California Department of Social Services - State Hearings
Division
Notes from the Training Bureau - January 26, 2004
Item 04-01-01A Paraphrased Regulations |
The year 2004 marks the beginning of a new era in our Division's ongoing Paraphrased Regulation (ParaReg) Project as we institute some changes in our maintenance procedures.
There will be two major changes.
First, we are committed to updating the ParaRegs on a far more frequent basis. Updates will occur on at least a bimonthly basis.
Second, we are changing the method for issuing "hard copy" versions of the Pararegs that have been added or revised. The responsibility for issuance is being shifted to the individual ALJ's regional office staff. We are doing this because Pat Coony has greatly simplified the process needed to issue the hard copy revisions. From now on, Regional Office staff need only log onto our revised Web page and identify the particular section of the pararegs they would like printed. There will be 85 different sections that could be identified. (For example, Medi-Cal Managed Care is one section, CalWORKs personal property is another.)
The advantage to this new process is that:
(1) Judges will have almost immediate access to revised pararegs since they will not have to wait for photocopying that had previously been done in Sacramento;
(2) There will no longer be any need to file and replace individual pages throughout their pararegs binder. Instead, an entire section will be replaced; and
(3) A Judge's system of notations to indicate which section is new or revised and where it could be found in his/her binder will no longer be necessary since the Judge will now be able to have the entire section replaced.
We will also notify each Judge both by email and the issuance of a Newsletter each time the ParaRegs have been updated. The e-mail and Newsletter will include the index reference for the specific paraphrased regulation that has been modified or added.
To print out the pertinent updated section, the Judge or support staff can:
1) Simply type in the following as the address for internet access:
www.dss.cahwnet.gov/shd/Paraphrase_1526.htm
2) Once on this page, click on ParaRegs Text.
3) Then go to desired program and you will see which section contains revisions as indicated by a date next to that section. Then click on the PDF icon to print the hardcopy for your binder.
To print out revised sections of the Index, simply click ParaRegs Index and
find revised sections. You will find only one Cross Reference file that will
need to be printed after each update.
The additions to the paraphrased regulations in the most recent update are the following:
Revised
431-3 | Transfers, CSRA (42 USC 1396r-5(f); ACWDL 98-49, 99-59, 00-58, 01-63, 02-53, 03-54)> |
431-4 | MMMNA, basic plus adjustments for indexing, at state hearing (42 USC 1396r-5(d), (e), (g); ACWDL 00-58, 01-63, 02-53, 03-54) |
437-4A | QI-1 program sunset extended to March 31, 2004 (ACWDL 03-51) |
438-8 | One spouse can receive A&D FPL, while the other spouse receives MN benefits, or declines Medi-Cal (ACWDL 02-38) |
531-1A | Rule on balance of removable partial denture (Denti-Cal Provider Manual 4-32; Denti-Cal Bulletin, Vol. 8, No. 9 (7/92) |
531-11 | Orthodontic requirements for handicapping malocclusion (Denti-Cal Provider Manual 4-44) |
531-11D | Handicapping malocclusion rules apply to cleft palate deformities when care is under CCS or when documented and necessary under the dental services program (Denti-Cal Provider Manual 4-44) |
531-11H | Maxillofacial services covered subject to prior authorization (Denti-Cal Provider Manual 4-37, 38) |
1333-3 3.02 | Chronic Pulmonary Insufficiency |
New
416-3 | Midyear status report requirement and exemptions from that requirement (W&IC 14011.16; ACWDL 03-41) | |
416-3A | Midyear status report filed six months after later of application date or annual redetermination (W&IC 14011.16; ACWDL 03-41) | |
416-3B | County must provide MSR to beneficiary in fifth or "mail"month; MSR must be returned by the fifth day of the sixth or "due" month (W&IC 14011.16; ACWDL 03-41) | |
416-3C | If MSR reflects change in circumstances effecting eligibility, county must do an SB 87 determination (W&IC 14011.16; ACWDL 03-41) | |
416-3D | If MSR is signed, but incomplete, county must do an SB 87 determination (W&IC 14011.16; ACWDL 03-41) | |
416-3E | Recipient failure to return an MSR results in discontinuance of benefits (W&IC 14011.16; ACWDL 03-41) | |
416-3F | If recipient submits an MSR within 30 days of discontinuance, county must evaluate and rescind discontinuance if eligibility exists (W&IC 14011.16; ACWDL 03-41) | |
417-8A | Second year of TMC eliminated (ACWDL 03-45) | |
430-2C | Income of parents living with pregnant minor is exempt for 200% disregard program purpos,es (ACWDL 03-34) | |
430-20 | Income of parents living with pregnant minor is exempt for 200% disregard program purposes (ACWDL 03-34) | |
437-2 | Medicare Part B premium increased to $58.70 in 2003 (ACWDL 02-56) | |
483-12 | Reasons funds in IRA may be unavailable (ACWDL 02-51) | |
530-8 | TAR must be approved or denied within average of five working days (W&IC §14133.9) | |
531-3B | Posterior crowns for adults only a benefit when used as abutment for a fixed partial denture or removable partial with cast clasps and rests. (Denti-Cal Bulletin Volume 19, Number 23) | |
585-12 | CCS services for children in managed care are billed on a fee-for-service basis (W&IC 14094.3) | |
585-13 | CCS services for children in managed care are billed on a fee-for-service basis (W&IC 14094.3) | |
585-14 | Managed care plan must provide Medi-Cal covered services unless excluded under contract (53851) | |
1310-3 | Person with earned income under 250% of FPL may qualify for Medi-Cal as disabled person even if income exceeds SGA limit (ACWDL 02-40) | |
1311-2A | Person with earned income under 250% of FPL may qualify for Medi-Cal as disabled person even if income exceeds SGA limit (ACWDL 02-40) |