CalFresh Application for MC

Overview

CF clients who wish to apply for MC may do so at any time. Timely action must be taken on ANY verbal, electronic or written request for MC from a CF client on an active CF case. This applies to both Intake and Continuing cases. The date of application for MC is the date the county is first notified by the CF client that MC benefits are being requested, or the date the written application is received. An approval or denial NOA must be sent.

Note: If a verbal request is made, the EW must clearly document in the Journal Entry.

The following forms may be used to determine MC eligibility:

“Good News for California Families!” (SCD 90), or
“Application for CalFresh Benefits” (CF 285), or
“Recertification for CalFresh Benefits” (CF 37).

Note: If a request for MC is received from someone who already has MC benefits, a NOA is not required; however, the EW must contact the client (by phone or in writing) and explain their eligibility status.

“Good News for California Families!” Requirements

California Welfare & Institution Code Sections 10618.5 (AB 59) and 18925 (SB 493) require counties to provide an informing notice/application for NACF clients who are not receiving MC. This requirement is intended to expedite MC enrollment for parents and their children as well as other adult CF clients.

The form “Good News for California Families!” (SCD 90) is both a MC informing notice and an application for MC. It may be used for CF clients who are not currently enrolled in MC.

Application Process

Initial Intake Applications

Intake EWs are required to explore eligibility for all programs requested and all benefits for which the applicant may qualify. If an applicant requests CF benefits, but not MC, the EW must determine if there is potential eligibility for MC for anyone in the household (linkage, income, etc.).

If...	Then the Intake EW...
The client is requesting MC and CF at the same time,	Provides the CF 285 to the client.
CF benefits are active and the client requests MC while the case is still in Intake,	Uses the information on the CF 285 for the MC application, if it is less than 12 months old and it contains sufficient information. Documents that the client is requesting MC and the information from the CF 285 is being used to determine eligibility. Has the client complete any other required MC form, and issue all mandated informing forms and NOAs.
The client is NOT interested in applying,	Asks the client to complete an SCD 166. Document the reason for refusal.

Continuing (Recertification)

As part of the CF Recertification (RC) process, EWs are to check to see if all members of the CF household are receiving MC coverage and explore eligibility for MC as follows:

Check MEDS to determine if they are already receiving MC benefits.
If any household members are NOT receiving MC and there is linkage (a child in the home, disabled adult, etc.), mail the SCD 90 to the client with the CF RC packet.

Processing the SCD 90

The MC date of application is the date the signed SCD 90 is received (date stamped).
A completed and signed SCD 90 is processed as a mail-in application, unless the applicant prefers to have a face-to-face interview.

Note: If a signed SCD 90 is received from an individual already on MC, a NOA is not required; however, the EW must contact the client (by phone or in writing) to explain their eligibility status and document the actions taken in the Search Case Comments window.

CalFresh Forms used for MC

CF clients are NOT required to complete a separate or additional MC application form when requesting MC benefits. The CF 285 or CF 37 may be used to determine MC eligibility for CF clients.

The CF 285 or CF 37 on file may be used instead of the SSApp as an application for MC if:

It is received within 12 months, and
It contains sufficient information to make a MC only determination.

The chart below explains which application form to use in various circumstances.

If...	Then...
A CF client applies for MC,	The CF 285 may be used for the MC eligibility determination if it is less than 12 months old and it contains sufficient information.
The CF 285/CF 37 does not contain sufficient information and/or verifications to determine eligibility for MC,	Additional information/verifications must be requested from the client by phone or if the client cannot be reached, send an SCD 50 (i.e. tax filing information).
The CF client's most recent CF 285/CF 37 is over 12 months old,	Current information/verification must be requested from the client by phone or if the client cannot be reached, send the SSApp.
A client is applying for CF and MC at the same time,	The CF 285 can be used for both CF and MC.
An applicant is approved for or active on CF, then later requests MC while the case is still with the Intake EW,	The CF 285/CF 37 must be used for MC, as the applicant is a CF client.
CF/MC client requests retroactive MC,	An MC 210 A must be completed.
A CF only client requests retroactive MC,	An SSApp must be completed if a current CF 285 is not on file. An MC 210 A must also be completed.

Misaligned Redetermination Dates

The MC RD due date is NOT based on the CF 285 application date. DO NOT SHORTEN THE MC RD 12-MONTH PERIOD.

The CF 285/CF 37 may be used to determine MC eligibility if the application is within 12 months, if there is a Change in Circumstance (CIC). Refer to Change in Circumstance During TMC Period. The MC RD date must be 12 months from the date MC eligibility is reestablished. DO NOT SHORTEN THE MC RD DUE DATE.

Reminder: Forms are no longer required from the client to complete the annual MC RD. The client can provide the information verbally, which is entered into CalSAWS and sent to the Federal Hub for e-verification. The client must provide paper verification of information not e-verified. Clients who are evaluated for Non-MAGI MC must provide paper verifications of income and property.

MC Eligibility Determination

Since CF regulations differ from MC, the CF 285 or CF 37 may not have all of the information needed to determine MC eligibility.

Citizenship/Immigration Status

Excluded members of the CF household (i.e., undocumented individuals) may qualify for MC if other eligibility requirements are met. Excluded household members must be evaluated individually based on their current citizenship/immigration status. Refer to Citizenship/Immigration Status and Refer to Noncitizen Categories for immigration status and program eligibility.

Property for Non-MAGI MC

Property paper verification must be received.

Tax Filing Information

Tax filing information is not required for CF, but it is required to accurately determine MAGI MC.

Informing Notices and Other Required Forms

When a CF client requests MC benefits, a complete MC Intake Packet is not required; however, the MC Intake Informational packet must be given to the client. Refer to MC Intake Informational Packet. Also refer to Supplemental Forms for a list of other required or supplemental forms.

CalFresh Ineligibility/Discontinuance

The reasons for CF ineligibility or discontinuance do not always apply to MC ineligibility or discontinuance. Follow the chart below to determine what action(s) are necessary:

If the reason for the CF ineligibility/discontinuance...	Then the EW must...
Is for failure to provide a SAR 7,	Continue MC benefits and assume that no change has occurred for MC unless one is reported.
May or may not affect MC eligibility, Example: CF is discontinued due to incomplete SAR 7.	Determine if any of the changes reported on the SAR 7 affect MC eligibility and take appropriate action. Additional information may be requested by using the “Medi-Cal Request for Information” (MC 355) and follow Ex Parte time frames.
Does not affect MC eligibility, Example: Failure to comply with work requirement.	Continue MC benefits.
Affects MC eligibility, Example: Move out of state or death of an individual.	Discontinue MC for the affected individual(s) only.

Required Documentation

EWs must clearly document ALL of the following in the case record:

The current CF 285/CF 37 in the case record was used to complete the eligibility determination.
All required information used to determine MC eligibility is on file (i.e., MFBU composition, linkage, OHC, income, property, etc.)
The date MC eligibility is established and the MC RD due date.