DPSS ePolicy

Individuals who reside in a medical facility, such as a hospital, nursing home, or intermediate care facility are not eligible for GR.

Applications received by mail, eFax, or via BenefitsCal from the individuals residing in a medical facility with no expected discharge date will be denied by the end of the 30th day from the application date. Applications for individuals soon-to-be- discharged from the medical facility within 30 calendar days from the date of application will be processed after their discharge. The Begin Date of Aid (BDA) for these applicants will be their discharge date from the medical facility.

Any time a participant with an active GR case enters a medical facility, they become ineligible for GR effective the beginning of the following month after their admission date, unless the participant's physician expects the period of hospitalization to end during the admission month or the following month.

1. If the participant leaves the medical facility by the end of the admission month, then GR case is not discontinued, and the participant remains eligible for GR.
2. If the participant leaves the medical facility as expected during the second month following the admission, then no negative action is taken on GR, and the participant remains eligible for GR. 
3. If the participant does not leave the medical facility as expected during the second month, then the GR case is discontinued effective the beginning of the following month.

Note: Medical facility residents do not have hearing rights if their GR case is discontinued, or if their benefits are reduced due to a participant's admission to a medical facility while they are still hospitalized.

Upon discharge from the medical facility, a participant may reapply for GR or have their GR benefits reinstated if the case is still in the Extended Suspend Period and the participant complies with all other GR eligibility requirements.

1. If the participant is discharged from a medical facility prior to the end of the Extended Suspend Period and provides a hospital discharge letter or a doctor's statement, the GR discontinuance is rescinded and their benefits are reinstated effective the discharge date, or the first day of the month after the discontinuance month, whichever is later. 
2. If the participant is discharged from the medical facility after the Extended Suspend Period ends, the case cannot be rescinded, and benefits cannot be reinstated. The participant must reapply for GR by submitting a new application. 
    

GR participants are required to report all mandatory mid-period changes including household (HH) composition changes within five calendar days from the date the change becomes known to the HH.

Refer to 40-104 Reporting Responsibilities for General Relief Applicants and Participants and 44-203 Household Composition and Living Arrangement policies for details.

GR Participant Residing in Board and Care (B&C) Facility Enters a Medical Facility

When a GR participant who is residing in a B&C facility enters a medical facility, the GR case will not be discontinued when the following conditions are met:

1. The participant's physician expects the period of hospitalization to end before the end of the month following the admission date; 
2. The participant intends to return to the same B&C facility; and 
3. The B&C facility is holding a room for the individual for their return.

Refer to 45-100 Board and Care policy for details.

GR Participant Requiring a Therapeutic Diet After Discharge From the Medical Facility

A therapeutic diet is a special diet to control the intake of certain foods as part of the treatment of a medical condition. The maximum allowable monthly rates for specific diets are listed in the Therapeutic Diet Chart.

Refer to 44-202 Special Needs policy for details.

As a condition of GR eligibility, applicants/participants must provide one of the following verifications to support the claim that they are no longer in the medical facility:

1. Discharge documentation from the medical facility; or 
2. A letter from the medical health care provider or other legally qualified medical professional.

Note: The documentation must include the admission and discharge dates from the medical facility. 

Applicants/participants who do not have the discharge documents from the medical facility or are unable to provide a medical verification from their health care provider may use the GEN 853, Sworn Statement to provide a written statement under penalty and perjury. 

Note: To assist the applicant/participant, the Eligibility staff may contact the medical facility to verify the discharge date.