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Discontinuance for Whereabouts Unknown
When mail is returned as undeliverable without a forwarding address provided, or USPS has provided an out-of-state address, Eligibility Workers (EWs) must take the following steps:
- Document in case comments that the mail was returned as undeliverable, the date the mail was sent, the date it was returned as undeliverable, the form, letter, or notice mailed to the client that was returned, and what address was used.
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Note: The mail that was returned as undeliverable, including both the envelope and its contents, must be in Case Imaging.
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- Complete an ex parte review. This includes the client’s case, electronic databases or verification services (i.e. MEDS), and CalWORKs (CW) and CalFresh (CF) cases of the client’s immediate family members which are open or were closed within the last 90 days.
- If the information is not located via ex parte review, mail an MC 355 requesting only the current address and any other information that is necessary to redetermine eligibility and allow 30 days for the client to respond. The MC 355 must be sent to the client’s last known address.
- If the MC 355 is returned undeliverable or not returned by the client mail a timely discontinuance Notice of Action (NOA) to the last know address.
Notice of Action
If an MC 355 is returned as undeliverable, the EW must discontinue with a NOA that includes the 90-day cure period language. The discontinuance NOA must list the missing information that is needed to determine eligibility, including that the address is not current. The NOA is not required to be mailed at least 10 days before the date of discontinuance. The EW must also document actions in Journal Detail Page in CalSAWS.
If an MC 355 is not returned and the missing information is not provided within 30 days, the EW must discontinue with a timely 10-day NOA that lists the missing information that is needed to determine eligibility and includes 90-day cure period language. The EW must also document actions in the case Journal in CalSAWS.
If the only missing information to determine ongoing eligibility is the address, MC must be discontinued for Whereabouts Unknown. If the Whereabouts Unknown NOA does not have 90 day cure period language, it must be added:
“You have 90 days from the date you are discontinued to provide the needed information. If we do not get the information by [discontinuance date plus 90 days], you must reapply for Medi-Cal. If you return or otherwise provide the information requested above before [discontinuance date plus 90 days], and the information establishes continued eligibility, your eligibility will go back to the date you were discontinued as though you returned the form or otherwise provided the needed information timely.
Welfare & Institutions Code, Section 14005.37(i).”
If any other information besides the address is needed to determine ongoing eligibility, discontinue for the appropriate reason (based on the other missing information) and send the appropriate NOA. The NOA must specifically list the address as information that was requested and not returned timely, in addition to any other missing information.
If a client provides updated address information and all other information that was requested within 90 days of the discontinuance date, EWs must immediately redetermine eligibility. If the client is found MC eligible, the discontinuance must be rescinded as if the information was submitted in a timely manner.
Related Topics
Denial or Discontinuance Due to Lack of Information, Non-cooperation, or Loss of Contact