Notices of Action

LTC MC NOAs

When issuing a NOA to a client in LTC, the EW must:

Mail the original NOA to the LTC individual at the nursing facility.
Mail a copy of the NOA to the individual’s representative if another person is acting on his/her behalf.
Mail a copy of the NOA to the administrator of the facility if requested by the family or responsible party.

NOAs and ARs for Competent Clients

A client may designate another person or organization to act as his/her AR. The AR is not automatically entitled to receive a copy of all NOAs. ARs are entitled to receive only the notices which the client specifically requests to be sent to the AR.

Exception: When there is a hearing request, the county is required to provide copies to the AR of all NOAs or other correspondence that the county has sent to a client regarding that hearing request or hearing issue if the county has received notification from the client that the AR is authorized to represent him/her.

Benefits Identification Card (BIC)

The BIC may be mailed to the following:

Community Spouse if he/she is acting as AR.
AR when the client is comatose, amnesiac, or incompetent.

Note: MEDS screen BIC-ID CROSS REFERENCE REPORT [INXB] shows the full BIC card number.

California Residency

Individuals who are in long term care may not have documents to verify their California residency (such as a mortgage or rent receipt, a current California DMV license, etc.). Receipt of public assistance can be used as verification in these cases. Public assistance includes any government benefits or pensions from federal, state, county, or city sources. Receipt of Social Security at a California address can also be used to satisfy the residency verification requirement.

Note: Many individuals have direct deposit of their Social Security and pension checks. Therefore, if the check is a direct deposit, and the client’s name and address is on the bank statement, the residency verification requirement is met.

Eligibility for Individuals in an Institution for Mental Disease (IMD)

If the disability...

Then...

Has not yet been determined,

Request a determination for disability.

If the individual is under age 21, then activate the individual on MEDS and use the appropriate aid code based on the linkage factor, until disability has been determined.
If the individual is age 21-65, then evaluate for aid code 53 until disability determination is received.

Has been approved,

Determine the share of cost. In determining the share of cost for these individuals, the EW must only allow a $35 maintenance need.

Place the individual in Aid Code 63.