Residential Care Homes

Residential Care Homes (RCH) are facilities that are licensed by the State’s Community Care Licensing Division (CCLD). These RCH facilities provide room, board, care and supervision to individuals who are living there due to drug addiction, physical disability, mental/emotional illness and/or developmental disability. A current list of providers/facilities can be viewed on the "GA and CF Facilities" list under reference materials.

Note: A copy of the facility license is required for each case. Refer to the "Required Forms" section below.

Momentum for Health is the main provider of Residential Care in Santa Clara County with over 15 residential, outpatient, and housing sites. Headquarters are located at 1922 The Alameda, San Jose, CA. Current programs under Momentum for Health can be found through the 'Services' section of their website: https://momentumforhealth.org/services/.

Important: Clients can call (408) 260-4040 to access services at Momentum or they can call 988 if they are experiencing a mental health emergency.

Application Process

An applicant who is a resident in the RCH facility, or their duly appointed representative, is required to complete the application process following the normal intake procedures unless specifically modified below. There are no specialized RCH Eligibility Workers (EW).

Note: If the applicant is serving a sanction and was hospitalized or was a resident in a Mental Rehabilitation facility, at the time of the noncooperation with Vocational Services (VS), the sanction will be rescinded. The rescission MUST be cleared through VS.

Important: All applicants/recipients who are in an authorized facility will be required to apply for Supplemental Security Income (SSI). Staff at the facility will help the applicant/recipient with the different steps in the process. Applicants are also required to apply for any other benefit to which they may be entitled to receive (e.g. RSDI, etc.). A denial letter is required as verification that the applicant has applied for all benefits that he or she may be eligible for.

Confidentiality

The Authorization to Release Information (SCD 1029 or CSF 13), must be signed by the client BEFORE information can be released to the RCH. If the signed authorization is not on file; the case CANNOT be discussed with the facility operator.

Note: The signed authorization form is valid for 12 months from the date it is signed by the client or until revoked by the client, which ever comes first. A new authorization form must be signed during the annual reinvestigation.

Convicted Drug Felons in RCH

Convicted Drug Felons in RCH facilities ARE potentially eligible for GA provided that they are NOT fleeing to avoid prosecution, or custody and confinement after conviction.

Reminder: Fleeing Felons are NOT eligible for GA.

Eligibility for Other Programs

Medi-Cal

Residents of RCHs are not automatically eligible for Medi-Cal. However, it is the EW's responsibility to explore the client’s eligibility for Medi-Cal.

CalFresh

Residents of RCHs are NOT eligible for, or entitled to receive CalFresh.

Employability

A good cause determination is not necessary if an applicant quit a job within 30 days of the application due to medical, mental or emotional problems. Good cause exists and written verification is not required.

GA regulations require that any applicant/recipient who is unable to work must provide a Request for Medical Information (SCD 1400) form from his/her doctor to verify both the inability to work AND the expected duration of disability. IN ADDITION, if the applicant/recipient resides in an RCH, the doctor MUST state in the SCD 1400 the need for care and supervision in an RCH.

Exception: Applicants/recipients under supervision of the Public Guardian/Administrator’s (PG/A) office are eligible for the RCH rate if the PG/A has determined the applicant/recipient requires the care and supervision of an RCH. This MUST be documented in a CalSAWS Journal Entry. Public Guardian cases are NOT referred to VS.

Identification

A cover letter from the Mental Rehabilitation program is acceptable evidence of a client's identity. This cover letter MUST include height, weight, hair color, eye color, Social Security number and date of birth. A copy of the applicant's Social Security card or completed Social Security Administration Referral Notice (MC 194) form is required.

Income

Income received in the month of application is considered available and must be used in computing the amount of the client’s GA benefits. Staff at the facility will provide SSA with a written statement if it is believed that there is no income (as stated by the applicant). If there is no evidence to the contrary, that statement will be acceptable.

If the exact amount of income cannot be verified, and it has been requested by the staff at the mental rehabilitation facility, then a “very high” estimate can be used for the initial determination of eligibility.

Note: The EW must use prudent judgment when calculating the estimated income.

Reminder: ALL applicants/recipients residing in an RCH MUST apply for SSI. If there is not an SSI application pending, the applicant/recipient is NOT entitled to the RCH payment level.

Income Reports

Income reports are to be completed by each resident of an RCH facility. If income reports are completed (either partially or totally) by a staff person at the facility; BOTH the staff person and the client MUST sign the income report. Refer to SAR 7 chapter.

Need Standards

The MAXIMUM GA amount for a State-licensed RCH is the standard amount listed in the Chart Book. Of this amount, the majority is allocated for the care and supervision of the recipient and a standard amount is issued to the recipient to meet the his/her personal needs.

If the recipient is in the RCH for LESS than one full month, BOTH the personal needs and the care and supervision amounts are prorated based on the actual number of nights the recipient stayed in the RCH.

If the provisions regarding residence, income and employability are not met, the RCH GA need standard does NOT apply. Instead, a room and board budget is calculated based on the appropriate shared housing level for the total number of other persons who share housing with the client. [Refer to "Needs Standards" in the GA chapter of the Chart Book].

Property

Personal Property

If the applicant has net personal property which exceeds the $500 limit, he/she must be responsible for payment to the RCH facility. Verification indicating that payment has been made to the RCH facility, and that applicant’s property is within the necessary limits is required.

Note: If the applicant pays his/her own bill, then the GA payment starts, the day after the time period covered by the applicant's payment (provided the applicant is otherwise eligible). The date on the Application for General Assistance (GA 1) form is the application date.

Real Property

Same requirements apply. Refer to Property chapter.

Residence

The Housing Verification-Specialized Programs (GA 2A) form is used to verify the applicant/recipient’s residence/stay in a RCH facility. The GA 2A must be completed and signed by the facility and submitted with a copy of the facility’s current and valid State license each time the client changes RCH facilities and at each RRR. The receipt of the GA 2A and facility’s State license (including the license number) must be documented in a CalSAWS Journal Entry and must be scanned to Imaging.

Recipients must notify the EW of their change in residence within 10 business days.

Applicants who are currently residing in an authorized facility are considered to be residents of Santa Clara County UNLESS, prior to their admission, they resided in another county, and the SOLE reason for their presence in Santa Clara County is for participation in that program. If the applicant/recipient was hospitalized prior to his/her admission to the facility, and if prior to his/her hospitalization his/her residence was in another county, he/she is NOT considered to be a resident of Santa Clara County.

Note: The applicant's statement regarding the above, in conjunction with his/her presence in the facility, will be acceptable evidence of Santa Clara County residence.

Note: If necessary, the EW may contact the State Community Care Licensing Division at (408) 324-2112 to verify the status/validity of the license.

Reminder: If the license cannot be verified, the client is not entitled to the RCH payment level.

Required Forms

The EW will ensure that the facility has the most current versions of all the required county forms.

Reminder: The EW must complete and provide the Notification to Facility Operator (GA 18 A) form to the RCH at the initial eligibility determination, and each time the client changes RCH facilities. This will be accompanied by the General Assistance Mandatory Billing (GA 18) form.

Important: All forms below are required even if there is an existing GA case.

Must be submitted by the RCH prior to the GA appointment date:

May be submitted by the RCH after the GA appointment date (but by the due date given), if necessary:

SCD 1400SCD 1400 General Assistance Program - Request for Medical Information
- Important: Must indicate that care and supervision in a State-Licensed Residential Care Home or Board and Care Facility is required.
SCD 169SCD 169 Referral to Social Security
- Note: Other proof of SSI application is also acceptable.

Must be submitted by the RCH by the 5th of the month after the last day of the calendar month for which the bill is submitted, or immediately (indicating a final bill) if the client leaves the facility before the end of the month:

GA 18GA 18 General Assistance Mandatory Billing Form
- Instructions for completing the GA 18 are on the Notification to Facility Operator (GA 18 A) form. Refer to RCH Payments in the GA Business Process handbook for more information.