DPSS ePolicy

To convert existing policy to new writing style only- No concept changes

A recurring special need is a special need that results in added costs to the family and is expected to occur during two or more months in a calendar year. Recurring special need payments can be authorized and issued for the following:

• Therapeutic diets;
• Special transportation need;
• Special laundry service;
• Housework;
• Special telephone equipment; and
• Excessive use of utilities.

Recurring special need payments are generally the result of a serious medical condition of one or more Assistance Unit (AU) members. The need is for goods or services that are essential for the AU's support and not common to the majority of participants. Staff must assist CalWORKs applicants/participants in identifying any recurring special needs which they may have and provide an explanation of the types of payments available.

Therapeutic Diet

When a special diet is needed due to a medical condition as recommended by the applicant's/participant's physician.

Transportation

When the applicant/participant must travel an unusual distance or travel daily to receive required medical treatments.

Laundry

When the applicant/participant needs to change and clean bedding or clothing more than usual because of a medical condition.

Utilities

When there is an excessive use of utilities due to a medical condition that exceeds the in-kind values for the utilities for the family.

Housekeeping

When the family caretaker(s), who has a medical condition, is unable to do the cooking, laundry, household cleaning and similar chores; and others in the home cannot perform these duties without charge.

Telephone

When a member of the household is handicapped by an auditory impairment.

To be eligible for a recurring special need payment, an applicant/participant must:

• Provide verification of the need; and
• Be eligible to receive CalWORKs (if an applicant); 
  or
• Be receiving CalWORKs (if a participant).

Note: A sanctioned person is not eligible to a recurring special need payment because they are not eligible to or currently receiving CalWORKs.

Payment Limit 

The total recurring special need payments, excluding Pregnancy Special Needs, cannot exceed $10 multiplied by the number of AU members.

Example: The AU consists of parent one, parent two, and two children. Parent two is excluded from the AU as they have reached the CalWORKs 60-month time limit. The only AU members are parent one and the two children. The total recurring special need payment for this AU cannot exceed $30 per month ($10 x 3 AU members).

The following lists the types of recurring special need and the payment amount allowed.

Therapeutic Diets: 

Therapeutic diets are not limited to those listed below. The applicant/participant can ask for actual expenses related to the diet.

Therapeutic Diet A

• Diabetic diet under 2200 calories daily;
• Bland diet;
• Low fat/low cholesterol diet;
• Low salt diet - sodium restricted to less than three grams daily; or
• Lactose intolerance.

Payment Amount

• Actual verified cost; or
• Without verification, $9.00 per month.

Therapeutic Diet B     

• Diabetic diet of 2200 or more calories daily;
• High calorie/high protein diet, including special formula for infants; or
• Lactation (breast feeding) diet.

Payment Amount

• Actual verified cost; or
• Without verification, $15.00 per month (also use when diet plan includes a combination of A and B).

Therapeutic Diet C

• A diet other than A and B.

Payment Amount

• The actual verified cost.

Special transportation need:

• The applicant/participant is required to travel an unusual distance for medical treatment; or
• The applicant/participant must travel daily for medical treatment. 

Payment Amount

• The actual verified cost must not exceed the actual cost of the least expensive mode of  transportation; or
• Without verification, $0. 12 per mile traveled.

Special laundry service:

Example - the applicant/participant is required to change bedding once daily or clothing more than once daily becuase of a medical condition.  

Payment Amount

• The actual verified cost; or 
• Without verification; $3.00 per month. 

Housework:

• The AU caretaker is unable to do the cooking, laundry, household cleaning and similar chores; and
• Others in the home cannot perform the duties listed above, without charge.

Payment Amount

• The actual cost of the provider of the service. 

Special Telephone Equipment: 

Someone in the AU cannot use the telephone without special equipment due to an uditory impairment.

Payment Amount

• The actual cost of the service or equipment. 

Excessive use of utilities: 

Excessive use of utilities is required and essential for an AU member's care, such as electricity usage for a medically necessary appliance.

To determine excessive use of utilities, use the actual cost of the utilities minus the in-kind value for the AU size. If the amount is greater than zero, the participant has excessive utility costs.

Payment Amount

• The actual verified cost; or 
• Without verification, $5.00 per month. 

Requests/Time Frames for Starting and Stopping

An applicant/participant may report a special need at Intake, SAR 7, Eligibility Status Report, Renewal (RE) or may voluntarily report (mid-period) a special need at any time during the Semi-Annual Reporting (SAR) or Annual Reporting/Child Only (AR/CO) period. When a participant makes a mid-period report, it is treated as a voluntary midperiod/ year report resulting in increased benefits.

Approved Cases

A participant is eligible to receive a recurring special need payment from the first of the month in which either the need was reported or the verification substantiates that the need exists, whichever is later. The participant is allowed ten calendar days to provide the necessary verification.

Approval/Starting and Stopping

Once verification is provided and the Eligibility Worker (EW) determines if the special need exists in the month reported, the special need payment will be issued for that month and the remainder of the SAR or AR/CO period.

The special need payment is discontinued at the end of the SAR or AR/CO period in which verification for the special need expires.

New Applications

An applicant is eligible to receive a recurring special need payment from the beginning date of aid through the end of the Payment Period in which the verification for the special need expires.

Denial

If the participant fails to provide verification of the need within the ten calendar days, the request is:

• Denied; and
• Documented on the CalSAWS Journal page, outlining the request for the special need, the date the request was made, the request for verification.

If the participant provides the verification after the ten calendar days, the receipt of the verification is considered a new request.

See the Examples Section for additional information.

Family Maximum Aid Payment (MAP) and AU MAP

When calculating the MAP, the following AU members may be allowed recurring special needs:

• AU Members; and
• Non-AU members if: 
  • Ineligible noncitizens; or 
  • Member's income is counted. 

When calculating the AU MAP, only AU members are eligible to receive recurring special needs.

When a participant makes a voluntary report of a special need, the EW will request the information needed to determine the participant's eligibility to the special need. The EW will allow the participant ten calendar days to provide the necessary verification.

Recurring special needs are generally the result of a serious medical condition of one or more AU members. Verification of the need must be a written statement from a physician, physician's assistant, or authorized staff member, and includes:

• What the need is;
• The condition for the need; and
• The period over which the need will continue.

When to verify

When the standard amount is issued for the recurring special need, it must be verified as follows:

• When the AU makes a request for the need; and
• At the time of RE; or
• Before the next RE based on the type of need and the potential for change.

When actual costs are used, they must be verified as follows:

• SAR Cases: Every six months on the SAR 7; and
  during the RE.
• AR/CO cases: During RE.
  

Note: The frequency to verify the actual costs more often can be substantiated considering the type of need and potential for change.

Therapeutic diets

• The PA 596, Special Diet Allowance Request is used to verify the physician's recommendation for a therapeutic diet. Los Angeles County/University of  Southern California provides the form H-4015 to authorize the diet.

Special Transportation 

• A medical statement from the physician.

Special laundry service

• A medical statement from the physician. 

Housework

• A medical statement from the physician. 

Special telephone equipment 

• A medical statement from the physician. 

Excessive use of utilities

• A medical statement from the physician. 

Failure to Request Verification 

If the EW fails to request recurring special needs verification, then the participant is entitled to recurring special need payments for the months otherwise entitled, regardless of when the verification is signed or when it was submitted.