DPSS ePolicy

Revision of existing policy and/or form(s)

What changed?

1. The policy and procedures have been revised to reflect the changes to the Hearing process. 
2. Clarified the instructions for complaint and duplicate filing processes. 
3. References to the General Relief Opportunities for Work (GROW) Program have been replaced with the Skills and Training to Achieve Readiness for Tomorrow (START) Program. 
   • Note: The GROW term will be used only when referencing California Statewide Automated Welfare System (CalSAWS) pages until the system is fully programmed. All notices and forms that are currently available in CalSAWS will also display the GROW term pending the system change. 
4. References to GROW Case Manager have been replaced with START Worker (SW). 
   
5. References to the Leader Replacement System (LRS) have been replaced with CalSAWS. 
6. References to the Electronic Document Management System (EDMS) have been replaced with CalSAWS Imaging Solution (CIS). 
7. References to Your Benefits Now (YBN) have been replaced with BenefitsCal, which is the new statewide self-service portal.

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

The Right to a Hearing

A hearing is a process for a participant to dispute any proposed adverse action that will be taken on their case. The hearing is conducted by an impartial Hearing Officer who has the authority to decide the outcome of the dispute.

Participants have a right to a hearing before benefits are reduced or discontinued, except for the following circumstances:

1. The participant does not want to proceed with the hearing and/or confirms in writing to waive their rights to a hearing;
2. The reason for discontinuance is: 
   • Death; 
   • Eligibility for another cash public assistance program (e.g., Cash Assistance Program to Immigrants (CAPI), CalWORKs, etc.); 
   • Entry into an ineligible institution (e.g., jail, hospital, rehab center, etc.). 
3. The reason for the reduction of benefits is the cessation or change of a Special Need Allowance; or 
4. Denials, except in the case of duplicate filing.
   
   Refer to 44-403.5 Noncompliance Review and Hearing Process policy for details on General Relief (GR)/START Hearing process.

Note: Applicants who wish to appeal their denial are advised of the Complaint Process.

Complaint Process

When the applicant/participant is dissatisfied with the handling of any aspect of their GR application/case and wishes to make a complaint.

Denial Complaint - When the applicant receives a denial notice, disagrees with the denial, and wishes to make a complaint about the denial of the application.

Notice of Action (NOA) Complaint - When the applicant/participant complains that they have not received a timely NOA prior to an adverse action taken on their case.

Refer to the Complaint Process section for details.

NOA

A NOA is a form that is provided to applicants/participants in their threshold language to inform them of an action which has been or will be taken concerning their eligibility status or changes in their benefits. All NOAs contain the following information:

1. The proposed decision;
2. The reason(s) for the proposed action;
3. The hearing or denial complaint contact information including the phone number of the Hearing Officer or Denial Complaint Liaison;
4. The GR regulations that are the basis for the proposed decision;
5. The instructions for the applicants/participants on how to keep their benefits or to dispute the proposed action taken on the case;
6. The phone numbers of the Customer Service Center (CSC), SW, District Administration, and free legal help; and
7. The back of the NOA includes the information about potential sanctions/penalties and the applicants/participants rights and responsibilities.

NOA Types

1. Approval NOA (ABP 4023-A) - A notice informing the applicant about the approval of the application, the benefit amount, reporting responsibilities, and their rights to dispute the actions taken on their case.
2. Denial NOA (ABP 4023-D) - A notice informing the applicant about the denial of the application. The denial NOA is sent no later than 30 days from the application date.
3. Discontinuance NOA (ABP 4023-T) - A notice informing the participant about the discontinuance of benefits. The discontinuance NOA is automatically generated and mailed to the participants at least ten calendar days prior to the effective date of the change.
4. Change NOA (ABP 4023-C) - A notice informing the participant about the action which has been or will be taken concerning their eligibility status or changes in their benefits.  
   
   Note: All Discontinuance and Change NOAs that include adverse action will be mailed ten calendar days prior to the effective date of change.

CalSAWS is programmed to auto-generate and mail the NOA to the applicant/ participant. The adverse action NOAs will be automatically generated and mailed to the participants in their threshold language at least ten calendar days prior to the effective date of the change.

Homeless applicants/participants who are using the district office address as a mailing address can receive the NOAs when they pick up their mail at the district office. All forms and notices generated by CalSAWS are also viewable in BenefitsCal for 90 days from the issue date.

N/A

Adverse Action NOA Content

Adverse action NOAs contain the following information:

1. The effective date of discontinuance/reduction;
2. If a reduction, the reduced amount;
3. A statement of all circumstances/facts that justify the action;
4. The GR regulations that are the basis for the action;
5. A summary of the applicable regulations;
6. The period of ineligibility when the discontinuance involves a penalty;
7. The 0, 30, 60 days penalty period for START or Mandatory Substance Use Disorder Recovery Program (MSUDRP) sanction;
8. The six months, 12 months or permanent penalty period for duplicate filing or welfare fraud conviction when the discontinuance involves a penalty. The penalty for applying for duplicate GR will be added to any other penalty imposed; and
9. The date the participant may reapply, if discontinued due to Time Limits

GR/START Hearing

The GR/START participant has the right to:

1. Review their case records;
2. Dispute the Department’s proposed decision as stated in the NOA with a Hearing Officer;
3. Request a telephonic or in-person hearing with an impartial Hearing Officer who has authority to reverse the proposed decision on the NOA if it is incorrect;
4. Provide a Good Cause for failure to comply with the GR/START Programs requirement(s); and
5. Receive written notification regarding the result of the hearing.

Refer to 44-403.5 Noncompliance Review and Hearing Process policy for details.

Note: When an application is denied, the applicant is not entitled to a hearing, except in the case of duplicate filings. Applicants who are denied and wish to appeal their denial are advised of the Complaint Process.

Participation in the Hearing

1. The participant must call the Hearing Officer and participate in a telephonic or in-person hearing. In GR family case situations involving an aided minor, either parent must participate on behalf of the aided minor child;
2. The participant has the right to be represented during a hearing by any person(s) of their choice. The participant or representative is permitted to record and/or take notes during the hearing; and
3. The participant may have a witness to participate during the hearing testifying on their behalf.

Refer to 44-403.5 Noncompliance Review and Hearing Process and 43-100 Responsible Relatives for General Relief policies for details.

Rescheduling a Hearing

The participant can reschedule a previously requested hearing:

1. The hearing is rescheduled when a participant informs the Hearing Officer of not being able to participate in the hearing;
2. The Hearing Officer can reschedule a mutually acceptable date that falls before the participant’s next stagger date (when possible), provided this date falls on or before the last date of the Extended Suspend Period;
3. If it is not possible to reschedule the hearing before the next stagger date, the hearing is scheduled within one week of the request to reschedule, provided this date falls on or before the last date of the Extended Suspend Period;
4. No benefits can be issued pending resolution of the hearing issue; and
5. When Good Cause is determined, the discontinuance is rescinded, and benefits are increased/restored without penalty or proration.

Refer to 44-403.5 Noncompliance Review and Hearing Process policy for details.

Failure to Request/Keep a Hearing Appointment

The first time a participant does not resolve the noncompliance by the end of the Extended Suspend Period or fails to request/keep a hearing appointment in a 12-month period, the GR case will remain discontinued, but no sanction will be imposed.

Any subsequent instances of noncompliance will cause the GR case to be discontinued and the participant to be sanctioned in accordance with the 0/30/60-day sanction policy.

Refer to 44-403.5 Noncompliance Review and Hearing Process policy for details.

Extended Suspend Period

Participants, except those discontinued for Time Limits or duplicate filing, are provided an Extended Suspend Period through the third Thursday of the month following the discontinuance in which they can comply with all noncompliance issues. When noncompliance issues are not resolved during this period, aid remains discontinued.

Note: Discontinuances due to Time Limits and duplicate filing do not have an Extended Suspend Period as these are not noncompliance issues (i.e., the participant did not fail to comply with any GR/START Programs requirements).

If DPSS made an error by discontinuing/reducing participant’s benefits, then the participant’s benefits will be restored by the designated DPSS staff as long as the participant requests such review within 90 days after the adverse action is taken.

Refer to 41-411 Noncompliance and Sanction and 44-403.5 Noncompliance Review and Hearing Process policies for additional information.

Complaint Process

Denial Complaint

Applicants who are denied for any other reason than for duplicate filing and wish to appeal their denial are advised of the Denial Complaint process.

1. The applicant may contact the phone number listed on the Denial NOA to request a telephonic or in-person meeting with the Denial Complaint Liaison. The Denial Complaint Liaison is a designated Eligibility Supervisor (ES) who has the authority to waive the denial/penalty action;
2. If the complaint is still unresolved, the applicant can contact the Deputy District Director (DDD) and request a complaint review;
3. If the complaint has not been resolved with the DDD, the applicant can request an interview with the District Director (DD) to finalize a resolution in the matter;
4. When a complaint cannot be resolved satisfactorily within the district, the district administration must contact GR Program for review and resolution; and
5. If the problem concerns anything other than eligibility or program interpretation, the matter is referred to the appropriate Division Chief for review and resolution.

NOA Complaint

Participants who complain that they did not receive a timely NOA prior to an adverse action taken on their case are advised of the NOA Complaint process.

1. If a NOA was mailed to the address on the record, it must be determined if an appropriate and timely notice was given prior to a grant reduction or discontinuance; or
2. If a NOA was not mailed to the address on the record in a timely manner, or the Post Office has caused an unforeseen delay in the delivery of the NOA
   • The participant has a right to schedule a telephonic or in-person hearing with a Hearing Officer; and
   • Benefits in the amount prior to the discontinuance will be issued pending the hearing outcome.

Note: Applicants who claim they did not receive the appropriate Denial NOA will be referred to the Denial Complaint Liaison for further assistance.

Duplicate Filing

If a participant submits a new GR application while they have an active or pending case in the same or other County, the duplicate application is denied.

All participants, except those with Needs Special Assistance (NSA) status, who file duplicate claims for GR benefits are subject to sanctions as follows: 

• Six-month GR ineligibility for the first offense;
• Twelve-month GR ineligibility for the second offense; or
• Permanent GR ineligibility for the third offense.

Participants accused of a duplicate filing are entitled to a hearing prior to adverse sanction action. This applies to denials and discontinuances.

When the hearing confirms that a duplicate filing occurred, both the application and the second case are denied/ discontinued. There is no Extended Suspend Period for participants discontinued for duplicate filings.

When it is determined that a participant reapplies for GR in error (e.g., did not understand the case was suspended, etc.) or have a NSA status, the current application is denied without a sanction.

For participants applying for GR while currently in a sanction/ ineligible period due to an overpayment, the application is withdrawn, and the participant is reminded of the ineligibility period. Because the participant is not being aided, this is not an attempt to receive duplicate aid. No further action is required.

Before or after the hearing interview, participants have the following options to provide the verification that supports the asserted cause of the noncompliance:

1. By United States (U.S.) mail or fax;
2. In person to the district office; or
3. Upload via BenefitsCal