Pregnancy Special Needs

General

[EAS 44-211.6, 80-301]

In addition to the basic CalWORKs grant, a Pregnancy Special Needs (PSN) payment is paid to an eligible pregnant person during any stage of their pregnancy. The PSN payment is $100 per month and does not get prorated. Send the client the appropriate Notices of Action (NOAs) when the PSN is approved and when it is discontinued.

Important: Remind the pregnant person that if the pregnancy should end prior to the estimated delivery date, not resulting in the birth of a child, it is a required mid-period reporting responsibility to report either verbally or in writing, within 30 days following the end of the pregnancy. Refer to Mandatory Mid-Period Reports.

If a recipient does not report the pregnancy but only reports the birth of the child, there is no eligibility for the PSN. It is the recipient's responsibility to report all changes, including pregnancy.

Medical Verification

To receive the PSN payment, medical verification of pregnancy must be provided. Acceptable verification is a written statement that provides information sufficient to substantiate the diagnosis of pregnancy and provides the estimated due date (also known as the EDC) from a:

Physician,
Physician's assistant,
State-certified nurse midwife,
Nurse practitioner, or
Designated medical or clinic personnel with access to the patient's medical record.

Sworn Statement/Verbal Attestation

Effective July 1, 2021, per ACL 21-140, all pregnant applicants and recipients who cannot provide medical verification of pregnancy shall be allowed to submit a sworn statement, signed under penalty of perjury, to verify the pregnancy for the PSN payment to be authorized. Acceptable sworn statements shall include the following:

Applicant’s name,
Date of application and
Declaration of pregnancy.

When a pregnant person is unable to provide a sworn statement, a verbal attestation, along with the signed Statement of Facts (SOF), shall be accepted. The eligibility conditions under which the pregnant person verbally attests must be documented in the CalSAWS Journal Detail page.

30 Working Day Follow-Up

Pregnant persons who provided a sworn statement/verbal attestation are required to provide medical verification of pregnancy within 30 working days following the submittal of the sworn statement/verbal attestation for the PSN payment to continue.

Important: Do not include weekends and holidays when calculating the 30 working days.

Example Example An applicant provides a sworn statement declaring pregnancy on 12/12/2023. The medical verification of pregnancy is due on 1/26/2024, due to weekends and the following approved holidays: 12/25/2023 (Christmas Day), 1/1/2024 (New Year’s Day), and 1/15/2024 (Martin Luther King Jr. Day).

If the pregnant person fails to submit medical verification of pregnancy within 30 working days, the PSN payment shall continue only when the pregnant person presents evidence of good-faith efforts to comply with this requirement. If there is no evidence of good-faith efforts to comply, the PSN payment shall discontinue at the end of the month of the 30 working day period with a timely and adequate NOA. If benefits continue beyond the end of the month of the 30 working day period, an overpayment must be established for any subsequent aided months the pregnant person failed to comply.

The PSN payment must resume upon receipt of medical verification of pregnancy, effective the month in which the verification was provided.

PSN for Applicants

[EAS 44-211.6, 88-410]

For pregnant applicants, including Pregnant Person Only (PPO) applicants, the PSN is granted from the date of application through the end of the payment period in which the child is expected to be born. If the birth of the child is voluntarily reported mid-period, the PSN payment must be discontinued at the end of the month prior to the month in which the newborn is added to the Assistance Unit (AU), once required verification has been provided. Refer to Pregnant Person Only for more information on PPOs.

Example Example A CalWORKs applicant submitted their application on September 27th and reported they are pregnant. They provided pregnancy verification to the EW on October 2nd. The PSN payment must be issued starting from September 27th.

Pregnant Teen

A pregnant teen parent with no other children (PPO) is eligible for the PSN payment if the unborn has a basis for deprivation.

The pregnant teen is claimed as eligible during the pregnancy, and is paid the Federal PSN for the entire length of the pregnancy.

PSN for Recipients

Semi-Annual Reporting (SAR) Cases

For SAR cases, the PSN payment is granted from the month of the request through the end of the semi-annual period in which the child is expected to be born. If the birth of the child is voluntarily reported mid-period, the PSN payment must be discontinued at the end of the month prior to the month in which the newborn is added to the AU, once required verification has been provided.

Example 1 Example 1 A recipient reported and provided pregnancy verification to the EW on April 10th. In this situation, the EW does not need to wait until the first day of the following month to increase cash aid if the recipient is determined to be eligible for PSN. A supplemental payment for the PSN must be issued for April and the remaining months in the payment period, or until the birth of the child has been voluntarily reported and the newborn has been added to the AU, whichever occurs first.

Example 2 Example 2 A recipient reports the pregnancy on the July SAR 7 received in August. The EW requests the pregnancy verification. The verification cannot be provided. The recipient is able to provide a sworn statement regarding the pregnancy on August 30th. The Request for Verification (CW 2200) is sent to the recipient requesting acceptable verification. The recipient is given 30 working days to provide the verification. The recipient’s PSN begins on the date the sworn statement is received.

Example 3 Example 3 A recipient notifies the EW on the July SAR 7, received August 11th, of the pregnancy, and the baby is due in September. The EW sends the CW 2200 requesting verification of pregnancy, which is received on August 25th. The recipient is eligible for the PSN from August.

Note: Currently, if there is no Pregnancy End Date in CalSAWS, then the Expected Delivery Date plus one month will be used for evaluation purposes. The program will result in an incorrect mid-period negative action. Until SCR CA-243360 is implemented, EWs must take the alternate steps provided in System Announcement 404: Update CW EDBC for Pregnant Person Only (PPO) When Pregnancy Ends Mid-Period to extend the Pregnancy Due Date to the reporting month.

Annual Reporting/Child Only (AR/CO) Cases

For AR/CO cases, the PSN payment is granted from the month of the request through the duration of the pregnancy. The birth of a child is a mandatory report and must be reported within 10 days. The PSN payment must be discontinued at the end of the month prior to the month in which the newborn is added to the AU, once required verification has been provided.

Caretaker of SSI/SSP Child, Foster Care Child, or Kin-GAP Child

If a caretaker relative of an SSI/SSP child, a Foster Care child, or a Kin-GAP child receives CalWORKs and becomes pregnant, that caretaker relative is eligible to receive the PSN, if otherwise eligible, effective the first of the month in which the request for the PSN was received through the month in which the birth is anticipated.

Example Example A needy caretaker is receiving CalWORKs, and the needy eligible child receives SSI/SSP. The caretaker becomes pregnant. The pregnancy is reported, and verification is provided on October 27th, which states the baby is due on March 11th. The EW approves the PSN beginning October 1st.