Los Angeles, California

Lawyers for Public Benefits Abuse Cases

This section was included to address this topic for several reasons:

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Mainly to provide an overview of programs that play an important role in the lives of low‑income people. Likewise, to develop an understanding of the particular relationship between the CalWORKS / TANF program and family law cases, as well as to develop some familiarity with key programs to identify issues before they become critical.

Many family law orders can significantly affect a person’s public benefits, child support, spousal support, and the sale or division of property.

For example, if a person is receiving Supplemental Security Income (SSI) for a permanent disability, it may not be appropriate to obtain modest spousal support. A support order for them would reduce or eliminate their cash aid and make them ineligible for Medi‑Cal benefits.

Note: Because some family law orders can negatively impact various public benefits, individuals who receive public benefits are advised to speak with a public benefits attorney before seeking family law orders that could affect their benefits.

Some Key Elements of the California CalWORKS Program

48‑Month Limit: With limited exceptions, adult recipients may receive only 48 months of cash assistance in their lifetimes. Cases are evident where recipients reach the stipulated time limits. Fortunately, when lifetime limits are reached, California only reduces the cash payment by the amount allocated for the parent, not the amount allocated for the child.
Welfare‑to‑Work (WTW) Requirements: All adult recipients, as well as some teen parents, must work or participate in CalWORK’s work activities to receive cash aid unless exempt or having good cause. The WTW program in Los Angeles is called Greater Avenues for Independence (GAIN). These activities may include subsidized employment, unpaid work experience for a certain number of months, on‑the‑job training, vocational training and education, work study, self‑employment, community service, job search or receiving mental health, substance abuse, or domestic violence services, including legal assistance.
CalWORKS recipients may receive training, education, and services up to the lifetime total limit of 48 months, based on an individual assessment of their skills and needs. Self‑Initiated Program (SIP): Recipients may receive training and education during the same period if they were enrolled in a qualified educational activity before participating in GAIN.
Basic Activities: At least 20 hours per week must consist of basic activities; Basic activities include work, unpaid work and the first 12 months of vocational education. If certain requirements are met, non‑basic activities such as classroom, lab, and internship hours may count toward meeting the 20‑hour basic requirement. Mental health, substance abuse, and domestic violence services may also be counted toward basic hours under some exception requirements.
Sanctions: If a CalWORKS recipient does not comply with any of the WTW program requirements, they are subject to sanctions, including loss of benefits. Sanctions are common, since WTW requirements are fairly demanding. However, there are many defenses, and a review process is available to challenge the sanctions. People who have been sanctioned should immediately contact a public benefits attorney for help.
Aid Prohibitions: Persons convicted of drug‑related felonies after January 1, 1998, are permanently ineligible for cash aid. However, other family members may still be eligible for cash assistance. Persons convicted or adjudicated by administrative hearing for welfare fraud are ineligible for a two‑year period.
Eligibility: A family must meet certain income and resource/property requirements: Income: The family’s gross income, minus a certain amount of earned income per employed person, must be below a specific level when the family applies. Resources: A family may not have more than $2,000 in countable property ($3,000 if someone in the household is age 60 or over). Some property items are excluded or exempt from the limit. For example, a house that is the family’s principal residence in CalWORKS is exempt. A car is also excluded if its fair market value does not exceed $4,650.
Child Care: CalWORKS families may obtain subsidized child care: for children aged 10 or under during the adult’s participation in WTW activities, for children aged 10‑13 to the extent funds are available, and for children older than 12 with special needs. Families leaving CalWORKS may also continue receiving child care assistance as long as they meet certain eligibility requirements. The county agency pays child care providers directly. Families with child care expenses may also be eligible for California’s Child and Dependent Care (CDC) Tax Credit.
Grant Amount: In California, grants are divided into two regions for welfare benefit purposes. Each region consists of two possible maximum aid levels. In Region 1, which includes Los Angeles County, families receive a higher grant amount based on the higher cost of living in the included counties. There are also two different grant scales; the higher amounts are for families exempt in which the parent or caregiver in the home is disabled and receives benefits under Supplemental Security Income (SSI)/State Supplement, In‑Home Supportive Services, State Disability Insurance or Temporary Worker Compensation benefits, or the caregiver relative is not on the grant herself, and is not the child’s parent (for example, a grandmother who does not receive aid for herself).
CalWORKs and Domestic Violence Support Services: Domestic violence survivors often cannot leave their abuser without financial support. However, many of these people cannot simply begin working. First, they must receive assistance to address the consequences of the abuse. Fortunately, welfare laws have begun to recognize the effect domestic violence can have on an individual’s ability to seek safe shelter and obtain financial independence and security. After a recipient is identified as a victim of domestic violence, they become eligible to receive a variety of services to address the abuse they have suffered, including domestic violence immunity services (such as shelter services), counseling for the recipient and their children, medical and public health services, financial planning, and legal assistance. Also, various provisions of CalWORK are designed to ease the burdens of the 48‑month lifetime aid limit and the WTW program requirements. A CalWORKs recipient may seek the benefit of one or all of the provisions that are most advantageous for their circumstances. Some of the requirements that may be waived include time limits for receiving assistance, work and educational requirements, child support and cooperation requirements of paternity (i.e., with the Department of Child Support Services) and the Maximum Family Grant rule (MFG).
Diversion Program: The lump‑sum diversion payment program is intended for families for whom a lump sum payment displaces the need for a monthly welfare assistance grant. Diversion payments can be used, for example, to pay for car repairs, a license or exam, tools, or owed back rent. Each county must offer a diversion payment program and notify applicants of its availability prior to CalWORKs approval.

What is Medi‑Cal

Medi‑Cal is the federal Medicaid implementation in California, and is a program that pays for medically necessary health and mental health services for most people who receive public assistance, and certain other low income persons, including those who are working. Unfortunately, not everyone who is poor or in need of medical care qualifies for Medi‑Cal.

Most poor children under 21, persons 65 or older, persons who are disabled or blind or pregnant, and families where at least one child is under 21 and one parent is absent or disabled, or when the working parent in the family is not working more than 100 hours per month, may qualify for Medi‑Cal. People may submit their application at a welfare office or at a clinic or hospital where they seek health care.

In general, persons may obtain Medi‑Cal if they are low income, meaning income and assets valued below a certain level, and fit into one of the above groups. If income is higher, they may still receive Medi‑Cal but must pay part of their health care cost.

Persons who receive CalWORKs are automatically eligible for full scope Medi‑Cal without a share of cost. A CalWORKs application also serves as a Medi‑Cal application. Persons who leave the CalWORKs program become eligible for Transitional Medi‑Cal for up to one year if they left CalWORKs under any of the following circumstances:

The person returned to work and obtained a certain level of income.

The person married or reunited with a spouse.
The family has begun receiving more child or spousal support.
Children also shift to Healthy Families after 6 months on Transitional Medi‑Cal.

Medi‑Cal pays for many, but not all, medical services. It pays for medically necessary services. If a person has a Medi‑Cal card, they have a right to visit doctors and other health professionals, clinics and hospitals that are certified Medi‑Cal providers to receive care. However, not all doctors and hospitals are certified providers.

Because of the notoriously low reimbursement rates that Medi‑Cal pays providers and healthcare facilities, and its overwhelming bureaucratic complexity, many doctors and hospitals choose not to participate in the Medi‑Cal program. However, many claimants consider Medi‑Cal an extremely important benefit, if not the most important, particularly those with children or serious health issues.

Always consider the potential effect of any family law action on a claimant’s eligibility for Medi‑Cal.

Eligibility under Section 1931(b) of the Social Security Act: The 1996 Welfare Reform Act requires that any person who met the rules for Medi‑Cal linked to AFDC in place in a state on July 16, 1996 still qualify for Medicaid under section 1931(b). In other words, a person eligible for AFDC under the old rules qualifies under the current rules for Medi‑Cal, regardless of whether they are eligible for or receive CalWORKs.

Medically Needy / Indigents Programs: Certain families who have too much income or too many work hours to qualify for free Medi‑Cal may still qualify under the “Medically Needy” or “Medically Indigent” programs. These programs cover children up to age 21 and may require a family contribution, depending on income level. Also, some disabled people and pregnant women may be eligible under this section. There are also “Transitional Medi‑Cal” benefits available for persons who lost CalWORKs benefits because their income increased beyond allowable limits. Under this provision, Medi‑Cal coverage may extend up to two years after other benefits end.

Coverage for Legal Immigrants: Currently, California has not changed its rules regarding immigrants’ eligibility for Medi‑Cal. Persons who meet the definition of qualified alien (for example, lawful permanent residents or persons with Green Cards) remain eligible for full scope Medi‑Cal—regardless of date of entry into the United States if they meet Medi‑Cal eligibility requirements. Also, “PRUCOL” immigrants (permanently residing under the color of law) are eligible for full scope Medi‑Cal benefits. Undocumented immigrants are eligible for emergency services (including labor and delivery and kidney dialysis), prenatal care benefits (assuming they meet financial eligibility criteria), as well as family planning, long term care, and nursing home care.

Receipt of medical care services does not make immigrants a “public charge” and therefore should not create a problem for immigrants trying to naturalize.

Healthy Families Program: This program is a health care program for children under 19 years old with family incomes up to 250% of the Federal Poverty Level, who are U.S. citizens or qualified immigrants, the parent or caregiver of the child is required to pay small premiums and copayments, although federal law imposes strict limits.

Supplemental Security Income (SSI)

SSI is a public assistance program for elderly or disabled persons provided by the federal government. The program is needs‑based, meaning it is based on the person’s indigence. SSI is available to persons who do not meet the forty quarters (10 years) of work required to receive Social Security Disability Insurance (SSDI).

Almost all income from any source is counted against the money that a person obtains from SSI: for example, if a claimant collects a small pension of $300 a month, that amount will be deducted dollar for dollar from their SSI award. The current SSI benefit for an individual is about $845 per month. This number is slightly higher for persons with visual disability, and may vary depending on whether a third party pays their living expenses and if they have cooking facilities.
Persons receiving SSI will not receive food stamps, but they may receive food assistance.
There are also resource limits ($2,000 for an individual, $3,000 for a couple): These do not include the applicant’s home or vehicle (in most cases). Once eligibility has been determined, the person (who could be a child or adult), is also automatically eligible for Medi‑Cal. The standards for determining eligibility based on disability or blindness are rigorous and virtually identical to those of SSDI.
Immigration: Non‑citizen workers (65 or older or disabled) who are not eligible to receive SSI may be eligible for benefits under another state‑created program from 1998: CAPI (Cash Assistance Program for Immigrants). CAPI recipients qualify for food stamp benefits.
Minor eligibility: A child under 18 is eligible for SSI if they have a physical or mental condition, or conditions that can be medically proven and result in marked and severe functional limitations. It must be expected that the condition will last at least 12 months or result in death. If the child is between 18 and 22 years old, they are only eligible for SSI benefits if the adult disability definition applies.
Joint Benefits: A person can receive both SSI and Social Security, although the maximum amount received can only be $20 over the SSI maximum amount (currently $845 for an individual).

Social Security

Social Security is a federal program that provides benefits to eligible workers and their families regardless of income. Social Security provides five main types of benefits: retirement, disability, family, survivor, and health. It covers both employees and self‑employed individuals. Most people need 40 quarters (10 years) of work to qualify.

Beneficios

Los beneficios de jubilación se pagan a los trabajadores con suficientes créditos elegibles. Existen beneficios familiares en el caso si es elegible para recibir beneficios por discapacidad, otros miembros de la familia también pueden recibirlos, incluido el cónyuge, ex cónyuge, hijos menores, hijos adultos discapacitados o padres.
Los pagos mensuales del Seguro Social por Discapacidad (SSDI) se pagan a cualquier edad a las personas que tienen suficientes créditos y que no pueden trabajar debido a problemas graves y certificados médicamente enfermedad u otra discapacidad que les impida realizar un trabajo “sustancial” durante un año o más o que se espera que resulte en muerte. SSDI tiene los mismos requisitos médicos que SSI, sin embargo, la elegibilidad para SSI se basa en la necesidad financiera, mientras que la elegibilidad para SSDl se basa en el historial laboral de una persona.
SSDI es financiado por los impuestos del Seguro Social, pero los beneficios de SSI no lo son; Los solicitantes de SSDI deben haber trabajado un cierto número de trimestres en relación con su edad para ser elegibles. A la edad de jubilación completa, estos beneficios se convierten automáticamente en beneficios de jubilación.
A diferencia de SI, los beneficiarios de SSDI pueden recibir cupones de alimentos, y pueden recibir manutención infantil, manutención conyugal y beneficios de pensión sin impacto negativo en su premio SSDI. Además, sus hijos pueden recibir beneficios derivados.
Los beneficios de sobreviviente se pagan a los miembros elegibles del trabajador elegible fallecido.

General Relief

General Relief (GR) is the last resort program for needy individuals or couples without minor children who are not eligible for federal or state cash assistance. Each county has its own GR program. In Los Angeles, a person must be a resident of Los Angeles County and have less than a certain amount in cash (currently $50). Also, a person must undergo drug screening, have no other resources except a car, tools of their trade, and a home they own and live in (though this is unrealistic in Los Angeles County, since the house must have a market value of $34,000 or less).

Employability resources have become a work program rather than a rights program, and all employable participants must spend at least 20 hours per week working or attending WTW activities under the General Relief Opportunities for Work (GROW) program. If offered minimum wage work, the GR recipient must accept it.
Persons who do not meet all program requirements are cut off and not allowed to reapply for 60 days. About 60% of GR cases are rendered inactive due to some physical or mental disability. There is no lifetime limit for unemployed participants.

In Los Angeles, healthy adults may receive GR only for a limited time, currently no more than six months (with a possible three‑month extension) in a 12‑month period, and only if they meet work requirements. GR recipients may also receive food stamps.

Este programa difiere de CalWORKs en que no hay límites de por vida. Sin embargo, las personas que abandonaron CalWORK después del límite de tiempo de 60 meses no son elegibles para GR hasta que todos los niños tengan 18 años o más.

Aquellos que huyen para evitar el enjuiciamiento por delito grave, o violar la libertad condicional o la libertad condicional no son elegibles para GR. Tampoco son elegibles aquellos excluidos de CalWORKs debido a la prohibición de delitos graves de drogas.

Food Stamps

Of all the programs described, the Food Stamp Program is probably the one that affects most applicants. A child or family does not have to be receiving CalWORKs or Medi-Cal to be eligible for food stamps. There are separate income and resource requirements for this program. Numerous reports indicate that the Food Stamp Program is the most underused public benefit available. Food banks have become overloaded because eligible individuals are not applying to receive food stamps. Even if applications for all other programs are denied and/or the applicant is not receiving or does not want to apply for any other government benefit, applying for this program should be recommended to the applicant.

It provides monetary credit on an Electronic Benefit Transfer (EBT) card to purchase certain, but not all, foods and household items. Non-food staples such as detergents and toiletries are excluded, as well as some fast food and hot ready-to-eat meals. Each month, the eligible household receives an allowance on its EBT card.

1. Reform

Since the first federal welfare reform bill passed in 1996, federal legislation has changed several times regarding food stamp eligibility for non-citizens. Under one of the most recent federal welfare reforms, the Food Stamp Program remained intact but was reduced by more than $27 billion over a six-year period. Eligibility was restricted and several protections for food stamp recipients were eliminated.

For example, certain healthy adults without children are now only eligible to receive three months of food stamp benefits within a 36-month period, unless they work at least 20 hours per week or live in an area where the work requirement has been waived.

In 1997, California chose to cover some children and elderly individuals who did not meet the new federal eligibility requirements. In 1999, the California program was expanded to include adults between 18 and 65 years old. Despite California’s broader rules, food stamp enrollment in California has decreased by 40% (1.4 million people) since 1995.

Note: Healthy immigrants between 18 and 59 years old who are not receiving CalWORKs must work at least 32 hours per week to receive food stamps under the California program (if there is more than one adult in the household, the work requirement per person is reduced).

Eligibility

Requirements are based on income and resources. A common issue is defining the eligible household. The basic definition is:

A person living alone, or living with others but usually purchasing food separately; or
A group of people living together who usually purchase and prepare food together.

For the purposes of the Food Stamp Program, parents and their children under 22 years of age, or spouses living together, are treated as a single household, even if they do not purchase or prepare food together.

A family living in a battered women’s shelter may be certified as a separate food stamp household.

Immigration

Federal legislation has changed several times regarding food stamp eligibility for non-citizens. Generally, a non-citizen must fall into the category of a “qualified alien” to be eligible for the Food Stamp Program.

Again, if the applicant appears poor and in need, ask whether they are receiving food stamps. If the answer is no, the applicant should be encouraged to apply.

WIC is a federally funded program that serves pregnant women, children up to age five, breastfeeding mothers for one year after the child’s birth, and mothers who do not breastfeed for up to six months. Participants receive vouchers to purchase milk, vitamins, and certain dairy and protein-rich foods.

WIC eligibility should be verified for all pregnant applicants and those with children under five years old. Participation does not affect a claimant’s income for purposes of determining child support, and there are no citizenship requirements for participation.

Applicants may have been referred by their healthcare providers, and those receiving public assistance may already be aware of the program.

School Lunch Program H. In Los Angeles County

59% of children in the public school system receive lunch through this program. It provides nutritious lunches to all children, regardless of their immigration status, whose family income is below 130% of the federal poverty level. Families with slightly higher incomes may still receive lunches by paying a small fee.

RESTRICCIONES A LOS BENEFICIOS PARA INMIGRANTES

Immigrants who arrived in the United States before August 22, 1996, and who are receiving or may need to receive SSI or food stamps should be encouraged to apply for citizenship. Although California has state programs to help this population, citizenship is the main path to maintain or receive benefits if they are needed.

This may be a limitation in receiving benefits for people who were sponsored to come to the United States. Refer such applicants to an immigration attorney through the local legal assistance program for further help.

Essential principles for understanding most government benefit programs:

Principle 1

Eligibility requirements are based on income and resources
In general, the amount of assets that an individual or family may have and still be eligible ranges from $2,000 to $3,000, depending on the program and the number and age of persons in the family or household. However, there are some resources that are not counted, regardless of value.

Exempt or excluded resources; and Availability.

Exempt Resources: Briefly, if the applicant’s home is their current primary residence and/or they have a car with a net value that does not exceed the specified amount, they are exempt from inclusion as a resource. If the individual does not live in the residence as their home (for example, it is partially rented out or spouse lives in it), they may not be exempt unless it can be shown it is not an available resource.
Availability: A resource is not “available” if the applicant has no way to access the resource. For example, the applicant has funds in a certificate of deposit that can be withdrawn, even if severe penalties would be imposed, those funds are considered available. However, a house in which the other person is living under court order is not available.

*Note: Be aware that the sale of the marital home can affect CalWORKs and SSI eligibility. If the claimant receives a lump sum, for example from selling the house, they may be ineligible for CalWORKs. The claimant should speak with a public benefits attorney before receiving a lump sum. It is important that benefit recipients report all lump sum payments of this nature to CalWORKs.

Principle 2

Any income brought into the household may negatively affect eligibility
For cash programs like CalWORKs and SSI, any income received is often deducted from the grant amount dollar for dollar.

Note: The definition of income is broad and will usually include child support and spousal support, although child support income may be prorated for some programs.

Principle 3

Child support

Paternity and enforcement of child support orders: After welfare reform, every state must provide the same services to families receiving TANF (called CalWORK in California) as were provided to AFDC recipients. These services include establishing and modifying paternity, and enforcing child support orders.
Impact of CalWORKs time limits: The Department of Child Support Services (CSSD) is supposed to open a child support case for every custodial parent who applies for CalWORKs. The custodial parent must assign their right to receive government assistance as a condition for receiving cash aid.
Custodial applicants should follow up on their child support cases, even if they are currently receiving cash assistance from CalWORKs.
Child support may be needed when CalWORKs benefits have expired. Applicants should determine if CSSD has obtained a support order against the other parent. If there is no order, and if the applicant believes the other parent has income, they should be encouraged to file or call CSSD to ask why not, and to provide any information that may help locate the other parent and establish their income.
The applicant should also verify existing support orders, especially if they know the other parent has regular employment. Persistence from a parent can make a difference.
“Disregard” of CalWORKs: If the non‑custodial parent is paying child support for children who receive CalWORKs, the family is entitled to receive the first $50 of any child support paid in a given month. This amount is called the “disregard,” as it is not considered income for the family’s eligibility for CalWORKs and for calculating the monthly amount they receive.

Child support for families leaving CalWORKs: When families leave welfare, the CSSD case remains open unless the custodial parent requests it to be closed. However, any child support collected after the family leaves welfare must be sent directly to the family. Unfortunately, there has been an issue with the interface between the two agencies, and the transition is not always smooth. In the past, the system frequently misallocated the first one or two child support payments made after the family was off aid, distributing the payment to the welfare agency instead of to the family. Though the error causing this has been corrected, it is still possible that it may occur. This can result in a serious problem for a family who has just left assistance, because they are relying on child support to replace cash aid. Also, often they do not know support was paid but misallocated. However, a complaint to CSSD usually leads to recovering the money from welfare and paying it to the claimant.

Principle 4

The claimant may work and be on CalWORKs or SSI
According to the strictly defined rules and regulations determining eligibility, it is possible for claimants to work and continue receiving aid. However, the cash grant will be reduced based on the amount of income.
It is extremely important to advise the claimant to discuss the effects of earned income on the amount of public benefits received with an attorney specializing in public benefits.

Principle 5

Custody and visitation arrangements may affect CalWORKs benefits
Physical joint custody may affect the applicant’s eligibility for CalWORKs. In summary, the rules for CalWORKs eligibility for physical joint custody are:

The eligible parent who has physical custody more than 50% of the time is considered the caretaker relative and will receive CalWORKs. CalWORKs benefits may not be prorated between parents.
If both parents have the child half the time, the parent designated in a current court order as the primary caretaker receives the public assistance. If there is no court order, the caretaker relative is the parent who has the greater responsibility for the child’s care and education, medical, dental, among others.

If both parents are eligible, the parent who applies first will receive aid. If an applicant has or contemplates joint physical custody, be aware that it may affect CalWORKs eligibility for your household. Also, if there is any change in custody when one parent is already receiving benefits, DPSS must be notified immediately so benefits can be terminated or paid to the other parent; otherwise, the parent receiving the benefits runs the risk of having to pay an overpayment or being accused of welfare fraud.

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