100% Program

Who is Eligible

The 100% Program provides no SOC MC benefits to otherwise eligible children who meet the following criteria:

Have reached age 6, and
Whose family income is over the Maintenance Need but below 100% of the FPL. For this program, an individual under age 19 is a considered a child.

Exception: A fourteen to nineteen year old who does not live with a parent or caretaker relative and is defined as an adult is considered a child for this program and is eligible for the 100% Program. If he/she is the only family member, his/her income is compared to the 100% of FPL amount for one.

Period of Eligibility

Eligibility can begin no earlier than age 6. Eligibility continues, depending on family income, until the end of the month in which the child reaches age 19.

Note: If an individual in the 100% Program becomes pregnant and has no increases in income, the income disregard (200%), program does not apply, because the 100% program provides full scope benefits including pregnancy related and postpartum benefits with no share of cost.

Exception: Eligibility for the 100% Program can be continued after age 18 if the child is receiving inpatient services for a continuous period which begins before and continues beyond his/her 18th birthday.

Aid Codes

The following aid codes are granted for children eligible under the 100% Program:

Aid Code	Description
7A	Citizen, permanent resident, PRUCOL, or conditional resident. (Full Scope)
7C	Undocumented or temporary visa. Restricted to emergency care and pregnancy services.

Eligibility Determination

CalSAWS will determine eligibility for all FPL Programs however if a manual determination is required for the 100% Program follow the steps below:

100% Program Manual Eligibility Determination

The 100/133/200% Programs Worksheet, MC 175-5 may be completed if the MFBU includes a Sneede class member, when a case has both:

A SOC, and
A child age 6 through 18.

Include all family members in the MFBU (eligible and ineligible individuals) when determining the Maintenance Need and Poverty Level. (Do not count excluded individuals or PA recipients.)
Allow only AFDC-MN/MI deductions when computing the net nonexempt family income for the 100% Program.

Exceptions: Health insurance premiums are not an allowable deduction. Also, if the MFBU includes an ABD-MN individual, complete an MC 176-M using only AFDC-MN/MI deductions for the 100% Program.

Repeat these steps if income changes and/or new information is received which affects the SOC or children eligible.

Approvals & Denials

Use this chart to determine the appropriate Approval/Denial actions. These rules apply both to new applications and continuing cases.

IF net nonexempt income of the MFBU is:	THEN:...
At or below Maintenance Need	Approve under the regular AFDC-MN/MI program. (May qualify for Property Waiver)
Between Maintenance need and 100% of FPL	Approve eligible child(ren) under the 100% Program.
Over 100% of FPL	Record 100% Program denial. Delete the denial NOA. Evaluate for AFDC-MN/MI with a SOC.

MFBU Requirements

A 100% eligible child will receive eligibility under the 100% Program, either full-scope or restricted to emergency care.
Include 100% eligible children in the Maintenance Need with other eligible AFDC-MN/MI family members.
When discontinuing a child from the 100% FPL program because he/she has turned age 19, evaluate for AFDC/MN-MI.

Note: CEC rules apply if the child would have a SOC

Note: The COLA increase in Social Security benefits which is received in January is to be disregarded for all federal poverty level programs (including Income Disregard, 100%, 133%, TLICP and Property Waiver programs) from January through March, if applying the increase will make the individual ineligible for those programs.

Notice of Action Requirements

Approval of Benefits

An approval notice for the 100% Program must be issued when establishing eligibility for that program.

Discontinuance of 100% Benefits Only

An adequate and timely 10-day notice of action is required when discontinuing individuals from the 100% Program due to either of the following reasons:

Increased income.
A child reaches age 19. (Determine eligibility for AFDC-MN/MI programs.)