62. intake telephone interview processesintake telephone interview processes page 62-4 update #19-01...

Medi-CalCommon Place 62. Intake Telephone Interview Processes

62. Intake Telephone Interview Processes

This handbook chapter provides Intake business processes for completing Telephone Interviews and Telephonic Signature Interviews for the CalFresh, CalWORKs and Medi-Cal programs.

62.1 Walk-In Applicants

This section includes processes for applicants who come into a district office to apply for CalFresh, CalWORKs and/or Medi-Cal, but would like to have their interview over the telephone.

62.1.1 CalWORKs or CalWORKs and CalFresh Walk-In Applicants

This process describes the actions to take when an applicant has come into the office to apply for CalWORKs or CalWORKs and CalFresh together.

Step Who Action

1. Application Support

1. Greet applicant.

2. Ask applicant if they have an emergency.

If Applicant Says... Then...

Yes, Follow the normal Face to Face Application process.

No, Continue with the application process step #3 below.

3. Give the applicant a “Do You Have Time for a Call” 1/4 sheet and ask if they would like to have their interview done by telephone.


Yes, Continue with the application process step # 4 below.

No, Follow the normal FTF application process.

Update #19-01Page 62-1

2Common Place 62. Intake Telephone Interview Processes

1 cont. Application Support

4. Provide applicant an Identification Intake Record (SCD 41) form and SAWS 1 to complete and sign (page 1 of the SAWS 1) to establish their beginning date of aid.

5. After the applicant completes the SCD 41 and SAWS 1 forms, date stamp the forms, review for completeness and add a Happy Face sticker to the SCD 41 to indicate it’s been reviewed. Ensure client’s correct phone number is noted so that an EW can call for a telephone interview.

6. IF the applicant is not known to our county and/or a photo ID for each adult household member is not on file, a photo ID MUST be provided, verified and scanned into IDM BEFORE benefits can be issued.

7. Give the applicant a “Ways to Submit Verifications” 1/2 sheet and ask the client if they have any other verifications to submit along with their application. (Make copies as needed.)

8. Check EBT screen and ask client if they already have an EBT card for Santa Clara County CalWORKs or CalFresh (EBT cards for CF can’t be from a GA case).

If... Then...

They already have one, A new card is not needed. Write “Has EBT Card” on the top of the SCD 41.

They already have one, but it is not for Santa Clara County CalWORKs or CalFresh,

• A new EBT card is needed for the applicant.

• Write “EBT Card Needed” on the top of the SCD 41

They don’t have one, Write “EBT Card Needed” on the top of the SCD 41.

9. Place the SCD 41 and signed SAWS 1 in the appropriate Triage basket.

Step Who Action



2 Triage 1. Review application for IN/ES eligibility.

2. View their valid photo identification and make a copy for the case record.

If IN/ES is... Then...

Approved, • Add IN/ES to EBT card if they have one, or schedule a FTF appointment.

Denied, • Schedule a future phone appointment.

• Issue an IN/ES denial NOA.

3. Provide a CW 2.1, SCD 95, SAWS 2 Plus and a CW 2200 with a list of items needed including the due date and 1/2 sheet identifying methods of submitting verification.

4. Place SCD 41 and signed SAWS 1 in appropriate basket. Write “Walk-in CalWORKs/CalFresh phone interview” on top of the application for the scheduling team.

3 Scheduling Team

1. Pick up the SCD 41 and signed SAWS 1 form with the “Walk-in CalWORKs/CalFresh phone interview” sheet from the basket.

2. Review for Approval/Denial of IN/ES. (Approved cases will receive a F2F appointment when an EBT card is needed. Denied cases will receive a future phone interview appointment.)

3. Page applicant to the window to schedule appointment in CalWIN and create TMT.

4. Provide applicant a CalWORKs/CalFresh Appointment letter and inform them they will receive a phone call from an Intake EW between 9-11am or 1-3pm.

5. Place the SCD 41 and SAWS 1 with the ½ sheet in appropriate basket for Application Registration.

4 App Reg Team

1. Pick up the SCD 41 and SAWS 1 application from the basket and completes the Application Registration (App Reg) process.

2. Assign application to an Intake EW in the Telephonic Signature unit, language first, appointment time 2nd in CalWIN and TMT.

3. Place a folder with the SAWS 1 application inserted, into the EW’s cubby.

5 EW 1. Retrieve the signed SAWS 1 application and prepares for scheduled interview day.

Step Who Action



Scheduled Telephone Interview Day

6 EW 1. Check TMTs and IDM for any documents submitted by the applicant.

2. Gather required forms for TS signatures; CW 2.1, CCP 7, CSF 67, SCD 95, SCD 103, SCD 508, and SCD 1264.

3. Sign into and open the Finesse desktop application.

4. Change agenda status in Finesse to “Not Ready - Intake”.

5. Select the [Telephonic Signature] tab in Finesse.

6. Select CalWORKs from the Program drop down field.

7. Enter the Case ID number and click on the [Get Case Info] button (this will populate the remaining fields from the Case Info database).

8. Select the appropriate office from the Office Location drop down field.

9. Telephone the applicant for the interview.

Note:In order for TS to work properly, users cannot be logged into more than one PC.

If the applicant... Then the EW...

Does not answer the call or is unavailableNote:

When clients call in, EWs need to explain they will call them back. This will allow the EW to sign into Finesse prior to calling the client.

• Makes at least 3 attempts and Documents in Maintain Case Comments, “No answer for scheduled phone intake interview”.

• A CalWORKs NOA will be generated at the end of the day.

• A Notice of Missed Interview (NOMI) will be generated by CalWIN for CalFresh.

Note:If the appointment was not scheduled in CalWIN, the NOMI must be sent manually by the EW.

30 days from the date of No-Show:CalWIN denies the CF component of the application and issues the appropriate denial NOA.

Step Who Action



6 cont EW cont. If the applicant... Then the EW...

Says they no longer wish to continue and declines to reschedule TS Phone Interview,

1. Checks the Telephonic Signature Declined box (near the bottom of the Finesse screen).

2. Selects NO from the Signed Statement of Facts drop down field in the Perform Data Wrap-up window.

3. Explains to the applicant they may come into the office to do a F2F interview (if they want to continue applying) or they may apply online at MyBCW.

4. If the applicant chooses to come into the office for a F2F interview, schedule an appointment for the applicant and mail them an appointment letter with a SAWS 2 Plus application.


Needs to stop the interview, but wishes to continue at a later date or time,

Example: Needs to pick up kids from school.

1. Schedule and inform the client of the continuance interview time and date before disconnecting the call,

2. Maintain Case Comments must be documented with information of the incomplete TS Interview date (for Calabrio review purposes) and the rescheduled date and time.

Note:Application will remain in Pending status until the TS interview is completed.

Step Who Action



6 cont. EW cont. If the applicant... Then...

Does not answer the call, or

Is unavailable for the scheduled 2nd interview,

The application will be denied due to failure to cooperate by the end of the business day.

Answers the call and is able to complete the interview,

1. Greets the client.

2. Informs the client the call is being recorded and provides a brief overview of the process [see Telephonic Signature Script page 1].

3. Starts the interactive interview by initiating the application through the appointment subsystem in CalWIN.

4. Asks the client each question generated from the Collect Case Questions window as they appear in the Queue.

5. Enters information into the system.

Step Who Action

Update #19-012-6


6 cont. EW cont.

Note:Pressing the # key on the telephone will stop the R & R recording. To replay the R & R recording for the applicant, press the * key on the telephone and the recording begins again.

Instructions for R & R Recording:

Prior to playing the R & R recording, advise the applicant they will need to hold any questions until the recording has ended. At that time they can ask any questions they may have.

Do NOT place the caller on “hold” at any time during the playing of the R & R recording. Placing the caller on hold causes music to play and will interfere with the R & R recording.

1. Play the recording of the Rights and Responsibilities as outlined in the Telephonic Signature Intake Script.

2. Press the [Consult] button on the Finesse window.

3. Dial the appropriate language line phone number (listed on the “phonebook” of the Finesse window) and select the appropriate language requested by the applicant.

4. Click the [Conference] button (connecting the caller and the worker to the recording).

When the recording ends, a tone will play on the recording and the conference call will end.

5. Refer to the TS Intake Script Step #4, “READ THE FOLLOWING INFORMATION TO THE CLIENT”

6. Press the [Start Recording] button at the bottom of the Telephonic Signature screen and gather the applicant’s telephonic signature and verbal confirmation that they understand their “Telephonic Signature” recording will carry the same weight and effect as a signature by asking the following TS Questions:

• Did you understand your Rights and Responsibilities?

• Do you have any questions?

• A signature over the phone has the same legal effect and can be enforced in the same way as a written signature. Would you like to sign this application over the phone?

• Do you certify, under penalty of perjury under the laws of the United States of America and the State of California that you understand the questions and statements read to you, and your answers are correct and complete to the best of your knowledge?

• Please state your full legal name and today’s date.

7. Press the [Stop Recording] button at the bottom of the Telephonic Signature screen.

8. Explain the next steps to the applicant and answer any questions they may have.

Step Who Action



6 cont. EW cont. Review Recording After the applicant has hung up, review the TS recording in Calabrio to ensure the applicant's consent was recorded.

If the recording is... Then...

Audible and applicant’s consent is on recording,

Proceed with the steps outlined after this chart.

NOT audible and/or the applicant’s consent is not recorded,

• Contact Information Systems (IS) at x4660 OR

• Send an email to IS at [email protected] investigate the problem

• Contact applicant to record their consent again.

Note:The new recording only needs to indicate that R & R’s were previously explained and ask the applicant the TS questions again.

Note:When Calabrio and/or Finesse are not working properly and the TS is unable to be recorded, follow procedures for mailing SOF to the client for their “wet” signature.

Required FormsRequired forms that were reviewed with the applicant MUST now be stamped “Telephonic Signature”, the current date entered on the client’s signature line and scanned into IDM. Forms include: CW2.1, CCP 7, CSF 67, SCD 95, SCD 103, SCD 508 and SCD 1264.

Case DocumentationDocument all case actions and all information gathered through the telephone interview, including the date the TS Phone Interview was recorded, in the Maintain Case Comments window.

IMPORTANT NOTE: The date the TS Phone Interview was recorded must be documented in the Maintain Case Comments window for Calabrio review purposes.

Step Who Action


mailto:[email protected]


Continue with the following procedures to authorize benefits:7 EW If Benefits... Then the EW...

Can’t be authorized due to missing verifications,

• Sends a “Request for Verification Form” (CW 2200) listing missing verifications and the due date of the verifications (10 days from mailing date).

• Documents actions in the Maintain Case Comments window.

Are approved or denied, • Issues appropriate Notice of Action (NOA).

• Documents case actions in the Maintain Case Comments window.

8 CSS Central Support Services (CSS) will mail the Statement of Facts to the client for their review along with the Informational CalWORKs Intake Packet.

Step Who Action



62.1.2 CalFresh Walk-In Applicants

Telephonic Signature interviews DO NOT apply to applicants applying only for CalFresh, who have already signed an application. An interview over the phone may still be done, but a recording of their TS is NOT required.

Step Who Action

1. Application Support

1. Greet applicant.

2. Ask applicant if they have an emergency.


Yes, Follow the normal Face to Face Application process.

No, Continue with the Telephonic Signature process.

3. Give the applicant a “Do You Have Time for a Call” 1/4 sheet and ask if they would like to have their interview done by telephone.


Yes, Continue with the application process step # 4 below.

No, Follow the normal FTF application process.

4. Provide applicant an Identification Intake Record (SCD 41) form and CF 285 (SAWS 1 is also acceptable) to complete and sign to establish the beginning date of aid.



Important:Telephonic Signature interviews DO NOT apply to CalFresh applicants who have already signed an application. A telephone interview may still be done, but a recording of their TS is NOT required.

5. After applicant completes the SCD 41 and CF 285/SAWS 1 forms, date stamp the forms, review for completeness and add a Happy Face sticker to the SCD 41. Ensure client’s correct phone number is noted so that an EW can call for a telephone interview.

6. Check EBT screen and ask client if they already have an EBT card for Santa Clara County CalWORKs or CalFresh (EBT cards for CF can’t be from a GA case).

If... Then...






7. Place the SCD 41 and CF 285 (or SAWS 1) in the appropriate Triage basket.

2 Triage 1. Review application for ES eligibility.

If ES is... Then...

Approved, Add ES to EBT card if they have one, or schedule appointment for client to pick up EBT card.

Denied, • Explain to applicant they are not eligible for ES.

• Document the reason the applicant is not eligible for ES.

• Generate and provide applicant with an ES denial NOA.

• Continue with application interview.

Step Who Action



2. Provide a CW 2200 with a list of items needed including the due date and 1/2 sheet identifying methods of submitting verification.

3. Place SCD 41 and CF285/SAWS 1 in appropriate basket. Write “Walk-in Telephonic CalFresh Interview” on top of the application for the scheduling team.

3 Scheduling Team

1. Pick up the SCD 41 and CF 285/SAWS 1 forms with the ½ sheet attached with “Walk-in CalFresh Telephone Interview” from the basket.

2. Review for Approval/Denial of ES. (Approved cases will receive a F2F appointment when an EBT card is needed. Denied cases will receive a future phone interview appointment.)

3. Page applicant to schedule appointment in CalWIN and create TMT.

4. Provide applicant a CalFresh Telephone Appointment letter and informs them they will receive a phone call from an Intake EW.

5. Place the SCD 41 and CF 285/SAWS 1 with the ½ sheet in appropriate basket for Application Registration.

4 App Reg Team

1. Pick up the SCD 41 and CF 285/SAWS 1 application from the basket and completes the Application Registration (App Reg) process.

2. Assign application to an Intake EW, language first, appointment time 2nd in CalWIN and TMT.

3. Place a folder with the CF 285 or SAWS 1 application inserted, into the Pilot Intake EW’s cubby.

5 EW Retrieve the signed application.


6 EW 1. Check TMTs and IDM for any documents submitted by the applicant.

2. Telephone applicant for telephone interview.


Step Who Action



6.cont. EW cont. Does not answer the call or is unavailableNote:


• “Makes at least 3 attempts to contact applicants then Document in Maintain Case Comments, “No answer for scheduled Telephone Intake Interview”.


Note:If the appointment was not scheduled in CalWIN, the NOMI must be sent manually by the EW.



Answers the call and is able to complete the interview process,

Note:Pressing the # key on the telephone will stop the R & R recording.To replay the R & R recording for the applicant, press the * key on the telephone and the recording begins again.

• Greets client.

• Starts the interactive interview by initiating the application through the appointment subsystem in CalWIN.

• Asks the client each question generated from the Collect Case Questions screen as they appear in the Queue.

• Enters information into CalWIN.

Step Who Action



6cont. EW cont. Note:To replay the R & R recording for the applicant, press the * key on the telephone and the recording begins again.

Instructions for R & R recording:



Plays the recording of the Rights and Responsibilities.

• Press the [Consult] button on the Finesse window

• Dial the appropriate language line phone number (listed on the “phonebook” of the Finesse window) and select the appropriate language requested by the applicant.

• Click the [Conference] button (connecting the caller and the worker to the R & R recording).

• When the recording ends, a tone will play on the recording and the conference call will end.

• Answer any questions the client may have and end the call.

Case DocumentationDocument all case actions and all information gathered through the telephone interview in the Maintain Case Comments window.

Step Who Action



62.1.3 CalFresh Phone Application

This process describes the actions to take when an applicant calls the office to apply for CalFresh.

Continue with the following procedures to authorize benefits:6. cont EW cont. If Benefits... Then the EW...






7 CSS Central Support Services (CSS) will mail the Statement of Facts to the client for their review along with the Informational CalFresh Intake Packet.

Step Who Action

1. Application Phone Support Team

1. Receives telephone call from an applicant requesting to apply for CalFresh.

2. Transfers as a warm call to designated number for the designated App Reg team.

2. Designated App Reg Team

1. Receives warm transfer from the Application Phone Support Team and greets the applicant on the phone.

2. Reviews and completes an Identification Intake Record (SCD 41) form and CF 285 for the applicant to establish the beginning date of aid.

3. Sends CF 285 via DocuSign to the applicant for their signature if they have email.

4. Date stamps the SCD 41 and CF 285 Application.

5. Checks EBT screen and asks client if they already have an EBT card for Santa Clara County CalWORKs or CalFresh (non GA case).

Step Who Action



2 cont. Designated App Reg Team cont.

If... Then...






6. Confirm the applicant’s phone number and email address are correct so the EW can call them for a telephone interview.

7. Perform App Reg then use the intake daily schedule to assign the case to the next available worker in CalWIN and TMT.

8. Attaches the generic appointment letter with date and hours between 1pm -3pm with a 1/2 sheet stating “CalFresh app received via phone.”

9. Place the SCD 41 and signed CF 285 in the EW’s cubby.


3 EW 1. Retrieve the SCD 41 and CF 285 from cubby.

2. Checks TMTs and IDM for any documents submitted by the applicant.

3. Gather required forms for TS signatures; CF 23 SAR, CSF 67, SCD 508, SCD 2300 and SCD 1264 (MC 219 If requesting Medi-Cal at same time).


5. Change agent status in Finesse to “Not Ready – Intake”.


7. Select CalFresh from the Program drop down field.

8. Enter the Case ID number and click on the [Get case Info] button (this will populate the remaining fields from the Case Info database).



Step Who Action



3 cont. EW cont. If the applicant... Then the EW...



• “Make at least 3 additional attempts to contact the applicant during their scheduled TS Intake Interview time period.

• Document each attempt made in Maintain Case Comments and “No answer for scheduled Telephone Intake Interview”.


• If the appointment was not scheduled in CalWIN, the NOMI must be sent manually by the EW.


If the Applicant... Then the EW...



2. Selects NO from the Signed Statement of Facts drop down field I the Perform Data Wrap-up window.

3. Denies ES if applicable and mails denial NOA.

4. Explains to the applicant they can come into the office to do a F2F interview or apply online through MyBCW.

5. If client chooses to do a F2F interview, mails the appointment letter with a CF 285 to the applicant.

Step Who Action



3 cont. EW cont. If the Applicant... Then the EW...




2. Schedules and informs the client of the continuance interview time and date before disconnecting the call,

REMINDER: The Maintain Case Comments window must be documented with information of the incomplete TS Interview date (for Calabrio review purposes) and the rescheduled date and time.

Note:The application will remain in Pending status until the TS interview is completed.


• Does not answer the call, or

• Is unavailable for the scheduled 2nd interview,



Follow the steps below to finish the interview.

Step Who Action






• Greets applicant.

• Reviews CF 285 with the applicant.

• Screens for ES eligibility.

If the applicant is... Then...

ES eligible, • Advise client that they are eligible for ES and their benefits will be added to their existing EBT card (if they have one),

OR

• They may come into the office when the application process is completed to pick up their new EBT card with their ES benefits on the card.

• Generate and send approval NOA(s).


Not ES eligible, • Explain to applicant they are not eligible for ES.

• Document the reason the applicant is not eligible for ES.

• Generate and send denial NOA to client.

• Continue with the application interview.

Step Who Action



3 cont. EW cont. 1. Informs the applicant the call is being recorded and provides a brief overview of the process [see Telephonic Signature Script page 1].


3. Asks the client each question generated from the Collect Case Questions screen as they appear in the Queue.

4. Enters information into CalWIN.

Step Who Action



3 cont. EW cont. Instructions for R & R recording



1. Plays the recording of the CalFresh Rights and Responsibilities as outlined in the Telephonic Signature Intake Script

•Press the [Consult] button on the Finesse window.

•Dial the appropriate language phone number (listed on the “phonebook” of the Finesse window) and select the language requested by the applicant.

•Click the [Conference] button (connecting the caller and the worker to the R & R recording)


2. Refer to the TS Intake Script Step #4 “READ THE FOLLOWING INFORMATION TO THE CLIENT” (Forms required to be reviewed with and signed by applicant)

3. Press the [Start Recording] button at the bottom of the Telephonic Signature screen and gather the applicant’s telephonic signature and verbal confirmation that they understand their “Telephonic Signature” recording will carry the same weight and effect as a signature by asking the following questions:

•Did you understand your Rights and Responsibilities? •Do you have any questions?•A signature over the phone has the same legal effect and can be enforced in the same way as a written signature. Would you like to sign this application over the phone?

•Do you certify, under penalty of perjury under the laws of the United States of America and the State of California that you understand the questions and statements read to you, and your answers are correct and complete to the best of your knowledge?

•Please state your full legal name, today’s date and current time.

Step Who Action



3 cont EW cont. 4. Press the [Stop Recording] button at the bottom of the Telephonic Signature screen.

5. Explain the next steps to the client and asks the client if they have any questions.

6. Answer any questions the client may have and terminate the call.

Review Recording

AFTER the call has ended with the client, review the TS recording in Calabrio to ensure the client’s consent was recorded.



• Proceed with the steps outlined after this chart.

NOT audible and/or the client’s consent is not recorded,


• Send an email to IS at [email protected] investigate the problem.

• Contact client to record their consent again.

Note:The new recording only needs to indicate that R & R’s were previously explained and ask the TS questions again.

Important:For situations when Calabrio and/or Finesse are not working properly and the TS is unable to be recorded, follow procedures for mailing SOF to client for their signature.

Required FormsRequired forms that were reviewed with the applicant MUST now be stamped “Telephonic Signature”, the current date entered on the client’s signature line and scanned into IDM. Forms include: CF 23 SAR, CSF 67, SCD 508, and SCD 1264.

Step Who Action




3 cont. EW cont. If Benefits... Then the EW...






4 CSS Central Support Services (CSS) will mail the Statement of Facts to the client for their review along with the Informational CalFresh Intake Packet.

Step Who Action



62.1.4 CalWORKs & CalFresh Combination Phone Applications

This process describes the actions to take when an applicant calls the office to apply for both CalWORKs and CalFresh benefits.

Step Who Action


1. Receives telephone call from an applicant requesting to apply for CalWORKs and CalFresh benefits.

2. Transfers as a warm call to designated number for the Application Registration team.



2. Reviews and completes an Identification Intake Record (SCD 41) form and SAWS 1 for the applicant to establish the beginning date of aid.

If... Then...

they have an email address

send SAWS 1 via DocuSign to the applicant for their signature.

• they don’t have an email address, or

• can’t access their email,

record their telephonic signature (Start Recording in Finesse by pressing the [Start Recording] button at the bottom of the Telephonic Signature screen) (Read the following statements to the applicant for their verbal affirmation.) • • “A signature over the phone

has the same legal effect and can be enforced in the same way as a written signature. Would you like to sign this application over the phone? (pause and wait for client’s response)

• • Do you certify, under penalty of perjury under the laws of the United States of America and the State of California that you understand the questions and statements read to you, and your answers are correct and complete to the best of your knowledge? (pause and wait for client’s response)

• • Please state your full legal name and today’s date.” (pause and wait for client’s response)



2. Cont.

Designated App Reg Team

(Press the [Stop Recording] button at the bottom of the Telephonic Signaturescreen.) Stamp the signature line with Telephonic Signature stamp.

3. Date stamps the SCD 41 and SAWS 1 Application.

4. Checks EBT screen and asks client if they already have an EBT card for Santa Clara County CalWORKs or CalFresh (non GA case).

If... Then...






5. Confirm the applicant’s phone number and email address are correct so the EW can call them for a telephone interview.

6. Perform App Reg then use the intake daily schedule to assign the case to the next available worker in CalWIN and TMT.

7. Attaches the generic appointment letter with the date and time filled in with a 1/2 sheet stating “CalWORKs/CalFresh app received via phone.”

8. Place the SCD 41 and signed SAWS 1 in the EW’s cubby.

Step Who Action




3. EW 1. Retrieve the SCD 41 and SAWS 1 from cubby.

2. Check TMTs and IDM for any documents submitted by the applicant.

Note:Identification for all adult CalWORKs applicants MUST be viewed in person unless they have received aid prior to July 1, 2018 AND a copy of their identification is already on file. CalWORKs shall NOT be authorized before the identification is viewed in person.









Step Who Action







• If unable to contact the applicant, document the number of attempts in Maintain Case Comments and “No answer for scheduled Telephone Intake Interview”.

• Deny Immediate Need (IN) & Expedited Services (ES) if applicable.

• Deny the CalWORKs application.







3. Denies IN/ES if applicable and mails denial NOA.


5. If client chooses to do a F2F interview, mails the appointment letter with a SAWS 2 Plus to the applicant.

Step Who Action








3. Deny IN/ES if applicable.



If the applicant... Then...






Step Who Action







• Reviews SAWS 1 with the applicant.

• Screens for IN/ES eligibility.


IN/ES eligible, • Advise client that they are eligible for IN/ES and their benefits will be added to their existing EBT card (if they have one and received aid prior to July 1, 2018 AND a copy of their ID is on file already),

OR

• They may come into the office when the application process is completed to provide identification and to pick up their new EBT card with their IN/ES benefits on the card.



Step Who Action



3 cont. EW cont. Not IN/ES eligible, • Explain to applicant they are not eligible for IN/ES.

• Document the reason the applicant is not eligible for IN/ES.

• Generate and send denial NOAs to client.


1. Informs the applicant the call is being recorded and provides a brief overview of the process [see Telephonic Signature Script page 1].




Step Who Action
















Step Who Action






Review Recording











Step Who Action




62.1.5 Medi-Cal Intake Applications by Telephone

This process describes the actions to take when an applicant calls the office to apply for Medi-Cal benefits.

3 cont. EW cont. Required FormsRequired forms that were reviewed with the applicant MUST now be stamped “Telephonic Signature”, the current date entered on the client’s signature line and scanned into IDM. Forms include: CW 2.1, CCP 7, CSF 67, SCD 95, SCD 103, SCD 508, and SCD 1264.


If Benefits... Then the EW...




Are approved or denied, • Issues appropriate Notices of Action (NOA).


4 CSS Central Support Services (CSS) will mail the Statement of Facts to the client for their review along with the Informational CalWORKs/CalFresh Intake Packet.

Step Who Action


1. Receives telephone call from an applicant requesting to apply for Medi-Cal.

2. Transfers as a warm call to designated number for the Application Registration team.

Step Who Action





2. Reviews and completes an Identification Intake Record (SCD 41) form and SAWS 1 for the applicant to establish the beginning date of aid.

3. Signs SAWS 1 application on behalf of the applicant. Example: Mary Starr for John Doe

4. Performs preliminary File Clearance procedures to make sure Medi-Cal application is valid.

5. Date stamps the SCD 41 and SAWS 1 Application.

6. Confirm the applicant’s phone number is correct so the EW can call them for a telephone interview.

7. Perform Application Registration then use the intake daily schedule to assign the case to the next available worker in CalWIN and TMT.

8. Attach the generic appointment letter with 1/2 sheet stating “Medi-Cal App Received via phone.”

9. Place the SCD 41 in the EW’s cubby.

Scheduled Telephone Interview

3 EW 1. Retrieve the SCD 41 and from cubby.


3. Gather required forms for TS signatures; SCD 115, SCD 508, SCD 1264 and SCD 2263.




7. Select Medi-Cal from the Program drop down field.




Step Who Action







• If unable to contact the applicant, document in Maintain Case Comments, the number of attempts made and “No answer for scheduled Telephone Intake Interview”.

• Send an SCD 50 listing the documents needed and the due date (10 calendar days from the date the SCD 50 is sent).


Does not provide the requested documents by the due date listed on the SCD 50,

Initiate a phone contact with the applicant to determine if assistance is needed to obtain the required documents.

Is unreachable, • Send a 2nd SCD 50 with instructions to provide the missing documents within 10 calendar days.

• If no contact after 10 calendar days, deny the application.

Step Who Action




At any time during the interview says they no longer wish to continue and declines to reschedule TS Phone Interview,


2. Selects NO from the Signed Statement of Facts drop down field I the Perform Data Wrap-up window.

3. Document the client’s request to withdraw their application for Medi-Cal and mail them an SCD 166 form.







If... Then...

The EW calls but is unable to contact the client,

• Send an SCD 50 listing the documents needed and the due date (10 calendars days from the date the SCD 50 is sent).

• If no contact after 10 calendar days, send a 2nd SCD 50 with instructions to provide the missing documents within 10 calendar days.

• If no contact after 10 calendar days, deny the application.

Step Who Action



3. cont.

EW cont. If the applicant... Then the EW...



• Determines if an immediate medical need exists.

If... Then...

There is an immediate medical need,

• Advise client that they are eligible for immediate need and may come into the office to complete the process and receive a MC card,

OR

• A Medi-Cal card can be mailed to them. Note: If there are extenuating circumstances, the temporary paper card can be scanned and sent via secure email to the client. The email address must belong to the client and the email must be encrypted [Refer to “WebSafe Email Quick Reference Guide”].



There is No immediate medical need,






5. Review the following forms with the applicant: SCD 115, SCD 508, SCD 1264 and SCD 2263. (see Medi-Cal Only Telephonic Signature Intake Script).

Step Who Action



3 cont. EW cont. Instructions for recording

1. Press the [Start Recording] button at the bottom of the Telephonic Signature screen and gather the applicant’s telephonic signature by reviewing the following information and asking the required questions:

“I declare under penalty of perjury that what I say below is true and correct.

• I understood all questions on this application and gave true and correct answers as far as I know. Where I did not know the answer myself, I made every reasonable attempt to confirm the answer with someone who did know.

• I know that if I do not tell the truth on this application, there may be a civil or criminal penalty for perjury that may include up to four years in jail.

• I know that the information in this application will be used to decide if the people who are applying qualify for health insurance. Covered California will keep the information private, as required by federal and California law.

• I agree to notify Covered California by calling 1-800-300-1506 (TTY: 1-888-889-4500) or visiting CoveredCA.com if anything changes on this application for any person applying for health insurance.

• If I am selecting a health plan by filling out and submitting Attachment D, and if I am determined eligible by Covered California to enroll in the plan I selected in Attachment D:

•I understand that by signing here I am entering into a contract with the issuer of that plan.

•I am at least 18 years of age or I am an emancipated minor, and I am mentally competent to sign a contract.

• A signature over the phone has the same legal effect and can be enforced in the same way as a written signature. Would you like to sign this application over the phone?

Step Who Action



3 cont EW cont. • Do you certify, under penalty of perjury under the laws of the United States of America and the State of California that you understand the questions and statements read to you, and your answers are correct and complete to the best of your knowledge?

• Please state your full legal name, and today’s date.”

2. Press the [Stop Recording] button at the bottom of the Telephonic Signature screen.



Review Recording











Step Who Action




3 cont. EW cont. Required FormsRequired forms that were reviewed with the applicant MUST now be stamped “Telephonic Signature”, the current date entered on the client’s signature line and scanned into IDM. Forms include: SCD 115, SCD 508, SCD 1264 and SCD 2263.

Case DocumentationDocument all case actions and all information gathered through the telephone interview, including the date the TS Phone Interview was recorded, in the Maintain Case Comments window.Note:

The date the TS Phone Interview was recorded must be documented in Case Comments for Calabrio review purposes.

Continue with the following procedures to authorize benefits:







4 CSS When the case has been approved and authorized Central Support Services (CSS) will mail the Statement of Facts to the client for their review along with the Informational CalWORKs/CalFresh Intake Packet.

Step Who Action



62.1.6 CalWORKs & CalFresh Combination Phone Applications

This process describes the actions to take when an applicant calls the office to apply for both CalWORKs and CalFresh benefits.

Step Who Action


1. Receives telephone call from an applicant requesting to apply for CalWORKs and CalFresh benefits.

2. Transfers call as a warm call to designated number for the Application Registration team to accept the application over the phone.




1. Receives warm transfer from the Phone Support Team and greets the applicant on the phone.

2. Identifies client in CalWIN and MEDS to ensure application is valid.

3. Completes an Identification Intake Record (SCD 41) form and SAWS 1 for the applicant to establish the beginning date of aid.

If Applicant... Then...

Has an email address Sends applicant the SAWS1 via Docusign to capture their signature.

Does not have an email address

Explain to the applicant:

• their signature will be recorded over the phone, and

• their Social Security Number will be needed to establish a case number. (Follow Clerical Intake script to record the signature.)

4. Date stamps the SAWS1.

5. Asks applicant if they already have an EBT card for Santa Clara County CalWORKs or CalFresh (non-GA case).

6. Checks EBT screen to verify EBT card is valid and documents Yes or No on the SCD 41 EBT Card section.

7. Confirm the applicant’s phone number and email address, if applicable, are correct so the EW can call them for a telephone interview.

8. Schedules next available interview date and time.

9. Creates appointment letter.

10. Performs full ID and Application Registration CalWIN/MEDS/CalHEERS and creates TMT.

11. IDM Scan appointment letter and application packet to IDM.

12. Uses the intake daily schedule to assign the case to the next available worker in CalWIN and TMT.

13. Attaches the generic appointment letter with the date and time filled in with a 1/2 sheet stating “CalWORKs/CalFresh app received via phone.”

14. Place the SCD 41 and signed SAWS 1 in the EW’s cubby.

Step Who Action




3 EW 1. Retrieve the SCD 41 and SAWS 1 from cubby.


Note:Identification for all adult CalWORKs applicants MUST be viewed in person unless they have received aid prior to July 1, 2018 AND a copy of their identification is already on file. CalWORKs shall NOT be authorized before the identification is viewed in person.









Step Who Action







• If unable to contact the applicant, document the number of attempts in Maintain Case Comments and “No answer for scheduled Telephone Intake Interview”.

• Deny Immediate Need (IN) & Expedited Services (ES) if applicable.

• Deny the CalWORKs application.







3. Denies IN/ES if applicable and mails denial NOA.


5. If client chooses to do a F2F interview, mails the appointment letter with a SAWS 2 Plus to the applicant.

Step Who Action








3. Deny IN/ES if applicable.



If the applicant... Then...






Step Who Action







• Reviews SAWS 1 with the applicant.

• Screens for IN/ES eligibility.


IN/ES eligible, • Advise client that they are eligible for IN/ES and their benefits will be added to their existing EBT card (if they have one and received aid prior to July 1, 2018 AND a copy of their ID is on file already),

OR

• They may come into the office when the application process is completed to provide identification and to pick up their new EBT card with their IN/ES benefits on the card.



Step Who Action



3 cont. EW cont. Not IN/ES eligible, • Explain to applicant they are not eligible for IN/ES.

• Document the reason the applicant is not eligible for IN/ES.

• Generate and send denial NOAs to client.






Step Who Action
















Step Who Action






Review Recording











Step Who Action




3 cont. EW cont. Required FormsRequired forms that were reviewed with the applicant MUST now be stamped “Telephonic Signature”, the current date entered on the client’s signature line and scanned into IDM. Forms include: CW 2.1, CCP 7, CSF 67, SCD 95, SCD 103, SCD 508, and SCD 1264.








4 CSS Central Support Services (CSS) will mail the Statement of Facts to the client for their review along with the Informational CalWORKs/CalFresh Intake Packet.

Step Who Action
