Reinvestigation

Review of Case Documents

Prior to the RRR, the Eligibility Worker MUST review Imaging for all documents which were obtained and completed during the preceding year, including:

  • The last “Statement of Facts for Medi-Cal” (MC 210),
  • “Statement of Facts for General Assistance” (GA 100), 
  • “Application for CalFresh Benefits” (CF285), and 
  • “Statement of Facts” (CSF 60), and 
  • All “Semi-Annual Eligibility/Status Reports” (SAR 7s). 

The Eligibility Worker is to compare current documents with past history, checking for consistency and correct information.

Rights & Responsibilities Explanation to the Client(s)

The EW must explain the General Assistance Program rights and responsibilities to the client and complete the following:

  • Provides the client with a copy of the “General Assistance Program - Rights and Responsibilities” (GA 14).
  • Advises the client that all changes in circumstances and income must be reported within ten days of occurrence and reported on the “Semi-Annual Eligibility/Status Report “(SAR 7). 
  • Explains the “Semi-Annual Eligibility/Status Report” (SAR 7) and the “Instructions & Penalties Semi-Annual Eligibility/Status Report” (SAR 7 addendum), and the form SAR 7A “How to Fill Out Your SAR 7".

Housing Assistance Information and Verification

Is client required to pay for shelter? 

If... Then...
Yes
  • “Housing Assistance Verification” (GA 31) or "Client’s Housing Assistance Statement" (GA 11) is required for GA.
  • CalFresh only cases -complete the “Shelter Cost Statement” (CSF 47). Verification of current living situation is required.
No If the client is in a specialized program (i.e., Mental Rehabilitation, State-Licensed Residential care, SLE/THU recovery homes, and etc.) the “Housing Verification-Specialized Programs” (GA 2A) is required to be completed at RRR.

Does the housing verification agree with the new Statement of Facts in amount of rent and street address? 

If... Then...
No
  • Documentation and new verifications are required. 
  • Housing cannot be allowed until new verification is received for GA, for Food Stamps refer to the three Housing Verification Forms *# 2 below.

Does the residence information on the current SAR 7 agree with the new Statement of Facts?

If... Then...
No
  • Documentation and new verifications are required. 
  • Housing cannot be allowed until new verification is received for GA, for Food Stamps refer to the three Housing Verification Forms *# 2 below.

Three Housing Verification Forms

  1. “Housing Assistance Verification” (GA 31) is to be used for GA client required to pay for shelter, obtain vendor/landlord information and is required for client to choose one of the three Personal Need Options, Section III of the form. Forms GA 2A is to:
    1. Verify address and type of facility the tenant is living in.
    2. Request a current State license.
    3. Be complete each time the client changes RCH facilities and at each RRR and send a copy to be scanned to Imaging.
    4. Submit with forms CSF 13 or SCD 1029.
  2. *“Shelter Cost Statement” (CSF 47) is used for Food Stamps only cases. 
    1. Shelter cost does not have to be verified again unless questionable.
    2. If rent increases. Shelter is not disallowed if the CSF 47 for verification of rental increase is not provided by the client, rent remains the same.
  3. "Client’s Housing Assistance Statement" (GA 11) is used if client’s landlord refuses to cooperate, client must complete the Vendor Payment Information, read the Acknowledgment, and chose one of the three Personal Needs Options on the form.

New Property

Has new property been acquired?

If... Then...
Yes Documentation and verification of how the new property was acquired is mandatory.

Has any property been transferred or sold? 

If... Then...
Yes
  • Documentation and verification of the details of the transfer/sale are mandatory. 
  • Calculation of a period of ineligibility may also be required.

Is the recipient property eligible? 

If... Then...
No The client must be discontinued with a timely NOA.

Employment Status and History

The following questions must be asked:

Is a new application for UIB/DIB/SSI necessary? 

If... Then a...
Yes
  • New Application must be documented and verified in order to complete the RRR. 
  • “Authorization for Reimbursement of Interim Assistance Initial Claim or Posteligiblity Case” (SSP 14), and a
  • “Referral to SSA” (SCD 169), may also be required (check last SSI denial).
No Document the reason in a Journal Entry.

Is a new work registration required? 

If... Then...
Yes Complete appropriate referrals.
No Document the reason in a Journal Entry.

Is a new verification of incapacity required? 

If... Then...
Yes New “General Assistance Program - Request for Medical Information” (SCD 1400) must be completed.
No Document the reason in a Journal Entry.

MEDS/CDB

A MEDS/CDB screen must be printed at each RRR for each recipient, in order to determine:

  • Status of SSI.
  • Status of Medi-Cal.
  • Status of Food Stamps.
  • Receipt of aid in another county.
  • Follow up on information received as required.

The MEDS screen print must be scanned to Imaging.

State Programs - Disability Determination Service Division (SP-DDSD) Referral

If a referral to SP-DDSD is needed, the EW must complete follow the procedures as described in the SP-DDSD section of the Medi-Cal Handbook.

[Refer to "DDSD - EW Procedures" in the MC HB]

CalFresh

The EW must complete all forms and follow procedures as described in the Food Stamp Handbook.

[Refer the Application sections in the CF HB].

RRR Dates

The EW must ensure the RRR due date is correct in CalSAWS. 

Example:

If a “Statement of Facts for Medi-Cal” (MC 210) or “Statement of Facts for General Assistance” (GA 100) is completed in February 2010, a new MC 210 or GA 100 is required in February 2011. The 12 months begins with the first month after the RRR is completed.

HOWEVER, if the case has food stamps, the Semi-Annual Reporting/Prospective Budgeting (SAR/PB) system requires that the RRR be done in a SUBMIT month. Therefore, it may be necessary for the EW to manually align the RRR due date with the Food Stamp RRR date. 

Refer to RD/RV/RC Date Alignment for the CalWORKs, General Assistance, CalFresh and Medi-Cal Programs.

Note: RRR for GA only cases may be scheduled one month in advance. However, if the GA RRR appointment is scheduled in advance; clients who “No Show” must be rescheduled as the case cannot be discontinued until the end of the month in which the RRR is due.