Recertification Forms

[63-300.2]

The forms below must be used to complete a CalFresh RC.

The series of application forms that are used are based on the type of CalFresh household, whether the interview is to be conducted face-to-face or over the telephone.

For CalFresh only cases:

  • “Recertification for CalFresh Benefits” (CF 37)

For CalFresh and CalWORKs or GA or Medi-Cal combo cases:

  • “Application for CalFresh, Cash Aid, and/or Medi-Cal/Health Care Programs” (SAWS 2 Plus), and
  • “Rights and Responsibilities and Other Important Information” (SAWS 2A SAR)

AND

  • “Appointment Letter (GEN 102) or “CalFresh Recertification Appointment Letter” (CF 29),
  • “How to Report Household Changes” (CF 23 SAR), and
  • “Would You Like to Register to Vote” (SCD 508), and
  • “Your Rights Under California Law” (PUB 13), and
  • “Notice of Language Services” (GEN 1365), and
  • “Demographic Questionnaire” (CW 2223), and

FOR Regular CalFresh HOUSEHOLDS

  • “CalFresh Notice of Expiration of Certification” (CF 377.2), and

OR

FOR ESAP HOUSEHOLDS

  • “CalFresh Notice of Expiration of Certification for Households with only Elderly and/or Disabled Members” (CF 377.2B).

CalFresh RC Packets

The complete list of recertification packets can be obtained from the “List of All DEBS Forms” located on the Program Bureau page, Reference Materials under the “Quick Reference Guides” heading.

For information regarding the RC packet, refer to DEBS Common Place Handbook Section 3.4.

When recertification is processed by paper application, benefits must not be interrupted if forms are returned, except the application for RC (i.e., CF 37).

Type of Interview

USDA FNS granted California a waiver of the face-to-face interview requirement for all non-assistance households. A telephone interview is required.

Telephone Interview

A telephone interview must be conducted at recertification in place of a face-to-face interview, unless a face to-face interview is required for the reasons listed below.

Telephonic Signature (TS)

For telephone interviews, the client has the option to provide a telephonic signature. A telephonic signature is a type of electronic signature using an individual’s recorded signature or verbal assent in place of an actual written signature and is considered legally enforceable.

The Telephonic Signature RC process eliminates the need to mail out the CalFresh RC packets, which includes the CF 37 form, for completion by the client prior to the telephone interview.

Face-to-Face Interview

A face-to-face interview must still be conducted at recertification in the following circumstances:

  1. When requested by the household or the household’s authorized representative, or
  2. When the county determines it is necessary to verify conditions of eligibility, or
  3. When doing the recertification in conjunction with another program (e.g., General Assistance, CalWORKs) and those programs require a face-to-face interview.

Scheduling of Interviews

Notice of Expiration of Certification (NEC)

The “CalFresh Notice of Expiration of Certification” (CF 377.2) must be used to end the certification period and is the only notice required if the household does not complete the recertification process.

Note: If the recertification interview is completed and the application is signed by the client, an eligibility determination must be made and an approval or denial NOA must be issued.

Telephonic Contact to Schedule an Interview (AB 79)

EWs must call the client to schedule an interview at a time that is mutually convenient for both the EW and the client. If an agreed-upon time cannot be determined, the EW will inform the client an interview will be scheduled for a later date, and an appointment letter will be sent. The EW should also inform the client that they may contact the worker before their appointment if they need to reschedule. A written notice of interview appointment must be sent in addition to scheduling an RC interview by telephone contact.

When scheduling an interview with the client, EWs must inform clients that a face-to-face interview option is available for them.

EWs must document when and how the interview was scheduled with the client. If the EW attempts to make telephonic contact and cannot reach the household, the EW must document the case record of the attempt to contact the household.

Recertification Appointment

EWs must send clients an “Appointment Letter” (GEN 102) to notify the scheduled interview for recertification. The GEN 102 informs the client of the date and time of the telephone interview and the option to request a paper application to be mailed.

Notice of Missed Interview (NOMI)

When a client misses a recertification interview, EWs are required to send a “Notice of Missed Interview” (CF 386).

The following chart provides examples about when to send a NOMI:

IF... AND... THEN...

The County sends a:

NEC,

RRR packet or

GEN 102 with the date and time of a scheduled interview

 The household mails the re-application form back but does not attend the scheduled interview, The EW must send a NOMI because the household missed the interview.

The County sends a:

NEC,

RRR packet or

CalSAWS with the date and time of a scheduled interview

 The household fails to return the recertification packet back and fails to attend the scheduled interview, The EW must send a NOMI because the household missed the interview.

The County sends a:

NEC,

RRR packet or

GEN 101 with the date and time of a scheduled interview

 The household contacts EW to reschedule the face-to-face or the telephone interview, The EW must send a NOMI because the household missed the first scheduled interview.

Personal Contact after Sending the NOMI

EWs must attempt to make personal contact with a household for RC before terminating benefits. When a household misses its scheduled interview, the EW must call the client no later than the 20th of each month and ask if the household can complete the RC interview over the phone. If yes, process the RC following the normal business process.

If the EW cannot reach the household, the EW must document in the case record that an attempt to contact client was made to complete the RC interview.

If the EW calls the household to complete an interview, but the client cannot complete the interview, schedule the interview at a mutually feasible time for both the EW and the household and case comment.

Interview Requirements

Rights and Responsibilities

The EW must inform the household of the following CalFresh rights and responsibilities as part of the RC.

  • The right to confidentiality.
  • The right to nondiscrimination.
  • A review of the pamphlet, “Your Rights Under California Welfare Law” (PUB 13).
  • EBT Card and PIN Responsibilities.
  • Availability, when applicable, of second language forms for non-English speaking households. Document this in the Journal Detail page.
  • Sales tax may not be charged on approved items purchased with CalFresh.
  • Disqualification penalties for failure to cooperate with:
    • QC reviews (discuss sanction time frame; Refer to Processing Time Frames [63-301]
    • Work Registration requirements
    • SSN requirements
    • Reporting requirements (explain IPV disqualification penalties)
  • 10-day mid-period reporting requirements:
    • Report when gross monthly income received exceeds the HH’s IRT, or
    • If applicable to the HH, report when an ABAWD's work hours drop below an average of 20 hours per week or 80 hours total per month, or
    • Report when the HH is in receipt of substantial lottery and/or gambling winnings (EWs must verbally inform recipients of the substantial lottery and/or gambling winnings mid-period reporting requirement and that substantial winnings will result in the discontinuance of CalFresh benefits. EW must case document that the recipient was informed of this mandatory reporting requirement).

      • Important: Substantial lottery and/or gambling winnings are defined as being equal to or over the Elderly and/or Disabled resource limit. This mandatory requirement is applicable even if the household immediately spends or loses a portion of the winnings and the remaining winnings are below the resource limit for Elderly and/or Disabled households. The client’s verbal statement along with case documentation is sufficient verification.

  • Collect calls will be accepted from outside the local calling area.
  • The opportunity to receive uninterrupted benefits by the next normal issuance date after the certification period ends.

Important: To obtain uniformity when explaining the Rights and Responsibilities to clients, Santa Clara County Staff must play the pre-recorded version to the client, whenever possible. (Until directed otherwise, EWs must verbally inform recipients of the substantial lottery/gambling winnings mid-period reporting requirement.)

Note: If there has been a failure to provide an eligible household with an opportunity to participate due to administrative error, the household is entitled to LOST BENEFITS if the period was the month following the expiration of the certification period. Refer to Delayed Processing for additional requirements.

Related Topics

Delayed Processing