California Department of Social Services - State Hearings
Division
Notes from the Training Bureau - December 15, 2005
| Item 05-12-01A Paraphrased Regulations |
This version of the paraphrased regulations provides ten additions and twelve revisions to paraphrased regulations. There is also one deleted paraphrased regulation and ten renumbered ones. Several of the renumbered pararegs are revised.
All the additions, revisions, renumbered pararegs and the deletion are in two sections of the Medi-Cal regulations 431-439 (Special Programs) and 440-449 (Program Eligibility)
A new issue code 439 has been added called Program income/premium limits. The Special Programs section has been reorganized. Pararegs in 431-438 list basic concepts applicable to those programs. For example, pararegs in 438-1 through 438-8 address general principals applicable to the A&D`FPL. Parareg 439-5 cites the current A&D FPL levels for an individual and a couple.
There are also current levels for the 100% of FPL, 120% of FPL, 135% of FPL, the CSRA, the MMMNA, the family member base allocation, the SSI/SSP standard allocation and Medicare Part B premium payment standards listed in the 439 section. Also, judges are given a parareg option to insert the appropriate standard in several instances. For example, parareg 439-1 states:
The CSRA was $92,760 in 2004, $95,100 in 2005 and is $99,540 in 2006. (All-County Welfare Directors Letters (ACWDLs) No. 03-54, 04-36 and 05-40)
Parareg 439-1B states:
Effective ______, the CSRA was _______. Effective _______, the MMMNA was _________. (ACWDL ________)
In some instances, the current standard remains in the general parareg section. For example, 431-3 describes the CSRA and lists the effective CSRA rate for 2006.
This section of the pararegs was reorganized to avoid duplication of pararegs. For example, sections 432-6, 433-6 and 437-6 dealing with SSI/SSP standard allocation amounts were all renumbered to 439-2.
The index for additions, revisions, deletions and renumbered pareregs are the
following:
Issue Codes
New
439 Program income/premium limits
Renumbered
432-6, 433-6 and 437-6 renumbered to 439-2 and also revised
433-2 renumbered to 439-6 and also revised
434-5 renumbered to 439-3
434-5A renumbered to 439-3A
437-2 renumbered to 439-4 and also revised
438-5C to 439-5
438-5D to 439-5A
447-8 to 447-8A and also revised
The following paraphrased regulations has been deleted:
Deleted
S438-5B
Those deleted paraphrased regulations that may still be found in the HTML version are those marked with an S before them while the others will not be found because it was determined that they would not be used.
The index for the revisions and additions to the paraphrased regulation are
the following:
Revised
| 431-3 | Transfers, CSRA (42 USC 1396r-5(f); ACWDL 05-40) |
| 431-4 | MMMNA, basic plus adjustments for indexing, at state hearing (42 USC 1396r-5(d), (e), (g); ACWDL 05-40) |
| 431-8 | State proposed regulations governing MCCA income, including exceptional circumstance rules and allocation to other family members (ACWDL 90-03, _______) |
| 431-8A | Family member maximum base allocation for current and prior year (ACWDL 05-20) |
| 432-4 | QMB requirements, including property and income limits (ACWDL 97-34) |
| 437-4A | QI-1 program sunset extended to September 30, 2007 (ACWDL 05-37) |
| 439-2 | Allocations in the QMB, SLMB, QI, and 250% working disabled programs in 2002 through 2005 (ACWDL 03-57, 04-39, 05-38) |
| 439-4 | Current and prior two years Medicare Part B premiums (ACWDL 03-57, 04-39, 05-38) |
| 439-6 |
SLMB income and resource limits (ACWDL 97-34, ______) |
| 447-6 | Pickle person disregard multiplier (Pickle Handbook, 15; ACWDL 05-35) |
| 447-7 | Pickle income is established on a monthly basis (Pickle Handbook, 15) |
| 447-8A | SSI payment levels to determine if Pickle eligibility exists (ACWDL _______) |
Additions
| 439-1 |
CSRA amount past two years and current (ACWDL 03-54, 04-36, 05-40) |
| 439-1A | MMMNA amount past two years and current (ACWDL 03-54, 04-36, 05-40) |
| 439-1B | Insert CSRA/MMMNA amounts (ACWDL______) |
| 439-1C | Family member base allocation amount last year and current (ACWDL 04-22, 05-20) |
| 439-1D | Insert family member base allocation amount (ACWDL _____) |
| 439-4A | Insert Medicare Part B premium (ACWDL_______) |
| 439-6A | QMB income limit is 100% of FPL (ACWDL 97-34) |
| 439-7 | FPL, SLMB and QI levels effective April 2005 (ACWDL 05-12) |
| 439-7A | Insert FPL (ACWDL ______) |
| 447-8 | Current year SSI/SSP payment standards (ACWDL 05-35) |