Residential Care Homes

RCH are facilities that are licensed by the State’s 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 the individual is developmentally disabled.

Unless specifically modified below, all standard General Assistance (GA) intake procedures and eligibility criteria apply to an applicant, or to a resident, of the RCH facility.

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

Momentum for Health is the main provider of Residential Care in Santa Clara County.

[Refer to "GA and CF Facilities" under reference materials].

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.

Note: Fleeing Felons are NOT eligible for GA.

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. There are no specialized RCH Eligibility Workers (EW), for an applicant or a resident in an RCH facility.

Medi-Cal/CalFresh Eligibility

Medi-Cal

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

CalFresh

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

Confidentiality

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

Note: The CSF 13 and SCD 1029 are valid for 12 months from the date they are signed by the client or until revoked by the client, which ever comes first. A new CSF 13 or SCD 1029 must be signed at each RRR

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.

Note: 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

All GA recipients are required to submit a “Semi-Annual Eligibility/Status Report” (SAR 7) in the Submit Month. If a staff person assists the client in the completion of the SAR 7, BOTH the recipient and the staff person MUST sign the form.

Employability

GA regulations require that any applicant/recipient who is unable to work must provide a “Request for Medical Information” (SCD 1400) 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.

Residence

The “Housing Verification-Specialized Programs” (GA 2A) 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.

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.

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].

Required Forms

Form	Additional Information
CSF 13 or SCD 1029	“Authorization to Release Information” (CSF 13) or DEBS Library “Authorization to Release Information (SCD 1029) Must be completed and signed in order to release any information to the RCH.
GA 2A	“Housing Verification - Specialized Programs” (GA 2A) this form is to: Verify address and type of facility the tenant is living in. Request a current State license. Be completed each time the client changes RCH facilities and at each RRR. Record the RCH Facility in CalSAWS.
GA 18	“General Assistance Mandatory Billing Form” (GA 18) Is the only acceptable method of billing the GA Program. 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. Must be completed with any relevant information in the “County Use Only”section and must returned to the facility as a receipt of payment.
GA 18A	“Notification to Facility Operator” (GA 18A) is an introduction letter with vital information and instructions, and it’s to be: Completed and provided to the facility at the initial RCH eligibility determination, and at each time the client changes RCH facilities. Provided to the facility with GA 18 and “RCH Prorated Chart” (GA 18B).
GA 18B	“RCH Prorated Chart” (GA 18B). It is a tool for the RCH facility to calculate a partial month payment. It must be provided to the facility with a GA 18A.
SCD 169	“Referral To/From Social Security” (SCD 169) Must be provided to all applicants/recipients residing in an RCH Must be completed by Social Security Administration as a verification of a filed application for SSI. NOTE: The SCD 169 must indicate that the client has applied for SSI. Verification of SSI application can also be obtained from the SDX3 window in MEDS.
SCD 1400	“General Assistance Program - Request for Medical Information” Must be completed by the applicant/recipient medical/mental health provider indicating that care and supervision in a State-Licensed Residential Care Home or Board and Care Facility is required. NOTE: The client is not entitled to RCH payment level if the SCD 1400 does not indicate the requirement for care and supervision in a state-licensed facility

NOTE: All forms are required and must be scanned to Imaging.

EW Responsibilities

The EW is responsible for informing both the client and RCH facility operator of the specific requirements for residents of the RCH and informing the RCH facility operator of the procedures for submitting the “General Assistance Mandatory Billing Form” (GA 18). Instructions are on the reverse side of the form.