40-101_9 General Relief for Pregnant Women

.Purpose

Policy

Background

Release Date:

November 27, 2019

Definitions

Requirements

Verification Docs

GENERAL RELIEF

40-101.9 General Relief For Pregnant Women

Purpose

( ) To release a new policy

( ) To release a new form

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

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

What changed?

Instructions for processing General Relief (GR) applications for pregnant women has been revised as follows:

1. Eligibility staff must provide the ABP 119, Important Notice to Pregnant Women, to pregnant applicants/participants at the time the pregnancy is reported.

2. Refer pregnant applicants/participants in their third month of the first trimester or later, to the District Navigator/Self-Service Assistant to submit a CalWORKs application via Department of Public Social Services’ (DPSS) online Your Benefits Now (YBN) application system, to prevent a break in aid, if the applicant wishes to submit a CalWORKs application the same day.

3. Customer Service Center (CSC) will inform pregnant applicants/participants that they may apply for CalWORKs beginning the third month of the first trimester by applying at the nearest CalWORKs office or online via YBN.

Note: Changes are shown highlighted in grey throughout the document.

Policy

Effective July 1, 2015, GR began to aid Pregnant Women Only (PWO) through their first trimester of pregnancy (months one, two, and three). Once a GR applicant/participant has entered her second trimester (months four, five, and six) or thereafter, she will no longer be aided on GR and will be considered potentially eligible to CalWORKs. Pregnant women age 19 and older, which include drug felons, would be potentially eligible for CalWORKs and the Pregnant Special Need (PSN) payment of $47 beginning the second trimester of pregnancy. Pregnant minors, aged 18 years or younger, are ineligible for GR because they are potentially eligible for CalWORKs, even in the beginning of the first trimester.

If the GR pregnant applicant is timed-out under the CalWORKs Program, the pregnant applicant may be aided on GR during her second and third trimesters of pregnancy until the baby is born.

To prevent a break in aid, when a pregnant individual is in the district office and in her third month of the first trimester or later, or GR application/case is denied/discontinued, a “warm hand-off” to the Self-Service staff at the GR district office will be done to assist the individual with submitting a CalWORKs application via YBN, if the individual is willing. If the individual does not wish to apply via YBN at the district office, the applicant/participant will be informed that they have the option of applying for CalWORKs at any CalWORKs office, or online via YBN and provided with the ABP 119, Important Notice to Pregnant Women and list of CalWORKs offices.

Background

Prior to the passage of Assembly Bill (AB) 1579, PWO receiving GR were aided until the end of their second trimester (benefits discontinued at the end of month six) and became potentially eligible for CalWORKs at the beginning of their third trimester (months seven, eight, and nine).

This policy became effective July 1, 2015, with the implementation of AB 1579, the Healthy Babies Act. AB 1579 allows PWO to apply for CalWORKs benefits beginning the second trimester of pregnancy instead of limiting their eligibility to the third trimester. GR should be discontinued for a pregnant woman at the end of her third month of pregnancy, and eligibility staff will refer her to apply for CalWORKs at any CalWORKs District or via the YBN website at: https://www.dpssbenefits.lacounty.gov/ybn.

Definitions

N/A

Requirements

Requirement	Limit/Condition
Eligibility	A pregnant woman in the first three months of pregnancy (with no other children in her custody) may apply for GR, as potential eligibility to CalWORKs does not begin until the fourth month of pregnancy. Pregnant minors, age 18 years or younger, are ineligible for GR because they are potentially eligible for CalWORKs, even in the beginning of the first trimester. When a pregnant woman and the father of the unborn are married, and living together, they are eligible for GR during the woman’s first trimester only. When the pregnant woman reaches the end of her first trimester, the couple is no longer eligible for GR. The GR case will be discontinued, and they will be referred to CalWORKs. The pregnant woman will be potentially eligible for CalWORKs beginning the second trimester of pregnancy, but the father of the unborn will not be eligible for CalWORKs until the child is born. When a pregnant woman and the father of the unborn are unmarried and living together, the pregnant woman is eligible for GR during her first trimester only. When the pregnant woman reaches the end of her first trimester, the GR case will be discontinued, and she will be referred to CalWORKs. The father may be aided on a separate GR case until the child is born.
Pregnancy Termination	If the pregnancy terminates during the first trimester due to a miscarriage, stillbirth, etc., the pregnancy end date and reason must be entered in LRS to prevent the GR case from discontinuing. The participant remains eligible for GR.
CalWORKs Time Limits	If the GR pregnant applicant is timed-out under the CalWORKs Program, the pregnant applicant may be aided on GR during her second and third trimesters of pregnancy until the baby is born.
Medi-Cal for Pregnant Women	An Immediate Need Medi-Cal card will be issued to a pregnant woman regardless of whether a card is requested. Pregnant applicants/participants with Satisfactory Immigration Status (SIS) [including Permanently Residing Under Color of Law (PRUCOL)] and with incomes up to and including 138% of the Federal Poverty Level (FPL), are eligible for full-scope Medi-Cal. PWO with non-SIS status are eligible for limited-scope Medi-Cal, which covers emergency services, pregnancy related or not. Pregnant minors may apply for Medi-Cal on their own behalf through the Minor Consent Program or the parent/guardian may apply for Medi-Cal on behalf of the minor child.

Verification Documents

Category	Acceptable Documents
Verification of Pregnancy	Applicant’s/participant’s verbal or written statement, doctor’s statement.