Client Reports Other Changes

A full eligibility review is NOT required until the next annual redetermination (RD) based on the last RD date established by the Sending County. If a client reports changes, during the eICT process, a Change In Circumstances can be explored after the transfer is completed, this may result in resetting the RD due date by 12 months from the date of the CIC. Refer to Change in Circumstance. 

If a client reports a change (other than the change in county residence) which may affect eligibility and/or share of cost, the reported change may ONLY be acted upon AFTER the transfer of county responsibility is complete AND the client is already active in the Receiving County. To ensure a successful transfer between counties all information must be accepted as it is sent, then updated after the initial connection is completed to avoid eHIT errors.

ExampleExamplePhil Moore works at ButterCupz bakery in Alameda County. Phil requests an ICT to Santa Clara County. Before the ICT is complete Phil reports to the SSBS in Santa Clara County that he has started working at Scramblz and no longer works at ButterCupz. The Santa Clara SSBS must first input all case data in CalSAWS as it was sent from Alameda and then after authorizing the case, enter any changes and redetermine ongoing eligibility.

Some examples of a change in circumstances, in addition to the move, that would justify an eligibility review after the eICT is completed are:

  • Adding additional family member(s) that may result in income and/or property re-computation.
  • New family composition that could result in a change of aid category, ineligibility or reduced benefits.
  • New income information that could result in an increase in SOC.
  • New property information that could result in discontinuance.

Reminder: The client must be given the option to spend-down after the eICT is completed.

The chart below details the needed actions:

Actions for ICTs with Other Changes

If the Client Reports Other Changes to the...

And the Sending County...

Then the...

Sending County

Has not yet initiated the eICT to the Receiving County,

Sending County must process the change and document the reported change in the eICT file.

Sending County

Has already sent the eICT,

Sending County must contact and manually notify the Receiving County of the change.

Receiving County,

Has not initiated or is still in the process of initiating an eICT,

Receiving County must instruct the client to contact the Sending County of the other change(s) so that those changes can be documented by the Sending County.

Receiving County

Has already initiated the eICT,

Receiving County may only complete a Medi-Cal eligibility review AFTER the:

  • Transfer of county responsibility is completed, AND
  • Client’s Medi-Cal record is active in the Receiving County.

This means the Receiving County must activate the client’s Medi-Cal record on MEDS based on whatever eligibility status the client had from the Sending County (e.g., same Aid Code, etc.). THEREAFTER, the Receiving County may then evaluate the reported change(s).

The Receiving County must follow Ex Parte procedures and redetermine eligibility. If the ex parte is not sufficient, then contact the client by phone. If unsuccessful, send a “Request for Information” (MC 355). SB 87 time frames must be followed.

Note: If the client refuses to cooperate with the Receiving County’s request for information, through phone contact or MC 355, then the client’s MC benefits may be discontinued.

Related Topics

California Residency

Change in Circumstance