HMS 16

Week 4

CalWorks

● California Work Opportunity and Responsibility to Kids is:o Program that provides financial assistance to needy

families with [or expecting] children o Helps pay for: housing, food, utilities, clothing,

medical care

● Families are eligible to receive cash aid and services when:o The eligible children are deprived of parental

support or care due to: Death, incapacity, unemployment/

underemployment or continued absence of one or both parents.

o A needy or non-needy caretakers providing care for foster children.

● Basic eligibility requirements applies:o Citizenship statuso Ageo Incomeo Resourceo Assets & other factors

● Cash Aid is Time Limitedo 48 months totalo As of July 2011, a parent or caretaker relative is not

eligible for cash aid when he/she has received cash aid for a total of 48 month.

o Exception: the 48 month time limit does not apply to children as a result of the Safety Net Program.

● Other programs and services that a CalWORKs recipient might receive or be qualified for:o Homeless Assistanceo CalLearn (teen parent program)o Welfare-to-Work/GAIN (Greater Avenues for

Independence)o Child careo Job preparation & opportunitieso Specialized supportive services: Domestic Violence,

Mental Health, Substance Abuse & Family Preservation Program

o Medical

CalWORKs Video

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Welfare-to-Work

● California’s Welfare to Work program is designed to assist welfare recipients to obtain or prepare for employment. o Employmento Job Searcho Assessmento Education o Trainingo Community serviceo Substance abuse treatmento Mental health serviceso Domestic violence counseling

Goal: help recipients find employment, stay employed, and move on to higher paying jobs.

Ultimate goal: Self-sufficiency and Independence

How do participants become successful in WTW?● GAIN experiences through:

o Unpaid work experience/preparationo Vocational training placementso Adult education or community college programs

● Financial assistant● Child care assistance

Requirements:● Must participate in a minimum of:

o 20 hours per week for single parents w/ children under 6yoo 30 hours per week for single parents w/children older than 6yoo 35 hours per week for 2 parents

● Exemptions from work requirements:o A child attending an elementary, secondary or vocational school full

timeo A custodial parent who is 18 or 19 yo & is a Cal-Learn participanto Caretakers relatives who are not the parent and are not aidedo Individuals caring for ill or incapacitated household memberso Parents or caretakers age 60 and oldero Pregnant women whose condition prevents involvement in work

activitieso Single parents caring for a child under one year of ageo Participants who are disabled or have a medical excuse

Cash Aid Program for Immigrants (CAPI)● CAPI is 100% state-funded program designed

to provide monthly cash benefits to:o Aged, blind and disabled non-citizens who are

ineligible for SSI/SSP due to their immigrant status.

● California created CAPI to help people who can’t get SSI as a result of the changes in SSI in the 1990s.

Eligibility:● 65 years of age or older● Blind● Disabled● Been denied of SSI due to immigration status● You must live in California● You must be a legal immigrant● Have income and resources below the CAPI limits (no more than

$2000 ($3000 for a couple)People Not Eligible:● A U.S Citizen● Receiving SSI benefits● Living in a public institution: public hospital or jail● Not a resident of California● Uncooperative w/ program requirements● A fleeing felon

Differences between CAPI and SSI:● CAPI is an alternative to the SSI program for

people who do not qualify for SSI due to immigration status.

● CAPI benefits are $10 (single) / $20 (couple) less than SSI payments.

● Example: SSI for disabled individual in 2014 is $877, CAPI $867

General Relief/Assistance

● GR/GA is temporary assistance designed to provide cash relief & support to:o Indigent adults who are not supported by their own

means.o Each county’s GA/GR program is established and

funded 100% by its own Board of Supervisors.

● If you are eligible for GR/GA, you might be eligible for CalFresh and CAPI

Eligibility:● U.S citizen or a documented non-citizen● Meet income and property requirements

You can have the following:● 1 care less than $4500● Household goods● House you live in if it is worth less than $34k● Monthly cash benefits of $221● Bus tokens● Care Kit● Emergency benefits, housing, food● Supplements for medically required diets● Health Care● Referral to a county paid drug or alcohol recovery program

The GR caseload includes the following employability status classifications:● Employables: participants w/ minor restrictions or no medical conditions

that would prevent employment. 9 mo to 12 mo. ● Temporary Unemployables: who have one or more medical conditions

affecting their ability to work and their condition will last less than 12 mo. No time limits

● Permanent Unemployables: who have one or more medical conditions affecting their ability to work, may qualify for SSI and condition will last more than 12 months/terminal. No time limits

● Unemployable Volunteers: are assigned to individuals who are unemployable.

● NSA (Need Special Assistance): identification of individuals who need special assistance due to a mental disability.

● Administratively Unemployable: other than physical or mental incapacity which prevents the individual from finding, accepting or continuing existing employment.

Refugee Cash Assistance

● RCA is cash assistance provided to individuals w/ refugee, asylee or trafficking victim status who have been determined to be ineligible for CalWORKs or SSI/SSP and who have resided in the U.S for no longer than 8 months from Date of Entry.

Time Eligibility:● The month of entry as indicated on the U.S

Citizen and Immigration Services (INS) form, is counted as the first month.

● Asylees begin on the date asylum was granted

● Trafficking victims are eligible to 8 months of RCA benefits from the date indicated on their certification letter.

Work registration requirements:● Applicant/recipient must register for employment

services w/ an employment services provider unless exempt.

● Must participate Self-Sufficient focused programs such as:o Vocational English (as 2nd lang.)o Short terms vocation trainingo Employment preparation workshopo Job counselingo Job search assistanceo Job Development and placemento Job Retention

CalFresh

● Formerly known as Food Stamps and federally known as Supplemental Nutrition Assistance Program (SNAP).

● Helps improve the health and well-being of qualified households and individuals by providing them a means to meet their nutritional needs.

● The program issues monthly electronic benefits that can be used to buy foods at many markets and food stores.

● For households to receive CalFresh benefits they must provide certain information in the following areas:

o Citizenship/Immigration Status

Have lived in the country for five (5) years, or

Are receiving disability-related assistance or benefits, regardless of entry date, or

Are children under 18 years of age regardless of entry date.

o Income

o CalFresh households, except those containing an aged or disabled member or where all members receive cash assistance, are subject to gross and net income determination tests.

o Reporting Changes

o Resources Work Requirements

o Fingerprint Imaging

CalFresh Video

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Women, Infants & Children (WIC)● The Women, Infants and Children (WIC Supplemental

Nutrition Program is federally-funded health and nutrition program for:

o Women who are pregnant, breastfeeding, or just had a baby

o Children under 5 years old (including foster children)

o Families with low to medium income (working families may qualify)

● The goal of the WIC program is to decrease the risk of poor birth outcomes and to improve the health of participants during critical times of growth and development.

● WIC is unique among federally administered programs in that it provides specific supplemental nutritious food and nutrition education to a specific target population as a short term intervention and adjunct to ongoing health care.

What can participants get with WIC?● Special checks to buy healthy foods from WIC-

authorized vendors – milk, eggs, bread, cereal, juice, peanut butter, and much more information about nutrition and health to help recipient family eat well and be healthy

● Support and information about breastfeeding

● Help in finding health care and other community services

Emergency Food Program

● The Emergency Food Assistance Program (TEFAP) is a federal program that provides food at no cost to low-income Americans in need of short-term hunger relief.

● The State Agencies that manage TEFAP distribute the product to qualifying emergency food organizations (EFOs), including—food banks, church pantries, soup kitchens, emergency shelters, and Community Action Agencies—which distribute the food directly to those in need or use it to prepare meals.

● The Emergency Food Assistance Program is designed to meet the short-term, emergency food needs of low-income Americans.

● TEFAP is a means-tested program, with income eligibility requirements set by the states, typically between 100 and 155 percent of the federal poverty threshold. o Recipients include many vulnerable populations,

including the elderly, children, working families, and the homeless.

Food Banks & Rescue Programs● A food bank is generally defined as a charitable

organization that solicits and warehouses donated food and other products.

o This food is then distributed to a variety of community agencies which serve people in need.

● Many food banks provide food to hundreds of organizations in their community, who would likely not be able to obtain a steady supply of food in other ways, nor would they have the space or equipment to store enough food to meet the needs of the people they serve.

● The primary purpose of a food bank is to help ensure an adequate flow of food through other community-based organizations.

Food Banks & Rescue Video

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Obama Care

Background

Beginning in 2014, Health Care Reform (also known as the Affordable Care Act)

required individuals to have “Minimum Essential Coverage" or pay a penalty with their

tax return.

• A person has Minimum Essential Coverage (MEC) if he or she has:

• An eligible employer-sponsored plan;

• An individual policy (obtained through or outside Covered California); or

• A government plan (Medicare, Medi-Cal without a Share of Cost (SOC), TRICARE, VA, etc.)

• Exceptions to MEC Requirement:

• Individuals with a religious conscience exemption (applies only to certain faiths);

• Incarcerated individuals;

• Undocumented immigrants;

• Individuals who cannot afford coverage (required contribution exceeds 8% household

income);

• Individuals with a coverage gap of less than 3 months;

• Individuals in a hardship situation (as defined by the U.S. Secretary of Health & Human

Services);

• Individuals with income below the tax filing threshold; and

• Members of Indian tribes.

Background

• In order for coverage to be MEC it must include all of the following services:

• Ambulatory patient services

• Emergency services

• Hospitalization

• Maternity and new born care

• Mental health and substance abuse disorder services, including behavioral health treatment

• Prescription drugs

• Rehabilitative and habilitative services and devices

• Laboratory services

• Preventive and wellness services and chronic disease management

• Pediatric services, including dental and vision care

Background

• In 2010, California was the first state in the nation to enact legislation to implement the provisions of the federal Affordable Care Act by creating a health care marketplace —Covered California

• Covered California goals:

• Enrollment in all available coverage

• No wrong door

• First Class Customer Service

• Coordinated Service

Enrollment Periods

To be eligible for coverage through Covered California, customers must apply for benefits during Open Enrollment or Special

Enrollment (if they experience a qualifying life event).

Open Enrollment

• This year November 15, 2014 – February 15, 2015

Where to apply

Online: Through Covered California website www.CoveredCA.com.By Phone: Statewide phone number or call (800) 300-1506.Mail: Send printed application to Covered CaliforniaIn person at Community Based Organization: Assisted by certified enrollment assisters

1. Identification Original identification card or driver’s license from Department of Motor Vehicles.

2. *Citizenship Original Birth Certificate, Passport, or Certificate of Naturalization

3. *Social Security Card

4. *Declared Immigrants Alien Registration Card or Receipt of Alien Registration Card from US Immigration Services

5. County Residency Utility bill, rental agreement, or postmarked mail with applicant’s name and home address.

6. *Proof of Income If employed – Most recent check stubs for applicant & dependents or letter from employer indicating hourly wage and how often paid.If self-employed – Either of the following: 1) Copy of previous year’s income tax return, including Schedule C, or 2) Recent profit/loss statements for the previous 3 months broken down monthly.Not employed – 1) A declaration stating sources of support from family or friends providing food and/or lodging or 2) Current unemployment check stubs or statement from EDD stating last date of employment or 3) Current disability or Workers Compensation check stub or 4) Current retirement or pension check stub.

7. Other Income Proof of alimony or child support payments, CalWORKs (cash aid) or CalFresh (Food Stamp) benefit allowances, verification of rental income, or any other sources of income

8. Vehicle Registration Copy of vehicle registrations for any vehicle registered to the applicant, or any member of the household.

Verifications at Application

Examples of information needed during the application process

FULL BENEFITSFULL BENEFITS

Citizenship and Immigration

Status

FULL BENEFITS RESTRICTED BENEFITS

US CITIZENS UNDOCUMENTED ALIENS

LAWFUL PERMANENT

RESIDENTS

UNABLE TO PROVIDE

PROOF

PRUCOL

Applicants to seek information from an Immigration Counselor or

U.S. Citizenship and Immigration Services (USCIS) at:

• Phone – 1-800-375-5283

• Web – www.uscis.gov

Insurance Affordability Programs

Modified Adjusted Gross Income

(MAGI)

• Adults: Income level at or below 138% FPL

• Children: Income levels higher (could be up to 250% FPL)

• Pregnant Women: Income level are up to 200% FPL

Non-MAGI

Medi-Cal

• Umbrella term for remaining Medi-Cal programs that will not follow MAGI rules.

CoveredCA Subsidized Coverage

• Not eligible for Medi-Cal

• Income between 100%-250% = Premium Assistance (APTC) and Cost Sharing Reduction(CSR)

• Income between 251%-400% = Premium Assistance

CoveredCA Unsubsidized

Coverage

• Income level over 400%

Obama Care

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