California Department of Social Services - State Hearings Division
Notes from the Training Bureau - August 13, 2003

Reference: Senate Bill (SB) X1 26; ACWDLs 01-36, 01-39 and 02-59

Effective August 1, 2003, SB X1 26 added W&IC §14011.16, which mandates the use of semiannual reporting requirements. Children under age 19 and persons who qualify for Medi-Cal because they are aged, blind or disabled are exempt from this reporting requirement.

Additionally, the DHS is permitted to and has exempted the following groups from mandatory MSR requirements:

¨ Pregnant women whose only eligibility is based on pregnancy.
¨ Individuals under age 21.
¨ Beneficiaries receiving Medi-Cal through Aid for Adoptive Children.
¨ Beneficiaries who have a Public Guardian.
¨ Medically Indigent Children who are not living with a parent or relative and who have a public agency assuming their financial responsibility.
¨ Individuals receiving Minor Consent services.
¨ Beneficiaries in the Breast and Cervical Cancer Treatment Program.
¨ Beneficiaries who are CalWORKs recipients and custodial parents whose children are CalWORKs recipients.

All Medi-Cal beneficiaries, including those exempt from MSR requirements are still required to report changed circumstances to the county within 10 days.

The MSR form is an MC176 S form. Beneficiaries are not required to submit documentation at this stage of the reporting process. Counties however, may request documentation if they cannot determine eligibility from the explanation provided from the beneficiary on the MC176 S.

Counties are required to mail the MSR form to the beneficiary by the 10th of the month prior to the month the MSR form is due. Beneficiaries must complete and return the MSR by the 5th of the due month.

This ACWDL goes on to explain MSR processing. It notes that the eligibility of children will not be effected if the parent or caretaker fails to meet MSR requirements. This ACWDL gives explanations of when an MSR is considered complete, what is an incomplete MSR and the process the county must follow for an incomplete MSR, what the county must do if an MSR is not received and what the county must do if the MSR is received within 30 days after the discontinuance date (if the MSR is returned complete within 30 days after the discontinuance date, and continued eligibility exists the discontinuance is rescinded).

This ACWDL also references income documentation and intercounty transfers. It provides a copy of the MC176 S and provides MSR example case situations.