................................................4-174.9.1 Overview/Policy.............................................................................4-174.9.2 How to Access On-Line Information..............................................4-184.9.3 Active Claim, SSN and Name Match.............................................4-184.9.4 Active Claim for SSN, Name Does Not Match ..............................4-194.9.5 No Active Claim for SSN ...............................................................4-194.9.6 EDD Issue to be Resolved ............................................................4-204.9.7 Messages Returned by EDD.........................................................4-20

4.10 Asset Match..................................................................................................4-22

4.11 Asset Match Information...............................................................................4-22

4.12 Asset Match with FEIN Numbers Only .........................................................4-23

4.13 Match but not for Given Name .....................................................................4-244.13.1 Helpful Hints..................................................................................4-24

4.14 Reviewing Asset Match ................................................................................4-254.14.1 Unrestricted Access to Accounts ..................................................4-254.14.2 Restricted Access to Accounts......................................................4-264.14.3 Processing Asset Match................................................................4-264.14.4 Applicant Incompetent...................................................................4-26



4.15 Resolving Asset Match Discrepancies .........................................................4-274.15.1 Overview .......................................................................................4-274.15.2 Client is Required to Come In .......................................................4-274.15.3 Client is NOT Required to Come In ..............................................4-284.15.4 Requesting Information.................................................................4-28

4.16 Title II, Title IV, Medicare and Social Security Validation.............................4-29

4.17 CalWORKs/CalFresh Disqualification Information .......................................4-29

4.18 Outstanding Overpayment/Overissuance Information .................................4-30

4.19 Social Security Forty Quarters Data.............................................................4-30

4.20 Nationwide Prisoner Match ..........................................................................4-32

4.21 Intentional Program Violators (IPV) Online Automation System ..................4-334.21.1 Designated Users .........................................................................4-334.21.2 Inquiries ........................................................................................4-334.21.3 Forms............................................................................................4-354.21.4 Reference Guide...........................................................................4-36

5. IEVS Recipient System ....................................................................................5-1

5.1 Overview ........................................................................................................5-15.1.1 History.............................................................................................5-15.1.2 Requirements..................................................................................5-15.1.3 Request for Online Action-SCD 1296 .............................................5-25.1.4 Sub-Systems...................................................................................5-25.1.5 Processing Recipient IEVS Reports ...............................................5-3

For Hard Copy Abstract Reports: ..............................................5-45.1.6 EW Responsibility Processing Recipient IEVS Reports..................5-65.1.7 Scanning .........................................................................................5-7

5.2 CalWIN IEVS Recipient Reports ....................................................................5-75.2.1 CalWIN Structure ............................................................................5-8

5.3 New Hire Registry ..........................................................................................5-85.3.1 Overview / Purpose.........................................................................5-85.3.2 Employer Requirements .................................................................5-95.3.3 CalWIN “View IEVS - NHR Report”...............................................5-105.3.4 New Hire Registry Report” (NHR410) ...........................................5-10

Distribution ...............................................................................5-10Description ...............................................................................5-11

5.3.5 “IEVS / New Hire Registry Roster” (NHR415)...............................5-13Usage ......................................................................................5-13Distribution ...............................................................................5-13



5.3.6 “IEVS / New Hire Registry Roster” (NHR420) ...............................5-13Usage .......................................................................................5-13Distribution ...............................................................................5-14

5.3.7 Processing NHR Reports - No Discrepancies...............................5-145.3.8 Processing NHR410 Reports - Discrepancies ..............................5-14

Medi-Cal/GA and Change Reporting CalFresh Households ...5-18

5.4 Payment Verification System (PVS).............................................................5-195.4.1 Overview .......................................................................................5-195.4.2 Format...........................................................................................5-195.4.3 Match Found .................................................................................5-205.4.4 Active Persons ..............................................................................5-205.4.5 Inactive..........................................................................................5-205.4.6 How Current is the Data?..............................................................5-205.4.7 Primary Verification .......................................................................5-215.4.8 Secondary Verification ..................................................................5-215.4.9 Exploring Health Coverage ...........................................................5-215.4.10 Time Frames .................................................................................5-225.4.11 Delays ...........................................................................................5-235.4.12 Response Document.....................................................................5-23

5.5 PVS Processing ...........................................................................................5-235.5.1 “Continuing” Eligibility Process......................................................5-23

5.6 RSDI Match ..................................................................................................5-245.6.1 Match ............................................................................................5-245.6.2 Payment Information .....................................................................5-255.6.3 Description of the RSDI Match......................................................5-25

5.7 UIB Match.....................................................................................................5-275.7.1 Match ............................................................................................5-275.7.2 Payment Information .....................................................................5-275.7.3 Description of The UIB Match .......................................................5-27

5.8 DIB Match.....................................................................................................5-295.8.1 Match ............................................................................................5-295.8.2 Description of the DIB Match ........................................................5-29

5.9 PVS040 Response Document......................................................................5-305.9.1 Overview .......................................................................................5-305.9.2 Processing the Response Document ............................................5-30

5.10 Jail/Prison Matches ......................................................................................5-315.10.1 Jail Reporting System (JRS) .........................................................5-315.10.2 California Youth Authority (CYA)...................................................5-315.10.3 Nationwide Prisoner Match (NPM)................................................5-32



5.11 JRS, CYA, NPM, DPM and FFM Process....................................................5-32

5.12 Deceased Person Match (DPM) ..................................................................5-35

5.13 Integrated Earnings Clearance/Fraud Detection System (IFD)....................5-365.13.1 Processing IFD Open Cases ........................................................5-365.13.2 IFD/ECS on Closed Cases ...........................................................5-37

5.14 Asset Match - Federal Tax Board (FTB) ......................................................5-385.14.1 Processing FTB Asset Match Abstracts........................................5-38

5.15 IRS Asset Matches.......................................................................................5-405.15.1 Processing IRS Asset Matches.....................................................5-41

5.16 BEER Match.................................................................................................5-435.16.1 BEER ............................................................................................5-435.16.2 Processing BEER Matches...........................................................5-45

5.17 Fleeing Felon Match.....................................................................................5-46

6. SSA Data and Interfaces..................................................................................6-1

6.1 Overview ........................................................................................................6-16.1.1 WTPY..............................................................................................6-16.1.2 Discrepancy Referrals.....................................................................6-1

6.2 SSN Validation ...............................................................................................6-26.2.1 Overview .........................................................................................6-26.2.2 Validation ........................................................................................6-26.2.3 SSN Validation Codes ....................................................................6-36.2.4 Processing SSN Information...........................................................6-4

6.3 SSA Data .......................................................................................................6-5

6.4 SSA Title II Data.............................................................................................6-56.4.1 SSA Title II Data Report Abstract ...................................................6-6

6.5 SSA Title XVI Data.........................................................................................6-86.5.1 SSA Title-XVI Data Report Abstract ...............................................6-9

6.6 Medicare Data..............................................................................................6-11

6.7 Forty Quarters Data .....................................................................................6-12

7. Unemployment Insurance Benefits (UIB).......................................................7-1

7.1 Telephone Claim Filing ..................................................................................7-17.1.1 Background.....................................................................................7-17.1.2 Telephone Verification Policy..........................................................7-1



7.1.3 How to Apply ...................................................................................7-27.1.4 What Happens to the Claim ............................................................7-5

7.2 Basics of UIB Eligibility...................................................................................7-6Types of Claims .........................................................................7-6Conditions of Eligibility ...............................................................7-6Payments ...................................................................................7-7Ineligibility for UIB ......................................................................7-7

7.2.1 Determining the Base Period ..........................................................7-8

7.3 Verification Documents and Procedures ........................................................7-97.3.1 Telephone UIB Check Information ..................................................7-97.3.2 “A Guide to Benefits and Employment Services”

DE 1275-A.....................................................................................7-10Information ...............................................................................7-10

7.3.3 “Pre-Claim Computation”...............................................................7-10Information and Procedures .....................................................7-10Verification Usage ....................................................................7-10

7.3.4 “Notice of Unemployment Insurance Award” Printout ...................7-11Information and Procedures .....................................................7-11Verification Usage ....................................................................7-11

7.3.5 “Payment History” .........................................................................7-12Information and Procedures .....................................................7-12Verification Usage ....................................................................7-12

7.3.6 Determination Codes ....................................................................7-127.3.7 DE 507 ..........................................................................................7-13

Information and Procedures .....................................................7-13Verification and Usage .............................................................7-14How to read a DE 507 ..............................................................7-14

7.3.8 ECC 586-A, the Claimant Abstract................................................7-15Information and Procedures .....................................................7-15Verification and Usage .............................................................7-15

7.4 DE 8720/DE 8720A, Request for Abstracts From EDD ...............................7-167.4.1 Purpose.........................................................................................7-167.4.2 Completion Instructions for the DE 8720 ......................................7-16

Mailing Address .......................................................................7-187.4.3 Purpose (DE 8720A) .....................................................................7-187.4.4 Completion Instructions (DE 8720A).............................................7-187.4.5 Mailing Address.............................................................................7-19

8. Disability Insurance Benefits (DIB) .................................................................8-1

8.1 Anticipating DIB..............................................................................................8-1

8.2 DI Benefit Schedule........................................................................................8-1



8.3 Verifying DI.....................................................................................................8-18.3.1 IEVS Applicant - DI Data Report .....................................................8-18.3.2 EDD Real-Time Match ....................................................................8-28.3.3 IEVS PVS-DI Data Report ..............................................................8-2

Response Document .................................................................8-38.3.4 DI Abstract ......................................................................................8-3

9. Citizenship ........................................................................................................9-1

9.1 U.S. Citizenship..............................................................................................9-1

9.2 Birth in U.S. Territories...................................................................................9-1

9.3 Former Trust Territories .................................................................................9-29.3.1 Republic of Palau............................................................................9-29.3.2 Northern Mariana Islands................................................................9-29.3.3 Republic of the Marshall Islands .....................................................9-39.3.4 Federated States of Micronesia ......................................................9-3

9.4 Derivative Citizenship.....................................................................................9-39.4.1 Documents......................................................................................9-3

9.5 Child Citizenship Act ......................................................................................9-49.5.1 Requirements..................................................................................9-49.5.2 Documents......................................................................................9-49.5.3 Determination of Citizenship ...........................................................9-4

Foreign Birth Certificates ...........................................................9-59.5.4 Date of Acquired Citizenship...........................................................9-5

9.6 Naturalization .................................................................................................9-79.6.1 Rule.................................................................................................9-79.6.2 Documents......................................................................................9-7

9.7 “Citizen Identification Card” (I-179 or I-197)...................................................9-8

9.8 U.S. Passport .................................................................................................9-8

10. Immigration.....................................................................................................10-1

10.1 Acronyms .....................................................................................................10-1

10.2 Definitions ....................................................................................................10-310.2.1 Affidavit of Support........................................................................10-310.2.2 Alien (Noncitizens) ........................................................................10-310.2.3 Authorization to Work....................................................................10-310.2.4 Deeming........................................................................................10-410.2.5 Documented Noncitizen (Alien) ....................................................10-410.2.6 Exception Criteria..........................................................................10-4



10.2.7 Federal Means-Tested Public Benefit Programs...........................10-510.2.8 Immigrant ......................................................................................10-510.2.9 Immigration and Naturalization Service (INS) ...............................10-610.2.10 Lawful Permanent Resident ..........................................................10-610.2.11 National .........................................................................................10-610.2.12 Naturalization ................................................................................10-610.2.13 Noncitizen (Alien) ..........................................................................10-610.2.14 Non-Immigrant ..............................................................................10-710.2.15 Public Charge................................................................................10-7

When is Public Charge Applied? .............................................10-7Public Charge Test ..................................................................10-7How Public Charge Test is Applied ..........................................10-8Persons Affected ......................................................................10-8Persons Not Affected ...............................................................10-9Benefits Subject to Public Charge Consideration ....................10-9Benefits NOT Subject to Public Charge Consideration ............10-9

10.2.16 Qualified Alien” ............................................................................10-1010.2.17 Undocumented Noncitizen (Alien)...............................................10-1110.2.18 U.S. Citizenship and Immigration Services (USCIS)...................10-11

10.3 Documentation ...........................................................................................10-12

10.4 Verification .................................................................................................10-13Exceptions .............................................................................10-13

10.5 Program Eligibility.......................................................................................10-13CalWORKs/CalFresh/Medi-Cal ..............................................10-14Refugee Cash Assistance (RCA) ...........................................10-18

11. Noncitizen Categories ....................................................................................11-1

11.1 Amerasians ..................................................................................................11-111.1.1 Definition .......................................................................................11-111.1.2 Rule...............................................................................................11-111.1.3 Documents ....................................................................................11-211.1.4 Coding..........................................................................................11-211.1.5 Program Eligibility .........................................................................11-3

11.2 Amnesty (IRCA) ...........................................................................................11-311.2.1 Definition .......................................................................................11-311.2.2 Filing Dates ...................................................................................11-411.2.3 Section 245A - “Pre-1982 Amnesty Aliens”...................................11-411.2.4 Section 210 - SAWS .....................................................................11-511.2.5 Section 210A - RAWS...................................................................11-511.2.6 Section 212(d)(5)- Immigrants/Asylees prior to

Jan. 1, 1982 ..................................................................................11-5



11.2.7 Section 249 - “Registry Aliens” pre-1972 ......................................11-611.2.8 Rule...............................................................................................11-611.2.9 Date of Adjustment .......................................................................11-6

I-551 .........................................................................................11-6I-689 .........................................................................................11-7

11.2.10 Unable to Determine Adjustment Date .........................................11-711.2.11 Coding..........................................................................................11-811.2.12 Tracking Amnesty Aliens ..............................................................11-811.2.13 Program Eligibility .........................................................................11-811.2.14 CalWORKs....................................................................................11-911.2.15 Medi-Cal........................................................................................11-911.2.16 CalFresh .....................................................................................11-1011.2.17 General Assistance.....................................................................11-10

11.3 Asylees.......................................................................................................11-1011.3.1 Definition .....................................................................................11-1011.3.2 Rule.............................................................................................11-1011.3.3 Documents..................................................................................11-1111.3.4 Coding........................................................................................11-1111.3.5 Program Eligibility .......................................................................11-11

11.4 Battered Noncitizens ..................................................................................11-1211.4.1 Definition .....................................................................................11-1211.4.2 Rule.............................................................................................11-12

The Battered Noncitizen Requirements are: ..........................11-12Who Determines Abuse .........................................................11-13

11.4.3 Program Eligibility .......................................................................11-14Requirement 1 .......................................................................11-14Requirement 2 .......................................................................11-15Requirement 3 .......................................................................11-16Requirement 4 .......................................................................11-16

11.4.4 Documents..................................................................................11-17 “Notice of Action” (I-797 or I-797C) .......................................11-17Final Order or Notice .............................................................11-18 ...............................................................................................11-18Verification .............................................................................11-19

11.5 Conditional Entrants...................................................................................11-2011.5.1 Definition .....................................................................................11-2011.5.2 Rule.............................................................................................11-2011.5.3 Documents..................................................................................11-2011.5.4 Coding........................................................................................11-2111.5.5 Program Eligibility .......................................................................11-21



11.6 Conditional Permanent Resident................................................................11-2111.6.1 Definition .....................................................................................11-2111.6.2 Rule.............................................................................................11-2111.6.3 Documents ..................................................................................11-2211.6.4 Coding........................................................................................11-2211.6.5 Program Eligibility .......................................................................11-22

11.7 Cross Border American Indian Tribes ........................................................11-2311.7.1 Definition .....................................................................................11-2311.7.2 Rule.............................................................................................11-2311.7.3 Documents ..................................................................................11-2311.7.4 Program Eligibility .......................................................................11-23

11.8 Cuban/Haitian Entrants ..............................................................................11-2411.8.1 Definition .....................................................................................11-2411.8.2 Rule.............................................................................................11-2411.8.3 Documents ..................................................................................11-2511.8.4 Coding........................................................................................11-2611.8.5 Program Eligibility .......................................................................11-26

11.9 Diversity (DV Program) ..............................................................................11-2611.9.1 Definition .....................................................................................11-2611.9.2 Coding........................................................................................11-2711.9.3 Program Eligibility .......................................................................11-27

11.10 Family Unity................................................................................................11-2711.10.1 Definition .....................................................................................11-2711.10.2 Rule.............................................................................................11-2711.10.3 Documents ..................................................................................11-2811.10.4 Coding........................................................................................11-2911.10.5 Program Eligibility .......................................................................11-29

11.11 40 Quarters ................................................................................................11-2911.11.1 Definition .....................................................................................11-2911.11.2 Rules to Determine 40 Quarters .................................................11-30

Lag Quarters ..........................................................................11-30Non-covered Earnings ...........................................................11-30Current Year - Computation of Credits of Qualifying Employment .11-30Establishing Credits/Quarters - 1978 through current year ....11-31Establishing Credits - 1977 and earlier years ........................11-32Combining Credits with Spouse/Parent(s) .............................11-32Example of Qualifying Employment .......................................11-34

11.11.3 Procedures to Request 40 Quarters Information.........................11-3411.11.4 Processing the Report.................................................................11-35



11.12 Hmong or Highland Laotian Tribal Members .............................................11-3711.12.1 Definition .....................................................................................11-3711.12.2 Rule.............................................................................................11-3711.12.3 Documents..................................................................................11-3711.12.4 Coding........................................................................................11-3811.12.5 Program Eligibility .......................................................................11-38

11.13 Jay Treaty Indians......................................................................................11-3811.13.1 Definition .....................................................................................11-3811.13.2 Rule.............................................................................................11-3911.13.3 Documents..................................................................................11-3911.13.4 Program Eligibility .......................................................................11-39

11.14 Lawful Permanent Residents .....................................................................11-3911.14.1 Definition .....................................................................................11-3911.14.2 Rule.............................................................................................11-4011.14.3 Documents..................................................................................11-4011.14.4 Coding........................................................................................11-4011.14.5 Program Eligibility .......................................................................11-40

11.15 Match Grant ...............................................................................................11-4111.15.1 Definition .....................................................................................11-4111.15.2 Rule.............................................................................................11-4111.15.3 Documents..................................................................................11-42

I-94 .........................................................................................11-42I-151 or I-551 .........................................................................11-42I-688B ....................................................................................11-42

11.15.4 Coding........................................................................................11-4211.15.5 Program Eligibility .......................................................................11-43

11.16 Parolees .....................................................................................................11-4311.16.1 Definition .....................................................................................11-4311.16.2 Rule.............................................................................................11-4311.16.3 Documents..................................................................................11-4411.16.4 Coding........................................................................................11-4411.16.5 Program Eligibility .......................................................................11-44

11.17 Private Sector Initiative ..............................................................................11-4511.17.1 Definition .....................................................................................11-4511.17.2 PSI Projects ................................................................................11-4511.17.3 Rule.............................................................................................11-4511.17.4 Documents..................................................................................11-4611.17.5 Coding........................................................................................11-4611.17.6 Program Eligibility .......................................................................11-47



11.18 Privately Funded Soviet Jewish Refugees .................................................11-4711.18.1 Definition .....................................................................................11-4711.18.2 Rule.............................................................................................11-4711.18.3 Documents ..................................................................................11-4811.18.4 Coding........................................................................................11-4811.18.5 Program Eligibility .......................................................................11-48

11.19 PRUCOL ....................................................................................................11-4911.19.1 Definition .....................................................................................11-4911.19.2 Rule.............................................................................................11-4911.19.3 Documents ..................................................................................11-5111.19.4 Coding........................................................................................11-5111.19.5 Program Eligibility .......................................................................11-51

11.20 Refugees ....................................................................................................11-5211.20.1 Definition .....................................................................................11-5211.20.2 Rule.............................................................................................11-52

Medi-Cal .................................................................................11-5311.20.3 Documents ..................................................................................11-5311.20.4 Coding........................................................................................11-5411.20.5 Program Eligibility .......................................................................11-54

11.21 Sponsored Noncitizens (Aliens) .................................................................11-5511.21.1 Definition .....................................................................................11-55

Affidavits of Support ...............................................................11-55Sponsorship Deeming of Income/Resources .........................11-55

11.21.2 Policy...........................................................................................11-5611.21.3 Guidelines ...................................................................................11-5611.21.4 Documents ..................................................................................11-5711.21.5 Coding........................................................................................11-5711.21.6 Program Eligibility .......................................................................11-57

11.22 Temporary Protected Status ......................................................................11-5811.22.1 Definition .....................................................................................11-5811.22.2 Rule.............................................................................................11-5811.22.3 Documents ..................................................................................11-5811.22.4 Coding........................................................................................11-5811.22.5 Program Eligibility .......................................................................11-58

11.23 Trafficking Victims ......................................................................................11-5911.23.1 Definition .....................................................................................11-5911.23.2 Rule.............................................................................................11-5911.23.3 Certification .................................................................................11-6011.23.4 Documents ..................................................................................11-61



11.24 Undocumented Persons.............................................................................11-6211.24.1 Definition .....................................................................................11-6211.24.2 Rule.............................................................................................11-6211.24.3 Program Eligibility .......................................................................11-62

11.25 Veteran Status ...........................................................................................11-6311.25.1 Definition .....................................................................................11-6311.25.2 Rule.............................................................................................11-6311.25.3 Documents..................................................................................11-63

Honorable Discharge .............................................................11-63Active Duty .............................................................................11-64Spouse, Unmarried Dependent Child, Unmarried Surviving Spouse ...................................................................11-64

11.26 Voluntary Departure ...................................................................................11-6611.26.1 Definition .....................................................................................11-6611.26.2 Rule.............................................................................................11-6611.26.3 Documents..................................................................................11-6611.26.4 Coding........................................................................................11-6711.26.5 Program Eligibility .......................................................................11-67

11.27 Withholding of Deportation/Cancellation of Removal.................................11-6711.27.1 Definition .....................................................................................11-6711.27.2 Rule.............................................................................................11-6811.27.3 Documents..................................................................................11-6811.27.4 Coding........................................................................................11-6811.27.5 Program Eligibility .......................................................................11-68

12. USCIS Codes...................................................................................................12-1

12.1 USCIS Documents .......................................................................................12-1

12.2 Sponsorship .................................................................................................12-1

12.3 Assorted Documents....................................................................................12-1

12.4 I-551 .............................................................................................................12-5

12.5 I-551 — Conditional ...................................................................................12-13

12.6 I-151 ...........................................................................................................12-1512.6.1 Adjustment Admission Codes .....................................................12-16

12.7 Non-Immigrants..........................................................................................12-1712.7.1 Non-Immigrant USCIS Codes.....................................................12-1712.7.2 Non-Immigrant Forms .................................................................12-20



13. Immigration Forms .........................................................................................13-1

USCIS Request for Information ...............................................13-1

13.1 Non-numbered Immigration Forms ..............................................................13-213.1.1 Foreign Passports .........................................................................13-2

“Processed for I-551” ...............................................................13-2“Conditional Resident” .............................................................13-3

13.1.2 Visas .............................................................................................13-3

13.2 Numbered Immigration Forms......................................................................13-313.2.1 AR-3/AR-3a “Alien Registration Receipt” ......................................13-313.2.2 I-94 “Arrival-Departure Form”........................................................13-4

Parolee .....................................................................................13-5Refugee ...................................................................................13-5Asylee ......................................................................................13-5Non-Immigrants .......................................................................13-5

13.2.3 I-130 “Petition for Alien Relative” ..................................................13-613.2.4 I-134 “Affidavit of Support” ............................................................13-613.2.5 I-151 “Resident Alien Card”...........................................................13-613.2.6 I-179 “U.S. Citizen Identification Card”..........................................13-613.2.7 I-181a “Memorandum of Creation of Record of

Lawful Permanent Residence” ......................................................13-713.2.8 I-185 “Canadian Border Crossing Card”........................................13-713.2.9 I-186 “Nonresident Alien Mexican Border Crossing Card” ............13-713.2.10 I-197 “U.S. Citizen Identification Card”..........................................13-713.2.11 I-210 “Voluntary Departure” ..........................................................13-813.2.12 I-221 “Order To Show Cause” .......................................................13-813.2.13 I-327 “Re-Entry Permit” .................................................................13-813.2.14 I-360 “Petition for Amerasian, Widow or Special Immigrant”.........13-813.2.15 I-444 “Mexican Border Visitors Permit” .........................................13-813.2.16 I-512 “Parole Authorization” ..........................................................13-913.2.17 N-550 “Certificate Of Naturalization” .............................................13-913.2.18 I-551 “Permanent Resident Card” .................................................13-9

1998 Version ..........................................................................13-102010 Version ..........................................................................13-10

13.2.19 N-560 “Certificate Of Citizenship”................................................13-1113.2.20 N-570 “Certificate Of Naturalization” ...........................................13-1113.2.21 I-571 “Refugee Travel Document”...............................................13-1113.2.22 I-586 “Mexican Border Crossing Card”........................................13-1113.2.23 I-688 “Temporary Resident Card” ...............................................13-1213.2.24 I-688A “Employment Authorization for Legalization Applicants” .13-1213.2.25 I-688B “Employment Authorization Document” ...........................13-12

Key to “Provision of Law” .......................................................13-1313.2.26 I-689 “Fee Receipt” .....................................................................13-14



13.2.27 G-711 “USCIS Cash Receipt” .....................................................13-14Key to Form Numbers ............................................................13-15

13.2.28 I-766 “Employment Authorization Document” .............................13-1613.2.29 I-797 “Notice of Action” ...............................................................13-16

I-797 .......................................................................................13-16I-797A ....................................................................................13-17I-797B ....................................................................................13-17I-797C ....................................................................................13-17

13.2.30 I-864 “Affidavit of Support” ..........................................................13-17

13.3 Processing USCIS Documents ..................................................................13-1713.3.1 Photocopying/Scanning USCIS Documents ...............................13-1713.3.2 Lost, Mutilated or Destroyed Documents....................................13-1813.3.3 Altered or Phony Documents ......................................................13-1813.3.4 Incorrect Information on Documents...........................................13-1813.3.5 Expired Documents.....................................................................13-19

Lawful Permanent Resident (LPR) ........................................13-19Any Other Immigration Status ................................................13-19

13.4 USCIS Fee Waiver.....................................................................................13-2013.4.1 Eligibility for a Fee Waiver ..........................................................13-2013.4.2 Requesting a Fee Waiver ...........................................................13-2013.4.3 Applications and Petitions Considered for Fee Waiver ...............13-21

14. SAVE................................................................................................................14-1

14.1 Definition ......................................................................................................14-1

14.2 Declaration ...................................................................................................14-2

14.3 Alien Registration Numbers .........................................................................14-2

14.4 SAVE Form Requirements...........................................................................14-314.4.1 Statement of Facts - SAWS 2 .......................................................14-314.4.2 CW 8 and CW 8A..........................................................................14-314.4.3 DFA 285-A2 ..................................................................................14-314.4.4 SOC 814 .......................................................................................14-314.4.5 MC 13 ...........................................................................................14-4

Medi-Cal/CalFresh Cases ........................................................14-414.4.6 Completion of the MC 13 ..............................................................14-514.4.7 Who Is Required to Sign ...............................................................14-614.4.8 Witness to Signature.....................................................................14-6

14.5 Informing ......................................................................................................14-6

14.6 Time Frames ................................................................................................14-7



14.7 Specific Programs [EAS 40-126.2, 40-171.11].............................................14-714.7.1 CalWORKs....................................................................................14-714.7.2 Refugee Cash Assistance (RCA)..................................................14-814.7.3 CalFresh........................................................................................14-814.7.4 Medi-Cal ........................................................................................14-914.7.5 Cash Assistance Program for Immigrants (CAPI) .........................14-9

14.8 Requirements .............................................................................................14-1014.8.1 USCIS Documentation ................................................................14-10

14.9 Primary SAVE ............................................................................................14-1114.9.1 Primary Request Procedure........................................................14-11

CalWIN IEVS Applicant SAVE Data ......................................14-11CalWIN Forced Add Transaction to MEDS ............................14-12Online MEDS Request ...........................................................14-12

14.9.2 Primary Abstract..........................................................................14-1314.9.3 Primary Messages ......................................................................14-1314.9.4 Acceptable Differences ...............................................................14-1314.9.5 Unacceptable Differences ...........................................................14-1414.9.6 Primary/Secondary Decision Chart .............................................14-14

14.10 Secondary SAVE........................................................................................14-1514.10.1 Secondary Request.....................................................................14-1614.10.2 G-845S Procedures ....................................................................14-16

Noncitizen Information ...........................................................14-16To/From/EW Information ........................................................14-17

14.10.3 USCIS Response To G-845S .....................................................14-18

14.11 Refugees ....................................................................................................14-2014.11.1 Procedures..................................................................................14-2014.11.2 Delayed SAVE Procedures .........................................................14-21

14.12 PRUCOL (Permanently Residing Under Color of Law)..............................14-2214.12.1 SAVE Procedures .......................................................................14-22

15. Voter Registration...........................................................................................15-1

15.1 Background ..................................................................................................15-115.1.1 Reception Areas............................................................................15-115.1.2 EW Requirements .........................................................................15-115.1.3 Who May Register.........................................................................15-215.1.4 SCD 508........................................................................................15-215.1.5 Procedures....................................................................................15-3

Intake/RRRs - Face to Face Interview .....................................15-3Intake/RRRs - Mail-In ...............................................................15-4Address Changes ....................................................................15-5Second Contact .......................................................................15-5



15.1.6 Inappropriate Voter Registration Applications...............................15-6

15.2 Voter Registration Card Completion ............................................................15-715.2.1 General .........................................................................................15-715.2.2 SECTION 1 - Name ......................................................................15-815.2.3 SECTION 2 - Last Name ..............................................................15-815.2.4 SECTION 3 - Title .........................................................................15-815.2.5 SECTION 4 - Home Address ........................................................15-815.2.6 SECTION 5 - Home Address Continued.......................................15-815.2.7 SECTION 6 - No Street Address ..................................................15-815.2.8 SECTION 7 - Mailing Address ......................................................15-915.2.9 SECTION 8 - Mailing Address ......................................................15-915.2.10 SECTION 9 - Date of Birth ............................................................15-915.2.11 SECTION 10 - Place of Birth ........................................................15-915.2.12 SECTION 11 - California Driver’s License or CA ID # ..................15-915.2.13 SECTION 12 - E-mail Address .....................................................15-915.2.14 SECTION 13 - Telephone Number .............................................15-1015.2.15 SECTION 14 - Choice of Party ...................................................15-1015.2.16 SECTION 15 - Vote by Mail Ballot ..............................................15-1115.2.17 SECTION 16 - Prior Registration ................................................15-1115.2.18 SECTION 17- Citizenship and Age.............................................15-1115.2.19 SECTION 18 - Signature ............................................................15-1115.2.20 Optional Section..........................................................................15-1215.2.21 Affidavit Receipt .........................................................................15-12

15.3 Mailing the Voter Registration Card ...........................................................15-1215.3.1 To Client......................................................................................15-1215.3.2 To Registrar ................................................................................15-13

15.4 Special Indicator Codes .............................................................................15-13

16. Electronic Benefit Transfer (EBT) .................................................................16-1

16.1 Overview ......................................................................................................16-116.1.1 Policy ............................................................................................16-116.1.2 Background...................................................................................16-116.1.3 How EBT Works............................................................................16-116.1.4 EBT Programs ..............................................................................16-216.1.5 Cash Programs .............................................................................16-216.1.6 CalFresh .......................................................................................16-316.1.7 Programs Exempt from EBT .........................................................16-3

16.2 Definitions ....................................................................................................16-316.2.1 Administrative Terminal Software .................................................16-416.2.2 Authorized Representative (AR) ...................................................16-416.2.3 Automated Response Unit (ARU) .................................................16-4



16.2.4 Automated Teller Machines (ATMs)..............................................16-416.2.5 Designated Alternate Cardholder (DAC).......................................16-416.2.6 Dormant Account (180 Days) ........................................................16-416.2.7 Electronic Benefit Transfer (EBT)..................................................16-516.2.8 EBT Client Website (ECW) ...........................................................16-516.2.9 Electronic Payment Processing and Information Control

(EPPIC) System ............................................................................16-516.2.10 Expunged Benefits (365 Days) .....................................................16-516.2.11 Inactive Account (135 Days) .........................................................16-516.2.12 MoneyPass ®................................................................................16-516.2.13 Personal Identification Number (PIN)............................................16-616.2.14 Point of Sale (POS) Device...........................................................16-616.2.15 Primary Cardholder (PCH) ............................................................16-616.2.16 QUEST ® ......................................................................................16-616.2.17 Statewide Automated Reconciliation System (SARS)...................16-616.2.18 Status Card ...................................................................................16-716.2.19 Surcharge......................................................................................16-716.2.20 Transaction Fee ............................................................................16-716.2.21 Unlock PIN ....................................................................................16-7

16.3 EBT Client Website ......................................................................................16-716.3.1 Create Login..................................................................................16-816.3.2 Account Balance ...........................................................................16-816.3.3 Transaction History .......................................................................16-816.3.4 Claim Status..................................................................................16-916.3.5 Change Password.........................................................................16-916.3.6 Lost, Stolen, or Damaged Cards...................................................16-916.3.7 EBT Brochures..............................................................................16-916.3.8 Other Links..................................................................................16-10

16.4 Electronic Benefit Transfer (EBT) Forms ...................................................16-1016.4.1 “Electronic Benefit Transfer (EBT) On-Line Request”

(SCD 2201) .................................................................................16-10Usage .....................................................................................16-10Completion .............................................................................16-11Section I .................................................................................16-11Section II ................................................................................16-12

16.4.2 “Client Electronic Benefit Transfer (EBT) Request” (SCD 2202) .................................................................................16-13

Usage .....................................................................................16-13Completion .............................................................................16-13

16.4.3 “Returned EBT Cards to be Destroyed” (SCD 2203) ..................16-13Usage .....................................................................................16-13Completion .............................................................................16-14



16.4.4 Electronic Benefit Transfer (EBT) Request for Designated Alternate Cardholder/Authorized Representative” (CSF 64).......16-14

Usage ....................................................................................16-14Completion .............................................................................16-14

16.4.5 “Electronic Benefit Transfer (EBT) Exemption From Cash Benefit Stagger Request” (CSF 65)...................................16-15


16.4.6 “Electronic Benefit Transfer (EBT) Exemption Request Form For Cash Aid” (CSF 66) ..............................................................16-16


16.4.7 “Electronic Benefit Transfer (EBT) Card & Personal Identification Number (PIN) Responsibility Statement” (CSF 67).....................16-17


16.5 CalWIN Interface........................................................................................16-18

16.6 CalWIN EBT Data ......................................................................................16-19

16.7 Benefit Posting Process .............................................................................16-2016.7.1 EBT Demographic File ................................................................16-2016.7.2 EBT Benefit File ..........................................................................16-21

Daily Runs .............................................................................16-21Monthly Runs .........................................................................16-21

16.8 Set-Up of EBT Accounts Policy..................................................................16-22

16.9 Pending Demographics / Unlinked Benefits...............................................16-2216.9.1 Pending Demographics File ........................................................16-2216.9.2 Pending Benefit File....................................................................16-23

16.10 EBT Account Usage .................................................................................16-2416.10.1 Withdrawal Amounts ...................................................................16-2416.10.2 Transaction Fees ........................................................................16-2516.10.3 Surcharges..................................................................................16-2516.10.4 Direct Deposit vs. EBT Account ..................................................16-26

16.11 Inactive Account .......................................................................................16-27

16.12 Dormant Account......................................................................................16-2716.12.1 Dormant Status When No Longer Receiving Aid........................16-2916.12.2 Reactivating a Dormant Account on a Closed Case...................16-29



16.13 Expunged Benefits ...................................................................................16-3016.13.1 Offsetting an Overissuance With Expunged Benefits..................16-30

CalFresh ................................................................................16-3016.13.2 Cash Benefits ..............................................................................16-3016.13.3 General Assistance (GA) Loan ...................................................16-31

16.14 “Golden State Advantage” EBT Card .......................................................16-3116.14.1 Replacing an EBT Card ..............................................................16-3216.14.2 EBT Card is Lost, Stolen or Damaged ........................................16-3316.14.3 EBT Card and/or PIN is Returned...............................................16-3416.14.4 EBT Card is NOT Received ........................................................16-3716.14.5 Issuing an EBT Card in the Office When Issuing Payments

via CalWIN “Batch” System.........................................................16-39

16.15 Personal Identification Number (PIN) .......................................................16-4016.15.1 Changing a PIN...........................................................................16-4016.15.2 PIN Lock / Unlock Procedures ....................................................16-4116.15.3 “Electronic Benefit Transfer (EBT) Card and PIN

Responsibility Statement” (CSF 67) ............................................16-42

16.16 EBT Cardholders ......................................................................................16-4316.16.1 Adding an Additional Cardholder to EBT ....................................16-4316.16.2 Deleting an Additional Cardholder from EBT ..............................16-4516.16.3 Changing a Payee in EBT...........................................................16-46

16.17 General Assistance Clients in a State Licensed Board and Care Facility ...............................................................................................16-47

16.18 Drug/Alcohol Treatment Centers ..............................................................16-4816.18.1 Issuing the EBT Card/PIN to the Treatment Center ....................16-4816.18.2 Client leaves the Treatment Center PRIOR to the

16th of the Month ........................................................................16-4816.18.3 Client leaves Treatment Center AFTER the

16th of the Month ........................................................................16-49

16.19 CalFresh Restaurant Meals Program .......................................................16-50

16.20 CalFresh Stagger Issuance ......................................................................16-51

16.21 Cash Stagger Issuance ..............................................................................16-5116.21.1 Cash Stagger Exemption ............................................................16-52

16.22 Exemption from Cash EBT .......................................................................16-5316.22.1 Exemption Due to a Disability .....................................................16-5416.22.2 Client Request for EBT Cash Exemption ....................................16-55



16.23 Electronic Repayment of Benefits ............................................................16-5616.23.1 Incorrect Amount Issued in Client’s Account ..............................16-5616.23.2 Overissuance and/or Overpayment Repayments .......................16-56

16.24 Holding/Releasing EBT Benefits ..............................................................16-5916.24.1 System-Generated Hold on EBT Benefits ..................................16-5916.24.2 System-Generated Release of a Hold on EBT Benefits .............16-5916.24.3 Manual Hold on EBT Benefits .....................................................16-5916.24.4 Manual Release of a Hold on EBT Benefits................................16-59

16.25 Voiding of EBT Benefits ...........................................................................16-6016.25.1 Procedure for Voiding EBT Benefits ...........................................16-6016.25.2 Reissuance of Voided EBT benefits ...........................................16-61

16.26 Administrative Terminals ..........................................................................16-6216.26.1 User Profiles ...............................................................................16-6216.26.2 Administrative Terminal Main Menu and Submenu ....................16-6216.26.3 Searching for Cardholder Information.........................................16-6316.26.4 Proper Use of EBT Administrative Terminal ...............................16-6416.26.5 Agency Policy .............................................................................16-65

16.27 Voice Mail Messages ...............................................................................16-66

16.28 Automated Response Unit (ARU) ............................................................16-6616.28.1 ACS’ Customer Service Functionality .........................................16-6716.28.2 Card Replacement ......................................................................16-6716.28.3 Excessive Card Replacement (ECR)..........................................16-6816.28.4 Individuals Without an SSN ........................................................16-70

16.29 Retailer Participation ..................................................................................16-7116.29.1 Manual Vouchers ........................................................................16-71

16.30 Benefit Adjustments .................................................................................16-7216.30.1 System Errors .............................................................................16-7316.30.2 Client-Initiated .............................................................................16-7316.30.3 Retailer / Commercial Initiated....................................................16-7316.30.4 Notice of Action (NOA) for Retailer- or

Commercial-Initiated Claims .......................................................16-7416.30.5 Procedure ...................................................................................16-75

16.31 CalWIN Electronic Benefit Transfer (EBT) Listings ..................................16-7616.31.1 MRC003R - Register of CalFresh EBT - Daily Process ..............16-7616.31.2 MRC012R - Register of CalFresh EBT - FME Process ..............16-7716.31.3 MRC009R - Register of CalFresh EBT - CME Process ..............16-7716.31.4 MRC00021R - Register of Cash EBT - Daily Process ................16-7716.31.5 MRC018R - Register of Cash EBT - FME Process.....................16-7716.31.6 MRC014R - Register of Cash EBT - CME Process ....................16-7816.31.7 MRC027R - Register of EBT Cards ............................................16-78



16.31.8 MRC050R - Register of CalFresh EBT Cancellations (Void) ......16-7816.31.9 MRC051R - Register of Cash EBT Cancellations (Void) ............16-7816.31.10 MRC047R - Expunged Account Report by Program...................16-7816.31.11 MRC048R - Expunged Account Report by CalFresh and

Case Number ..............................................................................16-7916.31.12 MRC057R - Expunged Account Report by Cash Program and

Case Number ..............................................................................16-7916.31.13 MRV007R - EBT Unlinked Benefits.............................................16-7916.31.14 MRV008R - EBT Unmatched Benefits ........................................16-79

16.32 Electronic Benefit Transfer (EBT) Reports Produced by ACS..................16-7916.32.1 “CA EBT System - Daily Administrative Transactions Report”....16-8016.32.2 “CA EBT System - Daily Administrative Actions Detail Report” ..16-8016.32.3 “CA EBT System - Daily Benefit Type Repayment Report” ........16-8116.32.4 “CA EBT System - Inactive/Dormant/Expunged Report”.............16-8116.32.5 “CA EBT System - California Pending Benefits Report”..............16-8116.32.6 “CA EBT System - ATM/POS Out-of-State Usage Report”.........16-8116.32.7 “CA EBT System - Lost/Damaged/Stolen Card Report”..............16-8116.32.8 “CA EBT System - Card Issuances Statistics Report”.................16-8216.32.9 “CA EBT System - Excessive Card Replacement Report”..........16-8216.32.10 EBT Out-of State Usage Report..................................................16-82

Processing the Report ...........................................................16-83

16.33 System Downtime/Network Outage ...........................................................16-85

16.34 No Interface Between CalWIN and EPPIC.................................................16-8516.34.1 Benefit Issuance..........................................................................16-8516.34.2 EBT Card Issuance .....................................................................16-8616.34.3 Establishing New Card Holder ....................................................16-8616.34.4 Repayments ................................................................................16-87

16.35 CalWIN is Operational and EPPIC is Not...................................................16-8716.35.1 Benefit Issuance..........................................................................16-8816.35.2 EBT Card Issuance .....................................................................16-8816.35.3 Establishing New Card Holders...................................................16-8816.35.4 Repayments ................................................................................16-88

16.36 EPPIC is Operational and CalWIN is Not...................................................16-8816.36.1 Benefit Issuance..........................................................................16-8816.36.2 EBT Card Issuance .....................................................................16-8916.36.3 Establishing New Card Holder ....................................................16-9016.36.4 Repayment ..................................................................................16-90

16.37 CalWIN and EPPIC are both Down............................................................16-91

16.38 Disaster Benefit Issuance...........................................................................16-91



16.39 Disaster Support Services..........................................................................16-9216.39.1 Invoking Disaster Support Services ............................................16-9216.39.2 Pre-Printed Disaster EBT Cards .................................................16-9216.39.3 Disaster Benefits .........................................................................16-9316.39.4 Disaster EBT Card Management ................................................16-9416.39.5 Emergency Equipment Supply....................................................16-95

16.40 Administrative Application (AA) Disaster Services.....................................16-9516.40.1 Disaster User IDs........................................................................16-9516.40.2 Disaster Account Setup ..............................................................16-9616.40.3 Disaster Card Replacement ........................................................16-9616.40.4 Disaster Benefit Issuance ...........................................................16-96

17. Electronic Funds Transfer (EFT) - Direct Deposit17-1

17.1 Overview ......................................................................................................17-117.1.1 Policy ............................................................................................17-117.1.2 Purpose.........................................................................................17-117.1.3 Cash Assistance Programs...........................................................17-117.1.4 Client Enrollment...........................................................................17-2

17.2 Definitions ....................................................................................................17-217.2.1 Automated Clearing House (ACH)................................................17-217.2.2 Benefit Issuance Unit @ Julian .....................................................17-217.2.3 Direct Deposit ...............................................................................17-317.2.4 Electronic Funds Transfer (EFT)...................................................17-317.2.5 National Automated Clearinghouse Association (NACHA)

Codes............................................................................................17-317.2.6 Pre-Note Status ............................................................................17-317.2.7 Transmittal ....................................................................................17-3

17.3 Direct Deposit Form .....................................................................................17-317.3.1 “Direct Deposit Enrollment Form” (SCD 1948)..............................17-4

Usage ......................................................................................17-4Completion ...............................................................................17-4Scanning ..................................................................................17-4

17.4 CalWIN Issuance Information ......................................................................17-417.4.1 Fiscal Month End - First of the Month Issuances..........................17-417.4.2 Daily Process - Supplemental Issuances......................................17-5

17.5 Initiating Direct Deposit ................................................................................17-617.5.1 Procedures....................................................................................17-617.5.2 EFT Status Codes.........................................................................17-8



17.6 Pre-Note Process .........................................................................................17-817.6.1 Pre-Note Approval.........................................................................17-817.6.2 Pre-Note Rejects...........................................................................17-917.6.3 Pre-Note Reject Actions..............................................................17-10

17.7 Direct Deposit Approval..............................................................................17-1117.7.1 Direct Deposit Approval on an Active Case ................................17-1217.7.2 Direct Deposit Approval on a Discontinued/Closed Case ...........17-1217.7.3 Direct Deposit on a Restored/Rescinded Case...........................17-13

17.8 Deleting Direct Deposit...............................................................................17-14

17.9 Direct Deposit Holds and Releases............................................................17-1417.9.1 Holds ...........................................................................................17-1417.9.2 Emergency Hold Process............................................................17-1517.9.3 Direct Deposit Returns ................................................................17-15

17.10 Non-Receipt of Direct Deposit....................................................................17-1617.10.1 Direct Deposit Changes ..............................................................17-1717.10.2 Changing Direct Deposit Bank Accounts ....................................17-1717.10.3 Payee Changes...........................................................................17-18

17.11 CalWIN Electronic Funds Transfer (EFT) Listings .....................................17-1817.11.1 MRC020R - Register of EFT - Daily Process..............................17-1817.11.2 MRC 046R - “EFT Bank Exception” Report ................................17-1817.11.3 MRC011R - Register of EFT - Fiscal Month End Process ..........17-1817.11.4 MRC041R - EFT Benefits Held ...................................................17-1917.11.5 MRC015R - Register of EFT - Calendar Month End Process.....17-1917.11.6 MRC045R - EFT Bank File Report..............................................17-19

17.12 CalWIN EFT Other Correspondence..........................................................17-2017.12.1 CSF 71 - Approval for Direct Deposit ..........................................17-2017.12.2 CSF 72 - Denial for Direct Deposit ..............................................17-2017.12.3 CSF 73 - Change in Direct Deposit .............................................17-2017.12.4 CSF 74 - Termination of Direct Deposit ......................................17-2017.12.5 CSF 75 Notification of Direct Deposit..........................................17-20

18. Warrants/Checks ...........................................................................................18-1

18.1 Cash Benefit Issuance Methods...................................................................18-1

18.2 Glossary of Terms ........................................................................................18-1

18.3 Paper Warrant or Check...............................................................................18-318.3.1 Securing Warrant (Check) Stock...................................................18-4



18.4 Cashing Paper Warrants..............................................................................18-418.4.1 Warrant Cashing Resources.........................................................18-4

Banks .......................................................................................18-4Grocery Stores and Other Small Businesses ..........................18-5

18.4.2 Identification Cards (State IDs) .....................................................18-518.4.3 "Certification of Identification Document" (CSF 54) ......................18-6

18.5 Client Returns Money/Benefits.....................................................................18-618.5.1 Active Case...................................................................................18-718.5.2 Closed Case .................................................................................18-7

18.6 Returned Paper Warrants ............................................................................18-818.6.1 Returned Directly by the Client .....................................................18-818.6.2 Returned in the Mail ......................................................................18-9

18.7 Cut-Off Times.............................................................................................18-1018.7.1 Cancelled Warrants ....................................................................18-1018.7.2 Client Pick-Up .............................................................................18-10

18.8 Damaged Warrants ...................................................................................18-11

18.9 Warrant Replacement ................................................................................18-1118.9.1 Assembly Bill (AB) 142 ...............................................................18-1118.9.2 Agency Policy .............................................................................18-1118.9.3 Replacement Procedures for Same Amount/Payee ...................18-1218.9.4 Reissuing Procedures for Different Amount/Payee.....................18-15

18.10 Lost or Stolen Warrant Replacement .........................................................18-1718.10.1 Forms..........................................................................................18-1718.10.2 Lost Endorsed Warrant ...............................................................18-1818.10.3 Replacement Procedure for Warrants With a

Restrictive Endorsement .............................................................18-1818.10.4 Cashed (Forged) Warrant Replacement .....................................18-19

EW Responsibility ..................................................................18-19Benefit Issuance Unit @ Julian Responsibility .......................18-20District Attorney’s (DA) Responsibility ...................................18-21

18.10.5 Recovery of Duplicate Aid Payments..........................................18-21

18.11 Intercounty Lost or Stolen Warrant Replacement (Aid Types: AAP, CalWORKs, CAPI, EA, FC, RCA) .............................................................18-2318.11.1 Warrant Issued By Another County ............................................18-2318.11.2 Santa Clara County's Warrant ....................................................18-2418.11.3 AAP Out of State Warrant Replacements...................................18-2618.11.4 AAP Out of Country Warrant Replacements...............................18-26

18.12 Emergency Holds (Paper Warrants ONLY) ...............................................18-2618.12.1 General Information About Emergency Holds ............................18-2618.12.2 Emergency Hold Actions.............................................................18-27



18.13 CalWIN Warrant/Check Listings.................................................................18-2918.13.1 MRC019R - Register of Warrants and Checks -

Daily Process ..............................................................................18-2918.13.2 MRC010R - Register of Warrants - FME Process.......................18-2918.13.3 MRC013R - Register of Warrants - CME Process ......................18-30

19. Integrated Document Management (IDM).....................................................19-1

19.1 Introduction...................................................................................................19-1

19.2 Policy...........................................................................................................19-119.2.1 New Benefit Intake Cases.............................................................19-119.2.2 New CWES Intake Cases .............................................................19-119.2.3 Full Scan for Intake Cases ............................................................19-219.2.4 Add-a-Program IDM Procedures...................................................19-219.2.5 Retention Center - Other Requests for Paper Case Files .............19-319.2.6 Partially Scanned Cases ...............................................................19-319.2.7 Benefits Cases ..............................................................................19-319.2.8 CWES Cases ................................................................................19-4

19.3 Filing Structure in IDM..................................................................................19-4

19.4 Category/Subcategory - Benefits .................................................................19-6

19.5 Category/Sub-Category - CWES Chart......................................................19-15

19.6 Processing of Periodic Reports ..................................................................19-25Processing Procedures ..........................................................19-25District Office Processing Procedure .....................................19-27

19.7 IDM Quality Assurance...............................................................................19-2719.7.1 Scanning Tips .............................................................................19-29

19.8 Client Access to IDM Documents...............................................................19-3019.8.1 Privileged Document ...................................................................19-30

19.9 Miscellaneous IDM Procedures.................................................................19-3119.9.1 Scanning of New Intake Documentation ....................................19-3119.9.2 Scanning Request Submission Requirement..............................19-3219.9.3 IDM Retrieval Problem ................................................................19-3219.9.4 Corrections to IDM Documents Index Fields...............................19-3219.9.5 Closed Case IDM Policy .............................................................19-3219.9.6 IDM Access by Non Social Service Agency Staff.......................19-33

19.10 Benefits Forms Cross Reference Chart .....................................................19-33

19.11 CWES FORMS CROSS REFERENCE CHART ........................................19-42



20. Self-Service Technologies.............................................................................20-1

20.1 My Benefits CalWIN (MyBCW) ....................................................................20-120.1.1 Benefits of BCW............................................................................20-120.1.2 Languages ....................................................................................20-220.1.3 MyBCW User Accounts ................................................................20-220.1.4 Mailing Address in MyBCW for Homeless Clients ........................20-220.1.5 MyBCW Questions and Answers..................................................20-3

20.2 Access CalWIN ............................................................................................20-420.2.1 Enhancements to IVR ...................................................................20-520.2.2 Cisco Desktop Agent ....................................................................20-520.2.3 Languages ....................................................................................20-620.2.4 Special Indicators..........................................................................20-620.2.5 PIN Requirement ..........................................................................20-6

20.3 MyBCW Mobile Application..........................................................................20-7

21. Verifications....................................................................................................21-1

21.1 Receipts Required by Law ...........................................................................21-121.1.1 “Receipt For Documents” (CSF30) ...............................................21-1

21.2 Computer-Generated Abstracts of Birth Records ........................................21-221.2.1 What the Abstract Will Include ......................................................21-221.2.2 Security Features..........................................................................21-321.2.3 Providing Copies of Abstract.........................................................21-321.2.4 Children Under Six Months Old ....................................................21-3

21.3 Requesting Certificates Within California.....................................................21-4

21.4 Requesting Certificates Outside of California ..............................................21-521.4.1 Photo IDs ......................................................................................21-521.4.2 Release of Information..................................................................21-621.4.3 Notarization of Application ............................................................21-6

21.5 Bank Verification ..........................................................................................21-721.5.1 Requirement .................................................................................21-7

CSF17 ......................................................................................21-721.5.2 Bank of America............................................................................21-721.5.3 Wells Fargo Bank..........................................................................21-8

21.6 Employment Verification - The Work Number..............................................21-821.6.1 Policy ............................................................................................21-921.6.2 IEVS Unit Usage of The Work Number.........................................21-9



22. Notices of Action ............................................................................................22-1

22.1 The Requirements of Timely and Adequate Notice......................................22-122.1.1 Adequate Notice............................................................................22-122.1.2 Timely Notice ................................................................................22-122.1.3 Exceptions to Timely Notice Requirements...................................22-222.1.4 Reinstatement ...............................................................................22-2

22.2 Providing Information on a Notice of Action .................................................22-322.2.1 Message Content ..........................................................................22-322.2.2 Meet the Client’s Needs ................................................................22-322.2.3 Complete Information....................................................................22-3

22.3 Writing the Notice of Action ..........................................................................22-422.3.1 Clear and Simple Statements .......................................................22-422.3.2 Multiple Issues ..............................................................................22-422.3.3 Required Items..............................................................................22-522.3.4 Change Notice ..............................................................................22-522.3.5 Computation..................................................................................22-622.3.6 Manual Section Cited ....................................................................22-622.3.7 Reestablish Eligibility ....................................................................22-622.3.8 Back of the Notice .........................................................................22-622.3.9 Checklist........................................................................................22-6

22.4 CalWIN and Notices of Action ......................................................................22-722.4.1 Batch Generated Notices of Action ..............................................22-722.4.2 Online Generated Notices of Action..............................................22-822.4.3 Manual Generated Notices of Action ............................................22-8

23. Forms Available in Shelf Stock .....................................................................23-1

23.1 Forms Not Available On-Line .......................................................................23-1

23.2 Forms Available On-Line and in Shelf Stock................................................23-1

23.3 CalWORKs State Forms ..............................................................................23-2

23.4 Cash Assistance Program for Immigrants (CAPI) State Forms ...................23-2

23.5 CalWORKs Employment Services (CWES) State Forms ............................23-3

23.6 CalFresh State Forms ..................................................................................23-3

23.7 Foster Care State Forms..............................................................................23-4

23.8 General Assistance Forms ...........................................................................23-4

23.9 Medi-Cal State Forms ..................................................................................23-5



23.10 Multi-Program State Forms ..........................................................................23-7

23.11 SCD/County Forms ......................................................................................23-8

23.12 Unable to Locate a Form............................................................................23-10

24. Intake/RRR Packets........................................................................................24-1

24.1 Intake Signature Packet ...............................................................................24-124.1.1 Introduction/Overview ...................................................................24-1

Mail-In Applications ..................................................................24-1Clerical Preparation .................................................................24-1Content ....................................................................................24-1

24.1.2 CalWORKs/RCA, Medi-Cal and CAPI ..........................................24-224.1.3 CalWORKs/RCA and CalFresh.....................................................24-224.1.4 CalFresh .......................................................................................24-324.1.5 Medi-Cal........................................................................................24-424.1.6 Medi-Cal and CalFresh .................................................................24-524.1.7 CAPI and CalFresh .......................................................................24-624.1.8 GA and CalFresh ..........................................................................24-7

24.2 Informational Intake Packet..........................................................................24-824.2.1 CalWORKs and PA CalFresh ......................................................24-924.2.2 CalFresh .....................................................................................24-1124.2.3 Medi-Cal......................................................................................24-1224.2.4 Medi-Cal Packets - Families .......................................................24-1324.2.5 Medi-Cal Packets - Adults...........................................................24-1424.2.6 General Assistance (GA) ............................................................24-1624.2.7 Cash Assistance Program for Immigrants (CAPI).......................24-18

24.3 Foster Care Intake Packets........................................................................24-1924.3.1 Voluntary Placements or Legal Guardian Placements................24-1924.3.2 Court Ordered Foster Care Placements .....................................24-2024.3.3 Medi-Cal Out-of-State (Foster Care AAP)...................................24-2024.3.4 Adoption Assistance Program (AAP) ..........................................24-21

24.4 CalWORKs and PA CalFresh RRR Packet................................................24-22

24.5 CalFresh RRR Packet................................................................................24-2324.5.1 Semi-Annual Reporting...............................................................24-2424.5.2 Change Reporting.......................................................................24-25

24.6 Medi-Cal RRR Packet ................................................................................24-2624.6.1 Medi-Cal Packets - Families .......................................................24-2624.6.2 Medi-Cal Packets - Adults...........................................................24-2724.6.3 Medi-Cal Packets - Long Term Care (LTC) ................................24-27

24.7 General Assistance (GA) RRR Packet.......................................................24-28



24.8 Cash Assistance Program for Immigrants (CAPI) RRR Packet .................24-30

24.9 Foster Care RRR Packets..........................................................................24-3124.9.1 Non-Dependent Legal Guardian .................................................24-3124.9.2 Adoption Assistance Program (AAP) ..........................................24-3224.9.3 Kin-GAP Program .......................................................................24-32

25. Case Narration ................................................................................................25-1

25.1 Purpose of Thorough Narration....................................................................25-1

25.2 Maintain Case Comments Window ..............................................................25-1

25.3 Required Narration .......................................................................................25-225.3.1 Information Provided by Clients Verbally (Phone or Office Visit) ..25-225.3.2 CalWORKs Common Cases .........................................................25-225.3.3 Collateral Contacts ........................................................................25-225.3.4 Reason for Actions Taken.............................................................25-325.3.5 QR 7/MSR Processing ..................................................................25-325.3.6 Reason for Non-System Determined Issuance.............................25-325.3.7 State/Federal Mandated Documentation ......................................25-325.3.8 Personal Contact Requirements for Late or Incomplete

QR 7/MSR.....................................................................................25-325.3.9 Personal Feelings .........................................................................25-425.3.10 Interpreter Services.......................................................................25-4

25.4 Documentation Samples ..............................................................................25-425.4.1 Intake / RRR..................................................................................25-425.4.2 Case Updates ...............................................................................25-525.4.3 Processing of Income Reports ......................................................25-625.4.4 Collateral Contacts ........................................................................25-625.4.5 Sanctions / Penalties.....................................................................25-625.4.6 Time on Aid (TOA) ........................................................................25-725.4.7 Fraud/FRED Referral ....................................................................25-725.4.8 Overrides.......................................................................................25-7

25.5 Recording Devices .......................................................................................25-725.5.1 Use of Devices ..............................................................................25-7

26. Services...........................................................................................................26-1

26.1 Protective Services for Children ...................................................................26-126.1.1 Employee Responsibility for Reporting Child Abuse/Neglect........26-1

26.2 Protective Services for Adults ......................................................................26-226.2.1 Reporting of Physical Abuse .........................................................26-226.2.2 Reporting of Other Abusers ..........................................................26-2



26.3 Safe at Home Program ................................................................................26-3Eligibility ...................................................................................26-3

26.4 Handicapped ................................................................................................26-426.4.1 Mandated Services to Hearing-Impaired Persons ........................26-4

26.5 In-Home Supportive Services ......................................................................26-526.5.1 Program Information .....................................................................26-526.5.2 IHSS Individual Provider Listing....................................................26-526.5.3 Referrals/Questions ......................................................................26-5

27. DFCS/DEBS Common Cases.........................................................................27-1

27.1 The Partnership............................................................................................27-127.1.1 Confidentiality ...............................................................................27-1

27.2 Common Case Criteria.................................................................................27-2

27.3 Referrals to the Partnership .........................................................................27-2

27.4 Referrals to DEBS Intake Office...................................................................27-3

27.5 Requests for Special Case Review..............................................................27-6

27.6 Identifying Common Cases ..........................................................................27-627.6.1 Co-Located DFCS/CalWORKs EW...............................................27-627.6.2 Identifying Common Cases Through CalWIN and CWS/CMS

Data Match....................................................................................27-727.6.3 Identifying Common Cases - CWES.............................................27-8

Procedures ..............................................................................27-8

27.7 Coordinating Case Plan ...............................................................................27-9

27.8 Participation Hours.....................................................................................27-11

27.9 Integrated Common Case Plan..................................................................27-11

27.10 Supportive Services ...................................................................................27-12

27.11 Participation Problem .................................................................................27-12

27.12 Good Cause ...............................................................................................27-13

27.13 DFCS Discontinued Case ..........................................................................27-1327.13.1 System Coding............................................................................27-14

27.14 CalWORKs Discontinued Case..................................................................27-14

27.15 Family Reunification (AB 429) Program Overview.....................................27-14



27.16 Eligibility .....................................................................................................27-1527.16.1 Case Status.................................................................................27-16

27.17 Cash Aid Benefits......................................................................................27-1627.17.1 Special Needs .............................................................................27-16

27.18 DFCS Social Worker ..................................................................................27-16

27.19 Quarterly Reporting ....................................................................................27-17

27.20 Eligibility Redetermination ..........................................................................27-17

27.21 Family Reunited .........................................................................................27-1727.21.1 CalWORKs Benefits ....................................................................27-1727.21.2 CWES Case ................................................................................27-18

27.22 Extension of the 180-Day Period................................................................27-18

27.23 CWES Participation...................................................................................27-1927.23.1 Volunteers ...................................................................................27-1927.23.2 Notice of Action ...........................................................................27-1927.23.3 Sanctioned Clients ......................................................................27-1927.23.4 Non-Cooperation.........................................................................27-2027.23.5 Good Cause ................................................................................27-2027.23.6 WTW Plan ...................................................................................27-20

27.24 CalWORKs Case Closings.........................................................................27-21

27.25 Child Placed with a Relative.......................................................................27-21

27.26 Cal-Learn Teens.........................................................................................27-22

27.27 Time Limits .................................................................................................27-2227.27.1 24-Month WTW Clock .................................................................27-2227.27.2 CalWORKs 48-Month Clock........................................................27-2227.27.3 TANF 60-Month Clock.................................................................27-23

27.28 Determining Income Eligibility ....................................................................27-2327.28.1 Post-Aid Services........................................................................27-2427.28.2 Procedures for Family Reunification (AB 429) Cases

(Identified by ER Clerical) ...........................................................27-2527.28.3 Procedures for Family Reunification (AB 429) Cases

(Identified at Orientation).............................................................27-2927.28.4 Terminating Family Reunification (AB 429) Cases......................27-30

27.29 Dependency Wellness Court (DWC)..........................................................27-3127.29.1 Procedures..................................................................................27-31

When children are not in the home, use the following procedures: ............................................................27-32



28. Homeless Mailing Address............................................................................28-1

28. Social Services Mail Request/Agreement (SCD 1483) Procedures.............28-2

• “Social Services Mail Request/Agreement” (SCD 1483) Form ....................28-2

• Processing the SCD 1483............................................................................28-3

5. Unclaimed Mail Procedures .........................................................................28-5

29. Immediate Need/Expedited Service Procedures .........................................29-1

29.1 Immediate Need/Expedited Service Procedures .........................................29-129.1.1 IN-ES Determination .....................................................................29-1

29.2 IN/ES Application Scheduling Procedures ...................................................29-129.2.1 EW Screeners...............................................................................29-129.2.2 Standby Procedure .......................................................................29-2

Standbys Who Do Not Come to the Appointment ...................29-3Standbys Who Come In ...........................................................29-3

30. Child and Medical Support: Overview and Referral Criteria .....................30-1

30.1 Definitions [EAS 43-105 CCR 50060.6, 50101, 50157] ...............................30-130.1.1 Child Support ................................................................................30-130.1.2 Medical Support ............................................................................30-130.1.3 Paternity ........................................................................................30-130.1.4 Spousal Support ...........................................................................30-1

30.2 Program Requirements ................................................................................30-230.2.1 Process .........................................................................................30-230.2.2 Paternity Referrals ........................................................................30-330.2.3 Parental Responsibility .................................................................30-4

Responsibility Continues .........................................................30-4Responsibility Stops ................................................................30-5

30.2.4 Stepparents...................................................................................30-530.2.5 Senior Parent ................................................................................30-530.2.6 Single Parent Adoption .................................................................30-5

30.3 CalWORKs Referral Criteria [EAS 82-508] ..................................................30-630.3.1 Who is Referred ............................................................................30-630.3.2 Who is NOT Referred (EAS 82-506).............................................30-730.3.3 Deferral of Referral for Pregnant Women .....................................30-730.3.4 When to Make a Child Support Referral .......................................30-830.3.5 FRED Referrals.............................................................................30-8



30.4 Medi-Cal Referral Criteria.............................................................................30-930.4.1 Who is Referred ............................................................................30-930.4.2 Who is NOT Referred..................................................................30-1030.4.3 Exemption to Referral for Pregnant Women ...............................30-1130.4.4 Continued Eligibility and Medical Support Referral

for Newborn ................................................................................30-1230.4.5 Referral at End of 60-Day Postpartum Period.............................30-1330.4.6 When to Make a Child Support or Paternity Referral ..................30-14

30.5 Voluntary Declaration of Paternity - CalWORKs and Medi-Cal..................30-15

30.6 Paternity Opportunity Program (POP)........................................................30-1630.6.1 Informing Requirement................................................................30-1630.6.2 “Declaration of Paternity” (CS 909) .............................................30-1730.6.3 Establishing Paternity Before Birth..............................................30-1830.6.4 “Rescission Form for the Declaration of Paternity”

(CS 915).....................................................................................30-1830.6.5 Judicial Set Aside [FCS 7575].....................................................30-1830.6.6 Minor Parents ..............................................................................30-19

31. Child and Medical Support Activities ...........................................................31-1

31.1 Referral Process [EAS 82-510; CCR 50157, 50185] ...................................31-131.1.1 Client Responsibility ......................................................................31-131.1.2 Domestic Abuse Good Cause.......................................................31-231.1.3 Domestic Abuse Good Cause Claims at Intake ............................31-231.1.4 Domestic Abuse Good Cause Claims in Continuing Caseloads ...31-231.1.5 Exemptions from LCSA Referral ...................................................31-331.1.6 Informing Requirements................................................................31-331.1.7 CS 196 ..........................................................................................31-431.1.8 Intake Referral Process.................................................................31-531.1.9 Paternity Referrals ........................................................................31-5

31.2 Continuing Activities .....................................................................................31-631.2.1 Redeterminations ..........................................................................31-631.2.2 New or Additional Information .......................................................31-631.2.3 Referral Not Required ...................................................................31-731.2.4 Communication with LCSA ...........................................................31-731.2.5 SCD 1603......................................................................................31-831.2.6 LCSA Notice to Recipients ............................................................31-9

31.3 Forms - Completion [EAS 82-510, CCR 50101, 50157, 50185]...................31-931.3.1 CW 2.1 N & A................................................................................31-931.3.2 CW 2.1Q .......................................................................................31-931.3.3 CW 51 .........................................................................................31-1131.3.4 CW 371 .......................................................................................31-11



31.3.5 CS 196 ........................................................................................31-1131.3.6 CS 909 ........................................................................................31-1231.3.7 SCD 95 .......................................................................................31-1231.3.8 SCD 1603 ...................................................................................31-13

31.4 Good Cause Determinations [EAS 82-512, 82-514, CCR 50175, 50771.5, 50185].................................31-1331.4.1 General .......................................................................................31-1331.4.2 Conditions for Good Cause.........................................................31-1431.4.3 Considering Emotional Harm ......................................................31-1531.4.4 Suggested Interview Questions ..................................................31-1531.4.5 Supporting Evidence...................................................................31-1631.4.6 Initial Good Cause Procedures for DEBS Cases........................31-1731.4.7 SSPM's Good Cause Determination...........................................31-1831.4.8 Approval of Good Cause ............................................................31-1831.4.9 Denial of Good Cause ................................................................31-19

32. Direct Child/Spousal or Medical Support.....................................................32-1

32.1 CalWORKs — Direct Child/Medical/Spousal Support [EAS 82-518, 82-520, MPP 12-425].............................................................32-132.1.1 Informing .......................................................................................32-132.1.2 Treatment of Directly Received Support .......................................32-232.1.3 Procedure for Turning in Support Payments.................................32-332.1.4 Budgeting......................................................................................32-332.1.5 Refusal ..........................................................................................32-432.1.6 Effect of Refusal on Medi-Cal Status ............................................32-4

32.2 Medi-Cal Only - Direct Medical Support [CCR 50175, 50185] .....................32-532.2.1 Requirements................................................................................32-532.2.2 Procedure for Turning in Medical Support Payments ...................32-632.2.3 Budgeting......................................................................................32-7

33. Failure to Cooperate — Child or Medical Support ......................................33-1

33.1 CalWORKs — Sanction/Penalty Procedures [EAS 82-510] ........................33-133.1.1 Failure to Assign Support Rights ..................................................33-133.1.2 Failure to Cooperate .....................................................................33-133.1.3 LCSA Determines Non-Cooperation.............................................33-233.1.4 Child Support Sanction Alert .........................................................33-333.1.5 Action if Client Agrees to Cooperate.............................................33-433.1.6 Good Cause Claim after Notice of Non-Cooperation....................33-433.1.7 Failure to Turn in Direct Support ...................................................33-533.1.8 Action When Recipient Agrees to Turn in Direct Support .............33-533.1.9 Action for Failure to Assign Support Rights and

Non-Cooperation...........................................................................33-5



33.1.10 Missed Appointment......................................................................33-633.1.11 Paternity ........................................................................................33-633.1.12 Senior Parent/Minor Parent Case .................................................33-6

33.2 Medi-Cal — Failure to Cooperate [CCR 50157, 50175, 50379, 51771.5] ...33-633.2.1 Non-Cooperation...........................................................................33-733.2.2 EW Determines Non-cooperation..................................................33-833.2.3 LCSA Determines Noncooperation ...............................................33-833.2.4 Action if Client Agrees to Cooperate .............................................33-933.2.5 Action After Second Non-cooperation.........................................33-1033.2.6 Good Cause Claim after Notice of Non-Cooperation ..................33-1033.2.7 Failure to Turn in Direct Medical Support....................................33-1133.2.8 Action When Client Agrees To Turn in Direct Medical Support...33-1133.2.9 Missed Appointment....................................................................33-1233.2.10 Paternity ......................................................................................33-12

34. Child Support Collection/Disbursement System.........................................34-1

34.1 Local Child Support Agency (LCSA) ............................................................34-134.1.1 LCSA Receipt of Support Referral ...............................................34-2

34.2 State Disbursement Unit (SDU) ...................................................................34-234.2.1 Redirection ....................................................................................34-234.2.2 Statewide Allocation......................................................................34-334.2.3 Annual Fee for Never-Assisted Child Support Cases ...................34-3

34.3 Systems Interface......................................................................................34-434.3.1 Reporting Responsibilities.............................................................34-434.3.2 Excess and Pass-On Payments....................................................34-434.3.3 Disregard Payments.....................................................................34-534.3.4 Multiple Issuance of Disregards ....................................................34-6

34.4 Child Support for MFG Child ........................................................................34-634.4.1 Rule...............................................................................................34-6

34.5 Replacement of Child Support Warrants.....................................................34-734.5.1 Damaged/Returned/Lost/Stolen Warrants ....................................34-734.5.2 Forged Child Support Warrants ....................................................34-734.5.3 Problems with Non-Issuance of Disregard Payments ...................34-734.5.4 LCSA Assistance with SDU Payment Issues................................34-7

34.6 LCSA Affidavit Requests ..............................................................................34-8

34.7 Total Aid Paid Requests..............................................................................34-8



35. Mandated Posters and Brochures for District Office Lobbies ...................35-1

35.1 Policy............................................................................................................35-1

35.2 Posters/Bulletins ..........................................................................................35-1

35.3 Pamphlets/Brochures/Other.........................................................................35-3

36. Civil Rights......................................................................................................36-1

36.1 Requirements...............................................................................................36-136.1.1 Non Discrimination Statement ......................................................36-136.1.2 Documentation..............................................................................36-236.1.3 Language Requirement ................................................................36-336.1.4 Interpreter Services.......................................................................36-3

36.2 Services to People with Disabilities..............................................................36-436.2.1 Accessibility ..................................................................................36-436.2.2 Visually Impaired...........................................................................36-536.2.3 Hearing Impaired ..........................................................................36-536.2.4 Documentation..............................................................................36-536.2.5 Training .........................................................................................36-536.2.6 Physical Facilities..........................................................................36-636.2.7 Section 504 Coordinator ...............................................................36-636.2.8 Grievance Procedures ..................................................................36-6

36.3 Federal Law .................................................................................................36-6

36.4 State Law .....................................................................................................36-6

36.5 Informing Signs ............................................................................................36-7

36.6 Required Form SCD 1264............................................................................36-736.6.1 Processing the SCD 1264.............................................................36-836.6.2 Mail-In Process .............................................................................36-9

36.7 Special Bilingual Instructions .......................................................................36-936.7.1 Bilingual Certification ..................................................................36-1036.7.2 “Your Rights Under California Welfare Programs”

(PUB 13) .....................................................................................36-10

36.8 Other Language Forms and Notices ..........................................................36-1136.8.1 Quarterly Eligibility/Status Report (QR 7)....................................36-1136.8.2 Midyear Status Report (MC 176S)..............................................36-12

36.9 Interpretive Services Requirement.............................................................36-13



36.10 Interpreter/Translation Services .................................................................36-1336.10.1 County Contracted Interpreter Services......................................36-1336.10.2 Use of Interpreter - “Confidentiality-Release of Information”.......36-1436.10.3 Responsibility for Scheduling ......................................................36-1436.10.4 Interpreter Arrives (Unrequested)................................................36-1436.10.5 Phone Call Interpretations...........................................................36-1436.10.6 Requesting Translations of Forms ..............................................36-1436.10.7 Requesting Interpreter Services..................................................36-1536.10.8 Use of Minors as Interpreters ......................................................36-1636.10.9 Special Intake Appointment Instructions .....................................36-16

36.11 Document Translation Services .................................................................36-1736.11.1 Procedures for Requesting Translations.....................................36-17

Non-Program Related ............................................................36-17Program Related Translations ...............................................36-17

36.11.2 Translation Committees ..............................................................36-1736.11.3 Composition of Committees ........................................................36-1836.11.4 Meetings of Translation Committees...........................................36-18

Regular Schedule ..................................................................36-18Overtime ................................................................................36-18

36.11.5 Identifying Translated Documents...............................................36-1836.11.6 “Bootleg” Forms ..........................................................................36-1936.11.7 Committee Requests for Forms/Documents Translations...........36-19

36.12 Translation Requests by DEBS Staff .........................................................36-2136.12.1 Referral Procedures ....................................................................36-2236.12.2 Time Allowance...........................................................................36-23

Routine Referrals ...................................................................36-23Other Referrals ......................................................................36-23Big Projects ............................................................................36-24

36.13 The Language Line (Interpreter Services)..................................................36-2436.13.1 Bi-lingual Languages Provided ...................................................36-2436.13.2 Procedures for Accessing Language Line Services....................36-25

36.14 Translated Forms .......................................................................................36-26

36.15 Language Coding .......................................................................................36-27

37. Appeals............................................................................................................37-1

37.1 General Information—Background...............................................................37-137.1.1 State Hearing/Appeal ....................................................................37-137.1.2 Appeal Requests...........................................................................37-137.1.3 Appeal Process Not Appropriate...................................................37-1



37.2 Terms Unique to the Appeal Process ..........................................................37-237.2.1 Claimant ........................................................................................37-237.2.2 Authorized Representative............................................................37-237.2.3 Issue .............................................................................................37-2

37.3 State Hearing Filing Procedures ..................................................................37-337.3.1 General ........................................................................................37-337.3.2 Oral Requests ...............................................................................37-337.3.3 Written Requests ..........................................................................37-3

37.4 Aid Paid Pending..........................................................................................37-437.4.1 Definition .......................................................................................37-437.4.2 Aid Paid Pending Determinations .................................................37-437.4.3 Procedures for Implementation.....................................................37-537.4.4 Other Overpayment/IHE ...............................................................37-537.4.5 Intercounty Transfers ....................................................................37-5

37.5 Appeals Process ..........................................................................................37-637.5.1 Appeals Representative................................................................37-637.5.2 Role of the Appeals Representative .............................................37-637.5.3 Hearing Presentation ....................................................................37-637.5.4 Post Hearing Instructions..............................................................37-637.5.5 Role of the EW Supervisor............................................................37-737.5.6 Role of the EW..............................................................................37-737.5.7 Witness .........................................................................................37-837.5.8 Representation..............................................................................37-8

37.6 Client Case Review Process........................................................................37-8

37.7 Withdrawals..................................................................................................37-937.7.1 Definition .......................................................................................37-937.7.2 Withdrawal ....................................................................................37-937.7.3 Conditional Withdrawal .................................................................37-937.7.4 Conditional Withdrawal Policy/Procedure .....................................37-937.7.5 EW Contacted.............................................................................37-1037.7.6 Agreement Cannot Be Reached .................................................37-1037.7.7 Compliance .................................................................................37-10

37.8 Decisions....................................................................................................37-1037.8.1 Definition .....................................................................................37-1037.8.2 Action ..........................................................................................37-1137.8.3 Copy of the Decision...................................................................37-1137.8.4 General .......................................................................................37-1137.8.5 Appeals Unit................................................................................37-1137.8.6 SSPM..........................................................................................37-1237.8.7 EW Supervisor ............................................................................37-1237.8.8 Controls.......................................................................................37-12



37.8.9 Role of the EW ............................................................................37-1237.8.10 Ineligible Due to a Factor NOT Covered in the Appeal ...............37-1337.8.11 Internal Transfers ........................................................................37-13

37.9 Rehearing Request ....................................................................................37-1337.9.1 Who May File ..............................................................................37-1337.9.2 EW Request ................................................................................37-13

38. Fraud................................................................................................................38-1

38.1 General Information......................................................................................38-138.1.1 Definition of Fraud.........................................................................38-138.1.2 Fraud Prevention...........................................................................38-138.1.3 FRED ............................................................................................38-238.1.4 Other Fraud Referrals ...................................................................38-238.1.5 Pre-Referral Requirements ...........................................................38-238.1.6 When to Refer ...............................................................................38-338.1.7 Possible Criteria for FRED/General On-Going Fraud Referral......38-4

38.2 Intake Investigation Referrals (FRED)..........................................................38-638.2.1 Overview .......................................................................................38-638.2.2 Prior to Referral .............................................................................38-638.2.3 Time Frames .................................................................................38-638.2.4 Initiating A Referral .......................................................................38-738.2.5 EW Action - Pending Investigations ..............................................38-838.2.6 Investigator Action - SIU ...............................................................38-938.2.7 Investigator Action - DHCS ...........................................................38-938.2.8 EW Action on Completed Investigations .....................................38-1038.2.9 SIU Investigator Disagreement With EW Action ........................38-11

38.3 General On-Going Fraud Referral..............................................................38-1138.3.1 Overview .....................................................................................38-1138.3.2 Prior to Referral ...........................................................................38-1138.3.3 Evaluation of Information ............................................................38-1238.3.4 To Refer: Yes or No ....................................................................38-12

38.4 Defense Attorney Requests .......................................................................38-1338.4.1 Overview .....................................................................................38-1338.4.2 Definition .....................................................................................38-1338.4.3 Requirements of Defense Request .............................................38-1338.4.4 Process .......................................................................................38-14

38.5 Suspected Employee Fraud Referral .........................................................38-1538.5.1 Definition of Employee Fraud......................................................38-1538.5.2 Training .......................................................................................38-1638.5.3 Referral Procedure......................................................................38-16



39. Complaints / Inquiries ....................................................................................39-1

39.1 Complaints vs. Inquiries ...............................................................................39-139.1.1 Complaints ....................................................................................39-139.1.2 Inquiries ........................................................................................39-1

39.2 Complaints/Inquiries Objectives ..................................................................39-239.2.1 Agency Objectives ........................................................................39-239.2.2 How to Achieve the Agency Objectives ........................................39-2

39.3 Complaint / Inquiry Desk ..............................................................................39-339.3.1 Designated Person Logging Procedure .......................................39-3

39.4 Child Abuse Complaints...............................................................................39-439.4.1 Mandated Reporting of Child Abuse .............................................39-4

39.5 Community Service Agencies and Related Professions .............................39-5

39.6 Complaints of Adult Abuse...........................................................................39-5

39.7 Community Complaints (Client/Employee) ..................................................39-539.7.1 Sharing Community Complaints ..................................................39-639.7.2 Exceptions To SCD 16 Procedure ................................................39-6

39.8 “Community Inquiry or Report” (SCD 16) Procedure ...................................39-839.8.1 Worker Responsibility .................................................................39-1039.8.2 Unit Supervisor ...........................................................................39-1139.8.3 Social Services Program Manager (SSPM)................................39-1139.8.4 Designated Person .....................................................................39-11

39.9 Referrals to Administration.........................................................................39-1239.9.1 How Communication is Received ...............................................39-1239.9.2 Where Calls are Referred ..........................................................39-1239.9.3 Resolution: Administration ..........................................................39-1339.9.4 Follow-Up....................................................................................39-13

39.10 Complaint Against Staff Member ...............................................................39-14

39.11 Fraud Referrals ..........................................................................................39-14

39.12 Staff Correspondence with Elected Officials ..............................................39-15

39.13 Procedure...................................................................................................39-15

40. Confidentiality.................................................................................................40-1

40.1 References...................................................................................................40-1

40.2 Confidential Information ...............................................................................40-1



40.3 Tax Information ............................................................................................40-240.3.1 Safeguards....................................................................................40-2

40.4 Penalties for Unauthorized Disclosure of Tax Information ...........................40-340.4.1 Franchise Tax Board (FTB)...........................................................40-340.4.2 Internal Revenue Service (IRS) ....................................................40-340.4.3 Civil Damage.................................................................................40-3

40.5 Non-Confidential Information........................................................................40-3

40.6 Confidential Information ...............................................................................40-440.6.1 Contractors....................................................................................40-440.6.2 Public Officials...............................................................................40-440.6.3 Law Enforcement Officials - Exception to the Rule .......................40-640.6.4 Requests that are not Authorized..................................................40-7

Guidance to this scenario is as follows: ...................................40-840.6.5 Written Request Procedures .........................................................40-840.6.6 Release of Confidential Information in Conjunction

With a Lawsuit ...............................................................................40-940.6.7 Release to Schools .......................................................................40-940.6.8 Disclosure to Parents Who Wish to be Reunited

With Their Family ........................................................................40-1040.6.9 Release to Research Organizations ...........................................40-10

40.7 Release to Applicant/Recipient or Authorized Representative...................40-10

40.8 Information Which May NOT Be Released to the Applicant/Recipient.......40-12

40.9 Eligibility Determinations ............................................................................40-1240.9.1 Collateral Contacts ......................................................................40-1240.9.2 Permission ..................................................................................40-1340.9.3 Acceptability and Discontinuances..............................................40-1340.9.4 Outside Contacts by Agencies Other than the CWD...................40-13

40.10 Documentation in Case Record .................................................................40-13

40.11 Personal Identifiable Information (PII) ........................................................40-1440.11.1 Privacy and Confidentiality ..........................................................40-1440.11.2 MEDS Privacy and Confidentiality...............................................40-1440.11.3 CalWIN Privacy and Confidentiality.............................................40-1440.11.4 Computer Security Safeguards ...................................................40-1540.11.5 Physical Security .........................................................................40-1540.11.6 Paper Control Documents...........................................................40-1540.11.7 Miscellaneous .............................................................................40-16



40.12 Breach of Confidentiality Policy..................................................................40-1640.12.1 Responsibility ..............................................................................40-16

User .......................................................................................40-16Supervisor/Manager ..............................................................40-17Medi-Cal Security Coordinator ...............................................40-17

40.12.2 Frequently Asked Questions.......................................................40-19

40.13 0Numbering System in District Offices.......................................................40-2540.13.1 Clerical Staff................................................................................40-2540.13.2 Eligibility Staff..............................................................................40-25

40.14 Burn Bag Policy..........................................................................................40-26

41. Case Responsibility .......................................................................................41-1

41.1 Application Date ...........................................................................................41-1

41.2 Add a Program Requests.............................................................................41-2

41.3 Transfer of Aided Family Member(s) Within Same Aid ................................41-3

42. Client / Third Party Case Reviews.................................................................42-1

42.1 Authorized Representatives .........................................................................42-1

42.2 Privileged Information ..................................................................................42-242.2.1 Removal of Privileged/Confidential Information ............................42-342.2.2 CalWIN Screens ...........................................................................42-5

42.3 Client Case Reviews ....................................................................................42-642.3.1 Request for Copies .......................................................................42-7

42.4 Case Reviews by a Third Party (Authorized Representative) ......................42-842.4.1 Request for Copies .......................................................................42-9

42.5 Case Review by a Third Party (Authorized Representative) When a Request for a Fair Hearing is Filed ...............................................42-1042.5.1 Request for Copies .....................................................................42-10

43. Subpoena and Courtroom Testimony Guide ...............................................43-1

43.1 Subpoena and Legal Process ......................................................................43-143.1.1 Agency’s Expectations..................................................................43-243.1.2 Subpoena Process and Preparation for Court ..............................43-2

43.2 Courtroom Decorum.....................................................................................43-4

43.3 Testimony.....................................................................................................43-4



44. Case Structure / Numbering ..........................................................................44-1

44.1 Glossary .......................................................................................................44-1

44.2 File Clearance ..............................................................................................44-244.2.1 Client Identification Number (CIN).................................................44-344.2.2 CalWIN Identification Number (CWIN)..........................................44-3

44.3 Description of Case Structure ......................................................................44-344.3.1 Household Composition Group .....................................................44-444.3.2 Medi-Cal Budget Units (MBUs) .....................................................44-4

44.4 Selection of Case Serial Numbers ...............................................................44-444.4.1 Assignment of CalWIN Case Serial Numbers...............................44-544.4.2 Case Contents ..............................................................................44-544.4.3 More Than One Household Group Residing in the Home.............44-644.4.4 Employment Services ...................................................................44-6

44.5 Types of Cases ............................................................................................44-644.5.1 Electronic Case .............................................................................44-744.5.2 Paper Folders/Cases ....................................................................44-7

44.6 Case Conversion..........................................................................................44-7

44.7 Person Numbers (Other than Relinquishment) ............................................44-844.7.1 Policy.............................................................................................44-844.7.2 Person Number Assignments .......................................................44-844.7.3 Reassignment of Recorded Person Numbers on the

Medi-Cal Eligibility Data System (MEDS) Network .......................44-944.7.4 Minor Consent Procedures ...........................................................44-9

44.8 Appropriate Use of Names .........................................................................44-10

44.9 General Case Categories...........................................................................44-10

44.10 Adult Cases ................................................................................................44-1144.10.1 Programs.....................................................................................44-1144.10.2 Typical Adult Case Situations .....................................................44-11

44.11 Family Cases..............................................................................................44-1244.11.1 Programs.....................................................................................44-1244.11.2 Policy for Establishing Case Names for Family Cases ...............44-12

44.12 Relinquishment for Adoption Child Cases..................................................44-1344.12.1 Case Rules..................................................................................44-1344.12.2 Person Rule ................................................................................44-1444.12.3 Definition .....................................................................................44-1444.12.4 Relinquished Aid/Program Type .................................................44-14



44.12.5 Relinquished Children's Case Rules...........................................44-1444.12.6 Person Numbers .........................................................................44-1444.12.7 Example #1: Adoption Assistance Program (AAP) .....................44-1444.12.8 Example #2: CalWORKs Case with AAP Service Case .............44-1544.12.9 Example #3: AAP Family Case...................................................44-1544.12.10 Example #4: Relinquished Child .................................................44-16

44.13 Change of Case From One Category to Another.......................................44-1644.13.1 Child Applying as an Adult ..........................................................44-16

44.14 Miscellaneous Case Examples ..................................................................44-1744.14.1 Example #1: Family Cases .........................................................44-1744.14.2 Example #2: Active Family Case ................................................44-1744.14.3 Example #3: Mother (Payee) Leaves the Household and

Children Move in With Needy Father - EBT Case.......................44-1844.14.4 Example #4: Mother (Payee) Leaves the Household and

Children Live with Non-Needy Grandmother - EBT Case...........44-1844.14.5 Example #5: Change in Payee on an EBT Case to a Different

Household Member.....................................................................44-19

44.15 CalWORKs CalWIN Case Structure Examples..........................................44-2044.15.1 Example #1: CalWORKs Family (Single Family Unit).................44-2044.15.2 Example #2: CalWORKs Family (Two Separate Households) ...44-2044.15.3 Example #3: Family Situation with Roommate............................44-2144.15.4 Example #4: Family Situation (Children with Different Parents) .44-2244.15.5 Example #5: Family Case (Separate Households) .....................44-2244.15.6 Example #6: Family Situation (Minor Mother over 18) ................44-2344.15.7 Example #7: Family Situation (Minor Mother Under 18) .............44-2344.15.8 Example #8: Family Group (Two Separate Families) .................44-2444.15.9 Example #9: General ..................................................................44-2444.15.10 Example #10: Household Composition.......................................44-2544.15.11 Example #11: Household Composition.......................................44-2544.15.12 Example #12: Adult Case Active.................................................44-26

44.16 Cash Assistance Program for Immigrants (CAPI) Case Examples............44-2644.16.1 Example 1: Cash Assistance Program for Immigrants (CAPI)

Couple with CalFresh..................................................................44-27

44.17 CalFresh Case Examples ..........................................................................44-2744.17.1 Example #1: CalFresh to Cash Aid.............................................44-2744.17.2 Example #2: CalFresh (Family) to GA ........................................44-2844.17.3 Example #3: Application Closed/Discontinued Family Case.......44-2844.17.4 Example #4: Active Adult Case and a Family Case....................44-29



44.18 Foster Care Case Examples ......................................................................44-2944.18.1 Example #1: Foster Care ............................................................44-2944.18.2 Example #2: Family Case and Foster Care ................................44-3044.18.3 Example #3: Family Case and Foster Care ................................44-31

44.19 General Assistance (GA) Case Examples .................................................44-3144.19.1 Example #1: General Assistance (GA)........................................44-3244.19.2 Example #2: GA Family ..............................................................44-3244.19.3 Example #3: GA Couple..............................................................44-3344.19.4 Example #4: GA Adult Living With Parents .................................44-3344.19.5 Example #5: GA Adult Becomes Pregnant .................................44-3444.19.6 Example #6: Application - Closed/Discontinued Family Case -

Director’s Exception ....................................................................44-3444.19.7 Example #7: Active Adult Case...................................................44-35

44.20 Medi-Cal Case Examples...........................................................................44-3544.20.1 Example #1: Medi-Cal .................................................................44-3544.20.2 Example #2: Active Family Case.................................................44-3644.20.3 Example # 3: Medi-Cal Long Term Care (LTC)...........................44-3644.20.4 Example # 4: Needy Caretaker Case..........................................44-37

44.21 Refugee Case Examples............................................................................44-3844.21.1 Example #1: Refugee..................................................................44-3844.21.2 Example #2: CalWORKs Family and Refugee Father ................44-3844.21.3 Example #3: Active Refugee Case .............................................44-39

45. Periodic Report Management ........................................................................45-1

45.1 Policy............................................................................................................45-145.1.1 General .........................................................................................45-145.1.2 Uniformity ......................................................................................45-145.1.3 Priorities ........................................................................................45-145.1.4 Time Limits ....................................................................................45-2

45.2 Equipment/Supplies .....................................................................................45-245.2.1 Continuing .....................................................................................45-2

45.3 Processing of Periodic Reports ....................................................................45-345.3.1 Periodic Reports Received Directly in District Offices ..................45-545.3.2 Periodic Report Status ..................................................................45-545.3.3 Continuing EW Periodic Report Control Procedures.....................45-645.3.4 Incomplete Periodic Reports .........................................................45-645.3.5 Processing of Periodic Report Procedure .....................................45-7



45.4 Transfers and Other Miscellaneous Problems .............................................45-845.4.1 Cases Retained at Control Clerk's Desk.......................................45-845.4.2 Cases Transferred to Intake that are Denied and

Returned to Continuing .................................................................45-9

46. Inter-County Transfer (ICT)............................................................................46-1

46.1 Electronic Inter-County Transfer (eICT) .......................................................46-146.1.1 System Data Transfer (SDT) ........................................................46-146.1.2 Imaged Document Transfer (IDT) .................................................46-146.1.3 eICT Requests ..............................................................................46-2

46.2 Timeframes ..................................................................................................46-246.2.1 30-day Transfer Period .................................................................46-346.2.2 Processing Incoming ICTs ............................................................46-346.2.3 eICT Disposition............................................................................46-3

46.3 Overpayment Claims....................................................................................46-446.3.1 Supporting Documentation ...........................................................46-4

46.4 Annual Redeterminations [40-187]...............................................................46-4

46.5 Processing eICT Requests from Other Counties .........................................46-5

46.6 Sending an eICT ..........................................................................................46-6

46.7 Cancelling an eICT Case Transfer...............................................................46-7

46.8 Creating an eICT Request in CalWIN ..........................................................46-8

46.9 Processing Incoming eICTs .........................................................................46-9

46.10 Imaged Document Transfers......................................................................46-1146.10.1 Documentation Required ............................................................46-11

46.11 California City/County List..........................................................................46-13

47. Retro Discontinuances/Closed Cases..........................................................47-1

47.1 Retroactive Discontinuances: Any Program.................................................47-147.1.1 Policy ............................................................................................47-1

47.2 Closed Cases...............................................................................................47-147.2.1 Policy ............................................................................................47-147.2.2 Paperwork.....................................................................................47-2

47.3 Process For Closed Cases ..........................................................................47-247.3.1 CalWIN Functionality ....................................................................47-347.3.2 Cases Converted to a Closed/Discontinued Status ......................47-3



47.3.3 Documents Received for Cases in a Closed Case Load ..............47-4

47.4 Cases in a Closed Status Requiring Action..................................................47-547.4.1 Designated Staff Person ...............................................................47-547.4.2 Client Service ................................................................................47-647.4.3 Intake Cases .................................................................................47-747.4.4 Cases Closed By Benefit Service Center (BSC) ...........................47-747.4.5 Cases Closed By Valley Medical Center (VMC) Medi-Cal

Eligibility Bureau............................................................................47-847.4.6 Cases Closed By Other District Offices.........................................47-8

48. Supervisory Reviews......................................................................................48-1

48.1 Types of Reviews .........................................................................................48-148.1.1 Full Case Reviews ........................................................................48-148.1.2 Targeted/Focused Case and RTF Reviews ..................................48-2

48.2 Objectives.....................................................................................................48-2

48.3 Review Requirements ..................................................................................48-3

48.4 Case Reviews - Intake ................................................................................48-3

48.5 Case Reviews - Continuing ..........................................................................48-448.5.1 Supervisor and Manager Discretion..............................................48-448.5.2 Computer Generated ....................................................................48-4

48.6 Types of Cases to be Reviewed...................................................................48-548.6.1 Review Process ............................................................................48-5

Full Case Reviews ...................................................................48-5Targeted Reviews ....................................................................48-5

48.7 Responsibilities ............................................................................................48-648.7.1 CalFresh Executive Committee.....................................................48-648.7.2 Corrective Action Bureau SSPM ...................................................48-648.7.3 DEBS Corrective Action Project Team (CAPT).............................48-648.7.4 District Office Corrective Action Committees ...............................48-748.7.5 DEBS Managers ..........................................................................48-748.7.6 Eligibility Work Supervisors ..........................................................48-7

49. Case Loans......................................................................................................49-1

49.1 Case Loans ..................................................................................................49-149.1.1 Case Loan Exceptions ..................................................................49-1

49.2 Case Loan Procedures.................................................................................49-1



49.3 Case Loans to Foster Care Bureau .............................................................49-349.3.1 All Other Foster Care Applications................................................49-3

49.4 Unassigned Cases in Control......................................................................49-3

49.5 Returning Loaned Cases .............................................................................49-4

50. Case Transfers................................................................................................50-1

50.1 Manage Case Assignment Screen...............................................................50-1

50.2 Special Case Characteristics .......................................................................50-2

50.3 Mass Transfers ............................................................................................50-3

50.4 Case Transfer Procedures ..........................................................................50-3

50.5 Specialized Bureaus ....................................................................................50-450.5.1 Transfer of Cases from Foster Care Eligibility ..............................50-450.5.2 Staff Development ........................................................................50-450.5.3 Specialized Offices .......................................................................50-4

50.6 Confidential/Sensitive Cases .......................................................................50-650.6.1 Purpose.........................................................................................50-650.6.2 District Offices...............................................................................50-650.6.3 Categories.....................................................................................50-6

Confidential Cases ...................................................................50-6Sensitive Cases .......................................................................50-7Other Cases .............................................................................50-7

50.7 Intake Policy For Confidential Cases ...........................................................50-7

50.8 Continuing Policy For Confidential Cases....................................................50-850.8.1 Case Determination ......................................................................50-850.8.2 Transfer Procedures for Confidential/Sensitive Cases .................50-950.8.3 Quarterly Monitoring Report........................................................50-10

50.9 Companion Cases .....................................................................................50-1050.9.1 Definition .....................................................................................50-1050.9.2 Policy ..........................................................................................50-1050.9.3 Guidelines ...................................................................................50-1050.9.4 Exceptions ..................................................................................50-11

50.10 Medi-Cal Cases / Calendar Month Holding Period ....................................50-1150.10.1 CalWORKs or CalFresh Restoration Required Within the

“Calendar Month Holding Period” ...............................................50-1550.10.2 Medi-Cal Related Inquiry and/or Urgent Actions Needed

Within the “Calendar Month Holding Period”...............................50-15



50.11 Transferring Cases Pending CalWIN Ticket Resolution.............................50-1650.11.1 Ticket Resolution.........................................................................50-17

50.12 Transferring Cases Out of Intake When a Program is in a Discontinued Status ...................................................................................50-17

51. Case Rejection Criteria ..................................................................................51-1

51.1 General.........................................................................................................51-1

51.2 CalWORKs Case Rejection Criteria .............................................................51-251.2.1 Application.....................................................................................51-251.2.2 Reinvestigation (RRR) ..................................................................51-351.2.3 Social Security Number.................................................................51-351.2.4 Citizenship.....................................................................................51-351.2.5 Address Verification

For School Age Children Under 16 ...............................................51-451.2.6 Deprivation ....................................................................................51-451.2.7 DA Referral / Non-Cooperation Sanction ......................................51-551.2.8 Standard Filing Unit (SFU) Composition .......................................51-551.2.9 Unrelated Adult Male (UAM) .........................................................51-651.2.10 School Attendance and Immunization Requirements ...................51-651.2.11 Property.........................................................................................51-651.2.12 Work Registration/Exemption/Exclusion/Sanction ........................51-751.2.13 "Quarterly Eligibility/Status Report’ (QR 7) Processing.................51-751.2.14 Unearned Income..........................................................................51-8

RSDI: .......................................................................................51-8Veteran’s Administration (VA) Benefits: ...................................51-8Unemployment Insurance Benefits (UIB): ................................51-9Child Support Contribution: ......................................................51-9Other Unearned Income (Loans, Grants, Pensions/Retirement, etc.): .....................................................................51-9

51.2.15 Earned Income............................................................................51-10Employment Ending: ..............................................................51-10Gross Earnings: .....................................................................51-10Unreported/Incorrectly Reported Earnings: ...........................51-10Pay Stubs: ..............................................................................51-10Tips: .......................................................................................51-10Income Exemptions: ..............................................................51-10Self-Employment Income: ......................................................51-11Other Earnings Computation: ................................................51-11Deductions: ............................................................................51-11CalWIN Entries: .....................................................................51-11Income-in-kind: ......................................................................51-11



51.2.16 Budgeting....................................................................................51-12Employable and Unemployable: ............................................51-12Prospective Budget: ...............................................................51-12Applicant Gross Income Test/Recipient Net Income Test: ....51-12Sponsored Noncitizen/Excluded Child/Senior Parent: ...........51-12SP/IP Unit: .............................................................................51-13Excluded Parent: ...................................................................51-13

51.2.17 Special Needs.............................................................................51-13Pregnancy: .............................................................................51-13Homeless Assistance (HA): ...................................................51-14Other Special Needs: .............................................................51-14

51.2.18 Overpayments.............................................................................51-1451.2.19 Notices Of Action ........................................................................51-1551.2.20 CalWIN Entries ...........................................................................51-1551.2.21 Caseload Reviews ......................................................................51-1551.2.22 Time Limits..................................................................................51-1551.2.23 Statewide Fingerprint Imaging System (SFIS) ............................51-16

51.3 CalFresh Case Rejection Criteria...............................................................51-1751.3.1 Application/Statement Of Facts ..................................................51-1751.3.2 Authorized Representative..........................................................51-1751.3.3 Recertification (RRR) ..................................................................51-1851.3.4 Social Security Number ..............................................................51-1851.3.5 Residency/Citizenship/Immigration Status..................................51-1851.3.6 Household Composition..............................................................51-1951.3.7 Adding or Deleting Persons ........................................................51-19

Adding: ...................................................................................51-19Deleting: .................................................................................51-19

51.3.8 Homeless ....................................................................................51-2051.3.9 Able Bodied Adults Without Dependents (ABAWDs)..................51-2051.3.10 Students......................................................................................51-2051.3.11 Resources For Nonassistance Household..................................51-2051.3.12 Work Registration .......................................................................51-2151.3.13 “Quarterly Eligibility/Status Report” (QR 7) Processing ..............51-2151.3.14 Income ........................................................................................51-2151.3.15 Deductions ..................................................................................51-22

Shelter Cost: ..........................................................................51-22Utilities/SUA: ..........................................................................51-22Dependent Care: ...................................................................51-22Excess Medical Cost: ............................................................51-23

51.3.16 Budgeting....................................................................................51-2351.3.17 Underissuance ............................................................................51-2351.3.18 Overissuance ..............................................................................51-2351.3.19 Issuance......................................................................................51-2451.3.20 NOAs ..........................................................................................51-2451.3.21 Statewide Fingerprint Imaging System (SFIS) ............................51-24



51.3.22 Miscellaneous .............................................................................51-24

51.4 Medi-Cal Case Rejection Criteria ...............................................................51-2551.4.1 Application...................................................................................51-2551.4.2 Retro Medi-Cal ............................................................................51-2551.4.3 Rights And Responsibilities.........................................................51-2651.4.4 Redetermination (RRR)...............................................................51-2651.4.5 Social Security Numbers (SSNs) ................................................51-2651.4.6 Residency and Citizenship/Alienage...........................................51-2751.4.7 Linkage........................................................................................51-2751.4.8 Aged............................................................................................51-2851.4.9 Disability/Blindness/SP-DDSB Referral.......................................51-2851.4.10 Medically Indigent .......................................................................51-2951.4.11 MFBU Composition .....................................................................51-2951.4.12 Special Programs........................................................................51-2951.4.13 QMB/SLMB .................................................................................51-2951.4.14 Change Reporting .......................................................................51-3051.4.15 Property.......................................................................................51-3051.4.16 Income and Deductions ..............................................................51-3051.4.17 Veterans’ Benefits .......................................................................51-3151.4.18 Income-In-Kind............................................................................51-3151.4.19 Income Allocations ......................................................................51-3151.4.20 ABD Special Deductions .............................................................51-3251.4.21 Budgeting ....................................................................................51-3251.4.22 Edwards V. Kizer.........................................................................51-3351.4.23 Transitional Medi-Cal (TMC) .......................................................51-3351.4.24 Section 1931 (b) Medi-Cal ..........................................................51-3351.4.25 CalWIN and MEDS .....................................................................51-3351.4.26 Other Health Coverage ...............................................................51-3451.4.27 Medicare .....................................................................................51-3551.4.28 CHDP and Family Planning ........................................................51-3551.4.29 Notices of Action .........................................................................51-3551.4.30 Third Party Liability......................................................................51-3551.4.31 Overpayment...............................................................................51-36

51.5 General Assistance Case Rejection Criteria ..............................................51-3751.5.1 Application...................................................................................51-3751.5.2 Reinvestigation (RRR) ................................................................51-3751.5.3 Basic Eligibility ............................................................................51-3851.5.4 Identification ................................................................................51-3851.5.5 Social Security Number...............................................................51-3851.5.6 Citizenship/Noncitizenship Status ...............................................51-3851.5.7 Property.......................................................................................51-3951.5.8 Work Registration/Exemption/Exclusion/Sanction ......................51-3951.5.9 “Quarterly Eligibility/Status Report’ (QR 7) Processing ...............51-3951.5.10 Unearned Income........................................................................51-40



RSDI: .....................................................................................51-40Veteran’s Administration (VA) Benefits: .................................51-40Unemployment Insurance Benefits (UIB): .............................51-41Other Unearned Income (Loans, Grants, Pensions/ Retirement, etc.): ...................................................................51-41

51.5.11 Earned Income............................................................................51-41Employment Ending: ..............................................................51-41Gross Earnings: .....................................................................51-41Unreported/Incorrectly Reported Earnings: ...........................51-41Pay Stubs: .............................................................................51-42Tips: .......................................................................................51-42Self-Employment Income: ......................................................51-42CalWIN Entries: .....................................................................51-42

51.5.12 Budgeting....................................................................................51-42Prospective Budget: ...............................................................51-42Sponsored Noncitizen: ...........................................................51-43

51.5.13 Overpayments.............................................................................51-4351.5.14 Notices Of Action ........................................................................51-4351.5.15 CalWIN Entries ...........................................................................51-43

51.6 CAPI Case Rejection Criteria.....................................................................51-4451.6.1 Application ..................................................................................51-4451.6.2 Reinvestigation (RRR) ................................................................51-4451.6.3 Non-Citizen Status ......................................................................51-4551.6.4 Basic Eligibility ............................................................................51-4551.6.5 Resources...................................................................................51-4551.6.6 Unearned Income .......................................................................51-46

Unemployment Insurance Benefits (UIB)/ Disability Insurance Benefits (DIB): .......................................51-46Other Unearned Income (Loans, Grants, Pensions/Retirement, etc.): ...................................................51-46

51.6.7 Earned Income............................................................................51-46Employment Ending: ..............................................................51-46Gross Earnings: .....................................................................51-46Unreported/Incorrectly Reported Earnings: ...........................51-47Pay Stubs: .............................................................................51-47Tips: .......................................................................................51-47Self-Employment Income: ......................................................51-47Other Earnings Computation: ................................................51-47Income Exemptions: ..............................................................51-47CalWIN Entries: .....................................................................51-47Income-in-kind: ......................................................................51-48

51.6.8 Budgeting....................................................................................51-48Prospective Budget: ...............................................................51-48Retrospective Budget: ...........................................................51-48Sponsored Noncitizen: ...........................................................51-48



51.6.9 Overpayments.............................................................................51-4851.6.10 Notices Of Action ........................................................................51-4951.6.11 CalWIN Entries............................................................................51-49

51.7 Foster Case Rejection Criteria ...................................................................51-5051.7.1 Application...................................................................................51-5051.7.2 Reinvestigation (RRR) ................................................................51-5051.7.3 Social Security Number...............................................................51-5151.7.4 Citizenship...................................................................................51-5151.7.5 Deprivation ..................................................................................51-5151.7.6 DA Referral .................................................................................51-5151.7.7 School Verification ......................................................................51-5251.7.8 Property.......................................................................................51-5251.7.9 Unearned Income........................................................................51-52

Social Security Benefits (SSA or SSI) ....................................51-52VA Benefits ............................................................................51-53Child Support Contribution .....................................................51-53

51.7.10 Earned Income............................................................................51-53Employment Ending ...............................................................51-53Gross Earnings: .....................................................................51-53Income Exemptions ...............................................................51-54Income-in-kind .......................................................................51-54Lump Sum ..............................................................................51-54

51.7.11 Budgeting ....................................................................................51-54Income Budget .......................................................................51-54185% Test/FET Test ..............................................................51-55Special Needs ........................................................................51-55

51.7.12 Overpayments (O/Ps) .................................................................51-5551.7.13 Notices Of Action (NOA) .............................................................51-5551.7.14 CalWIN Entries............................................................................51-5651.7.15 Caseload Reviews ......................................................................51-56

51.8 Procedures for Rejecting Cases.................................................................51-5751.8.1 Chart Summary of Where to Reject ............................................51-6051.8.2 Cases Assigned to Staff Development........................................51-62

51.9 Additional Rules .........................................................................................51-6251.9.1 Correcting All Errors ....................................................................51-6251.9.2 MEDS Screens............................................................................51-6251.9.3 CalWIN Alerts..............................................................................51-6351.9.4 Cases Returned from the Appeals Unit.......................................51-6651.9.5 Client Correspondence ...............................................................51-6651.9.6 Reject Only Once ........................................................................51-6651.9.7 Supervisor Agreement ................................................................51-6751.9.8 Case Assignment ........................................................................51-6751.9.9 Numerous and Difficult Errors .....................................................51-67



51.9.10 Rejects Beyond the 10 Day Period .............................................51-6751.9.11 Case Transfer Criteria for CalWIN Entries ..................................51-67

51.10 Mass Transfers ..........................................................................................51-6851.10.1 Case/Caseload Shifts .................................................................51-6851.10.2 Rejections/Exceptions.................................................................51-68

51.11 Transfer of Cases to Foster Care Eligibility (Units E92, E93, E94 and E95) ..................................................................51-6851.11.1 Requirements..............................................................................51-6851.11.2 Discontinue Child from SFU........................................................51-6851.11.3 Include on SAWS 2 or CSF 60 ...................................................51-6951.11.4 Inquires .......................................................................................51-69

51.12 Non- Task-Based Model ............................................................................51-70

52. Intra-Office Backlogs .....................................................................................52-1

52.1 Intra-Office Backlog Referral and Appointment Procedure ..........................52-152.1.1 Policy ............................................................................................52-1

52.2 Inter-Office Applications ...............................................................................52-152.2.1 Policy Exceptions..........................................................................52-252.2.2 Exception Procedure.....................................................................52-2

52.3 Courtesy Applications ..................................................................................52-352.3.1 Courtesy Application Process .......................................................52-352.3.2 Medi-Cal Courtesy Applications....................................................52-4

53. Court Reviews.................................................................................................53-1

53.1 Treatment of Retroactive Court Ordered Aid Payments ..............................53-153.1.1 CalWORKs [EAS 44-301] .............................................................53-153.1.2 RRP & CHEP ................................................................................53-153.1.3 Medi-Cal........................................................................................53-253.1.4 CalFresh .......................................................................................53-253.1.5 GA.................................................................................................53-2

53.2 Court-Ordered Review Activities: All Programs ...........................................53-353.2.1 History...........................................................................................53-353.2.2 Use of the “Court-Ordered Reviews” (SCD 1281).........................53-353.2.3 Miller vs. Youakim .........................................................................53-4



54. DEBS Program Information ...........................................................................54-1

54.1 Implementation for New DEBS Program Material ........................................54-154.1.1 History ...........................................................................................54-154.1.2 A Way to Help: General Information .............................................54-1

Introductory Review Sessions - (IR) ........................................54-1Question and Answer Sessions - (QA) ....................................54-2

54.1.3 Implementation Plans....................................................................54-2

54.2 Coordinator/District Office Line Staff Meetings ............................................54-354.2.1 Agenda..........................................................................................54-354.2.2 Conflicts in Schedule.....................................................................54-454.2.3 SSPM/Program Liaison.................................................................54-454.2.4 Program Coordinator Annual District Office Visit Schedule ..........54-4

54.3 Program Committees ...................................................................................54-554.3.1 Role of the Program Committee Liaisons......................................54-554.3.2 Role of the Committee Leader ......................................................54-654.3.3 Role of the SSPM..........................................................................54-6

54.4 Program Bureau - Request for Services (SC 116) Process .........................................................................................54-754.4.1 Program Requests ........................................................................54-7

54.5 SC 116 Process ...........................................................................................54-7Section I - Requestor Information ............................................54-7Section II - Type of Request ....................................................54-8Section III - Attachments ..........................................................54-8

54.5.1 Program Use Only.........................................................................54-8

54.6 Policy Interpretations (PIs) ...........................................................................54-954.6.1 Policy ............................................................................................54-954.6.2 Rationale .....................................................................................54-1054.6.3 Process .......................................................................................54-10

Process Variations .................................................................54-1154.6.4 Controls.......................................................................................54-11

Filing ......................................................................................54-11Numbering .............................................................................54-11Obsoleting ..............................................................................54-12Multiple Program PI's .............................................................54-12

54.6.5 PI's and Handbooks ....................................................................54-12



55. Administrative Support Bureau ....................................................................55-1

55.1 Overpayment Guidelines..............................................................................55-155.1.1 Reconstructing The Period of Discrepancy...................................55-2

55.2 Financial Eligibility Tests ..............................................................................55-255.2.1 Applicant Financial Eligibility Test .................................................55-255.2.2 Recipient Financial Eligibility Net Test ..........................................55-3

55.3 Budgeting: Prospective and Retrospective ..................................................55-355.3.1 Budgeting Method In Overpayment Computations .......................55-4

55.4 Overpayment Determinations ......................................................................55-555.4.1 Rule...............................................................................................55-555.4.2 RNT Application ............................................................................55-755.4.3 RNT Decision Chart ......................................................................55-8

55.5 Child Support And OP Computations...........................................................55-9

55.6 Determining The Overpayment Amount.....................................................55-10

55.7 Determining The Type Of Overpayment ....................................................55-1155.7.1 Administrative Overpayment .......................................................55-1155.7.2 Other Overpayment ....................................................................55-11

55.8 IHSS Individual Provider List......................................................................55-11

55.9 Task Clearance and Review Processes ....................................................55-12Corrective Action Tracking Reporting System (CATR) WEBB ....................................................................................55-13

55.10 Task Clearance ..........................................................................................55-1355.10.1 Task Clearance Process.............................................................55-14

55.11 Supervisor Reviews ...................................................................................55-15Active Program Review .........................................................55-15Inactive (Negative) Program Review .....................................55-15

55.11.1 Supervisor Review Step Chart ....................................................55-16

55.12 Definitions ..................................................................................................55-1755.12.1 Agency Caused Error..................................................................55-1755.12.2 Client Caused Error ....................................................................55-1755.12.3 Cumulative Error Rate ................................................................55-1755.12.4 Current Month Only.....................................................................55-1755.12.5 Federal Tolerance Level .............................................................55-1855.12.6 Random Sample .........................................................................55-1855.12.7 Review Month .............................................................................55-1855.12.8 State Average .............................................................................55-18



55.13 Quality Assurance ......................................................................................55-1855.13.1 QA Review Step Chart (Desk, RTF, etc. (Intake Office) .............55-1955.13.2 QA Review Step Chart (Desk, RTF, etc) (Continuing Office)......55-23

55.14 QC State Reviews ......................................................................................55-2555.14.1 State Sanctions ...........................................................................55-2555.14.2 QC State Review Chart ...............................................................55-2655.14.3 Client Refuses to Cooperate with QC .........................................55-2855.14.4 Procedures for Disagreements ...................................................55-3055.14.5 Time Lines...................................................................................55-30

55.15 Negative Case Actions ...............................................................................55-3055.15.1 Thorough Documentation............................................................55-3155.15.2 Cases Returned By CAB With a Case Negative Action ..............55-31

55.16 CCS Review Links to Tools/ Forms............................................................55-31

56. CCS General Assistance (GA) Workflows....................................................56-1

56.1 Client Submits an Application.......................................................................56-1

56.2 Face-to-Face Intake Interview Appointment.................................................56-356.2.1 Assumptions..................................................................................56-356.2.2 Business Process..........................................................................56-4

56.3 Continuing Unit Case Assignment................................................................56-956.3.1 Assumptions..................................................................................56-956.3.2 Task Assignment Process.............................................................56-956.3.3 Phone Support and Officer of the Day ........................................56-10

PHONE SUPPORT ................................................................56-10OFFICER OF THE DAY .........................................................56-11

56.4 Fiscal Operations Return to Residence Payments for GA Guest/Client. ...56-11

56.5 GA Sanctions (Non-Compliance)/FSET Registration.................................56-15

56.6 IAR Requests from Recovery and Legal (R&L) for GA/CAPI Cases..........56-16

56.7 County Appeals for General Assistance.....................................................56-19

56.8 Vendor (Landlord) Payments .....................................................................56-25

56.9 Vocational Services Requests....................................................................56-26



57. Medi-Cal Eligibility Bureau VMC (Valley Medical Center) Procedures ......57-1

57.1 Applications Processed in the VMC Bureau ................................................57-157.1.1 Walk-Ins ........................................................................................57-157.1.2 Telephone Interviews....................................................................57-657.1.3 BCW CalFresh Applications .......................................................57-1057.1.4 BCW Medi-Cal with CalFresh .....................................................57-1457.1.5 VMC Face-to-Face In-Patient, PACE, Renal/ EW Screener

Process .......................................................................................57-1757.1.6 Long Term Care Process............................................................57-2157.1.7 Craig v. Bonta Process ...............................................................57-2357.1.8 Low Income Subsidy (LIS) Applications Procedures ..................57-26

57.2 SCD 1230 Procedures ...............................................................................57-3057.2.1 Purpose.......................................................................................57-3057.2.2 When to Use ...............................................................................57-3057.2.3 SCD 1230 Outstanding 45 Days or Less ....................................57-3157.2.4 CD 1230 Outstanding 46 Days or More......................................57-31

58. CCS Foster Care Workflows..........................................................................58-1

58.1 PAC ES Role Miscellaneous........................................................................58-1

58.2 AAP Program Restoration Process..............................................................58-2

58.3 Processing a Freed Child Relinquishment of Parental Right ...................... 58-2

58.4 Foster Care Eligibility Bureau 5th Floor Walk-in Face to Face Reception ...58-4

58.5 Document Drop Off/Processing ...................................................................58-5

58.6 Incoming Intake Inter-County Transfer.........................................................58-7

58.7 Phone Support ...........................................................................................58-11

58.8 Processing a Sibling Supplement for Intake and Continuing .....................58-12

58.9 Processing New Social Security Card........................................................58-13

58.10 Processing a Wraparound Monthly Invoicing List ......................................58-15

58.11 Process an Immediate Intake Application - Medi-Cal Only .......................58-17

58.12 Process an Intake AAP Application ...........................................................58-20

58.13 Process an Intake Application Regular Foster Care .................................58-23

58.14 Process an Intake for Voluntary Placements from Bill Wilson Center (BWC) or Social Initiated for Foster Care...................................................58-27



58.15 Process an Intake Incoming ICAMA Medi-Cal Only Application ................58-31

58.16 Process an Outgoing ICAMA Medi-Cal Only Application ...........................58-34

58.17 Process an Intake Income ICPC Application .............................................58-34

58.18 Process Outgoing ICPC ............................................................................58-38

58.19 Process an Intake Application - JPD Foster Care and JPD Medi-Cal only.............................................................................................................58-40

58.20 Process an Kin-GAP Intake Application .....................................................58-44

58.21 Process an Intake Application Non-Dependent Legal Guardian ................58-48

58.22 Process an AAP Wraparound Intake Application .......................................58-51

58.23 Process a FC Wraparound Intake Application ...................................................................................................................58-53

58.24 Process an EA 1 Application - Emergency Assistance Document Processing ................................................................................58-55

58.25 Process an Intake Application – FC Relative Placement Including Miller v. Youakim Referral ..........................................................................58-57

58.26 JPD Placement Change Request...............................................................58-62

58.27 Process an SCZ 414Z Request – Intake or Continuing Including County Specific Payments .........................................................................58-63

58.28 Clothing Allowance Processing for Continuing...........................................58-66

58.29 SOC 158A Processing Detail Continuing ...................................................58-68

58.30 Foster Care SOC 158A Process - Placement Changes, Address, etc.......58-68

58.31 Redetermination (RRR) AAP......................................................................58-70

58.32 Redetermination (RRR) Foster Care or NDLG...........................................58-72

58.33 Redetermination (RRR) For ICAMA (Medi-Cal Only).................................58-74

58.34 Redetermination (RRR) For Incoming ICPC (Medi-Cal only) ...........................................................................................58-76

58.35 Redetermination (RRR) for JPD Foster Care or Medi-Cal Only.................58-78

58.36 Redetermination (RRR) for KinGAP...........................................................58-80



59. CCS Intake Model ...........................................................................................59-1

59.1 Return Envelopes.........................................................................................59-1

59.2 Triage/Screener ...........................................................................................59-259.2.1 Medi-Cal Screening ......................................................................59-359.2.2 Mail-In Applications.......................................................................59-559.2.3 Phone-In Applications ...................................................................59-5

59.3 Group Orientation.........................................................................................59-659.3.1 Assumptions .................................................................................59-6

59.4 Special Circumstances Face-to-Face Interviews .........................................59-8

59.5 Miscellaneous Priority Tasks........................................................................59-959.5.1 Vendor Payment Cases ..............................................................59-1059.5.2 Transitional CalFresh Cases.......................................................59-10

59.6 CCS Intake Supervisor Roles & Responsibilities .......................................59-1159.6.1 Information Supervisor ................................................................59-11

Responsibilities ......................................................................59-11Complaints .............................................................................59-12Schedule/Shift ........................................................................59-13

59.6.2 Triage Supervisor........................................................................59-13Responsibilities ......................................................................59-13Schedule/ Shift .......................................................................59-14

59.6.3 Emergency Unit Supervisor ........................................................59-14Responsibilities ......................................................................59-14Schedule/Shift ........................................................................59-15

59.6.4 Group Orientation Supervisor .....................................................59-15Responsibilities ......................................................................59-16Schedule/Shift ........................................................................59-17

59.6.5 Processing Supervisor ................................................................59-17Responsibilities ......................................................................59-17Schedule/Shift ........................................................................59-18

59.6.6 Transition Plan ............................................................................59-19

59.7 CCS Intake Business Processes ...............................................................59-2059.7.1 Triage Business Process ............................................................59-20

Expedited Services (ES) Eligible ..........................................59-2659.7.2 Benefits CalWIN (BCW) Triage...................................................59-2659.7.3 Emergency Unit Business Process.............................................59-2859.7.4 Group Orientation Business Process..........................................59-3059.7.5 Face-to-Face (F2F) Interview Business Process........................59-3459.7.6 No-Show Business Process........................................................59-3559.7.7 Denials for Medi-Cal Walk-In Applications..................................59-37



59.7.8 Program Denial Transfers ...........................................................59-38Business Process ..................................................................59-38

59.7.9 Phone Support Business Process...............................................59-39Pending Application ...............................................................59-40Change of Address ................................................................59-42Community Based Organizations (CBOs) .............................59-43EBT/ BIC/ Newborn/ QR7 ......................................................59-44DDSD Pending Application ...................................................59-45Transitional CalFresh (TCF) with CalWORKs ........................59-45Home Visit ..............................................................................59-46

60. CCS Generic Workflows.................................................................................60-1

60.1 Intake Workflows ..........................................................................................60-160.1.1 Benefits CalWIN CalFresh ............................................................60-160.1.2 Benefits CalWIN (BCW) Medi-Cal.................................................60-660.1.3 SSI Denials ...................................................................................60-8

60.2 Generic Workflows (Intake/Continuing)......................................................60-1060.2.1 Caller Requesting Information About DEBS Program.................60-1060.2.2 Overpayment/Overissuance........................................................60-1560.2.3 Listings ........................................................................................60-1660.2.4 Trouble Tickets - Worker Generated...........................................60-1760.2.5 Trouble Tickets - CATS Help Desk/Program/Child Support

Generated ...................................................................................60-2060.2.6 CCS Case Alerts .........................................................................60-22

60.3 Generic Workflows (Continuing).................................................................60-2360.3.1 Lobby Drop-In .............................................................................60-2360.3.2 Client Requests Discontinuance .................................................60-24

Phone Requests: ...................................................................60-24Mail-In Requests: ...................................................................60-24

60.3.3 New Applications.........................................................................60-2460.3.4 Add A Person ..............................................................................60-2660.3.5 Remove a Person .......................................................................60-2960.3.6 Add a Program ............................................................................60-3060.3.7 Restoration of Aid........................................................................60-3260.3.8 Phone/Walk-In Change of Address.............................................60-35

60.4 CWES Requests ........................................................................................60-3660.4.1 CCS Request Form.....................................................................60-3660.4.2 Communication Flow...................................................................60-3660.4.3 OD Calendar ...............................................................................60-3760.4.4 Processing CWES Requests ......................................................60-3760.4.5 Cases at BSC..............................................................................60-4160.4.6 Confidential Cases ......................................................................60-41



60.4.7 Escalation Process .....................................................................60-42Phone Support Delays ...........................................................60-42TMT Processing Delays .........................................................60-43

60.4.8 Case Transfers ...........................................................................60-4460.4.9 Closed CWES TMT Tickets ........................................................60-44

61. CCS Continuing Workflows...........................................................................61-1

61.1 Phone Support .............................................................................................61-161.1.1 PS Duties and Expectations for Eligibility Staff .............................61-161.1.2 PS Duties and Expectations for Supervisors ................................61-361.1.3 Phone Support Quick Reference Guide........................................61-4

61.2 Phone Support (PS) Processes ...................................................................61-961.2.1 Add a Person-PS Process ............................................................61-961.2.2 Case Reviews (extensive)-PS Process.......................................61-1161.2.3 CWES Requests-PS Process .....................................................61-1261.2.4 Electronic Intercounty Transfers-PS Process .............................61-1561.2.5 Other Health Care (OHC)-PS Process........................................61-1661.2.6 QR 7 Processing-PS Process.....................................................61-1861.2.7 QR7 General Phone Support Script............................................61-19

QR 7 sent via USPS mail or dropped off at CBS mailbox, but NOT in IDM and No TMT has been created or assigned ......61-20QR 7 is in IDM, but there is no TMT, or vice-versa ................61-21QR 7 is in IDM with a TMT assigned that is unprocessed for 4 days or less from date of TMT assignment .........................61-22QR 7 is in IDM with a TMT assigned that is unprocessed for more than 4 days from the date of the TMT assignment ..61-22

61.3 Unit Task-Based Procedures .....................................................................61-2361.3.1 Duties and Expectations for Eligibility Staff.................................61-2361.3.2 Walk-Ins / Officer of the Day (OD) ..............................................61-24

OD Process ...........................................................................61-2461.3.3 Officer of the Day (OD) Quick Reference Guide.........................61-2661.3.4 Unit Work Adjustments ...............................................................61-2961.3.5 Internal Case Corrections ...........................................................61-3061.3.6 SC Procedures for A6_T caseload .............................................61-32

61.4 Document Processing (DP) Processes......................................................61-3361.4.1 Processing QR 7 Received by Mail ............................................61-3361.4.2 Processing QR 7 Received via Benefits CalWIN (BCW) ............61-3561.4.3 Processing QR 7 Received via Office Drop Box.........................61-3661.4.4 RRR Processing .........................................................................61-3661.4.5 RRR Group Interviews ................................................................61-3861.4.6 Individual Face-to-Face Interview ...............................................61-4161.4.7 When RRR Packet is Received ..................................................61-44



61.4.8 Telephone Interviews - Client is Unavailable or RRR Packet has not been returned .................................................................61-45

61.4.9 Telephone Interviews - Client is Available and RRR Packet has been Received .....................................................................61-46

61.4.10 RRR No-Show.............................................................................61-4861.4.11 Eligibility Work Supervisor (EWS) Review of RRR......................61-49

61.5 Vendor Payment.........................................................................................61-4961.5.1 Initiating Vendor Payment ...........................................................61-4961.5.2 Client Chooses to Cure Sanction ................................................61-5161.5.3 Client Chooses Vendor Payment (VP) ........................................61-5461.5.4 Client Chooses to Appoint a Designated Alternate Cardholder

(DAC) ..........................................................................................61-5661.5.5 Client Fails to Cooperate with VP/DAC Requirements................61-5861.5.6 Changing the Vendor Payee .......................................................61-5961.5.7 Cancelling a Vendor Payment Warrant .......................................61-6061.5.8 Terminating Vendor Payment (VP) .............................................61-6061.5.9 Deactivating the Designated Account Cardholder (DAC)............61-6161.5.10 Split Payments ............................................................................61-62

61.6 Family Reunification Bottom Line Override (BLO) .....................................61-63

61.7 Homeless Assistance .................................................................................61-6461.7.1 Homeless Assistance Request by Telephone.............................61-6461.7.2 Homeless Assistance Request - Client in the Lobby...................61-6561.7.3 Subsequent Temporary HA Payments........................................61-66

62. CCS Application Support Narratives ............................................................62-1

62.1 Application Support (Clerical) Functions for CCS Model..............................62-162.1.1 Greeter ..........................................................................................62-162.1.2 Self-Service Station.......................................................................62-162.1.3 Lobby Windows.............................................................................62-262.1.4 Application / Registration ..............................................................62-262.1.5 MEDS - SCD 1296 Processing .....................................................62-262.1.6 SFIS Processing ...........................................................................62-262.1.7 Fiscal .............................................................................................62-262.1.8 Mail Room .....................................................................................62-362.1.9 IDM Station ...................................................................................62-362.1.10 Task Creation................................................................................62-3

62.2 Workflow Procedures (Narratives) ...............................................................62-362.2.1 Full Application / Registration - Walk-In ........................................62-562.2.2 Partial Application / Registration ...................................................62-962.2.3 Fax, E-Fax and Mail Applications................................................62-1062.2.4 Additional Scan Request .............................................................62-12



62.2.5 Fax, Mail, Drop-In Verifications...................................................62-1262.2.6 Lobby SFIS Request ...................................................................62-1362.2.7 Lobby Verification .......................................................................62-1362.2.8 Lobby EBT Card .........................................................................62-1462.2.9 “Request for On-Line Transaction” (SCD 1296) Request ...........62-1662.2.10 Lobby QR 7/MSR Request .........................................................62-1762.2.11 Lobby BIC Card ..........................................................................62-1862.2.12 Lobby Homeless Mail..................................................................62-1962.2.13 MEDS Alerts ...............................................................................62-2062.2.14 Fiscal Operations - Homeless Payments....................................62-2062.2.15 Fiscal Operations - Receipts for Overpayments .........................62-2162.2.16 Fax Job Search to the GA Office ................................................62-2262.2.17 Face-to-Face CalWORKs/RCA...................................................62-2262.2.18 CalWIN and Business Object Reports ........................................62-2462.2.19 Benefits CalWIN Medi-Cal ..........................................................62-2562.2.20 Lobby Request for Verification of Benefits ..................................62-2662.2.21 Lobby Appointments ...................................................................62-27

63. IEVS Unit Workflows ......................................................................................63-1

63.1 Overview ......................................................................................................63-1

63.2 IFD 440 CalWIN Interface Quarterly Report Review....................................63-1

63.3 Benefit Calculation Process .........................................................................63-7

63.4 Beneficiary Earnings Exchange Record (BEER) Internal Revenue Service (IRS) Asset Match Franchise Tax Board (FTB) Asset Match...................................................63-11

63.5 Intentional Program Violation .....................................................................63-17

63.6 General Fraud ............................................................................................63-19

63.7 Child Support Default and Trial Referrals ..................................................63-21

63.8 In-Home Support Services .........................................................................63-22

63.9 Compliance Desk Process .........................................................................63-2363.9.1 Sending IEVS Communication to DO .........................................63-2363.9.2 Case Assignment with Active Benefit Case ................................63-25

64. Reserve for Future Use..................................................................................64-1



65. General Assistance (GA) SSI Advocacy.......................................................65-1

65.1 CalWIN Referrals .........................................................................................65-165.1.1 Director’s Exception Referrals.......................................................65-465.1.2 Health and Hospital System (HHS) - Outstation Referrals............65-565.1.3 Data Match....................................................................................65-9

65.2 Case Assignment .......................................................................................65-1065.2.1 SSI Application at Initial or Reconsideration Level......................65-1065.2.2 SSI Advocacy Case Denied at Reconsideration Level................65-1165.2.3 GA Recipient’s SSI Application at Hearing Level ........................65-12

65.3 Unassigned Caseload ................................................................................65-13

65.4 Case Development/Maintenance ...............................................................65-1565.4.1 Application Stage-Initial SSI/SSDI Application............................65-1565.4.2 Denials ........................................................................................65-1965.4.3 Reconsideration (1st Appeal) ......................................................65-1965.4.4 Administrative Law Judge Hearing..............................................65-2165.4.5 Presumptive, TERI, or Compassionate Allowances -

Conditions of Disability ................................................................65-2265.4.6 In-House Psychological Evaluation.............................................65-2465.4.7 Client Fails to Cooperate with SSI Advocacy Unit.......................65-2565.4.8 Closings ......................................................................................65-26

65.5 Accessing and Completing the SSI Advocacy Application System............65-27

65.6 Integrated Document Imaging (IDM) ..........................................................65-34

65.7 IDM Retrieval..............................................................................................65-35

65.8 Laptop Downloading/Retrieval of IDM Documents.....................................65-37

65.9 Social Security Administration (SSA) Zip Code Listing For Use with SCP Claims Only ................................................................................65-39

65.10 SSI Contacts ..............................................................................................65-4065.10.1 SSI Advocacy SSA Field Office Directory ...................................65-4065.10.2 Disability Determination Services (DDS) Directory .....................65-4165.10.3 Most Common and Frequent Medical Providers for

Medical Information ....................................................................65-41


Table of Contents4.3 Summary Abstract.....4-7 4.3.1 Reviewing the Summary Abstract.....4-7 4.4...

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Transcript of Table of Contents4.3 Summary Abstract.....4-7 4.3.1 Reviewing the Summary Abstract.....4-7 4.4...