Form Na 692 - Notice Of Change - Cash Assistance Program For Immigrants (Capi) Page 3
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4YOUR HEARING RIGHTS
You have the right to ask for a hearing if you disagree with any county action. You have only 90
days to ask for a hearing. The 90 days started the day after the county gave or mailed you this
notice. If you have good cause as to why you were not able to file for a hearing within the 90 days,
you may still file for a hearing. If you provide good cause, a hearing may still be scheduled.
If you ask for a hearing BEFORE an action on Cash Aid, Medi-Cal, CalFresh or Child Care takes place:
• Your Cash Aid or Medi-Cal will stay the same while you wait for a hearing.
• Your Child Care services may stay the same while you wait for a hearing.
• Your CalFresh will stay the same until the hearing or the end of your certification period, whichever is earlier.
I
f the hearing decision says we are right, you will owe us for any extra Cash Aid, CalFresh or Child
Care services you got. To let us lower or stop your benefits before the hearing, check below:
Yes, lower or stop:
Cash Aid
CalFresh
Child Care
While You Wait For A Hearing Decision For:
WELFARE TO WORK:
You do not have to take part in the activities.
You may receive child care payments for employment and for activities approved by the county before this
notice.
If we told you your other supportive service payments will stop, you will not get any more payments, even if you
go to your activity.
If we told you we will pay your other supportive services, they will be paid in the amount and in the way we told
you in this notice.
• To get those supportive services, you must go to the activity the county told you to attend.
• If the amount of supportive services the county pays while you wait for a hearing decision is not enough
to allow you to participate, you can stop going to the activity.
CAL-LEARN:
• You cannot participate in the Cal-Learn program if we told you we cannot serve you.
• We will only pay for Cal-Learn supportive services for an approved activity.
OTHER INFORMATION
Medi-Cal Managed Care Plan Members: The action on this notice may stop you from getting services from
your managed care health plan. You may wish to contact your health plan membership services if you have
questions.
Child and/or Medical Support: The local child support agency will help collect support at no cost even if you
are not on cash aid. If they now collect support for you, they will keep doing so unless you tell them in writing
to stop. They will send you current support money collected but will keep past due money collected that is
owed to the county.
Family Planning: Your welfare office will give you information when you ask for it.
Hearing File: If you ask for a hearing, the State Hearing Division will set up a file. You have the right to see
this file before your hearing and to get a copy of the county’s written position on your case at least two days
before the hearing. The state may give your hearing file to the Welfare Department and the U.S. Departments
of Health and Human Services and Agriculture. (W&I Code Sections 10850 and 10950).
NA BACK 9 (Replaces NA BACK 8 And EP 5) (12/17)
Page 1 of 2
Required Form – No Substitute Permitted
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