.Purpose

Policy

Background

Release Date:

August 13, 2020

Definitions

Requirements

Verification Docs

Category

Treatment

CalFresh Application Packet

The applicant is not required to visit the district office to file an application.  When a potential applicant calls to request a CalFresh-only application from the Customer Service Center (CSC), or requests an application at the district office, or at outreach efforts to take home, the following forms must be included in the CalFresh Intake application packet:

·        CF 285, Application for CalFresh Benefits;

·        PA 106, Voter Preference Form;

·        CF-LA 100, CalFresh Electronic Benefit Transfer (EBT) Trafficking Flyer;

·        PUB 275, Family Planning…Making the Commitment for a Healthy Future Brochure;

·        MV-1, State of California County of Los Angeles Voters Registration; 

·        GEN 1365 LA, Notice of Language Services;

·        PA 2457, Civil Rights Information Notice;

·        SAR 7A, How to Fill Out Your SAR 7 Eligibility/Status Report;

·        SAR 7 Addendum, Instructions and Penalties;

·        Sample SAR 7, Blank sample of an actual SAR 7;

·        CF 377.11E, CalFresh ABAWD Time Limit Exemption Screening Form;

·        PUB 13, Your Rights Under California Welfare Programs;

·        ADA PUB 4, “Do You Need Help Because of a Disability?” Flyer;

·        EBT 2, EBT Tips Brochure;

·        EBT 23, How to Find the Day of the Month Your Benefits will be available;

·        TEMP 2214, Additional Information About EBT;

·        PA 2126, Do you Live in or Plan to Live in Public or Section 8 Housing;

·        PA 1914, Domestic Violence Referral Information; and

·        CW 2223, Demographic Questionnaire for CalWORKs, RCA, ECA, TCVAP, and CalFresh.

Note:   When the form is needed in a language for which we do not have a translation, provided applicant/participant the English version, along with the GEN 1365, Notice of Language Services.

ES Processing

All CalFresh applications submitted in-person, by mail, outreach, fax, drop-off, online through the Your Benefits Now (YBN) and getcalfresh.org website, or by telephone through CSC, must be evaluated for ES entitlement.  Eligibility staff must take the following steps to process the application for ES determination:

·        Contact the HH for an interactive interview on the day the application was received.

·        Schedule an interactive interview appointment on the same day the application is received for five days following the application received date, if initial contact is unsuccessful;

·        Disposition ES on the interactive interview appointment date;

·        Make additional phone calls for two consecutive days following the missed initial interview appointment date;

·        Make late discovery ES eligibility determination when the HH’s circumstances change prior to application disposition and the HH is entitled to ES; and  

·        Ensure that the Electronic Benefit Transfer (EBT) card and Personal Identification Number (PIN) are available to the participant by mail or for pickup no later than the third day following the date the application was received and the interactive interview was completed.

Note: ES benefits must be issued within three days from the date of late discovery.

Cancellation

An application cannot be cancelled if a case number has already been assigned.  Once an application has been filed, it can only be denied based on eligibility factors, or be withdrawn per the applicant’s request prior to an eligibility determination.

Application Date

The application date is the first business day the application was received by the Department of Public Social Services (DPSS).  Applications received on weekends, holidays, or after business hours will be post-dated for the next business/workday. 

The mail-in application date will be considered the date when the district office receives and stamps the application.  HHs must be advised of their right to file an application the same day of their inquiry, to avoid any loss in benefits.

Application Disposition

Withdrawal

An applicant has the right to voluntarily withdraw their application at any time prior to an eligibility determination.  Notification to the applicant(s) regarding their withdrawal decision must be provided.  Form CW10, Notice of Withdrawn Application must be provided/
mailed to the applicant.

The applicant is not required to sign any withdrawal forms.   He/she may verbally state his/her option to withdraw.

Approval

Applicant HHs must be interviewed prior to determining CalFresh Program eligibility. 

·       When the interactive interview is completed on the day the application is filed and the HH is found eligible for ES, entitlement of ES must be dispositioned on the same day or within three days from the application date.

·       When the HH is unavailable to be interviewed on the day the application is filed an interactive interview appointment must be scheduled the same day the application is received for the fifth day following the application received date.

When a HH is found eligible for ES after completing the interactive interview, the only mandatory verification needed is identity. All other verification can be postponed.

When the HH is found ineligible for ES after the interactive interview, the application must be processed within 30 days following the application date. 

Denial

Applicant HHs who do not keep their initial Intake appointment for the interactive interview must not be denied prior to the 30th calendar day from the application date.  Keeping the application for 30 days allows the applicant ample time to reschedule and complete the interview and provide any verification needed to determine eligibility: 

When the 30th day falls on a non-workday (weekend or holiday), the application should be denied on the first workday after the 30th day.

Notification

Approval

Upon approval of the application, the HH must be given an adequate Notice of Action (NOA) notifying the HH of the benefit allotment, number of eligible HH members, certification period, Income Reporting Threshold (IRT) limit, and their right to appeal.

If ES is being approved and there is postponed verification, the NOA will inform the HH to submit missing verification(s) timely to prevent discontinuance.

Denial

Applicants determined to be ineligible must be sent a NOA denying his/her application no later than 30 days following the application date. If the 30th calendar day falls on a weekend and/or holiday, the applicant is given until the first workday day after the 30-day deadline.

The Initial Application Denial Before the 30th Day Waiver allows counties to deny an initial application prior to the 30th day when an applicant fails to provide the required verification requested within ten days from the request for verification, provided that the applicant has had the interactive interview and mandatory verification(s) is requested in writing (CW 2200, request for Verification).

Note: Waiver is extended through April 30, 2024.

A CalFresh application may only be denied prior to the 30^th day from the application date in the following situations:

·        Excess Gross Income;

·        Excess Net Income;

·        Excess Resources (for Non-Modified Categorical Eligibility [MCE] or Categorical Eligibility [CE] HHs);

·        When the entire HH is determined ineligible for CalFresh benefits (e.g., fleeing felons or probation/parole violators, Intentional Program Violation [IPV], etc.);

·        When the HH fails to provide mandatory verification(s) within the ten-day timeframe, after the HH completed the initial interactive interview.

Note:    Eligibility staff must not deny eligibility to a HH due to failure to provide when the person(s) who fails to provide is outside of the HH.  Excluded HH members are not considered outside of the HH.

When requested mandatory verification is provided after the ten-day timeframe, the following applies:

Note: Verification cannot be requested prior to the initial interactive interview.

An application cannot be denied if the requested verification is not mandatory.

Note: A negative action is only valid if the case record supports the negative action, as well as the reason for the negative action that was presented to the HH.  A Quality Control reviewer will not consider a denial to be valid if the case record does not support the denial through documentation and/or verification.

Missed Interview Denial

Denials of applications due to missed interview cannot occur prior to the 30^th day following the application received date. HHs that fail to keep their scheduled interactive interview appointment must be sent a CF 386, Notice of Missed Interview (NOMI). The NOMI informs the applicant of the following:

1.     The HH failed to keep their initial interview appointment;

2.    The HH must contact the County to schedule another interview appointment to complete the Intake process; and

3.     The HH must be interviewed within 30 days following the application date.

Note: If the HH does not request a reschedule interview, a denial NOA must be sent on the 30^th day following the application date.

Term

Description

Normal Processing

A determination of eligibility on a submitted application must be made as soon as administratively possible, but no later than 30 calendar days from the application date.  The day the application is received, is considered day ‘zero’.

Collateral Contact

A verbal confirmation of a HH’s circumstances by a person outside the HH, who can furnish accurate and reliable documentation regarding the applicant HH.  The contact may be made by telephone, letter, or office interview.  Examples of collateral contacts are employers, landlords, social services agencies, neighbors, relatives of the HH, etc.

Note: Collateral contact is a method of verification used only when documentary evidence is not readily available.

Disability

Manual of Policies and Procedures (MPP) Section
63-102(d)(B) states that an individual is to be considered disabled if any of the following applies:

·       Receives SSI benefits under Title XVI, or disability or blindness payments under Title II (Social Security Disability Insurance Program) of the Social Security Act;

·       Receives disability retirement benefits from a government agency because of a disability considered permanent under Section 221(i) of the Social Security Act;

·       Receives interim assistance benefits pending receipt of SSI, if the eligibility to receive those benefits is based upon disability or blindness criteria which are the least as stringent as those used under Title XVI of the Social Security Act;

·       Receives disability related medical assistance under Title XIX (Medi-Cal) of the Social Security Act;

·       Receives disability-based general assistance benefits, if the eligibility to receive those benefits is based upon disability or blindness criteria which are at least as stringent as those used under Title XVI of the Social Security Act;

·       Determined to be Needs Special Assistance (NSA) for General Relief (GR) Program;

·       Is a veteran with a service connected or non-service-connected disability rated by the Veteran’s Administration (VA) as total or paid as total by the VA under Title 38 of the United States Code;

·       Is a veteran considered by the VA to need regular aid and attendance or permanently housebound under Title 38 of the United States Code;

·       Is a surviving spouse of a veteran and considered by the VA to need regular aid and attendance or is permanently housebound or a surviving child of a veteran and considered by the VA to be permanently incapable of self-support under Title 38 of the United States Code;

·       Is a surviving spouse or surviving child of a veteran and considered by the VA to be entitled to compensation for a service connected death or pension benefits for a non-service connected death under Title 38 of the United States Code and has a disability considered permanent, under Section 221(i) of the Social Security Act (“Entitled” as used in this definition refers to those veterans’ surviving spouses and surviving children who are receiving the compensation or pension benefits stated or have been approved for such payments, but are not yet receiving them); or

·       Receives an annuity payment under Section 2(a)(1)(iv) of the Railroad Retirement Act of 1974, and is determined to be eligible to receive Medicare by the Railroad Retirement Board; or Section 2(a)(1)(v) of the Railroad Retirement Act of 1974 and is determined to be disabled based upon the criteria used under Title XVI of the Social Security Act.

Documentary Evidence

The primary source of verification consists of a written confirmation of a HH’s circumstances.  Examples of documentary evidence include, but are not limited to:

·       Pay stubs;

·       Child support expense;

·       Child support income;

·       Medical expense; and

·       Dependent care expense.

Homeless

An individual or HH that:

·       Lacks a fixed and regular nighttime residence; and

·       Primary nighttime residence is:

o   A supervised publicly or privately-operated shelter (including a welfare hotel or congregate shelter) designed to provide temporary living accommodations;

o   A halfway house or similar institution that provides a temporary residence for individuals intended to be institutionalized;

o   A temporary accommodation for not more than 90 days in the residence of another individual; or

o   A public or private place not designed for, or ordinarily used as, regular sleeping accommodation for human beings (e.g., hallway, bus station, lobby, vehicle, or similar places).

Questionable Information

To be considered questionable, the information on the application must be inconsistent with the statements made by the applicant, and/or with other information on the application, interactive interview, and/or other information received.  Verification can be secured using methods such as, but not limited to:

·       Documentary Evidence;

·       Electronic Verification;

·       Collateral Contacts; or

·       Applicant Statement.

The case record must be documented as to why reported information is questionable before requesting verification from the HH.  As with mandatory verifications, when verifying questionable information, a specific type of verification must not be required.  

Rescission

When the application is rescinded, the HH does not experience a break-in-benefits and the applicant:

·       Is not required to reapply for CalFresh; and

·       Benefits are not prorated.

Restoration of Eligibility and Benefits

The Restoration of CalFresh Eligibility and benefits must be offered to every NACF HH eligible. The HH is entitled to choose to file a new application or have CalFresh benefits restored if the HH provides the mandatory verification between the 31^st and 60^th day following the application date.  

When the application is restored, the HH’s benefits are prorated from the date of compliance (i.e., the mandatory information and/or verification is received). The HH is not required to submit a new application.

Note: The second 30-day period (day 31-60) must not be applied when the HH has been denied for reasons other than FTP mandatory information and/or verification. 

Mixed HH

A CalFresh HH in which less than all members receive CalWORKs benefits.  For purposes of these regulations, mixed HH’s must be considered non-assistance HH’s and must be subject to the same procedures as non-assistance HH’s, unless otherwise specified.

NACF

A HH which receives CalFresh benefits only or receives CalFresh and either GR, Medi-Cal, CAPI or is a mixed HH.   

Public Assistance CalFresh (PACF)

A program funded under Title IV-A of the Social Security Act of 1935 as amended or matching State funds for public assistance programs.  The programs must be means-tested, and all HH members must be receiving or authorized to receive benefits from a Temporary Assistance for Needy Families (TANF), or a State-funded program, such as CalWORKs.  For purposes of determining CE, as specified in Section 63-301.7, Public Assistance (PA) recipients include individuals authorized to receive PA benefits whether or not they are receiving a PA payment.  This includes recipients whose PA benefits have been suspended or recouped, or those who are entitled to PA benefits, but are not paid such benefits because the grant is less than $10.00. 

Requirement

Limit/Condition

Application Submission

An application must be submitted/filed for a HH to be evaluated for CalFresh benefits.  An application can be submitted via any of the following sources:

·       In-person at any of the district offices;

·       By mail;

·       By fax;

·       By phone;

·       Online via YBN: https://www.yourbenefits.laclrs.org/ybn/Index.html and https://www.getcalfresh.org/;

·       Community-Based Organizations (CBO) or Faith-Based Organizations (FBO);

·       CalFresh Application Assisters; or

·       Outreach efforts.

No Wrong Door Policy

Los Angeles County applicants have the option to be served in the district office of their choice (even if the HH does not reside within the district’s geographic servicing area), or to accept a referral to another office.

The applicant must be informed of the following options available to them:

·       The option to have the application accepted and processed at the current office;

·       The option to have the application forwarded to the district office designated to service their area (based on applicant’s address); or

·       Provide the applicant with the address and telephone number to the district office designated to service their area (based on applicant’s address).

Note:  Application submitted at the wrong office is not a valid denial reason. If the applicant chooses to reapply at their designated district office, HHs must be advised of their right to file an application the same day of their inquiry, to avoid any loss in benefits.

Application

Any of the following applications can be submitted to request CalFresh benefits:

·       CF 285, Application for CalFresh Benefits;

·       SAWS 1, Initial application for CalFresh, Cash Aid/GR and/or Medi-Cal/Health Care Programs; or

·       SAWS 2 PLUS, Application for CalFresh, Cash Aid/GR and/or Medi-Cal/Health Care Programs.

All the above listed applications are acceptable.  Applicants are required to sign only one CalFresh application.  If SAWS 1 is completed and signed by the applicant at the district office, then it must be accepted as a single signed application for CalFresh.  When the application is received via YBN or the HH applied for other programs and has already signed the
SAWS 2 PLUS, no additional application or signature is required.  When the CF 285 application is received via mail or through outreach programs, no signature is required on the SAWS 1.

For CalFresh purposes, the minimum required information for any of the applications referenced must include the following:

·       Applicant’s full name;

·       Applicant’s address (if homeless, district address is acceptable); and

·       Head-of-HH, spouse, any other responsible HH member, or AR’s signature.

A copy of the completed system-generated Statement of Facts must be provided to the applicant for their review/or records at the time of the interview or mailed to the applicant if the interview occurred over the phone.

When the information provided on the application is not enough to make an eligibility determination for CalFresh, the HH is responsible for providing all information necessary for processing of the application.

Age Requirement

There is no age requirement in applying for CalFresh benefits.  Anyone, who under CalFresh policy is considered an individual living alone, should be given the opportunity to apply as a one-person HH.  It is possible that a youth applicant has been emancipated or is not under the parental control of any adult.

Applicants who are not allowed to have a separate HH regardless of purchasing and preparing food separately:

·       Minors under 18 years of age, living with and under the parental control of a HH member who is not his/her natural, adopted or stepparents;

·       A person under 22 years of age, who is living with his/her natural, adopted or stepparents;

·       A spouse of any member of the HH;

·       Boarders; and

·       Children of narcotic addicts or alcoholics who reside at a treatment center.

Parental control is defined as follows:

A child (other than a foster child) under 18 years of age who lives with and is under the parental control of a HH member other than his/her parent.  A child is under parental control for purposes of this provision if he/she is financially or otherwise is dependent on a member of the HH, unless State law defines such person as an adult.

When HHs include a homeless youth temporarily seeking accommodation in the residence of an adult individual that is exhibiting parental control over the youth, the youth must apply for CalFresh benefits as part of the same HH as the adult. 

Interview Process

An interactive interview is required for each filed application regardless of the source of the application.

Eligibility staff must conduct an interactive face-to-face or telephone interview with the HH on the same day the application is received.  If the HH is unavailable, an interactive interview appointment must be scheduled the same day the application is received for the fifth day following the application received date.

The face-to-face interview is to be conducted only if the applicant:

·        Requests a face-to-face interview;

·        Is in the district office;

·        Is also applying for another program, such as CalWORKs or GR, that requires a face-to-face interview; or

·        If deemed necessary to clarify a condition of eligibility. 

However, HHs may not be required to attend a face-to-face interview if attending the interview will be a hardship.  In this case, the interview must be conducted by telephone.

Note: The application process must not be negatively affected by a telephone interview.  The same information must be provided during the interview and the same verification must be requested regardless of the type of interview conducted.

At the time of the interactive interview the following must be reviewed with the applicant;

·        Income Reporting Threshold (IRT)Limit;

·        CF LA 100;

·        Sample SAR 7;

·        SAR 7A;

·        SAR 7 Addendum;

·        R&R; and

·        Voter registration information.

Note: CalFresh Interview R&R, SAR 7, and Voter Registration Information scripts and audio file are available in all threshold languages. Staff must read the scripts or play the audio file to all applicants during the interactive interview.

A copy of the R&R, sample SAR 7, SAR 7A, SAR 7 Addendum, CF LA 100 and Voter registration information must also be provided or mailed to the applicant.

Verification

Applicant HHs must be allowed 10 calendar days to provide requested verification(s).

Note: If the 10^th calendar day falls on a weekend or holiday, the applicant is given until the first workday after the 10-day deadline.

Income Eligibility Verification System (IEVS) Interface

All applicants of  CalFresh benefits must be notified in writing at the time of application that information available through IEVS will be requested, used, and may need to be verified when discrepancies are found.  Applicants must also be notified that such information may affect the HH’s eligibility and level of benefits.

Work Registration Requirement

Eligibility staff must effectively determine which individuals in the HH are work registrants.  Once the work registration process is complete, the individual is considered registered for work for the remainder of the certification period.

An ABAWD is a CalFresh participant, age 18 through 49, who is able-bodied without dependent children and does not meet the criteria for an exemption from the ABAWD time limit. ABAWD eligibility for CalFresh is limited to any three full months of benefits in a 36-month period unless the individual:

·        Satisfies the ABAWD work requirement;

·        Is exempt from the ABAWD time limit;

·        Qualifies for an additional three consecutive month period of eligibility;

·        Receives a discrepancy exemption; or

·        Lives in a county or area with a waiver of the ABAWD time limit.

Note: Work registration status must be determined at initial application and every 12 months thereafter.  When an individual no longer qualifies for an exemption from work registration due to a change in circumstance(s), applicants must be registered for work at the time the change is reported, unless the individual qualifies for another exemption.

Category

Acceptable Documents

Identity

·        Photo Identification (e.g., from a school or a bank);

·        Passport;

·        Social Security (SS) card;

·        Birth Certificate;

·        Driver’s License;

·        Matricula Consular;

·        Pay stubs;

·        Voter Registration card;

·        Immigration and Naturalization forms;

·        Credit/Check Cashing cards;

·        Identification for health benefits, or for another assistance or social services program;

·        Other readily available documentary evidence (e.g., “A” or “W” verifiers on the Medi-Cal Eligibility Data System (MEDS) or an identity verification listed on the system from a previous application);

·        Student’s Financial Aid Award letter;

·        Collateral Contact; or

·        Any document that reasonably establishes the applicant’s and the AR’s identity.

Note:  No requirement for any specific document is to be imposed.  A CalFresh applicant cannot sign an affidavit (self-declare), to identify himself/herself.

Social Security Number (SSN)

·        Social Security card (the card itself may be used as verification but it is not to be mandated);

·        MEDS- SSN verifiers with an ‘A’ or an ‘W’ indicator on MEDS are sufficient verification for this requirement; or

·        An Award Letter from Social Security Administration (SSA) showing the name and the SSN of the applicant.

Note:  If the applicant/participant is unable to provide a SSN or proof of application for an SSN for a newborn, the HH must provide the SSN or proof of application at its next certification or within six (6) months following the month the baby was born, whichever is later.

Citizenship (not required unless questionable)

·        Birth Certificate;

·        United States Passport;

·        United States Passport card;

·        Certificate of Naturalization or N-550/N-570;

·        Religious records; or

·        Citizenship verification previously provided and accepted by CalWORKs Program.

Non-Citizenship Status

·        Documents from United States Citizenship and Immigration Services (USCIS) i.e., Permanent Residency cards*;

·        I-94, Arrival/Departure Record;

·        NOA from USCIS;

·        Confirmation through Systematic Alien Verification for Entitlement (SAVE) System; or

·        Confirmation from the SAVE via the G-845S or G-845 Supplement forms along with the USCIS document provided by the HH.

Expired cards can only affect the individual’s ability to travel or work in the United States.  Expiration of the card does not change the status of the cardholder’s permanent resident status.  CalFresh benefits must not be denied solely on this factor.

Gross Non-Exempt Income

At application, the HH must provide verification of income received over the last 30 days unless the HH just started working. Examples of Gross Non-Exempt Income verification is included, but are not limited to:

·        Pay Stubs;

·        W-2 Forms;

·        1099 Forms;

·        Award Letters;

·        PA 167, Monthly Earnings Report;

·        Income Tax Returns; or

·        Copies of checks;

Income received during the past 30 days from the date of application must be used as an indicator of the income that is and will be available to the HH during the certification period. However, if changes in income have occurred or can be anticipated, eligibility staff must not use past income as an indicator of income anticipated.

When a HH states on the application or during the interview that its income exceeds the gross income limit, income verification of HH non-exempt gross income must be requested prior to denying an application for CalFresh.  An application cannot be denied based solely on an unverified statement of HH’s income.

When all attempts to verify the income have been unsuccessful because the person or organization providing the income has failed to cooperate with the HH and all sources of verification are unavailable, the eligibility staff with the applicant’s assistance must determine an amount to be used based on the best available information.

When no changes in income have occurred or can be anticipated and income fluctuates to the extent that a 30-day period alone cannot provide an accurate indication of anticipated income, eligibility staff can use a longer period of past time if it will provide a more accurate indication of anticipated income.

If the applicant has just started working and has not received a full month (30 days) of income, the employer’s statement and/or any pay stub received and information provided on the application and during the interview, can be used to reasonably anticipate the applicant’s income. 

Mandatory verification of job loss more than 30 days prior to the application date is not required. When a HH member claims to have recently lost a job, within 30 days of the date of application, then the HH member’s income must be verified and the HH member’s last day of work and last pay day must be considered to determine eligibility and benefit amounts for HH’s first month’s benefits. Staff will not anticipate income from that job to continue during the remainder of the certification period.

When a HH has zero income, unless the HH indicates otherwise or anticipates changes, a statement from the HH that it has zero income on the application is sufficient evidence that the HH cannot reasonably anticipate income during the certification period.  A HH is not required to provide verification of zero income, unless questionable.

Note: All circumstances taken in income determination must be thoroughly documented in case Journal page.

When a CalFresh HH reports a job loss subsequent to initial application he/she is required to provide verification of the decrease in income. When requesting verification, the County must determine whether the job loss led to;

1.     A decrease in income of $50.00 or more, the HH’s new gross non-exempt income must be verified to determine continuing eligibility.

2.     A zero income, a statement from the HH that it has zero income is sufficient evidence that a HH cannot reasonably anticipate income during the remainder of the certification period, unless questionable. 

Note: Reports subsequent to initial application refer to voluntary mid-period reports and periodic reports (i.e., SAR 7).

The following are acceptable types of verification of decrease in income:

·        A pay stub/check stub (this document must provide the reduction of working hours and gross income;

·        An employer’s statement that provides the reduction of working hours and gross income;

·        A reduction of benefit notice from a source/agency (e.g., SSA, Employment Development Department [EDD], Pension/Retirement, Worker’s Compensation);

·        Other written documentation; or

·        Affidavit as a last resort.

Disability

·        Award letter from SSA indicating receipt

·        of SSI or Social Security Disability;

·        Award letter from the VA;

·        Award letter from the Railroad Retirement Board Benefits certifying the individual eligible for Medicare benefits;

·        MEDS disability indicator under the INQX screen;

·        IEVS match; or

·        NSA verification from the General Relief Program.