DPSS ePolicy

• To convert existing policy to the new webpage – No content changes
• To revise existing policy and/or form(s)

What Changed?

1. Effective January 1, 2024, assets are no longer counted to determine eligibility under Non-Modified Adjusted Gross Income (Non-MAGI).  Any references to assets/property were removed from this document.
2. Includes the Disabled Adult Child (DAC) hierarchy.
3. Includes a Disabled Widow(er) (DW) Program example and updated the Supplemental Security Income/State Supplementary Payment (SSI/SSP) payment level for all examples.
4. All references to the LEADER Replacement System have been changed to the California Statewide Automated Welfare System (CalSAWS).
5. Gender-specific references within the policy have been replaced with gender neutral/inclusive language.

The Pickle Program, which includes the Disabled Adult Child(ren) (DAC) and Disabled Widow(er) (DW) Program, provides zero Share-of-Cost (SOC) Medi-Cal to eligible beneficiaries. 

Pickle eligibility is granted to certain Aged, Blind, or Disabled (ABD) individuals who once received or were entitled to receive Supplemental Security Income/State Supplementary Payment (SSI/SSP) and Title II Retirement Survivors and Disability Insurance (Title II RSDI) simultaneously and were later discontinued from SSI/SSP.

All ABD applicants with Title II RSDI income who are not in a Long-Term Care (LTC) facility must be screened for potential eligibility to the Pickle, DAC, or DW Program.

Property/Assets

Effective January 1, 2024, the asset test for Non-MAGI Medi-Cal was eliminated and all property is exempt.

Criteria for the Pickle Programs

Pickle

To be eligible to the Pickle Program, beneficiaries must meet all of the following conditions:

• Are currently receiving Title II RSDI, Social Security benefits;
• Received or have been entitled to receive both Title II RSDI and SSI/SSP benefits simultaneously at any time since April 1977;
• Was discontinued from SSI/SSP for any reason since April 1977;
• Received a Title II RSDI Cost of Living Adjustment (COLA) increase since being discontinued from SSI/SSP;
• Would be entitled to receive SSI/SSP benefits if the Social Security COLA received after SSI/SSP discontinuance was disregarded;
• Have met all other Pickle income eligibility requirements; and
• Have a total countable income that does not exceed the current SSI payment level to be eligible.

Note:  Citizenship or satisfactory immigration status is a requirement for all Pickle Programs.

DAC

DAC is a class of the Pickle Program and provides zero SOC Medi-Cal to a limited group of disabled adult children who have had their SSI/SSP discontinued.

To be eligible to the DAC Program, beneficiaries must meet all of the following conditions:

• Be at least 18 years old;
• Are currently receiving Title II RSDI benefits based on a parent’s claim;
• Have previously received SSI/SSP cash benefits based on blindness or a disability that began prior to age 22;
• Have been discontinued from SSI/SSP due to receipt of, or increase in Social Security Childhood Disability (Title II DAC) benefits;
• Have met all other Pickle income eligibility requirements;
• Have a total countable income that does not exceed the current SSI payment level to be eligible; and
• Would be entitled to receive SSI/SSP benefits if the Social Security COLA received after SSI/SSP discontinuance was disregarded.
  

Individuals discontinued from SSI/SSP due to admission to an LTC facility are not under the DAC provisions.

DW

The DW Program is also a class of the Pickle Program and provides zero SOC Medi-Cal to a limited group of DWs. Beneficiaries found eligible under the DW Program may receive benefits until they become eligible to Medicare Part A.

To be eligible to the DW Program, beneficiaries must meet all of the following conditions:

• Be between 50 and 64 years of age;
• Eligible for and currently receiving Widow(er) benefits under Social Security Title II Section 202;
• SSI/SSP was discontinued because of an increase in the amount of their Widow(er) benefits;
• Have received SSI/SSP in the month prior to the month in which Title II Section 202 Widow(er) benefits started;
• Are not entitled to receive Medicare Part A benefits;
• Have met all other Pickle income eligibility requirements;
• Have a total countable income that does not exceed the current SSI payment level to be eligible; and
• Would be entitled to receive SSI/SSP benefits if the Social Security COLA received after SSI/SSP discontinuance was disregarded.

Pickle, DAC, DW Aid Codes

• 16 - Pickle Aged
• 26 - Pickle Blind
• 6A - Blind DAC
• 6C - Disabled DAC
• 36 - Disabled Widow(er)
   

Medi-Cal Hierarchy

The Pickle Programs fall under the Mega Mandatory category.  Therefore, eligibility to the Pickle Programs must be granted before the Modified Adjusted Gross Income (MAGI) and Non-MAGI programs. 

A Pickle screening must be completed for recipients who contact the department to request an evaluation. 

DAC Hierarchy

DAC is the most beneficial of the Pickle Programs, as DAC income received from the applicant/beneficiary’s parent's or grandparent’s Social Security record is disregarded.  Therefore, it is crucial that potential eligibility to the DAC program be assessed before evaluating for the other Pickle Programs.

It is also important that DACs maintain their eligibility to the program and not transition to other programs.  Therefore, staff must ensure that DAC eligibility is documented in the case Journal for other staff viewing the case.

Lynch v. Rank Annual Notice

Each year the Department of Health Care Services (DHCS) is mandated to notify designated individuals of their potential eligibility to zero SOC Medi-Cal under the Pickle Program.

A Pickle screening must be completed for individuals who contact the department to request an evaluation.

The Pickle Program is a federally funded program administered by the State.  It is named after the 1976 amendment to the Social Security Act introduced by Congressman J. J. Pickle.  This amendment and the associated programs are known as the “Pickle Amendment” or “Pickle Program.”  The amendment requires that the individual is to be treated like an SSI recipient.  Therefore, eligible to zero SOC Medi-Cal if the individual meets the designated program criteria. 

DAC

In November 1986, the Social Security Act was amended to include DAC to the Pickle Program.

DW

The consolidated Omnibus Reconciliation Acts of 1987 and 1990 added DW to the Pickle Program.

Lynch vs. Rank

Lynch vs. Rank is a lawsuit which requires DHCS to notify designated beneficiaries of their potential eligibility to the Pickle Program.

Receipt of SSI/SSP benefits

• Receipt of prior SSI/SSP benefits must be verified.
   

Verification of receipt of SSI/SSP may be obtained via:

• Written notice from the SSA;
  
• Pickle Listing; or
  
• MEDS.
   

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