ARTICLE 9
SECTION
4
PRINCIPAL
RESIDENCE
1.
GENERAL Property used as a home or formerly used as a home that
meets the criteria contained in this section is exempt. This home is referred to as a principal
residence or PR. |
MEM 50425 |
This section provides instructions for the evaluation
and treatment as property of an applicant/beneficiary's home or former home. 2.
DEFINITIONS The following definitions relate specifically to the
treatment of a personal residence. A.
Appertains "Appertains" means any property or structure
which is connected to and was/is intended to be used as a permanent part of
the property. This includes, but is
not limited to: |
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1)
Acreage which
constitutes a farm or ranch; or 2)
Separately
assessed parcels used as a whole; or 3)
An entire parcel
or separately assessed parcels purchased or used as a whole, separated by,
but not limited to, any of the following: a)
Easements or
rights of way. b)
Water courses. c)
Streets, highways
and freeways. |
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B.
Dependent
Relative A dependent relative is a relative who relies/relied on
the applicant/beneficiary for financial, emotional or medical support. The relative may be any of the following: 1)
Child (of any
age) 2)
Grandchild 3)
Parent |
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4)
Grandparent 5)
Sibling 6)
Half-sibling 7)
Aunt or Uncle 8)
Niece or Nephew 9)
Step-child,
Step-parent, or Step-sibling 10) In-laws |
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C.
Legal Obstacles
to A legal obstacle is a condition which prevents or delays completion of actions necessary to sell the property in question. Examples include but are not limited to: 1)
The title is not
clear. 2)
The property
cannot be sold without the consent of the other owner(s) and the other
owner(s) refuses to sell. 3)
An incompetent
applicant/beneficiary who does not have a legal guardian or someone else who
can legally act on his/her behalf. A state of disrepair or other physical condition of the property would not constitute a legal obstacle. The condition of the property is a factor used by a qualified real estate appraiser in evaluating the fair market value of property. |
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D.
Principal
Residence A principal residence is a real or personal property which is/was the applicant/beneficiary's home and which is exempt according to the criteria in item 4., below. Property which does not meet this exemption criteria is other real property or personal property, as appropriate, and must be evaluated in accordance with regulations governing these types of property. An individual may have more than one residence but can only have one principal residence. |
DHS Clarification |
E.
Qualified Real
Estate Appraiser A qualified real estate appraiser is a person employed
as a real estate appraiser for a real estate company, a bank or mortgage
company, a title company, or an appraisal agency. |
MEM 50412 |
3.
SPECIAL PRINCIPAL
RESIDENCE CRITERIA A.
There is no
requirement that the applicant/beneficiary must have resided on the property immediately
prior to the current absence. If the
applicant/beneficiary ever resided on the property, it may be considered
his/her former home and must be evaluated according to the criteria in item
4.B.1) below. B.
Only one property
may be exempt as a PR. C.
The PR includes
all land appertaining to the residence and all other buildings on the land. D.
The PR includes
the entire multiple unit dwelling if any portion of it serves as the PR. If a portion of a multiple unit dwelling
qualifies as an exempt PR, the entire multiple unit dwelling is exempt. E.
A PR becomes
other real property, or personal property as appropriate, effective the first
of the month following the date exemption criteria are no longer met. |
MEM 50425 |
4.
EXEMPTION
CRITERIA Real or personal property which the
applicant/beneficiary uses or formerly used as a home is exempt as a PR if
any of the following situations exist.
There are no utilization requirements to be met to exempt PR property. |
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A. Applicant/Beneficiary and/or Family Resides on Property1)
If the
applicant/beneficiary resides on the property, it is exempt. 2)
If the
applicant/beneficiary's family, as defined in MPG Article 1, Section 1,
resides on the property, and either of the following conditions exist,
the property is exempt: a)
The
applicant/beneficiary and the family member(s) are in the same MFBU; or b)
The income of the
family member(s) is considered in determining the applicant/beneficiary's
eligibility. |
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B. Applicant/Beneficiary is Absent from PropertyIf the applicant/beneficiary is absent from the
property, and the applicant's family does not meet the conditions of item
4.A.2) above, the property is exempt if any of the following conditions exist: |
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1)
Intent to Return Property which the applicant formerly used as a
principal residence shall be exempt if the applicant/beneficiary is absent
from the property for any reason, including admittance to Long-Term Care
(LTC), and declares in writing that he/she intends to return to live. |
ACWDL 95-48 |
·
The principal
residence is exempt based upon a person's SUBJECTIVE intent to return,
even though he/she may never have the ability to return. ·
The intent to
return is indicated by the client, his/her representative (key person) on the
Statement of Facts by marking the appropriate box. ·
The worker cannot
restrict, in any way, the client, or his/her representative, in the process
of indicating that intent. |
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·
The worker must NOT
require verification of the client's ability to return to the principal
residence in order to grant the exemption (Note: Such a verification is required for the
income deduction for upkeep of the home of a person in LTC pursuant to MEM
Section 50605 and MPG Art. 11, Section 1, Item 3B.). ·
If a client, or
his/her representative incorrectly states that there is no intent to return
but later makes a correction, the worker must accept that correction. |
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a)
Worker Evaluation |
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The worker must evaluate whether the person has
established a new principal residence in order to determine whether or not
the former home is exempt. If the
person has established a new principal residence, the former home is not
exempt unless the person has entered long-term care or the former home is
listed for sale. See item 5. for
long-term care requirements and item 4.B.4) for homes listed for sale. |
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The following questions are to be used by the worker
when evaluating if the former home is still the principal residence. (1)
At which address
does the person receive mail? (2)
At which address
does the person receive payments?
(Social Security, Disability Benefits, etc.) (3)
Which address is
used for income tax purposes? (4)
Where are his/her
personal belongings? (5)
Where is he/she
registered to vote? (6)
Where is he/she
employed? (7)
Is the former
home rented out? (8)
Has he/she signed
a lease in the current residence? (9)
Has he/she
purchased the current residence? (10)
Is the former
home listed for sale? (See item 4.B.4
below.) There is no requirement that the individual own the property in which he/she resides in order to be considered a principal residence. b)
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2)
Spouse/Child or
Dependent Relative Lives on Property The applicant has a spouse, child under age 21, or
dependent relative living on the home property. |
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a) Documentation of Spouse or Child Living on PropertyThe worker must document that the applicant has a
spouse and/or child under age 21 living on the home property on form MC176P
in the area titled "Home" under the Real Property Section. |
County Policy |
b) Documentation of Dependent Relative Living on the Property |
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If only a “dependent relative” lives on the home
property, the worker must obtain a written statement describing the
relationship and basis of dependency (financial, medical, or emotional) from
the applicant/beneficiary or person acting on his/her behalf. The statement must be filed under the
“property” tab in the case folder.
This statement is acceptable evidence unless it is questionable. (e.g., An Adult son who depends emotionally
on his mother who has been in a coma in LTC for a year.) |
Proc.9H DHS Clarification |
c) Verification/Documentation of Disabled Adult ChildIf the dependent relative is a blind or disabled adult
child, and the worker views existing evidence that the child meets the
blindness or disability requirements for Medi-Cal as indicated in MPG Article
5, Section 3 (receipt of Title II disability benefits or SSI/SSP, MC221 on
file, etc.) a separate written statement is not required. Instead, the worker must document the
evidence viewed on form 07-104 DSS, and file it under the
"property" tab; or |
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3)
Sibling/Adult
Child Resides on Property The applicant/beneficiary resides in a skilled nursing
facility, intermediate care facility, or licensed community care facility
(Board and Care), and a sibling or child 21 years of age or older
resides on the property and has done so for at least one year prior to
the time the applicant/beneficiary entered the institution. The worker must document this fact on form
MC176P. Verification that these
conditions exist is not required unless the worker considers the accuracy of
the information provided, questionable; or |
MEM |
4) Bona Fide Effort to SellThe property does not meet any of the above exemption
criteria but a "bona fide effort" is being made to sell the
property. a)
Definition A bona fide effort to sell means that: (1)
The property is
listed for sale with a licensed real estate broker; and |
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(2)
The listing price
is fair market value as determined by a qualified real estate appraiser; and (3)
A good faith
effort is being made to sell the property, which includes evidence that the
asking price is being lowered if the property is not selling; and |
DHS Clarification |
(4)
Offers at fair
market value are accepted. b)
Verification/Documentation The worker will file a copy of the listing contract and appraisal in the case folder under the "property" tab. The applicant/beneficiary or key person must be advised to report all offers at fair market value or higher, and the acceptance of such offers. |
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The worker must TIC the case for review the month the listing contract expires or on a quarterly basis, whichever comes first. If the property has not been sold at that time, the beneficiary or key person must provide evidence that the property has been listed again. In general, the case record must include evidence that the property continuously meets the criteria of a bona fide effort to sell, as stated above. |
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5)
Legal Obstacles The property cannot be sold because there are legal obstacles preventing the sale and the applicant/beneficiary or person acting on his/her behalf provides evidence of attempts to overcome such obstacles. Verification/Documentation a)
There is no
requirement for the applicant/beneficiary or key person to provide
verification that a legal obstacle exists unless the worker considers the
accuracy of the information provided by the applicant/beneficiary to be
questionable. However,
"evidence" of attempts to overcome legal obstacles must be provided
before the property can be exempted.
The evidence may be photocopied and filed in the case, or viewed and
documented by the worker. |
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b)
The type of
efforts or attempts to overcome legal obstacles will vary with the type of
legal obstacle. However, since legal
actions are usually required most likely an attorney will be involved. A statement by the applicant/beneficiary or key person
that attempts will be made to overcome the obstacle(s) is insufficient
to exempt the property. At minimum,
evidence must be provided which shows that an attempt is in progress. An example
would be a statement signed by the applicant/ beneficiary's attorney listing
steps already taken (petitions filed with the court, etc.) and the date
results are expected to be known. |
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c)
To remain exempt,
unsuccessful attempts to overcome such obstacles must be followed immediately
by another attempt. The intent of the
regulation is that a continuous effort to overcome legal obstacles is
required, until such time as the obstacle no longer exists. |
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5.
LIENS A. ConditionsThe SDHS will record a lien against the beneficiary's ownership interest in his/her PR when all of the following conditions are met: 1)
The beneficiary
is in LTC; and 2)
The beneficiary
has listed his/her PR for sale and is making a "bona fide effort"
to sell the property; and 3)
The beneficiary
has received the correct mandatory notice of action (NOA 960) for persons in
LTC who are required to list their PR for sale. |
MEM 50428 |
The beneficiary does not sign or complete any separate
forms regarding the lien. The
beneficiary's consent is not required.
Information required by SDHS to record and dissolve the lien is
provided by the worker. The worker
must complete form DHS 7014 Property Lien Referral and send it to SDHS. (See Appendix 9-4-B.) B. ForeclosureLiens recorded by SDHS for amounts of medical care provided by Medi-Cal may be foreclosed only after: 1)
The beneficiary sells the property; or
2) The beneficiary dies and there is no surviving spouse, child under age 21, or child who is blind or disabled. |
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C. Dissolving the LienAny lien will be dissolved when the beneficiary is discharged from LTC and returns to the PR to live. The worker must complete form DHS 7013, which is used to notify SDHS of this change. |
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6.
PERSONAL PROPERTY
AS A PRINCIPAL RESIDENCE The regulations regarding treatment of personal
property used as a PR are the same as regulations regarding real property as
a PR. Most regulations dealing with
the principal residence use terms and impose conditions or requirements which
are not normally associated with personal property. To meet the intent of the regulations, SDHS
has advised that appropriate substitutions be used for personal property,
when necessary to meet criteria for exemption of the property as a PR. The following are examples of appropriate
equivalents applicable to mobile homes (when not assessed as real property),
motor vehicles, boats, etc.: |
DHS Clarification |
A.
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B. Lien RequirementsPersonal property used as PRs are not exempt from lien requirements. SDHS Recovery Branch will evaluate each situation and initiate appropriate recovery actions whenever possible. When personal property is/was the PR, questions 8 and
11 on form DHS 7014 may require modified responses. The fact that the PR is personal property
should be stated in question 8. In
question 11, the legal description such as a vehicle ID number would be
listed. Copies of ownership
certificates and/or similar documents relating to the property are attached
in lieu of the deed. |
MEM 50428 |
7.
KEY
PERSON/REFERRAL TO PUBLIC GUARDIAN A. Key Person (Authorized Representative) AvailableThe fact that an applicant/beneficiary is incompetent
and unable to list his/her former home for sale does not negate the
requirement to do so. If the key person has legal authority to act as the
applicant/beneficiary's agent in property transactions, then the
responsibility to comply on behalf of the applicant/beneficiary rests with
that person, and there is no legal obstacle. |
MEM 50425 |
If someone other than the key person has legal
authority to act on the applicant/beneficiary's behalf, then the key person
must obtain that person's cooperation in meeting the listing
requirements. A legal obstacle may
exist if the key person must petition a court, file suit, etc., to make the
property available for sale under the terms required by this rule. |
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B. Public GuardianIf there is no key person, or the key person is unable
or unwilling to attempt to acquire authority, then referral to the Public
Guardian is appropriate. 1)
Referral for
Guardianship/Conservator If there is no Public Guardian case, the worker must
call the Public Guardian's office, ask for the duty deputy, and explain the
situation, including the requirement to list for sale the
applicant/beneficiary's former home.
The Public Guardian will send a referral form PA40 to the worker to
complete and return it to mail station O95.
The worker must complete the form as thoroughly as possible. |
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Near the bottom of the form, in the section titled
"Problem," the worker must state that Medi-Cal eligibility is
dependent on continuous efforts to overcome any legal obstacles to the sale
of the property, and once the property is available for sale, a bona fide
effort to sell must be made. The worker must attach a gram explaining the urgency of
the situation; the need to be advised in writing of the status of all
significant legal steps taken by the Public Guardian's office, and a request
that a petition for conservatorship be filed immediately so that benefits may
be granted or continued. |
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For purposes of continuing eligibility, the filing of
the petition for conservatorship by the Public Guardian's office begins
the process of attempting to overcome legal obstacles to the sale of the
property. |
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2)
Public Guardian
as Key Person Once the Public Guardian is designated as the
conservator of the estate, the assigned Public Guardian becomes the
applicant/beneficiary's key person for purposes of sale of the PR. This means that NOA MC239-W (code 960) must be sent to
the Public Guardian immediately upon notification to the worker that
conservatorship has been established.
(See item 9.) The Real Property Agent at the Public Guardian's office
is a licensed real estate broker.
He/She is required to appraise or obtain an appraisal of the fair
market value of the property in order to sell it. |
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Written confirmation from the Real Property Agent which
states the date the property becomes assigned for sale, the fair market
values, and a copy of the appraisal used by the Real Property Agent is
considered adequate verification that a bona fide effort to sell the property
is being made. (See item 4.B.4).) |
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8.
A.
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MEM 50428 Proc. 9H |
B.
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5)
To complete the
review, the supervisor must reevaluate all information in the case file and
examine any additional written declarations or other documents submitted by
the applicant/beneficiary or key person, which are relevant to the following
issues: a)
Whether or not
the applicant/beneficiary is absent from the property but intends to return
to the PR to live. b)
Whether there are
any regulatory exemptions which would allow the applicant/beneficiary to
remain or become eligible without listing the PR for sale (e.g., a dependent
relative lives on the property). c)
Whether there is
any other reason which prevents the applicant/beneficiary from listing the
property for sale (e.g., the applicant/beneficiary is incompetent and there
is no legal conservator or guardian). |
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C. Exemption Status Pending County Review/Hearing Decision1)
Applications a)
If an applicant/key person requests a County review
within 30 days after the date of NOA MC 239-W, the application may not be
denied on the basis of the applicant's failure to list his/her property for
sale. The application is held pending
the County review decision. If the
requirement to list the property is not rescinded. The worker will deny the application 30
days after the date of the County review decision. |
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b)
State Hearing
Requested If an applicant/key person files for a State Hearing on
the issue of the requirement to list the property for sale, the property at
issue is not exempted pending the hearing decision. The worker must allow the applicant/key
person the required time to provide verification that the property is listed
for sale. Assuming the applicant/key
person does not comply, the property at issue must be evaluated as
"other real property," which will usually result in an excess
property situation. At that point, the
application would be denied and NOA MC 239-Y sent. |
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2)
Granted Cases a)
If an LTC beneficiary requests a County review within
30 days of the date of NOA MC 239-W, the requirement to list the property for
sale is suspended pending the County review decision. |
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b)
State Hearing
Requested If an LTC beneficiary files for a State Hearing in
response to NOA MC 239-W (code 960), or MC 239-Z (code 962), the supervisor
must complete the County review and notification process. This includes sending an NOA, if appropriate,
proposing discontinuance on the basis of excess other real property. However, if Appeals has determined that aid
paid pending the hearing is required, or, at the hearing, the Administrative
Law Judge orders aid pending to continue, discontinuance action may not be
taken at that time. The worker should contact the Appeals Representative
for clarification of aid paid pending status before taking any related
discontinuance action as a result of the completion of the County review and
notification period. |
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9.
FORMS AND NOTICES A. Forms1)
Property Lien
Referral - Form DHS 7014 This form is completed by the worker and sent to the
Recovery Branch immediately upon receipt of the required information and
verifications. Detailed completion
instructions are provided in Appendix 9-4-A2. |
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2)
Change of Status
- Liens - Form DHS 7013 This form is completed by the worker and sent to the
Recovery Branch any time there is a change to any of the information reported
on form DHS 7014, when the beneficiary requests a State Hearing, and when a
hearing decision is received. A copy
of each DHS 7013 sent must be filed in the case under the property tab. |
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3)
Principal Residence Questionnaire (Form 14-15 DSS) SDHS developed this questionnaire for use in evaluating
and documenting the exempt status of an applicant/beneficiary's former home. |
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a)
Required
Completion Completion of the form is required at intake
when the applicant owns property formerly used as a home. The worker must allow 20 days for return of
the form. If the form is not returned,
the worker must attempt to contact the beneficiary or key person to determine
the reason for the delay. If a valid
reason is provided, the worker must advise the beneficiary/key person of the
extended due date of 10 days. If the
applicant/beneficiary still has not returned form 14-15 DSS, a new evaluation
of the reason is required. |
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If the form 14-15 DSS is not returned and good cause is
not established, the case must be denied/discontinued for failure to provide
information. |
MEM 50175 |
Good cause includes, but is not limited to: Physical
or mental illness or incapacity of the beneficiary and the authorized
representative which prevents the completion or return of the form. b)
Optional Use Workers are encouraged to request completion of form
14-15 DSS whenever a beneficiary's living arrangements change, or a change
occurs which may affect the exempt status of the property. Form 14-15 DSS is not mandatory in these
situations. If the form is not used, the worker must document the
exempt/non-exempt status of the home property on form MC 176P. |
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B. NoticesSpecific notices of action must be used for certain property situations. The content of these notices may not be altered. Copies of these NOA's are included as appendices. SDHS has assigned specific form numbers to
the notices. For continued reference,
the State-assigned form number will be shown in the lower left corner of the
NOA's, and included as part of the description of the automated NOA. |
MEM 50428 Proc. 9H |
1)
List For (MC 239-W, NOA Code 960) This NOA must be sent to applicants or beneficiaries
who reside in an LTC facility (SNF, ICF or acute care hospital) whose former
home may be exempt only if it is listed for sale in accordance with
4.B.4) above. |
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The worker must TIC for 30 days to check for receipt of
the required verifications that the property has been listed for sale. 2)
List For (MC 239-X, NOA Code 961) This NOA must be sent to applicants or beneficiaries
who do not reside in an LTC facility but are required to list their
property for sale in accordance with item 4.B.4) above. |
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3)
Result of (MC 239-Z, NOA Code 962) This NOA must be used to notify
applicants/beneficiaries of the results of the If the review decision is that the list for sale
requirements were correct, the worker must enter a date 30 days after the
date of the notice in the spaces for that purpose. |
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9-4-A1
State of
PROPERTY
LIEN REFERRAL
Recovery
Branch - MS 4720
Telephone
number (916) 650-0490
DHS
7014 (1/99)
9-4-A2
INSTRUCTIONS
Property
Lien Referral
Form
DHS 7014
A. For each beneficiary owning real property that
may be liened in accordance with Section 50428, the county shall complete the Property
Lien Referral and forward it to the Department of Health Services' Recovery
Branch within 30 days of the date the List Property For Sale — Persons in LTC
(MC 239 W) notice is sent to the applicant/beneficiary.
B. The following describes the information which
is to be provided on the Property Lien Referral. Items 1 through 13 must be completed by the
eligibility worker. Items 15 through 18
are for DHS's use only.
1. Name of the county. This must be county of responsibility
regardless of where the property is located.
2. Name of the beneficiary. This must be the name that appears on the
SAWS 1. If the beneficiary's name is
different on the deed to the property, indicate with "AKA."
3. a. Name of Institution or facility.
b. Current
address of beneficiary.
4. Responsible party, if other than the
beneficiary. Include his/her name,
address, and telephone number.
5. Medi-Cal identification (ID) number. This must be the current entire case
number. If any changes are made to this
number, it must be reported to the Recovery Branch using the Change of
Status — Liens form (DHS 7013). The
new number should be noted in the information/change section.
6. Social Security number. This must be verified in accordance with
Section 50160. If any changes are made
to this number, it must be reported to the Recovery Branch using the Change
of Status — Liens form (DHS 7013).
The new number should be noted in the information/change section.
7. Medicare number or other health insurance
information.
8. Property address. Included in this section would be the county
and the state, if other than
9. Other legal owner(s). Identify individual(s) sharing title with the
beneficiary.
10. Fair market value (FMV). The real estate agency listing contract with
the FMV appraisal shown must be attached to the Property Lien Referral. The appraisal requirements specified in
Section 50425 must be followed.
11. Enter the county assessor's parcel number from
a tax statement, deed, etc. Furnish a
copy of the deed.
12. The date the Notice of Action — List Property
for
13. Enter the eligibility worker's name and
telephone number in case additional information is needed.
14. Enter the eligibility supervisor's signature,
showing that the form is complete and contains accurate information.
STATE USE ONLY
15-16. The form will be signed by the Recovery
Branch and a copy mailed to the county within ten days of receipt, showing that
the form was complete and all documents were received.
17. If information is missing that would prevent
the State from filing a lien, the Recovery Branch will indicate by checking the
appropriate box and returning the form and all attached documents to the
county.
18. Contact the Recovery Branch, (916) 650-0490,
if there are any questions regarding this form.
APPENDIX
9-4-B1
State of
CHANGE OF STATUS—LIENS
Mail to: Department of
Health Services
Telephone
number (916) 650-0490
DHS 7013 (9/97)
APPENDIX
9-4-B2
INSTRUCTIONS FOR DHS 7013
CHANGE
OF STATUS—LIENS
The form is completed in duplicate; the original sent to DHS Recovery, the copy retained in the case record.
1. Enter
beneficiary's full name, Medi-Cal ID number, and Social Security number.
2. Check
box and enter requested information.
3. Eligibility
Worker signs and dates form.
DHS
7013 (9/97)
9-4-C
PRINCIPAL
RESIDENCE QUESTIONNAIRE
Department of Social Services
Case
Name:
Case
Number:
ET:
Changes
in state law in 1983 (Chapter 1041, Statutes of 1983) require that we
re-evaluate any property you own and use or formerly used as your home
(principal residence). In order to correctly evaluate your property, please
answer the following questions and return this form by _______________________.
(NOTE: If you are completing this form for someone
else, the “I/We” as used in these questions refers to the person for whom
Medi-Cal is being requested or received.)
1.
Do
you own the property on which you now live?
______________
2.
Do
you own the property on which you once lived but do not live on now?
If
yes, where is that property located (address)?
If yes, do you intend
to return to that property to live in the future?
(If this intent
changes, you must notify the county within 10 days.)
If you do not intend
to return to that property, does anyone live there now?
If so, who? (Name) ____________________. .
(relation
to you)
How long have they
lived there? .
3.
Is
this property currently listed for sale? _____________.
Completed by:
_____________________________ Date:
Relation to Applicant/Beneficiary: ___________________ Phone:
14-15 DSS (4/86) (4/88)
9-4-D
NOA
239-W - CODE 960
State of
Medi-Cal
Program
MEDI-CAL NOTICE OF ACTION CASE
NAME:
LIST PROPERTY FOR
PERSONS IN LONG-TERM CARE
DISTRICT:
Information indicates that you own a
home (principal residence). Since you currently reside in either a skilled
nursing facility, intermediate care facility, or an acute care hospital and you
do not intend to return to your home, changes in state law may affect your
eligibility for Medi-Cal.
For your Medi-Cal eligibility to be
established or to continue, your property must be listed for sale with a
licensed real estate broker, and it must be priced at its fair market value.
Evidence that the property is listed with a licensed real estate broker at its
appraised fair market value and a copy of the deed must be provided to your
eligibility worker within 30 days of the date of this notice.
If you list this property for sale and
your Medi-Cal eligibility is established or continues, a lien will be recorded
against your property to cover the cost of medical care that you received under
the Medi-Cal Program. Your ownership of the property is not lost or transferred
when the lien is recorded.
If and when your property is sold, the
amount of the lien (which is based on your medical costs) will be recovered
from the proceeds of the sale and returned to the State of
You have a right to request county
review of the above requirements by submitting additional written information
on this matter to the county within 30 days of the date of this notice. Such
action on your part will constitute a request for a review of your case by the
county. You will not be required to take any action to list your home for sale
and no lien will be recorded while such a review is in progress. Information on
how to proceed with the county review may be obtained from your eligibility
worker.
While the county review and/or the state hearing results
are pending, the court order in Bagley v. Rank prohibits you from
transferring or selling this property without jeopardizing your eligibility for
Medi-Cal benefits, except:
1.
Upon your death,
property you hold in joint tenancy may be transferred to the surviving joint
tenant;
2.
If you are
ordered to do so by a court.
This office will notify you whether
the additional information you submit justifies withdrawing the requirement
that you list your property for sale. If the requirement is not withdrawn, you
may appeal the county review determination at your local county welfare
department.
Failure to either request county
review and/or state hearing or failure to provide evidence that you have listed
your property for sale within 30 days from the date of this notice may result
in denial or termination of your Medi-Cal benefits.
Your right to a state hearing on this matter is
explained on the reverse side of this notice. At this hearing you may introduce
facts concerning exemptions that apply to you.
For further information, please contact your eligibility
worker.
The regulations that require this action are Title 22,
California Administrative Code, Sections 50425 and 50428.
Eligibility Worker Phone
Number Date
NOTE: IF THE ABOVE-NAMED MEDI-CAL BENEFICIARY IS
UNABLE TO ACT ON HIS/HER OWN BEHALF, EITHER A FAMILY MEMBER, A CONSERVATOR, OR
AN AUTHORIZED REPRESENTATIVE MUST CONTACT THE ELIGIBILITY WORKER IMMEDIATELY
FOR FURTHER DETAILS ON HOW TO PROCEED.
PLEASE READ THE REVERSE SIDE OF
THIS NOTICE
MC 239 W (3/86)
9-4-E
NOA
239-X - CODE 961
State of
Medi-Cal Program
MEDI-CAL NOTICE OF ACTION
LIST PROPERTY FOR
PERSONS NOT IN LONG-TERM CARE
CASE
NAME:
CASE
NUMBER:
DISTRICT:
Information
indicates that you own a home (principal residence). Since you currently do not
reside in the principal residence and you do not intend to return to that
residence, changes in state law may affect your eligibility for Medi-Cal.
For
your Medi-Cal to be established or to continue, your property must be listed
for sale with a licensed real estate broker, and it must be priced at its fair
market value. Evidence that the property is listed with a licensed real estate
broker at its appraised fair market value and a copy of the deed must be
provided to your eligibility worker within 30 days of the date of this notice.
Your right to a
state hearing on this matter is explained on the reverse side of this notice.
At this hearing you may introduce facts concerning exemptions that may apply to
you.
For further
information, please contact your eligibility worker.
The regulations
that require this action are Title 22, California Administrative Code, Sections
50425 and 50428.
Eligibility
Worker Phone
Number Date
NOTE: IF THE ABOVE-NAMED MEDI-CAL BENEFICIARY IS UNABLE TO ACT ON HIS/HER
OWN BEHALF, EITHER A FAMILY MEMBER, A CONSERVATOR, OR AN AUTHORIZED
REPRESENTATIVE MUST CONTACT THE ELIGIBILITY WORKER IMMEDIATELY FOR FURTHER
DETAILS ON HOW TO PROCEED.
MC 239 X (4/86)
9-4-F
NOA
239-Z - CODE 962
MEDI-CAL NOTICE OF ACTION
RESULT OF
CASE
NAME:
CASE
NUMBER:
DISTRICT:
┌ ┐
└ ┘
Dear :
Our notice to you dated required that you list your former principal
residence for sale and that a 1ien be recorded against the property in order for
you to remain eligible for Medi-Cal. (MC
239 W).
WE HAVE RE-EXAMINED THAT FINDING AT
YOUR REQUEST. BASED ON INFORMATION
AVAILABLE TO US, WE HAVE DETERMINED THAT:
1. o The
requirement that you list your former principal residence for sale was incorrect. The notice requiring listing for sale is rescinded.
2. o The
requirement that you list your former principal residence for sale to remain
eligible was correct. You must comply
with the requirements of the notice on or before .
If
you are dissatisfied with this action, you may request a state hearing. Your rights are explained on the reverse side
of this notice.
3. o
WHILE THE COUNTY REVIEW AND/OR THE
STATE HEARING RESULTS ARE PENDING, THE COURT ORDER IN BAGLEY v. RANK PROHIBITS
YOU FROM TRANSFERRING OR SELLING THIS PROPERTY WITHOUT JEOPARDIZING YOUR
ELIGIBILITY FOR MEDI-CAL BENEFITS, EXCEPT:
1. UPON
YOUR DEATH, PROPERTY YOU HOLD IN JOINT TENANCY MAY BE TRANSFERRED TO THE
SURVIVING JOINT TENANT:
2. IF
YOU ARE ORDERED TO DO SO BY
(Eligibility
Worker) (Phone Number) (Date)
PLEASE
READ THE REVERSE SIDE OF THIS NOTICE
MC 239 Z (5/86)
9-4-G
PRINCIPAL RESIDENCE DESK AID
PRINCIPAL RESIDENCE (PR)
Determination of Status and Lien
Procedures
Precondition: The
applicant/beneficiary has an ownership interest in a principal residence. A principal residence is real or personal
property currently or previously used as a home. The principal residence is/was one of the
following:
1. Personal property (mobile home, trailer,
boat, etc.); or
2. Single family dwelling; or
3. Single family dwelling with other property
adjoining, with or without other buildings; or
4. Portions of a multiple unit dwelling; or
5. Portions of a multiple unit dwelling with
other property adjoining, with or without other buildings.
A/B-Applicant/Beneficiary FMV-Fair Market Value
PR-
Principal Residence NMV-Net
Market Value
|
CONDITION |
ACTION |
1. |
A/B lives on the property. |
Entire property
exempt from consideration. |
2. |
A/B in/enters long-term care or A/B absent from PR for any other
reason, and one or more of the following continue to reside in PR: a. Spouse. b. Child under 21. c. Dependent relative. d. Sister, brother, or adult child in PR and has continuously lived in
PR for one year prior to date A/B entered LTC. e. Family of the A/B lives in PR and are in the same MFBU or their
income is used in determining A/B’s eligibility. |
List and lien requirements do not
apply. |
3. |
A/B in/enters LTC and intends to return to the PR in the future. |
Entire property exempt from
consideration if A/B provides written declaration of intent to return. |
4. |
A/B absent from PR for any reason and intends to return to PR
(vacation, board and care, staying with relatives). |
Entire property
exempt from consideration if A/B provides written declaration of intent to
return. |
9-4-G
PRINCIPAL RESIDENCE DESK AID
|
CONDITION |
ACTION |
5. |
A/B absent from PR for any reason/length of time, A/B does not intend
to return to PR and PR cannot be sold due to legal obstacles. |
Entire property
exempt from consideration if A/B provides evidence of attempt to overcome
obstacles, such as statements from other owners of refusal to list. |
6. |
A/B absent from PR for any reason/length of time, A/B does not intend
to return to PR, none of the conditions in 1-5, above, apply; and PR cannot
be readily converted to cash. |
Entire property
exempt from consideration if the A/B: a.
Lists for sale
with a licensed broker for fair market value established by a qualified real
estate appraiser; and b. Provides documentation that good faith effort is being
made to sell the property; and c.
Accepts final
offer at FMV; and d. Reports all offers to the eligibility worker. If real
property of institutionalized individual, eligibility worker must send MC
7014 to Recovery; MC 239 to A/B. |