CSC Supervisor

responsibilities

CSC Supervisors will evaluate EW requests to hand-off actions as follows:  Consider complexity of the action, time already spent, number of actions

remaining, current call volume, and any other relevant information.  Determine if the action will be assigned to a CSC EW with more

experience, or to the district office.

When handing-off to the district office, the CSC EW or Supervisor will e-mail the Personally Identifiable Information (PII) document to the district Master Assignment Queue (MAQ) for control purposes.

References Refer to the following table for additional information/instructions. Handbook or Tool Chapter/Topic or Title Customer Service Center Handbook

(CSCHB)

Chapter 2 – Customer Service Center Communications

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-94

Health Care Programs Application Requests

Programs The procedures in this section apply to the Health Care Programs.

Introduction This section covers the basic requirements and procedures for Health Care Program phone applications. The decision whether to apply for health care coverage in-person, by phone, mail, C4Yourself, or Covered California (Covered CA) must be left to the customer.

Customers must be advised of his/her right to:

 Be interviewed by an Eligibility Worker (EW) when:  Assistance is needed, or

 For any other reason.

 Come into the Transitional Assistance Department (TAD) office in the event of:

 An emergency situation,  Homelessness, or  Minor Consent.

Note: Minor Consent applications must be taken in the district office and cannot be submitted by phone, mail, or online.

Health care request actions

The Customer Service Center (CSC) EW will complete the following actions when a customer calls requesting to apply for health care coverage:

Step Action

1 Screen the customer using the County Quick Sort Tool located on the TAD website, and:

If the customer is... Then...

 Under 21, and

 Living with parents, Determine if the application request is for a Minor Consent case:

If… Then…

Applying for confidential services for:

 Family planning,  Pregnancy related care,  Mental health,

 Drug and/or alcohol treatment or counseling,  Sexually transmitted diseases, or  Sexual assault,  Stop here.  This is a Minor Consent application.  Refer the customer to the district office.

Not a Minor Consent case, Go to Step 2.  Under 21 and not living

with his/her parents, or  21 years of age or older,

 Evaluate tax household to determine primary tax filer.

 Go to Step 2.

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-95

Health Care Programs Application Requests, Continued

Health care request actions (continued)

Step Action

2 Determine the type of application the customer is requesting, and: If the customer

is requesting a... Then...

Phone or mail-in application,

 Complete the Initial Application for CalFresh, Cash Aid, and/or Medi- Cal/Health Care Programs (SAWS 1) to preserve the application date,

 Inform the customer he/she will be

contacted by the district office with further instructions, and

 E-mail the completed SAWS 1 to the district CSC Inbox:

 Example: CSC TAD 01

 Include <Medi-Cal Phone App> or <Medi-Cal Mail In App> in the e-mail subject line.

Note: The district office will contact the customer or mail the customer an application packet.

Face-to-Face application,

Transfer the call to the appropriate District Admin phone number.

Note: The call will be handled per district procedures.

C4Yourself application,

Provide the customer with the:  C4Yourself web-address

(www.c4yourself.com), and/or

 Directions to his/her local district office for assistance with completing the C4Yourself application.

Covered CA application,

Provide the customer with the:  Covered CA:

 Web-address (www.coveredca.com),  Customer service line

(1-800-300-1506), and/or

 Directions to his/her local district office for assistance with completing the application. Option: Close call per policy.

3 Complete wrap-up:

 Clear any completed Task(s),  E-mail any impacted programs, and  Journal all case actions.

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-96

Health Care Programs Application Requests, Continued

References Refer to the following tools for additional information/instructions: Handbook or Tool Chapter/Topic or Title Health Care Programs

Handbook (HCPHB)

Chapter 2, Applications

TAD Forms Catalog  SAWS 1, form and Forms and Procedures Guide (F&P)

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-97

ICT Inquiry

Programs The procedures in this section apply to the following programs:

 California Work Opportunity and Responsibility to Kids (CalWORKs),  CalFresh, and

 Medi-Cal.

Overview The Customer Service Center (CSC) Eligibility Worker (EW) will utilize the following resources when a customer calls to inquire about the status of an Inter-County Transfer (ICT):

Step Action

1 Determine the status of the ICT, and: If inquiry is

regarding an… Then…

Incoming ICT,  Advise the customer following the chart below, and:

If the ICT is… Then…

Received,  The case will show pending and the assigned EW.

 Provide customer with EW’s name and contact number.

 The ICT Summary will show the Initiated Date, ICT ID, Primary Applicant,

sending county, and the ICT Status. Not received,  Inform customer our County has not

received the request.

 Notify the customer an electronic ICT (eICT) request will be submitted.  Proceed to Step 3.

Outgoing ICT,  Review Journal entries to determine the date the ICT/eICT was initiated.

 Review Tasks to determine the date of the discontinuance in our County.

 Review the ICT Summary page (which will show the

Initiated Date, ICT ID, Primary Applicant, receiving county, and the ICT Status).

 Proceed to Step 3.

Initiating an ICT,  Update the Contact Detail page with customer’s new address (see Address Change Task Action Guide [TAG]).  Ask the customer if the entire household moved.

 Advise customer the request will be initiated.

 Mail the following to the customer, if applicable (see Exceptions section within this TAG):

 Voter Registration (MC 200) (generated and printed locally from C-IV), and

 Voter Registration Card (SBDNOES 200).  Proceed to Step 2.

Option: Close call per policy.

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-98

ICT Inquiry, Continued

Overview (continued)

Step Action

2 Set a Task to initiate eICT process, if needed:  Task Type: Initiate ICT.

 Due Date: Next day.

 Long description: Enter details of the change including new address, Household (HH) composition, shelter and utility expense amount, etc.

3 Complete wrap-up:

 E-mail eICT worker (handles both manual/partial ICT and eICT) in the district to initiate the ICT.

 Clear any completed Task(s).

 Journal all case actions using the appropriate Journal Template(s) (e.g., Address Change, CalWORKs ICT In, etc.). Exceptions:

 The MC 200 is not mailed if the new address is outside of San Bernardino County; this form is only valid for San Bernardino County residents.  The SBDNOES 200 is not mailed if the customer moved out of state; this

form is only valid for California voters.

References Refer to the following tools for additional information/instructions.

Handbook or Tool Chapter/Topic or Title C-IV User Guide  Creating C-IV Tasks

 Journal Entry, Creating  Searching for Tasks Health Care Programs Handbook

(HCPHB)

Chapter 10 – Case Management Operations & Reference Handbook

(ORHB)

 Chapter H – IDT/ICT  Chapter T – e-Tools

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-99

Income Changes – CalWORKs/CalFresh/Welfare-to-Work

9B

Program The procedures in this section apply to the following programs:

 California Work Opportunity and Responsibility to Kids (CalWORKs),



CalFresh, and  Welfare-to-Work (WTW). 10B Income change actions

The Customer Service Center (CSC) Eligibility Worker (EW) will complete the following actions when a customer reports an income change:

Step Action

1 Determine if income verification is on file and change has been completed, and:

If the income change has… Then…

Been completed, Inform customer of case actions.  Not been completed, and

 Verification is:  On file,  Not on file, or

 Verified Upon Receipt (VUR).

 Determine increase or decrease in benefits, and  Go to Step 2.

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-100

Income Changes – CalWORKs/CalFresh/Welfare-to-Work,

Continued

10BIncome change actions (continued)

Step Action

2 Follow the chart below to determine the treatment of the income change, and: If income causes

the benefits to… Then…

Decrease due to exceeding the Income Reporting Threshold (IRT),

 Update the Income Detail page,

 Run Eligibility Determination Benefit Calculation (EDBC),

 Send appropriate Notice of Action (NOA) centrally.  See Step 4 if case results in discontinuance and the

customer has an open WTW case.

Note: Benefits may decrease or case may discontinue. See Policy handbooks, Budgeting chapter, for additional information.

Decrease, but does not exceed the IRT,

 Send a No Change NOA for:  CalWORKs, and

 Public Assistance CalFresh (PACF).

 For Non-Assistance CalFresh (NACF) cases, If the change is:

 VUR, then the EW must act to decrease benefits the next available month in which 10 day NOA can be provided.

 Not VUR, then benefits are not reduced, and a No Change NOA is sent.

 Increase, and  Verification was:

 Provided, or  VUR,

 Update the Income Detail page,

 Run and accept EDBC with supplemental benefits, and  Send appropriate NOA centrally.

 Increase, and  Verification was

not provided,

 Inform customer action will not be taken until verification is received,

 Request verification by completing the

 Request for Verification (CW 2200), sending locally with a postage paid return envelope for the

assigned district office, and  Send a manual NOA. Option: Close call per policy.

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-101

Income Changes – CalWORKs/CalFresh/Welfare-to-Work,

Continued

Income change actions (continued)

Step Action

3 Set a Task for all impacted programs. If new verification was:  Requested:

 Task Type: Verif Due.

 Due Date: Next working day after the 10th day.  Long Description: List what verification is due.  Not requested:

 Task Type: Income Change.

 Due Date: Next Semi-Annual/Annual Review.  Long Description: List information provided.

Note: Determination of whether verification is required is dependent upon whether a mandatory or a voluntary mid-period/year change has occurred. Refer to the Budgeting chapters of the CalFresh and CalWORKs policy handbooks for additional guidance.

4 Follow the chart below to determine if the customer needs to be referred to an Employment Services Specialist (ESS) for Job Retention services, and:

If the customer is…. Then…

 Employed, and  CalWORKs was or will be discontinued due to employment over-income,

 Inform the customer that he/she may be eligible for the following Job Retention Services:

 Ancillary (work attire, shoes, etc.)  Child Care, and

 Transportation assistance (gas cards, bus pass, transportation reimbursement, etc.), and

 Transfer the call to the assigned ESS in the appropriate district office to provide the customer with additional Job Retention information.

5 Complete wrap-up:

 Clear any completed Task(s),

 Review and update the CalFresh Work Registration if applicable,  Send an e-mail to the assigned ESS if the customer has an open

WTW case, and

 Journal all case actions.

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-102

Income Changes – CalWORKs/CalFresh/Welfare-to-Work,

Continued

References Refer to the following tools for additional information/instructions.

Step Action

C-IV User Guide  Income Record, Adding New Amounts to an Existing  Searching for Tasks  Journal Entry, Creating

 Income Record, Adding a New CalWORKs Policy Handbook

(CWPHB)

 Chapter 9 – Income  Chapter 12 – Budgeting CalFresh Policy Handbook (CFPHB)  Chapter 8 – Income

 Chapter 10 – Budgeting WTW Policy Handbook (WTWPHB) Chapter 15 – Employment

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-103

Income Changes – Health Care Programs

Programs The procedures in this section apply to the Health Care Programs.

Income change actions

The Customer Service Center (CSC) Eligibility Worker (EW) will complete the following actions when a customer reports an income change:

Note: Income changes are a Change Report Re-Evaluation (RE).

Step Action

1 Determine if income verification is on file and a change has been completed, and:

If the income change has… Then…

Been completed,  Inform customer of case actions.

 Go to Step 5.  Not been completed, and

 Verification is not on file,

Go to Step 2.  Not been completed, and

 Verification is on file,

Go to Step 4.

2  Enter required information reported by the customer into the following C-IV pages:

 Income (leave income in Pending status),  Employment, if applicable,

 Request Modified Adjusted Gross Income (MAGI), and:

If the response is… Then…

Electronically verified (e-verified):  MAGI, or

 Non-MAGI without a Share of Cost (SOC),

Go to Step 4.

 Non-MAGI with a SOC, or  Not e-verified MAGI,

Go to Step 3.

Delayed,  Hand-off completion of case actions to the assigned district office.  E-mail a Personally

Identifiable Information (PII) document to the Master Assignment Queue (MAQ) using <Income Change> in the e-mail subject line.  Go to Step 5.

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-104

Income Changes – Health Care Programs, Continued

Income change actions (continued)

Step Action

3 Complete the following actions when verification is required to be on file:

 Inform the customer action will be taken when verification is received,

 Complete Ex Parte review,

 Request verification by completing the Medi-Cal Request for Information (MC 355) if applicable,

 Print and send centrally the MC 355, and  Set a Task for all impacted programs:

 Task Type: Verif Due.  Due Date: 30 calendar days.

 Long Description: List what verification is due.  Go to Step 5.

Option: Close call per policy.

4 Complete the following actions when verification of the income change is on file:

 Request MAGI if not previously requested,

 Update the Income Detail and Employment List pages using the verification provided,

 Run and accept the Eligibility Determination and Benefit

Calculation (EDBC) for the month in which 10 day notice can be provided, and

 Print and send the Notice of Action (NOA) centrally. 5 Complete wrap-up:

 Clear any completed Task(s),

 Clear Medi-Cal Eligibility Data System (MEDS) Alerts,  E-mail other impacted programs, and

 Journal all case actions.

References Refer to the following tools for additional information/instructions. Handbook or Tool Chapter/Topic or Title C-IV User Guide  Income Record, Adding New

Amounts to an Existing

 Income Record, Adding a New  Journal Entry, Creating

 Searching for Tasks Health Care Programs Handbook

(HCPHB)

 Chapter 8 – Income

 Chapter 10 – Case Management  Chapter 18 – Re-Evaluations

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-105

Master Assignment Queue (MAQ) Communication

Programs The procedures in this section apply to the following programs:

 California Work Opportunity and Responsibilities to Kids (CalWORKs),  CalFresh, and Medi-Cal.

MAQ inboxes When communication is needed regarding a case assigned to a

Master Assignment Queue (MAQ), an e-mail must be sent to the e-mail address associated with the assigned Worker ID. The e-mail addresses are set up to include the:

 District office (i.e., TAD 01, TAD 79, etc.),

 Function – Continuing (will display as CONT in the e-mail address), and  The aid program with which the MAQ is associated (CalWORKs/CalFresh,

CalFresh, or Medi-Cal).

List of MAQs Below is a list of all MAQs associated with the district offices:

Location Program Outlook Name Internet E-Mail Address

Adelanto CalWORKs TAD 48 Cont CWCF [email protected] CalFresh TAD 48 Cont NACF [email protected] Medi-Cal TAD 48 Cont MC [email protected] Barstow CalWORKs TAD 06 Cont CWCF [email protected]

CalFresh TAD 06 Cont NACF [email protected] Medi-Cal TAD 06 Cont MC [email protected] Colton CalWORKs TAD 19 Cont CWCF [email protected] CalFresh TAD 19 Cont NACF [email protected] Medi-Cal TAD 19 Cont MC [email protected] Del Rosa CalWORKs TAD 07 Cont CWCF [email protected]

CalFresh TAD 07 Cont NACF [email protected] Medi-Cal TAD 07 Cont MC [email protected]

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-106

Master Assignment Queue (MAQ) Communication, Continued

List of MAQs (continued)

Location Program Outlook Name Internet E-Mail Address

Fontana CalWORKs TAD 09 Cont CWCF [email protected] CalFresh TAD 09 Cont NACF [email protected] Medi-Cal TAD 09 Cont MC [email protected] Hesperia CalWORKs TAD 108 Cont CWCF [email protected]

CalFresh TAD 08 Cont NACF [email protected] Medi-Cal TAD 08 Cont MC [email protected] Needles CalWORKs TAD 10 Cont CWCF [email protected] Medi-Cal TAD 10 Cont MC [email protected] Ontario

Back

CalWORKs TAD 15 Cont CWCF [email protected] CalFresh TAD 15 Cont NACF [email protected] Ontario

Front

CalFresh TAD 75 Cont NACF [email protected] Medi-Cal TAD 75 Cont MC [email protected] Rancho

Cucamonga

CalWORKs TAD 25 Cont CWCF [email protected] CalFresh TAD 25 Cont NACF [email protected] Redlands CalWORKs TAD 04 Cont CWCF [email protected] CalFresh TAD 04 Cont NACF [email protected] Medi-Cal TAD 04 Cont MC [email protected] Rialto CalWORKs TAD 39 Cont CWCF [email protected]

CalFresh TAD 39 Cont NACF [email protected] Medi-Cal TAD 39 Cont MC [email protected]

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-107

Master Assignment Queue (MAQ) Communication, Continued

List of MAQs (continued)

Location Program Outlook Name Internet E-Mail Address SB Fourth CalWORKs TAD 01 Cont CWCF [email protected] CalFresh TAD 01 Cont NACF [email protected] Medi-Cal TAD 01 Cont MC [email protected] SB Mass CalWORKs TAD 02 Cont CWCF [email protected]

CalFresh TAD 02 Cont NACF [email protected] Medi-Cal TAD 02 Cont MC [email protected] Twentynine

Palms

CalWORKs TAD 79 Cont CWCF [email protected] Medi-Cal TAD 79 Cont MC [email protected] Victorville CalWORKs TAD 18 Cont CWCF [email protected]

CalFresh TAD 18 Cont NACF [email protected] Medi-Cal TAD 18 Cont MC [email protected] Yucaipa CalWORKs TAD 24 Cont CWCF [email protected] CalFresh TAD 24 Cont NACF [email protected] Medi-Cal TAD 24 Cont MC [email protected] Yucca

Valley

CalWORKs TAD 03 Cont CWCF [email protected] CalFresh TAD 03 Cont NACF [email protected] Medi-Cal TAD 03 Cont MC [email protected]

References Refer to the following tools for additional information/instructions.

Handbook or Tool Chapter/Topic

Operations & Reference Handbook (ORHB)

Chapter V – PACE, Section 2 – Master Assignment Queue (MAQ)

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-108

Medi-Cal Customer Enters LTC - Other Aided Persons

Programs The procedures in this section apply to the Health Care Programs.

Overview The Customer Service Center (CSC) Eligibility Worker (EW) will complete the following actions when:

 A customer has been reported as entering a Long Term Care (LTC) facility, and

 There are other persons aided in the Medi-Cal program.

Step Action

1 Obtain the following information:

 Name of the customer who entered LTC.  Date the customer entered LTC.

 Name and address of LTC.

 Name of the Professional Authorized Representative (PAR) or Authorized Representative (AR) if acting on behalf of the customer.

Option: Close call per policy

2 Complete the following if the customer moved to a new address:  Update the physical and mailing addresses.

 See the Address, Adding a New C-IV User Guide.  Mail the following to the customer:

 Voter Registration (MC 200) (generated and printed locally from C-IV), and

 Voter Registration Card (SBDNOES 200). Exceptions:

 The MC 200 is not mailed if the new address is outside of San Bernardino County; this form is only valid for San Bernardino County residents.

 The SBDNOES 200 is not mailed if the customer moved out of state; this form is only valid for California voters.

3 Update C-IV Detail pages, including the Living Arrangements page. 4 Request Modified Adjusted Gross Income (MAGI), and:

If MAGI returns… Then…

Eligible,  Run the Eligibility

Determination and Benefit Calculation (EDBC), and  Go to Step 6.

Not Eligible, Go to Step 5.

CSCHB #2076 (10/15) TASK ACTION GUIDES 3-109

Medi-Cal Customer Enters LTC - Other Aided Persons,

Continued

Overview (continued)

Step Action

In document Customer Service Center (Page 159-200)