California Administrative Code

(a) CCS applicants with at least one of the following conditions shall be medically eligible for participation in the CCS program: (1) Noninfectious diseases of the central and peripheral nervous system which produce a neurologic impairment that is life threatening or physically …

(a) The county shall determine financial eligibility under provisions of Section 123870 of the Health and Safety Code within 30 days of receipt of documentation needed. (b) The county shall determine whether the family is exempt from financial eligibility determination for treatm…

Diagnostic services shall be available to all handicapped children in the county.

Treatment meeting standards pursuant to Sections 42030 and 42110 through 42129 shall be provided for all handicapped children who are eligible.

The supervisor or head nurse of the facility where crippled children are cared for shall have had postgraduate training or experience in pediatric nursing. There shall be sufficient staff to provide adequate nursing care. It is recommended that an average of 5.5 hours of nursing …

(a) Hospitals treating orthopedic cases shall provide physiotherapy personnel and equipment adequate to carry out the recommended treatment. (b) Hospitals providing long-time care to handicapped children shall offer adequate educational and occupational therapy services.

It is desirable that medical social services by qualified hospital personnel be available.

The Hearing Officer may, on his/her own motion or the motion of any party, as the Hearing Officer deems appropriate: (a) Consolidate for hearing or decision any number of issues or appeals when the facts and circumstances are similar and no substantial right of any party will be …

(a) When the request for a CCS Fair Hearing has been accepted, a party to the hearing, by a request in writing to the other party, is entitled to: (1) Obtain the names and addresses of witnesses to the extent known to the other party, limited to those intended to be called to tes…

(a) Prior to and during the hearing the Hearing Officer may issue subpoenas as deemed necessary. (b) Where a witness is material and necessary but attendance presents undue hardship on a medical professional's time and practice commitments, testimony may be taken by telephone con…

An employer required to deduct and withhold income taxes of other states, political subdivisions of such states or the District of Columbia from wages paid to a resident of California (as defined in Section 17014 of the Revenue and Taxation Code) shall deduct and withhold from th…

(a) In addition to the tax required to be deducted and withheld in accordance with the provisions of Section 13020 of the code, the employer and employee may agree that an additional amount shall be withheld from the employee's wages. The agreement shall be in writing and shall b…

(a) In General. (1) An employer, in computing the amount to be deducted and withheld as tax in accordance with Section 13020 of the code, may, at his election, disregard any wages paid in a medium other than cash for services performed for him or her by an employee if (A) the non…

(a) Withholding of Income Tax in Respect of Tips. (1) In General. Subject to the limitations set forth in paragraph (2) of this subdivision, an employer is required to deduct and withhold from each of his or her employees' tax in respect of those tips received by the employee whi…

(a) A proposal to train the employees of a small business may include training for the owner of the business provided the following criteria are met: (1) The business employs 100 or fewer full-time employees, excluding the owner. (2) The owner is an individual having all or a sub…

(a) The Panel may allocate up to fifteen (15) percent of the annually available training funds for Special Employment Training (SET) projects to improve the skills and employment security of frontline workers, as defined in Section 4400(ee), who earn at least the state average ho…

(a) For retraining projects, every employer must make a substantial contribution toward the cost of training, in the amount of: (1) Not less than 15% of the total training and administrative costs funded by the Panel, exclusive of in-kind contributions, if payment was earned for …

(a) The Panel may fund training contracts by applying a standard fixed -fee rate per trainee hour in lieu of a line-item budget to substantiate training costs. These standardized fixed-fee rates per hour may vary depending on the training delivery method (e.g., classroom/laborato…

(a) Contractors may enter into subcontracts for both training and administrative services with a third-party entity for training and/or administrative services, subject to review and approval by ETP. (b) All subcontracts shall include: (1) a provision that the Panel is not a part…

(a) The term of an ETP Agreement cannot begin prior to the date of Panel approval. (b) The Contractor shall not be reimbursed for the cost of training that starts prior to the term of the ETP Agreement. If the Contractor starts training before the ETP Agreement has been signed by…

(a) Contractors shall maintain and make available: (1) records that clearly document all aspects of training and retention related to the training program; (2) applicable financial records which document funds received and disbursed, and (3) payroll and personnel records related …

(a) The Department is the single state agency approved by the Secretary of the Department of Health and Human Services to administer the Medi-Cal program. (b) The Department shall administer the Medi-Cal program in accordance with the following: (1) The State Plan under Title XIX…

Regulations promulgated by the Department for purposes of administering the Medi-Cal program shall be known as Medi-Cal regulations. These regulations comprise Division 3, Title 22, California Administrative Code.

The applicability to the agency of the administrative adjudication provisions of the Administrative Procedure Act, which are set forth in Chapters 4.5 and 5 of Part 1 of Division 3 of Title 2 of the Government Code, is as follows: (a) Articles 1, 2, 3, 4, 6, 7, 8, and 16 of Chapt…

Applicant means the individual or family making, or on whose behalf is made, an application, request for restoration of aid or reapplication.

Application means a written request for aid.

Beneficiary means a person who has been determined eligible for Medi-Cal.

County department means the department authorized by the county board of supervisors to administer aid programs, including Medi-Cal.

The county case error rate means the number of quality control case reviews found in error divided by the total number of completed case reviews in that county, exclusive of state caused errors.

Eligibility and Assistance Standards Manual (EAS) means the portion of the Manual of Policies and Procedures published by the State Department of Benefit Payments which includes regulations pertaining to the AFDC, APSB, SSP and EVH programs.

Medical institution means any public or private acute care hospital, acute psychiatric hospital, intermediate care facility, skilled nursing facility, or other medical facility licensed by an officially designated state standard setting authority.

An institution for mental diseases means an institution primarily engaged in providing diagnosis, treatment or care for persons with mental illness.

Unless otherwise specified in the code or these rules, the time for filing or service may be extended, or late filing or service permitted, upon a showing of good cause.

A private institution means a proprietary or nonprofit facility managed and controlled by an individual, private association or corporation.

Tuberculosis institution means an institution which is primarily engaged in providing diagnosis, treatment or care of persons with tuberculosis, including medical attention, nursing care and related services.

Limited service status means that the beneficiary's use of the Medi-Cal card is limited because of enrollment in a noncomprehensive PHP or PCCM plan, improper utilization of service, application as a child under Section 50147.1 or participation in a pilot project conducted by the…

Linked means meeting the SSI/SSP requirements of age, blindness or disability or the AFDC requirements of deprivation of parental support or care.

Parent means the natural or adoptive parent of a child.

Minor parent means a person who meets the definition of a child and has his or her own child or children living in the home.

(a) If no other time is provided by the code or these rules, an appeal or board appeal shall be filed within 30 days after notice of the action, decision, or order being appealed was served on the appellant or board appellant. (b) A disputed coverage appeal may be filed by the cl…

Public funds means monies provided by local, state or federal government.

(a) Publicly operated community residence means a facility designed and planned to serve no more than 16 residents which is actually serving 16 or fewer residents. The facility provides food and shelter and must provide some additional services such as: (1) Social services. (2) H…

“Qualified Disabled and Working Individual” means an individual who meets the eligibility criteria for the Qualified Disabled and Working Individual program specified in Section 50256.

“Title II disregard person” means a person who meets all the conditions of Section 50564.

(a) The provisions of this rule apply except as otherwise ordered or required by law. (b) The agency shall maintain the case file, the audiovisual record, and any transcript that has been prepared for at least 36 months after the last date of service of any decision or order, and…

(a) The county department shall: (1) Be responsible for determining initial and continuing eligibility for Medi-Cal applicants or beneficiaries promptly and humanely, in accordance with: (A) Medi-Cal regulations. (B) Departmental directives. (2) Construe Medi-Cal regulations fair…

(a) The Department shall calculate the fiscal penalty for a liable county for each monitoring period as follows: (1) A penalty multiple shall be calculated by multiplying a county's case error rate times its percentage of statewide Medi-Cal cases. (2) A county's penalty multiple …

(a) A county may request reconsideration of a Medi-Cal fiscal penalty if the county case error rate is caused by circumstances outside the control of the county. Such circumstances may include, but are not necessarily limited to, the following: (1) Natural disasters which contrib…

(a) The county shall correct a case found in error during the Department's sample case review within thirty days after being notified of the Department's final decision that a case error has occurred. (b) A county whose case error rate is found to be in excess of fifteen percent …

The county of responsibility for determining Medi-Cal eligibility for persons eligible under AFDC or SSI/SSP shall be established in accordance with the regulations of the applicable public assistance program.