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The 250% California Working Disabled Program Question and Answer Sheet


Mitch Jeserich

former Policy Analyst

World Institute on Disability

3075 Adeline Street, Suite 280, Berkeley, CA 94703


1. What is the 250% California Working Disabled Program (CWD)?

The 250% California Working Disabled Program (CWD) is a new Medi-Cal program. Under this program workers with disabilities, who earn less than 250% of the Federal Poverty Level, can buy into Medi-Cal with a monthly premium payment.

2. What does the CWD program consider to be "work"?

"Work" is undefined. A disabled worker on the CWD program must provide proof of employment (for example, pay stubs or written verification from the employer that verifies employment.)

If you are self-employed, you will have to provide records (for example, W-2 forms) to demonstrate employment. Also, for the independent contractor, verification may be provided with a 1099 IRS form as proof of income and employment.

You are still considered to be working under the CWD program if you are receiving vacation or sick leave pay from your employer.

3. Who is eligible for the 250% California Working Disabled Program?

Any working disabled person who meets the Social Security definition of disability, earns less than 250% of the federal poverty line, and has $2,000 or less of personal assets.

Except for earnings, all applicants must continue to meet the Social Security definition of disability and meet the non-financial requirements of the Medi-Cal program. Earnings due to work are not a consideration in determining whether a disability exists.

You may already be receiving Medi-Cal benefits by paying a share of cost. If you are receiving share of cost Medi-Cal and feel that you may be eligible for the CWD program, contact your county eligibility worker and request to be evaluated. Although the medical coverage is the same, the CWD monthly premium payment may be less than your monthly share of cost.

4. What is the federal poverty level?
Federal Poverty Level Guidelines

From: http://aspe.hhs.gov/poverty

2001 HHS Poverty Guidelines

Size of Family Unit 48 Contiguous States and D.C. Alaska Hawaii
1 $ 8,590 $10,730 $ 9,890
2 11,610 14,510 13,360
3 14,630 18,290 16,830
4 17,650 22,070 20,300
5 20,670 25,850 23,770
6 23,690 29,630 27,240
7 26,710 33,410 30,710
8 29,730 37,190 34,180
For each additional person, add 3,020 3,780 3,470

SOURCE: Federal Register, Vol. 66, No. 33, February 16, 2001, pp. 10695-10697.

According to the chart, 250% the federal poverty line for a single individual in the year 2001 is $21,475, and for a family size of two is $29,025. (Note, you can calculate 250% of the federal poverty line by taking the income number equivalent to the family size and times that by 2.5)

When considering a disabled worker's income, the CWD program uses the Social Security earned income rules. According to these rules the first $65 of earnings, $20 from any source, plus one-half of the remaining income, are not counted. This means that half of one's earning are disregarded; thus a disabled worker can make approximately $42,000 a year and maintain eligibility for the CWD program.

5. If I buy into Medical through the CWD program, can I be eligible for In Home Supportive Services (IHSS)?

Yes. Under the CWD program, you are eligible for IHSS if you meet the IHSS' eligibility requirements in the same way as all other Medi-Cal beneficiaries have to.

The CWD program does not include personal care services for persons who receive advance pay or for persons whose caregiver is their spouse.

Neither IHSS services nor the Personal Care Services Program (PCSP) services are covered outside of the home. This means that personal care services needed at the work-site are not covered at this time.

6. What if I am married?

If you are married and spousal deeming applies, then 250% of the federal poverty line for two persons is used.

7. How do I get started into the CWD program?

To buy into Medi-Cal through the CWD program, you should go to your county welfare office, or, if you currently receive Medi-Cal, you should talk to you Medi-Cal eligibility worker. Appendix I is a list of county coordinators for the CWD program.

8. Can I qualify for the CWD program if I already receive SSDI and Medicare?

Yes. Many people who receive SSDI and Medicare also pay an expensive share of cost to receive Medi-Cal. As long as you are working, and meet all other eligibility criteria, you can buy into Medi-Cal with an affordable premium payment under the CWD program.

9. Can I have a retirement fund?

Yes. Any employer or individual retirement plan approved by the Internal Revenue Code is permissible under the CWD program (for example, an Independent Retirement Account).

10. What is the difference between the CWD program and the SSI 1619b program?

The SSI 1619b program allows a worker with a disability, who previously received SSI benefits, to maintain Medi-Cal for free after the worker's income is above Substantial Gainful Activity level (SGA) of $740 a month and not over $24,492 a year. 1619b does allow a worker with a disability to have certain types of retirement funds. (It is recommended that you speak with a benefits counselor to see what retirement funds that you can and cannot have.) Broadly defined, a worker with a disability can have a retirement fund that can be drawn from monthly, or a retirement fund that cannot be drawn from at all.

To qualify for 1619b a worker with a disability must have received SSI for at least 1 month, still be disabled, still meet all other eligibility rules, need Medi-Cal in order to work, and have a grossed earned income that is insufficient to replace SSI, Medi-Cal, and attendant care services.

The CWD program allows a worker with a disability to earn more money than 1619b. The CWD program also allows the worker to have any IRS approved retirement fund.

If you make less than $24,494 dollars a year, and don't have a retirement fund that can be counted as an asset, you may prefer 1619b because there would be no premium payment.

11. What are the reporting requirements for the CWD program?

There is an annual medical review for all recipients of any Medi-Cal program. However, there are no scheduled reporting requirements due to work. But you are required to report all changes (e.g., earnings, name/address changes) to your county eligibility worker within 10 days of the change.

12. Do I have to pay a premium payment?

Yes. To buy into the CWD program you must pay a monthly premium. The premium amount is determined by your countable income. Premium payments range from a minimum of $20 a month to a maximum of $250 a month.

Once you become eligible for the CWD program, your county eligibility worker will provide you with self addressed, postage paid envelopes in which to mail your monthly premiums. Premiums are due by the 10th of each month.

In the future an automated billing system will be implemented. On the 23rd of each month, you will be mailed a premium payment notice that will reflect the current month's premium and any unpaid balances. Until you begin receiving this premium balance notice, you will be required to send in your monthly premium payments each month using the envelopes and invoices provided. Additional invoices can be obtained from your eligibility worker.

13. Can my premium payments be increased or decreased?

Yes. If you report an increase or a decrease in your countable income, the county will decide whether your premium payment should be adjusted.

If your premium payments are increased, the county must send you a timely and adequate notice of action.

If the county decreases your premium payments for the months that you have already paid the premium payment, your overpayment for those months will be credited to your following premium payments.

14. What if I fail to pay my premium payments?

If the premium payments have not been received for two consecutive months, you will be sent a Notice of Action informing you of your termination from the CWD program. The Notice of Action will also inform you that you will be re-determined for eligibility under other Medi-Cal programs.

If you are discontinued from the CWD program for failure to pay the premium payments for two consecutive months and you are off the program, you will have a 6-month penalty period. If you wish to reenroll into the program during the 6-month penalty period, you must pay the current premiums and pay the previous payments that went unpaid. If you wish to enroll after the 6-month penalty period, you will be considered a new applicant and must prepay the premium for the first month of your new eligibility.

There is always an appeal process whenever a change in Medi-Cal eligibility takes place. If you wish to appeal your eligibility status, you should request the appeals process paperwork from your Medi-Cal eligibility worker.

15. What if I have private or employer health care?

Private or employer health care may not cover all the services a person with a disability may need (for example, a wheelchair, a respirator, certain prescription drugs, or In Home Supportive Services). If you have private or employer health care that does not meet your disability needs, you may want to see if you are eligible for the CWD program. Having private or employer health care does not make you ineligible for the CWD program.

16. If I stop working, when is the first month of my ineligibility for the CWD program?

The month of ineligibility begins on the first day of the following month in which you have stopped working, unless there is a good cause for your work stoppage.

If a good cause exists and you meet all other eligibility requirements, the county shall continue your eligibility into the CWD program for the next two months following the month in which you stopped working. A good cause includes such reasons as hospitalization, an inability to work that is directly related to the disability, a work-site closure, or a loss of current transportation and no other alternative means of transportation is available.

17. Can I qualify for the CWD program if I am an immigrant?

Yes. Disabled immigrants who are potentially eligible for the CWD program include qualified immigrants and some immigrants who are Permanently Residing in the United States Under Color of Law (PRUCOL). Qualified Immigrants include

  • Lawful Permanent Residents.
  • Immigrants Granted Asylum under section 208 of the Immigration and Nationality Act (INA).
  • Refugees admitted to the United States under section 207 of the INA.
  • Immigrants paroled into the United States under INA section 212(d)(5) for at least one year.
  • An immigrant whose deportation is being withheld under section 243(h) of the INA.
  • An immigrant granted conditional entry under section 203(a)(7) of the INA.
  • An immigrant who is Cuban and Haitian Entrant as defined in section 501(e) of the Refugee Education Assistance Act of 1980.
  • Battered immigrants who meet the requirements for qualified alien status.


A World Institute on Disability and the California Department of Human Services collaboration


APPENDIX 1

List of County Coordinators

01-ALAMEDA
Social Services Agency
8477 Enterprise Way
Oakland, CA 94621
(510) 267-9442
(510) 267-9428 FAX

02-ALPINE
Dept. of Social Services
75 Diamond Valley Rd.
P.O. Box 277
Markleeville, CA 96120
(530) 694-2235
(530) 694-2252 FAX

03-AMADOR
Dept. of Social Services
1003 Broadway
Jackson, CA 95642
(209) 223-6569
(209) 223-6208 FAX

04-BUTTE
Dept. of Social Welfare
P.O. Box 1649
Oroville, CA 95965
(530) 879-3521
(530) 879-3483 FAX

05-CALAVERAS
Works and Human Services Agency
891 Mountain Ranch Road
San Andreas, CA 95249
(209) 754-6447
(209) 754-6543 FAX

06-COLUSA
Health and Human Services
P.O. Box 370
Colusa, CA 95932
(530) 458-0264
(530) 458-0492 FAX

07-CONTRA COSTA
Employment and Human Services
40 Douglas Dr.
Martinez, CA 94553
(925) 313-1621
(925) 313-1758 FAX

08-DEL NORTE
Health and Social Services
880 Northcrest Dr.
Crescent City, CA 95531
(707) 464-3191
(707) 465-1783 FAX

09-EL DORADO
Dept. Of Social Services
3057 Briw Rd.
Placerville, CA 95667
(530) 642-7159
(530) 626-9060 FAX

10-FRESNO
County of Fresno
Dept. of Human Services
Fresno, CA 93750
(559) 253-9177
(559) 253-9250 FAX

11-GLENN
Human Resources Agency
P.O. Box 611
Willows, CA 95988
(530) 934-6514
(530) 934-6521 FAX

12-HUMBOLDT
Dept. of Social Services
929 Koster St.
Eureka, CA 95501
(707) 445-7706
(707) 441-5600 FAX

13-IMPERIAL Dept. of Social Services
2995 S. Fourth St. Ste. 105
El Centro, CA 92243
(760) 337-7408
(760) 370-0492 FAX

14-INYO
Dept. of Social Services
914 No. Main St.
Bishop, CA 93514
(760) 872-1394
(760) 872-1749 FAX

15-KERN
Human Services
P.O. Box 511
Bakersfield, CA 93302
(661) 631-6144
(661) 633-7047 FAX

16-KINGS
Human Services Agency
1200 South Dr.
Hanford, CA 93230
(559) 582-3211
(559) 585-0346 FAX

17-LAKE
Dept. of Social Services
15975 Anderson Ranch Pkwy
P.O. Box 9000
Lower Lake, CA 95457
(707) 995-4200
(707) 995-4204 FAX

18-LASSEN
Dept. of Social Welfare
720 Richmond Road
P.O. Box 1359
Susanville, CA 96130
(530) 251-8152
(530) 251-8373 FAX

19-LOS ANGELES
Dept. of Public Social Services
12860 Crossroads
City of Industry, CA 91746
(562) 908-3528
(562) 908-0593 FAX

20-MADERA
Dept. of Public Welfare
720 East Yosemite
P.O. Box 569
Madera, CA 93639
(559) 662-8364
(559) 675-7983 FAX

21-MARIN
Dept. of Health and Human Services
3501 Civic Center Branch
P.O. Box 4160 Civic Center Branch
San Rafael, CA 94913
(415) 499-7056
(415) 499-6731 FAX

22-MARIPOSA
Dept. of Social Services
P.O. Box 7
Mariposa, CA 95338
(209) 966-3609
(209) 966-5943 FAX

23-MENOCINO
Dept. of Social Services
747 South State St.
P.O. Box 1060
Ukiah, CA 95482-1060
(707) 463-7724
(707) 463-7859 FAX

24-MERCED
Human Services Agency
P.O. Box 112
Merced, CA 95341-0112
(209) 385-3000 Ext.5790
(209) 383-6925 FAX

25-MODOC
Dept. of Social Services
120 North Main St.
Alturas, CA 96101
(530) 233-6501
(530) 233-2136 FAX

26-MONO
Social Services
P.O. Box 2969
Mammoth Lakes, CA 93546
(760) 934-3411
(760) 924-5431 FAX

27-MONTEREY
Dept. of Social Services
1000 South Main St. Ste. 208
Salinas, CA 93901
(831) 755-4407
(831) 755-8476 FAX

28- NAPA
Health and Human Services
2261 Elm St.
Napa, CA 94558
(707) 253-4106
(707) 253-6095 FAX

29-NEVADA
Dept. of Public Soc. Svs.
950 Maidu Ave.
P.O. Box 1210
Nevada City, CA 95959
(530) 265-1632
(530) 265-7062 FAX

30-ORANGE
Dept. of Social Services
888 North Main St. Room 158C
Santa Ana, Ca 92701
(714) 541-7736
(714) 245-6188 FAX

31-PLACER
Human Services
100 Stonehouse Court Ste. A
Roseville, CA 95678
(916) 784-6092
(916) 784-6100 FAX

32-PLUMAS
Dept. of Social Services
270 County Hospital Road, Rm 207
Quincy, CA 95971
(530) 283-6350
(530) 283-6368 FAX

33-RIVERSIDE
Dept. of Social Services
1605 Spruce St.
Riverside, CA 92507
(909) 358-3992
(909) 358-3990 FAX

34-SACRAMENTO
Dept. of Human Assistance
2433 Marconi Ave.
Sacramento, CA 95821-4807
(916) 875-3731
(916) 875-3591 FAX

35-SAN BENITO
Human Services Agency
1111 San Felipe Rd. Ste. 206
Hollister, CA 95023-3801
(831) 636-4180
(831) 637-9754 FAX

36-SAN BERNARDINO
Dept. of Public Services
150 S. Lena Road
San Bernardino, CA 92415-0515
(909) 388-0279
(909) 388-0281 FAX

37-SAN DIEGO
Health and Human Services
8840 Complex Dr. Ste. 255
San Diego, CA 92123
(858) 492-2246
(858) 565-3080

38-SAN FRANCISCO
Dept. of Social Services
P.O. Box 7988 Y200
San Francisco, CA 94120
(415) 558-1951
(415) 558-1841 FAX

39-SAN JOAQUIN
Human Services
P.O. Box 201056
Stockton, CA 95201-3006
(209) 468-1153
(209) 468-1985 FAX

40-SAN LUIS OPISPO
Human Services Agency
3433 S. Higuera St.
P.O. Box 8119
San Luis Obispo, CA 93403-8119
(805) 781-1897
(805) 781-1846 FAX

41-SAN MATEO
Human Services Agency
400 Harbor Blvd. Bldg. C
Belmont, CA 94002
(650) 595-7570
(650) 595-7576 FAX

42-SANTA BARBARA
Dept. of Social Services
1100 West Laurel Ave.
Lompoc, CA 93436
(805) 737-7056
(805) 737-7098 FAX

43-SANTA CLARA
Social Services Agency
1725 Technology Dr.
San Jose, CA 95110
(408) 441-5590
(408) 436-5493 FAX

44-SANTA CRUZ
Human Resources Agency
1020 Emeline St.
Santa Cruz, CA 95060-1913
(831) 454-4163
(831) 454-4092 FAX

45-SHASTA
Dept. of Social Services
P.O. Box 496005
Redding, CA 96049-6005
(530) 245-6318
(530) 255-5288 FAX

46-SIERRA
Human Services
202 Front St.
P.O. Box 1019
Loyalton, CA 96118
(916) 993-6720
(916) 993-6741 FAX

47-SISKIYOU
Dept. of Human Services
818 South Main
Yreka, CA 96097
(530) 841-2752
(530) 841-2791 FAX

48-SOLANO
Health and Human Services Dept.
1745 Enterprise Dr.
Fairfield, CA 94533
(707) 421-7805
(707) 421-7237 FAX

49-SONOMA
Human Services Dept.
520 Mendocino Ave.
Santa Rosa, CA 95402
(707) 565-5304
(707) 527-2929 FAX

50-STANISLAUS
Community Services Agency
251 E. Hackett Rd.
P.O. Box 42 (94353)
Modesto, CA 95351
(209) 558-3684
(209) 558-2558 FAX

51-SUTTER
Welfare and Social Services
190 Garden Highway
P.O. Box 1535
Yuba City, CA 95992-1535
(530) 822-7230 Ext 218
(530) 822-7212 FAX

52-TEHAMA
Dept. of Social Welfare
22840 Antelope Blvd.
P.O. Box 1515
Red Bluff, CA 96080
(530) 528-4095
(530) 527-5410 FAX

53-TRINITY
Dept. of Health and Human Services
P.O. Box 1470
Weaverville, CA 96093
(530) 623-8236
(530) 623-1250 FAX

54-TULARE
Health and Human Services
5957 South Mooney Blvd.
Visalia, CA 93277
(559) 737-4660 Ext. 2106
(559) 737-4694 FAX

55-TUOLUMNE
Dept. of Social Services
20075 Cedar Road North
Sonora, CA 95370
(209) 533-5735
(209) 533-5714 FAX

56-VENTURA
Human Services
505 Poli St.
Ventura, CA 93001
(805) 652-7522
(805) 652-7845 FAX

57-YOLO
Dept. of Employment and Social Services
120 West Main St.
Woodland, CA 95695
(530) 661-2806
(530) 661-2847 FAX

58-YUBA
Health and Human Services
P.O. Box 2320
Marysville, CA 95901
(530) 749-6480
(530) 749-6381 FAX