Recurring Special Needs

[EAS 44-211.2]

Types

Recurring special needs include:

  • Therapeutic Diets
  • Special Laundry Costs
  • Special Chore Services
  • Excessive Use of Utilities
  • Special Transportation Needs
  • Special Telephone Service or Equipment

A recurring special need results in added costs to the family which they are expected to incur during two or more months in a calendar year.

Allowance

The allowance for a recurring special need cannot exceed the actual increase in costs to the family as a result of the special need. Actual costs in excess of the allowable are to be verified on the “Eligibility Status Report” (SAR 7). If, however, the special need allowance guidelines are utilized, the EW may authorize payment at the rates indicated, without verification of actual cost. Special needs must be reverified at least once a year. This may be required more often, depending upon the type of need and the potential for change.

The total allowance which is available for each AU per month for all recurring special needs cannot exceed the amount resulting from multiplying $10 by the number of persons in the AU. If a recipient within a CalWORKs AU of three applies for a recurring special need allowance, they will only be eligible for a maximum of thirty dollars ($30) per month. An AU of One will only be eligible for a maximum of the dollars ($10) per month.

Note: The total allowance rule does not apply to the Pregnancy Special Needs. It is specific to the recurring special needs listed in this chapter.

Persons who are not aided because they are excluded from the AU are not eligible for a recurring special need allowance, nor is an individual with a penalty that requires that their needs not be considered in the Maximum Aid Payment (MAP) determination. Individuals subject to a child support penalty may be eligible for a special needs payment as their needs continue to be considered in the MAP determination.

Therapeutic Diets

When recommended by a physician, a special need may be allowed for a therapeutic diet. The allowance for a therapeutic diet is not limited to those listed below. However, the final determination of the need should be based upon consultation with the EW Supervisor and/or the District Office Manager.

A recipient is entitled to establish actual expenses related to the diet plan if it is to his/her benefit to do so. However, if the recommended diet plan includes one or a combination of the following diets, the EW may pay the amount indicated for the highest cost diet without verification of actual costs.

Procedure

The EW must take the following steps when it is discovered that the applicant/recipient may be eligible for a special need based upon the need for a therapeutic diet:

  1. Print out the “Special Diet Request” form (SCD 414) from CalSAWS.
  2. Give the form to the client.
  3. Document the statement of facts or on the Journal Detail page that the SCD 414 was given, for whom, etc.
  4. Authorize payment of the special need when the SCD 414 has been completed by the physician and returned.
  5. Follow-up at the appropriate time.

Example Example A recipient indicates at RV that she is diabetic and her doctor has recommended that she go on a special diet. The EW generates a SCD 414 from the Client Correspondence subsystem, giving the form to the recipient to take to her doctor. When completed by her physician, the client brings the SCD 414 back to her EW, who authorizes a special need payment. The physician has indicated that this diet is needed for a period of 5 months. The EW must follow up at the end of the SAR or AR/CO Payment Period in which the special need is expected to end, so that a timely and adequate NOA can be issued.

Therapeutic Diet Amounts

If the client is determined eligible for a therapeutic diet and wishes to use the standard, the EW allows:

  • $15 for:
    • Diabetic, 2200 calories or more.
    • High Calorie - High Protein (including special formula for infant).
    • Lactation (while breast-feeding).
  • $9 for:
    • Diabetic, under 2200 calories.
    • Bland.
    • Low Fat - Cholesterol.
    • Low Salt (sodium, under three grams).

Special Laundry Costs

When a recipient is required to change and clean bedding or clothing more often than usual because of a medical condition, these additional laundry costs may be allowed. Without verification of actual costs, the EW may authorize $3.00 per month. To substantiate this payment, a statement from a medical doctor, verifying the medical condition must be on file.

Special Chore Services

When it is verified that the family caretaker is unable to perform household chores such as cooking, cleaning, ironing, etc. for members of the AU, due to health reasons, and these chores cannot be done by other household members, it is possible to allow the actual cost of employing someone to perform these chores.

Excessive Utility Usage

When it is verified by the EW that a recipient has excessive use of utilities due to a reason not common to the majority of our recipients, the actual cost of this excessive use may be allowed. The use must be essential for their health. Their actual cost must be in excess of the in-kind utility values for that size AU. Without verification of actual cost by the recipient, only allow $5.00 per month. To substantiate this cost, the county must have on file a statement from a medical doctor, verifying the medical condition that would necessitate this excessive use of utilities.

Special Transportation Needs

When a recipient must travel daily or an unusual distance to receive required medical treatments, the actual cost of special transportation can be allowed. This cost should not exceed the actual cost of the least expensive method of transportation. The EW must take into consideration:

  • What transportation is reasonably available to the recipient?
  • Is it reasonable to expect the recipient to take the bus, or does she need to drive her car?
  • The practicality and availability of transportation must be considered.
  • The recipient's health.

The EW must document the computation on the statement of facts, the SAR 7 or the Journal Detail page. This must include:

  • What method of transportation is being used,
  • How many days the transportation is needed per month,
  • The number of miles traveled, and
  • To what doctor, clinic, etc.

If the recipient uses their own car, a rate of $0.12 per mile can be allowed.

Special Telephone Service or Equipment

When the recipient incurs a cost of special telephone service or equipment such as the cost of an amplifying device when a member of the household has an auditory impairment.

CalSAWS Entries for Recurring Special Needs

Recurring special needs are entered in the Recurring Special Needs Detail page in  CalSAWS. Here is an exampleexample of entries for a Therapeutic Diet (Diabetic 2200 calories or more):

The recurring special needs will be issued along with the grant. [Refer to "How to enter Recurring Special Needs Detail" in CalSAWS Help.

Related Topics

Special Needs Overview

Nonrecurring Special Needs