California Administrative Code

(a) Each local child support agency shall: (1) Obtain a surety bond against losses resulting from employee dishonesty for every employee who receives, disburses, handles, or otherwise has access to any child support funds or support collections under the child support enforcement…

Certified Long-Term Care Insurance Policy or Certificate means any long-term care insurance policy or certificate certified by the Department of Health Services and approved for issue or delivery to California residents by the Department of Insurance as meeting the requirements s…

(a) The information provided shall enable the Director to make a determination as to the percent of match required or to waive the required match based on demonstrated hardship. Each applicant shall submit either: (1) A plan for matching the grant by in-kind services, cash or bot…

“Podiatry Services” means services a podiatrist may perform under California laws.

(a) Aliens whose status has been adjusted in accordance with Immigration and Nationality Act sections 210, 210A or 254A (8 USC sections 1160, 1161 or 1255a) who are applying for full Medi-Cal benefits shall present one of the following INS documents: (1) Aliens granted lawful tem…

(a) Within 15 business days of determining that a non-requesting party's location is unknown, the local child support agency shall access all appropriate locate tools, as set forth in 22 California Code of Regulations, Section 113100, for a period of 30 business days. (b) If the …

Vendor authorization number means a unique number assigned by the Program to a vendor at the time of initial authorization to participate in the Program.

(a) Treatment plans within the program shall be developed for: (1) Children whose parents or legal guardians cannot finance any part of the costs of the necessary care; (2) Children whose parents or guardians are able to finance a part of the costs of the necessary care. (b) Sinc…

(a) (Reserved) (b) In addition to the filing options described in Section 35141, the Statement of Understanding shall contain statements which summarize the following: (1) For a mother or a presumed father of the child who is not detained, a juvenile court dependent in out-of-hom…

The property reserve is the net market value of the nonexempt property of those persons whose property is considered in determining the eligibility of the MFBU.

(a) When selecting new agencies, the Department shall consider the following priority system, which is based upon the relative availability of health and administrative services: (1) First consideration shall be given to a public or a private nonprofit health agency that will pro…

“Expert physician” means a physician and surgeon who is certified as a specialist by the American Board of Medical Specialists and has a faculty appointment at an accredited medical school.

(a) All items of clothing shall be exempt. (b) The following jewelry shall be exempt: (1) Wedding and engagement rings. (2) Heirlooms. (3) Any other item of jewelry with a net market value of $100 or less. (c) The net market value of jewelry not exempted above shall be included i…

(a) “Commercial fishermen” means individuals who are members of a crew of a vessel, engaged in the capture of fish for sale and not in pleasure or sport fishing. (b) “Inclement weather” means weather of such severity as would cause a reasonable master to refrain from making a fis…

Burial insurance with no cash surrender value shall be exempt. Burial insurance with a cash surrender value shall be considered a revocable burial fund and shall be treated as provided for in section 50479.

(a) When the standard skin test is administered to a person, the reaction to the test shall be read by a physician or his/her designee between 48 and 72 hours after administration of the test. The reaction shall be recorded in millimeters of greatest induration. (b) When the mult…

(a) CCS applicants shall be eligible for participation in the CCS program for diagnostic services to determine the presence of a hearing loss when the applicant: (1) Fails two pure tone audiometric hearing screening tests performed at least six weeks apart at levels not to exceed…

(a) Mobile Electronic Device Controls. A Demonstration Project Participant shall limit and protect any storage of IHI on mobile electronic computing devices and passive storage media. A Demonstration Project Participant shall limit and protect any storage of IHI on mobile electro…

“Hearing Officer” means a person designated by the Director to conduct state hearings.

(a) The agency shall inform the parents of a child subject to the provisions of the ICWA that within five years of the time a decree of adoption is granted, the parent may petition the court to set aside a decree of adoption upon the grounds that the consent or relinquishment was…

General supervision, for purposes of reimbursement by CCS is the overall responsibility for the supervision of the total care for a CCS patient, and includes providing and/or arranging for necessary treatment and follow-up care as authorized by the CCS agency in accordance with S…

Certification for Medi-Cal means the determination by the county department or the Department that a person is eligible for Medi-Cal and has no share of cost, has met the share of cost or is in long-term care and has a share of cost which is less than the cost of long-term care a…

A board appeal shall be decided upon the evidence of record in the proceeding, matters officially noticed in the proceeding, the case register, any new or additional evidence admitted by the board, and any written or oral argument before the board

(a) “Nurse practitioner” means a licensed registered nurse: (1) Who is certified by the Board of Registered Nursing as a nurse practitioner. (2) Whose practice is predominantly that of primary care. (b) “Certified family nurse practitioner” means a nurse practitioner, as defined …

(a) A child may apply for Medi-Cal without parental contact in order to receive minor consent services. (b) A child applying on the basis of a need for minor consent services other than mental health care shall submit to the county welfare department a completed and signed form R…

County agency means either an administrative division of a county government or a noncounty organization that has a contract with the county to act on the county's behalf.

(a) If the agency knows or reasonably suspects the petitioners have endangered the physical or mental health of a child by abuse or neglect, the agency shall immediately contact the appropriate child protective agency and file the mandatory “Suspected Child Abuse Report” (Form SS…

CCS applicants with at least one of the following eye conditions shall be medically eligible for participation in the CCS program: (a) Strabismus, when surgery is required and either until fusion is obtained, or a visibly abnormal deformity is corrected. (b) Infections that produ…

State caused errors means case errors in a county for which the state assumes responsibility.

(a) Counties shall report annual enrollment fees due and collected on a quarterly basis on a hardcopy quarterly report form or electronic tape to the department. (b) Counties which share program administration with state regional offices pursuant to Section 123850 of the Health a…

(a) If the records relating to a trainee claim have been destroyed under proper approval, the trainee shall execute the affidavit provided for in Section 2768 of the code. The affidavit shall be on a form prescribed by the department and shall specify: (1) The date of the prior c…

(a) Good cause for refusal of employment or training or for quitting a job or training as required in Section 50215 (b), shall be found if the applicant or beneficiary refuses or quits for any of the following reasons: (1) The offer of employment was from an employer who did not:…

(a) Refugees and entrants who are not otherwise eligible for Medi-Cal under federally-funded AFDC, SSI/SSP, MN or Medically Indigent Child programs may be eligible for Medi-Cal through the special federal programs of Refugee Medical Assistance (RMA) or Entrant Medical Assistance …

(a) The provider facility shall submit claims for reimbursement for costs of care and services provided, in the manner and at the times prescribed by the Department in the signed contract. Claims will be periodically audited by the Department. (b) The Department shall reimburse m…

(a) The MC 800 program is an eligibility process that a county department may choose to utilize to determine eligibility for persons receiving health care services at either a county medical facility or a county contract hospital. This process shall not be utilized unless the cou…

A Medical Review Team shall be comprised of a physician and other appropriate health and social service personnel necessary to conduct medical review.

(a) If the CCS client's request for appeal or CCS Fair Hearing includes a request for continuation or resumption of services previously authorized by the CCS agency, during the time the appeal is under active consideration, the medical decision regarding the need for continuation…

“Preenrollment period” or “preenrollment” includes the period of time during which an application package for enrollment, continued enrollment, or for the addition of or change in a location is pending with the Department.

(a) The agency shall accept a consent o adoption from a parent for whom the court has appointed a conservator only if the order of conservatorship specifically allows such a transaction and the parent's ability to understand the nature, content, and effect of signing a consent to…

“Provider Number” means the unique identification number used by an applicant or provider to obtain reimbursement from the Medi-Cal program. For purposes of substance use disorder clinics, the term “provider number” shall mean the national provider identifier (NPI) number.

(a) In addition to the identifying and nonidentifying information provided by the birth parents on the AD 67 and the AD 67A, the agency shall obtain the following information from other individuals or agencies: (1) Verification of the birth mother's marital history. (A) When veri…

(a) In General. An employee and his or her employer may enter into an agreement under Section 13029 of the code to provide for the withholding of income tax upon payments of amounts described in subdivision (c) of this regulation. Such an agreement may be entered into under this …

Intraprogram status change means a change in a person's or family's eligibility from one aid category to another aid category, in which the first digit of the aid code remains the same.

(a) Except as otherwise provided, the Panel shall not reimburse an employer or contractor for any costs associated with an out-of-state vendor, either through a budget or the Fixed Fee Rate Table, if those costs are for services, such as training. (1) For purposes of this section…

(a) When provisional provider status or preferred provisional provider status is granted, a provider number shall be used by the provider for each business address for which an application package has been approved. This provider number shall be used exclusively for the locations…

The following abbreviations shall apply to chapter 2 of this division: ABD. Aged, Blind or Disabled. ABD-MN. Aged, Blind or Disabled--Medically Needy. AFDC. Aid to Families with Dependent Children. AFDC-MN. Aid to Families with Dependent Children--Medically Needy. BRU. Benefits R…

When a provider of services has a grievance or complaint concerning the processing or payment of his claims for services provided under the Medical Assistance Program the following procedures must be met: (a) The provider shall initiate an appeal, by submitting a grievance or com…

(a) The Panel may allocate available funds from a source other than the Employment Training Tax for an Alternative Funding Source training program, consistent with the program goals of the source and the best judgment of the Panel. (b) The Panel will follow the definitions and pr…

(a) Persons who are granted, denied or discontinued from county cash-based programs shall be notified by the county department, in writing, of their eligibility or ineligibility for county cash-based Medi-Cal. Additionally, persons who are discontinued shall be notified of their …

(a) A party appearing in a hearing shall have his or her evidence and witnesses and be ready to proceed. (b) An administrative law judge shall consider only those issues in a department action which are appealed, petitioned, or noticed by the agency. A related issue shall not be …