ASH 004 - Adequate And Timely Notices

.Purpose

Policy

Background

Release Date:

July 26, 2021

Definitions

Requirements

Verification Docs

APPEALS and STATE HEARINGS

ASH 004 - Adequate and Timely Notices

Purpose

( ) To release a new policy

( ) To release a new form

(X) To convert existing policy to new writing style only – No concept changes

( ) Revision of existing policy and/or form(s).

Policy

Whenever an action is taken on a case, the County is required to provide an adequate Notice of Action (NOA) concerning a claimant’s aid; except for certain actions involving Social Services and the CalFresh Program. An adequate notice is required when:

1. Aid is granted, increased, decreased, discontinued, denied or partially denied;

2. The County determines that immediate need does not exist;

3. The County demands repayment of an overpayment (OP) or CalFresh overissuance (OI); or

4. The County takes action pursuant to a conditional withdrawal (CWD) of a hearing request or a State hearing decision.

Background

Except for certain actions concerning Social Services [Manual of Policies and Procedures (MPP) Division 30] and the CalFresh Program (MPP 63-504.266), the Appeals and State Hearings (ASH) section has jurisdiction to review and resolve any request for a State hearing filed within the 90-day period following the effective date of the disputed action or inaction (MPP 22-009.1). The review of the amount of aid shall be extended back as far as 90 days from the filing date, at the claimant’s request (MPP 22-009.2). However, ASH jurisdiction is subject to the County requirement to provide the claimant with an adequate NOA. A late filing past the 90-day period is admissible, should good cause exist. Good cause is determined by the California Department of Social Services (CDSS) director [Welfare & Institutions Code (WIC)10951].

Definitions

Term	Description
Adequate Notice of Action	In accordance to the provisions outlined in MPP 22-001(a)(1), a written notice must: 1. Be written in the claimant’s designated preferred written language, or otherwise, the County must offer and provide interpretive services for NOAs not provided in the claimant’s primary language. See MPP 21-115.2 for language compliant NOAs; 2. Inform the claimant of the action the County intends to take; 3. Provide the reason(s) for the intended action; 4. Include the specific regulations supporting such action; and 5. Inform the claimant of their right to request a State hearing. An Adequate NOA must also: 1. Provide adequate computations, if applicable; 2. Note the effective date of the action; 3. List availability of free legal representation; and 4. Be properly addressed to the appropriate household (HH) member.
Adverse Action	A County action that has resulted in the suspension, reduction, discontinuance or termination of public assistance and/or CalFresh benefits [an adverse action in the Medi-Cal Program would also include an increase in the Share of Cost (SOC) amount].
Compliance Issue	An allegation by the claimant that the County has failed to abide by a State hearing decision concerning issues clearly resolved in the order where the County did not have to make further determinations regarding the claimant’s eligibility or amount of benefits.
Timely Notice of Action	A written NOA which gives the claimant at least 10-day notice prior to the effective date of the proposed action. In computing the notice period, the 10-day period does not include the date of mailing or the date that the action is to take effect (MPP 22-072.4).

Requirements

Language Services

ASH staff is required to follow the policies and procedures outlined in this release, except as otherwise instructed by the District Director of the ASH section, or by the designated Deputy District Director.

Staff must take reasonable steps to ensure that claimants are provided effective services in their self-declared preferred language.

Staff must always document the claimant’s self-declared preferred verbal and written language on the Daily Activities screen on the Appeals and State Hearings Tracking System (ATS).

Note: If a claimant can communicate effectively in English, they must still be given the option to designate their preferred language for both verbal and written communication.

To ensure that claimants are provided with effective language services, the Appeals Hearing Specialist (AHS) must complete the following steps:

1. Before communicating with the claimant, identify the claimant’s preferred spoken and written language and be prepared to assist the claimant in the preferred spoken language;

2. Be prepared to inform the claimant that free interpreter services can be provided;

3. Use forms translated in the claimant’s preferred language or provide verbal translation of English forms if they are not available in the claimant’s preferred written language;

4. If a form is not available in the claimant’s preferred language, provide the form in English along with a Notice of Language Services form (GEN 1365); and

5. Confirm the claimant’s spoken and written language preferences and inform the district/region Fair Hearing Liaison (FHL) of any changes to the claimant’s language preferences.

Note: NOAs are required to be provided only in DPSS threshold languages or languages in which CDSS has translated the NOA. If the NOA is not available in the claimant’s preferred written language, the County must offer and provide verbal translation of the NOA in the claimant’s preferred spoken language.

If the claimant decides to use an interpreter provided by the County, the AHS must:

1. Call the Language Services vendor: Language Line Solutions at 1-855-267-1141, and

2. Provide the following information:

a. Internal Services Department (ISD) Language Services Cost Center code;

b. Employee Number; and

c. Department Name.

3. If the claimant’s preferred language is American Sign Language (ASL), the ASH Civil Rights Liaison shall submit an “ASL Interpreter Services Request” form to the Civil Rights section at least three (3) work-days prior to the requested service appointment date. Refer to CRM 13-03 (December 9, 2013) for additional information.

If the claimant decides to use their own interpreter, staff must:

1. Inform the claimant of the Department’s free interpretive services, offer free interpretive services, and advise that a free interpreter can be provided at any time;

2. Inform the claimant of potential problems with using their interpreter, such as: ineffective communication, conflict of interest, and inaccurate interpretation;

3. Inform the claimant about the need to disclose private/confidential information to their interpreter; and

4. Use an Interpreter Services Statement and Confidentiality Agreement (PA 6181) as needed.

Case Documentation

1. Document the Daily Activities on ATS to detail the steps taken above and include the claimant’s self-declared preferred written and spoken language;

2. This includes claimants who designated English as their primary language for verbal and written communication;

3. Update ATS accordingly, if any changes to the claimant’s preferred spoken and/or written language have been made; and

4. Complete the Language Line Solutions log when Language Line Solution’s services were requested.

Please see the sample case documentation below:

“The claimant’s preferred spoken language is [insert language] and preferred written language is [insert language]. Offered free interpretive services; the claimant [insert accepted or declined] the services. Language services provided by [insert Language Services Method]. [Include any other relevant information specific to the case].”

The County is required to give the applicant/recipient/claimant adequate notice in the following instances per MPP 22-071:

An Adequate Notice is Required when…
1.	Aid is granted (approved) or increased.
2.	Aid status and/or benefit amount is: a. Denied; b. Decreased (including due to an OP/OI adjustment); c. Not changed following the receipt of a mid-period report; or d. Cancelled, terminated, or discontinued. Note: For California Work Opportunity and Responsibility to Kids (CalWORKs) and CalFresh Program cases: When aid is not changed due to a voluntary recipient mid-period report, the NOA shall be sent as soon as administratively possible, but no later than 30 days from the date the voluntary report is made.
3.	The County demands repayment of an overpayment (OP) or a CalFresh overissuance (OI). Relevant computation(s) must be included.
4.	The County takes corrective action after the claimant has conditionally withdrawn a request for a State hearing. Refer to the ASH 006 Withdrawals ePolicy for more detailed information.
5.	A CalFresh application is pended because some action or verification is necessary to complete the application process.
6.	The County determines that Immediate Need for the CalWORKs program does not exist, according to CalWORKs 40-129 Immediate Need ePolicy.
7.	The County takes action regarding compliance related issue(s) resulting from State hearing decisions (also see Compliance Issue listed in the Definitions section and MPP 22-078 for Compliance with State Hearing Decisions).
8.	The County takes action to change the manner or form of payment to a protective or vendor payment.

Language Compliant Notice

A written notice must be in the claimant’s designated preferred written language or the County must offer and provide interpretive services for NOAs not provided in the claimant’s preferred language.

According to the provisions of MPP section 21-115.2, forms and other written material required for the provision of aid or services shall be available and offered to the applicant/recipient in the individual's preferred language when such forms and other written material are provided by CDSS. When such forms and other written material contain spaces (other than "for agency use only") in which the County is to insert information, this inserted information shall also be in the applicant/recipient’s preferred language.

Currently, there are nine (9) DPSS threshold languages:

Armenian, Cambodian, Chinese, English, Korean, Russian, Spanish, Tagalog and Vietnamese.

Notice of Language Services (GEN 1365) must be provided to participants. Any notice sent in English to a person speaking one of the threshold languages must include the GEN 1365 written in the threshold languages indicating that this is an important notice and to contact their worker. If the GEN 1365 is not issued for threshold language notices, the NOA is not considered adequate. The California Statewide Automated Welfare System (CalSAWS) automatically sends the GEN 1365 when the NOA is generated by CalSAWS.

Timely Notice

When the County plans to take an adverse action, the notice of intended action must be mailed in time to be postmarked so that no less than 10 intervening calendar days are provided prior to the effective date of the adverse action, except in those situations listed below under “Exceptions to the Timely Notice Requirement”, or when a signed waiver of the right to an advance notice is obtained from the recipient.

Example:

In computing the notice period, the 10-day period shall not include the date of mailing and the date that the action is to take effect. Thus, if the effective date of the action is June 1, the notice must be mailed no later than May 21.

The notice of intended action must be complete, clear and contain regulatory citations for the intended action. The original and one copy of the notice must be mailed to the recipient and postmarked on the same day shown on the notice as the mailing date.

The AHS shall determine whether notices issued by the district/region office, that relate to the appealed issue, meet the adequate and timely notice requirements.

Exceptions to the Timely Notice Requirement (MPP 22-072.2)

Timely Notice is Not Required When…
1.	The County has factual information confirming the death of the person who was receiving aid and is affected.
2.	The County receives a clear written statement signed by the person affected that: a. They no longer wish aid; or b. Gives information, which requires discontinuance or reduction of aid and the person has indicated, in writing, that they understand that this must be the consequence of supplying such information.
3.	The person affected has been admitted or committed to an institution, and further payments to that individual do not qualify for Federal Financial Participation (FFP) under the State’s plan.
4.	The person affected has been placed in a skilled nursing facility, intermediate care facility, or long-term hospitalization.
5.	The whereabouts of the person affected are unknown and the County mail directed to them has been returned to the Post Office indicating no known forwarding address. However, the person’s aid payment shall be made available to them if their whereabouts become known during the payment period.
6.	A CalWORKs child is removed from the home as a result of a judicial determination or voluntarily placed in foster care by their parent or legal guardian. Also see CalWORKs 82-812.67 Family Reunification and 82-808 Caretaker Relative Requirements.
7.	The person affected has been accepted for aid in a new jurisdiction and the County previously providing aid has established that fact.
8.	A change in the level of medical care is prescribed by the recipient patient’s physician or modified by utilization review.
9.	A special allowance granted for a specific period is terminated and the recipient had been informed in writing at the time of initiation that the allowance shall automatically terminate at the end of the specified period.
10.	The County receives a complete Semi-Annual Eligibility Status Report (SAR 7) after the 11th calendar day of the SAR Submit Month and the County’s action to discontinue or decrease aid is a result of the information reported on the SAR 7 or as a result of the recipient’s failure to submit a timely or complete report of earnings without good cause as specified in MPP section 40-1818.23 (SAR). Note: Good cause exists only when the recipient cannot reasonably be expected to fulfill their reporting responsibilities due to factors outside of their control. The burden of proof rests with the recipient/claimant.
Important: Although a timely notice may not be required, an adequate notice must be sent no later than the effective date of action.

Time Limit on Request for a State Hearing

The request for a State hearing shall be filed within 90 days after the date of the action or inaction with which the claimant is dissatisfied. If the last date for the performance of any act required by these regulations is a holiday, the period will be extended to the next day which is not a holiday. “Holiday” as used herein means Saturday, Sunday or the holidays.

Where a request for a State hearing concerns the current amount of aid, at the claimant’s request, such review shall extend back as many as 90 days from the date the request for hearing was filed and shall include review of any benefits issued during the entire first month in the 90-day period.

Verification Documents

N/A