DPSS ePolicy

Revision of existing policy and/or form(s)

What changed?

1. General Relief (GR) applicants who disclose that they are not able to work due to a mental health condition and prefer to provide a verification from their own mental health care provider will be granted a Temporary Needs Special Assistance (NSA) designation for 60 calendar days from the GR application date pending a receipt of the medical verification. The GR application will be approved, if all other GR requirements are met. 
2. GR participants, who disclose that they are unable to secure a timely medical appointment with their own mental health care provider and/or provide a medical verification on or before the expiration of their current NSA designation, will be deemed Temporary NSA for up to 60 calendar days from the current NSA designation expiration date, unless they agree to see the
   co-located/remote Department of Mental Health (DMH) Clinician for a Mental Health Assessment (MHA) on the same day. 
3. Effective July 24, 2023, California Statewide Automated Welfare System (CalSAWS) was programmed to not schedule an appointment with Countywide Benefit Entitlement Services Team (CBEST) Advocates automatically, if the GR applicants/participants have a Temporary NSA designation for 12 months or more within the last 18 months. 
4. Applicants/participants have the option to complete the MHA in-person with the co-located DMH Clinician or telephonically with the remote DMH Clinician. 
5. The district administration is no longer required to submit a monthly report to GR Program to report the number of MHAs and outcomes. The monthly reports will continue to be provided by DMH. 
6. 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 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.  
7. START participants who experience mental health crisis are no longer referred to START Clinicians for a Mental Health Clinical Assessment, but instead are referred to the co-located/remote DMH Clinicians for a MHA. 
   
8. Updated CalSAWS instructions for participants who are designated NSA and willing to participate in the START Program as a volunteer. 
9. References to the GR Annual Agreement have been replaced with GR Renewal (RE). 
10. References to the Electronic Document Management System (EDMS) have been replaced with CalSAWS Imaging Solution (CIS).
11. Included reference to BenefitsCal, which is the new statewide self-service portal that replaced Your Benefits Now. 
12. References to GR Quarterly Reporting (QR-7) have been removed. 
13. Removed the instructions for transferring discontinued NSA cases to storage, as the worker’s file information automatically drops from CalSAWS after 30 calendar days of the case discontinuance, regardless of the participant’s employability status. 
14. Updated the information about the annual staff training provided by DMH staff.

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

NSA is a designation given to a GR applicant/participant who has a mental health condition that prevents them from obtaining and/or retaining employment, as determined by a mental health care provider. These individuals are exempt from some GR Program rules including welfare-to-work activities via the START Program.

GR applicants/participants who declare they are not able to work because of a mental health condition may need a MHA referral. MHA is an evaluation conducted by a mental health professional to determine whether the individual’s mental health condition prevents them from working or participating in employment related activities.

The Eligibility Workers (EWs) and START Workers (SWs) use the ABP 4029, Mental Health Screening Form (11/23) as a screening tool when determining whether an applicant/participant needs a MHA referral. GR applicants/participants are referred by the EW/SW to the co-located/remote DMH Clinicians if they:

• Need a mental health evaluation based on the mental health screening results;
• Disclose they are under the care of a mental health professional, have thoughts of harming themselves or others, and/or are taking prescribed medication;
• Request a mental health evaluation by DMH; or
• Have observable characteristics indicating the applicant/participant may have a possible mental health condition.

GR applicants/participants who indicate they have a mental health care provider, have the option to provide a medical verification of their condition from their own
mental health care provider or to be referred to the co-located/remote DMH Clinicians for in-person or telephonic MHA.

If a GR applicant cannot be seen by a co-located/remote DMH Clinician for a MHA at the time of their GR application, a return appointment will be scheduled with a DMH Clinician within the next three business days and they will be provided with transportation expenses. In those rare circumstances when no DMH Clinician is available to conduct the MHA on the same day and there is no return appointment available within the next three days, the GR applicant may be granted a Temporary NSA designation for six months with the approval of the GR Deputy District Director (DDD) or higher level.

GR applicants who disclose they are not able to work due to a mental health condition and prefer to provide a verification from their own mental health care provider will be granted a Temporary NSA designation for 60 calendar days from the GR application date pending a receipt of the medical verification. The GR application will be approved if the GR applicant complies with all other GR requirements.

GR participants who disclose they are unable to secure a timely medical appointment with their own mental health care provider and/or provide a medical verification on or before the expiration of their current NSA designation, will be deemed Temporary NSA for up to 60 calendar days from the current NSA designation expiration date, unless they agree to see a co-located/remote DMH Clinician for a MHA on the same day.

GR applicants/participants who disclose a disability will be offered a reasonable accommodation per current Americans with Disabilities Act Title II Accommodations policy.

Identification of Cases with NSA Designation in CalSAWS

GR applicants/participants with a NSA designation are identified in CalSAWS with the employability status of Temporary NSA or Permanent NSA. The employability status is changed as soon as the determination is made that a GR applicant/ participant is designated NSA.

Once the GR applicant’s/participant’s NSA designation is updated in CalSAWS based on the results of their recent MHA or doctor’s statement, the Notification of Your Employability Status (ABP 23C-MH or ABP 23D-MH) notice is automatically generated by CalSAWS and centrally mailed to the GR applicant/participant. The notice informs the GR applicant/participant about their Temporary or Permanent NSA designation, the expiration date of the designation and the exemption from some GR Program rules, including participating in the START Program.

A reminder notice(s): ABP 23E-MH 60-Day Employability Status Change Notice and/or ABP 23A-MH 10-Day Employability Status Change Notice is issued to GR participants at 60 days, if applicable, and ten days respectively, prior to their NSA designation expiration date providing participants with instructions on how to obtain proof of their continuing unemployable status.

If the NSA designation expires, or is no longer applicable, the employability status in CalSAWS automatically changes to Employable. The ABP 23B Notification of Your Employability Status notice is automatically generated and centrally mailed to the applicant/participant regarding their employability designation change.

Individuals Need Help With Reading And Writing

If the GR applicant/participant has difficulty reading and/or writing, they will be assisted by the Eligibility staff with reading and completing the forms. This practice is consistent with the Department's customer service policies and would be provided irrespective of whether an applicant/participant has a NSA designation, if needed.

The NSA designation is one type of accommodation provided to GR applicants/ participants who are unable to obtain or retain employment due to a mental health condition.

Authorized Representative (AR)

A person who has permission from the applicant/ participant to act on their behalf. Therefore, ARs are to be allowed to inspect and receive hard copies of
non-privileged or non-confidential information contained in the case records regardless of whether the applicant/ participant is present.

BenefitsCal

A website for applicants/participants to apply for, view, and renew benefits for health coverage, food, and cash assistance. The BenefitsCal portal also allows applicants/ participants to upload supporting verifications/ documents online.

Employable

A designation given to an applicant/participant who is able to obtain and/or retain work.

GR RE

A process that is required to establish a participant’s ongoing eligibility for GR benefits. It must be completed once every 12 months after the initial GR eligibility determination.

MHA

An assessment conducted by a DMH Clinician or Mental Health Care Provider to determine (a) whether the applicant/participant has a mental health condition; and (b) whether the applicant’s/participant’s mental health condition prevents them from obtaining or retaining employment.

Mental Health Care Provider

A licensed physician, psychiatrist, psychologist, clinical social worker, or other licensed health care professional, who provides services for the purpose of improving an individual’s mental health or to treat mental illness.

Mental Health Condition

A condition that affects a person’s thinking, feeling or mood. There are different reasons someone can develop a mental health condition such as: stress, trauma, diseases, etc. This condition may affect an applicant’s/ participant’s ability to relate to others or function each day.

Mental Health Screening Tool

A form with questions to be answered by the applicant/ participant that provides a numerical score used to help decide if they should be referred for a MHA.

NSA

A designation given to an applicant/participant who has a mental health condition that prevents them from obtaining and/or retaining employment, as determined by a mental health care provider.

NSA Volunteer

An applicant/participant designated as NSA, who chooses to participate in the START Program at intake, annual redetermination, or at any other time.

Permanent NSA

A designation given to an applicant/participant whose mental health condition is expected to last 12 months or longer.

START Program

A mandatory welfare-to-work program for employable GR participants that provides education and training opportunities, supportive services, and case management to help them better succeed in their career goals and future.

Temporary NSA

A designation given to an applicant/participant whose mental health condition is expected to last less than 12 months.

GR applicants/participants who indicate they are unable to work due to a mental health condition have two options in providing verification about their mental health condition:

1. Referred to a co-located/remote DMH Clinician for a MHA, or
2. Provide verification from their own mental health care provider by submitting:
   
   
   • The “Third-Party Verification” ABP 1676-3 GRMH Mental Health Assessment for General Relief and ABP 1676-4 GRMH Authorization For Use And Disclosure of Protected Health Information forms; or
   • The physician’s statement on the clinic/hospital letterhead.

All GR applicants/participants must complete the GR eligibility requirements. However, in the event an applicant/participant is unable to comply with or complete the requirements due to a mental health condition, some eligibility requirements may be temporarily deferred with the approval of the DDD or higher level.

Effective July 1, 2018, the Statewide Fingerprint Imaging System (SFIS) requirement was eliminated. GR applicants/participants (with or without a NSA designation) are no longer required to comply with the SFIS requirement as a condition of GR eligibility.

Refer to 40-112 Statewide Fingerprint Imaging System Requirements policy for additional information.

All GR applicants are required to have a verifiable Social Security Number (SSN) as a condition of an initial eligibility.

Refer to 40-113 Social Security Number Requirement policy for additional information.

GR participants with a NSA designation are required to complete the annual GR RE as a condition of continuing eligibility for GR.

Refer to 40-116 General Relief Renewal policy for additional information.

Temporarily Deferred Requirements

If the GR applicant/participant is unable to comply with eligibility requirements due to a mental health condition that are not specified below, the DDD or higher level will contact the GR Program staff to evaluate the need for a deferral and discuss an appropriate period of time for the deferral on a case-by-case basis.

The following requirements may be temporarily deferred:

1. Providing a permanent identification;
2. Applying for other benefits or resources that may be potentially available such as CalWORKs, Veterans Benefits, Social Security Benefits, Disability Insurance Benefits;
3. Providing documents or information to verify the value of real/personal property;
4. Providing the names/addresses of legally responsible relatives; and
5. Providing the verification about a new benefit/resource.

Note: In some situations, because of the severity of the applicant’s/participant’s mental health condition, an extended period of time may be required to encourage compliance with requirement(s). There is no limit on the period of time required to get the applicant/participant with a mental health condition to comply with requirement(s) even after DMH involvement. During this period, the requirement remains deferred.

Participation in the START Program

Applicants/participants with Temporary/Permanent NSA status are not required to participate in the START Program. Applicants/participants who voluntarily choose to participate in the START Program will not be penalized for failing to comply with START Program requirements, and their GR will not stop.

SAR 7 Requirement

SAR 7 Requirement Completion of the SAR 7 for CalFresh purposes is a state requirement and may not be waived. CalFresh regulations require that applicants/participants with mental or physical disabilities are to be provided with assistance when completing CalFresh forms.

Use of Affidavits

Applicants/participants with a NSA designation may sign affidavits, but like all applicants/participants, should not be forced to sign them. Affidavits are helpful for Good Cause determination and to document information when original documents cannot be obtained.

Workers must exercise judgment to determine if the applicant/ participant with a NSA designation has the mental capacity to understand the affidavit and the situation requiring the use of the affidavit. If there is uncertainty regarding the applicant’s/ participant’s ability to understand and complete the affidavit due to a mental health condition, the co-located/remote DMH Clinician or DDD should be consulted.

If it is determined that the applicant/participant with a NSA designation is unable to complete the affidavit, the EW must determine if the GR eligibility requirement for which the affidavit was being sought may be deferred.

CONFIDENTIALITY OF NSA RECORDS

Names, addresses and all other information concerning the circumstances of any applicant/participant are confidential. Applicants/participants/ARs are entitled to view their case records except for privileged information. Paper copies of non-privileged case documents and/or CIS documents must be provided to the applicant/participant/ARs at no cost.

The information can only be released to an AR if the applicant/participant previously reported an AR and signed the CSF 117, Authorized Representative Designation for Cash Benefits form. Refer to 19-005.1 Access To Public Assistance Case Records policy for details.

If a NSA applicant/participant designates an AR as their Electronic Benefits Transfer (EBT) Alternate Cardholder, then the applicant/participant and AR must also sign the TEMP 2201, Cash Aid/CalFresh Electronic Benefit Transfer – EBT Request for A Designated Alternate Cardholder/Authorized Representative form. 

Refer to Call-Out 17-04 dated March 30, 2017, for detailed instructions.

PA 2012, Referral For Mental Health Services

A form completed by the DMH Clinician indicating applicant’s/participant’s NSA designation and its duration.

ABP 1676-3 GRMH, Mental Health Assessment for General Relief

A verification completed by the applicant’s/participant’s mental health care provider indicating that the individual has a mental health condition that prevents them from obtaining or retaining employment and the duration of the mental health condition.

Physician Statement

A letter from the mental health care provider with the clinic/hospital letterhead indicating the applicant’s/ participant’s mental, developmental, and/or behavioral impairment(s), limitations, and duration of the disability.