Eligibility Status Action Code (ESAC)

The ESAC has the following functions:

Acts as a check/confirmation that the data being sent to MEDS is correct.
Must be sent in both CalSAWS and MEDS-generated transactions in order for the transaction to be successful.
Advises MEDS/CDB what the EW intends the transaction to do. What ESAC is sent depends on the entries made in CalSAWS.
If the assigned ESAC conflicts with other elements of the transaction, it may cause:
- The entire action to fail,
- Only part of the new information to be accepted, or
- MEDS to generate a hold for the record into the MEDS-Generated Hold Database (Burman).

How ESACs are Selected

Online Transactions

The MTO selects an ESAC which is appropriate for the transaction requested.

Batch (CalSAWS) Transactions

CalSAWS compares the before and after picture based on the entries into CalSAWS and decides what has changed. From these entries CalSAWS determines the appropriate transaction to be sent.

CalSAWS adds the appropriate ESAC based on the transaction being generated.

Failed Transactions

The ESAC is printed on the CEWA, along with information from the rejected/failed transaction and any other conflicting MEDS/CDB data.

The EW must determine if the ESAC which was sent with the transaction was appropriate, based on what they were attempting to accomplish. This serves as a clue as to what is wrong with the transaction generated by either the MTO or batch and how to possibly resolve the problem.

ESAC Codes for MEDS

Continuing Eligibility Periods

These ESACs are used to report ongoing eligibility. MEDS will establish eligibility starting from the transaction effective date (EFFECTIVE-DATE) and continuing into the future (no TERM-DATE) until a subsequent transaction changes eligibility.

CODE	EXPLANATION
1	New eligible, including QMB pending Part A confirmation
2	Active client eligible update (e.g., change from one Aid Code to another Aid Code)
3	Linked program eligible - Declined Medi-Cal
4	Exception Eligible (e.g., eligibility beyond the normal age limit for that Aid Code)

Closed Eligibility Periods

These ESACs are typically used to report history months or certain types of time limited eligibility (e.g. postpartum or transitional eligibility; approval of Medi-Cal for one or two months only) When these ESACs are reported on other than immediate need transactions, the EFFECTIVE-DATE, TERM-DATE, and TERM-REASON must be included on the transaction.

CODE	EXPLANATION
6	New eligible
7	Active client eligible update (e.g., Aid Code change)
8	Linked program eligible - Declined Medi-Cal
9	Exception Eligible (e.g., eligibility beyond the normal age limit for that Aid Code)

Other Eligibility Update

These ESACs are used for several unique reporting situations

CODE	EXPLANATION
0	(Zero) County confirmed immediate need for SSI/SSP recipient
A	Unborn
B	Hold, questionable eligibility

Recon Generated Hold on MEDS

These ESACs are generated by the MEDS Recon process to put a hold on the MEDS record.

CODE	EXPLANATION
K	Recon Hold - on MEDS not on County
L	Recon Hold - key field discrepancy in County-ID or Birthdate
M	Recon Hold - Critical Eligibility Errors on County Transaction
N	Recon Hold - Duplicate Errors on County Transaction

Legacy System Only

These ESACs are valid for legacy systems only.

CODE	EXPLANATION
F	QMB pending part A confirmation (obsolete - will be treated by MEDS like ESAC 1)
P	Pending application
Q	Drop pending change; also drop pending eligibility for future month displayed on INQM or INQ4 screen.
R	Release hold; also use on online transaction EW40 to release h

ESAC Codes for CDB

CODE	EXPLANATION
1	New eligible
9	Terminate eligibi

ESAC Example

Click herehere to view an example of where ESAC information can be found on the County Eligibility Worker Alert (CEWA):

EW20 (Add) transaction generated by CalSAWS nightly batch process, with an ESAC of ‘1’.