Pre-Release Application (AB720)

Incarceration does not prevent an individual from applying for and receiving MC. The Department of Health Care Services (DHCS) and the CDCR work together to determine potential MC eligibility for incarcerated individuals before their release date to allow for the individual to receive MC cover immediately upon release, if eligible.

Per AB720 the Santa Clara County Sheriff’s Department (SD) was appointed in Santa Clara County to act as an Authorized Representative for the purpose of completing the MC application. In certain situations applications for county inmates may be submitted by advocacy groups (i.e. Health Trust) to expedite eligibility for highly sensitive populations.

The CDCR and SD will assist inmates nearing their release date and complete and submit a MC application to the Social Services Agency (SSA) AB720@ssa.sccgov.org e-mail box. The county will accept pre-release applications, determine MC eligibility for the month of release, and notify CDCR of the eligibility outcome (no notification to SD is necessary for County Jail applicants).

CDCR and SD AB720 Application Process Responsibilities

The responsibilities of the CDCR and SD include:

Helping the inmate complete and submit the MC application and available verifications before the scheduled release date.
Provide timely notice to the County of any changes to the inmate’s parole date or residence and/or mailing address.
Ensure that pre-release applicants have the appropriate county contact information upon release.
Maintain a supply of the Single Streamline Application (SSApp) and other applicable forms.
Notifying the county of the applicant’s parole date and residence address by sending the designated Cover Letter and the Single Streamline Application (SSApp).

SSA AB720 Application Process Responsibilities

The responsibilities of SSA include:

Process all inmate applications, including add a person requests.
Receiving all inmate applications by email in the AB720@ssa.sccgov.org e-mail box, by fax or by mail.
Identifying the source of the application in CalSAWS when application registration is performed.
Suspending MC if the inmate is expected to be incarcerated beyond 28 days.
Entering the application date as the date the application is received from CDCR or SD, unless the release date is before the received date. If the inmate has been released before the date the application is received, the release date will be the application date.
Assisting inmates who are homeless upon release with no mailing address by using the General Assistance (GA) office address as their mailing address: 1919 Senter Rd. San Jose, CA 95112. Note: Mail initially needs to be picked up within 90 days, or will be returned. If client remains homeless, mail will need to be checked every 30 days.
In order to ensure the client receives their mail to their Santa Clara County address once they are released.
- Update the inmate’s residence address and
- Delete the AR’s mailing address.
Maintaining contact with CDCR and SD throughout the application process.
Sending the BIC and Notice of Action (NOA) to the prison address in care of the AR before the release date.

Note: It will take ten (10) business days for the BIC to be generated from MEDS and additional days to deliver to the mailing address. A paper BIC should be issued and sent to the AR if the inmate will be released prior to receiving the BIC. If time permits, MC Managed Care Enrollment Packet is sent to the inmate’s AR, who will ensure the inmate completes the health plan enrollment form.

Processing the application before the inmate’s release date:

If...	Then...
There is no active record for the inmate,	Process the Medi-Cal application.
The inmate will be added to the existing case,	The application will be forwarded to the appropriate district office to process as an add a person/add a program.
The inmate is currently active on a CalFresh, CalWORKS, or General Assistance case,	The application will be forwarded to the appropriate district office to process as an add a person/add a program. The continuing EW will follow up with CDCR or SD to determine how long the inmate was incarcerated to discontinue the inmate and generate Overpayments/Over Issuance as necessary.

Completing the Disability Determination Service Division (DDSD) procedures, when applicable.

Note: A DDSD referral for an inmate must be identified as an inmate request and include the date of release in the County worker comment(s) section of the “Disability Determination and Transmittal” (MC 221). If DDSD requires a medical exam and the disability determination cannot be made before the inmate’s release date, DDSD will return the packet. If the inmate is released within 30 days of the original DDSD referral the EW must resubmit the packet once the inmate is released.

MC 0025 form

The “Transmittal to CDCR Public Benefit Specialist on Determination of a Ward’s/Inmate’s Medi-Cal Eligibility” (MC 0025) form must be used to communicate with CDCR as follows:

Inform CDCR the application was received.
Request for additional information and/or verifications from CDCR following the current verification request time frames.
Notify CDCR of the inmate’s eligibility status 10 days before the release date.
Notify CDCR at least 10 days before release if the eligibility determination will not be completed before the inmate’s release date.
If there is a change to the inmate’s release date, a new MC 0025 describing the change must be sent to CDCR.

A completed MC 0025 should be sent to Imaging. The MC 0025 is not a Notice of Action. This form should not be given to the pre-release MC applicant. The MC 0025 must use the “Inmate CDCR Number” on the cover letter submitted with the MC application to identify the client.

AB720 Health Trust Application

Health Trust submits applications for the AB720 population that have Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS). These applications are URGENT because the individuals with HIV/AIDS must have MC coverage when they are released from jail to avoid a gap in coverage and necessary medication. The AB720 Pre-Release applications submitted for this population will include the “AB720 Health Trust” (SCD 2363 B) indicating that the application is URGENT. When clerical staff perform application registration for AB720 Health Trust applications the AB 720 Health Trust application type must be used.

Justice Appointed Coordinator (JAC)

When a Pre-release application is received for an individual with an expected release of “JAC,” the application must be processed as a priority, as the inmate has been granted a court-ordered release to substance abuse or mental health treatment services. Do not suspend MC or report incarceration data to MEDS. Medi-Cal must be activated in Santa Clara County, and MC suspensions must be released for the individual to obtain treatment services. These applications originate as MC referrals from Behavioral Health Treatment Court, also known as Department 61.

28-day Pre-Release Application Policy

When a pre-release application is received for an individual with an expected release less than 28 days from the date of application (DOA), the EW will approve the application, if otherwise eligible, and must not suspend or report the incarceration to MEDS. “Reference 28-day MC Suspension Policy”

For situations where a pre-release application is received for an individual expected to be incarcerated for more than 28 days, the EW will approve the application, if eligible, and then apply the MC suspension. Set a Manual Task [Refer to CATS Chewable Byte: How to Create Manual Task in CalSAWS] with the individual's scheduled release date for the follow-up to lift the MC suspension.

Example:Example:

An individual is incarcerated on 1/1/2022 with an expected release date of 3/1/2023 (14 months of incarceration). A pre-release application is submitted and approved for Medi-Cal. The EW should suspend the Medi-Cal benefits until the inmate is released. A Case Alert is set with the inmates release date. The continuing EW will review the case alert and lift the Medi-Cal suspension on the release date of 3/1/2023.

An individual is incarcerated on 1/1/2022 with an expected release date of 3/1/2023 (14 months of incarceration). A pre-release application is submitted and approved for Medi-Cal. Once MEDS shows active, the EW should suspend the Medi-Cal benefits until the inmate is released. A Manual Task is set with the inmates release date. The continuing EW will review the task and lift the Medi-Cal suspension on the release date of 3/1/2023.

Note: CDCR/SD Pre-Release applications should have a scheduled release date indicated on the cover letter. Receiving a pre-release application with no specified release date is not a common occurrence. If this occurs, process the application accordingly without applying the MC suspension.

AB720 Application Procedures

The following are the procedures to process AB720 Pre-Release applications for inmates:


Step	Who	Action
1.	CDCR/SD	Completes, signs and send the inmate's MC application with a cover letter to the AB720 e-mail box. The cover letter will contain information necessary to identify the inmate, release date, contact information and source of application.
2.	Clerical	Receives the MC application and Cover Letter from e-mail box daily: Performs File Clearance Note: Individuals who must be added to an ongoing case will be processed as an add a person/add a program by a continuing unit. Clerical will forward these applications to the appropriate district office for processing. Performs the Application Registration. The application date is the date the application is received unless the release date is before the received date. If the inmate has been released before the date the application is received, use the release date as the application date. Records inmate’s MC application on the AB720 application log in the S: Drive. Creates a Task for application assignment.
3.	Intake EW/ Continuing EW	Receives Application Task and evaluates application. If the inmate is active on a CF, CW or GA case, follows up with CDCR or SD to determine how long the inmate has been incarcerated. Discontinue the inmate and generate OP/OI as appropriate. If the release address is the same as an active family case, contacts the family to determine if the inmate should be added to the case upon their release. Informs CDCR the application for the inmate was received using MC 0025 (no notification to the SD is necessary for county jail inmates). If the inmate will be added to the existing case, processes the request. Informs CDCR the application for the inmate was received using MC 0025 (no notification to the SD is necessary for county jail inmates). The application date should be the date the application was received, unless the release date is before the received date. If the client has been released from prison or jail when application is received, process application with the release date as application date. If necessary, the application date in CalSAWS must be changed before running EDBC. Reviews the application for completeness and takes any necessary steps to complete the eligibility determination by the date of release. Contacts CDCR via MC 0025 if more information or verifications are needed. For SD contact the AR on the Pre-Release cover letter via email or phone. Enter AR for CDCR applications only and enter relevant admission and release dates for both CDCR and SD. Mails disability referral packet to DDSD if the inmate is claiming a disability. Mails BIC and NOA to CDCR before the release date, if the BIC will not arrive by the inmate’s release date, sends the paper BIC to CDCR (BIC and NOA should be mailed to the release address for county jail applicants). Pre-Release application with an expected release less than 28 days: • Follow the Pre-Release Application Procedures above. • Process the MC application and if eligible, do not suspend MC. • Send MC 0025 to notify CDCR of the inmate’s eligibility status 10 days before release (no notification necessary to SD for county jail applicants). Pre-Release application with expected release more than 28 days: • Follow the Pre-Release Application Procedures above. • Process the MC application, if eligible approve. Wait 2 business days, verify MEDS is active, and then suspend MC by updating the [Living Arrangement Detail] page. (If additional HH members in case refer to MC Suspension) • Send “Suspension Notice of Action” MC 0466A. (10-day notice required). • Send MC 0025 to notify CDCR of the inmate’s eligibility status 10 days before release (no notification necessary to SD for county jail applicants). • Set a [Manual Task] with the individuals release date for the continuing EW to release the suspension. Enter a Journal entry for the actions taken.
4.	EWS	Reviews case/Task before transfer.

AB720 Verifications

All case information must be verified in accordance with current MC rules. If an individual appears to be eligible but there is a verification missing and the individual cannot provide verifications due to incarceration, eligibility should be approved, and the EW must follow up with the individual after their release from incarceration.

Household and Tax Filing Status

Individuals who identify themselves as primary tax filers because their household status or tax filer status is uncertain must be treated as single individuals for purposes of approving the pre-release application. If that status changes after release, the EW must update the case and add the former inmate to the family case if appropriate. If the individual is being added to an ongoing case the EW must communicate with the primary contact to determine if the inmate is part of the tax filing household.

Income

Income is first verified through the federal hub, if the reported income is not reasonably compatible the EW must review all other electronic systems (MEDS, etc.). If the income cannot be verified and the inmate is not able to resolve the discrepancy due to incarceration, (but is otherwise eligible), the EW must grant eligibility and follow up with the individual to resolve the income issue as soon as possible after the release date.

Identity

Verification of citizenship and identify through the Social Security Administration electronic verification process meets both citizenship and identity requirements for U.S. citizens. If an inmate is not a citizen or identity is not verified through the electronic verification process, verification by CDCR or SD that the individual is a inmate can be used for identity purposes. Title 22, California Code of Regulations, Section 50167(A)(6)(D)(1) provides that the identity may be verified by presence in the institution if the facility verifies presence in the institution. That basic verification of identity can be accepted for
pre-release applicants if there is no other evidence available and no evidence that contradicts the identity information provided by CDCR or SD (such as a discrepant Social Security Number (SSN)).

Citizenship/Immigration Status

MC applicants must provide information about their citizenship or immigration status as part of the normal application process. Citizenship and immigration status must be declared, but MC eligibility can be granted while citizenship or immigration status is being verified, in accordance with current MC rules, if the applicant is otherwise eligible.

SSN

If a pre-release applicant has an SSN, or is taking steps to obtain one, and is otherwise MC eligible, eligibility can be granted but the county must follow up with the inmate upon release to verify the SSN. If the SSN cannot be verified electronically, or there is reason to believe there is a discrepancy with the inmate’s SSN, MC eligibility cannot be granted until the issue is resolved.

Property

MC eligibility must be granted if there are no identified assets that would make the inmate ineligible. Counties should work with the inmate or his or her representative to obtain any additional verification information after the inmate is released.

Residency

Inmate status may be used to verify California residency if: 1) there is no other evidence of California residency available, 2) CDCR or SD confirms that the inmate is incarcerated in a correctional facility, 3) the inmate declares an intent to reside, and 4) there is no evidence to suggest the inmate will not be a California resident in the month of release. If this verification of residency is used because the inmate cannot obtain the necessary verification due to his or her incarceration, the county may grant MC eligibility, if the pre-release applicant is otherwise eligible. The county must follow up with the inmate upon release to obtain the necessary verification based on the inmate’s California residence.