Public Assistance Programs

Imperial County

Department of Social Services

2995 South Fourth Street

Suite 105

El Centro, CA 92243

Ph: (760) 337-6800

FAX: (760) 337-5716

Public Assistance Programs

Medi-Cal Program

The Medi-Cal program (called Medicaid in other states) is a partnership between the federal and state governments and provides medical coverage for children and adults who have limited income and resources. Some persons may be required to pay a share of the cost of their medical services based upon countable income.

Persons who may be eligible for Medi-Cal are those who are:

· age 65 or older, blind, disabled,

· under age 21,

· pregnant,

· certain refugees,

· residing in a skilled nursing or intermediate care facility,

· parent or caretaker relative of a child under age 21 and:

· the child’s parent is deceased or is absent from the home,

· the child’s parent is incapacitated or

· the child’s parent who is the primary wage earner is unemployed or under-employed.

Persons who have medical insurance can still be covered by Medi-Cal. The medical provider will bill the insurance company first with Medi-Cal being the secondary insurance.

Individuals receiving cash assistance through the CalWORKs, Refugee Assistance, Foster Care and Adoption Assistance programs may be automatically eligible to Medi-Cal benefits.

According to the latest statistics from the ISAWS system, the average monthly number of all active Medi-Cal programs in cases from September 2007 through September 2008 is 15,788. There has been a gradual increase in the number of Medi-Cal cases during this time frame. The number of Medi-Cal only and cash linked Medi-Cal programs in cases has increased from 15,109 in September 2007 to 16,378 in September 2008.

The Director of Social Services obtained approval from the County Board of Supervisors for an additional twenty-three Medi-Cal and Medi-Cal support staff positions on February 26, 2008 through receipt of enhanced Medi-Cal funding. The positions will address the growing Medi-Cal caseloads and will help supply Medi-Cal staffing for the proposed expansion of services to the county’s north end.

County Medical Services Program (CMSP)

Imperial County is one of 34 primarily rural California counties participating in the CMSP. CMSP serves Imperial County residents ages 21 to 64 who are who are not eligible for Medi-Cal and whose income is at or below 200% of the federal poverty level. CMSP has property limits and other requirements that must be met to be eligible for program benefits. Some persons eligible for CMSP have a share of cost obligation depending upon their income. Persons with a share of cost must pay or agree to pay, part of their monthly income toward medical expenses in the month of service before CMSP will pay for covered benefits.

CMSP eligibility is time-limited to six months for individuals without a share of cost and three months for persons with a share of cost. Persons who are noncitizens without satisfactory immigration status may be eligible to emergency services only for the month of applications and the following month. Individuals may reapply at the end of their certification period.

CMSP coverage includes most of those benefits covered by the Medi-Cal program, with the exception of pregnancy-related services, long-term care, services provided by chiropractors, acupuncturists, and psychologists. Dental and vision benefits are limited.

For enrolled CMSP members, CMSP will pay for qualifying medical services resulting from a “qualifying medical event” that occurred during the ten calendar day period immediately before the member’s first month of CMSP enrollment. CMSP does not provide for any other retroactive coverage of medical services.

Individuals receiving CMSP medical benefits must obtain services from providers who are a part of CMSP/BC Life and Health network. Prescription drug services are provided under the CMSP/MedImpact pharmacy network. There may be some limitations on the amount of care that may be received. Also, some services require prior approval by CMSP benefits administrators before they are given.

General Assistance

General Assistance (GA), also known as General Relief (GR), is county funded aid for the relief and support of indigent residents of the county who are not eligible for any other cash assistance program. Assistance is intended for those who are incompetent or incapacitated by age, disease or accident and not supported by any other means. An applicant who is employable must be actively seeking employment. Any real or personal property owned by the applicant and all income from any source is considered when determining eligibility for GA. Individuals who are disabled with the impairment expected to last at least twelve months must apply for SSI/SSP as a condition of GA eligibility.

Strategic Plan

Medi-Cal/CMSP/ Food Stamp Eligibility Strategic Plan

The mission of the Medi-Cal/CMSP/Food Stamp eligibility section is to provide qualified individuals and families with program benefits to access quality health care and assist in supplying a healthy diet. To fulfill our mission and provide quality service, we will seek improvement in the following areas:

Goal #1: Ensure the accuracy and timeliness of program eligibility determinations and meet or exceed state mandated Medi-Cal performance standards in general and disability-based applications, annual eligibility redeterminations, Medi-Cal to Healthy Families Bridging and Medi-Cal Eligibility Data System (MEDS) Reconciliations and Alerts processing. The strategies to be utilized to obtain this goal are to:

· Monitor staff performance and competency through DHCS quality assurance reviews, focused reviews and department case reviews.

· Develop program and subject matter experts within the staff development section as a program resource to line staff.

· Provide line staff with regular ongoing refresher training in identified areas to achieve needed program knowledge and competence.

· Standardize work processes with written guides to ensure accuracy and uniformity.

· Direct department resources to caseloads or programs where additional help is needed.

Goal #2: Seek efficiency in our internal operations. The strategies to be utilized to obtain this goal are to:

· Analyze internal processes for ways to improve department policies, procedures and staff efficiencies.

· Streamline key support systems that would improve areas of operations to enhance the quality and timeliness of services.

· Utilize available technology to allow customers better access to services through resources such as video conferencing, Food Stamp telephone interviews and internet application process.

Goal #3: Improve customer service and in collaboration with other sections of the department, design a seamless customer service delivery system. The strategies to be utilized to obtain this goal are to:

· Assess customer service needs through customer dialog and staff input/feedback.

· Develop a department wide culture of customer service through staff training developing written department customer service standards and expectations and utilize new service delivery computer systems.

· Identify and prioritize services that can effectively be delivered in a seamless fashion without the customer leaving the department.

· Collaborate with the CalWORKs, Welfare to Work, Adult and Children’s Services sections in developing policies and procedures to achieve a “No Wrong Door” customer service policy.