Courtesy Applications

Courtesy Applications

The following steps must be followed when the applicant who resides in another county applies for aid in our county, or when the applicant is requesting aid on behalf of a relative or friend who resides in a county outside of Santa Clara.

1. Provide and obtain standard paperwork (Application, SCD 41 and the appropriate application packet), as if the client were applying for aid in Santa Clara County.
2. Handwrite “Courtesy Application” on the top right-hand corner of the application.
3. Schedule a regular appointment for the client with an Eligibility Worker:
   1. If the client is applying for Medi-Cal only, then...
      1. place the application in the designated inbox for Application Registration.

      2. Note: The initial county must determine Medi-Cal eligibility, issue benefits, then initiate ICT to the client’s county of residence as appropriate.

   2. If the client is applying for other assistance program (CalWORKs, CalFresh, etc.), then...
      1. do not complete Application Registration or enter any information into CalSAWS. 

      2. Note: The assigned worker forwards the complete set of paperwork to the county of residence.

Medi-Cal Courtesy Applications

If an applicant requesting a courtesy application is applying for Medi-Cal, the following must occur:

• The Application/Registration process must be initiated by Clerical in CalSAWS.
• The Medi-Cal application must be assigned with an EW who will follow normal eligibility procedures. Medi-Cal eligibility must be determined, benefits issued and an ICT initiated to the county where the client/applicant resides.