Triage Business Process

Triage is responsible for screening Immediate Need (IN) for CalWORKs (CW), Expedited Services (ES) for CalFresh (CF), and Medi-Cal (MC) IN or MC Minor Consent applications.

Triage Supervisor

The role of the Triage Supervisor is to primarily oversee all functions of the triage process and ensure all applicants are informed of the general eligibility regulations for emergency benefits, such as IN, ES, MC IN, or MC Minor Consent. In addition, the Triage Supervisor:

  • Works in tandem with the Information Supervisor and clerical staff.
  • Consults with the Clerical OMSs/Leads regarding inventory of required forms.
  • Determines if back-up staff is needed for any triage coverage shortages.
  • Trains staff on triage process.
  • Addresses all client complaints, questions, and concerns related to triage.

CalWORKs Immediate Need (IN) or Medi-Cal IN or Medi-Cal Minor Consent Process

Who  Action
Triage EW
  • Receives report of all CW IN or MC IN/ Minor Consent applications.
  • Reviews the application and makes IN determination.
  • If the applicant is:
    • Eligible
      • Refer to the clerical priority intake assignment.
    • Not Eligible
      • Refer to clerical for regular intake processing.

Refer to CW HB Chapter 7 for the IN policy, CF HB Chapter 4 for ES policy, MC HB Chapter 4 for MC IN policy, or MC HB Chapter 27 for the Minor Consent policy.
Intake EW
  • Conducts the interview.
  • Plays the appropriate Rights & Responsibilities recording for the client.
  • Determines eligibility and dispositions (approves or denies) all benefits the client applied for, appropriately.

 

CalFresh Expedited Services (ES) Process

All CF applications will indicate Yes for Expedited Services (ES) on the Case Summary page once the application registration has been completed.

Step Who Action
1

Clerical
Application Source Process
For walk-in and mail-in applications,
  • Uses paper application to complete application registration.
For phone applications,
  • Captures application through TS and complete application registration.
For BenefitsCal applications,
  • Monitors Pending Clearance applications submitted through the e-Application Search page.
  • Searches/ filters by CalFresh Program to prioritize ES.
  • Assigns application to themselves preventing duplicate work (i.e., two clerks clearing the same application at the same time).
  • Registers the CF applications, including response to the ES Qualification Questions, if available (i.e., client completed questions in the application).
  • Answers are pre-populated for BenefitsCal applications if the client answers.
2 MA Team

Throughout the day, sends the report of pending ES applications to the SSPMs, the AAC Triage Eligibility Work Supervisors (EWSs), and to Clerical.

  • Permanent Plan: Report of pending ES applications.  (This is tentatively expected to be available on day 10 after CalSAWS implementation.)
  • Interim Plan: Until the Permanent Plan above is available, staff will follow the Interim Plan. From CalSAWS, pulls the Expedited Services CalFresh Management Report of applications that have:
    • A Program Status of Pending, and
    • No entry for ES Entitled.

Note: The Expedited Service CalFresh Management Report information is available in real time in CalSAWS under Reports/On Request/Administrative/ES CF Management Report.
3 Triage Eligibility Work Supervisor (EWS)
  • Receives report of all CF applications to evaluate for ES.
  • Equally divides and distributes CF applications to Triage EWs.
  • Emails report to Triage EW (screeners).
4 Triage Eligibility Worker (EW)
  • Receives report of all CF applications to evaluate for ES from EWS.
  • Reviews the application (in CalSAWS and Imaging).
  • Clicks on Task if it has been created.
  • Makes an ES determination and selects Yes or No in the ES Entitled field on the CalFresh Detail page:
If... Then...

Any ES Qualifying Questions are a Yes, and

Other pertinent application information indicates potentially eligible for ES,
  • Selects Yes for the ES Entitled field on the CalFresh Detail page.
  • Selects appropriate Yes or No for Postponed Verifications Authorized field, as appropriate.
  • Makes journal entry indicating applicant is ES eligible (i.e., Applicant has been screened and meets ES criteria).

All ES Qualifying questions are No or blank, and

Other pertinent application information indicates potentially ineligible for ES,
  • Selects No for the ES Entitled field on the CalFresh Detail page.
  • Makes journal entry indicating applicant is not ES eligible (i.e., Applicant has been screened and does not meet ES criteria). 

Any ES Qualifying Question is Yes, and

Other pertinent application information indicates potentially ineligible for ES,
  • Selects No in the ES Entitled field on the CalFresh Detail page.
  • Makes journal entry indicating applicant is not ES eligible (i.e., Applicant has been screened and does not meet ES criteria).

All ES Qualifying questions are No or blank, and
Other pertinent application information indicates potentially eligible for ES,
  • Selects Yes for the ES Entitled field on the CalFresh Detail page. 
  • Selects appropriate Yes or No for Postponed Verifications Authorized field, as appropriate.
  • Makes journal entry indicating applicant is ES eligible (i.e., Applicant has been screened and meets ES criteria).
5 Clerical
  • Permanent Plan: Report of Pending ES applications (This report is tentatively expected to be available on day 10 after CalSAWS implementation).
  • Interim Plan: Until the Permanent Plan above is available, staff will follow the Interim Plan. From CalSAWS, pulls the Expedited Service CalFresh Management Report and assigns pending CF applications as follows:
    • For CF applications with “Y” for ES Entitled, assign them to EWs as ES processing.
    • For CF applications with “N” for ES Entitled, assign them to EWs as regular processing.
  • Creates Intake Task and assigns application. 

Note: If the Intake Task was already created, the clerical assigns that task to the Intake EW. 
6 Intake EW
  • Conducts intake interview application process, including making a complete ES determination. 
  • Ensures appropriate benefits and NOAs are sent.
  • Enters case journal entry of intake interview, including ES determination. 
  • Dispositions of the CalFresh application and all benefits the applicant applied for, as appropriate. Refer to the Intake Interview Business Process topic. 
If verifications... Then...
Need to be postponed after they were initially not postponed, 
  • On the CalFresh Detail page, change the No in the Postponed Verifications Authorized field to a Yes.
    • The Postpone Verifications Due Date field is auto populated with 30 days out from the date of application. 
    • Select No in the Postpone Verifications received drop-down field.
  • On the Verification List page, select the Postpone button.
Do not need to be postponed, after they were initially postponed, 
  • On the CalFresh Detail page, change the Yes in the Postponed Verifications Authorized field to a No.
  • Enter verifications received, as appropriate.

 
7 SSPM May use the Expedited Service CalFresh Management Report to review pending CF applications with a blank ES Entitled status to monitor undetermined ES that are routed to Triage EWs.