Child/Medical Support Overview

As a condition of eligibility for both Medi-Cal and CalWORKs, applicants and recipients are required to cooperate with Child and Medical Support requests. Referrals must be made for children under the age of 18 who have an absent parent who may be responsible for providing medical and/or financial support.

Exception: Referrals are not to be made for undocumented children or households in which the children are not receiving aid.

Definitions

EAS 43-105 CCR 50060.6, 50101, 50157

Child Support

The monetary or financial liability or payments established under court order to meet the basic needs of a child.

Child Support Referral

A referral to the DCSS is electronically sent when CalSAWS interfaces with the DCSS’s automated system, CCSAS. The interface from CalSAWS to CCSAS is triggered when the CalSAWS Absent Parents page is completed.

Medical Support

Any responsibility, liability, or payments established under court order to meet the medical needs of a child. Most commonly, it means responsibility to obtain other health coverage or additional health insurance for dependents, if it is available through an absent parent's employer. It also includes specific dollar amounts for medical purposes and payments received from a third party (for example, Blue Cross) specifically for a child's medical care.

Paternity

Refers to the legal determination of parentage. It may be established because a child was conceived within a marriage, or the father signed a voluntary declaration of paternity, or a court order was established.

Spousal Support

The monetary or financial liability or payments established under court order to meet the needs of a former wife or husband. Its orders are usually established during divorce proceedings.

Program Requirements

The informing requirements, forms completion, referral procedures and good cause determinations are the same when enforcing medical support (for Medi-Cal Only) and child support (in CalWORKs and FC). However, major differences occur in two areas when comparing medical and child support activities in determining:

Which persons are exempt from referral, and
What happens when a person does not cooperate in support activities.

Note: Where differences in child support and medical support enforcement occur, “CalWORKs” and “Medi-Cal Only” will be noted. Where there are no notations, the information applies to both CalWORKs and Medi-Cal applicants/recipients.

A CalWORKs cash recipient must cooperate both in turning in any direct child support received AND in providing information about other health coverage available from the absent parent. Medical support requirements apply to Medi-Cal applicants/recipients. Child support collection of financial support is NOT mandated for Medi-Cal Only cases; these services are available, if requested.

Both child support and medical support requirements apply to all CalWORKs applicants/recipients and to FC. Refer to Foster Care Handbook Chapter 9 Child/Medical Support Referrals for additional information about FC.

Example 1 Example 1 A Medi-Cal-Only recipient requests that all child support payments go through the State Disbursement Unit (SDU) of the California Department of Child Support Services (DCSS). A referral is made to DCSS for medical support and to enforce child support activities at RECIPIENT’S REQUEST.

Example 2 Example 2 A Medi-Cal Only recipient receives $200/month in direct child support. She is not required to turn in the child support, but she is required to give information about any health coverage provided by the absent parent and to report the $200/month to her EW as income.