DPSS ePolicy

Revision of existing policy and/or form(s)

What changed?

1. Pregnant persons receiving a Pregnancy Special Need (PSN) payment are to be referred to the Home Visiting Program (HVP);
2. The M82-820D, No Longer Eligible - Discontinue, Notice of Action (NOA) was modified; and
3. Guidance is provided in relation to when a fraud referral should be initiated when there is a pregnancy verification discrepancy.

Note: Changes are shown highlighted in grey throughout the document.

An eligible pregnant person can receive the following from the beginning of the first trimester effective July 1, 2022:

1. A basic CalWORKs grant; and
2. A PSN payment.
    

Effective July 1, 2022, Pregnant Person Only (PPO) applicants age 19 or older with no other eligible children in the home are eligible for CalWORKs at any stage of their pregnancy and are no longer required to wait until their second trimester in order to be eligible for CalWORKs.

Effective July 1, 2022, PPO applicants age 19 or older with no other eligible children in the home will not be eligible for General Relief (GR) during the first trimester of pregnancy.

CalWORKs eligibility requirements for pregnant teens with no other eligible children in the home, who are under age 19 and have not graduated from high school or obtained a high school diploma or its equivalent, remain unchanged.

Assembly Bill (AB) 135

With the implementation of AB 135 (Chapter 85, Statutes of 2021):

1. The monthly PSN payment increased from $47 to $100 effective May 1, 2022;
2. Eligibility for PPO applicants begins at the beginning of the first trimester (any stage of pregnancy) effective July 1, 2022, once the medical verification of pregnancy has been received; and
3. PPO applicants can satisfy the medical verification requirement by initially providing a sworn statement or verbal attestation for PPO applicants effective July 1, 2021. Once a sworn statement or verbal attestation is received, the participant’s CalWORKs case can be approved if the PPO meets all of the other CalWORKs eligibility requirements and must provide a medical verification of the pregnancy within 30 working days from the date of the initial submission of the sworn statement or verbal attestation to continue to be eligible to CalWORKs benefits, including the PSN payment.

AB 172

With the implementation of AB 172 (Chapter 696, Statutes of 2021), pregnant participants with other eligible children can initially satisfy the medical verification requirement by providing a sworn statement or verbal attestation effective July 1, 2021. Once a sworn statement or verbal attestation is received, the pregnant person is eligible to receive the PSN payment and must provide a medical verification of the pregnancy within 30 working days from the date the initial submission of the sworn statement or verbal attestation to continue to be eligible to the PSN payment.

Refer to the Verification Documents Section for guidance on the verification flexibilities for PPO applicants and pregnant persons with other eligible children.

The below table displays policy eligibility, upon receipt of pregnancy verification, including the verification flexibilities outlined as a result of AB 135 and AB 172:

Senate Bill (SB) 1083

With the implementation of SB 1083 (Chapter 715, Statutes of 2022):

1. Staff is required to refer pregnant applicants/participants who are receiving the PSN payment to the CalWORKs HVP. As a result, the PA 6275/CW 2224, Home Visiting Program, form was created and must be provided to pregnant persons who are receiving the PSN payment. Although staff is required to refer pregnant persons, the participant is not required to participate in the HVP as it is a voluntary program.
2. Pregnant persons can satisfy the pregnancy verification requirement with a written or verbal statement for CalWORKs Homeless Assistance (HA) applications. The flexibility of providing a written or verbal statement was only applicable to CalWORKs applications due to the passage of AB 135. SB 1083 extended this flexibility to the CalWORKs HA applications. For more information on HA, please refer to 44-211.52 Temporary Homeless Assistance policy.

Programming

Previously, the system discontinued a CalWORKs case that contained a pregnant person with other eligible children when pregnancy verification was not provided; this was not in alignment with policy.

Effective July 20, 2020, the system was programed to:

1. Approve the pregnant participant with other eligible children for CalWORKs even though the pregnancy verification is not provided, as long as they have met the CalWORKs eligibility requirements; and
2. Stop issuing the PSN payment.

N/A

CalWORKs Eligibility - PPO

A PPO CalWORKs case is established when a pregnant person without an eligible child meets all of the following conditions:

1. A medical verification of pregnancy has been provided;
2. The PPO meets all CalWORKs eligibility requirements;
3. The PPO cannot be included in another Assistance Unit (AU); and
4. The PPO is:
   • Nineteen years or older with no other eligible children in the home at any stage of the pregnancy; or
     
     Note: A 19-year-old teen may continue to participate in Cal-Learn on a voluntary basis until they graduate from high school/equivalent or turn 20 years old.
   • Eighteen years or younger:
     • Has graduated from high school or equivalent. Effective January 1, 2013, the teen is eligible for CalWORKs anytime during their entire pregnancy and is required to comply with Welfare-to-Work; or
     • Has not graduated from high school or equivalent and therefore eligible to the Cal-Learn Program. The teen is eligible for CalWORKs anytime during their entire pregnancy.

Apparent Eligibility

When the information on the SAWS 2 PLUS, Application for CalFresh, Cash Aid, and/or Medi-Cal/Health Care Programs, and other information available indicate the applicant would be eligible for aid if the following information is verified:

1. Medical verification of pregnancy; and
2. Verification of eligible noncitizen status.

PSN

Effective July 1, 2022, a pregnant person may be eligible to receive a PSN payment in the amount of $100 per month if all other eligibility requirements are met. This includes:

1. An eligible pregnant person in an AU with other eligible persons; and
2. An eligible pregnant person in a PPO case.

Note: A pregnant person who is sanctioned or is not aided for other reasons is not eligible for a PSN payment. If the sanction is cured, the pregnant person would be eligible to receive the PSN payment.

GR Eligibility

Effective July 1, 2022, PPO applicants age 19 or older with no other eligible children in the home are no longer eligible for GR at any stage of their pregnancy.

• If a pregnant person and father of the unborn are married and living together, then both are not eligible for GR at any stage of the pregnancy.
• If a pregnant person and father of the unborn are not married and living together, then the pregnant person is not eligible for GR at any stage of the pregnancy. However, the father of the unborn child might be aided for GR until the child is born.

Note: A pregnant person with no other eligible child(ren) can apply for CalWORKs benefits starting in June 2022 as CalWORKs policy supports the receipt of an application when there will be eligibility for the applicant within 60 calendar days of the application date. Although the application date will be sometime in June 2022, the Begin Date of Aid (BDA) will be July 1, 2022.

Refer to 40-101.9 General Relief for Pregnant Person Only, dated 08/22/2024, for detailed instructions.

Cal-Learn Eligibility

The Cal-Learn Program was established to address the unique educational, vocational, training, health, and other social service needs of teens under 19 years old who are custodial parents or pregnant to help them achieve self-sufficiency.

To encourage these teen parents to stay in or return to high school or an equivalent program and earn a diploma or its equivalent, the Cal-Learn Program provides fiscal incentives, supportive services, and intensive case management.

An otherwise eligible teen who is 19 years old may continue to participate in the Cal-Learn Program on a voluntary basis until they earn a high school diploma or its equivalent or turn 20 years old.

Note: Cal-Learn noncompliance may lead to financial penalties.

Unaided father of unborn

When the unaided father of the unborn is living in the home with a pregnant person who is in an AU of one without an eligible child, the father is an excluded parent, and their income is counted towards the CalWORKs AU.

Reporting Requirements

If the pregnancy ends prior to the estimated delivery date, not resulting in the birth of a child, CalWORKs participants (PPO cases and pregnant persons with other eligible children) are required to report (verbally or in writing), within 30 calendar days following the end of their pregnancy.

Note: If a form or NOA is not available in the applicant’s/participant’s preferred language, the English form or NOA must be provided along with the GEN 1365, Notice of Language Services, and must be verbally translated in the applicant’s/participant’s preferred language using a telephone language interpreter or by bilingual staff, without undue delay. Staff must also offer free interpretive services to Non-English and Limited English Proficient applicants/participants and document in the case Journal whether services were accepted or rejected and the method of interpretation provided.

Additionally, should an applicant/participant provide any disability information, staff must offer a reasonable accommodation. Staff must also review the case information to determine if any reasonable accommodations exist.

Mental Health Referral

In these instances, staff must provide information about, and referral to, mental health services, including, but not limited to, services provided by the Department of Mental Health (DMH) that include grief and loss resources.

The information about mental health services must be provided to the participant either by:

1. Providing the DMH 24/7 Help Line number: (800) 854-7771; or
2. Providing the DMH web address: https://dmh.lacounty.gov/resources/grief-loss/.

CalWORKs Home Visiting Program (HVP)

The CalWORKs HVP is a voluntary program administered by participating counties throughout California to support positive health, development and well-being outcomes for pregnant and parenting individuals, families, and infants born into poverty.

As a result of the implementation of AB 135, effective July 1, 2022, pregnant persons may be considered eligible for CalWORKs during the first trimester of pregnancy. In order to be eligible for HVP, an individual must meet both of the following criteria:

1. The individual is one of the following:
   • A member of a CalWORKs AU;
   • The parent or caretaker relative for a child-only case; or
   • An individual who is apparently eligible for CalWORKs Aid (including those who are newly eligible because of their first trimester pregnancy).
2. The individual is:
   • Pregnant; or
   • A parent or caretaker relative of a child less than 36 months of age at the time the individual enrolls in the program.

Effective October 1, 2023, as a result of SB 1083 (Chapter 715, Statutes of 2022), pregnant persons receiving a PSN payment must be referred to HVP by providing the participant the PA 6275/CW 2224.

Note: This form is included in the CalWORKs Intake and Renewal packets sent to applicants/participants. When PSN is evaluated during SAR 7 or mid-period, the PA 6275/CW 2224 must be provided manually.

CalWORKs Eligibility for a Pregnant Person

• If  the PPO applicant is 19 years old or older, then the PPO is eligible for CalWORKs at any stage of their pregnancy.
  
  Note: 19 years old PPOs voluntarily enrolled in Cal-Learn are eligible.
• If the PPO applicant is 18 years old or younger, and without a high school diploma or equivalent, such as a General Education Development degree (eligible to Cal-Learn), then the applicant is eligible to receive CalWORKs anytime during the pregnancy.
• If PPO applicant is 18 years old or younger, and with a high school diploma or equivalent (ineligible to Cal-Learn), then the applicant is eligible to receive CalWORKs anytime during the pregnancy.

Medical Verification of Pregnancy

The PPO applicants/participants are required to provide a medical verification of pregnancy:

1. Initially when the pregnancy is reported; and
2. When the pregnancy continues beyond the originally estimated date of birth.

Medical verification of pregnancy includes a written statement from a:

1. Physician;
2. Physician’s Assistant;
3. State certified nurse mid-wife;
4. Nurse Practitioner; or
5. Designated medical or clinic personnel with access to the patient’s medical record.

Note: The verification must specify the applicant’s/participant’s name and estimated delivery date.

Verification Flexibility

Sworn Statement: A PPO applicant or a pregnant person with other eligible children who cannot provide medical verification of pregnancy at the time of application/request will be allowed to initially submit a sworn statement, signed under penalty of perjury, to verify the pregnancy in order for the CalWORKs benefits and/or the PSN payment to be authorized. Acceptable sworn statements should include the applicant’s name, date of application, and the declaration of pregnancy.

Verbal Attestation: When an applicant is unable to provide a sworn statement, a verbal attestation and a signed SAWS 2 PLUS should be initially accepted. Staff must ensure the eligibility conditions under which the PPO applicant or pregnant person with other eligible children verbally attests are documented in the case Journal.

Follow-up Verification

Applicants who provided a sworn statement or verbal attestation are required to provide medical verification of pregnancy within 30 working days following initial submission of the sworn statement and/or verbal attestation for benefits to continue (CalWORKs benefits and/or the PSN payment). The participants will continue to be aided when they provide medical verification of pregnancy or present evidence of a good-faith effort to comply with this requirement.

Note: CalWORKs requirements for obtaining evidence to determine eligibility remain unchanged. Staff must continue using the CW 2200, Request for Verification form, to request medical verification of pregnancy within 30 working days from the date of application.

• If the PPO doesn’t provide the medical verification within 30 working days from the date of the written sworn statement or verbal attestation and the participant is making a good-faith effort, then:
  1. The CalWORKs benefits will continue; and
  2. A second 30-working-day period will be granted.
     
     Note: Only one additional 30-working-day period can be provided.
• If the PPO fails to provide the medical verification within 30 working days from the sworn statement or verbal attestation and the County has determined there is no evidence of a good-faith effort to comply, then CalWORKs benefits will be discontinued at the end of the month of the 30-working-day period and the M82-820D is to be generated.
• If the CalWORKs benefits continued beyond the end of the month of the 30-working-day period and verification was not provided, then an overpayment will be established for any subsequently aided months the pregnant person failed to comply.
• If the pregnancy ends prior to the expected estimated delivery date and did not result in the birth of a child, then PPO participants are required to report verbally or in writing within 30 calendar days following the end of the pregnancy. 
• If the participant fails to report the loss within 30 calendar days and benefits continued, then an overpayment will be established according to current policies for any subsequently aided months the pregnant person failed to comply with the reporting requirement.

 PPO applying for Immediate Need (IN) and/or Homeless Assistance (HA)

PPO applicants who are also applying for IN and/or HA may use the same verification flexibilities authorized under AB 135 and SB 1083. PPO applicants who are unable to provide a medical verification of pregnancy at application will be allowed to provide a sworn statement or verbal attestation to be determined apparently eligible for IN and HA.