Program Review Requirements

Program Types

There are two types of programs that are reviewed:

CalFresh Program, and
Medi-Cal Program.

CalFresh Review Requirements

The Supervisor has the authority and is expected to randomly pull case(s) from their workers to complete full case and targeted reviews. For the CalFresh program, a minimum of 16 full case reviews and 4 negative reviews must be submitted per month.

CalFresh Review Reductions and Exemptions

A reduction of 8 reviews will be given to all units if the County meets all of the following mandatory Performance Measurements Standards:

Expedited Services above 95%
30 day approvals and denials above 90%
CAPER and Active Error Rates below State and Federal level.

New Eligibility Supervisors expectations are as follows:

Month	Active Reviews	Negative Reviews
First Month	4	2
Second Month	8	4
Third Month	16	4

New supervisor reductions do not apply to Supervisors who transfer to a new unit.

Important: Supervisors are exempt from completing CalFresh case reviews when their current unit or assigned project does not include CalFresh cases.

Eligibility Workers who are assigned WOOC duties as a Continuing EW Supervisor for one month or longer, will be granted a case review reduction as follows:

If the WOOC caseload percentage is...	The active reviews are reduced to...	The negative reviews are reduced to...
81% or more	zero	zero
66% to 80%	four	one
65% or less	eight	two

Reminder: Managers must report WOOC caseloads percentages to the Corrective Action Coordinator the first week of the month to ensure the correct long-term WOOC expectation is applied.

Supervisors participating in the Eligibility Worker I interview panels are granted one active review reduction for each full day of participation. If the supervisor completes two half days of interviews it will be counted as one active review exemption. Review exemptions will be applied the following month after the supervisor participates in the interview panel.

Note: Additional review reductions or exemption requests must be requested by the Social Services Program Managers to the DEBS Program Manager and Corrective Action Coordinator for approval.

Medi-Cal Review Requirements

Supervisors have the authority and are expected to randomly pull case(s) from their workers to complete full case and targeted reviews. Program will provide further instructions on what cases will be reviewed.

A minimum of 16 full case reviews must be submitted each month.

Medi-Cal Review Reductions and Exceptions

New Eligibility Supervisors expectations are as follows:

Month	Active Reviews
First Month	4
Second Month	8
Third Month	16

Long-term Eligibility Supervisors Working Out of Class (WOOC) for one month or more will be reduced to 8 active reviews each month during their assignment.

Effective October 2020 HCR supervisors are required to complete a total of 11 Medi-Cal case reviews and 5 CalFresh reviews each month.

Supervisors participating in the Eligibility Worker I interview panels are granted one review reduction for each full day of participation. If the supervisor completes two half days of interviews it will be counted as one active review exemption. Review exemptions will be applied the following month after the supervisor participates in the interview panel.