DPSS ePolicy

During the CAPI application/redetermination process, the Eligibility Worker (EW) must determine potential SSI/SSP eligibility for CAPI (refer to Determining Potential SSI Eligibility for CAPI).

A CAPI applicant/participant who is a Qualified Alien should be required to apply/reapply for SSI/SSP (refer to 49-020: Immigration Status - Qualified Alien).
 

Ineligibility for SSI/SSP

A CAPI applicant/participant who meets the CAPI "ineligibility for SSI/SSP" requirement should not be required to apply/reapply for SSI/SSP when:

1. A CAPI applicant/participant provides a formal denial letter from SSA issued within the past six months of the CAPI application/redetermination shows that the CAPI applicant/participant is ineligible for SSI/SSP solely due to their immigration status is provided.
   
   
2. A CAPI applicant/participant provides an informal denial letter, or other verification from SSA issued within the past six months of the CAPI application/redetermination shows that the CAPI applicant/participant is ineligible for SSI/SSP due to their immigration status is provided.
   
   
3. A CAPI applicant/participant provides verification that shows an SSI/SSP application is currently pending, which includes a pending appeal related to the applicant’s/participant’s disability or immigration status is provided.
   
   
4. A CAPI applicant/participant is not a Qualified Alien (refer to 49-020: Immigration Status - Qualified Alien) or their immigration status is one of the PRUCOL categories for CAPI purposes (refer to 49-020.1: Immigration Status - PRUCOL).

Qualified Alien

If the CAPI applicant/participant is a Qualified Alien (refer to 49-020: Immigration Status - Qualified Alien); and

• Unable to provide verification that an SSI/SSP application has been filed with SSA, the EW must:
  
  
  • Provide the CAPI 103, Referral for SSI/SSP application form, to the CAPI applicant/participant and refer them to SSA to apply/reapply for SSI/SSP.
    
    
  • Assist the CAPI applicant/participant in completing the SSI/SSP application with SSA, if needed.
    
    
  • Direct the CAPI applicant/participant to appeal the denial of the SSI/SSP application, as applicable.
    
    Note: Applicants/participants can be referred to the Countywide Benefits Entitlement Services Team (CBEST) to request SSI representation. CBEST provides coverage for CAPI SSI applicants requesting appeal representation.
    
    
  • Deny the CAPI application (or suspend/terminate existing CAPI benefits) if the applicant/participant neither applies/reapplies for SSI/SSP, nor appeals the SSA denial within 30 days from the date of the CAPI 103, unless the EW determines the applicant/participant had good reason for not complying (example: hospitalization).
    
    Note: Currently, the California Statewide Automated Welfare System (CalSAWS) does not have the suspension functionality for CAPI cases. The EW will terminate the case and utilize the Reapply button when the applicant has complied with the requirements. The date of compliance will be used when re-opening the case.
    
    CAPI applications/redeterminations should be processed upon receipt of SSI/SSP ineligibility verification. Approve the CAPI application/redetermination if the CAPI applicant/participant meets all the CAPI requirements.
    
    
• Discontinued from the SSI/SSP program due to expiration of the “SSI/SSP seven-year period of eligibility” previously available to certain refugees and other humanitarian immigrants, and ineligible for SSI/SSP benefits solely due to their immigration status, the EW must confirm discontinuance by accessing the Medi-Cal Eligibility Data System (MEDS) to verify that the payment status code is N13. If the EW is not able to verify through MEDS, the EW must: 
  
  
  • Contact SSA to verify SSI/SSP discontinuance; or
    
    
  • Request CAPI applicant to submit a written verification from SSA.

The EW must continue in the determination of initial/ongoing eligibility in the following situations:
 

1. A CAPI applicant/participant is 65 years old or older, the CAPI application must be processed. The CAPI applicant is eligilbe for CAPI (if they meet all CAPI requirements) while SSI/SSP application is pending. 
   
   
2. A CAPI applicant/participant is under 65 years old and claiming to be disabled: 
   
   
   1. A disability packets must be completed and sent to the California Disability Determination Services Division (DDSD) for evaluation (refer to 49-025: Age and Disability); or
      
      
   2. A Presumptive Disability determination must be made while awaiting the DDSD’s formal disability or blindness determinations (refer to 49-025: Age and Disability).
      
      Note: To be eligible for CAPI benefits based on a finding of presumptive disability, a person must meet all CAPI requirements (refer to 49-025: Age and Disability). 
      
      CAPI payments based on presumptive disability cannot be made for longer than six months (refer to 49-025: Age and Disability).
      
      Payments based on a presumptive disability are not considered overpayments if the applicant is ultimately determined to be not blind or disabled (refer to 49-025: Age and Disability). 

• Discontinued from the SSI/SSP program due to expiration of disability (MEDS payment codes N07 or N08) and under 65 years old, the EW must:
  
  
  • Obtain an SSA medical printout showing the date of re-exam; or
    
    
  • Complete a disability packet and send to the DDSD for evaluation (refer to 49-025: Age and Disability). 

Interim Assistance Reimbursement 

To ensure the CAPI benefits are repaid by the CAPI applicant/participant properly, the EW must:

1. Require CAPI applicant/participant to sign the following during the CAPI Intake (refer to 49-015.1: CAPI Application Procedures) and annual redetermination, which is within 12 months from the date of application and each succeeding 12-month period, (refer to 49-070: Redeterminations): 
   
   
   • SSP 14, Authorization for Reimbursement of Interim Assistance Initial Claim or Posteligibility Case form.
     
     Note: Require the CAPI applicant/participant take the SSI/SSP application and CAPI 103 to SSA.
     
     
   • SOC 455, State Interim Assistance Reimbursement form.
      
2. Terminate CAPI benefits as soon as possible after determining the CAPI participant has been approved for SSI/SSP benefits to avoid overpayments.

CAPI 103, Referral for SSI/SSP Application (09/03)

SSP 14, Authorization for Reimbursement of Interim Assistance Initial Claim or Posteligibility Case (09/10) 

SOC 455, State Interim Assistance Reimbursement (01/99)

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How to Generate the SSP 14

Generate the SSP 14 through the Template Repository Search page.

Access the form through the hyperlink.

Re-opening Suspended Cases

Access the terminated case through the Case Summary page.

Expand the Program section and click on the View Details radio button.

Click the Edit radio button.

Click the Reapply radio button.

Complete the required fields and click the Save and Return radio button.

The case should now show a pending status.

Manual Policy and Procedure §49-005, §49-030, and §30-009

ACL No. 17-31, Application Procedures for the Cash Assistance Program for Immigrants (CAPI), dated May 18, 2017

ACL No. 16-34, Cash Assistance Program for Immigrants (CAPI) Redeterminations – Clarifying Regarding Supplemental Security Income (SSI) Referrals, dated May 3, 2016

ACL No. 98-82, Cash Assistance Program for Immigrants (CAPI), dated October 16, 1998

All County Information Notice (ACIN) No. I-98-08, The Impact of H.R. 2608, Known as the “Extension for Elderly and Disabled Refugees Act” on CAPI, dated December 23, 2008

ACIN No. I-07-04, Cash Assistance Program for Immigrants (CAPI) Eligibility for Refugees Discontinued from the Supplemental Security Income/State Supplemental Payment (SSI/SSP) Program, dated January 28, 2004

ACIN No. I-71-98, Cash Assistance Program for Immigrants, dated December 9, 1998

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Administrative staff may contact the GR Special Projects & SSI Advocacy at (562) 908-6732.

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Determining Potential SSI Eligibility for CAPI Cases Decision Chart