California Code of Regulations
Title 22 - Social Security
Division 2 - Department of Social Services-Department of Health Services
Part 2 - Health and Welfare Agency-Department of Health Services Regulations
Subdivision 7 - California Children's Services
Chapter 3 - Client Application and Eligibility Requirements
Article 1 - General Provisions
Section 41514 - Application for CCS Services

Universal Citation: 22 CA Code of Regs 41514

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) Anyone may make a referral to CCS including the patient or family.

(b) The parents, legal guardian of a minor child, or applicant 18 years of age or older shall submit a written application to the county.

(c) The county shall, upon receipt of a referral, within five calendar days, mail or deliver to the parents, legal guardian of a minor applicant or applicant 18 years of age or older, written notification of a minimum of information which shall include:

(1) The source and date of referral of the patient.

(2) A blank application form which is either provided by the State or prepared by the county and requests identifying information such as name and address of applicant and parents or legal guardian and a request for CCS coverage. The application form must contain a privacy notification meeting the requirements of Civil Code Section 1798.17.

(3) A statement that a completed application is required for CCS coverage.

(4) A statement that receipt of a completed and signed application by CCS within 20 calendar days of the mailing date of the notice is required for the referral date to be considered the application date.

(5) A brief description of CCS.

(d) If the county does not receive the application within 20 calendar days of the mailing date the county shall send a second notification with five more calendar days containing a minimum of information which shall include:

(1) A statement that a completed application is required for CCS coverage.

(2) A statement that the county has not received an application.

(e) If the county does not receive the application within 20 calendar days after the second notice a third written notification shall be sent by the county within five (5) more calendar days after the second due date. That notice shall contain, at a minimum, the following information:

(1) A statement that the county has not received a completed application to CCS.

(2) A statement that the county has not opened the applicant's case and that no services shall be paid for by CCS.

(3) A statement that if the county receives a completed application within 20 calendar days of the date the county sent either the first or second notice, the referral date shall be considered the application date and that if the completed application is not received by the county within 20 calendar days after the second notice is mailed the date the application is received by the county shall be considered the application date.

(f) A copy of the third and final letter shall be sent to the referral source.

1. New section filed 12-31-90; operative 1-30-91 (Register 91, No. 8).
2. Change without regulatory effect relocating chapter 3 and article 1 headings from preceding section 41700 to preceding section 41514, renumbering former section 41514 to new section 41421 and renumbering former section 41700 to section 41514, including amendment of section and NOTE, filed 1-28-2009 pursuant to section 100, title 1, California Code of Regulations (Register 2009, No. 5).

Note: Authority cited: Sections 20, 100275, 123805 and 123990, Health and Safety Code. Reference: Sections 123870, 123900 and 123990, Health and Safety Code.

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