2. Application Process...CAPI payments are considered exempt income for Medi-Cal, but are NOT exempt in CalFresh budget computations. 2.1.3 Date of Application The “Statement of

Medi-CalCAPI 2. Application Process

2. Application Process

2.1 General Information

2.1.1 Where to Apply

CAPI applications are processed at the General Assistance (GA) Office of the Santa Clara County Social Services Agency. Applications may be submitted as follows:

• In Person at the GA Office located at 1919 Senter Rd., San Jose or,

• By Telephone, calling (408) 758-3600 or,

• By mail to 1919 Senter Rd. San Jose, Ca 95112

Note:

If a CAPI application is received in a District Office other than the GA office, it must be date-stamped and immediately forwarded to the GA office. When received in the GA office, an intake appointment will be scheduled, and required forms and notification will be sent to the applicant. Refer to [“Application Process” on page 2-5]

2.1.2 Other Programs

Most CAPI recipients will be eligible for Medi-Cal, and may also qualify for CalFresh. Eligibility for these programs must be evaluated at the time of the CAPI application.

Related Medi-Cal and CalFresh only cases are maintained in the GA office with the CAPI cases.

Note:

CAPI payments are considered exempt income for Medi-Cal, but are NOT exempt in CalFresh budget computations.

2.1.3 Date of Application

The “Statement of Facts Cash Assistance Program for Immigrants (CAPI)” (SOC 814) is the required CAPI application form.

Update #20-03Page 2-1

page 2-2CAPI 2. Application Process

Date of the CAPI application or Protected Application Date, is determined as follows:

If the application was received... Then the application date is...

In person the date the application was submitted in person

By mail the date the application was received in the mail

By phone the date the application was completed with the client over the phone.

NOTE: The SOC 814 must be stamped the date that its received in person or by mail. In the case of phone applications, it must be stamped the date the application is completed with the client over the phone.

2.1.4 Face-to-Face Interview

A face-to-face interview is required with the applicant for Intake ONLY.

A face-to-face interview is NOT required at redetermination, unless clarification is needed of a questionable situation.

Note:

If the applicant is prevented from traveling to the local social services agency office for a face to face interview due to disability or other good reason, an appointment for a home visit must be arranged, in order for the applicant to complete the application process.

2.1.5 Processing Time

A CAPI application must be processed within 30 days from the date the SOC 814 is date-stamped by the Social Services Agency. An application may be held in a pending status for 30 days from the date of the application, to allow the applicant to obtain required verifications.

2.1.6 30-Day Processing Time

A CAPI application must be processed as soon as possible and a decision to approve or deny an application must be done no later than 30 days following the date of application.

When an SSI/SSP application is required, the applicant/recipient must apply within 30 days of the CAPI application.



Exception: When a Medi-Cal determination is required from the Disability Determination Service Division (DDSD), the 30-day processing time begins on the day that the county obtains a disability determination from DDSD. However, if the applicant is ultimately found to be disabled, the county must provide the applicant with retroactive CAPI benefits extending back to the first day of the month following the protected application date.

If an application is denied for failure to provide essential information, and the applicant provides the required form and/or verification within 30 days of the application date, the denial must be rescinded and the original application processed. A new SOC 814 is NOT required.

2.1.7 Beginning Date of Aid

The beginning date of aid for CAPI is the first of the month following the date of application or the date the client would otherwise become eligible for benefits, whichever is later.

Example:

Mr. Nguyen will turn 65 years old on March 29. He can file an application as early as February 1st, but his CAPI benefits will not be effective until April 1st.

Reminder:

Even if the applicant files an application on the FIRST of the month, aid payment is not effective until the first of the NEXT month.

2.1.8 Immediate Needs

There are NO immediate needs in the CAPI program.

2.1.9 Retrospective Budgeting

The first 2 months of aid are budgeted prospectively. Subsequent months are budgeted retrospectively. [Refer to “Retrospective Budgeting,” page 8-2].]

If there is a break in aid of 30 days or more, the budget must be calculated prospectively for the first 2 months of restored aid, then changed to retrospective budgeting for the third and subsequent months. [Refer to “Prospective Budgeting,” page 8-1].]

2.1.10 Application Withdrawal

If an applicant decides to withdraw their CAPI application, a “Informal Application Refusal / Withdrawal of Application” (SCD 166) MUST be completed and an adequate NOA issued.



Reminder:

The EW must inform the client of other benefit program he/she may be eligible. If the client refuses to apply, the SCD 166 must be completed and signed by client, and scanned in IDM.

2.1.11 Documentation

Per state requirements; basic case information, changes, and EW actions must be thoroughly documented on the Maintain Case Comments window in CalWIN. Failure to do so may adversely affect the outcome of state audits.

2.1.12 Failed or Rescheduled Appointments

CAPI applications must be denied if clients fail to attend their scheduled interview appointment. However, if clients request to reschedule the appointment within 30 days, the original application date is granted.

If the client misses the second appointment, the CAPI application must be denied if the 30 days are over. If the client fails two scheduled appointments and calls to rescheduled one more time, the client must be informed that the application is denied and must submit a new application.

2.1.13 Application Signature

The CAPI application must be signed by the applicant in the presence of the Eligibility Worker.

In the case of telephone application, the designated staff must signed the “Remarks” section of the application, indicating the reason for this signature. The applicant must sign the application during the face to face interview.

In the case of an applicant who can only sign with an “X” mark, the EW must witness the action and confirm the applicant’s identity.

2.1.14 Married Couples

Each person applying for CAPI or certifying continued eligibility for CAPI benefits must complete his or her own CAPI application forms and comply with all requirements. If both members of a married couple are found eligible for CAPI, the benefit amount will be determined using the couples’ payment standard and the monthly payment will be divided evenly among the spouses. (MPP §49-055.4). Each of the spouses will receive his or her own CAPI payment each month. When CAPI benefits are approved, denied, suspended, terminated or reinstated, a separate Notice of Action must be sent to each of the spouses at his or her address of record.



2.2 Application Process

The steps below are to be followed when processing a CAPI application according to the method it is received by the county:

2.2.1 CAPI Application In Person

Step Who Action

1 Client Walks in to the GA Office and requests to apply for CAPI.

2 Clerical • Provides the client with the following forms:

• SCD 41

• SOC 814 (client must provide sufficient information to initiate the application registration).

Note: If client is applying for all programs (CAPI, Medi-Cal and CalFresh) provides the SAWS 2 plus in addition to the SOC 814.

• Informs the client to complete the provided forms and to return to clerical to be scheduled a CAPI intake interview appointment.

3. Client Completes and signs the application packet and returns to clerical.

4. Clerical • Reviews the application forms for completeness, signatures and dates.

• Date-stamps the application form.

• Schedules a CAPI intake appointment

• Provides client with the “Appointment Notice for Public Benefits” (SCD 67) along with the CAPI application packet which contains additional application forms and informational material necessary for the intake interview.

Note: If client is also applying for CF, follows the triage process for CF Expedited Services screening. [“Triage Business Process,” page 59-10].

5. Client Returns on the date/time of their scheduled appointment.

6. EW • Conducts a face to face interactive interview.

• Makes eligibility determination to approve or deny all benefits the client applied for, as appropriate.

• SAWS 1



INTER-OFFICE APPLICATION

An inter-office application must be taken, if a client requests to apply for CAPI in any District Office other than GA.

NOTE: All District Offices are responsible for ensuring that CAPI application packets are available at all times. Packets must include a self addressed envelope marked for GA as R1 unit.

STEP WHO ACTION

1. Non-GA Designated Clerical Staff

• Provides the client with the forms following forms:

• Ask the client to complete and sign the forms.

NOTE: If CalFresh and/or Medi-Cal is also requested, a SAWS 2 plus must also be provided.

• Date stamps all completed forms and emails to the General Assistance office email box [email protected], for application registration and processing.

• Informs the client that the application is forwarded to the CAPI application processing office and that he/she will be mailed an appointment letter.

2. GA Designated Clerical Staff

• Retrieves the CAPI application in the General Assistance email box

• Completes CAPI application registration (Application date is the date stamped).

• Schedules a CAPI face to face appointment.

• Mails the “Appointment Notice for Public Benefits” (SCD 67) along with the CAPI application packet which contains additional application forms and informational material necessary for the intake interview.

3. Client Returns on the date/time of their scheduled appointment.

6. EW • Conducts a face to face interactive interview.


• SOC 814, SCD 41 and SAWS 1 Note: The client must provide sufficient information in the SOC 814 to initiate the application registration.



2.2.2 CAPI Application by Telephone

When the client calls in to the Social Services Agency requesting to apply for CAPI, the steps below are to be followed:

Step Who Action

1 Client Calls in the Social Services Agency and requests to apply for CAPI

2. Phone Support Team

• Receives the telephone call from an applicant requesting to apply for CAPI

• Completes Section 1 - Applicant Information, and Section 3 - Marital Status with the client over the phone.

• Signs the “Authorization and Certification Statement” of the SOC 814 with the client’s expressed permission. The signature must be in the “Remarks” section of indicating that the CAPI telephone application was signed with client’s expressed permission, and the client was informed that his/her signature will be required at the face to face interview.

• Completes SCD 41, and SAWS 1, with the client on the phone.

• Date stamps all forms

• Informs the client that the application has been taken and will be forwarded to the CAPI application processing office, and an intake appointment letter will be mailed.

• Scans all forms and emails them to the General Assistance email box [email protected]

3. GA designated clerical

• Access the CAPI application in the GA email box

• Performs application registration referring to the date stamp for the application date.

• Schedules a CAPI Intake appointment and mails the “Appointment Notice for Public Benefits” (SCD 67) along with the CAPI application packet which contains additional application forms and informational material necessary for the intake interview.

Note: If client is applying for all programs (CAPI, Medi-Cal and CalFresh) provides the SAWS 2 plus in addition to the SOC 814 and follows triage process.

4. Client • Attends the CAPI intake appointment as scheduled.

5. EW • Conducts a face to face interview.

• Asks applicant to sign the SOC 814 and all other required forms.


NOTE: All District Office are responsible for ensuring that CAPI application packets are available at all times. Packets must include a self addressed envelope marked for GA as R1 unit.



2.2.3 CAPI Application by Mail

When the client calls in to the Social Services Agency and requests that a CAPI application be mailed, the following steps are to be followed:

STEP WHO ACTION

1. Client • Calls the Social Services Agency requesting that a CAPI application be mailed.

2. Phone Support Team

• Receives the applicant’s call.

• Informs the applicant that an application can be also taken by phone and follows the process for CAPI application by telephone,

or

• Mails a CAPI application packet to the client if he/she does not wishes to apply by telephone. Includes a return enveloped marked with R1 unit.

3. Client • Completes the CAPI application and mails it back in the enveloped provided.

4. GA Clerical • Receives the CAPI application by mail.

• Registers the application in CalWIN

• Schedules a CAPI intake appointment and mails the “Appointment Notice for Public Benefits” (SCD 67), along with the CAPI application packet.

5. EW • Conducts a face to face interview


NOTE: All District Office are responsible for ensuring that CAPI application packets are available at all times. Packets must include a self addressed envelope marked for GA as R1 unit.

2.2.4 Home Visits

If an applicant is unable to travel to the local Social Services Agency to for a face to face interview, due to a disability or other good reason, an evaluation for a home visit must be made.

Note:If client is applying for all programs (CAPI, Medi-Cal and CalFresh) provides the SAWS 2 plus in addition to the SOC 814 and follows triage process.

Note:If client is also applying for CalFresh, follows triage procedures to screen Expedited Services eligibility.



2.2.5 Authorized Representative

State law provides that “any person shall have the right to apply for services or to make application through another person on his behalf” and that “the application may be signed by the applicant or his Authorized Representative (AR).” An individual may apply for CAPI and may sign the CAPI application (SOC 814) either personally or through another person whom the applicant has authorized to represent him/her.

The applicant must sign the AR agreement in the presence of the EW. The AR may be authorized to signed most of the CAPI forms. However, per Social Security Administration, the SSP 14 must be signed only by the applicant.

In the case of telephone applications, the applicant may request for the application to be completed on the phone by a person that he/she designates. However, the AR status must be established at the face to face interview where both the applicant and the authorized representative must sign the AR agreement in the presence of the EW.

“The Authorization for Release of Information Authorized Representative” (CSF 14) can be manually generated from CalWIN.

Note:

Advocates are not Authorized Representatives, unless the client expresses in writing in and signs the AR form in the presence of the EW and the designated AR.

NO pre-signed authorization forms are acceptable.

2.3 Required Forms

2.3.1 Intake Forms

The following forms are required for Intake:

FORM # FORM NAME

CSF 67 EBT Card and PIN Responsibility Statement

EBT 2216 EBT Surcharge Free - Direct Deposit Handout

PUB 13 Your Rights Under California Welfare Programs

PUB 388 California Electronic Transfer (EBT) Card

SCD 103 Acknowledgment of Limited Sharing of Information for the Administration of Cash Aid Programs



[Refer to “Intake/RRR Packets,” page 24-1] for more information.]

Note:

As described in the Application Process [Figure 2.2], the forms SAWS 1, SCD 41 and pages 1 and 6 of SOC 814 are given up front for application registration.

2.3.2 Reimbursement Agreement

All CAPI applicants MUST sign the “Authorization for Reimbursement of Interim Assistance Initial Payment or Initial Posteligibility Payment” (SSP 14). If the CAPI applicant fails or refuses to sign either of the Interim Assistance Reimbursement Authorizations, there is NO CAPI ELIGIBILITY.

The SSP 14 MUST be forwarded to the Social Security Administration (SSA) for proper recording of the CAPI application. Failure to forward the SSP 14 to SSA will result in a loss of reimbursement funding for Santa Clara County.

[Refer to “Interim Assistance/Reimbursement (IAR),” page 14-1 for further instructions.]

SCD 122 CAPI - General Eligibility Information and Payment Levels

SCD 571 EBT Brochure

SCD 573 Cash Assistance Program for Immigrants (CAPI) Application Notice

SCD 574 Important Information About Required Verifications for CAPI

SCD 575 CAPI - Important Notice

SCD 576 CAPI Recipients are Required to Apply for Supplemental Security Income (SSI/SSP)

SCD 1264 Language Survey - Interpreter/Translator Request

SCD 2300A Proof Needed

SOC 453 CAPI Statement of Household Expenses and Contributions

SOC 455 CAPI - State Interim Assistance Reimbursement Authorization

SOC 814 Statement of Facts - Cash Assistance Program for Immigrants (CAPI)

SSP 14 Authorization for Reimbursement of Interim Assistance Initial Payment or Initial Posteligibility Payment

Temp 2214 Additional Information About EBT

FORM # FORM NAME



Note:

The “Cash Assistance Program for Immigrants State Interim Assistance Reimbursement Authorization” form (SOC 455) must also be completed if a client is receiving GA benefits while his or her CAPI application is pending.

2.3.3 State Programs-Disability Determination Service Division (SP-DDSD) Referral

The following forms are required to process a DDSD referral:

• MC 220 – Authorization for Release of Information• MC 221 – Disability Determination and Transmittal (CAPI case to be flagged)• MC 223 – Applicant’s Supplemental Statement of Facts for Medi-Cal

Write “CAPI CASE” in RED ink on the MC 221 in Item 8, next to the box that is checked to indicate Initial Referral.

[Refer to Medi-Cal Handbook, “Procedure,” page 30-2. for more information]

Note:

A new DDSD referral is NOT needed if client’s disability-based Medi-Cal benefit is active, unless it is a sponsor-deeming disability evaluation. The EW must ensure that the reexamination date of the current DDSD determination has not expired and there is no indication that the medical condition has improved.

2.4 Verifications

All required verifications must be provided for an application to be considered complete.

The primary verifications required for ALL applicants include:

• Age• Immigration status• Blindness/Disability• Income• Resources • Living arrangements, and• Sponsorship information (e.g. Affidavit of Support, sponsor’s income and property)



Note:

The “CAPI Application Notice” (SCD 573) and the “Important Information About Required Verifications for CAPI” (SCD 574) must be given to the CAPI applicant on the date of application.

2.4.1 Age

Acceptable verification of age includes:

• Birth certificate, validated copy of a birth certificate;• Baptismal record;• Verification of previous receipt of SSI/SSP based on age;• Verification of receipt of Social Security (SSA) benefits based on age;• Proof of current Medi-Cal eligibility based on age; or• United States Citizenship and Immigration Services (USCIS) documentation such as an I-551,

I-94 when the date of birth is noted.

2.4.2 Immigration Status

Verification of citizenship or immigration status is required to determine CAPI eligibility. Refer to [“United States Citizenship and Immigrant Status Codes,” page 11-1] and [“Immigration Documents,” page 12-1] of the Common Place Handbook for a complete description of USCIS documentation and immigration status.

Immigrant status must be reviewed at EVERY intake.

If, at any time, the worker becomes aware of any change in the immigrant’s status that could affect the individual’s eligibility for CAPI, the recipient must be notified to take the appropriate action. Appropriate action may include the requirement to file for Supplemental Security Income/State Supplementary Payment (SSI/SSP) if the change in status would make the individual eligible for federal benefits.

Expired Legal Permanent Resident (LPR) Cards

An expired LPR card must be accepted as valid verification if it can be verified that the applicant has a current lawful permanent resident status.

The immigration status of a CAPI applicant must be verified before benefits can be approved. If an applicant presents an expired LPR card, the immigration status must first be verified through a SAVE query. If the initial SAVE query does not provide verification, a secondary SAVE must be initiated.



CAPI benefits of an applicant with an expired LPR card, who is meeting all other eligibility criteria, can only be denied if the applicant’s immigration status can not be verified after making all efforts to obtain such verification.

The LPR card and SAVE reports must be scanned into the case IDM. Thorough case comments must be included in the case indicating why an expired LPR card was accepted.

The Eligibility Worker must inform applicants/recipients with expired LAPR cards that they may visit www.uscis.gov to begin the LPR card renewal process, or may go to the nearest USCIS field office to obtain further assistance.The EW must also inform the applicant/recipient of the USCIS Request for Fee Waiver form I- 912 that may also be obtained from the USCIS website.

2.4.3 Sponsorship

If the applicant is sponsored, sponsorship status must be verified, as well as any claims of death of the sponsor, disability of the sponsor or abusive actions of the sponsor or the sponsor’s spouse.

Note:

If a Lawfully Admitted for Permanent Residence (LAPR) immigrant alleges no sponsor, verification of that LACK of sponsorship must be obtained from USCIS.

Affidavit of Support

A copy of the Affidavit of Support signed by the sponsor must be on file whenever sponsor-deeming applies. The client can request a copy from USCIS under the Freedom of Information Act, if the Affidavit was lost or destroyed.

[Refer to “Definitions,” page 1-3], for a description of Affidavits of Support.]

[Refer to “Sponsorship,” page 11-1] for detailed information on the Affidavit of Support.]

Sponsor’s Income/Resources

The sponsor of an immigrant must provide verification of income, resources, and living expenses. A “CAPI Sponsor’s Statement of Facts Income And Resources” (SOC 860) or “Sponsored Noncitizens Applying for or Receiving Cash Aid and/or CalFresh” (SAR 22) MUST be completed by the sponsor and scanned into the Integrated Document Management (IDM) system. The “Sponsor Alien Deeming Worksheet” (SOC 454) MUST be completed by the EW PRIOR to the approval of CAPI benefits.


https://www.uscis.gov/

https://www.uscis.gov/i-912

https://www.uscis.gov/i-912



https://www.uscis.gov/sites/default/files/document/forms/i-912-pc.pdf


Note:

For CAPI only cases SOC 860 must be used. For cases with CAPI and CalFresh the SAR 22 may be used.

Reminder:

For extended CAPI applicants, the sponsor-deeming period is 10 years, regardless of which Affidavit the sponsor signed.

Deceased Sponsor

A death certificate or newspaper obituary notice is required to verify the death of an immigrant’s sponsor.

Disabled Sponsor

If the sponsor is disabled, he/she must provide a medical verification that his/her disability is expected to last at least 30 days and significantly impairs the sponsor’s ability to be regularly employed or participate in Welfare-To-Work activities. The sponsor is required to be actively seeking treatment.

Abusive Sponsor

If the sponsor or the sponsor’s spouse is abusive to the immigrant, one of the following verifications must be provided:

• Sworn statement from victim, or victim’s representative when the victim is not competent, AND police, government agency, or court records or files; OR

• Documentation from a domestic violence program, legal, clinical, medical, or other professional from whom assistance was sought; OR

• Statement from another individual with knowledge of the circumstances upon which the allegation of abuse is based; OR

• Physical evidence of abuse.



Note:

When the previously listed items are not available, a sworn statement will be accepted if it is determined the victim is credible and the EW has documented this determination in the Maintain Case Comments window.

Definition of Abuse

Abuse is defined as assaulting or coercive behavior that includes, but is not limited to physical abuse, sexual abuse, psychological abuse, economic control, isolation, stalking, and threats or other types of coercive behavior.

Mandatory Referral

If a person is applying for CAPI on the basis of abusive sponsor and/or sponsor’s spouse, a referral to Adult Protective Services (APS) or Child Protective Services (CPS) is MANDATORY.

2.4.4 Blindness / Disability

Medical verifications are required when the application is based on blindness or disability.

Current Determination

A current determination of disability is one that has not lapsed due to benefit termination. A determination established for one of the following programs is acceptable verification of blindness or disability for CAPI:

• Title II Social Security,• SSI/SSP, or• Medi-Cal.

Note:

A new DDSD referral is still needed for sponsor-deeming disability evaluations even if there is a current DDSD determination and client’s disability-based Medi-Cal is active.

Disability Evaluation

If there is no existing verification of a physical or mental disability from Social Security, SSI/SSP, or Medi-Cal, a SP-DDSD referral must be completed for CAPI eligibility based on disability.



Note:

If the disabled individual is age 65 or over, CAPI benefits may be paid on the basis of age while the disability determination is pending.

2.4.5 Presumptive Disability

If an individual’s blindness / disability meets one of the presumptive disability conditions and the individual meets all other CAPI eligibility criteria, CAPI benefits may be paid presumptively pending the final disability determination from the “State Programs-Disability Determination Service Division” (SP-DDSD). A presumptive disability determination MUST be documented in the case record. [Refer to “Deeming Exception Due to the Sponsored Noncitizen’s Disability (for I-134 only),” page 11-15].]

Presumptive CAPI payments are LIMITED TO SIX (6) MONTHS.

The case must be reviewed at the beginning of the sixth month from the date of initial payment to determine appropriate action. Presumptive aid payments must be stopped at the end of the sixth month, even if the SP-DDSD is still pending.

Note:

Payments based on a presumptive disability are NOT considered overpayments if the applicant is ultimately determined to be NOT blind or disabled.

2.4.6 Income

All income, both earned and unearned belonging to the client and/or the client’s sponsor/sponsor’s spouse MUST be verified prior to the approval of CAPI benefits.

2.4.7 Resources

All resources belonging to the client and/or the client’s sponsor/sponsor’s spouse MUST be verified prior to the approval of CAPI benefits.

2.4.8 Living Arrangements

The client’s living arrangements MUST be verified. If the client does NOT reside alone, a “CAPI-Statement of Household Expenses and Contributions” (SOC 453) must be obtained.



In Home Supportive Services Referral (IHSS)

If the CAPI applicant/recipient answers “YES” to questions 14 (a) and (b), or expresses the need of assistance with personal care or hygiene, dressing, taking medications, etc., the client must be provided with the contact phone number for In-Home Supportive Services (408) 792-1600.

2.5 Rights

2.5.1 Interpreter Services

If an individual needs an interpreter to complete the CAPI application process or ongoing program requirements, it is the responsibility of the Social Services Agency to provide appropriate services.

The form “Notice of Language Services” (GEN 1365) must be included in all correspondence and notices of action if the client’s preferred language is not a CAPI threshold language and it is listed in the form.

2.5.2 Notices of Action (NOAs)

As in other programs, an adequate and timely Notice of Action (NOA) is required when any action is taken by the Agency which affects eligibility for CAPI or the amount of benefits to be issued.

Adequate NOA

An adequate notice informs the applicant/recipient of the action being taken, the reasons for the action, the regulations supporting the action, and an explanation of the right to request a State hearing.

EWs must ensure that the information on the NOA, including budget computation, is COMPLETE. If the NOAs do not contain complete information, the NOAs are invalid.

Even in situations when a TIMELY notice is not required, an adequate NOA is still needed for actions such as approval or denial of an application or certain discontinuances listed as exceptions to the timely NOA requirement in the following section.

Timely NOA

A timely NOA meets the definition of an adequate NOA and is mailed to the recipient at least ten (10) days prior to the effective date of any negative action. The ten-day period does not include the date the NOA is mailed or the effective date of action. The timely notice requirements for CAPI follow the same timing as CalWORKs, CalFresh and Medi-Cal.



Exception:Exception:

An ADEQUATE notice is still required for the following denial or discontinuance actions, but the 10-day requirement does NOT apply:

• Death of the applicant / recipient;• Application withdrawal;• Written request from recipient to discontinue aid;• Verbal request for discontinuance (must be documented in case record);• Admission to an ineligible institution;• Whereabouts unknown;• Verified approval of assistance in another county; or• Time-limited special allowances when prior timely notice has been given.

Reminder:

Per MMP 10-116.32, a notice of action reducing or discontinuing a service payment shall be mailed or released at least ten days in advance of the effective date of the intended action. Therefore, a 10-day timely NOA is required when discontinuing CAPI due to the approval of SSI/SSP benefits.

2.5.3 Computer Generated Text Messages

Applicants and recipients may opt for receiving some information regarding their CAPI case (such as appointment reminders) via computer generated text messages by indicating this in the SOC 814 or SOC 804. This permission may be withdrawn at any time by providing a written statement, or at their annual redetermination by competing the SOC 804.

Important:Applicants/recipients must not be contacted via text messaging if they have not provided their written permission in the SOC 814 or the SOC 804. Although, the “Consent To Receive Electronic Communications From The County Of Santa Clara” (SCD 2551) may be used for all other programs, it does not meet CAPI regulations.

To prevent identity theft and data privacy breaches, the following precautions must be taken:

Client’s name - The client must be identified by his/her first name only or last name only, the text must not include both, first name and last name.

Case identifying information - The text must not include any type of case identifying information such as (social security number, case number, etc.).



Important:Notices of action must not be sent to clients via text messages.

Refer to Agency Memorandum #16-09 and #16-17 for more information on text messaging.

2.5.4 Hearings and Appeal Rights

An applicant or recipient for CAPI has the same appeal and hearing rights as any other applicant or recipient of a state program. CAPI appeals are heard through the State hearing process, which is separate from the County hearing process used for General Assistance.

Hearing rights and Legal Aid information are listed on the reverse of the Notice of Action. Applicants/Recipients must request an appeal hearing within 90 days from the date of the NOA.

Aid Paid Pending (APP)

If the request for a hearing is filed before the effective date of the County negative action, a CAPI recipient is entitled to have aid payments continue while the hearing decision is pending. Aid Paid Pending (APP) benefits will be paid at the same level as they were before the negative action was taken.

Note:

APP is considered an overpayment if the Administrative Law Judge (ALJ) upholds the County’s position and determines that the action taken was correct.

The recipient has the right to request that APP be withheld to avoid possible overpayment.

Representation at Hearing

CAPI applicants/recipients who appeal an action taken by the Agency and request a hearing have the right to have representation at the hearing. There is information on Legal Aid services on the reverse of the NOA, or they may choose to have a friend or relative assist them through the hearing process.

If they need an interpreter, the County is responsible for providing one, or the applicant/recipient may choose to bring their own interpreter to the hearing.


https://ssaconnect.sccgov.org/ssa_departments/debs_program/Documents/calwin_agency_memos/agency_memo_1617.pdf

https://ssaconnect.sccgov.org/ssa_departments/debs_program/Documents/calwin_agency_memos/agency_memo_1609.pdf


State Hearing File

Information in the state hearing file may be shared with or viewed by the:

• Applicant or recipient;• Applicant’s or recipient’s representative;• County Social Services Agency; and • California Department of Social Services (CDSS).

[Refer to Common Place Handbook, “Appeals,” page 37-1 for more information.]

2.6 Responsibilities

2.6.1 Providing Verifications

CAPI applicants and recipients must provide all verifications discussed in this chapter as requested by the Eligibility Worker (EW), as well as other verifications needed.

[Refer to “Sponsorship,” page 11-1] for more information on obtaining Sponsorship Verification.

2.6.2 Reporting Changes

All changes which affect eligibility status or payment amount must be reported within 10 calendar days of occurrence, either in writing or by telephone. [Refer to “Sponsorship,” page 11-1].

2.7 Suspension, Reinstatement, Termination and Reapplication of CAPI Benefits

2.7.1 Suspension

When a CAPI recipient no longer meets eligibility conditions/requirements, the CAPI benefits get discontinued and may remain in discontinue/suspended status for up to a maximum of twelve (12) months. CAPI recipients mus be notified in writing of the adverse change. Notice of Action (NOA), CAPI Notice of Change - NA 692 must be sent timely.

CAPI benefits may be discontinued/suspended for a wide variety of reasons. Below are some examples:



• Income in the budget month exceeds the appropriate payment standard in the payment month.• Resources exceed allowable limits.• Recipient fails to provide proof of application for Supplemental Security Income (SSI) benefits

within 30 days of county referral or fails to take all necessary steps to obtain SSI.• Recipient becomes eligible for SSI/SSP benefits.• Recipient is outside the United States for 30 consecutive days.• Recipient is a resident of a public institution for an entire calendar month.• Recipient fails to cooperate or provide requested information within the alloted time.

2.7.2 Reinstatement Of Discontinued/Suspended CAPI Benefits

CAPI recipients who request reinstatement within 12 months of the discontinuance/suspension of CAPI benefits do not need to file a new CAPI application. However, they must submit the required verification to re-establish eligibility. Reinstatement of CAPI benefits is processed by continuing Eligibility Workers (EW).

Reinstated CAPI payments must be effective on the first day that the recipient meets eligibility requirements and benefits must be prorated as appropriate. In cases where the payments can not be issued until the first of the following month, the prorated benefits must be added to the following month’s CAPI payment.

NA 692 must be sent to the recipient no later than the date on which the first reinstated CAPI payment is made. See examples below.

Example 1 A recipient exceeds his resource limit for the month of September 2017and CAPI benefits are suspended effective September 30, 2017. In February 2018, the recipient provides evidence that, since December 2017, the amount of his resources has remained under the applicable resource limit. The EW determines that the suspended recipient has regained eligibility., reinstate the CAPI program and process payment retroactively to December 2017.

Example 2 A CAPI recipient fails to return the RRR packet for April and CAPI benefits are suspended effective May 1. On July 15, the recipient provided the county with all of the information it had requested. On July 25, the EW process the RRR and finds that the recipients continues to meet eligibility. The CAPI benefits are retroactively reinstated as of May 1.

2.7.3 Termination

CAPI cases must be Terminated at the end of the twelfth month of being in discontinued/suspended status. Former CAPI recipients must be notified in writing that the time limit for re-establishing eligibility has passed. Notice of Action NA 692 must be sent timely before the end of the twelfth month.



Example:

At annual redetermination, a CAPI recipient reports that she left the country within the year to visit her daughter in India for approximately 3 weeks. The EW request verification of the length of time that the client was away from the United States and schedules an appointment for her to come back in two weeks with her stamped passport. The client fails to come to the appointment and to provide verification. The EW sends an SCD 50 as a reminder of the verification needed. The client does not respond to the SCD 50 by the due date and her benefits are Suspended with NOA NA 962. The client does not contact the county. Twelve months after the suspension took effect, a second NOA NA 692 must sent to the client to inform her that her CAPI eligibility has been terminated.

Note:

CAPI NOA NA 692 will be automatically sent by system by the fifth working day of the twelfth month.

2.7.4 Reapplication

A terminated CAPI recipient may reapply for CAPI at any time. Reapplication following termination requires filing of a new CAPI application and assignment. New application forms are required and a new protected application date applies.

Example:

In the previous scenario, the client appears at the District Office with her passport, two months after the county issues the notice of termination. Although she has now cooperated with the EW’s request, benefits can no longer be reinstated. The EW must inform the client that her case has been closed because too much time has passed and that she may reapply by completing a new SOC 814 and starting the CAPI application process over.
