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Home My WebLink AboutMINUTES - 01181994 - H.4 H.4 M THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on January 18. 1994 by the following vote: AYES: Supervisors Smith, Bishop, McPeak and Powers NOES: None ABSENT: Supervisor Torlakson ABSTAIN: None ----------------------------------------------------------------- ----------------------------------------------------------------- SUBJECT: Hearing On Appeal From Administrative Decision Rendered On General Assistance Benefits Filed By Jess James This is the time heretofore noticed by the Clerk of the Board of Supervisors for hearing on the appeal from administrative decision rendered on General Assistance benefits filed by Jess James . Jewel Mansapit, General Assistance Program Analyst, Social Service Department, advised of a request for a continuance of this hearing. IT IS BY THE BOARD ORDERED that the hearing on the above matter is CONTINUED to January 25, 1994 at 2 : 00 p.m. I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Sup isors on the date shown. ATTESTED: le, M4 PHIL CHELOR Jerk of the Board o pe and County ministrator Orig. Dept . : Clerk of the Board By ,Deauty CC : Social Service Department Appeals Unit Program Analyst County Counsel County Administrator Jess James Contra Costa Legal Services Foundation Attn: Eleanor Madrigal TO: Board of Supervisors FROM: Perfecto Villarreal, Director Social Service Department DATE: January 18, 1994 SUBJECT: APPEAL OF GENERAL ASSISTANCE EVIDENTIARY . HEARING DECISION BY DARRIN THOMPSON SPECIFIC REQUEST(S) OR RECOMMENDATIONS AND BACKGROUND AND JUSTIFICATION RECOMMENDATION: That the Board dismiss Darrin Thompson's appeal of the General Assistance Hearing decision. BACKGROUND: Claimant filed request for Hearing on September 14, 1993. The .Hearing was scheduled for October 28, 1993. The claim was denied. The Social Service Department has granted Mr. Thompson's claim, making this appeal moot. Signature: 10 7� Utz ACTION OF BOARD ON January 18 , 1994 APPROVED AS RECOMMENDED x OTHER On January 11 , 1994 , there being no quor.um present, the .Clerk of the Board of Supervisors continued to this date the hearing on the above ..appeal . idweI'-M&f§2iprt, GA Program Analyst, Social Service Department, appeared and presented the department recommendation. The appellant did not appear. IT IS BY THE BOARD ORDERED that the above recommendation is APPROVED; and the appeal by Darrin Thompson is DISMISSED. VOTE OF SUPERVISORS x UNANIMOUS (ABSENT V ) AYES: NOES ABSENT ABSTAIN Contact: Jewel Mansapit, 313-1601 Original: I HEREBY CERTIFY THAT THIS IS A CC: Social Service Dept. TRUE AND CORRECT COPY OF AN ACTION Program Analyst TAKEN AND ENTERED ON THE MINUTES Appeals Unit County Counsel OF THE BOARD OF SUPERVISORS Darrin Thompson ON THE DATE SHOWN. County Administrator ATTESTED January 18 , 1994 PHIL BATCHELOR, CLERK OF THE BOARD OF SUPERVISORS AND CO NTY ADMINISTRATOR BY , DEPUTY H. ,3 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 11, 1994 In The Mater of Appeal Of ) General Assistance Evidentiary ) Hearing Decision by ) Darrin Thompson. ) This is the time heretofore noticed by the Clerk of the Board of Supervisors for hearing on the appeal by Darrin Thompson from a General Assistance Evidentiary hearing decision. The Clerk having ascertained there was not a quorum of . the Board of Supervisor present, continued the hearing on the above matter to January 18, 1994 at 2 :30 p.m in the Board chambers . 1 1,ereby certify that this is a true and correct COPY Of an action taken and entered on the minutes of the Board of Su rvisors on the date shown. ATTESTED: PHIL TCHELO Jerk of the Board Su ora and unty Administrator a BY .DeoutY cc : Social Service Department Appeals Unit Program Analyst County Counsel County Administrator Darrin Thompson CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 7, 1993 Appeals and Complaints Division and Program Analyst i FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT:New hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By Darren Thompson Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by December 7, 1993, plus any information which your department may wish to file for the Board appeal which is set for 2 :30 p.m. on Tuesday, January 11, 1994 . Attachment cc: Board members County Administrator i County Counsel The Board of Supervisors Contra Cerkko�h'eoard end County Administration Building �+ta County Administrator Co ( 651 Pine St, Room 106 Costa (510)646-2371 Martinez, California 94553 County Tom powers,1st District Melt Smith,2nd District Gayle Bishop,3rd District /�"�.L Sunne Wright McPeak 4th District ;� ` • Tom Tortakson,5th District December 7, 1993 rT,�_c6iit:t' Darren Thompson 1648 Elda Court Pleasant Hill, CA 94523 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 11, 1994 . In accordance with Board of Supervisor Resolution No. 92/554, your written presentation and all relevant material pertaining to the appeal must be filed with the Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure. Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Admi ' strat BX-AAd y00 J n Cer i, Deputy Clerk Enclosure cc: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator SOCIAL SERVICE DEPARTMENT CONTRA COSTA COUNTY December 2, 1993 c.c. : Jewell Mansapit G.A. Program Manager TO: Ann, Clerk of the Board of Supervisors FROM: Kate Quisenberry, Appeals Officer of the Day SUBJECT: Request for Board Appeal Darren Thompson Mr. Thompson filed his appeal for Board Hearing with our office todaty (12/2/93) . Attached is his Board Hearing request and a copy of the Hearing Decision which he is appealing. ERECE' FED VE K E3 19:93 BOARD 70F SUPERVISORS — CONTRA COSTA CO. Gen 9c (New 3/86) aocial Service Department Contra Please rev-. < Costa :0=;uglas Dive erteclo Villarreal t,a*.•nez.Ca!dornia 94553-4055 rectc County ;.♦♦<.,::�Est :� Y 'T tUl'�t EVIDENTIARY HEARING DECISION IN THE MATTER OF: County 107-09-485363-A4AC Darrin Thompson, Claimant Date of County Notice: 09-03-93 1648 Elda Ct. Effective Date of Action: 08-03-93 Pleasant Hill, CA 94523 Filing Date: 09-14-93 Hearing Date: 10-28-93 Aid Paid Pending: no Appeals Officer: Charl Chapman Income Maintenance Representative: Simone St. Germine Witness: Scott Rummel Place of Hearing: Martinez ISSUE Whether the claimant is ineligible for a six months due to allegedly falsified application. STATEMENT OF FACTS COUNTY ACTION AND POSITION: By September 3, 1993, Notice of Action, County denied claimant's General Assistance application, based on a finding that he had provided fraudulent information relative to his housing and, would not be eligible for a six month period. County action was based on an "Early Fraud" report by L. Sarcos, who made a home call to claimant's father's house on August 31, 1993, and stated in the report claimant was found there, apparently in an intoxicated state. Said report went on to note that, on the following day, Sarcos spoke with an officer, Kirk Haskell, of the Pleasant Hill Police, who seemed to be quite used to picking up the client in an intoxicated state. Haskell stated his opinion to Sarcos that claimant resided with his father. CLAIMANT'S POSITION: Claimant stated he frequently went to his father's but he did not live there. Witness Scott Rummel testified this was the case and stated they both essentially lived nowhere in particular, but did • Evidentiary Hearing Decision barrin Thompson, Claimant Page 2 sometimes clean up at his father's. Claimant stated that, as far as Officer Haskell was concerned, he acknowledged a number of contacts with the police department; he stated he did give them William Thompson's address to avoid being vagrant. He submitted the California Driver's License (for signature evidence) along with an apparent letter for William Thompson, dated October 27, 1993, stating claimant has not resided at William Thompson's since the spring of 1993. It noted claimant neither worked nor paid William rent. REASON FOR DECISION While the hearing officer does not doubt that the report of L. Sarcos is a valid report of her observation and experience, neither she nor Officer Haskell were present at the hearing. Therefore, the report is merely second and third level hearsay and is not given substantial weight, since it is directly and adequately rebutted by the testimony of Rummel, the claimant, and the father's direct letter. Since Officer Haskell's comments to the investigation dealt with an opinion based on time passed, his direct testimony would have been of little use in any case. ORDER The claim is granted. A six month ineligibility period does not apply. Claimant may reapply immediately and be granted as otherwise eligible. Social Service A eals Officer Dat Program Manager, Appeals Date CC:nf If you are dissatisfied with this Decision, you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be filed in writing with the Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553 within thirty (30) days of the date of the Evidentiary Hearing Decision. No further aid' is paid pending a Board of Supervisors appeal . 1 AV ct , ,� X� e1 Q Y� D C�► �.i[4 [Y. a opikoiL 000, a 2 4� ��99 CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 7, 1993 i Appeals and Complaints Division and i Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT:New hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By I Darren Thompson Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by December 7, 1993 , plus any information which your department may wish to file for the Board appeal which is set for 2 :30 p.m. on Tuesday, January 11, 1994 . Attachment cc : Board members County Administrator County Counsel The Board of SupervisorsContra Phil ofthe Batchelor and County Administration BuildingCota County Administrator Costa 651 Pine St., Room 106 J (510)646-2371 Martinez, California 94553 County Tom Powers,1st District Jeff Smith,2nd District SE Gayle Bishop,3rd District Sunne Wright McPeak 4th District %+ Tom Torlakson,5th District i December 7, 1993 ^°T COUP `Ty Darren Thompson 1648 Elda Court Pleasant Hill, CA 94523 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 11, 1994 . In accordance with Board of Supervisor Resolution No. 92/554 , your written presentation and all relevant material pertaining to the appeal must be filed with the Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure . Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Admin' strat By J n Cer i, Deputy Clerk Enclosure cc : Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator SOCIAL SERVICE DEPARTMENT CONTRA COSTA COUNTY December 2, 1993 c.c. : Jewell Mansapit G.A. Program Manager TO: Ann, Clerk of the Board of Supervisors FROM: Kate Quisenberry, Appeals Officer of the Day SUBJECT: Request for Board Appeal Darren Thompson Mr. Thompson filed his appeal for Board Hearing with our office todaty (12/2/93) . Attached is his Board Hearing request and a copy of the Hearing Decision which he is appealing. F RECEIVED! 3 IN3 iWARD OF SUPERVISORS L.� CONTRA COSTA CO. Gen 9c (New 3/86) se )ocial Service Department Contra �1eacugla Drive R -�=;Ugla�^t,ve eriectaVillarreal { ('�C}� t•lar,mez.Ca:,iorn,a9-X53-spSE IC! V1.1s?t County ��= 4 EVIDENTIARY HEARING DECISION IN THE MATTER OF: County 107-09-485363-A4AC Darrin Thompson, Claimant Date of County Notice: 09-03-93 1648 Elda Ct. Effective Date of Action: 08-03-93 Pleasant Hill, CA 94523 Filing Date: 09-14-93 Hearing Date: 10-28-93 Aid Paid Pending: no Appeals Officer: Charl Chapman Income Maintenance Representative: Simone St. Germine Witness: Scott Rummel Place of Hearing: Martinez ISSUE Whether the claimant is ineligible for a six months due to allegedly falsified application. STATEMENT OF FACTS COUNTY ACTION AND POSITION: By September 3, 1993, Notice of Action, County denied claimant's General Assistance application, based on a finding that he had provided fraudulent information relative to his housing and, would not be eligible for a six month period. County action was based on an "Early Fraud" report by L. Sarcos, who made a home call to claimant's father's house on August 31, 1993, and stated in the report claimant was found there, apparently in an intoxicated state. Said report went on to note that, on the following day, Sarcos spoke with an officer, Kirk Haskell, of the Pleasant Hill Police, who seemed to be quite used to picking up the client in an intoxicated state. Haskell stated his opinion to Sarcos that claimant resided with his father. CLAIMANT'S POSITION: Claimant stated he frequently went to his father's but he did not live there. Witness Scott Rummel testified this was the case and stated they both essentially lived nowhere in particular, but did Evidentiary Hearing Decision barrin Thompson, Claimant Page 2 sometimes clean up at his father's. Claimant stated that, as far as Officer Haskell was concerned, he acknowledged a number of contacts with the police department; he stated he did give them William Thompson's address to avoid being vagrant. He submitted the California Driver's License (for signature evidence) along with an apparent letter for William Thompson, dated October 27, 1993, stating claimant has not resided at William Thompson's since the spring of 1993. It noted claimant neither worked nor paid William rent. REASON FOR DECISION While the hearing officer does not doubt that the report of L. Sarcos is a valid report of her observation and experience, neither she nor Officer Haskell were present at the hearing. Therefore, the report is merely second' and third level hearsay and is not given substantial weight, since it is directly and adequately rebutted by the testimony of Rummel, the claimant, and the father's direct letter. Since officer Haskell's comments to the investigation dealt with an opinion based on time passed, his direct testimony would have been of little use in any case. ORDER The claim is granted. A six month ineligibility period does not apply. Claimant may reapply immediately and be granted as otherwise eligible. xx Social Service Aprj5eals officer .DA V;�Ogram Manager, Appeals Date CC:nf If you are dissatisfied with this Decision, you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be filed in writing with the Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553 within thirty (30) days of the date of the Evidentiary Hearing Decision. No further aid is paid pending a Board of Supervisors appeal . =vdr+t -Z L 7J7 467' _ .�.. Ajuv. L�- 47Aq ----- a ` LA 419g c.w.c.wc.wr ROUTESUP TO: `�� '.- !� P[1� DATE: Mese Check Correct Ad**= � p A. 30 Muir Road,Martinez p x, 40 Douglas Dr.,Martinex [3 T. 1340 ArnoldDrive02"Allartinex O Admimistrotim tTra�Aooaahl C) M. 2SOO Alhambra Aw..Martlnez O A<N AVW4yon" C) c. 4S45 Delta fair,Antioch O p w. 3431 Macdonald Ave.,Rich. O 1 �''Martinez p N. 130S Macdonald Ave.,Richriand p x. 2301 Stanwell Dr.,Concord p o. 304S Research Dr.,Richmond lCowalind Closed two C3 c. 3630 San Pablo Dam Rd..91 Sob. O V. 2f4SOn SWfwmU Dr.,Concorc E3 R. 52S Second Sueet,.Rodeo ' C1 r. 330.2Sth Street,Richmond(MQ .OTHER DIPARTIAENTI MART1NMt p Audita Koneroaer p DA Ealallr Supvolt "p Count A'"i wctrata O W01106SOMM O—� O DAtAtrettloNioee i p RM Manloget" t p NaNtb s"" O Dela Pmom"Se vw O cou"eon O COW41twpm O Prohetion p Alternate Oehnda► O w.rr°I � O O tomer ftnonw O CCC tlialth Plea O_ O CONtow WALNUT CUEtK` 1111121111101110, ANE110.E.coUR C3 Central Services O OHw 01 llwanw CoYectba 01hiOYc Desendw .93 Antioch Q Iubk Det•nder Q O O Rkkmwd O O MerWtet p OTHER: al ❑ lkequested !QQ O Nec murvAction NOTE I O Return ❑ Discussed O lntotmatim O Discard O O .w O Approwl/Spnetun COMMENTS I FROM: TEIEPMONE NUM N I ,_. APPEALS 3..1790 A. SOCIAL SERVICE DEPARTMENT CONTRA COSTA COUNTY December 2 , 1993 c.c. : Jewell Mansapit G.A. Program Manager TO: Ann, Clerk of the Board of Supervisors FROM: Kate Quisenberry, Appeals Officer of the Day SUBJECT: Request for Board Appeal Darren Thompson Mr. Thompson filed his appeal for Board Hearing with our office todaty (12/2/93) . Attached is his Board Hearing request and a copy of the Hearing Decision which he is appealing. CEIVEW D F."C 3 1993 CWRK BOARD{ SUPERVISORS CONTRA COSTA CO. Gen 9c (New 3/86) Social Service Department Contra P!e ;Serer-. Perfecto Villarreal (� t� %Iar,,nez.C.F:aornia 9_553-»t?6S Cos L County J EVIDENTIARY HEARING DECISION IN THE MATTER OF: County 107-09-485363-A4AC Darrin Thompson, Claimant Date of County Notice: 09-03-93 1648 Elda Ct. Effective Date of Action: 08-03-93 Pleasant Hill, CA 94523 Filing Date: 09-14-93 Hearing Date: 10-28-93 Aid Paid Pending: no Appeals Officer: Charl Chapman Income Maintenance Representative: Simone St. Germine Witness: Scott Rummel Place of Hearing: Martinez ISSUE Whether the claimant is ineligible for a six months due to allegedly falsified application. STATEMENT OF FACTS COUNTY ACTION AND POSITION: By September 3, 1993, Notice of Action, County denied claimant's General Assistance application, based on a finding that he had provided fraudulent information relative to his housing and, would not be eligible for a six month period. County action was based on an "Early Fraud" report by L. Sarcos, who made a home call to claimant's father's house on August 31, 1993, and stated in the report claimant was found there, apparently in an intoxicated state. Said report went on to note that, on the following day, Sarcos spoke with an officer, Kirk Haskell, of the Pleasant Hill Police, who seemed to -be quite used to picking up the client in an intoxicated state. Haskell stated his opinion to Sarcos that claimant resided with his father. CLAIMANT'S POSITION: Claimant stated he frequently went to his father's buz he did not live there. Witness Scott Rummel testified this was the case and stated they both essentially lived nowhere in particular, but did Evidentiary Hearing Decision Darri'n Thompson, Claimant Page 2 sometimes clean up at his father's. Claimant stated that, as far as Officer Haskell was concerned, he acknowledged a number of contacts with the police department; he stated he did give them William Thompson's address to avoid being vagrant. He submitted the California Driver's License (for signature evidence) along with an apparent letter for William Thompson, dated October 27, 1993, stating claimant has not resided at William Thompson's since the spring of 1993 . It noted claimant neither worked nor paid William rent. REASON FOR DECISION While the hearing officer does not doubt that the report of L. Sarcos is a valid report of her observation and experience, neither she nor officer Haskell were present at the hearing. Therefore, the report is merely second and third level hearsay and is not given substantial weight, ight, since it is directly and adequately rebutted by the testimony of Rummel, the claimant, and the father's direct letter. Since officer Haskell's comments to the investigation dealt with an opinion based on time passed, his direct testimony would have been of little use in any case. ORDER The claim is granted. A six month ineligibility period does not apply. Claimant may reapply immediately and be granted as otherwise eligible. Social Service Api6eals Officii—rDat — Program Manager, Appeals Date CC:nf If you are dissatisfied with this Decision, you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be filed in writing with the Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553 within thirty (30) days of the date of the Evidentiary Hearing Decision. No further aid is paid pending a Board of Supervisors appeal . W �r- P TO: Board of Supervisors FROM: Perfecto Villarreal, Director Social Service Department DATE: January 18, 1994 SUBJECT: APPEAL OF GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION BY ODIS HARPER SPECIFIC REQUEST(S) OR RECOMMENDATIONS AND BACKGROUND AND JUSTIFICATION RECOMMENDATION: That the Board deny Odis Harper's appeal of the General Assistance Hearing decision. BACKGROUND: Claimant filed request for Hearing on November 1, 1993.The Hearing was scheduled for November 17, 1993. The claim was denied. Signature: lz&helz� ACTION OF BOARD ON January 18 , 1994 APPROVED AS RECOMMENDED x OTHER On January 11 , 1994 , there being no quorum present, the Clerk of the Board of Supervisors continued to this date the hearing on the appeal by Odis Harper from the General Assistance Evidentiary Hearing decision. Jewel Mansapit, GA Program Analyst, Social Service Department, presented the staff recommendation. The appellant did not appear to testify. The hearing was closed. IT IS BY THE BOARD ORDERED that the above recommendation is APPROVED: and the appeal by Odis Harper from the General Assistance Evidentiary Hearing decision is DENIED. VOTE OF SUPERVISORS _X UNANIMOUS (ABSENT V ) AYES: NOES ABSENT ABSTAIN Contact: Jewel Mansapit, 313-1601 Original: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION cc: Social Servide Dept. TAKEN AND ENTERED ON THE MINUTES Program Analyst OF THE BOARD OF SUPERVISORS Appeals se County Counnsell ON THE DATE SHOWN. County Administrator Odis Harper ATTESTED January 18 , 1994 PHIL BATCHELOR, CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR BY 0 00DEPUTY H. THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 11, 1994 In The Mater of Appeal Of ) General Assistance Evidentiary ) Hearing Decision by ) Odis Harper ) This is the time heretofore noticed by the Clerk of the Board of Supervisors for hearing on the appeal by Odis Harper from a General Assistance Evidentiary hearing decision. The Clerk having ascertained there was not a quorum of the Board of Supervisor present, continued the hearing on the above matter to January 18, 1994 at 2 :30 p.m in the Board chambers. I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Su ism on the date shown. ATTESTED: PHIL CHELOR Clerk of the Board of pe so nd COun Administrator lj�By `� ,DeDuty cc : Social Service Department Appeals Unit Program Analyst County Counsel County Administrator Odis Harper I CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 10, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT:New hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By Odis Harper ------------- ---- ------- ------------- Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by December 7, 1993 , plus any information which your department may wish to file for the Board appeal which is set for 2 :30 p.m. on Tuesday, January 11, 1994 . Attachment cc: Board members County Administrator County Counsel The Board of Supervisors Contra CPr"othe Booard and County Administration Building Costa County Administrator 651 Pine St., Room 106 (510)646-2371 Martinez, California 94553 County Tom Powers,1st District J Jeff Smith,2nd District E Gayle Bishop,3rd District Sunne Wright McPeak 4th District �. Tom Tortakson,5th District 4-440 December 10, 1993 , Couh oma.. Mr. Odis Harper 248 S. 33rd Street Richmond, CA 94804 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 11, 1994 . In accordance with Board of Supervisor Resolution No. 92/554, your written presentation and all relevant material pertaining to the appeal must be filed with the Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure. Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Admini rat BPo Y Cervelli, eputy Clerk Enclosure CC: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator ocia( Service DepartmerlL Contra Please reply to: rfecto Villarreal Costa 40 Douglas Drive mfor Martinez,California 94553-4068 .r County EOARD ECEIVED OF SUPERVISORS NTRA COSTA CO. EVIDENTIARY HEARING DECISION: NOTICE OF DISMISSAL IN THE MATTER OF: County #07-506312-W4JC Date of 'Notice: 10/19/93 Mr. Odis Harper Date of Action: 10/31/93 3614 Ohio Ave, Filing Date: 10/1/93 Richmond, CA 94804 Hearing Date: 11/17/93 Aid Paid Pending? YES STATEMENT OF FACTS An Evidentiary Hearing was scheduled for November 17, 1993 . Claimant was duly notified of the date, time and place of Hearing via' letter November 5, 1993. Claimant failed to appear for the Evidentiary Hearing; no postponement was requested. REASONS FOR THE DECISION Department Manual Section 22-300, V, A, 3 states that if claimant fails to appear for an Evidentiary Hearing without previously arranging for a postponement, the claim may be dismissed. The originally proposed action shall take place immediately upon dismissal. ORDER The claim is dismissed as claimant failed to appear for the Evidentiary. Hearing. The benefits shall be discontinued as proposed in the Notice. If you are dissatisfied with the order of this Decision, you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be filed in writing with the Clerk of the Board, 651 Pine Street, Martinez, 94553. Appeals must be filed within fourteen (14) days of the date of the Evidentiary Decision. No further aid paid pending a Board of Supervisors appeal. Date: November 22 , 1993 Carole Allen Social Service Appeals Officer CA:gs -___-- o' , THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,CALIFORNIA Adopted this Order on August 4,M2 by the following vote: • AYES: Supervisors Fanden, Schroder, Torlakson, Weak NOES: None ABSENT: Supervisor Pavers ABSTAIN: None s:sssssssssssssssss,sssssss=ssssesess=ssss=sass==s==== r SUBJECT: General Assistance Hearing } Resolution Number 92/554 and Appea] Procedures } The Contra Costa County Board of Supervisors RESOLVES that the provisions of Resolutions No. 74/365,75/28, 87/468, and 88/576 which established standards for General Assistance Hearings and Appeals are bereby superseded effective September 1, 1992: Part i Hearings 101. General Assistance applicants shall be given written notice of action to deny an application. 102. General Assistance recipients shall be given written notice,mailed at least 10 days prior to the effective date, of proposed action which will reduce, suspend or terminate his or her General Assistance grant for cause.Prior notice is not required for action resulting from Board of Supervisors' changes in grant levels. 103. A General Assistance applicant or recipient shall receive a Social Service Department bearing upon their timely written request. (a) The applicant or recipient must deliver or mail a written request for a bearing within fourteen days of the date the Notice of Action was mailed. Absent evidence to the contrary,the notice is presumed to have been mailed on the date it bears, and a request for a bearing is presumed to have been delivered on the date it is received and mailed on the date it is postmarked. 104. Where a GA recipient timely requests a bearing challenging a proposed action which will reduce, suspend or terminate his or her General Assistance grant, the proposed action will be stayed until a decision is rendered. (a) Actions implementing Board of Supervisor changes in grant levels are not appealable, and • bearing requests based thereon may be summarily denied. 105. Hearings will be scheduled within thirty days of the date of receipt of a request for a bearing. The Appeals Unit will mail a written notice of the bearing to the claimant at least ten days in advance of the Hearing date. 106. When a request for a bearing has been received,the claim may be reviewed and resolved in the claimant's favor by a pre-bearing review. (a) Proposed pre-bearing resolutions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager. 107. if the claimant is unable to attend the bearing at the originally scheduled date and time, and a timely request for postponement is made,the Hearing Officer will make an evaluation of the request.The bearing will not be continued beyond the bearing date unless authorized by a Hearing Officer on one of the following grounds,which require verification: (a) bearing is continued at request of the Social Service Department, qft" .r►,r W"M^1L. ILTrVLinren w^tP• (b) mandatory court appearance which cannot be accommodated by adjusting the bearing time, (c) illness which prevents travel, (d) death in the immediate family, (e) other substantial and compelling reason. (as approved by the Appeals Manager) 108. Decision (a) A written derision shall be mailed to the claimant within thirty days after the bearing record is dosed,unless the Department extends the time in writing,for cause. (b) Proposed decisions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager prior to notification of the claimant.'1be Hearing Officer's findings of fact are not subject to change,but the General Assistance Policy Manager may order re- ' bearing for cause. Part 2 Appeals to the Board 202. The applicant or recipient may appeal an adverse bearing decision to the Board of Supervisors. 202. A written appeal must be received by the C3erk of the Board of Supervisors within fourteen days after the decision has been mailed to the claimant.Absent evidence showing the contrary, a bearing decision is presumed to have been mailed on the date it bears. (a) An appeal to the Board will not stay the implementation of the Hearing decision, and the recipient shall not be entitled to continue to receive assistance pending further bearing. (b) The appeal will be scheduled for the first available Board meeting,but no earlier than the third meeting following receipt of the appeal. 203. The Administrative Review Panel may review appeals of Hearing decisions and recommend proposed action to the Director. ; (a) If the Director supports the bearing decision,the Appeals unit will be notified to proceed with the presentation to the Board. (b) If the Director finds in favor of the claimant,the Qerk of the Board will be notified to withdraw the item from the Board agenda The appropriate Social Service District office will be advised to take corrective action. 204. Both the appellant and the Department must fate all written materials at beast one week before the date set for the Board bearing.New material must be served by mad on the opposing party. 20' 5. (a) Upon bearing the appeal, the Board sball make any required fact determinations based on the record on appeal and testimony received by the Board.Ibis record shall include the Department's Hearing Officer's fact findings,plus any papers filed with that Officer. (b) If the facts upon which the appeal is based are not in dispute or if any disputed facts are not relevant to the issue ultimately to be decided by the Board,the Board will proceed immediately to the next step without considering fact questions.The parties may stipulate to an agreed set of facts. RESOLUTION NN'L MBER 12/L54 206. (a) Once the farts are determined,or if there are no fact determinations required by the appeal, • the Board will consider legal issues presented by the appeal. Legal issues are to be framed, insofar as possible,before the Hearing and &ball be based on the Department's Hearing Officer's derision and such other papers as may be filed. (b) Appealing parties may make legal arguments both by written brief and orally before the Board. If the issues are susceptible of immediate resolution,the board may immediately deride them at the appeal bearing. If the County Counsel's advice is needed on legal questions, the Board may take the matter under submission,reserving its final judgment until it receives such advice. 207. The Board may decide an appeal immediately after bearing or take the appeal under xsubmission. 1 tWWY or"IM wr r.to w0 MR"am Of a, W.qn Sksm and 0AMb M "0" O' " Dow d$UP» .Z. ATTf&� WW'��Of VO S"FG&OW@ r RESOLUTION NUMBER 92/jL CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 10, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT:New hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By Odis Harper Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by December 7, 1993 , plus any information which your department may wish to file for the Board appeal which is set for 2 : 30 p.m. on Tuesday, January 11, 1994 . Attachment cc : Board members County Administrator County Counsel Social• Seirvice DepartmeraCOnti- Please reply to: 'erfecto Villarreal �� 40 Douglas Drive hrector Martinez.California 94553-4068 County -~� RECEIVED 7.13 CLERK 80ARD OF SUPERVISORS `+ CONTRA COSTA C0.... EVIDENTIARY HEARING DECISION: NOTICE OF DISMISSAL IN THE MATTER OF: County #07-506312-W4JC Date of Notice: 10/19/93 Mr. Odis Harper Date of Action: 10/31/93 3614 Ohio Ave. Filing Date: 10/1/93 Richmond, CA 94804 Hearing Date: 11/17/93 Aid Paid Pending? YES STATEMENT OF FACTS An Evidentiary Hearing was scheduled for November 17, 1993 . Claimant was duly notified of the date, time and place of Hearing via letter November 5, 1993. Claimant failed to appear for the Evidentiary Hearing; no postponement was requested. REASONS FOR THE DECISION Department Manual Section 22-300, V, A, 3 states that if claimant fails to appear for an Evidentiary Hearing without previously arranging for a postponement, the claim may be dismissed. The originally proposed action shall take place immediately upon dismissal. ORDER The claim is dismissed as claimant failed to appear for the Evidentiary. Hearing. The benefits shall be discontinued as proposed in the Notice. If you are dissatisfied with the order of this Decision, you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be filed in writing with the Clerk of the Board, 651 Pine Street, Martinez, 94553 . Appeals must be filed within fourteen (14) days of the date of the Evidentiary Decision. No further aid paid pending a Board of Supervisors appeal. Date: November 22 , 1993 Carole Allen Social Service Appeals Officer CA:gs 0 O`er 00� Z S y � W Z Q to "> cn O O A ' m m � Cl o0 Z C> 00 in C3 rn C) y �' 44 y o� � '� vn 4�, i„, Z G.h .-A ?' CO _ Z m goo 1 G C7 (n 7 ol ..:,�y k 6• y Anil'"�. - TO: Board of Supervisors FROM: Perfecto Villarreal, Director Social Service Department DATE: January 18, 1994 SUBJECT: APPEAL OF GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION BY JAMES LINCOLN SPECIFIC REQUEST(S) OR RECOMMENDATIONS AND BACKGROUND AND JUSTIFICATION RECOMMENDATION: That the Board deny James Lincoln's appeal of the General Assistance Hearing decision. BACKGROUND: Claimant filed request for Hearing on September 29, 1993. The Hearing was scheduled for October 26, 1993. The claim was denied. Signature: ACTION OF BOARD ON January 18 , 1994 APPROVED AS RECOMMENDED OTHER X On January 11 , 1994 , there being no quorum of the Board present, the Clerk of the Board continued to this date the hearing on the appeal by James Lincoln from the General Assistance Evidentiary Hearing decision. Jewel Mansapit, GA Program Analyst, Social Service Department, presented the staff report on the appeal , James Lincoln, the appellant, appeared and presented testimony in support of his appeal and he presented a letter in support of his testimony. Ms . Mansapit spoke in rebuttal . The hearing was closed. Supervisor Powers moved to grant the appeal . IT IS BY THE BOARD ORDERED that the appeal by James Lincoln from the General Assistance Evidentiary hearing decision is GRANTED. VOTE OF SUPERVISORS x UNANIMOUS (ABSENTy ) AYES: NOES ABSENT ABSTAIN Contact: Jewel Mansapit, 313-1601 Original: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES cc: Social Service Dept. OF THE BOARD OF SUPERVISORS Program Analyst ON THE DATE SHOWN. Appeals Unit County Counsel County Administrator ATTESTED January 18 , 1994 James Lincoln PHIL BATCHELOR, CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR BY , DEPUTY (H-3 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFO�mA January 11, 1994 In The Mater of Appeal of General Assistance Evidentiary Hearing Decision by James Lincoln This is the time heretofore noticed by the Clerk of the Board of Supervisors for hearing on the appeal by James Lincoln from a General Assistance Evidentiary hearing decision. The Clerk having ascertained there was not a quorum of the Board of Supervisor present, continued the hearing on the above matter to January 18, 1994 at 2 :30 p.m in the Board chambers. I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Su 1SOrS On the date shown, ATTESTED: 14 94 PHIL TCHELOR,(I�Ierk'of the Board 1 ofsupe IP�4"d M Administrator 13Y Deputy cc: Social Service Department Appeals Unit Program Analyst County Counsel County Administrator James Lincoln DOUBLE L JANITORIAL SERVICE TO WHOM IT MAY CONCERN: I operate a small janitorial service, and from time to time I 'm in need for additional help for various reasons. Dut to an emergency on August 18, 1993, I asked Mr. Lincoln to -come in for an interview and application review, to help with the emergency. Mr. Lincoln asked me to comment on, his where-abouts on this date. Sin rely, Linda Lockett 20824 MISSION BOULEVARD, Box 834 ' HAYWARD, CA 94541 , PFIONE• (510)632-7900 ' PACER(510)729-9230 4 A RTAN SA �Mp+D .M- Foa PATE M OF NUMBER _ pR,A CODECALL AGAtN . YELEPK4Ef} Yttt! SEE gus CGU IAL `«:'::;::':: ; SPEG �Lips ME58AGE ---�J-`SIGNeD ufHD tN V.B.A- lops FOSSA 3d02W December 6, 1993 Clerk CWED Contra Costa County Board of Supervisors t1 County Administration Building �� 651 Pine Street Martinez CA 94553 C�RK� Re: James Lincoln 4741 Hershey Court Richmond CA 94804 This is to appeal the evidentiary hearing decision of November 22, 1993 which affirmed the termination of his General Assistance or one month. Please schedule a Board hearing on this matter as s on as possible. Gimme ames Lincoln laimant RECEIVED .s� 7 QM BQARD OF SUPERVISORS COSTA CO. OCG � O N S -• cn � V 1 37 o c7e- � - rx s C!4 �R� int a Y�6Q«�.�a+baa CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 7, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT:New hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By James Lincoln Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by December 7, 1993 , plus any information which your department may wish to file for the Board appeal which is set for 2 :30 p.m. on Tuesday, January 11, 1994 . Attachment CC : Board members County Administrator County Counsel The 'Board of Supervisors Contra Ce'rkloftthe Board and County Administration BuildingCOSta County Administrator 651 Pine St., Room 106 (510)646-2371 Martinez, California 94553 County Tom Powers,1st District J Jett Smith,2nd District E t 0f- O Gayle Bishop,3rd District f _ Sunne Wright McPeak.4th District /, �,• Tom Torlakson,5th District December 7, 1993 CaUK `*y James Lincoln 4741 Hershey Court Richmond, CA 94804 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 11, 1994 . In accordance with Board of Supervisor Resolution No. 92/554 , your written presentation and all relevant material pertaining to the appeal must be filed with the Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure . Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Ad:4n ' tr for By O ell Deputy Clerk Enclosure cc: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator nyr DCi�!L/�II/F,� 12— ib'93 L�3:5O F'i� FROM CONTRA December 6, 1993 Clerk Contra Costa County Board of supervisors County Administration Building 651 Pine Street Martinez CA 94553 Re: James Lincoln 4741 Hershey Court Richmond CA 94804 i This is to appeal the evidentiary hearing decision of November 72, 1993 which affirmed the termination of his General Assistance or ane month. Please schedule a Board hearing on this matter as e on as possible. ames Lincoln laimant i IY DEC-67-1993 09:57 FROM SOCIAL SERVICE DEPT. TO 861059 P.03 Social Servic ' Department ,�f g► 5e rear;° Ma© Pertecfo YAtarr"l �S a Martinez. Drive C Martinez.CdiifCrnia 94553-;=^S teror County L AS TANC V.11V AG D SI IN HE R OF: James Lindoln, Claimant County #:46£898-W4NG 4741 Hershey court Date of County Notic:e:9-15-93 Richmond, Ca 94804 Effective Date of Action: 9-30-93 Filing Date:9-29-93 Hearing Date:iv-26-93 r Aid Paid Pending: yes Hearing -Officer: Ruby Molinari Income Ma ntenance Representative:Lee Weikert, IM Supervisor Place .of ]Fearing: Richmond, Ca SUE Whether tt a claimant had good cause for missing a GAADs meeting on 8-18-93. OPJ CMULANO FO The claimant has received General Assistance intermittently since 10-91. His most recent application was 3-24-93 at which time he signed a ` agreement to cooperate with all General Assistance requiremeits. On 9-7-93 the worker was notified that the claimant had failed a to attend a t reatment-planning group on '8-18-93. He had not presented a good cause reason for the failure so the county is proposing to discontinue General Assistance and impose a one month penalty. CL&I N Pos ON i The claim nt testifies his former GAADs counselor was a man named Max. IIe ,h- d talked with Max and explained that he was constantly job hunt" g and consequently would not be able to attend all the GAADs nee, ings. He was supposed to Gall Max when he missed a meeting a` d let him know the claimant had been job hunting. Max orally ag eed and this was the procedure which had been followed. DEC-07-1993 09:56 FROM . SOCIAL SEROICE DEPT. TO 861059 P.02 Max was tio longer his counselor but he assumed Max had passed along the infomation regarding the procedure to hid now counselor. The reco d was left open for the county representative to try to reach Malt to confirm the claimant's statements. Max is no longer employed by the CuunLy $0 no confirmation was received. R-EAS Departmeit Memorandum No. 193, dated 21/25/91,, provides that General ssistance recipients who are referred to the GAADS program must act vely and cooperatively purtivipate in the program once a referrallhas been 'made. Departme t manual section 49-112,I1 ,Ff provides for good cause reasons dor failure to cooperate with program requirements. ="VSjC,W The clainant, described a situation which , is contrary to all establisY ed procedures. Since his claim cannot be confirmed it must .i be denieV4. The county's discontinuance action and -imposition of a one mon.&-,a penalty is sustained. ORD The clain is denied go—c-ill Service Appeals Officer Date .LI Wo:cj4ramrl4anage ;' Appeals Date If you a, 0 dissatisfied with this decision you may appeal the matter directly to the Contra Costa County Board of Supervisors. . Appeals must be filed in writing with the Clerk of the Board, 651 Pinam -Strcet, Mart-Ana-z, CA, 94553. Appeals must be filed within fourteen , (14) , (14) days of the date of this SVIdentiary Hearing Decision.:' No furth 'r aid paid pending a Board of Supervisors appeal. CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 7, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT:New hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By James Lincoln Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by December 7, 1993 , plus any information which your department may wish to file for the Board appeal which is set for 2 : 30 p.m. on Tuesday, January 11, 1994 . Attachment CC : Board members County Administrator County Counsel December 6, 1993 Clerk Contra Costa County Hoard of Supervisors County Administration Building 651 Pine Street , Martinez CA 94553 Re: James Lincoln 4741 Hershey. Court Richmond CAi94804 This is to appeal the evidentiary hearing decision of November 22, 1993 which alffirmed the termination of his General Assistance or one month. 'Please schedule a Board gearing on this matter as s on as possible. amesc Lincoln laimant i ' DE C"0 09/57 , 7-1993 ��un' SOCIAL SERVICE DEPT. TO 861059 F.03 Social Servic Depart:ment Please reply 1c: Costa County James Lin oln' claimant County #:466898-W4NG 4741 Hers ey court! Date ot County Xotiue:9-15-93 Richmond, , Ca 94804 Effective Date of Action: 9-30-93 Filing DatO:9-29-93 Hearing Date:IU-26-93 Aid Paid Pending: yes cer Hearing-0 ficer: Ruby Molinari Place of I learing.* Richmond, Ca Whether te claimant had good cause for zissing a GAADs. meeting on The claimint has received General Assistance intermittently since 10-91. His most rp'taent application was 3-24-93 at which time he signed a ' agreenent to cooperate with all General Assistance requireme. s. On 9-7-93 Le work'b: r was notified that th.e claimant had failed a to attend a reatment-planning group on 8-18-93. He had not presented a 00d oa � oe reason for the failure so the county is proposing to discontint GenerAl Assistance and impose a one month penalty. The claim n testifies his former GAA'Ds counselor was a man named Max. Ile hidttalkcd: with Max and explained that he was constantly job hunti ' g and co' nsequently would not be able to attend all the GAADs nee: ings . �e was supposed to call Max when he missed a meetina a' d let him know tho claimant had been job !'iuntinq. Max orally ag eed and this was the procedure which had been followed. ' , TOTAL P.03 DEC---07-1993 09:56 FFROt ' SOCIAL SERUICE DEPT. TO 9E1059 P.02 Max was �0 longer ;his counselor but he assumed Max had passed along Lhe i"If0imation r:p'� qarding the procedure to hiz now counselor. The resod was 14ft open for the county representative to try to reach Mal to confirm the claimant's statements. Max is no longer employed!Iby trild uu' Unty $0 no confirmation was received. REASON D-FC T Q Tn'� M R I Departmek Memorindum No. 193, dated 11/25/91, provides that tme 11 General ssistance recipients who are referred to the GAADS program must aT0tve31y anal., cooperatively purtivipate in the program once a referral has been made. DepartmeZ t Manual SectiOn 49-112,11 ,F, prov.LUL-b for good cause reasons #or failurie to cooperate with program requirements. LUSIGN I *I The cla' ant described a situation which . is contrary to all establisSed procedures. Since his claim cannot be confirmwa it must be denie , - The county's discontinuance action and -imposition of a one mont penalty, is sustained. The clai is denied Soci l S rvice Appeals Officer Date Pr6gram Xanage1, Appeals Date-te If you ai e dissatisfied with this decision you may appeal the matter directly to the Contra Costa County Board of Supervisors. . Appeals must be filed in writing with the Clerk of the Board, 651 Pin* Strdet, Mart;jnaz, CA, 94553. Appeals must be filed within fourteen , (14) drays of the date of this Evidentiary Hearing Decisi No furthelaid paid pending a Board of Supervisors appeal . LAW+QE'�+ICES OF CONTRA COSTA A LEGAL SERVICES S FOUNDATION :� 1►4atli�Ca +� f 1017 Macdo"W Avonua Woo Couay(510)233 9954 P.O.Sm 2299 Bait�"iitlj 139-916d RMMMW,Wfim&94802 Ca"010)3724M Fax(S 10)2*4W ' ZLZCOPIER TRANSMISSION COVER XXXORANbUM DATE: TO: rIRMI FAX NO: 1� FROM: _ m l q TOTAL NUMBER OF PAGES (including cover sheet) : COHMZNTS s PLEASE DO ONE OR MORE OF TSE FOLLOWING: Please deliver immediately to the Recipient. Please request the Recipient to telephone the Bonder immediately upon receipt and review. Please have the Recipient verify receipt by telephone. Original will not follow. original will follow by (check one of the following) : Regular Mail Certified Xail, , Return Receipt Requested _,._. E$pressi Mail Federal Express Other: (FOR QUESTIONS CALL: (510) 233-9954) The information contained in this transmission is privileged and confidential. Tt is intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copy of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone and return the original message to us at the above address vis the U.S. Postal Service. Thank you. 601 DEC-07-1993 09:56 FROM SOCIAL SERUICE DEPT. TO 661059 P.01 i SOCIAL SERVICE DEPARTMENT CONTRA COSTA COUNTY SOCIAL. SERVICE DEPARTMENT 40 Douglas Drive Martinez, California 945534068 FAX Number: 51.0/31.3-1.575 FACSIMILE MESSAGE W-YER SHEET DATE: /.2- T- 13 DELIVER 0: -�.- - FROM: 'I' message contains _ pages, including the cover sheet For voice contact, call: (510) 313- 7 p REMARKS: i I Gen 9c (New 3/86) ------- nl_�i,�i.i -.. .,... .. _- LAW OT44 H2!OF CONTRA COSTA LEGAL SERVICES FOUNDATION Main Office Talephoeee 1017 Maudmald Aveme wet cawsl7(5!o)233-9454 . P.O.Sox 2289 Brut CS 10)43"166 XkhnkwW,Caliket a 94902 t7eatra!('F!0)372 104 Fax(510)2364" TBLECOPIER TRANSMISSION COvBR 1[EMO"MIUX DATE: f�'!p TO o VXRX: PAX NO: - r FROM: ' 9e W- � RL: G"t �-E:J TOTAL NUNBUR OF PAGES (including cover sheet) : -- COMMENTS: PLEASE DO ONE OR MORE Or THE POLLOWINGo Please deliver immediately to the Recipient. 'Please request the Recipient to telephone the Sender immediately upon receipt and review. Please have the Recipient verify receipt by telephone. Original will not follow. Original will follow by (check one of the following) Regular mail Certified Mau l, . Return Receipt Requested Express Mail Federal Express Other: (FOR QUESTIONS CALL: (510) 233-9954) The information contained in this transmission is privileged and confidential. It is intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copy of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone and return the original message to us at the above address via the U.S. Postal Service. Thank you. 604 -ti rr ,per , ,�- L' _ �' r iU li•i_ [december 6, 1993 Clerk Contra Costa County Board of Supervisors County Administration Building 651 Pine Street Martinez CA 94553 Re: James Lincoln 4741 Hershey Court Richmond CA 94804 This is to appeal the evidentiary hearing decision of November 22, 1993 which affirmed the termination of his General. Assistance or one month. Please schedule a Hoard hearing on this matter as �s on as possiblef�.. aures Lincoln laimant TO: -Board of'Supervisors FROM: Perfecto Villarreal, Director Social Service Department DATE: January 18, 1994 SUBJECT: APPEAL OF GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION BY MANUEL JARAMI LLO SPECIFIC REQUESTS) OR RECOMMENDATIONS AND BACKGROUND AND JUSTIFICATION RECOMMENDATION: That the Board deny Manuel Jaramillo's appeal of the General Assistance Hearing decision. BACKGROUND: Claimant filed request for Hearing on October 22, 1993. The Hearing was scheduled for November 29, 1993. The claim was denied. Signature: a ACTION OF BOARD ON January 18 , 1994 APPROVED AS RECOMMENDED OTHER x This is the time heretofore noticed by the Clerk of the Board for hearing on the appeal by Manuel Jaramillo from the General Assistance Evidentiary Hearing decision. Jewel Mansapit, .GA Program Analyst, Social Service Department, presented the department recommendation. Manuel Jaramillo, appellant, appeared and presented testimony in support of his appeal . Supervisor Smith moved to deny the appeal . The Board discussed the matter. Jewel Mansapit advised that the department would change its recommendation to grant the appeal . Supervisor Smith moved to grant the appeal . IT IS BY THE BOARD ORDERED that the appeal by Manuel Jaramillo from the General Assistance Evidentiary Hearing decision is GRANTED. VOTE OF SUPERVISORS x UNANIMOUS (ABSENTy ) AYES: NOES ABSENT ABSTAIN Contact: Jewel Mansap'it, 313-1601 Original: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES cc: Social Service Dept. OF THE BOARD OF SUPERVISORS Program Analyst ON THE DATE SHOWN. Appeals Unit County Counsel . County Administrator ATTESTED January 18 , 1994 Manuel Jaramillo PHIL BATCHELOR, CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR BY , DEPUTY �I a a • � f CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: January 4, 1994 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk A / Ann Cervelli, Deputy Clerk W-' SUBJECT: Hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By Manuel Jaramillo Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by January 11, 1994 plus any information which your department may wish to file for the Board appeal which is set for 2 :30 p.m. on Tuesday, January 18, 1994 . Attachment CC : Board members County Administrator County Counsel Batchelor The Board of Supervisor Contra ` Cerk`o the Board and County Administration BuildingCota County Administrator Costa 651 Pine St., Room 106 J (510)646-2371 Martinez, California 94553 County Tom Powers,1st District Jeff Smith.2nd District Gayle Bishop.3rd District `•i' 0^ Sunne Wright McPeaK 4th District —7 �•,• Tom Torlakson,5th District ni di< Y 11 yy January 4, 1994 ra_cd"u •t' Manuel Jaramillo C/o 30 Muir Road Martinez, CA 94553 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 .006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 18, 1994 . In accordance with Board of Supervisor Resolution No. 92/554, your written presentation and all relevant material pertaining to the appeal must be filed with the Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure. Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Adm' • strr By r I A At I OLO n C V'6111, Deputy Clerk Enclosure cc: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on August 4, 1992 by the following vote: AYES: Supervisors Fanden, Schroder, Torlakson, McPeak NOES: None ABSENT: Supervisor Powers ABSTAIN: None SUBJECT: General Assistance Hearing } Resolution Number 92/.554_ and Appeal Procedures } The Contra Costa County Board of Supervisors RESOLVES that the provisions of Resolutions No. 74/365, 75/28, 87/468, and 88/576 which established standards for General Assistance Hearings and Appeals are hereby superseded effective September 1, 1992: Part 1 Hearings 101. General Assistance applicants shall be given written notice of action to deny an application. 102. General Assistance recipients shall be given written notice, mailed at least 10 days prior to the effective date, of proposed action which will reduce, suspend or terminate his or her General Assistance grant for cause. Prior notice is not required for action resulting from Board of Supervisors' changes in grant levels. 103. A General Assistance applicant or recipient shall receive a Social Service Department bearing upon their timely written request. (a) The applicant or recipient must deliver or mail a written request for a bearing within fourteen days of the date the Notice of Action was mailed. Absent evidence to the contrary, the notice is presumed to have been mailed on the date it bears, and a request for a bearing is presumed to have been delivered on the date it is received and mailed on the date it is postmarked. 104. Where a GA recipient timely requests a bearing challenging a proposed action which will reduce, suspend or terminate his or her General Assistance grant, the proposed action will be stayed until a decision is rendered. (a) Actions implementing Board of Supervisor changes in grant levels are not appealable, and bearing requests based thereon may be summarily denied. 105. Hearings will be scheduled within thirty days of the date of receipt of a request for a bearing. The Appeals Unit will mail a written notice of the hearing to the claimant at least ten days in advance of the Hearing date. 106. When a request for a bearing has been received,the claim may be reviewed and resolved in the claimant's favor by a pre-bearing review. (a) Proposed pre-bearing resolutions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager. 107. If the claimant is unable to attend the bearing at the originally scheduled date and time, and a timely request for postponement is made,the Hearing Officer will make an evaluation of the request. The bearing will not be continued beyond the hearing date unless authorized by a Hearing Officer on one of the following grounds,which require verification: (a) bearing is continued at request of the Social Service Department, QFCAT.Tmn%., vTmmriD a,)xzd (b) mandatory court appearance which cannot be accommodated by adjusting the hearing time, (c) illness which prevents travel, (d) death in the immediate family, (e) other substantial and compelling reason. (as approved by the Appeals Manager) 108. Decision (a) A written decision shall be mailed to the claimant within thirty days after the bearing record is closed,unless the Department extends the time in writing,for cause. (b) Proposed decisions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager prior to notification of the claimant.The Hearing Officer's findings of fact are not subject to change,but the General Assistance Policy Manager may order re- bearing for cause. Part 2 Appeals to the Board 201. The applicant or recipient may appeal an adverse hearing decision to the Board of Supervisors. 202. A written appeal must be received by the perk of the Board of Supervisors v►ithin fourteen days after the decision has been mailed to the claimant.Absent evidence showing the contrary, a bearing decision is presumed to have been mailed on the date it bears. (a) An appeal to the Board will not stay the implementation of the Hearing decision, and the recipient shall not be entitled to continue to receive assistance pending further hearing. (b) The appeal will be scheduled for the first available Board meeting,but no earlier than the third meeting following receipt of the appeal. 203. The Administrative Review Panel may review appeals of Hearing decisions and recommend proposed action to the Director. (a) U the Director supports the bearing decision,the Appeals unit will be notified to proceed with the presentation to the Board. (b) U the Director finds in favor of the claimant, the Clerk of the Board will be notified to withdraw the item from the Board agenda.The appropriate Social Service District office will be advised to take corrective action. 204. Both the appellant and the Department must file all written materials at least one week before the date set for the Board bearing. New material must be served by mail on the opposing party, 205. (a) Upon hearing the appeal, the Board shalt make any required fact determinations based on the record on appeal and testimony received by the Board.This record shall include the Department's Hearing Officer's fact findings,plus any papers filed with that Officer. (b) U the facts upon which the appeal is based are not in dispute or if any disputed facts are not relevant to the issue ultimately to be decided by the Board, the Board will proceed immediately to the next step without considering fact questions.The parties may stipulate to an agreed set of facts. RESOLLMON NUMBER 92/3 206. (a) Once the facts,are determined, or if there are no fact determinations required by the appeal, • the Board will consider legal issues presented by the appeal.Legal issues are to be framed, insofar as possible,before the Hearing and &ball be based on the Department's Hearing Officer's decision and such other papers as may be filed. (b) Appealing parties may make legal arguments both by written brief and orally before the Board. if the issues are susceptible of immediate resolution,the board may immediately decide them at the appeal hearing. If the County Counsel's advice is needed on legal questions,the Board may take the matter under submission,reserving its final judgment until it receives such advice. 207. The Board may decide an appeal immediately after bearing or take the appeal under wsubmission. ear b a VW aae WV am CO aGtiOn 1akn+ and WWW on " p*u" of the aoaM of�,� an aia ear�,1992. Al1ES Ma of&OWW"Mvie eciert+ano BOOM RESaOLMON NUMBER 92/ 4 RECEIVED 3 100A CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. ._.1A�)' - �o �hEy o S��g1 hen fat k C.AA,P.P,5, o1v O6yvPsrx 4, X171'Jcl'7 1 GGllu& ,o sicp fovz G,'Ao ,AID , 56. 5-To( 6G1-f'3- . -ra CsAAV,,D,S , 1-/fm am goipq � Q �i��c4 r:lr6 Ins�- lyltv-W-, a //1 1'4' 64 - A P' I ddrl P6. c► V'�-k a cha c k �,p Ae , wk w- . kiosk AE tvMlc cn-�1� � ,�� r•�� h-� 1-3-1G� r +` Tease reply to: }tial Service Department Contra o Appeals Costa - (510) 313-1790 Perfecto-Villareal 40 Douglas Dr. Director C0U* Martinez, Ca. 94553 GENERAL ASSISTANCE EVIDENTIARY NEARING DECISION peals Officer: `"j Hearing Date: ace of Hearing: "artinez (3 Antioch ❑ Richmond le proceeding was tape recorded and all testimony and evidence was accepted under penalties of perjury. I THE MATTER OF: Case#07-13 D-soa�7 UN u V-( .�Q.(� t 110 Filing Date: 10 "f> C40 3 p JO L)M Aid Paid Pen3sng Nearing Yes ❑ No t Y `u<+w ems- Dateof Notice: Effective Date of Action: .i :SENT: Caimant County Representative(s): Authorized Repreientative(s): ❑ Witness(es): Other: M 'nON UNDER APPEAL: Denial 'Discontinuance ❑ Application Date ❑ Effective Date ❑ Notice of Action ❑ Notice of Action Period of Ineligibility My 2 A48 Employment Requlr fmtnts ; Unemployability Requirements ❑ Employability Assessmem [) Medical verification Q Job Search r,, Unemployability Assessment 0 %,"Jorl:tare C) AIRS assessment and panec+pation n Job QuIV f urtt lul cati-w ( Other: Q v410ft;shorr 0 Olh�t r- Good CEUse - - - -- GENERAL ASSISTANCE f9DENTIARY HEARING DECIS.100-Cont'd.) URISDICTION (DM 49-760: DM 49-701): Timely Filing of Appeal ❑ Challenge only to Regulation ❑ Untimely Filing of Appeal 0 issue Outside Scope of Program Period Expired: 0 Good Cause /IDENCE CONSIDERED : Claimant Testimony 0 Documentary County Testimony 0 GA 34 Cooperation Agreement Document Date: 0 Assessment Appointment Notice ❑ Work Programs Notice Other:(",FA) qf c q SPOSITIONAL FINDINGS/CONCLUSION, -we.evidence and testimony having been heard and considered.the following findings are reached: (Claimant receive A94 Fec-eive notice of the particular assignment under review r0aimant vvasAwwaecapable of understanding and meeting the particular assignment under revie;w.";, 0 1ducational - , 0 Physical 0 Emotional (DM 49=10211 B.) I Good Cause (DM 49-111 11 F Good Cause Exists Good Cause Does Not Exist 0 Employment has been obtained 0 Scheduled Job Interview or Testing 0 Mandatory Court Appearance 0 incarceration 0 Illness 0 Death in the Family 0 Circumstances beyond AoplicanVRecipient*s control Willfulness (DM 49.111 11 H) Willfulness Exists 0 Willfulness Does Not Exist' 0 Failure was deliberate ar-c intentional 0 County rescinded willfulness determination 0 failure wa\more than a s.ngle occurrence 0 County failed to provide sufficient evidence to 0 Failure was the result of intentional mistake/omission establish willfulness ❑ Failure was inoicative ol a pattern of non-cooperation ❑ Other FailLre uas ui&wt ca or ex=Ljse GENERAL ASSISTAN*EVIDENTIARY HEARING DECI�N(cont'd) SUMMARY OF FACT AND STATEMENT OF THE EVIDENCE: Claimant failed to attend the October 4, 1993 GAADDS appointment. Claimant stated he missed the appointment as he was told his Work Programs case had been closed for other failures. He was told this in September, 1993 and did not think he needed to go to GAADDS. He did receive his October GA check. The Notice of Action regarding the work program failure and stopping assistance was not issued until October 5, 1993 and he filed his hearing request on October 7, 1993. It is found that claimant did not have good cause for the failure and that it is willful as claimant has no reasonable excuse for failing to appear for the October 4, 1993 failure. ORDER: 79- Claim Denied: ❑ Claim Dismissed: Pir Aid shall be discontinued and the Period of Ineligibility imposed. ❑ Aid shall be discontinued. The Period of Ineligibility shall be expunged from the record. Claimant may reapply at any time. ❑ Claim Granted: ❑ General Assistance shall be restored. The proposed discontinuance is reversed. The Period of Ineligibility shall be expunged from the record. ❑ Other: L- Written copies of the Order were issued by 'mail 0 at Hearing ❑ Additional Regulatory Authority was attached to the foregoing Order Social Services Appea s Officer Date Pro ram Manager, ppeals Date If you are dissatisfied with this Decision you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be f_�si -�rutixi wi h the Clerk of the Board, 51 Leine Street;�2oom-306, Martinez, CA 94553. Appeals must be filed within fo een (l4 dayso ts-of—the-_Evidentiary Decision. No further aid paid pending a Board of Supervisors appeal. GC 2](revised 6/921 I IVEDRECE JAN „ 3 .1994 rat, i5olle5'.: Al CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. ' . - - �i it :i epleaw teply to: iclal Service Department Contra 0 Appeals (510) 313-1790 Fi6kfecto-Villareal Costa 40 Douglas Dr. ' Director County Martinez, Ca. 94553 GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION ppealsOfficer: (;CDt±- L�2",-JQAJ Hearing Date:11W ace of Hearing: Martinez 0 Antioch C] Richmond -%e proceeding was tape recorded and all testimony and evidence was accepted under penalties of perjury. 4 THE MATTER OF: Case#07-13 0-s oai237 Filing Date; cio 3 D Aku-vc Aid Paid Pending Hearing 13 Yes Ll No A Date ofNotice; 10—)::2-q3- Effective Date of Action: ESENT: r-Claimant �-County Representative(s): Cuc Authorized Repreientative(s): 0 Witness(es): Other: MON UNDER APPEAL: I Denial Discontinuance 0 Application Date 0 Effective Date 0 Notice of Action 0 No:tice of Action Period of ineligibility QV-P- AA04�. JE: Employment Requirements Ja Unemployability Requirements 0 Employability Assessment 0 MedfcaiVefdication 0 Job Searcli, UnemployabillilyAswssmeni, AIRS assessment and parj*(4patoon 0 Job Quit/I I(vd IV$ cover Olhec 0 0 4q Good Caise r _GEWERAL ASSISTANCE (SIDENTIARY HEARING DECI$I(j&.cont'd.) URISDICTION (DM 49-700; DM49-701): Timely Filing of Appeal 0 Challenge only to Regulation 0 Untimely Filing of Appeal : 0 issue Outside scope of Program Period Expired: ❑ Good Cause VIDENCE CONSIDERED : 3 Claimant Testimony ❑ Documentary 5'County Testimony 0 GA 34 Cooperation Agreement Document Date: 0 Assessment Appointment Notice 0 Work Programs Notice Other: q/'„ ISPOSITIONAL FINDINGS/CONCLUSION-: he evidence and testimony having been heard and considered.the following findings are reached: Claimant received/did 004 F96eive notice of the particular assignment under review. jUaimant washNas*mt capable of understanding and meeting the particular assignment under review...- ❑ 'Educational 0 Physical ❑ Emotional (DM 49-10211 B-) Good Cause (DM 49-111 It F) 7- Good Cause Exists �Good Cause Does Not Exist Employment has been obtained 0 Scheduled Job Interview or Testing 0 Mandatory Court Appearance 0 incarceration 0 illness 0 Death in the Family 0 Circumstances beyond Aoplicant/ReCipient's control -Willfulness (DM 49-111 11 H) Willfulness Exists Willfulness Does Not Exist C] Failure was deliberate anc intentional C) County rescinded willfulness determination 0 Failure waS more than a single occurrence 0 County failed to provide sufficient evidence to ❑ Failure was the result cii,nientional mistake/omission establish willfulness ❑ Failure way incii(ative o' a pattern of non-cooperation D Other Failure uas iddnk r--samble caw or acuse . GENERAL ASSISTAY9 EVIDENTIARY HEARING DECIIVN(cont'd) SUMMARY OF FACT AND STATEMENT OF THE EVIDENCE: Claimant failed to attend the October 4, 1993 GAADDS appointment. Claimant stated he missed the appointment as he was told his Work Programs case had been closed for other failures. He was told this in September, 1993 and did not think he needed to go to GAADDS. He did receive his October GA check. The Notice of Action regarding the work program failure and stopping assistance was not issued until October 5, 1993 and he filed his hearing request on October 7, 1993. It is found that claimant did not have good cause for the failure and that it is willful as claimant has no reasonable excuse for failing to appear for the October 4, 1993 failure. ORDER: Claim Denied: ❑ Claim Dismissed: Aid shall be discontinued and the Period of Ineligibility imposed. ❑ Aid shall be discontinued. The Period of Ineligibility shall be expunged from the record. Claimant may reapply at any time. ❑ Claim Granted: ❑ General Assistance shall be restored. The proposed discontinuance is reversed. The Period of Ineligibility shall be expunged from the record. ❑ Other: N-- Written copies of the Order were issued by i�-mail ❑ at Hearing ❑ Additional Regulatory Authority was attached to the foregoing Order V s v Social Services Appea s Officer Date s Pro ram Manager, Appeals Date If you are dissatisfied with this Decision you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be f`_Si - ting wi h the Clerk of the Board, 51 .. Tine Street;�toom`106, Martinez , CA 94553. Appeals must be filed within fo een (14 days o t-e-of--the--Evidentiary Decision. No further aid paid pending a Board of Supervisors appeal. GC 23(revised 6/92) Please Socia! Service Department Contra 40Dougla Drive 40 Douglas Drive Peditlo Villarreal Costa Martinez.California 94553-40E8 Director +�1• County P'P 10/21/93 .r- *: MANUEL JARAMILLO 30 Muir Rd. Martinez, CA 94553 Re: 502637 EW: A4AC Filing Date: 10/07/93 Dear MANUEL JARAMILLO We have received your request for an Evidentiary Hearing about your General Assistance benefits. Your hearing is scheduled for: Location: .40 MUIR"RD. MARTINEZ, CA 9455 Date: 11/03/93 Time;: 1:00 PM Because 7 or more hearings re scheduled for the same hearing time; it may be necessaryfor you to 4<it for' some time before your case is called. Cases will be heard on -a first-come, first-served basis. The Hearing Officer will appreciate your patience. If you are unable to attend the hearing, please call 313-1790 If you do not attend, the Hearing officer may dismiss your request for Hearing. You have a right to an interpreter if you need one. If you have also filed a request for a State Fair Hearing, you will receive a letter from the State Department of Sacial Services about the time and place for that hearing. The State Fair Hearing is separate and apart from the County Evidentiary hearing. Lv%0- — , RE EIVED .SOCIAL SERVICE APPEALS UNIT 13 BRW:gs CD q rN CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. unL) -:k l. i?. County ANI) ATTENDANCE" RECORD _Departmenty PARTICIPANT: MANUEL JARA., _LO CASE �.•...:� 502637-00 EW F'C'N-. C4RG 7AaZA7�trt-tad'------------ -------------------- ----------------------------------------- ,ADDRESS: TELEPHONE: ASSIGNMENT: Show this form to the Work-- I WORK SCHEDULE I Site SUrlervi-sor when you report at the i Day Date TimeI time and place listed below: I___________________ ____________----I I Monday 10/25/93 8:00-4-:30 I Work Site Agency: I Thursday 10/8/9" 8:00-4-:30 I GENERAL SERVICES - MARTINEZ I I Position Title: I ThUl-Sday 11/04/93 8:00-4:30 I MUST PROVIDE OWN TRANSPORTATION TO SITE I Monday 11/1.5/93 8:00-4:30 1 Sc,eci<<1 RegUi.rements.- I Monday i.1/22/93 8:00-4 :30 BRING YOUR LUNCH NO SHORTS OR SANDALS t I Loc ztt io n: 220 GI._AC.T.F..R DRIVE :r.. TE 2 Next Al::�r�oi.ntrnen 1.1./23/93 at :LO:OOA __________________.______-_______--___.. !F'Icrase trr•i.vc. 10 minutes early) Transportation to the jot, site or r'is k-Uri point IS YOUR RESPONSIBILITY. If you are rel-Iui.red to participate in GAADDS„ YOU must continue to keep all GAADDS appoi.ntmc�nts . in addition to 7 Acknowl. • d"J(D F"'e :r Il, of my, Ac .:- ignment the Workfare appointments shown on this form. V1� ...... _..... .... .1/!.` �. ..... /28/93 S .gnatUr•e Date ATTENDANCE RECORD Time In Out I Tot Hrss i Part ' :: ian • S 3.gnattU ' I Worksite Comments C).,--d I Op I I � � 9e-f-o oo -t---- u Day 6 1 I 1 I I Day 7 1 1 I I I ------I--------I_-_---------I---------I------------------------ -------------------------- Day 8 1 1 I I 1 ----=--- --------------- -------f--------I--------I------ I-----------------------I------=----------------- 1 Day 101 I I I 1 ------------------------------___--------------___------_______-___________.______ A.--ldi.ti.onal. Comments II Total HoUrs Worked for Month of 'f p Copy 1: C1 ient/Fart is ipant /3 Copy 2: Case Record ........... . Kri .........._....«..Werr•ksi.te Suor SiDate Copy 3: Worksite File ' ' Contra ta WORK PROGkAM� P�4CEM�� —'- - --- -- - -- County ` C' T' , pp"TICIPAN�: �DDFE9S: Shcw this form Su�ervi�or :Dr t.. E:. time and place listed below: i ---------- Work Site Agency: GENERAL SERVICES - MARTINEZ Position Title: MUST PR(TVIDE OWN TRANSPORTATION TC, Special Recuirements : y YO/'/� r)In ........� �ext AP�'yinto`�n -............-..................................................................................................................... - :i.,::: � Ac, czoanr ' s 1Time In � Time Out ! �ot +rs | / ............................. ) -------- � ------- | ~~» ------ /-- ---- -- ---- --- --- ! �� '�� xo~ &» � �� = ------ ! --�----- ! --------! --- Ica .��-�� -��----- / --][ ---- i --��-_' i ............................................................. - Af A �-�,--- | ---�---- | --��--- | ........��--- � - ~�J - -�------.. -_'------__ � `- - - - ------ i -------- /-------- i------- i ----------------------- ' ------------------- _ � 6 | r- - ------ | -------- i-------- | ------- | ----------------------- / ---------_--------__ ------ |-------- |-------- / ------- | ----------------------- / ------_----_-_------ - ------ !-------- ! -------- ! ------- '----------------------- / -----------......................----r... �av 9 | ------ !--------/--------! ------- |----------------------- � -----------....................................... �_ ------------------------------------- -----_------- - ------ --------r-A'�dzticnal Ccmments AC ^ ....................... . - - ~ ii' �o��` ___ _ ______ _�� ... - N Wcrksite Su"e��zsor Siqnature Da�e �c//' � . ' ! - � Contra Costa WORK PROGRAM� PLACEMENT - Social Service �cucty AND ATTENDANCE RECORD Department ----------- HuuWOO: / c�crnunc =============================== ======================================= ASSIGNMENT: Show this form to the Work | WORK SCHEDULE / Site Supervisor when you report at the > Day Date Time | time and place listed below: ) --------------- --------------- } | Thursday 1/06/94 8:00-4:30 | Wnrh Site Agency: | Thursday 1/13/54 8:00-4 :30 i GENERAL SERVICES - MARTINEZ | Monday 1/24 8:00-4:30 ! Position Title: MUST PROVIDE OWN TRANSPORTATION TO SITE- / \ Special Requirements: | /' 1 YOUR LUNCH NO SHORTS OR SANDALS I | Location: | | 220 GLACIER | i Next Aopoint ------------------------------------ (Please ar Transpertation to the job site or pick-up point IS YOUR RESPONSIBILITY. | If you are required to participate in ! GAADD5, you must continue to keep all GAADDS appointments in addition to I A ent the Workfare appointments shown on this form. A.� � Participant ' ��5iqnature Date ATTENDANCE RECORD / Time In ! Time OutiTot Hr" / site Comments J i -------- i -------- i ------- | ----------------- Day 1 � dn i --��0� !i - � ��- ��--... � / Day 2 2 i ------ | -------|----------------------- |----------------------- Day 3 | / / U ----------------------- ------------------------- Day 4 | | | | | ------) -------- i -------- | ------- i----------------------- |----------------------- � Day 5 | ------ i -------- \ -------- |------- |----------------------- |----------------------- � Day 6 | ------> --------|--------{-------/--------------------------- ------------------------- Day 7 | ------/ -------- \ -------- |------- ! ----------------------- |----__-____-_---------- Duy 8 | ----------------------- ------------------------- Day 9 / ------ /--------(---------- /-------|------------------------ |----------------_-__-__ Day 10/ ! / , | f ________________________________________________________________________ i | AdditionaI Comments ! / TctaI Hours Worked for Month of ' Copy 1 : Client/Particisant -------------_---------'_-_-_-______ _________ Copy 2: Case Recori::� Worksite SuPerviscr Signature Date Copy 3: Worksite File - Please reply to: Social Service Department Contra 40 Douglas Drive Costa ` Martinez,California 94553-4068 perfecto Villarreal Co ,Director J County 11/17/93 z sT'4 COUK� MANUEL JARAMILLO 30 Muir Rd. Martinez, CA 94553 Re: 502637 EW: A4AC Filing Date: 10/212,193 Dear MANUEL JARAMILLO We have received your request for an Evidentiary Hearing about your General Assistance benefits. Your hearing' is scheduled for: Location: 40 MUIR RD. MARTINEZ, CA 94553 Date: 11/29/93 Time: 1:00 PM Because 7 or more hearings are scheduled for the same hearing time, it may be necessary for you to wait for some time before your case is called. Cases will be heard on a first-come, first-served basis. The Hearing Officer will appreciate your patience. If you are unable to attend the hearing, please call 313-1790 If you do not attend, the Hearing Officer may dismiss your request for Hearing. You have a right to an interpreter if you need one. If you have also filed a request for a State Fair Hearing, you will receive a letter from the State Department of Social Services about the time and place for that hearing. The State Fair Hearing is separate and apart from the County. Evidentiary hearing. i Social Service Appeals Unit SC/nf • Social Service Department Contra Please reply to: Perfecto Marmot 40 Douglas Drive Director Costa Martinez,California 94553-4068 County ............... (iO 1n NOTICE OF DISMISSAL: THIS MATTER IS RESOLVE IN THE MATTER OF: County #07-502637-A4AC Date of Notice: 10/12/93 Mr. Manuel Jaramillo Date of Action: 10/31/93 30 Muir Rd. Date of Filing: 10/07/93 Martinez, CA 94553 Resolved: 11/3/93 Date: November 4, 1993 We received your request for an Evidentiary Hearing to appeal a proposed loss of General Assistance benefits. The County Representative has indicated that your issue for hearing has been resolved at Hearing. Therefore, the proposed action for this filing date has been rescinded. Your request for Evidentiary Hearing is dismissed without further action on the matter. If you still wish to have a hearing on this matter, please contact this of f ice in writing within fourteen (14) days of the date of this notice. farbara R. Wei feld social services Appeals Officer BRW:gs cc: . IM Division WP Division TO: Board of Supervisors FROM: Perfecto Villarreal, Director Social Service Department DATE: January 18, 1994 SUBJECT: APPEAL OF GENERAL ASSISTANCE EVIDENTIARY HEARING D E C I S I O N B Y B E R N A R D M C C O Y - - - - - = - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - SPECIFIC REQUEST(S) OR RECOMMENDATIONS AND BACKGROUND AND JUSTIFICATION RECOMMENDATION: That the Board deny Bernard McCoy's appeal of the General Assistance Hearing decision. BACKGROUND: Claimant filed request for Hearing on September 23, 1993. The Hearing was scheduled for November 23, 1993. The claim was denied. Signature: ACTION OF BOARD ON January 18 , 1994 APPROVED AS RECOMMENDED OTHER x This is the time heretofore noticed by the Clerk of the Board of Supervisors for hearing on the appeal by Bernard McCoy from the General Assistance Evidentiary Hearing decision. Jewel Mansapit, GA Program Analyst, Social Service Department, presented the staff report on the appeal . Ellen J. Tabachnick, Contra Costa Legal Service Foundation, representing the appellant, presented testimony in support of his appeal . The hearing was closed. Supervisor Bishop moved to approve the staff recommendation. The motion died for lack of a second. Supervisor McPeak moved to grant the appeal . IT IS BY THE BOARD ORDERED that the appeal by Bernard McCoy from the General Assistance Evidentiary Hearing decision is GRANTED. VOTE OF SUPERVISORS _ UNANIMOUS (ABSENT ) AYES: 2 . 4 , 1NOES 3 ABSENT 5 ABSTAIN none Contact: Jewel Mansapit, 313-1601 Original: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION cc: Social Service Department TAKEN AND ENTERED ON THE MINUTES Program Analyst OF THE BOARD OF SUPERVISORS Appeals Unit ON THE DATE SHOWN. County Counsel County Administrator ATTESTED January 18 , 1994 Bernard McCoy Contra Costa Legal Services PHIL BATCHELOR, CLERK OF THE Foundation BOARD OF SUPERVISORS AND CO TY ADMINISTRATOR BY a , DEPUTY LAW OFFICES OF CONTRA COSTA LEGAL SERVICES FOUNDATION Main Office Telephone 1017 Macdonald Avenue West County(510)2339954 P.O. Box 2289 East(510)439-9166 Richmond,California 94802 Central(510)372-8209 Fax(510)236-6846 January 11, 1994 _RFECELVED . Sent by FAX 646-1059 JAN 12 10 Chairman, Board of Supervisors CLERK BOARD-O': j fts Contra Costa County L_ CONTRA COSTA Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553 Re: IN THE MATTER OF THE 11/93 EVIDENTIARY HEARING DECISION OF BERNARD McCOY Contra Costa County Denial of General Assistance and Six Month Period of Ineligibility (Personal property) Dear Board Members: This summarizes the claimant's position, the issues, facts, and legal arguments. The Board Appeal is set for January 18, 1994 . POSITION STATEMENT Bernard McCoy applied for General Assistance August 2, 1993 . This application was denied September 22, 1993 . The County withdrew the denial based on a dispute over his homeless status - solely for due process reasons. The second reason he was denied G.A. with fraud alleged was due to DMV records indicating ownership of cars. This was not reported by client but there were non-fraudulent reasons that should have resolved this. At no time during the application process did the County ever to ask him about a 1974 Buick opal or clarify DMV status. The County's LAW OFFICES OF CONTRA COSTA LEGAL SERVICES FOUNDATION Main Office Telephone 1017 Macdonald Avenue West County(510)233-9954 P.O.Box 2289 East(510)439-9166 Richmond,California 94802 Central(510)372-8209 Fax(510)236-6846 January 11, 1994 Sent by FAX 646-1059 Chairman, Board of Supervisors Contra Costa County Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553 Re: IN THE MATTER OF THE 11/93 EVIDENTIARY HEARING DECISION OF BERNARD McCOY Contra Costa County Denial of General Assistance and Six Month Period of Ineligibility (Personal property) Dear Board Members: This summarizes the claimant's position, the issues, facts, and legal arguments. The Board Appeal is set for January 18, 1994 . POSITION STATEMENT Bernard McCoy applied for General Assistance August 2, 1993 . This application was denied September 22 , 1993 . The County withdrew the denial based on a dispute over his homeless status solely for due process reasons. The second reason he was denied G.A. with fraud alleged was due to DMV records indicating ownership of cars. This was not reported by client but there were non-fraudulent reasons that should have resolved this. At no time during the application process did the County ever to ask him about a 1974 Buick Opal or clarify DMV status. The County's 1 0 8/24/93 G.A. Application Statement of Facts asks in relevant part about resources: At Question 7D, the applicant is asked to answer if they: "have a car, truck, van, motorcycle, or other vehicle". Claimant, Bernard McCoy, had two choices, to answer yes or no. He wrote no. At question 7G, he is asked if he: "gave away money or sold or gave away property, land, or buildings, during the last two years". He checked the box that said no. At Question 2, which talks about his living situation, County staff wrote: "client claims he sleeps in various places - friends and brother. Keeps things in brother's car or parents house. Does food and shower at brother's house." At the hearing Mr. McCoy testified to the best of his capabilities that he did not consider himself the owner of the 1974 Buick. He stated that he knew it was registered to him, but this did not, in his mind make him the owner. He testified that he had given it to his brother (mid 1993, exact date unknown) because he was homeless and therefore his brother would be better able to help his parents with their medical transportation needs. He testified he did not even know that the car was still registered to him until he was denied aid. He testified he did not have physical possession of the car, that his brother had the car, the keys, the maintenance responsibility along with the responsibility of driving his parents where they needed to go. NOTE: The records reflects the car was originally bought and registered in his name by his mother for the parents' use. This car was registered to him he believed so he could legally drive his parents in this car. When he gave the car to his brother, he assumed (incorrectly) that his brother would change the 2 registration. He testified that he believed (erroneously) his brother could do this without his participation. In doing so he demonstrated his lack of knowledge as to DMV procedures. This testimony shows he was wrong, but not that he committed fraud in the application for G.A. LEGAL ARGUMENTS THE HEARING OFFICER ERRED IN FINDING FRAUD IN THE APPLICATION AND THE DECISION SHOULD BE REVERSED. The record does not reflect the findings. Bernard McCoy answered the eligibility worker's questions as to where he kept his possessions. They were in his brother's car or at his parent's house. Bernard McCoy told the County what he thought was true. This was not fraud because the element of intent is missing and is deemed to exist by implication only. This was a mistake. Furthermore, the value of the car is relevant because of the motive needed to prove fraud. This is a requirement for any finding of fraud. If this decision were correct, then Bernard McCoy A) . intentionally failed to report a car he didn't know he owned and B) . which if he had known he owned would have been within G.A. personal property limits and C) . that he kept his personal belongings in his brother's car in order to obtain aid rather then to answer the staff's question during the normal G.A. interview. The decision also refers to a second car not mentioned in the denial notice However, it is incorrect to say the County did not know about car #2 because the DMV printout provided to CCLSF consisted of two cars, not one. In addition, he explained the circumstances of the second car in the hearing that it had been bought by his sister for her boyfriend, but due to her age, 3 sister for her boyfriend, but dud to her age, was registered to Mr. McCoy. He did not consider himself the owner. Further, the client was not asked on the G.A. Application whether he had any automobile registered to him; he was asked if he had a car. He answered the question correctly: He did not have the car in question. And no evidence whatsoever was presented at the hearing that he either: 1. had physical possession of the car; 2. that he used the car for his own transportation, or, 3 . that he physically possessed the title to it. 4. that he knew when he applied for G.A. that DMV records showed him as the registered owner. The hearing officer simply chose not to believe him. Since the DMV printout said the car was registered to him, any evidence to the contrary was not believed. His explanation was taken step by step and showed his errors in thinking but not misrepresentation. If one reviews the G.A. Application transfer of property question used as the second reason for the decision, it must be considered: that the term "Property" , followed by the terms, "land" or "buildings" could reasonably be assumed to apply to real property. The question does not say personal property, or Property including a car or automobile. The client had no idea that the all inclusive phrase of the selling or giving away of property was asking him if he gave away a car. This question was not answered wrong to Mr. McCoy since he did not know. In fact, his entire . demeanor demonstrated that he did not think there was any car to report. He forgot to report the car he 4 testified he didn't know was still registered to him and which he had little to do with except that some of his possessions were in his brother's car. This is the same car he told the EW about. His mother's declaration explains that she knew little about the details, only that his brother was the owner of the car in question. The fact that she did not know the details does not negate the fact that this car belonged to her other son. She is certainly in a position to know since the primary purpose of her buying the 1974 Buick was so she and her husband could get to medical appointments. The DMV records prove nothing more than ownership of record, not ownership under General Assistance regulations (D.M. 49-208 et. seq. ) and his lack of knowledge of the true facts is not G.A. fraud. The fraud regulation at D.M. Section 49-111-II1a. ) reads: Fraud 1. An applicant or recipient who provides fraudulent information in order to qualify for a General Assistance grant or for a larger grant, or to avoid termination or reduction of aid shall be required to serve a six month period of ineligibility. a. Application of this period of ineligibility requires the review and approval of a Social Service Division Manager. Incorrect information is distinguishable from fraud. The intentional or wilful or purposeful withholding of material facts in order to obtain General Assistance must be shown. The fact is he thought his brother owned the car does not carry the required burden of proof. Mr. McCoy told the intake worker that was where 5 he kept some of his possessions. In addition, the car he did not know was still registered to him was a fact of no General Assistance legal significance. He did not know he could sell it and receive any money. He did not know if the smog certificate was current, ge only knew only that he was homeless, and told the Department he was using public transportation or getting rides to get around. He testified he gave the car away because he was moving around too much to be available as a driver for his parents. Since he had neither the pink slip or the car, he did not "have" a car. And he did not know the word "property" also meant a car. The client's responses at the hearing were consistent with what little he understood. His testimony was persuasive because it showed what he did and did not know. However, the decision does not address why at no time between 8/2/93 and 9/22/93 was Mr. McCoy ever asked during this seven week time fraud to clarify this, as required by D.M. 49-102 111 A7. In fact, the DMV printout came to staff attention at least 5 e CC)KLbAA.A. two weeks before the denial. The car was in factAto a major dispute over the question of his h,,�elessness. Had the County intake worker complied with the G.A. regulation to deal with perceived inconsistent statements on the application about eligibility, they could and should have asked him (D.M. 49-102 III A.7) . Why this was not done when the county has the legal duty to verify eligibility is reason to believe that they simply chose to approve this denial without giving claimant any opportunity to explain it (49-102 111 A.7) . It appears the County was attempting to prove he was not homeless and so never chose to deal with the questionable information in question. 6 f • • During to the pendency of his appeal, he was not asked. The County did not contact anyone. CONCLUSION The County produced no evidence that claimant defrauded the County when he forgot to tell them about a car he did not believe he owned and which had he known would have been excluded, by regulation "in determining eligibility" . DM 49-208 [�I� B. 1. How can Mr. McCoy have intentionally withheld information when he was being asked about a car within GA property limits that he didn't know he owned until the county asserts it on a denial notice (he reported the possessions in brother's car) ? The County had a duty to this client to investigate this but instead asked him nothing. Then, this car was used to deny him aid for 6 months. This was a severe penalty without proof. This should only have happened if he knowingly made a misstatement. This decision requires reversal because it assumes facts that were not in evidence at the hearing. The County never offered any evidence other than the DMV printout. This does not prove fraud. Mr. McCoy was sanctioned for not knowing what he was supposed to know. He has a duty (49-102 B2) to cooperate with staff but when he is never asked, this is not non- cooperation. The Agency Responsibility includes the EW responsibility in "assisting the applicant in establishing his/her eligibility. " (49-102 III A. 2) . Therefore, Contra Costa Legal Services Foundation requests reversal. This client was denied aid for six months for reasons other than those mandated by the Board. We request that the Board insure that this denial not be wrongfully upheld. 0 Thank you very much for your consideration. Sincerely, CONTRA COSTA LEGAL SERVICES FOUNDATION By: _pyw ELLEN J. TANICK EJT:vh cc: Bernard McCoy 7 8 25 -- LAW OFFICES Oil CONTRA COSTA LEGAL SERVICES FOUNDATION Main Ofte Tolophong 1017 Maodonald Avonve Wea County(510)233-9934 P.O. Box 2260 Ust(510)439.9166 PjohnwM,California 94802 canual(510)'273.5204 Fax(510)236-6946 TZLZCOPIER TRANSMISSION COVER MEMORANDUM DATE: January 11.12_93 Tot Burd Of SuRervisors0eRLItY Clerk-lBllt, FIRM: Bd.- of Supervisors /Contra-C2sta County- FAX NO 1 646-1059 FROM$ E1,1,EN J. TABACf1NICK,CCT,S1,' RE! Poeition Statement/Board, &epal./BERNARD 2MCCOY _LGA TOTAL NUMBER OF PAGES (including cover shoot) : 9 COMMENTS: Hard ard coey to fallow. Thank you. This is_w/reference to the BoardAppealset for 1/1.8/94. PLEASE Do ONE OR MORE Or THE FOLLOWING** X Please deliVer immediately to the Recipient. Please requ'ast the Recipient to telephone the Bonder immediately upon receipt and review. Please have, the Recipient verify receipt by telephone. original will not follow. X original Will follow by (check one of the following) $ X Regular: Mail Certified Maid,, Return Receipt Requested Expresv. Mail Federal Express Other: (#014 QV2&TX0Y8 CALL$ (310) 233-0*84) f �i , = ! ,,r�� .,� , �;�;:;_.. i P:sj'-.4' LAW OFFICES OF CONTRA COSTA LEGAL SERVICES FOUNDATION Main Office Telephone 1017 Macdonald Avenue West County(510)233-9954 P.O.Box 2289 Haat(510)439-9156 Richmond,Califotrls 94842 Central(510)372-8209 Fax(510)236-6846 January 11, 1994 ant by FAX 646-1Q59 Chairman, Board of Supervisors Contra Costa County Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553 Re: IN THE MATTER OF THE 11/93 EVIDENTIARY HEARING DECISION OF BERNARD MGCOY Contra Costa County Denial of General Assistance and Six Month Period of Ineligibility (Personal property) Dear Board Members: This summarizes the claimant's position, the issuers, facts, and legal arguments. The Board Appeal is set for January 18, 1994. POSITION STATEMENT Bernard McCoy applied for General Assistance August 2, 1993. This application was denied September 22, 1993 . The County withdrew the denial based on a dispute over his homeless status solely for due process reasons. The second reason he was denied G.A. with fraud alleged was due to DMV records indicating ownership of cars. This was not reported by client but there were non-fraudulent reasons that should have resolved this. At no time during the application process did the County ever to ask him about a 1974 Buick Opal or clarify DMV status. The County's l iii F jV1 (',�1r,1' is�_I '?' L L�a �! • ! j �_I LAW OFFICES OF CONTRA COSTA LEGAL SERVICES FOUNDATION Main Office Telephone 1017 Macdonald Avenue Woe County(510)233-9954 P.O. Box 2289 Ban(5 10)439.9166 Richmond,Callfornla 94802 Central(510)372-8209 Fax(510)236-6846 January 11, 1994 Sant by FAX 646-1059 Chairman, Board of Supervisors Contra Costa County Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553 Re: IN THE MATTER OF THE 11/93 EVIDENTIARY HEARING DECISION OF BERNARD McCOY Contra Costa County Denial of General Assistance and Six Month Period of Ineligibility (Personal property) Dear Board Members: This summarizes the claimantfs position, the issues, facts, and legal arguments. The Board Appeal is set for January 18, 1994 . POSITION STATEMENT Bernard McCoy applied for General Assistance August 2, 1993 . This application was denied September 22, 1993 . The County withdrew the denial based on a dispute over his homeless status solely for due process reasons. The second reason he was denied G.A. with fraud alleged was due to DMV records indicating ownership of cars. This was not reported by client but there were non-fraudulent reasons that should have resolved this. At no time during the application process did the County ever to ask him about a 1974 Buick Opal or clarify DMV status. The County's 1 �_I. I_'�(I t�',— J�,g� �1J 1'',,� I ;�•;�� '_}`^A ..�� i �''T � _ I!�-I n /I-II 1�/.r�tY 71 8/24/93 G.A. Application Statement of Facts asks in relevant part about resources: At Question 7D, the applicant is asked to answer if they: "have a car, truck, van, motorcycle, or other vehicle". Claimant, Barnard McCoy, had two choices, to answer yes or no. He wrote no. At question 7G, he is asked if he: "gave away money or sold or gave away property, land, or buildings, during the last two years" . He chocked the box that said no. At Question 2 , which talks about his living situation, County staff wrote: ,*client claims he *loops in various places - friends and brother. peeps things in brother0s car or parents house. Does food and shower at brother's house." At the hearing Mr. McCoy testified to the best of his capabilities that he did not consider himself the owner of the 1974 Buick. He stated that he knew it was registered to him, but this did not, in his mind make him the owner. He testified that he had given it to his brother (mid 19930 exact date unknown) because he was homeless and therefore his brother would be better able to help his parents with their medical transportation needs. He testified h% didd,.not even know, that the car was still registered to him until he was denied aid. He testified he dial not have physical possession of the car, that his brother had the car, the keys, the maintenance responsibility along with the responsibility of driving his parents where they needed to go. NOTE: The records reflects the car was originally bought and registered in his name by his mother for the parents, use. This car was registered to him he believed so he could legally drive his parents in this car. When he gave the car to his brother, he assumed (incorrectly) that his brother would change the 2 registration. He testified that he believed (erroneously) his brother could do this without his participation. In doing so he demonstrated his lack of knowledge as to DMV procedures. This testimony shows he was wrong, but IlQ_t that he committed fraud in the application for G.A. LEGAL ARGUMENTS THE HEARING OPEIgER ERRED IN FINDING FRAUD IN THE APPLICATION ANS THE DECISION OHOULD BE .REVERSED. The record does not reflect the findings. Bernard McCoy answered the eligibility worker's questioner as to where he kept his possessions. They were in his brotherfe car or at his parent's house. Bernard McCoy told the County what he thought was true. This was not fraud because the element of intent is missing and is deemed to exist by imps ation only. This was a mistake. Furthermore, the value of the car ,g relevant because of the motive needed to prove fraud. This is a requirement for any finding of fraud. If this decision were correct, then Bernard McCoy A) . intentionally failed to report a car he didn't . now he owned and B) . which if he had known he owned would have been within G.A. ,personal property limits and C) . that he kept his personal belongings in his brother's ear in order to obtain aid rather then to answer the staff's question during the normal G.A. interview. The decision also refers to a second car not mentioned in the denial notice However, it is incorrect to say the County did not know about car ,#2 because the DMV printout provided to CCLSF consisted of two cars, not one. In addition, he explained the circumstances of the second car in the hearing that it had been bought by his sister for her boyfriend, but due to her age, 3 fir... sister for her boyfriend, but due to her age, was registered to Mr. McCoy. He did not consider himself the owner. Further, the client was not asked on the G.A. Application whether he had any automobile registered to him; he was asked if he had a car. He answered the question correctly: He did not have. the car in quest-ion. And no. eXidence what$oevcr was presented at the. hearing that he either: 1. had physical possession of the car; 2 . that he used the car for his own transportation, or, 3 , that he physically possessed the title to it. 4 . that he knew when he applied for G.A. that DMV records showed him as the registered owner. The hearing officer simply chose not to believe him. Since the DMV printout said the car was registered to him, any evidence to the contrary was not believed. His explanation was taken step by step and showed his errors in thinking but not misrepresentation. If one reviews the G.A. Application transfer of property question used as; the second reason for the decision, it must be considered: that the term ",prop..erty", followed by the terms " ndu or "builds s" could reasonably be assumed to apply to rgal property. The question does not sayyerft2na.l property, or ggQperty including a caror automo)alg. The client had no idea that the all inclusive phrase of the selling or 'giving away of proper±y was asking him if he gave- w—ay a car. This question was not answered wrong to Mr. McCoy since he did not know. In fact, his entire demeanor demonstrated that he did not think there: was any car to report. He forgot to report the car he 4 ��, 1 ._1=� •' - - - yll �l-.'. _ _.C ._ .. i,. :�:L�r • f _�� I. . .li _i testified he didn't know was still registered to him/ and which he had little to do with except that some of his possessions were in his brother's car. This is the same car he told the EW about. His mother's declaration explains that she knew little about the details, only that his brother was the owner of the car in question. The fact that she did not know the details does not negate the fact that this car belonged to her other son. She is certainly in a position to know since the primary purpose of her buying the 1974 Buick was so she and her husband could get to medical appointments. The DMV records prove nothing more than ownership of record, not ownership under General Assistance regulations (D.M. 49-208 et. seq. ) and his lack of knowledge of the true facts is not G.A. fraud. The fraud regulation at D.M. Section 49-111-I11.a. ) reads: Fraud 1. An applicant or recipient who provides fraudulent information in order to qualify for a General Assistance grant or for a larger grant, or to avoid termination or reduction of aid shall be required to serve a six month period of ineligibility. a. Application of this period of ineligibility requires the review and approval of a Social Service Division Manager. Incorrect information is distinguishable from fraud. The intentional or wilful or purposeful withholding of material facts in order to obtain General Assistance must be shown. The fact is he thought his brother owned the car does not carry the required burden of proof. Mr. McCoy told the intake worker that was where 5 i he kept some of his possessions. In addition, the car he did not know was still registered to him was a fact of no General Assistance legal significance. He did not know he could sell it and receive any money. He did not know if the smog certificate was current,ge only knew only that he was homeless, and told the Departmont he was uoing public transportation or getting rides to got around. He testified he gave the car away because he was moving around too much to be available as a driver for his parents. Since he had neither the pink slip or the car, he did not 11 ave" a car. And he did not know the word "property" also meant a car. The client's responses at the hearing were consistent with what little he understood. His testimony was persuasive because it showed what he did and did not know. However, the decision does not address why at no time between 8/2/93 and 9/22/93 was 'Mr. McCoy ever asked during this seven week time fraud to clarify this, as required by D.M. 49-102 III A7 . In fact, the DMV printout came to staff attention at least s t C-OKdUAAA two weeks before the denial. The car was in factAto a m .to dispute over the question of hie h:*�elessness. Had the County intake worker complied with the G.A. regulation to deal with perceived inconsistent statements on the application about eligibility, th=_.comld and should have asked him (D.M. 4.9-102 T.T. A. 7) . Why this was not done when the county has the legal duty to verify eligibility is reason to believe that they simply chose to approve this denial without giving claimant any opportunity to explain it (49-102 III A. 7) . It appears the County was attempting to prove he was not homeless and so never chose to deal with the questionable information in question. II - � -�-�:i+�__� '_� �i^' F-•-!�- -I--'� �_�'�4.I i _ L�. '�r • i.ii � i --Iii 1 During to the pendency of his appeal, he was not asked. The County did not contact anyone. CONCLUSION The County produced no evidence that claimant defrauded the County when he fgraot to tell them about A car -hp—did not believe he owned and which had he known would have been excluded by regulation "in determining_eligibility" . DM 49-208 W B. 1. How can Mr. McCoy have intentionally withheld information when he was being asked about a car within GA property limits that he didn't know he awned until the county asserts it on a denial notice (he reported the possessions in brother's car) , The County had a duty to this client to investigate this but instead asked him nothing. Then, this car was used to deny him aid for 6 months. This was a %.evere penalty without proof. This should only have happened if he knowingly made a misstatement. This decision requires reversal because it assumes facts that were not in evidence at the hearing. The County never offered any evidence other than the DMV printout. This does not prove fraud. Mr. McCoy was sanctioned for not knowing what he was supposed to know. He has a duty (49-102 H2) to cooperate with staff but when he is never asked, this is = non- cooperation. The Agency Responsibility includes the HW responulbility in "assisting the applicant in establishing his/her eligibility. ,, (49-102 IIT A.2) . Therefore, Contra Costa Legal Services Foundation requests reversal. This client was denied aid for six months for reasons other than those mandated by the Hoard. We request that the Board insure that this denial not be wrongfully upheld. 7 i I —� � —'.1•- - - - '- _ i.is,,- - -- � - - _. __'._ _ • —;_� _� _ �V —— Thank you very much for your consideration. Sincerely, CONTRA COS'T'A LEGAL SERVICES FOUNDATION By: E LEN J. TAlk ICK EJT:vh cc: Bernard McCoy a CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 15, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT: Hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By Bernard McCoy Please furnish us- with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by January 11, 1994 plus any information which your department may wish to file for the Board appeal which is set for 2 :30 p.m. on Tuesday, January 18, 1994 . Attachment cc: Board members County Administrator County Counsel tchelor The Board of SuperviAs Contra • Cerrkloftthe Board and County Administration BuildingCta County Administrator Costa 651 Pine St., Room 106 V (510)646-2371 Martinez, California 94553 County Tom Powers,1st District Jeff Smith,2nd District FE L Gayle Bishop,3rd District Sunne Wright McPeak 4th District C•, Tom Torlakson,5th District o' :S December 15, 1993 rTq-�o�Nr� Mr. Bernard McCoy 7 Leeward Way Pittsburg, CA 94565 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 18, 1994 . In accordance with Board 'of Supervisor Resolution No. 92/554 , your written presentation and all relevant material pertaining to the appeal must be filed with the-Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure. Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Administra r By n ervelli, eputy Clerk Enclosure CC: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator Contra Costa Legal Services Foundation THE BOARD OF SUPERVISORS OF CONTRA COSTA AL"N,CALIFORNIA Adopted this Order on August 4, 1992 by the following vote: AYES: Supervisors Fanden, Schroder, Torlakson, Weak NOES: None ABSENT: Supervisor Powers ABSTAIN: None SUBJECT: General Assistance Hearing } Resolution N=ber 92/.E54 and Appeal Procedures } The Contra Costa County Board of Supervisors RESOLVES that the provisions of Resolutions No. 74/365,75/28, 87/468, and 88/576 which established standards for General.Assistance Hearings and Appeals are hereby superseded effective September 1, 1992: Pan 1 Hearings 101. General Assistance applicants shall be given written notice of action to deny an application. 102. General Assistance recipients shall be given written notice, mailed at least 10 days prior to the effective date, of proposed action which will reduce, suspend or terminate his or her General Assistance grant for cause. Prior notice is not required for action resulting from Board of Supervisors' changes in grant levels. 103. AGeneral Assistance applicant or recipient shall receive a Social Service Department bearing upon their timely written request. (a) The applicant or recipient must deliver or mail a written request for a bearing within fourteen days of the date the Notice of Action was mailed. Absent evidence to the contrary, the notice is presumed to have been mailed on the date it bears, and a request for a bearing is presumed to have been delivered on the date it is received and mailed on the date it is postmarked. 104. Where a GA recipient timely requests a bearing challenging a proposed action which will reduce, suspend or terminate his or her General Assistance grant, the proposed action will be stayed until a decision is rendered. (a) Actions implementing Board of Supervisor changes in grant levels are not appealable, and bearing requests based thereon may be summarily denied. 105. Hearings will be scheduled within thirty days of the date of receipt of a request for a bearing. The Appeals Unit will mail a written notice of the bearing to the claimant at least ten days in advance of the Heating date. 106. When a request for a bearing has been received,the claim may be reviewed and resolved in the claimant's favor by a pre-bearing review. (a) Proposed pre bearing resolutions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager. 207. If the claimant h unable to attend the bearing at the originally scheduled date and time, and a timely request for postponement is made,the Hearing Officer will make an evaluation of the request.The bearing will not be continued beyond the bearing date unless authorized by a Hearing Officer on one of the following grounds,which require verification: (a) bearing is continued at request of the Social Service Department, RESOLUTION NUMBER 92A54 (b) mandatorycourt appearance which cannot be accommodated by adjusting the hearing time, (c) illness which prevents travel, (d) death in the immediate family, (e) other substantial and compelling reason. (as approved by the Appeals Manager) 108. Decision (a) A written decision shall be mailed to the claimant within thirty days after the hearing record is closed, unless the Department extends the time in writing, for cause. (b) Proposed decisions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager prior to notification of the claimant.The Hearing Officer's findings of fact are not subject to change,but the General Assistance Policy Manager may order re- hearing for cause. Part 2 Appeals to the Board 201. The applicant or recipient may appeal an adverse bearing decision to the Board of Supervisors. 202. A written appeal must be received by the Clerk of the Board of Supervisors v►ithin fourteen days after the decision has been mailed to the claimant.Absent evidence showing the contrary, a bearing decision is presumed to have been mailed on the date it bears. (a) An appeal to the Board will not stay the implementation of the Hearing decision, and the recipient shall not be entitled to continue to receive assistance pending further bearing. (b) The appeal will be scbeduled for the first available Board meeting,but no earlier than the third meeting following receipt of the appeal. 203. The Administrative Review Panel may review appeals of Hearing decisions and recommend proposed action to the Director. (a) If the Director supports the bearing decision,the Appeals unit will be notified to proceed with the presentation to the Board. (b) If the Director finds in favor of the claimant,the Qerk of the Board will be notified to withdraw the item from the Board agenda The appropriate Social Service District office will be advised to take corrective action. 204. Both the appellant and the Department must file all written materials at least one week before the due set for the Board bearing.New material must be served by mail on the opposing party. 205. (a) Upon bearing the appeal,the Board shall make any required fact determinations based on the record on appeal and testimony received by the Board.This record shall include the Department's Hearing Officer's fact findings,plus any papers filed with that Officer. N If the fats upon which the appeal is based are not in dispute or if any disputed facts are not relevant to the issue ultimately to be decided by the Board,the Board will proceed immediately to the next step without considering fact questions.The parties may stipulate to an agreed set of facts. RESOLUnON NUMBER 92j35 206. (a) Once the facts are determined,or if there are no fact determinations required by the appeal, • the Board will consider legal issues presented by the appeal.Legal issues are to be framed, insofar as possible,before the Hearing and shall be based on the Department's Hearing Officer's decision and such atter papers as may be filed. {b} Appealing pasties may make legal arguments both by written brief and orally before the Board. If the issues are susceptible of immediate resolution,the board may immediately decide them at the appeal hearing. If the County Counsel's advice is needed on legal questions,the Board may take the matter under submission,reserving its final judgment until it receives such advice. 207. The Board may decide an appeal Immediately after bearing or take the appeal under .submission. t rw.er aM++r are a►r ti• �kNt � «t i0t 11M0►7 aM* 4� rawd� 2. ATiEbTEPHtl 7ATPHE ,b a'VW 90gra �f Wprvwxs RESOLUTION NUMBER 02J 554 1L {_�3 �;L I p M '�i��q 4;fJ}'kj�T� ^ iS1tl L�•1 Y �� ^� /t^I� r � 1 2 �L_ LAW OFFICES OF CONTRA COSTA LEGAL SERVICES FOUNDATION Main Office Talepheaa 1017 Macdonald Avenue West County(510)233-9954 F.O.]sox 2289 East(510)439-9166 Richmond,California 94802 Central(5 10)372.9209 Fax(510)236.6846 December 13, 1993 By Fax Clerk Board of supervisors Contra Costa County 651 Pine Street Martinez, CA 94553 RE: Appeal to .the Boad Bernard MrCoy - General Assistance Dear Members: This is to appeal the General Assistance evidentiary hearing decision dated December 1, 1993 which upheld the determination of the Department of Social Services to deny General Assistance to Bernard McCoy. Please rend a copy of the notice of the Board hearing on this appeal to both the claimant and to me. Thank you. Sincerely, CONTRA COSTA LEGAL SERVICES FOUNDATION By: ELLEN. J. TABACHNICK Law Graduate EJT:vh cc: Bernard McCoy • L E C — 1 3 — 9 3 M O N 1 4 - 4 4 • R _ 0 2 Social Service Department Contra Please reply to: 40 Douglas Drive Perfecto VillarroalCr1 lC�l Mai,-nez Ci3tifornia 34553-4066 D�ector o County �N, la: •r GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION Bernard McCoy 7 Leeward Way Pittsburg, CA 9456.5 County No. : 0792-429211-C3.LE Notice of Action: 9/22/93 Effective Date: 8/2/33 Appeal Filing Date: 9/23/93 Aid Paid Pending; No, Denial Date of Hearing: 11/23/93 Place of Hearing: Antioch, California Appeals officer: Kate Quisenberry County Pepresentative: G. Gwaltney Eligibility Worker Authorized Representative: E. Tabachnik, Legal Services Foundation JJ5AM 4 Whether .the :denial of Claimant's General Assistance Application, . elated. August 2, 1993, for fraudulent failure to report a vehicle :registered to him is correct.. C laimant. applied for General. Assistance on August 2, 1993 after. having been discontinued 7/32/93 for failure to comply with Work. Programs:, On August 24 he completed the General Assistance. st toment of Facts declaring under penalty of perjury that he did r)bt' own a car and that he had not transferred property during; the . last. two years. Subsequently staff received a print-out from: DN'V showing Claimant as the registered owner of a 1974 Buick which if rpp6rted..may, not have made him ineligible to aid. County contends that the failure to report the vehicle and correctly answer DEG - 1 3 - 93 MON 1 .4& 4 • p _ 03 McCoy Page 2 questions. respecting property transfer was intentional and for purposes of qualifying for aid. County testified that as the . property was not reported, no determination of eligibility based on the. car was .possible. Detervinations respecting homelessness, cited inthe denial notice, were resolved prior to hearing. Cl.aim'arit testified that he did not report the car because he did not' ,d0h9ider himself to. be its owner. He testified that the car toad' been- paid for by his ,parents so that he could transport them bocay.se: they are disabled. He testified that he was the registered ownbr� of the car and could use the vehicle for his purposes also. Ike .`testi.f'ied that he gave JIm car"; to his brother, Roosevelt. but could! :not recall the date or mobth. He had. not changed the c Lstx`atiotx. To support his testmony he presented a written statement signed by his mother indicating that he had given the car. t4 Poosevelt. The mother's .stat.;zzent .said she did not know the date 'of the alleged .transfer but..i.ndicated the year as 1993. The statement said that she did not know 'the details of the transact, 6n., Claimant acknowledged that he knew he was registered as owner of the car at the'. time Of application. - He test-if Led.. that he did not report the transfer of the car, allegedly occurring. within the past two .years. be-64ise he forgot. Testimony was provided respecting an -additional. car, but .the County apparently hack, no. kno�iledge of that car, `why.ch was, according to Claim'antis. t�stirbny owned by his sister and his "brother-in-law". S.ubl vduently identified as her boyfriend. C1ai.mant's contention is that his reporting error was based on. mitke:, He testified that i"f reported, the . car would have been exempted, and would not have made him ineligible. 103 De.partment Manual Section 49-111,11,1. , provides that an appliraht orcripient who prc�victcs f�.audulent . inforn�Mtion in order to gu&Itfy fora General Assistance vant or for a larger grant,. or to avoid termination or .reduction of aid shall be required to servea sig month period of ineligibility. a. Application of this period of ineligibility requires the review and approval of a .Social .Service Division Manager. Department Manual Section 49--102 x1.8. Application Responsibilitio.s provides that during the determination of initial, eligibility, the applicant shall assume as much roasponsibility as s/he can within his/her physical or mental capabilities. The applicant is res.taonsibie for: .14, Providing all information necessary to .determine D E C - 1 3 - 19'3 M O N 1 4 4 !5 R _ 0 4 Hocoy Page 3 eligibility and amount of grant 2. Cooperating with social Service Staff. . . 3. Taking all actions necessary to obtain resources from ;any source available Department , Manual Section 49-501 I.11. ,seginning .date of .Aid provides A. The beginning date 9f aid is. the date of application ;or the first of the month in ,which aid is authorized, which- ever is later. B. If eligibility does not begin until after the date of application, Aid is lbsid effective the date of eligibility, and is prd--rated from that date, if appropriate. (Azo app' icati©n may be held if applicant is currently ineligible, but wi.l.l 'be eligible within 30 days. ) Absent a showing .of mental incompetance, an applicant is presgmed, to know the factsof his own 3rcumstan�ces. Claimant's excuse for failing to.report informat'ion�about his car is based on his ignorance of those. facts. In hearing he acknowledged that he 1 n'ewr he was. the registered owner of the. 1974. Buick, .and he knew he �haci '. not. ,+hanged; his ownership opt the pink slip. . This was a fact is be reported to his eligibility � orket. While he claimed in hearibgi that he had given the car- to his brother; he stated on "application. form, signed under. penalty of perjury.. that he had !not gven away ; property during :,the last two years. This was� an inconsistency which he dial not cure at hearing. Claimaint,'s statements j in hearing that he did not know the facts of '2 is situation were not credible. The preponderance of eviog ; supports the County's fihd..ing that he knowingly withheld inforxzation; which he had :and ,which the county wanted. claimant's contention that no, .fraud occurred because the car would leave .bee.n exempt.edi if r+eport6d is not persuasive. Whether or not the car had; value, or wa.s transferred or would have been exempted Are determipat.ions to be made! by the County eligibility worker land . not by the applicant. The County's action is sustained. Claim denied. DEC - 1 3 - 9 3 M O N 1 4.4 G • P _ 0 5 McCoy Page 4 SociaX Services Appeals .Officer. nate _._ Z.�_... ._ Appeals' Progra anager Date Xf you are. dissatisfied with this decision you may appeal th.e matter.:directly to the Contra .Costa County Board of Supervisors. Appeals must be filed in writing with the Clerk of the Board, 651 . Pine St.. , Martinez, CA .. 94553. . Appeals must be filed within foOrteen :(14) days of the date of this Evidentiary Hearing ber.,f si cin. No further :aid is paid pending a Board of Supervisors appeal. \ LAW OFFICES OF CONTRA COSTA LEGAL SERVICES FOUNDATION Main Office Telephone 1017 Macdonald Avenue West County(510)233-9954 P.O. Box 2289 East(510)439-9166 Richmond,California 94802 Central(510)372-8209 Fax(510)236-6846 December 13, 1993 By Fax Clerk Board of Supervisors Contra Costa County 651 Pine Street Martinez, CA 94553 RE: Appeal to the Boad Bernard McCoy - General Assistance Dear Members: This is to appeal the General Assistance evidentiary hearing decision dated December 1, 1993 which upheld the determination of the Department of Social Services to deny General Assistance to Bernard McCoy. Please send a copy of the notice of the Board hearing on this appeal to both the claimant and to me. Thank you. Sincerely, CONTRA COSTA LEGAL SERVICES FOUNDATION ELLEN J. ABACHNICK Law Graduate EJT:vh cc: Bernard McCoy 0 cn 7 cC)? cr . 6GtiU; i 7 t� lit n yG ••' Q\ : �PA v f NN WA u U , o o td o "dQ N w to a V O a .. a A U O i v � v LAW OFFICES OF CONTRA COSTA LEGAL. SERVICES FOUNDATION Main Office Tclwbom 1417 Madonald Memo Wet Caudy(310)233-9954 P.O.Hex 2289 E&A(310)439-9166 Woknwmd,Califon%6 44802 CanwW(510)3724209 Psx(31f>)236-6846 TXLBCOPIER TRANSMISSION COVER XEMORANDOM DATE: f TO: i I RX i - f FAQ NO: FROM: RE: TOTAL NUMBER OF PAGES (including cover shoot) : `�--- COKMENTS: PLEASE DO ONE OR MORE OF THE FOLLOWING: r ' Please deliver immediately to the Recipient. Please request the Recipient to telephone the Sander immediately upon receipt and review. Please have the Recipient verify receipt by telephone. Original will not fallow. Original will follow by (check one of the following) : k Regular Mail Certified Mail, Return Receipt Requested Expraaet Mail Federal Express other: (FOR QUESTIONS CALL: (S14) 233-9954) The information contained in this transmission is privileged and confidential, it is intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copy of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone and return the original message to us at the above address via the U.S. Postal Service. 'Thank you. 601 DEC: — 1 ? MCl ha 1 *14 • P Fl,•,1C ROUTE SLIP _,f Hequct�_cd FOR Necessary Action Disc.... ..ed wu..iw�r�+na�ea..un.+e.:W�.w..'M,•. .vnc+::{-+�I•saw.:{.:rAf�:cnretYwr+w�,at�.cwa�J�c 1.Geta::.',,,.s•.exu:A-r:cue.�'Y:.�r:ah::Ctc:.l,.ra'1:�n:�•a:.e_asv+v.'�vr.•a.-:�aera.,:x-:c-se:.s-:-.+':��wTn+a�.•n.xs�e�omo:,oc+r:y�'.c>�.rw:.`.V�.xo.:+ta9er� COMMENTS, FROK.. .APPEALS 4 c,�,, - (_!..�7 �Q.�. � Page 3 of , r 17 L L LAW OFFICES OF CONTRA COSTA LEGAL SERVICES FOLT"ATION Tg1cpho" Main of 1017 Macdonald Avenue West County(510)233.99$4 PA Box 2289 rust($10)439-9166 lkirhmnd,CaiWrnia 94802 Central(310)372-8209 Paz(510)2364946 December 13, 1993 By FaX Clerk Board of Supervisors Contra Costa county 651 Pine Street, Martinez, CA 94553 RE; Appeal to the Boad B2Xnar.d jjqQcLY- - General Assistawe Dear Members: This is to appeal the General Assistance evidentiary hearing decision dated December 1, 1993 which upheld the determination of the Department of Social Services to deny General Assistance to Bernard McCoy. Please send a copy of the notice of the Board hearing on this appeal to both the claimant and to me. Thank you. sincerely, CONTRA COSTA LEGAL SERVICES FOUNDATION By: ELLEN J. ,TABACHNICK /Of Law Graduate EJT:vh cc: Bernard McCoy LEC: — 1 ? — 9 3 1110 " 1 *4 4 • P . 02 Social Service Department Contra Paean`^,.l.•to: }r� 40'�0-jrIa3 OfivE Periecto Villzrroal Costa Ma-,inez G3!ilornjn 3fS53 4066 County •: 'F�i S GENERAL, ASSISTANCE EVIOENT1ARy MEARING DECISION ATTIE Bernard McCoy 7 Leeward W;;ty Pittsburg, GA 94565 county No. : 0792-429211.-05LE Notice of Action: 9/22f93 Effective Date: 8/2/93 Appeal Filing Date: 9/23/93 Aid Paid Pending; No, Den3.al Date of Hearing: 11./23/93 Place of hearing: Antioch., California Appeals ...officer: Kate Qui.senberry County Pe:pre.sentati,ve: G. Gcral.t_ney Eligibility Worker Authorized Representative: E. Tabachnik, Legal Services Foundation 113bether the denial. of Claimant's General Assistance Application, dated. August 2, 1993 , for fral-idulent failure to report a veh:Xcle registered to him is correct. C .1a.'inant applied for General. Assistance on August 2 , 1993 after. having been discontinued. 7/31/93 for ;faiiure to comply with Work. Programs. On August 24 he . covpl.eted the General Assistance ':tat: ment of: Facts declaring under penalty of per jury that he did not own a car and that he had not transferred property during- the. last two years. Subsequently staff received a print-out from DMV showing Claimant as the registered owner of a 1974 Buick which if re orted. may not have made him ineligible to aid. County contends that the: failure to report the; vehicle and correctly answer DEC - 1 3 - TO3 NON 1 _W 4 • P _ 0 :3 MCCoy Page 2 questions, respecting property transfer was . intentional and for purposes of qualifying for aid. County testified that as the property was not reported, no determination of eligibility based on the: car was possible. Deter.-Atinations respe.c:ting homelessness, cited iii the denial notice, were re;:olved prior to hearing. Czainant testified that he did not report the car because lie did trot, consider himself to be its owner. Fie testi.£ied that the car had' been; paid for by his pax•ents so that he could transport t be.n bocausO they are disabled. He testified that he was the registered o�rn it of the car and could use tT,> vehicle for lois purposes al se 1. He .testified that he gave ""rdy OR.. to his brother, Roos.evelt b, could :not recall the date or 4anth. He had not changed the r . 1. P-at.ion. To support hila .test l ony he presented a written st tem *nt signed by his .mother indicating that he had given the car. to ,Roo evelt. The mother's statement said she did not know the date bf the alleged .t.ra)isfer :lout . indi.cated the year as 1993 . The s-�atement said that she did not Xnow the details of the tran6.act,iom. Claimant acknowledged that he knew he was registered as owner of. the carattae. time .of application. He test•i.fied.. that he did not report the transfer of the car, allegedly occurring within the past two .years bcckuse he forgot. Testimony has provided respecting an additional czar, but the County apparently had. no knowledge of that car, whioli was, according to Claimant"s teStimp,by owned by his sistp-r and his "brother-in-law",. so.bsequently identified as her boyfriend. Claimant's contention its that" bis reporting . orror was based on rtstake. lie testifi6d, that if reported, the cox would have been e einpt d., and would not have Imade him ineligible. Depa.rtvie:nt Manual Section. 49-1110 11,l - , provides that an applicant or irec:.ipi.ent who provid-es fraudulent information in order to qualify fora General Assistanc=e grant or for a l:arge;r grant,. or to avoid. t<erminat~ion ar .reduc:tion of aid shall be required to serve 'a six Dionth p0rlod of ineligibility. a. Application of this period of ineligibility requires the review and approval of a Social Service Division Manager. pepart.ment Manual Section 49--x.92 '1I.B. Application Responsibilities provides that during the detea.,min6ti.on of ini.ti,al, eligibility, the app.lica�nt shall assume as zruch r ., ponsi.bility as s/he can within hls�her physical or -mental capabilities. The applicant is responsible for: 1 . Providing all infornatian necessary to determine DEI- - J .� - 93 MOt4 i 5 P . 04 McCoy eligibility and amopot of grart 2. Cooperating with Soc: ial Service Staff. . . 3. Taking all actions necessary to obtain resources from any source available Department - Manual Section 49-501 , III. ,Beginning Date of :Aiid provides: A. Thp beginning date of aid is the date of application !o1r. . thd first of the ronth in which aid is authorized, which- ever is later. u. Tf; eligibility does not begin until after the date of, application aid is paid effective the date of eligibility and is pro -rated .frolyl that data, if appropriate. (An Application may be he: 14 J.f' applicant is currently tneligible, but will be eligible within 30 days. ) Absent a Showing of mental incompetan.ce, an applicant is presumed to know the; facts of his own circumstances. Claimant's excuse :fpr failing to keport inf orma';,.-ion! -about his car is based on his alleged ignorance of those facts. 1111' hearing he acknowledged that he knew he was the registered owner 6f the: 1974 Buick, and he knew he ;heal &,his ownersbip on the slip. t. o be not change This was a fact r6ported tO his eligibility 'Worker. While tie claimed in 1:he* a ng , 'that he had given the car to his brother ' he stated on hi,$ application i form, signed undi-�r pen.61ty of perjury, that he had of . given away 1 property during . the last two years. This was' an. inconsis'tency which he did , not cure at hearing. claima'nV' S statements in hearing that � he did not know the facts of 'his situation were not credible. The preponderance of evid,qnc' e supports the County's f jr;ding that fie knowingly withheld information; which he ha,d and wb ioh the Cotinty wanted. clai'mant's Contention that nqfraud occurred because the car would have been ex: enpted - if reporte:d is, not persuasive. Whether or of ,the cat had value, or wa.s transferred or wou.Id have been exepipt6, d are determinations to be made by the County eligibility worker And . not by the applicant. Jile county's action is sustained. Claim. denied. DEC ] - 9 s I11101-4 1 ►� • P J mc:c'oy Page 4 ,Social Services Appeals officer. Date Appea].s Progra at a�ger Date Tf you . Pre dissatisfied with this decision you may appeal t.he. viatter. directly to the Contra . Costa County Board of Supervisors.. Appo.aIs must be filed in writing with the Clerk of the Board, 651. . Pine $t. , ;Martinez, CA:. 94563. . Appear must be filed vithin torirte6n. (14) days of the. date of this Evidentiary He4rinq No further zi.d is -paid pending a Board of Supervisors appeal. a> TO: Board of Supervisors FROM: Perfecto Villarreal, Director Social Service Department DATE: January 18, 1994 SUBJECT: APPEAL OF GENERAL ASSISTANCE EVIDENTIARY HEARING D E C I .S I O N B Y J A M E S P E R R Y SPECIFIC REQUEST(S) OR RECOMMENDATIONS AND BACKGROUND AND JUSTIFICATION RECOMMENDATION: That the Board deny James Perry's appeal of the General Assistance Hearing decision. BACKGROUND: Claimant filed request for Hearing on September 22, 1993. The Hearing was scheduled for November 2, 1993. The claim was denied. Signature: C--,es ACTION OF BOARD ON January 18 , 1994 APPROVED AS RECOMMENDED x OTHER This is the time heretofore noticed by the Clerk of the board of Supervisors for hearing on the appeal by James Perry from the General Assistance Evidentiary Hearing decision. Jewel Mansapit, GA Program Analyst, Social Service Department, appeared and presented the staff recommendation on the appeal . James Perry, the appellant, presented testimony in support of his appeal . Ellen J. Tabachnick, Contra Costa Legal Services Foundation, spoke in support of Mr. Perry ' s appeal . The hearing was closed. Supervisor Powers moved to deny the appeal . IT IS BY THE BOARD ORDERED that the above recommendation is APPROVED; and the appeal by James Perry from the General Assistance Evidentiary Hearing decision is DENIED. VOTE OF SUPERVISORS _ UNANIMOUS (ABSENT ) AYES: 3 ,4 , 1 NOES 2 ABSENT 5 ABSTAIN none Contact: Jewel Mansapit, 313-1601 .Original: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION cc: Social Service Department TAKEN AND ENTERED ON THE MINUTES Program Analyst OF THE BOARD OF SUPERVISORS Appeals Unit ON THE DATE SHOWN. County Counsel County Administrator ATTESTED January 18 , 1994 James Perry PHIL BATCHELOR, CLERK OF THE BOARD OF SUPERVISORS AND CO TY ADMINISTRATOR BY a , DEPUTY Al 30 elm TO 6461059 P.01 01-10-1994 04:10PM FROM CCLSF—pitts-432.16?5 CONTRA COSTA LEGAL SERVICES FOUNDATION Mains Office Tclephoae 1017 Macdonald Avexaw weer Coumy(516)233-9954 P.O.BOX 7.299 Bast(510)439-9166 Akhmomf,California 94802 Ccntral(310)372-8209 Fax(S10)236.6845. TELECOPSER TRANS143:68ION COVER MEM©RANDtM DATE: January 10,1994 TO: Clerk, -Board off; supeTy�EQrp FIRM: CCC Board FAX NO: 6461059 FROMI Jarmes perry, ?ro Per . RE: Januar 18,1994 BOAXd of Pup, Appeal TOTAL NIIMBER OF PAGES (including cover sheet) : t COMMENT8: .Thank 'vou. PLEASE DO ONE -OR 'MORE OF THE FOLLOWING: X Please deliver immediately -to- the Recipient. ' Please request the. Recipient to telephone the sender .� immediatelX upon. receipt .and review. . Please have the Recipient .verify receipt by 'telephone. Original will .not :foilow. . Original will: fallow by (check one of the follawing) : Regular Mai3 Certified. Mail, Return Receipt Requested . Express `Kaii .Federal ._Express Other FOR QUESTIOX5 CALL: (510) 233-9954) The information contained in this transtnissian is. priviZeyed and confidential,. It is intended only for the use of- the individual or entity named above. If the reader of this message .is not'the intended recipient, . you .are hereby notified .that tiny .dissemination, distribution Cir. copy of. this communication; is; strictly prohibited, if you have received this communication'.in, error, please notify" us immediately by, telephone and return the original message to-us at - the above. address 'via the U.S. Postal Service. Thank you. 4ot 01-10-1994 04: 11PM FROM CCLSF-pitts-432-1675 TO 6461059 ( P.02 G� 4 T To the Contra Crista Board of Supervisors: Regarding: General Assistance Evidentiary Hearing Decision IN THE MATTER OF: James Perry 2864 Dutch Slough Rd. Oakley, CA 84561 Date of Hearing: 1112193 Place of Hearing: Antioch, CA Appeals Officer : Kate Quisesnberry I believe that the Decision reached in the hearing of 1112193 should be reversed or alternately, the penalty should be sett aside for good cause for the following reasons: 1. The alleged program violation was not an intentional, negligent, or without reasonable excuse. 2. The underlying violation contrary to the Decision was in fact, for "Good Causer" --- substantial and compelling reasons: inability to do workfare in Martinez beginning at 8 AM coming from East County with no access to public transportation during Social Servicers hours_ This is what I would have to have done in order to comply with my orders from Work Programs on 8120 and 313 <this was presented at the Hearing) : During the period in which my alleged "failures to comply" in August and September of 1993 occurred, 2 was staying in the Bethel Island area. (see #5) An the transit maps will show, there is NO buys service to the island. <see 01 and #2) The nearest public transit is 4 718 miles away, that is the BART PEI bus lines route from Concord to .Brentwood from the location I was staying at at the time, which was to the north of Dutch Slough Rd. (see #4 and #33 ' I would have to: 1. leave homer at about 2:50 AM to be certain of making it to the bus stop by 4:50 2. take, the BART PE-1 bus that leaves from Brentwood at 4:48* (which would arrive at the stop sant about 5 AM) to get to Concord BART 3. County Connection bus route 108 leaves Concord BART 0 6:50 AN 4. arrive at workfare assignment at recycling center by 8 AN. In other words, in order for me to comply which I wanted to do, I had no choice but to spend 5 to 6 hours. begininning in the middle of the night in order to be at workfare. I wanted to cooperate contrary to the hostile decision, The County erred in viewing this Sect pattern as a request for good cause based on lack of transportation although this is true, on these occasions the substantial and compelling reason for failure is due to circumstances beyond my control . The County is well aware of the distance problem. Nonetheless, despite my request, they present no solution which would enable 01-10-1994 04:11PM FROM CCLSF-pitts-432-1675 TO 6461059 P.03 rc( ` a far Feet County resident without access to reliable public transportation to get from the Oakley/Bethel Island to Martine. IN ADDITION THESE TWO ASSIGNMENTS WERE IN THE WRONG PART OF THE COUNTY. WHEN I WAS AT MY HEARING THIS COULD AND SHOULD HAVE BEEN RESOLVED. AN EAST COUNTY RESIDENT SHOULD DO AN EAST COUNTY WORKFARE ASSIGNMENT. CLAIMANT POSITION (page 2) This is an error in reporting my testimony at the hearing. "He testified that in order to catch the bus to Martinez he would have had to walk two miles to the nearest bus stop." It was 5 miles, not 2 (I said `•TWO HOURS•', NOT -TWO MILES") I submitted a map of the island and a bus schedule with map to prove my statement and snowed that it was in fact, approximately 5 miles directly on the map in front of the hearing officer . The Appeals Officer had access to both a tape recording and her notes, and she should easily have been able to remember my presentation of distances as indicated on the map due to the unusual difficulty in showing this due to the fact that showing the route from my location to the nearest public transit stop required tracing two sections of the 'snap with two different distance scales. Furthermore, this was my testimony which I maintain reflects my willingness to cooperate. The Hearing Officer account of my testimony is therefore obviously wrong and inconsistent with documentary evidence presented at the hearing. I believe that this is due to a strong predisposition against Claimant without reference to facts presented at the hearing, as if this was sufficiently important to cite In the Hearing Decision, this should have been recorded correctly. CONCLUSION AND FINDING OF "FACT" (page 4) "His failures to report the change promptly to his eligbility worker. . . There was no failure. When I had a change in permanent address or mailing address to report, I did so promptly as shown in the Decision, which cites both my Income Report for 9193 and a subsequent speedletter in which I reported my address change to my case worker (page 4) . This means the Hearing Officer herself stated in the Decision that I COMPLIED WITH ADDRESS CHANGE REPORTING REGULATIONS in the Decision. . . . and to advise Work Programs that he was living in Hutch Slough in Oakley" As can be seen below, I attempted to advise Work Programs that I was homeless in East County, NOT Central . Her finding is an obvious error as the County was obligated to act on the timely Information I gave., Work Programs. The Hearing Officer confused the issue by casting doubt on my credibility as to WHICH PART of East County that I wars a homeless 01-10-1994 04:12PM FROM CCLSF-pitts-432-1675 TO 6461059 P.04 resident of,. ratbir than considering whether an OAKLEY OR ANTIOCH (using the Hearing Officer's logic) resident must do any workfare assignment in Central Contra Costa County. The following resolves this question: CONCLUSION AND FINDING OF "FACT" (page 4) "It is noted that evidence presented in searing failed to establish as fact Claimant's contention that on 8/20 he was living in Oakley and thus a defense to a finding of willfulness based on a belief that remoteness prevented his participation did not exist. His hearing testimony contradicted his sworn statement on the 9/93 income report as well as Ms. Roden's statement on the housing form, both of which contradicted each other. Moreover, the signature attributed to Me. Baden on the unsworn note Claimant presented at hearing seemed at variances with her signature on the housing form raising questions of its reliability. The ALLEGED contradictions in my testimony regarding my location is due to errors In memory UNRELATED TO ANY DATE AT ISSUE IN THE HEARING as to WHICH portion of East County I was staying in as a homeless person at the time. I made a simple mistake in preparing the statement for Me. Boden's signature. The dates at issue in the hearing were 8/25/93 and 9/2/93. The documents I submitted to the county stated that I moved on 1.0/9/93 in the income statement and IOYIO/93 in the speedletter. I think that 30/34/93 was the data I actually moved in. The undated statement by Ann Boden said 34/24/93. These dates are OVER A MONTH after the last date at issue at the, hearing. The undated statement referred to was done months after the event from memory of a rather stressful period. In the general time period, I was staying most of the time in a boat owned by a Ran Stacey in a dock approximately across the street from my current place of residence, as well in a variety of other places in the Bethel Island area. (that's the, nature of being homeless) To the best of my knowledge, I was staying on his boat during the dates in question. The "undated" statement Simply says that I was there up to 34.120/93 . The last date in that statement should have been 10/S or 101/14 . Unfortunately, Mr. Stacey was not available for we to obtain any statement verifying that I was doing this. I do not believer that he resides in this area anymore. It is the nature of a marine resort community where people show up on boats and leave to be transient, and people, aren't legally obligated to give people they never expect to see again forwarding addresses. While I was homeless, I Was trying to be as inconspicuous as 01-10-1994 04: 13PM FROM CCLSF-pitts-432-1675 TO 6461059 P.05 posaible so that I could avoid situations where I might wind up going to jail. or to avoid general hostility from people due to being homeless, so there are no significant number of witnesses Who can testify to my location any date actually at issue at the hearing, to protect my interests at the time. I got a statement from Ms. Soden because she lives across the street from where his boat was docked at the time and she generally DID know where I was, due to her being a personal friend of mine, which made her the only available witness and her statement the only possible evidence as to where I was at the time. 3 didn't provide better documentation, such as requesting that the statement being signed and dated because I had no reason to believe that it would be required as this was regarding a point I regarded as miner. . "seemed at variance with her signature" The person who wrote this statement is my current landlord. Had there been a question the Hearing Officer should have cross-examined me on this or left the record open for clarification. The Appeals Officer for reasons unknown to me questioned why I moved from homeless - Central County to homeless - East County. This line of questioning was beyond .the scope of the issue in question, It it difficult enough to be homerless without being assaulted under oath about a time that was most difficult in that regard. While it Is not in the Hearing decision, it should be noted that these questions were framed in a manner intended to intimidate. From an "impartial" decisionmaker, I expected courtesy, From County Position (page 1) "appeared for an appointment with Work Programs and advised them that he was homeless in Antioch . . . did not indicates a problem in appearing for workfare the next day" This quote is a logical fallacy. If I hadn't stated there was a problem in that my location would be make it difficult to get to the assignment at the time, there would have been NO reference to a change of address in the file entry In fact, I requested that, the workfare assignment be shifted to East County, because I was staying in East County . The Work Programs Counselor replied that it wouldn't be possible for her to do so without a PRINTOUT FROM THE COUNTY COMPUTER SYSTEM INDICATING THAT MY MAILING ADDRESS HAD CHANGED TO EAST COUNTY. The County erred in not reassigning me to East County. They had Information as to my whereabouts. The General Assistance workfare program regulation. mandate that the assignment be given in that part of the county in which the person reaide-s_ Therrefore the failure to comply was with cause. In addition, the 1 01-10-1994 04:14PM FROM . CCLSF-Pitts-432-1675 TO 6461059 P.06 P burden oX proof is on the County to prove that .I should be sanctioned for missing Central County appointments when they know I lived in East County. The Decision does not conform to Board of Supervisors Resolution No,92/857, part 7, section 703. CONCLUSION AND FINDING OF "FACT" <page 4) From County Position <page 2) "did not contact Work Progams to explain his failure- I also had already- informed her at the time I was given the assignment of the nature of the problem precluding my appearance in Martinez at the date in question and was told there were no options for me. Assuming arguendo that such information had not been given the facts were that it waz beyond my control to comply due to the distance and hours Involved. This is not a matter of unreasonableness, rather, It was impossible. Therefore, both appointments should have been reassigned and I hove substantial and compelling reasons for not being there. I am doing the beat to comply that I can. CONCLUSION I ask that the Board reverse the termination and find that there was no willfulness and that there was "good cause", This basis for resolution was never considered In the decision. Thank you very much for your consideration. 4 inc •ely Your 1� a/�Perry Exhibits: 01 Tri-Delta Transit map #2 BART PE-1 map Y schedule #3 strip mileage chart #4 map of Bethel Island area #5 "undated statement from Ann Boden" unavailable, Appeals was given the only copy #6 County Connection Route 10a schedule 01-10-1994 04:14PM FROM CCLSF-pitts-432-1675 TO 6461059 P.07 Arrive Leave 7Concord Willow. Diablo Diablo Center Howe Rd/ Bush/ Bush/ I Pass/ Valley Valley Ave/ Veterans Pacheco Pacheco Arrive Leave Pacheco Fry Way College C011e9e Clacler Dr Hospital Blvd Blvd AMTRAK AMTRAK Blvd 6:40 6:45 6:20 6:25 6:34 6:36 6:45 6:54 7:00 704 7:25 7:31 6:50 6:55 7:04 7:06 715 7:24 7:30 7:34 7:55 8:01 7: 7: 7: 7:51 8:01 8:09 13 8:25 8:33 7:50 7:56 8:09 8:11 8:21 8:31 8:39 8:43 8:55 9;02 9 'C7 8:20 8.25 8:35 8-37 8:46 8:55 8159 9:01 9:05 9:25 9:30 9 \ 8:50 8:55 9105 9:07 :16 9:25 9:29 9:31 :35 T,55 10:00 10 9:20 9:25 9:35 9:37 9:46 9:55 9:59 10:01 10:05 10:25 10:30 10 9:50 9:55 10:05 10:07 10:16 10:25 10:29 10'31 10:35 10:55 11:00 11 10-:20 10: 5 10:35 10:37 10:46 10:55 10:59 11:01 11:05 -T1 11:30 11 10:50 10:55 11:05 11:07 11.16 11:25 11:29 1131 11:35 11:55 12:00 12 11:20 11:25 11:35 11:37 11:46 11'55 11:59 12:01 12:05 12:25 12:30 12 11:5 11:55 12:05 12:07 12:15 12:25 12:29 12.31 12:35 12:55 1100 1 12:20 12:26 12:39 12:41 12:51 1:00 1:06 1:08 1:12 1:30 1.35 1 12:50 12:56 1:09 1:11 1:21 1:30 1:36 1:38 1:42 2:00 2:05 2 1:20 1:26 1:39 i.41 1:51 2:00 2:06 2:08 2:12 2:30 2:36 2 1:50 1:56 2:09 2:11 2:21 2:30 2:36 2:38 2:42 2:55 3:01 2:20 2:26 2:39 2:41 2:51 3:01 3:09 3:13 3:25 3:31 2:50S :5 2:55 3:01 314 3:16 3:26 3:36 3:44 3:48 3:55 4:01 3:25S 3:34S 3:45S 3:25 3:31 3.44 :46 096 4:05 411 4:13 4:17 425 4:31 3:50 3:56 4:09 411 4:21 4:30 4:36 4:38 4:42 4:55 5.01 4:20 4:26 4:39 4:41 1 4:51 5:01 5.09 5:13 5:40 5:46 4:50 4:56 5:09 5:11 5:21 5:31 5:39 5:43 6:10 6:16 5:20 5:25 5:39 5:41 5:51 5:01 6:09 6.13 5:25 6:31 5:50 5:55 6:09 6:11 6:21 6:31 6:39 1 6:43 6:55 7:00 7 6:29 :35 6:48 6:50 7:0 7:09 7:15 7:17 7.2i 7:25 7:30 7' 7:05 7:10 7:19 7:21 7:30 7:39 7:43 7:45 7:49 7:50 7:55 8:04 8:06 8:15 1 8:24 8:28 8:30 8:34 9:05 9:10 9: :� iP - _ .:.x. A,.f.z,'" �' ,.frpv2 :' ter.:'�`' "�•:=` - .,. .. 4..,.V :s.,y-i,::.�:�:,�Y?c::;,,......,*5KF. �,*R.. :N�,. i:�R _ .,�v'^::�•�':,;.,;....:t.:a1;ir�;;:f �` Willow Arrive Leave Center Leave Diablo Diablo BART Pass/ Ave/ Howe Rd/ Sushi Bush/ Concord Fry Way Valley Valley GlacierHogrialPo pePacheco I oCollege College DrBlvd Blvd AMTRAK AMTRAK Bd 7:00 7:04 7:00 7:04 .7:12 7:14 7.23 7:32 7:36 7:38 7:42 7:50 7:54 7:50 7:54 8:02 8:04 8:13 8:22 8:26 8:28 8:32 8:40 8:44 8:40 8:44 8:52 8:54 9:03 9:12 9.16 9:18 9:22 9:30 9:34 9:30 9:34 9:42 9:44 9:53 10:02 10:06 10:08 10:12 10:20 10:25 10:20 10.24 10:33 10:35 1 10:44 10:53 10:58 111:00 11:05 11:10 11:15 11:10 11:14 11:23 11:25 11:34 11:43 11:48 11:50 11:55 12:00 12:05 12:00 12:04 12:13 12:15 12:24 12:33 12:38 12:40 12.45 12:50 12:55 12:50 12:54 1:03 1:05 1:14 1:23 1:28 1.30 1:35 1.40 1.45 1:40 1:44 1:53 1:55 2:04 2:13 2:18 2:20 2:25 2:30 2:35 2:30 2:34 2:43 2:45 2:54 3.03 3:08 3:10 3:15 3:20 3:25 3:20 3:24 3:33 3:35 3:44 3:53 3:58 4:00 1 4:05 420 4:15 4:10 4:14 4:23 4:25 4:34 4:43 4:48 4:50 4:55 5:00 5:05 5:00 514 5:13 5:15 5:24 5:33 5:38 5:40 5:45 5:50 5:55 5:50 5:54 6:03 6:05 6:14 6:23 6:28 6:30 6:35 6:40 6:45 6:40 6:44 6:53 6:55 7:04 7:13 7:18 7:20 7:25 7:30 7:34 7:30 7:34 7:42 7:44 7:53 8:02 8:06 8:08 1 8:12 01-10-1994 04:16PM FROM CCLSF-pitts-432-1675 TO 6461059 P.09 H.Sp. ' l S 1 S OHAAAI J J"O"y J = C/ HWY 4 H.LLCREST PARK B RIDE ; . LATH ROUTES _ PEI..,. .r t Cv PRESS ,. 0.4•., t' - . wu no. PEI T ....... P2X i ., a gi •.1: . e; .SeW:.0 LEGEND ROUTE PE ROUTE PEI j ROUTE P2X ® EXPRESS(NO STOPS) 1 SCHEDULE POINTS �f od © STOPS ;�,.` f,.�„• "�J, • S`,,,• '�'!,'' . 2ND/OA*-.aoo I. 01-10-1994 04:15PM FROM CCLSF—pitts-432-1675 TO 6461059 P.08 Ida ,: Weekday x y 4i. ..w'�iiR` : L 1 a BART IT Express Bus BART Express Bus Thain ;I ,•:, W PittSDu.' 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[3L. 100 Glacier Dr.,Martinez [3 (Lion's G.3 i e) ❑ H. x1305 Macdonald Ave.,Richmond ❑ x. 2301 Stanwell Dr.,Concord ❑ G. 3045 Research Dr., Richmond (Central.:va Closed Files) [3E. 3630 San Pablo Dam Rd., EI Sob. ❑ Y 2450 A Stanwell Dr.,Concord (YIACT) ❑ R. 525 Second Street, Rodeo ❑ F. 330-25th Street, Richmond (PIC) ❑ _ .OTHER DEPARTMENTS ;RTI ❑ Auditor/Controller �) DAFamily Support ounty Administrator p Welfare Section p C) DA Investigations ❑ Risk Management ❑ Health Services ❑ Data Processing Services ❑ County Counsel p County Hospital ❑ Probation ❑ Alternate Defender O Ward ❑ Purchasing ❑ County Personnel p CCC Health Plan p ❑ CONCORD WALNUTCREEK RICHMOND JUVENILE COURT E3 Central Services ❑Office of Revenue Collection ❑Public Deli rider ❑ Antioch ❑Public Defender ❑ ❑ ❑ Richmond ❑ ❑ Martinez ❑ OTHER: AS ❑ Requested FOR ❑ Necessary Action NOTE & ❑ Return ❑ Discussed ❑ Information ❑ Discard ❑ Recommendation ❑ .-Ile ;❑ Approval/Signature COMMENTS FROM: A P P E A L S PCN' IE�[PNQNEy�p(IBER R 2(Rev.6/92) 5EE REVERSE FOK ADDITIONAL COMMENTS Social Service Department Contra Please reply to. Perfecto Villarreal -:0 Douglas Drive Directc• Costa Costa Mart nez,California e-553---�& Count Y CONTRA COSTA COUNTY ``F°\ RECEIVED : .r DEC2 3 1 OFFICE OF COLINITY ADMINISTRATOR GENERAL ASSISTANCE EVIDENTIARY HEARING IN THE MATTER OF:. James Perry 2860 Delta Slough Rd. Oakley, CA 94561 County No, : 07 09-398685-A4AB Notice of Action: 9/15/93 Effective Date: 9/30/93 Appeal Filing Date: 9/22/93 Aid Paid Pending: Yes Date of Hearing: 11/2/93 Place of Hearing: Antioch,, California Appeals Officer: Kate Quisenberry County Representative: C. Dudley Authorized Representative: None ISSUE: Whether the County's proposed discontinuance of General Assistance .for willful failure to comply with workfare assignments on 8/26/93 and 9/2/93 for a period of one month is correct. COUNTY POSITION: Claimant has received General Assistance periodically since 1991. County records reflect that he reported himelf as homeless in Central County until 8/25/93 when he appeared for an appointment with Work Programs . and advised them that he was homeless in Antioch. He was given his workfare appointment slip during that contact and did not indicate a problem in appearing for workfare the next day. He subsequently failed to appear for work fare assignments but only .the 8/26 and 9/2 failures are in issue at this hearing. Perry Page 2 He did not contact . Work Programs to explain his failure. On October 11 County received Claimant's 9/93 income report indicating that he had moved to 2860 Dutch Slough Rd. Oakley on 10/9/93. On 10/12/93 the County sent a Living Arrangements Speedletter to Claimant to verify' his new housing arrangement and Claimant returned the form 10/26 indicating his date of move as 10/10/93 The verification form was signed by both Claimant and Ms. Boden, his landlord. County's position is that Claimant's failure to appear for workfare was without reasonable excuse and was willful. CLAIMANT POSITION: In hearing Claimant presented an undated statement which he testified was signed by Ann Boden which stated that he was staying on a boat belonging to Ron Stacy from about 8/20/93 to about 9/10/93 . Ms. Boden was not present at hearing, and no statement. from Mr. Stacy was presented. Claimant testified that he was unable to appear for the Martinez workfare assignment because transportation was not readily available. He testified that in order to catch the bus to Martinez he would have to walk two miles to the bus stop, and that the trip to Martinez by bus, including stop-over at Bart in Concord would take several hours which he considered unreasonable. He testified that he believed he should be excused from Work- Programs based on transportation distance and inadequate transportation service from that area. He denied telling Work Programs that he was homeless in Antioch and said he advised them that he was homeless in the East County area. REGULATORY AUTHORITY: Department Manual Section 49-210,II,B,1, provides that an individual who does not have a medically verified physical or mental disability, or who has not been determined to be unemployable by the Vocational Counselor, is considered employable. Board of Supervisors Resolution 192/857 adopted December 15, 1992, provides: Part 7, Section 703: A recipient who fails or refuses to comply with General Assistance Program requirements as expressed in this resolution or. in the Social Service Department Manual of Policies and Procedures shall be discontinued aid and sanctions will be imposed as follows unless the recipient shows that the failure or refusal to comply was for good cause. Perry Page 3 Department Manual Section 49-111,II,F,2, provides that a recipient who fails to cooperate with the Social Service Department by failing to meet any one of his or her enumerated responsibilities without good cause, shall be discontinued aid, and sanctions will be imposed as follows: a. first failure: one month. b. second failure: three months. c. third failure: six months. Department Manual Section 49-111,II,G,2, provides that the reasons which establish good cause for a failure to cooperate or comply are subject to verification and include, but are not limited to, the following: a. the failure has occurred by reason of a disability under the Americans with Disabilities Act 1) The burden of proof to establish that the failure occurred because of a disability is on the applicant or recipient 2) The applicant/recipient's showing may -be rebutted by the Department b. employment has been obtained, .c. scheduled job interview or testing, d. mandatory court appearance, e. incarceration, f. illness, g. death in the family, h. other substantial and compelling reason. These must be * reviewed and approved by the Division Manager. Department Manual Section 49-111,II,H,1 provides that a willful act is one that is intentional or without- reasonable excuse or cause. It need not be done with a specific purpose to violate program requirements. a. The burden of proof to establish good cause, which may -include proof that the failure was not willful is on the applicant/recipient. b. The Department may rebut a showing of good cause by proving that the failure to comply was willful, in which case the Department has the burden of proof. c. In all cases it is presumed, subject to rebuttal, that the ordinary consequences of the applicant/recipient's voluntary acts are intentional, and thus willful. 2. Willfulness cannot be found where the person is mentally disabled to the, extent that s/he does not understand his/her responsibilities or is incapable of fulfilling them. 3. Conduct which involves negligence, inadvertence, or disability may or may not be willful. Perry Page 4 a. Three or more acts of negligent failure of the recipient to follow program requirements, which may include acts for which the recipient previously has been discontinued from aid or, sanctioned, evidence willfulness. CONCLUSION AND FINDING OF FACT: There is no regulatory authority permitting a Hearing Officer to excuse a recipient from Work Program participation based on remoteness and Claimant is advised to submit his request for such exemption to the General Assistance Review Panel, located at 40 Douglas Drive, Martinez, 94553. Under current regulation, transportation is not acceptable good cause and thus it is concluded that good cause does not exist for the failure. Moreover, the County's finding that Claimant intentionally failed to appear for his assignment is sustained. It is noted that evidence presented in hearing failed to establish as fact Claimant's contention that on 8/20 he was living in Oakley and thus a defense to a finding of willfulness based on a belief that remoteness prevented his participation does not exist. His hearing testimony contradicted his sworn statement on the 9/93 income report as well as Ms. Boden's statement on the housing form, both of which contradicted each other. Moreover, the signature attributed to Ms. Boden on the unsworn note Claimant presented in hearing seemed at variance with the signature on the housing form raising questions of its reliability. And his failures to report the change promptly to his eligibility worker and to advise Work Programs on 8/25 when he met face-to-face that he was living on Dutch Slough in Oakley undermined his contention that he had moved on August 20 and failed to create a basis for a finding of good faith. ORDER• Claim denied. Kate Ouisenberry 11130193 Social Services Appeals Officer Date AppecAs Program Wdnage—r Date If you are dissatisfied with this decision you may appeal the CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 23, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT: Hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By James R. Perry III Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by January 11, 1994 plus any information which your department may wish to file for the Board appeal which is set for 2 :30 p.m. on Tuesday, January 18, 1994 . Attachment cc: Board members County Administrator County Counsel Phi The Board of Supervises Contra lark f the Boar Clerk of the Board and County Administration BuildingCOSta County Administrator 651 Pine St., Room 106 (510)646-2371 Martinez, California 94553 County Tom Powers,1st District Jeff Smith,2nd District Gayle Bishop.3rd District �' ° Sunne Wright McPeak 4th District .• Tom Torlskson,5th District December 23, 1993 a co ,r James R. Perry III 2860 Dutch Slough Road Oakley, CA 94561 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 18, 1994 . In accordance with Board of Supervisor Resolution No. 92/554, your written presentation and all relevant material pertaining to the appeal must be filed with the Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure. Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Admini trat By An e velli, Deputy Clerk Enclosure CC: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,CALIFORNIA s Adopted this Order on August 4, 1992 by the following vote: AYES: Supervisors Fanden, Schroder, Torlakson, McPeak NOES: None ABSENT: Supervisor Powers ABSTAIN: None =a=a===aa==aa====a===a=a======aa===aa=aaa====________ r SUBJECT: General Assistance Hearing } Resolution Number 92/.L54 and Appeal Procedures } The Contra Costa County Board of Supervisors RESOLVES that the provisions of Resolutions No. 74/365,75/28, 87/468, and 88/576 which established standards for General Assistance Hearings and Appeals are hereby superseded effective September 1, 1992: Part 1 Hearings 101. General Assistance applicants shall be given written notice of action to deny an application. 102. General Assistance recipients shall be given written notice, mailed at least 10 days prior to the effective date, of proposed action which will reduce, suspend or terminate his or her General Assistance grant for cause. Prior notice is not required for action resulting from Board of Supervisors' changes in grant levels. 103. A General Assistance applicant or recipient shall receive a Social Service Department hearing upon their timely written request. (a) The applicant or recipient must deliver or mail a written request for a hearing within fourteen days of the date the Notice of Action was mailed. Absent evidence to the contrary, the notice is presumed to have been mailed on the date it bears, and a request for a bearing is presumed to have been delivered on the date it is received and mailed on the date it is postmarked. 104. Where a GA recipient timely requests a bearing challenging a proposed action which will reduce, suspend or terminate his or her General Assistance grant, the proposed action will be stayed until a decision is rendered. (a) Actions implementing Board of Supervisor changes in grant levels are not appealable, and bearing requests based thereon may be summarily denied. 105. Hearings will be scbeduled within thirty days of the date of receipt of a request for a bearing. The Appeals Unit will mail a written notice of the bearing to the claimant at least ten days in advance of the Hearing date. 106. When a request for a bearing has been received,the claim may be reviewed and resolved in the claimant's favor by a pre-bearing review. (a) Proposed pre-bearing resolutions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager. 107. If the claimant is unable to attend the bearing at the originally scheduled date and time, and a timely request for postponement is made,the Hearing Officer will make an evaluation of the request.The bearing will not be continued beyond the bearing date unless authorized by a Hearing Officer on one of the following grounds,which require verification: (a) bearing is continued at request of the Social Service Department, RESOLUTION NUMBER 92/554 (b) mandatory court appearance which cannot be accommodated by adjusting the bearing time, (c) illness which prevents travel, (d) death in the immediate family, (e) other substantial and compelling reason. (as approved by the Appeals Manager) loS. Decision (a) A written decision shall be mailed to the claimant within thirty days after the bearing record is dosed,unless the Department trends the time in writing,for cause. (b) Proposed decisions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager prior to notification of the claimant.The Hearing Officer's findings of fact are not subject to change,but the General Assistance Policy Manager may order re- bearing for cause. Part 2 Appeals to the Board 201. The applicant or recipient may appeal an adverse bearing decision to the Board of Supervisors. 202. A written appeal must be received by the perk of the Board of Supervisors%ithin fourteen days after the decision has been mailed to the claimant. Absent evidence showing the contrary, a bearing decision is presumed to have been mailed on the date it bears. (a) An appeal to the Board will not stay the implementation of the Hearing decision,and the recipient shall not be entitled to continue to receive assistance pending further bearing. (b) The appeal will be scheduled for the first available Board meeting,but no earlier than the third meeting following receipt of the appeal. 203. The Administrative Review Panel may review appeals of Hearing decisions and recommend proposed action to the Director. r (a) If the Director supports the bearing decision,the Appeals unit will be notified to proceed with the presentation to the Board. (b) U the Director finds in favor of the claimant,the Clerk of the Board will be notified to withdraw the item from the Board agenda.The appropriate Social Service District office will be advised to take corrective action. 204. Both the appellant and the Department must file all written materials at least one week before the date set for the Board bearing. New material must be served by mail on the opposing party. 205. (a) Upon bearing the appeal,the Board shall make any tequired fact determinations based on the record on appeal and testimony received by the Board.This record shall include the Department's Hearing Officer's fact findings,plus any papers filed with that Officer. (b) If the fasts upon which the appeal is based are not in dispute or if any disputed facts are not relevant to the issue ultimately to be decided by the Board,the Board will proceed immediately to the next step without considering fact questions.The parties may stipulate to an agreed set of facts. RESOLLMON NUM3ER 92 f 5__ 206. f. (a) Once the facts are determined,or if there are no fact determinations required by the appeal, • the Board will consider legal issues presented by the appeal.Legal issues are to be framed, insofar as possible,before the Hearing and shall be based on the Department's Hearing Officer':decision and such other papers as may be filed. {b} Appealing parties may make legal arguments both by written brief and orally before the Board. If the issues are susceptible of immediate resolution,the board may immediately decide them at the appeal bearing. If the County Counsel's advice is needed on legal questions, the Board may take the matter under submission,reserving its final judgment until it receives such advice. 207. The Board may decide an appeal immediately after bearing or take the appeal under ",submission. 1�w�e + s►k Y t go old er�e+�ct sour M „n action rkon IM 0 d^ ** 1pkW1M d ifi� scam of on go dW* z ATTMEZIIU.ine Ciounb a�%► RESOLU nON NUMBER 92/J34„ CA 2 ��, � oAAo o� a��'�G 9 kki C�RK�QNT co Q C " QVA Ok ©0 0 Qvel 00 t , p w� -V V- LA 71 1 o� a4vo, 0 ev I eA L) 0 C, r� C. Olq '-) 14.(- vv t 5 t2- rA I- � 0 ; , �--� 0� � r OV C �1 C � C © � � 71 1 Social Service Department Contra 1 -, rleasereplyto: • 40 Douglas Drive Wncbr Perfecto�� ' Costa Martinez,California 94553-4068 County ............... Tqcov�`� GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION IN THE MATTER OF: James Perry 2860 Delta Slough Rd. Oakley, CA 94561 County No. : 07 09-398685-A4AB Notice of Action: 9/15/93 Effective Date: 9/30/93 Appeal Filing Date: 9/22/93 Aid Paid Pending: Yes Date of Hearing: 11/2/93 Place of Hearing: Antioch, California Appeals Officer: Kate Quisenberry County Representative: C. Dudley Authorized Representative: None ISSUE: Whether the County's proposed discontinuance of General Assistance for willful failure to comply with workfare assignments on 8/26/93 and 9/2/93 for a period of one month is correct. COUNTY POSITION: Claimant has received General Assistance periodically since 1991. County records reflect that he reported himelf as homeless in Central County until 8/25/93 when he appeared for an appointment with Work Programs and advised them that he was homeless in Antioch. He was given his workfare appointment slip during that contact and did not indicate a problem in appearing for workfare the next day. He subsequently failed to appear for work fare assignments but only the 8/26 and 9/2 failures are in issue at this hearing. Social Service Department Contra Please reply to: 1 40 Douglas Drive ,Perfecto VillarrealCosta Martinez.California Directo County CONTRA COSTA COUNTY RECEIVED DEC i 3 ` OFFICE OF COUNITY ADMINISTRATOR GENERAL ASSISTANCE EVIDENTIARY HEARING D9CISION IN THE MATTER OF: James Perry 2860 Delta Slough Rd. Oakley, CA 94561 County No. : 07 09-398685-A4AB Notice of Action: 9/15/93 Effective Date: 9/34/93 Appeal Filing Date: 9/22/93 Aid Paid Pending: Yes Date of Hearing: 11/2/93 Place of Hearing: Antioch,, California Appeals Officer: Kate Quisenberry County Representative: C. Dudley Authorized Representative: None ISSUE: Whether the County's proposed discontinuance of General Assistance .for willful failure to comply with workfare assignments on 8/26/93 and 9/2/93 for a period of one month is correct. COUNTY POSITION: Claimant has received General Assistance periodically since 1991. County records reflect that he reported himelf as homeless in Central County until 8/25/93 when he appeared for an appointment with Work Programs and advised them that he was homeless in Antioch. He was given his workfare appointment slip during that contact and did not indicate a problem in appearing for workfare the next day. He subsequently failed to appear for work fare assignments but only the 8/26 and 9/2 failures are in issue at this hearing. Perry Page 2 He did not contact Work Programs to explain his failure. On October 11 County received Claimant's 9/93 income report indicating that he had moved to 2860 Dutch Slough Rd. Oakley on 10/9/93. On 10/12/93 the County sent a Living Arrangements Speedletter to Claimant to verify his new housing arrangement and Claimant returned- the form 10/26 indicating his date of move as 10/10/93 The verification form was signed by both Claimant and Ms. Boden, his landlord. County's position is that Claimant's failure to appear for workfare was without reasonable excuse and was willful. CLAINMT POSITION: In hearing Claimant presented an undated statement which he ,testified was signed by Ann Boden which stated that he was staying on a boat belonging to Ron Stacy from about 8/20/93 to about 9/10/93. Ms. Boden was not present at hearing, and no statement. from Mr. Stacy was presented. Claimant testified that he was unable to appear for the Martinez workfare assignment because transportation was not readily available. He testified that in order to catch the bus 'to Martinez he would have to walk two miles to the bus stop, and that the trip to Martinez by bus, including stop-over at Bart in Concord would take several hours which he considered unreasonable. He testified that he believed he should be excused from Work- Programs based on transportation distance and inadequate transportation service from that area. He denied telling Work Programs that he was homeless in Antioch and said he advised them that he was homeless in the East County area. 'REGULATORY AUTHORITY: Department Manual Section 49-210,II,B,1, provides that an individual who does not have a medically verified physical or mental disability, or who has not been determined to be unemployable by the Vocational Counselor, is considered employable. Board of Supervisors Resolution 192/857 adopted December 15, 1992, provides: Part 7, Section 703: A recipient who fails or refuses to comply with General Assistance Program requirements as expressed in this resolution or in the Social Service Department Manual of Policies and Procedures shall be discontinued aid and sanctions will be imposed as follows unless the recipient shows that the failure or refusal to comply was for good cause. Perry Page 3 Department Manual Section 49-111,II,F,2, provides that a recipient who fails to cooperate with the Social Service Department by failing to meet any one of his or her enumerated responsibilities without good cause, shall be discontinued aid, and sanctions will be imposed as follows: a. first failure: one month. b. second failure: three months. c. third failure: six months. Department Manual Section 49-111,II,G,2, provides that the reasons which establish good cause for a failure to cooperate or comply are subject to verification and include, but are not limited to, the following: a. the failure has occurred by reason of a disability under the Americans with Disabilities Act 1) The burden of proof to establish that the failure occurred because of a disability is on the applicant or recipient 2) The applicant/recipient's showing maybe rebutted by the Department b. employment has been obtained, c. scheduled job interview or testing, d» mandatory court appearance, e. incarceration, f. illness, g. death in the family, h, other substantial and compelling reason. These must 15e - reviewed and approved by the Division Manager. Department Manual Section 49-111,II,H,1 provides that a willful act is one that is intentional or without reasonable excuse or cause,_ It need not be done with a specific purpose to violate program requirements. a. The burden of proof to establish good cause, which may include proof that the failure was not willful is on the applicant/recipient. b. The Department may rebut a showing of good cause by proving that the failure to comply was willful, in which case the Department has the burden of proof. c. In all cases it is presumed, subject to rebuttal, that the ordinary consequences of the applicant/recipient's voluntary acts are intentional, and thus willful. 2. Willfulness cannot be found where the person is mentally disabled to the extent that s/he does not understand his/her responsibilities or is incapable of fulfilling them. 3. Conduct which involves negligence, inadvertence, or disability may or may not be willful. Perry Page 4 a. Three or more acts of negligent failure of the recipient to follow program requirements, which may include acts for which the recipient previously has been discontinued from aid or sanctioned, evidence willfulness. CONCLUSION AND FINDING OF FACT: There is no regulatory authority permitting a Hearing Officer to excuse a recipient from Work Program participation based on remoteness and Claimant is advised to submit his request for such exemption to the General Assistance Review Panel, located at 40 Douglas Drive, Martinez, 94553. Under current regulation, -transportation is not acceptable good cause and thus it is concluded that good cause does not exist for the failure. Moreover, the County's finding that Claimant intentionally failed to appear for his assignment is sustained. It is noted that evidence presented in hearing failed to establish as fact Claimant's contention that on 8/20 he was living in Oakley and thus a defense to a finding of willfulness based on a belief that remoteness prevented his participation does not exist. His hearing testimony contradicted his sworn statement on the 9/93 income report as well as Ms. Boden's statement on the housing form, both of which contradicted each other. Moreover, the signature attributed to Ms. Boden on the unsworn note Claimant presented in hearing seemed at variance with the signature on the housing form raising questions of its reliability. And his failures to report the change promptly to his eligibility worker and to advise Work Programs on 8/25 when he met face-to-face that he was living on Dutch Slough in Oakley undermined his contention that he had moved on August 20 and failed to create a basis for a finding of good faith. ORDER: Claim denied. Kate Quisenberry 11Z30J23 Social Services Appeals officer Date AppeAs Program k6inager Date If you are dissatisfied with this decision you may appeal the REGEvED -'7- R .� Iq I c A" r G� of SUPEfiVISOR G l CI ER co FtD co Q t tQ 1 t:a eVIC) aa ve A5577 44avv LA t l CA)- P--.4vovvv � -�- ev- � � lv c - Social Service Deparent Contra Please reply to: 40 Douglas Drive Perfecto Villarreal Costa i' Director Martinez,California 94553-4068 County SF Ofja,a t��P GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION IN THE MATTER OF: James Perry 2860 Delta Slough Rd. Oakley, CA 94561 County No. : 07 09-398685-A4AB Notice of Action: 9/15/93 Effective Date: 9/30/93 Appeal Filing Date: 9/22/93 Aid Paid Pending: Yes Date of Hearing: 11/2/93 Place of Hearing: Antioch, California Appeals Officer: Kate Quisenberry County Representative: C. Dudley Authorized Representative: None ISSUE: Whether the County's proposed discontinuance of General Assistance for willful failure to comply with workfare assignments on 8/26/93 and 9/2/93 for a period of one month is correct. COUNTY POSITION: Claimant has received General Assistance periodically since 1991 . County records reflect that he reported himelf as homeless in Central County until 8/25/93 when he appeared for an appointment with Work Programs and advised them that he was homeless in Antioch. He was given his workfare appointment slip during that contact and did not indicate a problem in appearing for workfare the next day. He subsequently failed to appear for work fare assignments but only the 8/26 and 9/2 failures are in issue at this hearing. the Contra Costa Board of Supervisors: RECEIVED Regarding: ne al Assistance Evidentiary Hearing Decision IN THE MATTER OF: JAN I 11994 James Perry CORKBOARD OF SUPERVISORS 2860Dutch Slough Rd. NTRACOSTACO. Oakley, CA 94561 Date of Hearing: 1112/93 Place of Hearing: Antioch, CA Appeals Officer : Kate Quisenberry I believe that the Decision reached in the hearing of 1112193 should be reversed or alternately, the penalty should be set aside for good cause for the following reasons: 1 . The alleged program violation was not an intentional, negligent, or without reasonable excuse. 2. The underlying violation contrary to the Decision was in fact, for "Good Cause" -- substantial and compelling reasons: inability to do workfare in Martinez beginning at 8 AM coming from East County with no access to public transportation during Social Services hours. This is what I would have to have done in order to comply with my orders from Work Programs on 8/20 and 913 (this was presented at the Hearing) : During the period in which my alleged "failures to comply" in August and September of 1993 occurred, I was staying in the Bethel Island area. (see #5) As the transit maps will show, there is NO bus service to the island. (see #1 and #2) The nearest public transit is 4 3/8 miles away, that is the BART PEI bus line route from Concord to Brentwood from the location I was staying at at the time, which was to the north of Dutch Slough Rd. (see #4 and #3) I would have to: 1 . leave home at about 2:50 AM to be certain of making it to the bus stop by 4:50 2. take the BART PE-1 bus that leaves from Brentwood at 4:48* (which would arrive at the stop at about 5 AM) to get to Concord BART 3. County Connection bus route 108 leaves Concord BART @ 6:50 AM 4. arrive at workfare assignment at recycling center by 8 AM. In other words, in order for me to comply which I wanted to do, I had no choice but to spend 5 to 6 hours begininning in the middle of the night in order to be at workfare. I wanted to cooperate contrary to the hostile decision. The County erred in viewing this fact pattern as a request for good cause based on lack of transportation although this is true, on these occasions the substantial and compelling reason for failure is due to circumstances beyond my control . The County is well aware of the distance problem. Nonetheless, despite my request, they present no solution which would enable • • Py a far East County resident without access to reliable public transportation to get from the Oakley/Bethel Island to Martinez. IN ADDITION THESE TWO ASSIGNMENTS WERE IN THE WRONG PART OF THE COUNTY. WHEN I WAS AT MY HEARING THIS COULD AND SHOULD HAVE BEEN RESOLVED. AN EAST COUNTY RESIDENT SHOULD DO AN EAST COUNTY WORKFARE ASSIGNMENT. CLAIMANT POSITION (page 2) This is an error in reporting my testimony at the hearing. "He testified that in order to catch the bus to Martinez he would have had to walk two miles to the nearest bus stop." It was 5 miles, not 2 (I said "TWO HOURS", NOT "TWO MILES") I submitted a map of the island and a bus schedule with map to prove my statement and showed that it was in fact, approximately 5 miles directly on the map in front of the hearing officer. The Appeals Officer had access to both a tape recording and her notes, and she should easily have been able to remember my presentation of distances as indicated .on the map due to the unusual difficulty in showing this due to the fact that showing the route from my location to the nearest public transit stop required tracing two sections of the map with two different distance scales. Furthermore, this was my testimony which I maintain reflects my willingness to cooperate. The Hearing Officer account of my testimony is therefore obviously wrong and inconsistent with documentary evidence presented at the hearing. I believe that this is due to a strong predisposition against Claimant without reference to facts presented at the hearing, as if this was sufficiently important to cite in the Hearing Decision, this should have been recorded correctly. CONCLUSION AND FINDING OF "FACT" (page 4) "His failures to report the change promptly to his eligbility worker. . . There was no failure. When I had a change in permanent address or mailing address to report, I did so promptly as shown in the Decision, which cites both my Income Report for 9153 and a subsequent speedletter in which I reported my address change to my case worker (page 4) . This means the Hearing Officer herself stated in the Decision that I COMPLIED WITH ADDRESS CHANGE REPORTING REGULATIONS in the Decision. . . . and to advise Work Programs that he was living in Dutch Slough in Oakley" As can be seen below, I attempted to advise Work Programs that I was homeless in East County, NOT Central . Her finding is an obvious error as the County was obligated to act on the timely information I gave Work Programs. The Hearing Officer confused the issue by casting doubt on my credibility as to WHICH PART of East County that I was a homeless resident of, rather than considering whether an OAKL£Y OR ANTIOCH fusing the Hearing Officer's logic) resident must do any workfare assignment in Central Contra Costa County. The following resolves this question: CONCLUSION AND FINDING OF "FACT" {page 4) "It is noted that evidence presented in hearing failed to establish as fact Claimant' s contention that on 8/20 he was living in Oakley and thus. a defense to a finding of willfulness based on a belief that remoteness prevented his participation did not exist. His hearing testimony contradicted his sworn statement on the 9/93 income report as well as Ms. Boden' s statement on the housing form, both of which contradicted each other. Moreover, the signature attributed to Ms. Boden on the unsworn note Claimant presented at hearing seemed at variance with her signature on the housing form raising questions of its reliability. " The ALLEGED contradictions in my testimony regarding my location is due to errors in memory UNRELATED TO ANY DATE AT ISSUE IN THE HEARING as to WHICH portion of East County I was staying in as a homeless person at the time. I made a simple mistake in preparing the statement for Ms. Boden's signature. The dates at issue in the hearing were 8/26/93 and 9/2/93. The documents I submitted to the county stated that I moved on 30/9/93 in the income statement and 10/10/93 in the speedletter. I think that 10/10/93 was the date I actually moved in. The undated statement by Ann Boden said 10/20/93. These dates are OVER A MONTH after the last date at issue at the hearing. The undated statement referred to was done months after the event from memory of a rather stressful period. In the general time period, I was staying most of the time in a boat owned by a Ron Stacey in a dock approximately across the street from my current place of residence, as well in a variety of other places in the Bethel Island area. (that's the nature of being homeless) To the best of my knowledge, I was staying on his boat during the dates in question. The "undated" statement simply says that I was there up to 10/20/93 . The last date in that statement should have been 10/9 or 10/10 . Unfortunately, Mr. Stacey was not available for me to obtain any statement verifying that I was doing this. I do not believe that he resides in this area anymore. It is the nature of a marine resort community where people show up on boats and leave to be transient, and people aren't legally obligated to give people they never expect to see again forwarding addresses. While I was homeless, I was trying to be as inconspicuous as possible so that I could avoid situations where I might wind up going to jail or to avoid general hostility from people due to being homeless, so there are no significant number of witnesses who can testify to my location any date actually at issue at the nearing, to protect my interests at the time. I got a statement from Ms. Boden because she lives across the street from where his boat was docked at the time and she generally DID know where I was, due to her being a personal friend of mine, which made her the only available witness and her statement the only possible evidence as to where I was at the time. I didn't provide better documentation, such as requesting that the statement being signed and dated because I had no reason to believe that it would be required as this was regarding a point I regarded as minor. "seemed at variance with her signature" The person who wrote this statement is my current landlord. Had there been a question the Hearing Officer should have cross-examined me on this or left the record open for clarification. The Appeals Officer for reasons unknown to me questioned why I moved from homeless - Central County to homeless - East County. This line of questioning was beyond the scope of the issue in question. It it difficult enough to be homeless without being assaulted under oath about a time that was most difficult in that regard. While it is not in the Hearing Decision, it should be noted that these questions were framed in a manner intended to intimidate. From an "impartial" decisionmaker, I expected courtesy. From County Position (page 1) "appeared for an appointment with Work Programs and advised them that he was homeless in Antioch . . . did not indicate a problem in appearing for workfare the next day" This quote is a logical fallacy. If I hadn't stated there was a problem in that my location would be make it difficult to get to the assignment at the time, there would have been NO reference to a change of address in the file entry. In fact, I requested that, the workfare assignment be shifted to East County, because I was staying in East County. The Work Programs Counselor replied that it wouldn't be possible for her to do so without a PRINTOUT FROM THE COUNTY COMPUTER SYSTEM INDICATING THAT MY MAILING ADDRESS HAD CHANGED TO EAST COUNTY. The County erred in not reassigning me to East County. They had information as to my whereabouts. The General Assistance workfare program regulation mandate that the assignment be given in that part of the county in which the person resides. Therefore the failure to comply was with cause. In addition, the burden of proof is on the County to prove that I should be sanctioned for missing Central County appointments when they knew e I lived in East County. The Decision does not conform to Board of Supervisors Resolution No.92/657 , part y, section 703. CONCLUSION AND FINDING OF "FACT" (page 4) From County Position (page 2) "did not contact Work Progams to explain his failure" I also had already informed her at the time I was given the assignment of the nature of the problem precluding my appearance in Martinez at the date in question and was told there were no options for me. Assuming arguendo that such information had not been given the facts were that it was beyond my control to comply due to the distance and hours involved. This is not a matter of unreasonableness, rather, it was impossible. Therefore, both appointments should have been reassigned and I have substantial and compelling reasons for not being there. I am doing the best to comply that I can. CONCLUSION I ask that the Board reverse the termination and find that there was no willfulness and that there was "good cause". This basis for resolution was never considered in the decision. Thank you very much for your consideration. inc �Perry rs: an Exhibits: #1 Tri-Delta Transit map #2 BART PE-1 map / schedule 43 strip mileage chart 44 map of Bethel Island area #5 "undated statement from Ann Boden" unavailable, Appeals was given the only cosy #6 County Connection Route 108 schedule • D AFRIDAY Arrive Leave Leave Willow Diablo Diablo Center Howe Rd/ Bush/ Bush/ Ho' BART Pass/ Valley Valley Ave/ Veterans Pacheco Pacheco Arrive Leave Pacheco Pa Concord Fry Way College College Glacier Dr Hospital Blvd Blvd AMTRAK AMTRAK Blvd I 6:40 6:45 6:20 6:25 6:34 6:36 6:45 6:54 7:00 7:04 7:25 7:31 6:50 6:55 7:04 7:06 7:15 7:24 7:30 7:34 7:55 8:01 7:20 7:26 7:39 7:41 7:51 8:01 8:09 8:13 8:25 8:33 7:50 7:56 8:09 8:11 8:21 8:31 8:39 8:43 8:55 9:02 9: 8:20 8:25 8:35 8:37 8:46 8:55 8:59 9:01 9:05 9:25 1 9:30 9: 8:50 8:55 9:05 9:07--J-9-16 9:25 9:29 9:31 9:35 9:55 10:00 10: 9:20 9:25 9:35 9:37 9:46 9:55 9:59 10:01 10:05 10:25 10:30 10: 9:50 9:55 10:05 10:07 10:16 10.25 10:29 10:31 10:35 10:55 11:00 11: 10:20 10:25 10:35 10:37 10:46 10:55 10:59 11:01 11:05 11:25 11:30 11: 10:50 10:55 11:05 11:07 11:16 11:25 11:29 11:31 11:35 11:55 12:00 12: 11:20 1 11:25 11:35 11:37 11:46 11:55 11:59 1 12:01 12:05 12:25 12:30 12 11:50 11:55 12:05 12:07 12:16 12:25 12:29 12:31 12:35 12:55 1:00 1: 12:20 12:26 12:39 12:41 12:51 1:00 1:06 1:08 1:12 1:30 1:35 1: 12:50 12:56 1:09 1:11 1:21 1:30 1:36 1:38 1:42 2:00 2:06 2 1:20 1:26 1:39 1:41 1:51 2:00 2:06 2:08 2:12 2:30 2:36 2. 1:50 1:56 2:09 2:11 2:21 2:30 2:36 2:38 2:42 2:55 3:01 2:20 2:26 2:39 1 2:41 2:51 3:01 1 3:09 3:13 3:25 1 3:31 2:50S 2:59S 3:10S 2:55 3:01 3:14 3:16 3:26 3:36 3:44 3:48 3:55 4:01 3:25S 3:34S 3:45S 3:25 3:31 3:44 3:46 3:56 4:05 4:11 4:13 4:17 4:25 4:31 3:50 3:56 4:09 4:11 4:21 4:30 4:36 4:38 4:42 4:55 5:01 4:20 4:26 4:39 4:41 1 4:51 5:01 1 5:09 5:13 5:40 1 5:46 4:50 4:56 5:09 5:11 5:21 5:31 5:39 5:43 6:10 6:16 5:20 5:26 5:39 5:41 5:51 6:01 6:09 6:13 6:25 6:31 5:50 5:56 6:09 6:11 6:21 6:31 6:39 6:43 6:55 7:00 7: _ 6:29 6:35 6:48 6:50 7:00 7:09 7:15 7:17 7:21 7:25 7:30 7: 7:05 7:10 7:19 7:21 7:30 7:39 7:43 7:45 7:49 7:50 1 7:55 8:04 1 8:06 1 8:15 1 8:24 1 8:28 1 8:30 8:34 9:05 1 9:10 1 9: SATURDAY Willow Arrive Leave Center Leave Diablo Diablo BART Pass/ Valley Valley Ave/ Howe Rd/ Bush/ Bush/ Concord Fry WaY GI College College Dr Veterans Pacheco tal Blvd PachecoBlvd d AMTRAK AMTRAK Blvd Pacheco 7:00 7:04 7:00 7:04 7:12 7:14 7:23 7:32 7:36 7:38 7:42 7:50 7:54 7:50 7:54 8:02 8:04 8:13 8:22 8:26 8:28 8:32 8:40 8:44 8:40 8:44 8:52 8:54 9:03 9:12 9:16 9:18 9:22 9:30 9:34 9:30 9:34 9:42 9:44 9:53 10:02 10:06 10:08 10:12 10:20 10:25 10:20 1 10:24 10:33 10:35 1 10:44 10:53 10:58 11:00 11:05 11:10 11:15 11:10 11:14 11:23 11:25 11:34 11:43 11:48 11:50 11:55 12:00 12:05 12:00 12:04 12:13 12:15 12:24 12:33 12:38 12:40 12:45 12:50 12:55 12:50 12:54 1:03 1:05 1:14 1:23 1:28 1:30 1:35 1:40 1:45 1:40 1:44 1:53 1:55 2:04 2:13 2:18 2:20 2:25 2:30 2:35 2:30 2:34 2:43 2:45 2:54 3:03 3:08 3:10 3:15 3:20 3:25 3:20 3:24 3:33 3:35 3:44 3:53 3:58 4:00 4:05 4:10 4:15 4:10 4:14 4:23 4:25 4:34 4:43 4:48 4:50 4:55 5:00 5:05 5:00 5:04 5:13 5:15 5:24 5:33 5:38 5:40 5:45 5:50 5:55 5:50 5:54 6:03 6:05 614 6:23 6:28 6:30 6:35 6:40 6:45 6:40 6:44 6:53 6:55 7:04 7:13 7:18 7:20 7:25 7:30 7:34 7:30 7:34 1:4'l.. 7:44 7:53 8:02 8:06 8:08 8:12 1 iday • Y yam' I v A i BART xsl T Express Bus BART Express Bus Train 1,,,i„ W Piltsbur P,ttsbur Antioch BrBnlwood OaRle y Antioch PlllsbLir W Pittsburg Concord aa] (Lti nb Q C .. -NO � cc u _ Y « N cryL m O >.c f- CJ I ... m a = 2 2 d c -- m o 0 3 m cu N c\j } - LV LV LV LV LV LV LV LV LV ARR LV ARR 6:42 6:47 712 4:18 4 32 4:49 5:06 5:13 5:19 5:45 707 7:12 7:37 448 5:02 5:19 5:36 5:43 5:49 6:15• 2,., 742 7:47 8:12 5.15 529 5:46 6:03 6:10 616 SA1 8.07 812 8:37 5.51 605 622 639 -...Q:49, _ .652 ..7.17. . 2 837 8:47 9:07 616 6:30 6:47 7:11 7:17 742 937 9:47 10:07 "6:48 702 7:19 7:36 7:43 7:49 8:14 1:29 10:37 10:47 11:07 7:22 7.36 7 55 8:10 8:17 8:23 8:48 ':01 11:37 11:47 12:07 7.52 806 8:25 8:40 8:47 8:53 9:18 ). 1 12:37 12:47 1:07 8.52 906 925 9:40 9:47 9:53 10:18 1:37 1:47 2:07 9:47 g:59 10:16 10:33 10:40 10:46 11:11 16 12 I zi 2:37 2:47 3:07 1045 1059 11:16 11:33 11:40 11:46 12:11 12:16 3:37 3:42 4:07 1 145 11:59 12:16 12:33 12:40 12:46 1:11 1:16 4:07 4:12 4:37 12:45 12:59 1:16 1:33 1:40 1:46 2:11 2:16 4:37 4:42 5:07 1:45 1:59 2:16 2:33 2:40 2:46 3:11 3:16 ,{ 1'' 5:12 5:17 5:42 3:05 3:19 3:36 3:53 4:00 4:06 4:31 • 4:33 :� 1'' 5:37 5:42 6:07 3:45 3:59 4:16 4:33 4:40 4:46 5:11 • 5:18 6:12 6:17 6:42 4:15 4:29 4:46 5:03 5:10 5:16 5:41 • 5:48 6:37 6:42 7:07 4:45 4:59 5:16 5:33 5:40 5:46 6:11 6:18 7:07 7:12 7:37 5:15 5:29 5:46 6:03 6:10 6:16 6:41 6:48 ,:21 7:37 7:42 8:07 5:48 6:02 6:19 6:36 6:43 6:49 7:14 7:24 6 8:37 8:42 9:07 6:18 6:32 6:49 7:06 7:13 7:19 7:44• 8:04 7:23 6:48 7:02 7:19 7:36 7:43 7:49 8:14 8:24 8:2,3 Sctill c. 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IV' 4 A I p 1' 3� I la-a CREEK S1DE C1 s z Nl/SMOOV3W W r >r r� oi� Ig I I i yaar" ysiaHi / zi o I =� z DMHVM a " a a V I� i � zriwva m".dq.33HIO3B1DNOWlV 1 C (n." —c MOIL o 'NV ?i Id O•ltHgiH I C V A.MH 1S Ol0 "\ AV 3S0tl .''•I:/,� �_..._�_____�_. yl i l73N:0 �Ct p.IAoiYi�!�. c u 1 Is nz 15 .X15 O O /� t -S:!NZ Os F-pitt_-43 -16;5 TO 6461059 P.01 01--lo-1994 04:1OPf'l FRO CONTRA COSTA LEGAL SERVICES FOUNDATION Main Office, Tctophonc 1017 Macdoctaid Avenue weA County(510)2333-4454 P.U.Box 2284 Basi(510)439-9166 Ri&mond,California 94842 Centrad(514)3724209 Fax($10)23"&", TBLECOPIER TRANSMISSION COATER MENORANDUM DATE: January 10, 1994 TOO Clerk, Beard of $Lir_erti=js.orS FIRM: CCC Board PAX NO: 6461059 FROM: Ja-,�es :ferry, Pro Per RE. January 18,1994 Board of Sint 4Ppedl TOTAL NUMBER OF PAGES (including cover sheet) : f COMMENTS: Thank vou. 6 PLEASE ISO ONE OR MORE OF THE POLLOWING: X Please deliver immediately "to' the Recipient. Please request the recipient to telephone the sander immediately upon receipt and review. . Please have the Recip�ent verify receipt by telephone. Original will not follow. x driginai will f6llow by (check one of the following) Regular Mail certified. Mail, Return ReceiptRequested . Express Mail Federal Express .Ether*-. (FOR QUESTIONS CALL; (510) 233-9954) � The information contained in this transmission is privileged and confidential.. It is intended only for the use sof the ,individual or entity named above. If the reader of this message is not the intended reci.pient, . you .are" hereby , notified that any dissemination, distribution or copy of this communication is: � strictly prohibited. If you have .received this communication in error, please notify us immediately ;by telephone' and• return the original message to. us at f1 the above address via the U.S. Postal Service, Thank you. i 601 01-10-1994 04: 11PM FROM-L'3F-pit.ts.-432-16?5 TO • 6461159 P.02 of G To the Contra Costa Board of Supervisors: Regarding: General Assistance Evidentiary Hearing Decision IN THE MATTER OF: James Perry 28G4 Dutch Slough Pd_ Oakley, CA 94561 Date of Hearing: 11/2/93 Place of Hearing: Antioch, CA Appeals Officer : Kate Quise•nberry I believe that the Decision reached in the hearing of 11/2193 should be reversed or alternately, the penalty should be set aside for good cause for the following reasons: 1 . The alleged program violation was not an intentional , negligent, or without reasonable excuse. 2. The underlying violation, contrary to the Decision was in fact, for "Good Cause" -- substential and compelling reasons: usability to do workfare in Martinez beginning at S AM coming from East County with no access to public transportation during Social Servicers hours. This is what I would have to have done in order to comply with my orders from Work Programs on 8/27 and 9i3 tthis was presented at the Hearing) During the period in which clay alleged "failures to comply" in August ,and September of 1993 occurred, I was staying in the Eerthel Island area. (see #5) As the transit maps will show, there is No bus service to the island. (see #1 and 42) The nearest public transit is 4 718 miles away, that is the SART PE1 bus line router from Concord to Brentwood from the location I was at.aying at at the time, which was to the north of Dutch Slough Rd. (see 04 and I would have to: 3 . leave homey at about 2:50 AM to be, certain of making it to the bus stop by 4:50 2. take the BART PE-1 buts that leaves from Brentwood at 4:48R (which would arrive at the stop at about 5 AM) to get to Concord BART 3. County Connection bus route 148 leaves Concord BART @ 6:50 AM 4. arrive at. workfare assignment at recycling center by 8 AM. In other words, in order for mcg to comply which I wanted to: do, I had no choice but to spend .5 to G houre. begininning in the middle of the night in corder to be at workfare_ I wanted to cooperate contrary to the hostile decision. The County erred in viewing this fact pattern as a request for good cause based on lack of transportation although this is true, on these occasions the substantial and compelling reason for failure is due to circumstances beyond ray control . The County is well aware of the distance problem. Nonetheless, despite my request, they present no solution which would enable 01-10-1994 04: 11PM FROM W'6F-p it.t=:-432-16 r5 TO • 6461059 P.03 ra 2- a far East County resident without access to reliable public transportation to get from the Oakley/Bethel Island to Martinez. IN ADDITION THESE TWO ASSIGNMENTS WERE IN THE WRONG PART OF THE COUNTY. WHEN I WAS. AT MY HEARING THIS COULD AND SHOULD HAVE BEEN RESOLVED. AN EAST COUNTY RESIDENT SHOULD Dia AN EAST COUNTY WORKFARE ASSIGNMENT. CLAIMANT POSITION <page 2) This is an error in reporting my testimony at the hearing. "He testified that in order to catch the bus to Martinez he would have had to walk two miles to the nearest bus atop." It was 5 miles, not 2 (I said "TWO HOURS", NOT "TWA] MILES") I submitted a map of the island and a bus schedule with map to prove my statement and showed that it was in fact, approximately S miles directly on the map in front of the hearing officer . The Appeals Officer had access to Doth a tape recordings and her notes, and she should easily have been able to remember my presentation of distances as indicated on the map due to the unusual difficulty. in showing this due to the fact that showing the route: from my location to the nearest public transit stop required tracing two sections of the snap with two different distance scales. Furthermore, this was my testimony which I maintain reflects my willingness to cooperate. The Hearing Officer account of my testimony is therefore obviously wrong and inconsistent with documentary evidence presented at the hearing. I believe that this is duty to a strong predisposition against Claimant without reference to facts presented at the hearing, as, if thin was sufficiently important to cite in the Hearing Decision, tbls should have been recorded correctly. CONCLUSION AND FINDING OF "FACT" (page 4) "His failures to report the change promptly to his eligbility worker. . . There was no failure. When I had a change in permanent address or mailing address to report, I did so promptly as shown in the Decision, which cites both my Income Report for 9/93 and a subsequent spe!edletter in which I resorted my address change to my case worker <page 4) . This means the Hearing Officer herself stated in the Decision that I COMPLIED WITH ADDRESS CHANGE REPORTING REGULATIONS in the Decision. and to advise Work Programs that hes was living in Butch Slough in Oakley" As can be aeon below, I attempted to advise Work Programs that I was homerless in East County, NOT Central . Her finding is an obvious error as the County was obligated to act on the timely information I gave Work Programa. The Hearing Officer confused the isaue by casting daunt ars my credibility .as to WHICH PART of East County that I was a homeless 01-10-1994 04: 12PM FROMOC:LSF-pitts-432-1675 TO • 6461059 P.04 resident Of, rather than considering whether an OAKLEY OR ANTIOCH {using the Hearing Officer's logic) resident must do any workfare assignment in Central Contra Costa County. The fallowing resolves this question: CONCLUSION AND FINDING OF "FACT" (page 4) "It is noted that evidence presented in hearing failed to establish as fact Claimant' s contention that on 8/20 he was living in Oakley and thusa defense to a finding of willfulness based on a belief that remoteness prevented his participation did not exist. His hearing testimony contradicted his sworn statement on the 9193 incase report as well as Ms. Boden's statement on the housing form, Doti, of which contradicted each other. Moreover, the signature attributed to Ms. Baden on the unsworn nate Claimant presented at hearing seemed at variance with her signature on the housing farm raising questions of its reliability. •' The ALLEGED contradictions in my testimony regarding my location is due to errors in memory UNRELATED TO ANY DATE AT ISSUE IN THE HEARING as to WHICH portion of East County I was staying in as a homeless person at the time. I made a simple mistake in preparing the statement for Me. Borden's signature_ The dates at issue in the hearing were 8/26/93 and ' 12193. The documents I submitted to the county stated that I moved on 10/9/93 in the income statement and 10110/93 in they sppeedlettar. I think that 10114193 was the data I ;actually moved in. They undated statement by Ann Boden said 14120/93_ These dates are OVER A MONTH after the last date at issue at the hearing. The undated statement referred to was done months after they event from memory of a rather stressful period. In the general time period, I was staying most of the time in a boat awned by a Ran Stacey in a dock approximately across the street from my current place of residence, as well in a variety of other places in the Bethel Island area. (that's the, nature of being homeless) To the best of my knowledge, I was staying on his boat during the dates In question. The "undated" statement simply says that I was there up to 1O120/193 . The last date in that statement should have been 1019 or 10110 . Unfortunately, Mr_ Stacey was not available for me to obtain any statement verifying that I was doing this. I do not believe that he resides in this area anymore. It is the nature of a marine restart community where people show up on boats and leave to be transient, and people aren't legally obligated to give people they never expect to see again forwarding addresses. While I was homeless, I was trying to be as inconspicuous as 01-10-1994 04:13PM FROM W- SF-pitts-432-IG75 TO 0 6461059 P-05 f—S possible so that I could avoid situations where I might wind up going to jail or to avoid general hostility from people due to being homeless, so there are no significant number of witnesses who can testify to my location any date actually at issue at the hearing, to protect my interests at the time. I got a statement from Ms. Boden because she lives across the street from where his boat was docked at the time and she- generally DID know where I was, due to her being a personal friend of mine, which made her the only available witness and her statement the only possible evidence as to where I was at the time. I didn't provide better documentation, such as requesting that the statement being signed and dated because I had no reason to belleve that it would be required as this was regarding a point I r"arded as minor. -seemed at variance with her signature'* The Person who wrote this statement is my current landlord. Had there been a question the Hearing Officer should have cross-examined me on this or lelt the record open for clarification. The Appeais Officer for reasons unknown to me questioned why I moved from bomeleaft - Central County to homeless - East County. This line of questioning wags beyond the scope of the issue in question. It it difficult enough to be homeless without being assaulted under oath about a time that was most difficult in that regard. While it is not in the Hearing Decision, it should be noted that these questions were framed in a manner intended to intimidate. From an ,impartial- decisionmaker, I expected courtesy. From County Position (Page 1 ) "appeared for an appointment with work Programs and advised them that he was homeless in Antioch . . . did not indicate a problem in appearing for workfare the next day" This quote is a logical fallacy. If I hadn't stated there was a problem in that my Irication would be make it difficult tc, get to the assignment at the time, there would have been No reference to a change of address in the file entry. In fact, I requested thet, the workfare assignment be shifted to East County, because I was staying in Rest County . The Work Programs Counselor replied that it wouldn't be possible for her to do so without. a PRINTOUT FROM THE COUNTY COMPUTER SYSTEM INDICATING THAT MY MAILING ADDRESS HAD CHANqED TO EAST COUNTY. The County erred in not reassigning me to East County. They had information as to my whereabouts- The General Assistance workfare program regulation mandate that the assignment be given in that part of the county in which the Person resides. Therefore the failure to comply was with cause. In addition, the 01-10-1994 04: 14PP1 FROr*,�LSF-Pitts-432-16 5 TO • 5461059 dP.06 burden of proof is on tile County to prove that .1 should be sanctioned for missing Central County appointment& when they knew 1 lived in East. County, The Decision does not conform to Board of Supervisors Fesolution No,92/857, part 7, section 703. CONCLUSION AND FINDING OF "FACT" (page 4) From County Position (page 2) "did not contact Work Progams to explain his failure" I also had already informed her at the time I was given the assignment of the; nature of the problem precluding my appearance in Martinet at they date in question and was told there were: no options for me. Assuming arguendo that such information had not been given the facts were that it was beyond my control to comply due to the distance and hours involved. This is not a matter of unreasonablEeneoss, rather, it was impossible_ Therefore, both appointments should have been reassigned and I have substantial and compelling reasons for not being there. I ram doing the best to comply that I can. CONCLUSION I ask that the Board reverse the termination and find that there was no willfulness and that there was "good cause". This basis for resolution was never considered In the decision. Thank you very much for your consideration. Since ely Yours: a Perry Exhibits: #1 Tri-De:lte Transit map 02 BART PE-1 map Y schedule #3 strip mileage chart #d map of Bethel Island area *5 "undated statement from Ann Boden" unavailable, Appeals was given the only copy #6 County Connection Route 108 schedule 01-10-1994 04: 14PM FROM�'LSF-pitt.s-432-1675 TO • 6461059 P.07 MONDAY Arrive Leave Leave Willow Diablo Diablo Center Howe lid/ Bush, Bush/ H BART Pass/ Valley Valley Ave/ Veterans Pacheco Pacheco Arrive Leave Pacheco P Concord Pry Way College College Glacier Dr Hospital Blvd Blvd AMTRAK AMTRAK Blvd 6:40 6:45 6:20 6:25 6;34 6:36 6'45 6:54 7:00 7:04 7:25 7:31 6:50 6:55 7:04 7:06 7.15 7;24 7'30 7:34 7;55 8:01 --77(T-- 7: --771— 7:51 8:018'09 :13 8:25 8:33 7:50 7:56 8109 8:11 8;21 831 8:39 8:43 8:55 9;02 f 8'20 8:25 8:35 8:37 8:46 8:55 3:59 9:01 9:Q5 9:25 9:30 f 8'50 8:55 9105 9:07 9:16 925 9:29 9:31 :35 9:55 10:00 1( 9:20 9:25 9'35 9-37 9:46 9:55 9:59 10;01 10:05 10:25 10,30 1( 9:50 9:55 10:05 10:07 10:16 10:25 10:29 10 31 1 Q:35 10:55 11:00 1" 1 20 10:25 10:35 10:37 10:46 10:55 10:59 11101 11:05 11:25 1130 i" 10:50 10,55 11:05 11'07 11,16 11'25 11:29 11:31 11'35 11:55 12:00 1i 11:20 11:25 11:35 11:37 11'46 11,55 11:59 12:01 12:05 12:25 72:30 12 11:50 11:55 12'05 12:07 12:16 12:25 12:29 12:31 12:35 12:55 1100 1 12:20 12:26 12:39 12:41 12:51 1:00 1:06 1:08 1:12 1:30 1:35 1 12:50 12:56 1:09 1:11 1:21 1:30 1:36 1:33 1:42 2:00 2:06 2 1:20 06 1:39 1:41 1:51 2:00 2:U6 2:08 2:12 2:30 2:36 2 1:50 1:56 2:09 211 2:21 2:30 2:36 2:38 2:42 2:55 3:01 2:20 2:26 2:39 2:41 2:51 3.•01 3:09 313 3:25 3:31 2:52:59S 3:1 US 2:55 3:013:14 3:16 3:26 3:3s 3:44 3:48 3:55 4:01 _ 3:25S 3:345 3:455 3:25 3:31 :44 :46 3:56 4:05 4: 4:13 4:17 4:25 4:31 3:50 3:56 4:09 4:11 4:21 4:30 4:36 4:38 4:42 4:55 5:01 4:20 4:26 4:39 4:41 4:51 5:01 5:09 5:13 5:40 5:46 4:50 4:56 5:09 5:11 5:21 5:31 5:39 5:43 6:10 6:16 5:20 5:26 5:39 5:41 5:51 5:01 6:09 6:13 6:25 6:31 5150 5.56 6:09 6:11 6:21 6:31 1 5:39 6:43 6:55 7:00 7 6:29 :35 6:48 6:50 7:00 7:09 7:1 S 7:17 7:21 7:25 7:30 7 7:05 7:10 7:19 7:21 7:30 7:39 7:43 7:45 7:49 7:50 7:55 8:04 8:06 8:15 8:24 8:28 8:30 8:34 9:05 9:10 9 SATURDAY Willow Arrive Leave Center Leave Diablo Diablo BART Pass/ Valley Valley Avel Howe Rd/ Bush/ Bush/ Concord Fry Way College College Glacier Veterans Pacheco Pacheco Arrive Leave Pacheco Dr fias ital Blvd Blvd AMTRAK AMTRAK Blvd 7:00 7:04 7:00 7:04 7:12 7:14 7:23 7:32 7:36 7:38 7:42 7:50 7:54 7:50 7:54 8:02 8:04 8:13 8:22 8:26 8:28 8:32 8:40 8:44 8:40 8:44 8:52 8:54 9:03 9:12 9.16 9:18 9:22 9:30 9:34 9:30 9:34 9:42 9:44 9:53 10:02 10:06 10:08 10:12 10:20 10:25 10:20 10:24 10:33 10:35 10:44 10:53 10:58 11:00 11:05 1 11:10 11:15 11:10 1114 11:23 11:25 11:34 11:43 11:48 11:50 11:55 12:00 12:05 12:00 12:04 12:13 12:15 12:24 12:33 12:38 12:40 12:45 12:50 1255 12:50 12:54 1:03 1:05 1 1:14 1:23 1:28 1:30 1:35 1:40 1:45 1:40 1:44 1:53 1:55 2:04 2:13 2:18 2:20 2:25 2:30 2:35 2:30 2:34 2:43 2'45 2:54 3.03 3:08 3:10 3:15 3:20 3:25 3:20 3:24 3:33 3:35 3:44 3:53 3:58 4:00 4'05 4'10.-- 4:15 4:10 4:14 4:23 4:25 4:34 4:43 4:48 4:50 4:55 540 5:05 5:00 5:04 513 515 5:24 5:33 5138 5:40 5:45 5:50 5'55 5:50_ 5:54 6:03 6'05 6:14 6:23 6:28 6:30 61-35 6.40 6;45 6:40 6;44 fi:53 6:55 7:04 7:13 7;1$ 7:20 7:15 7'30 7:34 7:30 7:34 7:42 '1:44 7:53 8:02 $;06 8:08 8:12 01-10-1994 04: 16PM FRO ,--LSF—pitt:s-432-1675 TO • 6461059 P.09 = OHARAI rl HbVY @ THWY 4 HILLCREST ...�. ...... 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AntiOf..tl Brentwood Clzkie1' ar`?:6; PitlsbL.rg ld Fltsb:tr( i Cr CJrtl a an — C] LV LV LVLv LV LV LV LV LV ARR LV ARR 6:42 6:47 7:12 4:18 4,v2 :.49 5'06 5:13 5:19i 5:45 7:07 7:12 7:37 4:48 1.).- 5:19 5:?6 5:43 5:49, 6:15• c.2;. 7:42 7.47 2:12 5:15 5:2w 5'46 6:03 6'10 x:16 6�1 8:07 8:12 8:37 x:51 6:05_ ^_:22 6:?G X0;52 8:37 8:47 9:07 ~fi:i6 a,?0 g4; 7:11 7:'.7 7:427. 9:.37 9.47 1+1:07 X6:43 ;2 ':19 7:3k 7:4.3 -.49 6:14 10'37 !i!:47 11;07 ?:t2 ?3r• 7:55 8:10 8:17 823 8:48 11.37 11:47 12;07 7 52 8 Oc 8:25 0:44 6:47 8:53 5:13 9 12:37 12:47 1:07 8 52 9 X. 9:25 9:40 9:47 9:53 10.18 1;37 1:47 2:074.95 5:5 1'::16 10:33 10740 10:46 1111 2:37 2:47 3:07 1045 13:9 11:16 11'33 11 40 11:46 12:11 12:16 3:37 3:42 4:07 11;45 11:59 12:16 12:33 12:40 12:46 1:11 1;16 4:07 4:12 4:37 12;45 12:59 1:16 1:33 1:40 1:46 2:11 2:'i, ' 1:; 4:37 4:42 5:07 1 AS 1:59 2:16 2:33 2:40 2:46 3:11 3:16 5:12 5:17 5:42 3:05 3:19 3:36 3:53 4:00 4:06 4:31 • 4:33 5:37 5:42 6:07 3:45 3:59 4:16 4:33 4:40 3:46 5:11 • 5:18 6:12 6:17 6:42 4:15 4;29 4:46 5:03 5:10 5:16 5:41 + 5:48 6:37 6:42 7:07 4:45 4:59 5:16 5:33 5:40 5:46 6:11 3.18 7:07 712 7:37 5:15 5:29 5:46 6:03 6:10 6116 6:41 6:48 7:37 7:42 8:07 5:48 6:02 6:19 6:36 6:43 6:49 7:14 7:24 6-c" 8:37 8:42 9:07 6:18 6:32 6:49 7:06 7:13 7:19 7:44+ 8:04 6:48 7:02 7:19 7:36 7;43 7:49 8:14 8;24 " LV ARR AM ISM y �_... ----------- # W. 3RD ST.! H ST. 4TI(ST 3RD$r. orH ST. PE,PEI &P2X ye P2X a STOP AT{iWY 4 Av Fey 18TFIST. 14 Uj COUNTY EASE ~ MAI.J.6RAN$BER FORX-RI-DELTA _-..S'ERVIGEj =i • `H11 .. �• LCREST TR[GALLAS PARK 6 RIDE LOT(ALL ROUTES i BOTH 91RE4ft0NS; i \ PEI P2x f•, T a1-1O-1994 04: 16PM FROf*:C:LSF—pitts-432-1675 TO • 6461059 P. 10 W. _:e.• � u iM u, r V9a .2 •3 � a` tea° u�3 G� iaLx3/ I q ii N�� uY �sr • � • C. Y �a � �•r C' C. Lu �• •�' - o ••1:: _ 13 _ ..� Lu C a • '- - _ cpm Lu dmf/ r e 332a .ac3c Y 444 � u� 2Qyiac c c Lk _-`• zoo ICU) xx !I!I!I � �� c�f =Y• 3 e .�E• h• m' � „ o- �5a _ r./TE •'"'l�`'"'�� 3 570. � x LIS k-jec �� r•� 37 •4 �tiS3 LL 0. � Lu 470. ,1t, g•.::�:" �yU 3r, }W4 sa.m !l 'rt a m ■ ME u 01-10-1994 04:17PM FROM LSF—pitts-4-72-1675 TO • 6461059 P. 11 'A Olf c SAN On Tr- UUI) l c; -2 Q -No wi. Q1 ly' 41 CC Cc J cz, ahvlsa QU -Nfyld 3 IL Oki main In III 1-------------- - ------------ ------------- ---------1 N ;NA !1.1f III /f/f `y� / j CL) tj z 171 331 Cc AV Ud 77, Ei wi 17 •'8-.' JI TOTAL P. 11 TO: Board of Supervisors FROM: Perfecto Villarreal, Director Social Service Department DATE: January 18, 1994 SUBJECT: APPEAL OF GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION BY WESLEY C A N T R E L L SPECIFIC REQUEST(S) OR RECOMMENDATIONS AND BACKGROUND AND JUSTIFICATION RECOMMENDATION: That the Board.deny Wesley Cantrell's appeal of the General Assistance Hearing decision. BACKGROUND: Claimant filed request for Hearing on October 8, 1993. The Hearing was scheduled for October 26, 1993. The claim was granted in part and denied in part. Signature: ACTION OF BOARD ON January 18 , 1994 APPROVED AS RECOMMENDED x OTHER This is the time heretofore noticed by the Clerk of the Board of Supervisors for hearing on the appeal by Wesley Cantrell from the General Assistance Evidentiary Hearing decision. Jewel Mansapit, GA Program Analyst, Socia.1 Service Department, ,presented the staff recommendation on the appeal . Wesley Cantrell , the: appellant, spoke in support of his appeal . The hearing was closed. , IT IS BY THE BOARD ORDERED that the appeal by Wesley Cantrell from the General Assistance Evidentiary Hearing decision is DENIED. VOTE OF SUPERVISORS x UNANIMOUS (ABSENT V AYES: NOES . ABSENT ABSTAIN Contact: Jewel Mansapit, 313-1601 Original: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION cc: Social Service Department TAKEN AND ENTERED ON THE MINUTES Program Analyst OF THE BOARD OF SUPERVISORS Appeals Unit ON THE DATE SHOWN. County Counsel County Administrator Wesley Cantrell ATTESTED January 18 , 1994 PHIL BATCHELOR, CLERK OF THE BOARD OF SUPERVISORS AND COU Y ADMINISTRATOR BY n/vvv, DEPUTY a; 3oP:M CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 15, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT: Hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By Wesley Cantrall Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by January 11, 1994 plus any information which your department may wish to file for the Board appeal which is set for 2 : 30 p.m. on Tuesday, January 18 , 1994 . Attachment CC : Board members County Administrator County Counsel tchelor The Board of SuperversContra 0 Ce'rkioftthe Board and County Administration BuildingCota County Administrator Costa 651 Pine St, Room 106 J (510)646-2371 Martinez, California 94553 County Tom Powers,1st District Jeff Smith,2nd District c Gayle Bishop.3rd District Sunne Wright McPeak,4th District Tom Torlakson.5th District c. December 15, 1993 Wesley Cantrell P.O. Box 5541 Hercules, CA 94547 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 18, 1994 . In accordance with Board of Supervisor Resolution No. 92/554 , your written presentation and all relevant material pertaining to the appeal must be filed with the• Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure. Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County AdmiIn -Cervelii, ' r or By e Deputy Clerk Enclosure CC: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,CALIFORNIA Adopted this Order on August 4,1992 by the following vote: . AYES: Supervisors Fanden, Schroder, Torlakson, McPeak NOES: None ABSENT: Supervisor Powers ABSTAIN: None ss=ssssss:sssssssssss:sss=ssss=s=s=ss:sss=s=s===s==== SUBJECT: General Assistance Hearing } Resolution Number 92/.L54_ and Appeal Procedures } The Contra Costa County Board of Supervisors RESOLVES that the provisions of Resolutions No. 74/365,75/28, 87/468, and 88/576 which established standards for General Assistance Hearings and Appeals are hereby superseded effective September 1, 1992: Part 1 Hearings 101. General Assistance applicants :ball be given written notice of action to deny an application. 102. General Assistance recipients shall be given written notice, mailed at least 10 days prior to the effective date, of proposed action which will reduce, suspend or terminate his or her General Assistance grant for cause.Prior notice is not required for action resulting from Board of Supervisors' changes in grant levels. 103. A General Assistance applicant or recipient shall receive a Social Service Department bearing upon their timely written request. (a) The applicant or recipient must deliver or mail a written request for a bearing within fourteen days of the date the Notice of Action was mailed. Absent evidence to the contrary,the notice is presumed to have been mailed on the date it bears, and a request for a bearing is presumed to have been delivered on the date it is received and mailed on the date it is postmarked. 104. Where a GA recipient timely requests a bearing challenging a proposed action which will reduce, suspend or terminate his or her General Assistance grant, the proposed action will be stayed until a decision is rendered. (a) Actions implementing Board of Supervisor changes in grant levels are not appealable, and bearing requests based thereon may be summarily denied. 105. Hearings will be scbeduled within thirty days of the date of receipt of a request for a bearing. The Appeals Unit will mail a written notice of the hearing to the elaitnent at least ten days in advance of the Hearing date. 106. When a request for a hearing has been received,the claim may be reviewed and resolved in the claimant's favor by a pre-bearing review. (a) Proposed pre-bearing resolutions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager. • 107. If the claimant is unable to attend the bearing at the originally scheduled date and time, and a timely request for postponement is made,the Hearing Officer will make an evaluation of the request. 7be bearing will not be continued beyond the bearing date unless authorized by a Hearing Officer on one of the following grounds,which require verification: (a) bearing is continued at request of the Social Service Department, RESOLUTION NUMBER 921554 (b) mandatory court appearance which cannot be accommodated by adjusting the bearing time, e ' (c) illness which prevents travel, (d) death in the immediate iiamily, (e) other substantial and compelling reason. (as approved by the Appeals Manager) 108. Decision (a) A written decision shall be mailed to the claimant within thirty days after the bearing record is dosed,unless the Department extends the time in writing,for cause. (b) Proposed decisions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager prior to notification of the claimant.The Hearing Officer's findings of fact are not subject to change,but the General Assistance Policy Manager may order re- hearing for cause. Part 2 Appeals to the Board 201. The applicant or recipient may appeal an adverse bearing decision to the Board of Supervisors. 202. A written appeal must be received by the Qerk of the Board of Supervisors within fourteen days after the decision has been mailed to the claimant.Absent evidence showing the contrary, a bearing decision is presumed to have been mailed on the date it bears. (a) An appeal to the Board will not stay the implementation of the Hearing decision, and the recipient shall not be entitled to continue to receive assistance pending further bearing. (b) The appeal will be scheduled for the first available Board meeting,but no earlier than the third meeting following receipt of the appeal. 203. 7be Administrative Review Panel may review appeals of Hearing decisions and recommend proposed action to the Director. (a) If the Director supports the bearing decision,the Appeals unit will be notified to proceed with the presentation to the Board. (b) If the Director finds in favor of the claimant,the Clerk of the Board will be notified to withdraw the item from the Board agenda.The appropriate Social Service District office will be advised to take corrective action. 204. Both the appellant and the Department must file an written materials at feast one week before the date set for the Board bearing.New material must be served by ma0 on the apposing party. 205. (8) Upon bearing the appeal,the Board shall make any required fact determinations based on the record on appeal and testimony received by the Board.Ibis record shall include the Department's Hearing Of fact findings,plus any papers filed with that OJfioer. (b) If the facts upon which the appeal is based are not in dispute or if any disputed facts are not relevant to the issue ultimately to be decided by the Board, the Board will proceed immediately to the neat step without considering fact questions.7be parties may stipulate to an agreed set of facts. RESOLUTION NUMMER 92/35 246. (a) Once the facts are determined,or if there are no fact determinations required by the appeal, • the Board will consider legal issues presented by the appeal.Legal issues are to be framed, fnsofar as possible,before the Hearing and shall be based on the Department's Hearing Officer's decision and such other papers as may be filed. (b) Appealing parties may make legal arguments both by written brief and orally before the Board. If the issues are susceptible of immediate resolution,the board may immediately decide them at the appeal bearing. If the County Counsel's advice is needed on legal questions,the Board may take the matter under submission,reserving its final judgment until it receives such advice. 247. 7be Board may decide an appeal immediately after bearing or take the appeal under �sttbmissioa .. t low, or"Ow Nr fa i rw end W, am� an SOW thtf+ W d W(MW d Nt DOW a z AM Z IL 41 Oind o a w eo.ro A*MnWMW 6 RESOLUTION NUMBER 92/,554 1 CONTRA COSTA COUNTY SOCIAL SERVICE DEPARTMENT TO: Board of Supervisors DATE: December 9, 1993 FROM: Kate Quisenberry CC: Jewel Mansapit Appeals Worker of the DAY SUBJECT: Attached Board Appeal Request Attached is Mr. Cantrell's Request for Hearing and Hearing Documents. He is appealing the decision dated 11/18/93 . The request for hearing was filed 12/6/93 and is not within the 14 day filing period which expired 12/2/93. KQ/nf RECEIVED 1 Q 1993 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. . 41 AA EL-w Zt- f 5....x BOAD OF SUPERVISORS CONTRA COSTA COUNTY 4 TOM POWERS v�4 SUPERVISOR,FIRST-f STRICT r ct6iii='t'{ December b, 1993 To: Social Services Appeals From: Tom Powers, First District Supervisor Subject: Appeal Request -Wesley Cantrell Please refer to the attached request for an appeal hearing. Mr. Wesley Cantrell filed this in my office. TP:hf cc: W. Cantrell _ TOM POWERS r fr1 A SUPERVISOR,FIRST DISTRICT G7 Cis C: 'rsw 100.371h STREET,ROOM 270 W. RICHMOND.CALIFORNIA 94605 fC ............... - `t!z—';6 Jj�C Social Service Dept. 40 Douglas Drive Attention: Appeals Martinez, CA 44553 yWESS:3-4066 3 100-37th STREET,ROOM 270 • RICHMOND,CALIF6RNIA 34805-2136 • TELEPHONE(510)374-3231 • FAX(510)374-3429 I � ♦ l ,d _ 1 e ss 4 1 ti je w GLE,�-cam- &--. x-4- -,w�?tr-7 re --1144le - .1 !1— aro ,-,9 3 .� . d SS V1 r. '-DENTIARY HEARING NOTES ,,,,- '"P k N THE SCATTER OF: . - - Record Ten upti11D-, dot- ` ,claimant Date of NOA: �r Effective date: Filing date: A.P.P.? ,uthorized Representative: .nterpreter: language: lork Programs Representative: .M. Representative: lace of Hearing: Richmond; ,Antioch; _,_,„,_Martinez late of Hearing: .T ISSUE FOR HEARING: / County Position f ` 1 ✓ Claimant's Position 3C .G,iJ ..":.-��2.1-a'6`%d-.rc.� �.�'.7 � ,-�-� .i1.c_.c..7` rr,.•y,"`c-,'-r� 1 f^-.L,... i��'�`�"- �j�' G�t.�� js�C _.. �— Gf �� gyp/ _ �,�-'✓l�-zc•.�`� ��..�� ,;.,.;�.,� ,2,,1�,�� ,.� Zee, cry Cyt-�.-L..�' •.C,�z'�^�i.a-Y,. �.t%l fG.,C-G�i 'r/ � ✓ �� ftp��_ ✓� �ti�7 .��" �.:-ct,7��yt,.s �:•.a�-.,�-- �;,.,t,;,T�. ��,�C.�Le!.F'��.... `w LG�E.v�K. .. ''/L.r'1�ti.G-G�.�-�' �•-'2`-�^�- �=`��/�•••f_'G Vii^ 1 WELFARE CASE -DATA SYSTEM 2 7 8 F • CASE FINANCIAL• INFORMATION CASE_ NUMBERA 278 B/F DATE PRINTED 278 LMB FORK 278E RiV. life - DEL 10/90 ELip. NORKER ' 515455-00-0 A3 10-04-93 04 CONTRA COSTA PG 1 OF 1 W4KB SERIAL FBU MULT. SEC SEC FOOD STAMPS ID - TYPE CASE NAME POSITIVE NEGATIVE CASE STATUS HOLD LAST FIRST (OR HUSBAND) MIDDLE COR WIFE) 96 3 CANTRELL WESLEY 1`896 10-8" s3 dWb 00- 11-00 ACTIVE C9DE _ AAAA rill OF.. .10.-.0.4-.93.....:::.::..::::::.:..,;:F:ROM/.THRU. ' . .0.8/93::: :::.::.0.9.l.9.3... :..::::10./9,3: ': : FUjURE::; ::.. 1:«.0 0. = ----~:3::x_:0 0.: ::.> :.:::>:.:......8 PA.<GRAt+E:T ;MA�lt#A:L>?:::.........................::: :.:, :.; :: ::> :': sPEc. PERS INCOME ST#T 9 PA .GRAN,T.-AU,T.O.::::::::::::: :::..:::.:::::...:::::.: . ::::::::::: :::::::._:.::::_..::: ::::::::::::::::::::: _:::..::1:6:8,.,.:0..0 MAIL O1 000 AD ET .0.0 - AAAA ... ... AAAA AAAA .. ALLOTMENT AAAA .. AAAA AAAA .. ... r � AAAA.. .. ... .. .. IbO. R£NT:/MDR. 90, H H TYPE. /P_E;RSO:N S:::::::::::::::::::::::::::::::.::::. :::::::K:::0•.1: :::.;K:•: . : .:;•>: ';.: : :';:':.:;;. :;:>;>;:>K:::< k<::<:::>: 92' PRO=:RA:TFD::::::AMa':::<:::::>::»:::::>::;»>a:::::::: ::>:<:»::::> :�:; ::>::>::>:»::::>;:...3. . 112. 00 _ 6 ...NO ,..I.N.C.O,ME... ' ::..:::.:::::.::::. :::.:,:XXXXXX. .,....::.XXXXX.X.. .,:.:::.XXXXXX. XXX,XX.x. cERTtFJc#noN PERIOD a :......... ......... 07-94 08-93 THRu .�. R>CLI RE"=U.T OATE 10/931 ........ AAAA... . ......... __.. ......... AAAA.______............ ..._._........ AAAA. - -- .:::' T O T A L G R O S.S., EARNINGS- A __ �__,_._ ._0«0 .0 0 .0 0..._ •0.0 FIRST-OF-MONTN «uERANT :::: _. .-_:. ..:... -::::-:: :.::::-::-::::::-::.-.::::::::::_:�:::::::.--_::::_:�._ ....____..__._..._:_-r.::_:::a:u::..:._-.__..-.: _.., _ ..:._-.::_:::::c ::: :4:::.-.....::::a:. :i�rdd DATE AMOUNT P Sr__FA-:;GRANT : ::::;:::_: AAAA.-_- _�-__ _�- _. ._ 1_0 0; _._.._.1=: .Q _:: . .._::._.. ... ....... TOTAL._.GR_OSS INCOME _ 1 .00 1 . 00 168.00 11/93 168.00 =:._.....:.:...:._..:_...__:..--_...__..::�__..:..._.- ._..._. _.__........__..---_--AAAA_.. -_ x; -- _-_--- --: A.::.. ._..___.____....._...._-T--_._ _ _______..._:-:_::::_:.�_.:::�-.� ...._..._._._....._.�__...._....:::_-,�a:::::�_:=.=::a:_:=�-_:::.::::::_:W::: _..AAAA.__-_....___.___._..._.__._ ::---:___�_-::::_::-�:f--�=��:_r�a:�::-�•�_�.-:-_:�-.�_-_::-:_::::_-.__......__...........__-__......;.. MIp-MONTN NARRANT HH TYPE/NUM_BE_R.• -OF_- .Pita ONS_ K=_0.1_. K_o1, K_0_l .._..Ke_0..1 DATE AMOUNT MA7ALL3WABLR_ iSS INOflMG= _ -:_-�":s8 0,0. = 350 Q = -•.:_S a 0 0 0 11/931 . 0 0 ::.; _,AAAA_ .:AAAA ._. :.,. _.,_ __..__.__.... . ..... _ : :'. :: =' --, 173 -- lD :G1OSS_ ARI -I; [ =-•-.__.:. _._....__.__ �.._ t, ..Q.. _�.,B . :..._-__ ,--- :_;_. PLUS OTHER I.N.CO_M.E....... _ � -= 1.. 0.R.._ - _. _1_ WE- 1.6.8 0.0 -_- -_ NDARD;°=_I� ._ll �'1`�17tt-.:_��-�=__--�= CASE NAME CASE NUMBER 14 Ila A-,4J11-5, Person Applying LAST NAME I FIRST NAME MIDDLE INITIAL SOCIAL SECURITY NUMBER 3 STREET DDRESS - - APT NO CITY STATE ZIP CODE ' n f TELEPHONE NO BIRTHPLACE / BIRTHDATE SEX ptwo- NIJ O ij ALE O FEMALE Ir PLEASE ANSWER ALL QUESTIONS • FOR EACH QUESTI N,CHECK THE ' ❑ YES` OR ❑ NO`BOX. FOR SOME QUESTIONS,YOU WILL ALSO HAVE TO WRITE IN SOME INFORMATION. I AM MARRIED ❑ YES NO IF YES,please give Information below: SPOUSE'S NAME SPOUSE LIVES WIIN ME SPOUSE RECEIVES WELT ARI ON SSI ❑ Y 1:11:1Y 1:1N SPOt15E'S ADDRCSS SPOUSE'S SOCIAL SECURITY NUMBER 2 I LIVE ALONE ❑ YES NO IF YES,GO TO QUESTION 3. IF N0,ANSWER QUESTIONS A,B.C AND D BELOW AND THEN GO TO QUEST 3. A. THE TOTAL NUMBER OF PEOPLE LIVING WITH ME r' B. THE NAMES OF THE PEOPLE(WHO WILL NOT BE AIDED ON THIS CASE)WHO LIVE WITH ME,AND THEIR RELATIONSHIP TOME. NAME RELATIONSHIP RELATIONSHIP mother,aunt,friend,etc. NAME (mother,aunt,friend,etc.) ^-- C . C. Vl RENT OR PAY SOMEONE FOR HOUSING ❑ I OWN OR AM BUYING MY HOUSING ❑ 1 HAVE FREE HOUSING D. THE KIND OF HOUSING I HAVE IS [:] APARTMENT ❑ HOTEUMOTELSALITY OOM E] MISSION FACILITY HOUSE ❑ TRAILER `. ❑ CAR/VAN E] BOARD 8 CARE 13 ROOM 8 BOARD ❑ DORMITOR ❑ OTHER•please state kind: 3 THE AMOUNT OF MONE Y I PAY FOR HOUSING EACH MONTH IS S O 1 PAY UTILITIES SEPARATELY E] NG YES 11,NO 'IF YES,THE TOTAL MONTHLY COST OF UTILITIES(gas,water electricity)IS: S THE PERSON I PAY HOUSING TO IS(Name) STREET ADDRESS APT NO CI Y STATE I ZIP CODE ev 4 1 1 AMA VETERAN PrIYES ❑ NO IF YES,PLEASE GIVE INFORMATION BELOW: BRANCH OF SERVICE VETERAN'S NUMBER DATE OF SERVICE MONTH/YEAR S Frum lu S ❑ IF YES COUNTY USA:UNI.y A 1 MOVED TO THIS COUNTY WITHIN THE LAST YES NO 30 DAYS FROM ANOTHER COUNTY OR STATE coUNIV a SIAU B. I LIVE IN CONTRA COSTA COUNTY AND ❑ IF NO,what are your plans: PLAN TO STAY HERE. YES NO C. I AMA UNITED STATES CITIZEN ❑ YES O uIENNuMaER IF NO.1 AM IN THE UNITED STATES LEGAL LY AND ❑ ❑ ❑ CA 6 CAN GIVE PROOF OR GET PROOF FROM INS YES NO SPON%ON i 5 LIST YOUR RELATIVES AND FRIENDS: cuLlNrl'uscuNtS' RELATIONSHIP NAME ADDRESS TELEPHONE CON IACI r NO Sul IS SPOUSE (If not In home) .............. ....................................... ......................................... .......................... ........................................................ F APPLICANT'S T .................... .. ................................ .......................... ........................................................ H SPOUSE'S E R OA APPLICAN.. I's /1<•L/�•��.'. ...... ......................... ......................................................... T c �a1�•vM-" �S w9il� Ute. .. H SPOUSE'S E R ......................... ....... YOUR CHILDREN .......... ./ •Y�+�. �sF+lr./.Fa ... .L�'c�r�`�..�.j :... OVER 18 -.. _.._ ..... ._ uu4L If YES 1__�__ _ YL S NC! Amu"Ni ❑ GA 201 P If IHAVEMONEY INA CFIECKtNGORSAVINGS if YES S. ACCOUNT OR CREDIT UNION OR O THER PL ACE & NO AMU++h! C I HAVE A LIFE INSURANCE OR BURIAL ❑ if YES S POLICY YES NO D I HAVE A CAR,f RUCK,VAN.MOTORCYCI E .tt❑ IF YES,how many" ONFIHitRVIH1Ei1 S'i Jt, i/SAD� s 15Cf�l-�(In rlr t../1 ■TNI. VAIu+ Y S FIND VAI HI E. I IiAVE A HOUSE TRAIL ER,MOBILE HOME. ❑ IF YES 1 HOUSE BOAT OR BOAT. YES NO RIND VAI UI ' F I OWN LAND.A HOUSE,APARTMENTS OR ❑ a,IF YES.ASSESSED VALUES OTHER BUILDINGS. YES NO G I GAVE AWAY MONEY OR SOLD OR GAVE ❑ 9 IF YES S AWAY PROPERTY,LAND OR BUILDINGS YES NO VAI 01 DURING THE PAST TWO YEARS I AME RECEIVED OR E XPEC f TO RECEIVE MONEY THIS MONTH FROM: wuik ing,AFDC.Sochi $'luINrY t1Sk VNI-y Security,SSI/SSP,Unemployment Insurance((JIB).Disability Insurance(DIB),Workers'Compensation, Veterans Benefits(VA),loans,scholarships or reterement`free rent or food or money from anyone else ❑ YES NO _ NAMfOfP(RSONWHO RECtIVES Mr.DME YiNDO1INCONIF AMOIJNIRECEIVED NOW RI LEIVINPj DATE 1,1011pt0 Wit RL01vqi DATE IT WILL STARE ❑ n; JC, _ _ _____ ❑Irl:_'=�`x�' II YOI J Rl.f 1'IW 1 HIC MONI Y 1 NOM A REI.A I IVI t)1(11(11 MIT, RF 1 A I IONSIIIP TO Y01 PE HSON'S NAME; ADDRESS NAME OF PERSON WHO RECEIVES INCOME KIND OF INCOME AMOUNT RECEIVED NOW RECEIVING DATE STOPPED WILL RECEIVE DATE IT WILL START ❑ YES ❑NO ❑ YES ❑NO IF YOU RECEIVE THIS MONEY FROM A RELATIVE OR FRIEND, RELATIONSHIP TO YOU PERSON'S NAME: ADDRESS A. I HAVE WORKED IN THE LAST 2 YEARS ❑ ❑ GA 13 Y NO B. I QUIT A JOB OR WAS FIRED WITHIN ❑ IF YES THE LAST SIX MONTHS YES FO win N NF ASON C. I AM ABLE TO WORK IFN ,give the r son(sick,disabled,other): PrGA 341 YES O �Sy47 IF YES,I am willing to work off the ❑ Referred tQ W.P.Orientation money I receive or go to a training Apo"d"1 program,and look for a fob Q 'Q 1F NO,give the reason: ❑ GA 34 YE5,NO Spwse D. I HAVE A JOB ❑ IF YES: k YE5 NO HOURS Olt R MON III AMOIINI PER MONTH DECLARA71ON I DECLARE UNDER PENALTY OF PERJURY TNA T ALL INFORMATION t NAVE GIVEN ON MY GENERAL ASSISTANCE APPLICATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. OU F OR MARK COUNTY WHERE SIGNEO SIGNATURE OF WITNt SS IQ ARK.IN1(R1`RtIt OR PERSON COMT9 FNNG IQRM FOR APPEICANT DAIS E11110,17'Y VSA ON1 Y+ In addition to the Statement of Facts,the fallowing forms have been completed: .tib tMPLOYABLES R EMPLOYMENT HISTORY ❑ PROPERTY ❑ MULTIPLE PERSONS GA 34 GA 13 GA 201 P GA 202 If EI IGISI tTY WORKF N SIGMA I URI DA r[ G J. _ r. +. r �• �� ^3 :tea... '.�. '�� •'. ..x� /P ti *tom y� ..}¢ ', .. •. �'' - *�#`.� ` ' ..�!.t. _. �V4� _...ate Continuous'11er101ded a W.,,8usness Forms,im.401 tiA 60C•1260 9.85 rp r+ T aiT, r• 0 C UG zC -' ur + -i 7 . Z i-iZ --iTL L zTOn ' 2T. il• 2 £ = T �' c71T.+ z '*' to Z l w r -C C i7 Z Xr = Z 3: ;T "' r c C D G > .,n -+ Z'Z ►' L C D c %ti i•, i•+ z c :A ?,+ v :Ji D .t -! z v '** 0 i•+ ! � `J: z *+ d � :: '� ^1 zTr •n T, ¢ . G ^ 7 +-+ �=+ ^ Z e: �+ t- -C GyC ti• ;; �7 ^ CZCi '. { .^.+ C: .'`. 1 T u O v ;r, .� ✓ = ir -< z Z i-i = C --j 7. = - T -r " D O 1.4 Z X C ZD C MDZM -r .. X GT ,T; ZC i-+ --i - C Z i 0 - n -+ • -CCC -i ?• -+ k D DT-• �1 iT Z OT X. ^ n 0 D i *rI., � ;--r :' D C z 'n "^ ^_ 3 3 D -C C ^ � C a D �.�+ *� - .. . -c C: Z = C i!► -, ►•+ .^, -C rn tri Z T :.�: £ Z -CW -C r M, Ir V !r'r 'AZT T ,T :� TJ ;T; •r* � (D N O R1 T. "( Ir! �: i-+ D i7' v `{ C i+ C C y 0 d i CC ZD z TDA-4 z V �' TZ �lTO �: -z -< '� -rZ c T M T ~ £ .,W.. w T V = M C C -< Ti if it = T v -7 T y J T I n Q a V i a z D T � 2 'r"v '^ D -J T cri Z 0 i-,.� r- D D '- C '^ r Z zcl T T IM. X i-irr �` -C ►+ :, DC: �: � X "' i�: .. 't? -cDZtr, Q Q ^' fJi -+ zCM -ccz +-' rn ..err ,"rM c � �: cr: a 3 r• T -1T! Z '*' Z cri ;rt -< ;•; y m C CT. ^vii:^. Ta X G ,Z' ya T D !�! .^. r,iy-' u: = rU, r.0. a, T.• i-i3> LTi Z ^ " DZ -1 T. rr cD = Z L Z2 -[ � TCzcr Obi r Z i. d► X = v y 'r1 c �; T—x - 0 1+ a a Md m cm GL" ZC :l; -+ ;T i-. C; T z •• T nC XX £ ^ D O = C y; °• -� .. ✓ T :A ;�; Ou '�• T3i T *+ rrv^ ZT -r. : 7 - CTC = DO -nC rp z 7r qtr MMM C = M Ti-. r • 1 1••i 1 -� Z �' Z C. U' T -� ..� �'ri �.I T z ` -T r" c C � T^-+ -' TD • � Z -C T D T ,R, T D DyC. .^, T 1� t-' X -+ D --a � C -� £ �.'. :. .;: = Z --i C y O -! T ? tri Cz ? £ D C = _ :. • D -CTC •\' s., s-; :1i ^ C' :-. l-+ X n K }'+ �^. 'r, L z i.. i ' T D z £ -C '*? _ v 'r T C -i �? i. „ T 0 r S c J. z Z T Z -� r-+ t D it ^ rp D O T; y ;n Z +-+ _ Z T. TC: Za "r1 i-• C ! r T ^ ^. a C. ir+ 0, MM ` C0 v ;r. I., fit '- Z :^ :l z z n �- rr ="oroxzm-r W' Z*O °mm..W-CfmaOX i♦ � yvi � m � m ^ Z 1+ D Z Z TC C n fT- 3m y G :c z D ;r. O .n \ ., V O r+ i i 1 rr a r m v CA � r T n NA D D x • -• t j f a m i.�. tr D z' T T �^ rn vT m W m b Z z C) r^O 0 kilI�f= l 0 00 0i (PZ $ _ a 0 U. X A M Z CA rn D V T ' A, «, ; ter .� too J m T T T �, T i.. i+ y . C: C T IN; L r i,� a J' �'• O \ c0 G M w w -. O 'r lov _ :• •` c• •`li�`•;p ,Sii;�..� Fh+,;:-"c'.:'Y F'• ;C2';. S�"`S.E• `J - •.,yw.- Jb ��3ai' Y r,:�• A. ' tic fir" .�?�iliri) , ter?:,;Y,i.•i_ - "x. " i'�^."d:':"�i - ` kis•-:. •<,7• "R:= X.' a -•y. a,9, ..��,LS:r,;y.,•-,�r.rC- '�f!•i ii• r. `'1+� :' •.r.1:'•,:.s.�i•sY l+�%Ah .-F$.. ��` x ki✓'% `•.,''' 'e.;;�,...'..'.'..- F_c•.rf +rte r. f. � I NT OF OF S'A'E OF CA:1-pRNA.HEALTH AND WELFARE AGENCY pEPAHtbEDlt OF!EA • . APPLICATION FOR CASH AID, FOOD STAMPS, AND/OR MEDICAL SSISTANCE (SAWS o,at our Before completing this application,read the Coversheet. You have the right to fill out this form yourself or have someone help y y request. h you need more space to answer, write on the back of this sheet of paper. SECTION A - APPLICANT INFORMATION COUNTY USE ONLY 1 A. Name of Applicant(First.Middle Initial,Last) B. Social Security Number(SSN) COUNTY OF APPLICATION (APPLICANTS FOR RESTRICTED CCCIMSLEY MEDICAL BENEFITS DONT NEED C. Maiden or Other Name(If Any) TO GNE AN SSN) Co.c(la"dence IN Diff) 561 - 46 1213 Rece D. Home Address: Number Street E. Mailing Address(If different) D" Ned 1415 — 26th St. —31-93 City Zip Code 94806 City Zip Code RICH. F. Telephone Number(s): Home Work Message G. Is your home address permanent? :& YES t❑ NO ❑ No Home If no home,tell us where you live. H0Q oile" FS A=HA • 2. Is anyone applyin;for 3. Has anyone ever asked for or gotten EYES ❑ N ❑ YES ❑ YES Cash Aid %93 YES C NO aid anywhere? NO ❑ NO Food Stamps ): YES ❑ NO If YES,explain:under what name, ❑ CA 42 Medical Assistance G YES NO where,when and types)of aid. Any Other Program(s)? YES NO TYPE OF APPLICATION If YES,exc:ain: 30 Yrs o. to fs M& a. Is anyone a migrant or seasonal YESv NO 5. Is anyone pregnant? ❑ YES to N -7 AFDC A ❑ Initial Full farmworker? I If YES,who? _i RCA C Recent❑ Restrich I'YES,who? C ECA u Rest o. Does anyone have a personal emergency? L YES NO It YES,what kind? Check(4 below: Referral Date: Medical _ Pregnancy _ Child Abuse C Spousal Abuse J Elder Abuse ❑ Other: The law says we must get your ethnic group and primary language. If you dont want to complete these items,the county will do it for you. This won't affect your eligibility. a. Ethnic G.ouD- -_X White = Hispanic _ Blank Filipino ❑ Chinese _ American Indian or Alaskan Native Asian Indian _ Laotian 7 Cambodian Ernie Group: _ Japanese _ Korean Guamanian _ Samoan Vietnamese ❑ Hawaiian ---- O:her Asian or Pacific Islander(specify): _-__ ---------------------------------------------- ----------- - ry ung fl b. Language- : English _ Cantonese Lao C Tagalog LJ American Sign Pana w e Soanish E Cambodian Vietnamese r 011ier(Specify): 1 SECTION B -FOR AFDC,COMPLETE ALL QUESTIONS IF YOU HAVE AN EMERGENCY. FOR FOOD STAMPS,COMPLETE QUESTIONS 6,9,10 and 11 IF YOU WANT EXPEDITED SERVICE. FOR MEDICAL ASSISTANCE,COMPLETE QUESTIONS 6,9,and 10 Section B AFDC tN YOU ARE PREGNANT OR HAVE A MEDICAL EMERGENCY. r_. NOA pep' S. How much liquid resources does everyone have. 12a. Do you have an Eviction Notice or notice `YES NO ApproveExpedited Grant including children? to pay or quit? _ Applicant ed Cash.uncashed checks or _ complete money orders S 0 b. Have our ubirties been shut off? _YES _NO y tomm B Checking•savings or c Do ou have a shut-off notice? YES NO By ( mars) cred,t union account(s) $ d W!i:vour food run out in three days or less?C YES=NO Trust deeds.notes receivable, stocks or bonds $ 0 e.Do you need essential clothing,including ❑YES C NO Other(explain) $ Cl_ diapers or clothing needed for cold weather? Section B-FS ES Not completed S How much income did everyone,including children,get I. Do you need help with transportation to get❑YES_NO Scree for ES or will they ge:•!tis month? food clotrilno medical care or other emergencyitem? ate S _ Da:e S Date F7�w-_,,hl yu have another kind of emergency C YES NO • threatens your health or safety? 5 Dare $ Date If YES,exparn: t0. , c:+is your rent or mortgage this month% R rr S Processing S .1. How mucn are your utilities that are not included to your _ Regular Processing rent this r+on*'r $ CERTIFICATION AND PERJURY STATEMENT I cert•fy that I -ave been given a copy of the coversheet. I understand and agree that I have to comply with = CVVprecadsdeared Ei iib 1•!y rules. some of which I may be asked to do before any aid can be given. I understand that the = MEDS CDB neared s!a:elner:s I tave made on this form may be checked and ver-!led. _ IEVS Initiated I cecia,e unde• penalty of perjury under the laws of the Unred Stales of America and the State of California — �SpAWS I Cowshest given no trapicant . ►rte rr'a:ron 1 hav ve ,is form is:+ue,correct. and comp;e!e. ;ase Narne 3 S-- e; •11-pa. i Appil 9!0 Aum n live D .5 Crj4� S- :-a a'V.. ss t Mark or Inver eie• Da:e S,gned Case Number f_ ?' :A'==A2°5 A, !Recj•e--Fo—s-No S..os!:.,: -e• es re-- e' a beauwulplace to buy a Ca, 3280 Auto Plaza 0 Richmond, California 94806 (S 10) 222-4444 17 7f' . ale ;Z HILLTOP FORD 3280 Auto Plaza RICHMOND.CA 94806 testis Escort Tempo Ptok Taurus Cmwn ifictaris Thunderbird vifts TnKks MILO HARRIS Sales Manager Bus.Phone(510)222 4444 Salt Ser'vice Leasing Also now in El Cerrito L. Moore Chrys-Ply Inc. H.L. MOORE We Buy -Sell -Trade -Finance (CHRYSLER - PLYMOUTH Used Cars&Trucks 10293 SAN PABLO AVE (IN THE REAR) 10293 San Pablo Ave. (rear) Rich Weyeneth EL CERRITO, CA 945: (510) 524-4313 (510) 524-4313+526.6669 El Cerrito Sales Mgr. OCTOBER 2, 1993 ESTIMATE OF VALUE OF AUTOMOBILE TO WHOM IT MAY CONCERN: We have been in the automobile sales business for over 40 years in the Albany, El Cerrito, California area. In our opinion the value of one 1981 Cadillac Yellow El Dorado, license IATU310, is $ 785-00. Thecar needs alot of work, and is not a very good model to begin with. The 4-6-8 engine has been a real problem and is expensive to do any work on. If more information is needed please do not hesitate to contact the undersigned. Yours- ery truly, H.R. Weyeneth Le I Sales Manager U1111 0C 0 4 IY93 Zi-XIA1 AN A AUTO:CENTE16 � IA R NORTH MAIN STREET JAGUAR EUROPEAN AUTO CENTER NUT CREEK, CA 94596 Best Selection Of Preowned European Cars (415) 933-4300 Sales&Service (510)5244100 10269 San Pablo Ave. DAN HARTWELL El Cerrito,CA 94530 ♦ t�lIo ui Lo ♦ ♦ ♦ 2 ♦ '�.Ea. kgc) iA7IX 3lri ♦ • • • ♦ • • • 1� vt RC1 04 Z ♦ ♦ • ♦ ♦ Social Service De artmet '� Please reply to: p C o n t I'a 40 Douc as Drive Perfecto Villarreal Costa Martinez.California 94553-4068 Director County 10/14/93 Wesley CANTRELL P.O. Box 5541 Hercules, CA 94547 Re: 515455 EW: W4JA Filing Date: 10/08/93 Dear CANTRELL WESLEY We have received your request for an Evidentiary Hearing about your General Assistance benefits. Your hearing is scheduled for: Location: 1305 Macdonald Ave. Richmond, CA 94801 Date: 10/26/93 Time: 9:00 AM Because 7 or more hearings are scheduled for the same hearing time, it may be necessary for you to wait for some time before your case is called. Cases will be heard on a first-come, first-served basis. The Hearing Officer will appreciate your patience. If you are unable to attend the hearing, please call 313-1790 If you do not attend, the Hearing Officer may dismiss your request for Hearing. You have a right to an interpreter if you need one. If you have also filed a request for a State Fair Hearing, you will receive a letter from the State Department of Social Services about the time and place for that hearing. The State Fair Hearing is separate and apart from the County Evidentiary hearing. 4 Social Service Appeals Unit RM/nf READ THIS FORM CAREFULLY. iT HAS IMPORTANT INFORMATION ABOUT YOUR GENERAL ASSISTANCE CASE. IF YOU DO NOT UNDERSTAND SOMETHING,ASK YOUR lSILITY WORKER TO EXPLAIN.AFTER YOU READ THIS St OUR NAME AND WRITE THE DATE. AUTHORIZATION FOR REIMBURSEMENT OF INTERIM ASSISTANCE GRANTED PENDING SSI/SSP ELIGIBILITY DETERMINATION I understand that the public assistance paid to me,or on my behalf,by Contra Costa County Is considered interim assistance if it is paid during the period of time that my Supplemental Security income(SSI)/State Supplementary Payment(SSP)eligibility is being determined. (Assistance financed wholly or partly with Federal funds shall not be considered interim assistance) In consideration of such interim assistance paid to me,or on my behalf,I authorize the Secretary of the United States Department of Health and Human Services,through the Social Security Administration(SSA)to send the first payment of any SSI/SSP benefits,for which I may be determined eligible,to the above Agency I authorize the above Agency to retain from that payment an amount equal to the sum of public assistance payments the above agency and other California interim assistance agencies paid to me,or on my behalf,to meet my basic needs both before and after the date of this authorization,but limited to the period my SSi/SSP eligibility determination was pending initial yl42,r beginning with the month for which I am found eligible for an SSI/SSP payment and ending with the month my SSI/SSP payments begin; or 0 Post Eligibility beginning with the month lot which my SSIiSSP payments are reinstated after a period of suspension or termination and ending with the month my payments resume i I understand that,after makutg the above deduction flair,my payment,the above agency shali pay to me the balance,if any,no later than ten(t0)wofk mg days from the day the above Agency recawes my payment from SSA: I understand that,if I fret that the amount deducted fritm my SS(tSSP retroactive payment is more than the amount of public assistance paid to me, or on my behalf,by the above Agency,or if I feel the abuve Agency fdlled to pay me the excess within Tile len00)day period,l have aright to request a fair hearing from the State Department of Social Services. This request must be flied within ninety(90)days of the date the above Agency notifies me of the receipt and disbursement of the payment. I understand that if I file an initial claim for SSI/SSP benefits at a Social Security Office within 60 days of the date the above Agency receives this signed form,my eligibility for SSIISSP benefits can begin as early as the date the above Agency receives this signed form I understand that this authorization is effective from the date the above Agency receives this signed form and that It will cease to have effect: it1 Clalm at the end of one(t)year frcim the datr the above Agency receives this signed form,unless I file fur SSI/SSI'within that time,or one of the events listed below occurs earlier,in which case the authorization will cease to have effect as of the date of such event; ° SSA makes an initial payment nr reinstates payment on my claim; ° SSA denies my claim and I do not file a timely appeal of that determination; ° The above Agency and I agree to terminate this authorization. or ❑Post Eligibility at the end of one(t)year from the date the above Agency receives this signed form,or at the end of the maximum period within which to request review of the determination to suspend or terminate my SSI/SSP payments.whichever period of time is longer, unless I file a timely request for review,or one of the events listed above occurs earlier,in which case the authorization will cease to have effect as of the date of such an event. REPAYMENT RESPONSIBILITIES I understand t have promised to repay to the County of Contra Costa all General Assistance i have received or will receive. I understand I have signed a legal document known as a Reimbursement A;reement The Reimbursement Agreement will be recorded and will place alien against any property I have now or may acquire in the future for the outstanding amount of General Assistance furnished tome. f understand it also gives the county the right to file a creditor's claim against my estate upon my death for any amount of General Assistance remaining to be repaid to the county. if I become employed,receive money as a result of an inheritance.litiglltlrin aw from any other sources.i am expected to notify the Social Service Department and arrange fur repayment This may be drive by writing Of falling the Social Service Department I understand i will be contacted by the Office of Revenue Coliection noun after my aid is disco stinued My lenancial ability for rtpayment will be evaluated and a repayment plan may be initiated t DECLARATION I HAVE READ,OR HAD READ TOME,THE INFORMATION ON BOTH SIDES OF THIS FORM f HAVE BEEN GIVEN THE OPPORTUNITY TO ASK QUESTIONS ABOUT THESE RESPONSIBILITIES AND REQUIREMENTS. I UNDERSTAND THESE RESPONSIBILITIES AND AGREE TO COOPERATE BY MEETING THEM IN ORDER TO RECEIVE GENERAL ASSISTANCE. YOUR INATUnk MARK nit Pt ACt Welt itC NGNtU IA Ali SIG At URt 01 WSPitS t1 MARK,IN IRIryiI it it,OR PERSON COMM EhNGIORMIORAPPUCANi f11 I CERTIFY THAT I HAVE EXPLAINED THESE RESPONS/BIL ITtES AND THE PENALTY PROCEDURE TO THE ABOVE-NAMED APPLICANT/RECIPIENT,AND HAVE GIVEN H/MI HER AN OPPORTUNITY TO ASK OU[STIUNS ABOUT THESE RESPONSIBILITIES AND PROCEDURE Etifilatllt♦WORK x AMPR; N1.11VVI UAI t A ) G J, .�� 1. 1 must provide all information requested to determine eligibility to General Assistance. This includes completing forms, providing verifi ons, and signing releases of information en requested. I must provide this information by the dateWuired,and if I have not done so my aid may beWed or discontinued. 2. 1 must seii'd a M66thly tli-giliility Report(CA 7)by the fifth'of the month following the report'mbrith. 3. 1 must keep all appointments made by the Eligibility Worker,Vocational Counselor,or Social Worker. If I cannot keep an appointment,I must call Social Service before the appointment time to see whether the appointment can be rescheduled. 4. If I am fired or quit a job without good cause,I will be ineligible for General Assistance for 60 days from the date I was last employed. S. If my case is selected for review by the Quality Control unit 1 must cooperate with that review. failure to do so may result in discontinuance of aid,and ineligibility for one month. 6. :.I must give my Social Security Number(SSN).--The SSN will be used in checking identity and preventing duplicate issuance of GA. The SSN and any other information provided may also be used for computer matches, reviews, and audits. 7. 1 must CALL or WRITE my Eligibility Worker when there is ANY CHANGE in my address, income, property, or number of people living in my home,WITHIN 3 WORKING DAYS of the change. 8. A state law requires the county to give to law enforcement agencies certain information about GA recipients who have died or for whom a felony arrest warrant has been issued. This information is: name, address, birthdate, SSN,and physical description. 9. If I have no home address,and my mail is being delivered to the Social Service Office or other mailing address,it is my responsibility to pick it up. I agree toy pick it up every week. 10. If I give information that is not true,or if I don't report changes to my Eligibility Worker which affect my case or the amount of GA I get,I may be criminally prosecuted and have to pay a fine or go to jail. •TYPES OF CHANGES EVERYONE MUST REPORT 1. A change of residence(the place you'aie actually livirlg)� You must report your new address and the name and address of your landlord. You must sign an approval for your landlord to release information verifying your living arrangements. Change in housing costs=rent'or utility changes. 2. If you.plan to leave this county., 3. A change of household composition-if anyone, including children, moves into or out of the house. A change of marital status ` 4. A change of employment status-if anyone, including children, in the household starts working,stops working, or becomes unable to work,or goes to school/training. ' S. A change in property holdings-if any member of the household buys,sells, or receives as a gift or inheritance, a house,car insurance,stocks,bonds,etc.,or if a bank account is opened or closed. 6. A change in income-following is a list of types of income that must be reported. This list is not all-inclusive. • money borrowed(loans) • Alimony/Child support • money earned(wages) • income from, or acquisition of real or personal property •agate money from prison • checking/savings accounts • Income Tax Refunds(State or Federal) • Inheritances • State Disability payment • Unemployment Insurance Benefits • Union payments/.Pensions • Grants./-Scholarships / Loans given to you to attend school • Social Security Payments • _Gifts or money from relatives or friends • Federal IQisability Payments • Money received from giving blood or plasma _ • WoikersCompensationpayments • Department of Rehabilitation money given to you to attend classes,or for any other reason • Private Disability payments • Life Insurance money • • Welfare payment from any other state or county • Legal settlements and/or awards by the court • Income from self-employment,including street vending • Veterans Pensions/Awards/Bonuses • Retirement pensions or funds • Other pensions • Gifts of food,clothing,or other contributions in-kind • Lottery winnings • Money from any other source • Pan Handling 7. ANY LUMP SUM PAYMENT MUST BE REPORTED IMMEDIATELY. A LUMP SUM PAYMENT IS EXPECTED TO SUPPORT _ YOU AT THE RATE OF $325 PER MONTH. YOU WILL BE INELIGIBLE TO RECEIVE GENERAL ASSISTANCE DURING THAT PERIOD. ADDITIONAL RESPONSIBILITIES OF ALL UNEMPLOYABLE APPLICANTS/RECIPIENTS 1. 1 understand that I have the responsibility to get proof that I am unemployable. - - 2. 1 understand that�,l.hlUst'Wooly for SSVSSP if the Social Service Department requests me to do so, and will then be considered an applicant focJnterim General Assistance. 3. 1 understand iFiai I must actively,participate in a training, ie-tiaining, educational or rehabilitation program, if required by the Social Servlte_bepartment. - 7- /993 P46F. - C�urn� . . `�D Dov cfi4cs p�r✓C 1�ury z� OA 9 yss 3 Co,�frn.g C�sr�- z`7' _f'oCJ,aL-3e�bc� - - Cosriq --- - 1. pal ------ -- — #�-- '�N? lla m--�aVdj JS - LDC7?A/6 �eo�cl 'i o•c1 PG Z. • 1 ._....._... 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I✓i,rJ.��Zs( /�e��,�s /�'/3E" -tti�,";ennl2#. 1��•�.k/'c�::� 1✓i;1C /jfl�/C}14�/�7/N 10 � � %�CaVC 7t) ti+zil54' f}r !�c"Zc,"� .RyvX.`�•7�/ E7✓1�77 cYi.��4�- l7�'J l`�2 c"�a t '�1��J�;�A-�.. r7r}-.n,f t?x.''D �.:r r�-•�UiJ� r}�'� `3��:: �.�C�'s�L.. l-�-h'�tl i Ct u .::..: St�C� /1 C-�'✓1�c?�Eb r 17iQtr?79rn/rti'G' ?`2� � 1J/�f /l.�c�7'i�.� 7v Il•�r_:•i/•t� ,`4'EL��crG �-'%:zY4� ��J-s / o� G�-�.,�R.c".-� Z;>7 Jr.j j jk tZ Lc/}1 fti'•?,i..c j� -{�T<._��.s u-)ice .-r, 7c. •. ._ ......_ ..._.................... . . _. .._. L n -�o � G � o m C � o.,uj t rJ Q' 4DC M U I a •.0 b Vti 4 " sal; IlLn a f i W i o c m. 2• om••,O o w n 0 2 n m r Contra Costa County Sowl Service Departn. GENERAL ASSISTANCE ALTERNATE MAILING ADDRESS REQUEST CASE NAME CAS NUMBER EW PCN C/ i _ t ,,SIJ I request that my General Assistance checks and all other mail from the Social Service Department be sent to: ❑ My home address is: I have no home address. REASON FOR REQUEST: 6) W— 'yr, ',� j �.SSLJrwJQ (9,4 /3gz� j ,baa ,.�'',.� ".-3Y:�2ti� J)tJ77'L .i�tltil11� = Leldz d I understand that it is my responsibility to pick up my mail regularly, and that failure to do will not be considered good cause for failure to keep appointments with Social Service. I understand that if I do not have a current home address, I must contact my Eligibility Worker monthly. When I obtain a home address,I understand that 1 must report it to my Eligibility Worker right away. I understand that if I do have a home address other than my mailing address,I must include my home address on my monthly income report,and that I must report any change in my home address to my Eligibility Worker right away. I understand that I must provide verification of my home address(such as rent receipts, utility bills,etc.)to my Eligibility Worker every six months. I UNDERSTAND MY RESPONSIBILITIES AND DECLARE THE ABOVE TO BE TRUE AND CORRECT TO THE BEST OFMY KNOWLEDGE. fA, SIGNATURE DATA E COUNTY ush*uw.Y METHOD OF VERIFICATION 0 APPROVED TICKLER SET FOR ❑DISAPPROVED Reason: TO RE V IE W ELIGIBILITY WORKER SIGNATURE DATE SUPIRVISOR'S SIGNATURE DATE v= i GA 8(Naw 9187) Ref: OM 49"SOT Copy T: IM Case fde fastener/?;Copy? Applicant JRr:oar" • l j 01 C -To 3� AJ3ol- a; f u O Ak Lk ° 0 4 - r • j. r Social Service Department Contra Please reply to: Perfecto Villarreal Costa 40 Douglas Drive DIrLC20r 1 Martinez,California 94553-408E County GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION IN THE MATTER OF: Wesley Cantrell, Claimant County x`:515455-W4JA P.O. Box 5541 Date of County Notice:NA Hercules, Ca 94547 Effective Date of Action:10-1-93 Filing Date:10-8-93 Hearing Date:10-26-93 Aid Paid Pending: no Hearing Officer: Ruby Molinari Income Maintenance Representative:Lee Weikert, IM Supervisor Place of Hearing: Richmond, Ca ISSUE I. Whether 10-1-93 is the correct beginning date of aid. II. Whether the claimant is living in a shared living arrangement. COUNTY ACTION AND POSITION Issue I. The claimant applied for General Assistance on 8-31-93. He attended a gfoup meeting on 9-16-93. At that time he submitted all verifications which had been identified as necessary to complete his application. He submitted a copy of his vehicle registration and also submitted an estimate of value of the vehicle from Hilltop Ford. Hilltop Ford estimated the value of the claimant's vehicle as $500.00. The worker used the registration fee schedule from Department of Motor Vehicles rather than the estimate and determined the claimant's automobile had a value in excess of the maximum. Late in 9-93 she sent the clainant a notice advising him he could submit two more estimates of the value of the automobile if he did not agree with the DMV evaluation. The claimant submitted two more estimates which were under the property limit. • The claimant did not submit the second two. estimates until after the first day of October so aid was granted effective 10-1-93. Issue II. The claimant completed a General Assistance Statement of Facts and stated that there were three other people living with him. Those people were Mark Cantrell, son; Debbie Cantrell, daughter-in-law; and, Travis Cantrell, grandson. The claimant stated he was renting a room from them and paying $150.00 per month rent. Since the claimant was living in a home with three other people he must be considered living in a shared living arrangement. The county contends the claimant was eligible to a grant of $168.00 which is the allowance for a shared living situation. CLAIMANT'S POSITION Issue I The claimant stated he would have submitted the estimates earlier if he had been notified the worker needed them. He did not get the notice from the worker until 10-1-93. He does not believe he should be penalized for not submitting the estimates earlier. Issue II The claimant moved into his son's three bedroom, one bath house with the agreement he would have one room with kitchen and bath privileges. He agreed to pay rent of $150.00 per month. After he moved in his son and daughter-in-law began having marital problems as his daughter-in-law did not want him there. On 10-6-93 his daughter-in-law told him to get out so he left the house. He has been staying with friends or sleeping in his car since that date. REASON FOR DECISION Department Manual Section 420820,II,A, provides that ownership is defined .as having the right to,use, receive proceeds from, and dispose of property; usually the person who holds legal title, or in whose name it stands, owns the property,. Department Manual Section 49-208,IV,1, provides that cash, checking or savings accounts, credit union shares, motor vehicles, . . . .with a value in excess of $500 which are owned by the applicant/recipient. Departmental Manual Section 49-501, III. A. provides the beginning date of aid is the date of application or the first of the month in which aid is authorized, whichever is later. _ r ._._:.... ................_.._.._...._......__.... - -- .....-- ...__._... ...._....._.__... -- ---------------------.._._.....-.-..._. Departmental Manual Section 49-207.111, B. 1 defines shared housing as an individual shares a dwelling with other, whether related or not. Departmental Manual Section 49-501, VI, D.I. When a recipient's housing situation changes during the month, and the housing allowance is increased, the difference shall be supplemented. CONCLUSION Issue I The claimant timely provided all the information he was aware was required of him. Since he did not receive the request for the additional estimates on his car until 10-1-93 he cannot be held responsible for the delay in obtaining them. Issue II The claimant was living in a shared living arrangement until 10-6- 93 so the county correctly computed the grant from 10-1-93 through 10-6-93 as a shared living arrangement. Since the claimant's housing changed on 10-6-93 the county must issue a suppliment for a single housing allowance from 10-7-93 through 10-31-93. ORDER Issue I The claim is granted. The County shall change the beginning date of aid to 9-1-93 and issue a supplement as appropriate. Issue II The claim is granted in part and denied in part. The county properly determined the claimant was living in a shared living arrangement, however, that changed on 10-6-93. The county shall issue a supplement for the changed housing in 10-93. Social ervice Appeals Officer Date Program Manage , Appeals Date If you are dissatisfied with this decision you may appeal the matter directly to the Contra Costa County Board of Supervisors. r f Appeals must be filed in writing with the Clerk of the Board, 651 Pine Street, Martinez, CA, 94553. Appeals must be filed within fourteen (14) days of the date of this Evidentiary Hearing Decision. No further aid paid pending a Board of Supervisors appeal. ti :, • ' 30 RECEIVE® JAN I 11994 A1,PCAZ -7v 43a.4.eo o� 50 -Xlj;sd�.s COMA 0�11 OAA/74446 07 Amo P.��pa� rr Fae J ) Psi:: ,4 Mo,Z') (3�4 FAOOo l A-Oau r pq i L,#•clji,4 B mr (aY-9 9,3, A e e&S;nr 7Z FtIll 04e- d-1- 774'6- pVALO' ,, , n'&O fecpA& L16 At Ampsh 5e7tvet c�cJ 59r <<S', 1993 ;7 ,� �v� 7a PAI O;V OW-Ion 194 cL uJ.�tS &-WQr-Z Fa-l- -p ypftj, 7m o e�s�,►J �' o��.r� ®s' ovukq� N�B•h""I3 y °� s�� AVS 9,3 &-X*,007-.0 to HA*rio�7z) � I/ m l-� Q v�T'`i -repT, �-3 Z7,9,1 l o-F cv;term , o cr. 9r3 P&A16b 9 � ct 0 CL � i ��a �. wpm-�.�-.� .,�.�.� t rr r G J Contra Costa County K f� Social Service Depertm GENERAL ASSISTANCE ALTERNATE MAILING ADDRESS REQUEST CASE NAME CAS NUMBER EW PCN i request that my General Assistance checks and all other mail from the Social Service Department be sent to: ❑ My home address is: Lll�� I have no home address. r REASON FOR REQUEST: "TC�, � sUf J.)A-7Zn � !Ram R—3Z C,1,c rrr'� ,;Lo — —� I2"28.,5222"4IZZ 4R 4]_..TI1["4t;_ RE DL 9Jr-0A)'—_5 1 understand that it is my responsibility to pick up my mail regularly, and that failure to do will not be considered good cause for failure to keep appointments with Social Service. C understand that if 1 do not have a current home address, i must contact my Eligibility Worker monthly. When I obtain a home address,I understand.that I must report it to my Eligibility Worker right away. (understand that if I do have a home address other than my mailing address, I must include my home address on my monthly income report,and that I must report any change in my home address to my Eligibility Worker right away. I understand that i must provide verification of my home address (such as rent receipts, utility bills,etc.)to my Eligibility Worker every six months. I UNDERSTAND MY RESPONSIBILITIES AND DECLARE THE ABOVE TO BE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. SIGNA URE DATE COUNTY USE ON1,Y METHOD OF VERIFICATION ❑ APPROVED TICKLER SET FOR ❑ DISAPPROVED Reason: TO REVIEW ELIGIBILITY WORKER SIGNATURE DATE SUPERVISOR'S SIGNATURE DATE i 1 GA 8(New 9187) Ref: DM 49-581' Copy 1: IM Case file fastener#2; Copy 2: Applicant 1 Retipw// Come CowC&AVY ' ROUTE SUP fwmfn.+no Pieft" TO: PCN: OATF: ANN CERVELLI Phase Check Correct Addrea p A. 30 Muir Road,Martinez p x. 40 Douglas Dr.,Mardnex p T. 1340 ArnoldDrivef1220.AWdnex O Adnkt tration (TraininyAPpaafs) O M. 2SOOAlhambra Aw.,Martinex O Ain ARancyonAglrsO O c. 4S45 Delta fair,Antioch O O w. 3431 Macdonald Ave.,Rich. O 4 100 Wsdsr Or.,Martinet . Won'sGaal 13 N. 1305 Macdonald Ave.,Richmond p x. 2301 Stanwell Dr.,Concord O G. 3045 Research Dr.,Richmond ICOW&NndcbwdPfNs1 O E. 3630 San Pablo Dam Rd.,EI Sob. O v• 2450 A Stanwell Dr.,Concord C) R 32S Second Sweet,Rodeo G4" of Board of Sups. O F. 330.2Sth Street.Richmond(PIC) 651 Pine St. , Martine z aINER DEPARTM[NTt MARTMIEx O AuddW IControUar p DA Family Tuppoet � p CountyAdmMatrator p Weft aSoctioa 0_ O DAMN80@2 iorn O R"Mafia O Haft Soma O oats Proven"sanies+ O Cou"touraal O fit► r O hoealioe O Alternate Wonder p Ward p Pwdw" O County Pew-- al O CCC Norah P40 O O CONCORD WALNUT CREEK RICHMOND MANU COURT O Central SereKes Q OMrca of Mwnw Collection p PtdtYc Defender .O Antioch O Public Defender O Q Q RidlaspIId O O Wrtlnas O OTHER: fil O Requested 17 NacowryAction NOTE A O Wurn 0 Discussed O Information O Discard O Recommendation O riles 13 Approval Kpnature COMMENTS FROM. TEIEPNONE NUMBER APPEALS r: 3-1790 1111111111111112 A I(new 6192) n giver WurmP a»AAnNnrwat irnm AffC CONTRA COSTA COUNTY SOCIAL SERVICE DEPARTMENT TO: Board of Supervisors DATE: December 9, 1993 FROM: Kate Quisenberry CC: Jewel Mansapit Ybl/ Appeals Worker of the DAY SUBJECT: Attached Board Appeal Request Attached is Mr. Cantrell ' s Request for Hearing and Hearing Documents. He is appealing the decision dated 11/18/93 . The request for hearing was filed 12/6/93 and is not within the 14 day filing period which expired 12/2/93 . KQ/nf RECEIVED 2-14 -`�3 �� ,.,, OE 1 0 1993 CLERK BOARD OF SUPERVISORS. CONTRA COSTA CO. 4e�— IL c ,1-116-�L7 -- - - a a— -- -- -z � ;�.. mm -- - - G —/� �3-- - - -- — - - -- =` =X te L a . di s--v- - / I `£------ BOARD OF SUPERVISORS ��.... CONTRA COSTA COUNTY 40 TOM POWERS SUPERVISOR,FIRST:-ISTRIC7 ---------- c------ December 6, 1993 To: Social Services Appeals From: Torn Powers, First District Supervisor Subject: Appeal,Request -`Nesley Cantrell Please refer to the attached request for an appeal hearing. Mr. Wesley Cantrell filed this in my office. TP:hf cc: W. Cantrell s. ..c •oma �t .:. �, � _ ��...��,..._..,� TOM POWERS ; r.. Yj SUPERVISOR, FIRST DISTRICT n o' < 104-371h STREET.ROOM 270 ► G i Cc", �c RICHMOND,CALIFORNIA 94,805 :6 .. Social Service Dept. 40 Douglas Drive Attention: Appeals Martinez, CA 94553 `14SS:-406u Si IIIIIIIIItill 11 lV , 100-37th STREET, ROOM 270 RICHMOND,CALIFORNIA 04805-2136 - TELEPHONE(510)374-3231 FAX(510)374-3428 f w N t . . .. . . . . ... . . .. r.v' "NTIARY HEARING NOES^ IN THE MATTER OF: _ - Record uptilZ�D 5, i #07- claimant Date of NOA: Effective date: Filing date: A.P.P.? a Authorized Representative: Interpreter: Language: Work Programs Representative: : I.M. Representative: Place of Hearing: Richmond; Antioch; Martinez Date of Hearing: AT ISSUE FOR HEARING: r --�---- �''•c�� `-Ct 1 � c«iirvl� Lim s .C/�!.«� :�OO�--L'�i County Position 42 '-Z j Claims is Position .i "V, ,!/� l �7iC—f•�1/L� � !t // "f / iI c_cC-/ '7'`"Y,_' f � !� fit.! L�.✓�(:��' -'!� — lZ-G' . L�u-L ../L G�-r..�v'.�'tel /.iZ-'-2-�=-s-L'='� C�G`zC _....._._._..._....... ....._._..- -- - ---- _ l��-�G�cy✓�CG�=�- ems- � ��h v l72 /��—�L..ivy .:-.L--•--�, C ✓CK.'-�`.".' � �/Gf..t�L.c�� /y3�z.�t�.-�Ll-,��-�L�!`.��-z-�.<-s-- .�-' �, i iC) // - � �t��>C J /" <'�t-��✓"( �.;.,�� ,.;��./' �- � `"-��, j-� GL�4'�'l u+f--tom,_ =�'�.(�.Z.L f/ .��.r�.:��C'� '�=ct-Z � „-C�� z<� �C.� .•�.tiL{. _.i_-.,: _-L �- �'�'- � / c,��Zt---.-�I -t•� j r - WELFARE CASE -DATA SYSTEM • 2 7' $ F LASE FINANCIAL INFORMATION CASE NUMBER 278 B/F DATE PRINTEb 278 LMB FORM 278E REV. 4/79 DEL 10/90 JELIG*�JM�R, 515455-00-0A3 10-04=93 04 CONTRA COSTA PG 1 OF 1 WB SERIAL FBU MOLT. SE0 SE0 FOOD STAMPS .ID - TYPE CASE NAME POSITIVE NEGATIVE CASE STATUS HOLD LAST FIRST•(OR HUSBAND) MIDDLE COR WIFE) 96 3 CANTRELL WESLEY 1�8D� lo-81II-93 6Vb 00-� -00 ACTIVE CODE AS. OF....10.-0;4.-..93.............:.:::::::,...........F:RO.M./.TH:RU.. :....:.....:0.8./.9..3.::... ::.:.:....0.9./,9.3... . .......1.0./9.3..........F.U.TU.RE... h,_% 04"Mils ;n1:.,sNl 1::3.8 PA:::GRA:N:T MA:Nt1AL::: ;:;. .: ::1 . n n. 1':'.:.0 0. MAID ..PERS INCOME STAT 1..3.9 PA..G.RA.NT.-A.0:T.O:. ::::.. ::::::,::::::::::::::.::::::. 1.6:8.,:.0..0 01 000 W. ;16: m. ' ..M .R.I.�AIY.E..................................................... ....................... ... ... .... ..:: ::::::. ::::.�,'''.:::..:::.1:5.0....:b:b ALLOTMENT - 9.0.. H H.::-T Y P:E./P.E.R S O.-1,... ::.:K :..:0::1.....:..,. ...::::K:....0.1.::::.....:::::::K..::.0..'.::......... .:,:::::-- (J::1..:::.:.. R . .RA.T.ED...A.M.T.................. ........................ ....................3.1. .. 112. 00 �6 ..:.N.O...:.:z.N:GQ.M.E.......... ::. X.XX.X.X.X....:..:.......XXXXX.X....:...:::. .'XXXX....::.....::.X.XX- • CERTIFICATION PERIOD I 08-93 07-94 THRU .......... ............... ......................... ar .............. ... .. . .. ..................................................... .. �� .. .... ............... ............ x .s W h r�4t MID-MONTH WARRANT DAT A E MOUNT ...................... .00 : .:::..:..::::::: : ::::::::::::::4...... : . . ....................... ... ... . ................. ..: ::::::::::::::::::::::::_::::::::::::::::::::::::::: .:::....::....... .::: :....:::..::.. ....:.::.::..:..... .. ._. ... ......................... .: . ..... .. ................. .... .... ..... ... .................. ... ...... ................. . ................................................__...........__._... ._..................................._..............................._............................................... .. . ,:...x.,. . i T O T A L G R O S S EARNINGS . 0 0 . 0 0 . 0 0 . 0 0 FIRST-OF-MONTH WARRANT ::::::: _ :::[+. . FA- RA.N7" ii '`_ _ "' [[i€i - -: i ;;;,.. .: :....::.. - .:..::- ::::::::-. at r DATE AMOUNT TOTAL GROSS INCOME - --1 00 1 00 1 d.68. 00 11/93 168. 00 #:::::::::::::.. :.::.:-=,._;...::::::...:::::::::::::::::::.:::::...:::::::.::::::::::::::.::...::..::........:: ::::: ... :::..---._:::......_,.:.:..::....::::::::::::::.:::.......::::::::::.:.:::::::::=::::::::::::::::...:..._,:._,,.:......:: ::::::!:::___-:-::::::::::::,:::=::::::::::.:::::::::::::::::::: :::::::::::::::::::::: ,:::::..:..--"""':;___ �' ' :::::: ; _ _.- =-- ; 1::::::;�;::;;� :;::::::::::: -::_:: :::::::::::::::::::::::::::::.:::::::::::::::::::::::::::::::::::::::::;:::::::::::::::::::::::::-::::::-:::::::::::::: :_ :::::::::::::::::::::: __ -::::::::::::::::: :_ _ M D MONTH WARRANT HH TYPE/N::: 0 .... _ R F PERSO N S K 01 K 01 K O1 K 01 DATE AMOUNT _.:A;. :. . ..: .: .: .: : . E'...... 3 8"Ma_-_'='�38'_:' ii :: _'' 0.0. ; i ;6.......,,.. -::: ::,:::. nn 756 bn 756 do 11/93 . 00 .......... .... A1:: .:::::: :::::::::::-:::::::::-::::::::;::::::::::.-:::-:::::::::::::::::::::::::::--.- _ _:.-_-:.--ni-n::::::::::::::::::::::. ::::::.........::::::::::::::-:::::- . ::G:E t1.SS.:...:DARNED......:.A ..:..............._................::.._:...::::::::::::::::::::::::::_.::::.......:_-__::::::�::n::nn:::--_:::::_ ::::.:n- .........................=...... .. .. . ..."-"".".""".................. . .. ...............................................................................................................................- . -- ......................._..........---1. 0..n0........::....-.-:-:1 n0 n0::::::::::::::::::168. 00 :6:::: 1::a - ........................_.,::::..........__............-._._. a:::::P L U S:::::0 T H E R: INCOME. _ .....:. .: :. :- ...:::::::::::!:::::::::-_::::-:::,:::::::::-::::::::::::::::::.:::::::-::::-:::::::::::::::--:-__._... ................................ ... ......................................... _8.... 0 0 ......:::: : :: ::: :: :::U.C::,::::: : :::::::::::::::-:_:=:::!::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.-::::ME _:: :: ::::......::::::...I:. ::.::::::::: :: :::::::::::::::::I'.:-3::= Contra Costa County Social Service Department GENERAL ASSISTANCE STATEMENT OF FACTS CASE NAME CASE NUMBER 7 Person Applying LAST NAME FIRST NAME MIDDLE INITIAL SOCIAL SECURITY NUMBER **�� STREET DDRESS APT NO CITY STATE ZIP CODE TELEPHONE NO BIRTHPLACE '�- I BIRTHDATE SEX SEX cG�_ ALE ❑ FEMALE PLEASE ANSWER ALL QUESTIONS FOR EACH QUESTI N,CHECK THE " ❑ YES'" OR �()(_❑ NO BOX. FOR SOME QUESTIONS,YOU WILL ALSO HAVE TO WRITE IN SOME INFORMATION. 1 I AM MARRIED ❑ YES NO IF YES,please give Information below: SPOUSE'S NAME SPOUSE LIVES WIT ME SPOUSE RECEIVES WE LE ARE ORSS1 El YES ❑ N ❑ YE ❑ N SPOUSE'S ADDRESS SPOUSE'S SOCIAL SECURITY NUMBER 2 1 LIVE ALONE ❑ YES NO IF YES,GO TO QUESTION 3. IF NO,ANSWER QUESTIONS A,8,C AND D BELOW AND THEN GO TO QUEST 3. A. THE TOTAL NUMBER OF PEOPLE LIVING WITH ME ,73 B. THE NAMES OF THE PEOPLE(WHO WILL NOT BE AIDED ON THIS CASE)WHO LIVE WITH ME,AND THEIR RELATIONSHIP TOME. NAME RELATIONSHIP RELATIONSHIP mother,aunt,friend,etc. NAME (mother,aunt,friend,etc.) C. 9—IRENT OR PAY SOMEONE FOR HOUSING ❑ I OWN OR AM BUYING MY HOUSING ❑ I HAVE FREE HOUSING D. THE KIND OF HOUSING I HAVE IS ❑ APARTMENT ❑ HOTEUMOTEL a ROOM ❑ MISSION FACILITY ;K HOUSE ❑ TRAILER ❑ CARIVAN ❑ BOARD&CARE ❑ ROOM&BOARD ❑ DORMITORY FAC LITY ❑ OTHER,please state kind: 3 THE AMOUNT OF MONE Y I PAY FOR HOUSING �EACH MONTH IS$ I PAY UTILITIES SEPARATELY ❑ YES Y 1�NO IF YES,THE TOTAL MONTHLY COST OF UTILITIES(gas,water electricity)IS: S G THE PERSON I PAY HOUSINTO IS(Name)— DEHR."O—�- STREET ADDRESS APT NO CITY STATE ZIP CODE _. 47 I AM A VETERAN YES ❑ NO IF YES.PLEASE GIVE INFORMATION BELOW: BRANCH OF SERVICE VETERAN'S NUMBER 7—T ATE OF SERVICE MONTH/YEAR Srum lu 5 IF YES COUNTY(TSB:LJNI.Y El A. I MOVED TO THIS COUNTY WITHIN THE LAST YES NO 30 DAYS FROM ANOTHER COUNTY OR STATE COUNTY a SIA 11 B. I LIVE IN CONTRA COSTA COUNTY AND ❑ IF NO,what are your plans: PLAN TO STAY HERE. I YES NO C. I AMA UNITED STATES CITIZEN Ix ❑ YES'NO ALIEN NUMBER IF NO,I AM IN THE UNITED STATES LEGAL LY AND ❑ ❑ ❑ CA 6 CAN GIVE PROOF OR GE1 PROOF FROM INS YES NO SPONSOR 5 LIST YOUR RELATIVES AND FRIENDS. CO(INVY USEONLY RELATIONSHIP NAME ADDRESS TELEPHONE CONIACI/NI SUI IS SPOUSE (If not In home) ...................... ....................................... ......................................... .......I.................. ......................................................... F APPLICANT'S A T .i1� ��C'$r0 T72crs ll. .......�...� fi3c�� .................... . HSPOUSE'S .......................... .......................... ........................................................ E R ............. (.q APPLICANT'S � .................. ................................................................ ... .......... 5 01/b' ... . H SPOUSE'S -�....... ......... G . E R . ....................... ....... YOUR /�f .......... ....... . CHILDREN ....... .. ./.A&,/— 4J7Tnr.l7h /........I G.��J r7,to...... .I . OVER 18 ... ........... ............ .... ................ .... ... . ...... .............. .............. ....... ............................................................................ ANYONE ELSE WHOCAN ...... ........ ....... ... . .............. . SUPPORT YOU GA201(RE V 7/88) IIIE FILEFAS IINLK 7 Y A I IIAVE MORE Ti IAN SS&IN CASH ❑ IF YES S YtS NO AMUUNI L_1 GA 201 P R. 1 HAVE MONEY IN ACHECKINGORSAVINGS 11 X11 YES S --- ACCOUNT OR CREDIT UNION OR OTHER PEACE YES NO AMU,r.1 C I HAVE A LIFE INSURANCE:OR BURIAL ❑ li YES S--- -- POLICY YLS NO Vntill j) D i HAVE A CAR,TRUCK,VAN,MOTORCYCI E VID IF YES,how many? (des(ribt•bvl:,w) ORO f l I 111 RVI 1110 1 1'I J() � .{atLR- •---_ _J CI' -�c'L*? !N K IN1, —VM ill (VI k.INIl vAl tit E. I HAVE A HOUSE TRAII Eft,MOBILE HOME, ❑ IF YES $ HOUSE BOAT OR BOAT, YES NO r.iNu vni ui F I OWN LAND,A HOUSE,APARTMENTS OR ❑ OTHER BUILDINGS. YES NO IF YES,ASSESSED VALUE G. I GAVE AWAY MONEY OR SOLD OR GAVE ❑ IF YES S AWAY PROPERTY,LAND OR BUILDINGS YES NOS VAI tit DURING THE FAST TWO YEARS I/VdERECLIVEDOREXPEL] TO RECEIVE MONEY THIS MON]It FROM: wcoking.AFDC,Soua) l.YN IN7'Y t!SJiON1.Y Security,SSI/SSP.Unempluyrnent Insurance(UM),Disability Insurance(DIB),Workers'Compensation, Veterans Benefits(VA),loans,scholarships or retirement,free rent or food or money from anyone else ❑ YES NAMT OF PF ItSON WIIO RE(I IVFLS INCOME - �w KIND OI ItJC_(}MF-�— AMC)UNT RECEIVE U NOW RT Q IVINCJ DATf.SI("A'MD WILI10.(LiVE DATE 11 WILL START it Y031)RECf IVF,11115 MONI Y 11tr IM A RF I.A I IVI E.)Ir I IM MI. RE1 A 1IONSHIP'TO YOi J IILRSON'S NAME. ADDRESS NAME OF PERSON WHO RECEIVES INCOME F:IND OF INCOME AMOUNT RECEIVED NOW RECEIVING DATE STOPPED WILL RECE=IVEDATE IT WILL START ❑ YES [] NO ❑ YES ❑ NO IF YOU RECEIVE THIS MONEY FROM A RELATIVE OR FRIEND, RELATIONSHIP TO YOU PERSON'S NAME: ADDRESS A. I HAVE WORKED IN THE LAST 2 YEARS ❑ ❑ GA 13 YES N _ B. i QUIT A JOB OR WAS FIRED WITHIN ❑ IF YES: T THE LAST SIX MONTHS YES O WHIN N III ASON C. I AM ABLE TO WORK IF NO, ive the r son(sick,disabled,other): GA 341 r IF YES,I am willing to work off the YES Oma" tz� ❑ Referred to W.P.Orientation money I receive or go to a training Applicant program,and look for a Job IF NO,give the reason: ❑ GA 34 YES NO SP�u>.c D I HAVE A JOB ❑ IF YES: S YES NO — 11011Rst'ERMONIti AMOUNT PER MONIfl DECLARATION I DECLARE UNDER PENALTY OF PERJURY THAT ALL INFORMATION F HAVE GIVEN ON MY GENERAL ASSISTANCE APPLICATION IS TRUE AND.CORRECT TO THE BEST OF MY KNOWLEDGE. OU t EOR MARK U COUNTY W10 RE SIGNEU SIGNATURE OE Will LSS to ARK,INIERPRETER OR PERSON COMPI[TING FORM FOR APPI.ICANI [)Art COUNTY IISh'ON1.Y, In addition to the Statement of Facts,the following forms have been completed: , EMPLOYABLES .CJ EMPLOYMENT HISTORY ❑ PROPERTY ❑ MULTIPLE PERSONS GA 34 GA 13 GA 201 P GA 202 1.11GIti1LITY WORK[R SIGNAL URI Un 11� 1 GA 201 REVERSE AOL Affili 1 Continuous!rwicxled`-Moore Business Forms,Inc.401 6OC-1260 9-85 • • • • CD C ►- T t-' Tii. 1. .n T -0 S--t -i f - 7;o:.a. C0 G z C z z :v ZZ T_ ,`T ;tom = i = TTm z '*' v :!1 z y'•� :- � � iZ = Y � ti• .� ^ T .^-- !'^ C C � v ' � -J �.z !•+ ;Tj 3 z 'C zT.• - M7 -� � v �� s.� vC z < sr -[ O � C %+.• ^ C7 ^� ` .'� v fD Z i 7: v v .. T 56 .� z sr -< z '^ = v -[ T = C -� _ -� y O �Q �' C z " D = s1 7 - '*' y z M '^ •• % ':v '�' ;rt z s.� -i _ C Z Ti ^ -i •^_ z :� ^, � � -CCv -[ ? � :-+ '- D D. X. t�. T `7T �t• � - n 0 i T T ,..t` Tl /T T T ^ T ; '.1 Z+ i �? 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ZET - rOx Zm_r mn,Z*0 omym-.s-C)mm z O O o p mOT z a 0 ^ m I=v CCO D .L r 07 O O w m C n C z z _Tc o m z m X, :-. - T y r+ x s+ = \ m y w �r � ^[) a rf•• � o T ^ N T v > D r y.. _ 7D 1C _� T2n � '- r r" AJ M '� :r CS n -N-1Ml > W O = o CO O \ 00,x Ft o' p ;. y . >a0lilt �n > .60 'C � rn N 5 37 O M y-n z o m IIIII�, O C C C X o n M < 2 Y•• � TJ R1 y t� %� •� T o > Z ice: a. y, C 0",< M 3" x T 0 C!r m n v C � O O O O O -a r- 3J G. ..+ 0 m C \ L•. O j >C \ G O V • O A `_ 0 5-A-E OF GA;i=ORN:A-HEALTHAND WELFARE AGENCY 1 ' DEPARTMENT N.. oEPARrMENT Cal APPLICATION FOR CASH AID, FOOD STAMPS, AND/OR MEDICAL ASSISTANCE (SAWS 1) Before completing this application, read the Coversheet. You have the right to fill out this form yourself or have someone help yourequest. H you need more space to answer, write on the back of this sheet of paperSECTION A - APPLICANT INFORMATIONCOUNTY 1 A. Name of Applicant(First,Middle Initial,Last) APPLr e. Social Security Number'FOR RESTRICt(SSN' COUNTY OF APPLICATION ED NE-SUEY !✓i;)��1'�'1, L (NIEDI CAL�BENEEF S DON'TDON'TNEED CCC C. Maiden or Other Name(If Any) TO GIVE AN SSN) Co.of Residence(If Dili 561- 46 1213 D. Home Address: Number Street Y E. Mailing Address(If different) Dare '" 1415 - 26th St. -31-93 City Zip Code City Zip Code RICH. 94806 F. Telephone Number(s): Nome Work Message G. Is your home address permanent? Homeless 1� YES t❑ NO ❑; No Home If no home,tell us where you live. ES MX HA 2. Is anyone applying for 3. Has anyone ever asked for or gotten t YES ❑ NO ❑ YES ❑ YES Cash Aid 19i YES ❑ NO aid anywhere? NO ❑ NO Food Stamps :: YES ❑ NO If YES,explain:under what name, CA 42 Medical Assistance YES ❑ NO where,when and type(s)of aid. El Any Other Program(s)? YES L- NO TYPE OF APPLICATION If YES,exc:ain: 30 Yrs Ago. 4 Is anyone a migrant or seasonal. YES =,Y NO I5. Is anyone pregnant? L-; YES to N = AFDC 03In cal ❑ Fdu&ll farmw•orker? If YES,who? RCA ❑ Recer,❑ Restricb If YES,who? ECA u Rest c. Does anyone have a personal emergency? YES NO It YES,what kind? Check(.0 below: Referral Date: Medical _ Pregnancy - Child Abuse 7 Spousal Abuse 1 Elder Abuse ❑ Other: The law says we-must get your ethnic group and primary language. If you dont want to complete these items,the county will do it for you. This won't affect your eligibility. a. Ethnic Grout- White _ Hispanic _ Black L_ Filipino ❑ Chinese American Indian or Alaskan Native Asian Indian _ Lao!:an Cambodian En.^..c Group: _ Japanese Korean r Guamanian — Samoan _ Vietnamese r' Hawaiian O:her Asian or Pacific Islander(specify): ___ ___________ ----------------------------------------------------------- j b. Language- _1 English ❑ Cantonese Lao Tagalog J American Sign Primary Language: Spanish Cambod;an _ Vietnamese _ O!her(Specify): SECTION B - FOR AFDC,COMPLETE ALL QUESTIONS IF YOU HAVE AN EMERGENCY. FOR FOOD STAMPS,COMPLETE OUESTIONS 8,9,10 and 11 IF YOU WANT EXPEDITED SERVICE. FOR MEDICAL ASSISTANCE,COMPLETE QUESTIONS 8,9,and 10 IF Section a AFDC IN YOU ARE PREGNANT OR HAVE A MEDICAL EMERGENCY. ` Denied NOA prep. Approved 6. How much liquid resources does everyone have, 12a. Do you have an Eviction Notice or notice YESE; N ` includingchildren? to pay or quit _ Expedited Grant — Applicant reauested Cash.uncashed checks or money orders $ 0 b. Have our utilities been shut off? YES NO CWD to compete _ Check:ne'savings or c Do ou have a shut-off notice? YES NO ey (Initials) cred,1 union account(s) $ 0 d W;';vour toed run out in three days or less?—'7 YES_NO Trus;deeds.notes receivable, or bonds $ 0 e. Do you need essential clothing,including ❑YES C NO stocks ars or c Other(explain)bon ) $ rJ d clothing needed for cold weather? Section 8-FS ES Not completed 9. How much income did everyone,including children,get I. Do you need help with transportation to get 'YES_Nt4w or will they get,:his month? food dothina medical care or other emergency item? S 0 Da-.e $ Date g. Do you hate another kind of emergency r YES NO wk-Ch threatens your heath or safety? Dasa $ Date If YES.explain: 10. Ho cn is your rent or mortgage this month% R rred for: c S Processing ! t 1. How mucn a•e your utilities that are not included in your _ Regular Process,ng rent,th:5 r-Dnl� f $ CERTIFICATION AND PERJURY STATEMENT • 1 cerf-ly Ina! I -ave been given a copy of the coversheet. I understand and agree that I have to oomply with - CWDrecords ceared e'0aiI) *.y roves. some of which I may be asked to do before any aid;can be given. I understand that the - MEDS CDG oewed st3ternen:s I rare made on this form may be checked and ver-!:ed. — IEVSintiated • f ceciare Linde enaft of perjury under the laws of the Un".ed States'of America and the State of California — saws coversheetgive+o0 P Y P l y aPP1#Cant tha*the uranon I hav ve ,is form is true, correct. and comD:e!e. 9_C vase Name •3 S g-q:-,e; •Mal, ) APP( n!o Autn n t:ve D �1 /- S;.Lf..Ye-:,-v.. ss t Mark or Inter eier I Dare Signed Case Number -:A 2?S-A, 'Rec.:'ec FS -s-No S-,)s:!j;e5 GF.•-•..�T. • •�a beaur;rul Alace ro bu v a ca r 3280 Auto Plaza • Richmond, California 94806 (S 10) 222-4444 17 7 /�� HILLTOP FORD 3280 Auto Plaza musrcans ��' RICHMOND,CA 94806 Festiva Escort Tempo Probe•Taurus Crown Vittoria Thunderbird Cans Trucks MILO HARRIS Sales Manager Bus.Phone(510)222-4444 St1If ' • Service • LeasingT ) -—Also now in El Cerrito H. L. Moore Chrys-Ply Inc. We Buy -Sell *Trade *Finance H.L. MOORE & (CHRYSLER - PLYMOUTH Used Cars Trucks 10293 SAN PABLO AVE (IN THE REAR) 10293 San Pablo Ave. (rear) Rich Weyeneth EL CERRITO, CA 945' (510) 524-4313.526.6669 El Cerrito Sales Mgr. (510) 524-4313 OCTOBER 2, 1993 ESTIMATE OF VALUE OF AUTOMOBILE TO WHOM IT MAY CONCERN: We have been, in the automobile sales business for over 40 years in the Albany, El Cerrito, California area. In our opinion the value of one 1981 Cadillac Yellow El Dorado, license 1ATU310, is $ 785 .00. Thecar needs alot of work, and is not a very good model to begin with. The 4-6-8 engine has been a real problem and is expensive to do any work on. If more information is needed please do not hesitate to contact the undersigned. ery truly, H.R. We eneth F, ri Le Sales Manager F. L1 OCT 04 1993 p �.'. r ��►1►�♦ AN AUTCJ:CSN � jAGLAR NORTH MAIN STREET JAGUAR EUROPEAN AUTO CENTER NUT CREEK, CA 94596 Best Selection Of Preowned European Cars (415) 933-4300 } Sales&Service + {510}524-4100 i 10269 San Pablo Ave. DAN HARTWELL + EI Cerrito,CA 94530 v ♦ C) ! ♦ ! ! _ 1 V..e � ! b 79 7 '3EL /3 ! ! ! 'l. tC- �t0 ! VIP ! ♦ ♦ ! -� r ' 0 ► r; ! ♦ ♦ ! ♦ ! ! + ♦ + ! + ♦ ♦i♦��►♦♦��►♦��►^►i�A+►♦♦�►♦♦�►♦♦Irk♦tW4--W •► .►--W�►•►•►��►r�•►��►��•►•►It•►irt Social Service Departmentas Drive Contra Please . 40 Douc as Perfecto Villarreal COSta Martinez California 94553-4068 Director County .t,, 10/1-14 93 I. li Wesley CANTRELL ..; P.O. Box 5541 Hercules, CA 94547 Re: 515455 EW: W4JA Filing Date: 10/08/93 Dear CANTRELL WESLEY We have received your request for an Evidentiary Hearing about your General Assistance benefits. Your hearing is scheduled for: Location:- 1305 Macdonald Ave. Richmond, CA 94801 Date: 10/26/93 Time: 9:00 AM Because 7 or more hearings are scheduled for the same hearing time, it may be necessary for you to wait for some time before your case is called. Cases will be heard on a first-come, first-served basis. The Hearing Officer will appreciate your patience. If you are unable to attend the hearing, please call 313-1790 If you do not attend, the Hearing Officer may dismiss your request for Hearing. You have a right to an interpreter if you need one. If you have also filed a request for a State Fair Hearing, you will receive a letter from the State Department of Social Services about the time and place for that' hearing. The State Fair Hearing is separate and apart from the County Evidentiary hearing. Social Service Appeals Unit RM/nf Contra Costa County, Soccal Service Depertmcint GENERAL ASSISTANCE AGREEMENT READ THIS FORM CAREFULLY. IT HAS IMPORTANT INFORMATION ABOUT YOUR GENERAL ASSISTANCE CASE.-IF YOU DO NOT UNDERSTAND SOMETHING,ASK YOUR ELIGIBILITY WORKER TO EXPLAIN. AFTER YOU READ THIS SiGN YOUR NAME AND WRiTE THE DATE. AUTHORIZATION FOR REIMBURSEMENT OF INTERIM ASSISTANCE GRANTED PENDING SSI/SSP ELIGIBILITY DETERMINATION I understand that the public assistance paid to me,or lin my behalf,by Contra Costa County.is,considered Interim assistance if It is paid during the period of time that my Supplemental Security income(SSi)i State Supplementary Payment(SSP)eligibility is being determined (Assistance financed wholly or partly with Federal funds shall not be considered interim assistance) In consideration of such interim assistance paid to me, or on my behalf, I authorize the Secretary of the United States Department of Health and Human Services,through the Social Security Administration(SSA)to send the first payment of any SSI/SSP benefits, for which I may be determined eligible,to the above Agency I authorize the above Agency to retain from that payment an amount equal to the sum of public assistance payments the above agency and other California interim assistance agencies paid to me,or on my behalf,to meet my basic needs bath.befcare and after the.date of this authorization,but limited to the period my SSi/SSP eligibility'determination was pending. ❑ initial beginning with the month for which i am found eligible for an SSIISSP payment and ending with the month my SSI/SSP payments begin; , or ❑ Post Eligibility beginning with the month for which my SSI/SSP payments are reinstated after a period of suspension or termination and ending with the month my payments resume I understand that,after making the above deduction fiwri my SSi/S5P Payment,the above agency shall pay tome the balance,If any,no later than ten(10)working"days from the day the above Agency receive,.my payment from SSA: I understand that,if I feel that the amount deducted film my SSIJSSP retroamve payment is mise than the amount of public assistance paid to me, or on my behalf, by the above Agency,or if i feel the ,ai,uve Ayency failed to Pay me the excess within the ten(10)Jay Peflud, I-itave a right to request a fair hearing from the State Department of Social Services. This request must be filed within ninety(90)days of the date the above Agency notifies me of the receipt and disbursement of the payment. I understand that if i file an initial claim for SSl/SSP benefits at a Social Security Office within 60 days of the date the above Agency receives this signed form,my eligibility for SSI/SSP benefits can begin as ear ly as the date the above Agency receives this signed form I understand that this authorization is effective from thv date the above Agency receives this signed form and that it will cease t0 have of fect: iti Claim at the end of one(1)year from the date the above Agency receives this signed form,unless I file for SSI/SSP within that time,or one of the events listed below occurs earlier, in which case the authorization will cease to have effect as of the date of such event; ° SSA makes an initial payment or reinstates payment on my cia m; ° SSA denies my claim and I do not file a timely appeal of that determination; ° The above Agencyand i agree to terminate this authorization. or ❑ Post Eligibility at the end of one(1)year from the date the above Agency receives this signed form,or.at the end of the maximum period within which to request review,of the determination to suspend or terminate my SSl/SSP payments,whichever period of time is longer, unless i file a timely request for review,or one of the events listed above occurs_earlier,in which case the authorization will cease to have effect as of the date of such an event. REPAYMENT RESPONSIBILITIES I understand I have promised to repay to the County of Contra Costa all General Assistance i have received or will receive. I understand I have signed a legal document known as a Reimbursement Agreement The Reimbursement Agreement will be recorded and will place alien against any property i have now or may,acquire in the future for the outstanding amount of General Assistance furnished tome. I understand it also gives the county the right to file a creditor's claim against my estate upon my death for any amount of General Assistance remaining to be repaid to the county. i If I become employed, receive,money as a result of an Inheritance, litigation or from any other sources, i am expected to notify the Social Service Department and arrange for repayment. This may be done by writing or(.ailing the social Service Department. I understand i will be contacted by the Office of Revenue Collection soon after my aid is discontinued My financial ability for repayment will be evaluated and a repayment pian may be iniw ted DECLARATION I HAVE READ,OR HAD READ TOME,THE INFORMATION ON BOTH SiDES OF THIS FORM. I HAVE BEEN GIVEN THE OPPORTUNITY TO ASK QUESTIONS ABOUT THESE RESPONSIBILITIES AND REQUIREMENTS, I UNDERSTAND THESE RESPONSIBILITIES AND AGREE TO COOPERATE BY MEETING THEM IN ORDER TO RECEIVE GENERAL ASSISTANCE, YOUR NATU1 It MAIM A+k- PI Act wr it rtr SIGNIU SIG At IIRV OF W k S 10 MARK,IN !Ip'Itt!F R,Oft F'f RSON COMF•!F i IMG I OHM t 0R APPi iCANT I CERTIFY THAT)HAVE EXPLAINED THESE RESPONSIBILITIES AND THE PENAL TY PROCEDURE TO THE ABOVE-NAMED APPLICANT I RECIPIENT,AND HAVE GIVEN HIM/HER AN OPPORTUNITY TO ASK QUE S rIONS ABOUT THESE RESPONSIBILITIES AND PROCEDURE Fflriltl2(TYWORK R 1<Hkr+Hr NI,�riVl r)Ar 1 GA>01 A(Rev 11/89) Copy 1.. Client; Copy 2: IM Case file fastener #2 tap -AGREEMENT As a General Assistance applicant/recipient I understand and agree to the following requireMents: 1. 1 must provide all in formation.requested to determine eligibility to General Assistance. This includes completing forms, providing verifications, .and signing releases of information when requested. I must provide this information by the date required,and if I have not done so my aid may be denied or discon-c,inued. 2: 1 mdst-senti a rn6rithly tligilSiility Report(CA 7)by the fifth of the month following the report'morith. " 3. 1 must keep all appointments made by the Eligibility Worker, Vocational Counselor, or Social Worker. If I cannot keep an appointment, I must call Social Service before the appointment time to see whether the appointment can be rescheduled.. 4. If I am fired or quit a job without good cause, I will be ineligible for General Assistance for'60 days from the date I was last employed. 5. If my case is selected for review by the Quality Control unit 1 must cooperate with that.review. Failure to do so may result in discontinuance of aid,and ineligibility for one month. i i 6 I-must give-my.Social Security;Number (SSN):-The SSN-will be used in checking identity and preventing duplicate issuance`of'GA.' •The 5SN".and"any other information provided may also be used for computer matches, reviews, and audits, 7. 1 must CALL or WRITE my Eligibility Worker when there is ANY CHANGE in my address, income, property, or number of people living in my home,WITHIN 3 WORKING DAYS of the change. 8: A state law requires the county to give to law enforcement agencies certain information about GA recipients who have died or for whom a felony arrest warrant has been issued. This information is: name, address, birthdate, SSN,and physical description. 9. If 1 have no home address,and my mail is being delivered to the Social Service Office or other mailing address, it is my responsibility to pick it up. I agree to pick it up every week. 10. if I give information that is not true, or if I don't report changes to my Eligibility Worker which affect my case or the amount of GA I get,I may be criminally prosecuted and have to pay a fine or go to jail. TYPES OF CHANGES EVERYONE MUST REPORT 1. A change of residence (the place you'.are actual ly'liv.1.6d). You'Must report your new address and the namIrd address of your landlord. You must sign an approval.for your landlord to release information verifying your arrangements. Change in Housing costs='rent'or utility changes. 2. if you plan to leave this county., 3. A change of household composition- if anyone, including children, moves into or out of the house. A change of marital status 4. ' A change of employment status.-if anyone, including children, in the household starts working, stops working, or becomes unable to work,or goes to school/training. 5. A change in property holdings- if any member of the,household buys, sells, or receives as a gift or inheritance, a house,car insurance,stocks,bonds,etc.,or if a bank account is opened or closed. 6. A change in income-following is a list of types of income that must be reported. This list is not all-inclusive. a money borrowed(loans) a Alimony/Child support a money earned(wages) a income from, or acquisition of real or personal property f gate money from prison a checking/savings accounts a Income'Tax Refunds(State or Federal) a inheritances a State Disability payment a Unemployment Insurance Benefits a Union payments/Pensions a Grants],Schol arshi ps : Loans given to you to attend school a Social Security Payments a Gifts or money from relatives or friends a Federal Qisability Payments a Money received from giving blood or plasma _ a Workers Compensation payments • Department of Rehabilitation money given to you to attend classes,or for any other reason e Private Disability payments a Life insurance money a Welfare payment from any other state or county a Legal settlements and/or awards by the court a Income from self-employment,including street vending a Veterans Pensions/Awa;rds/Bonuses a Retirement pensions or funds a Other pensions a Gifts of food;clothing,or other contributions in-kind • Lottery%rvinnings a Money from any other source . a Pan Handling 7. ANY-LUMP SUM PAYMENT MUST BE REPORTED IMMEDIATELY. A LUMP SUM PAYMENT 15 EXPECTED TO SUPPORT _ YOU AT THE RATE OF $325 PER MONTH. YOU WILL BE INELIGIBLE TO RECEIVE GENERAL ASSISTANCE DURING THAT PERIOD. -ADDITIONAL RESPONS11310TIES OF ALL UNEMPLOYABLE APPLICANTS/RECIPIENTS 1. 1 understand that I have the responsibility to get proof that I am unemployable. 2. 1 understand that'l'.i:ri1ust1Wooly for SSI/SSP if the Social Service Department requests me to do so, and will then be considered an applicant for:Interim General Assistance. .3. 1 understand ilial I,must,active'ly, participate in a training, re-training, educational or rehabilitation program, if required by the Social Servlcel3epartment. dei 7- X993 ... ................... .._ COS. 779 --._..--------- - s' ` • •�! . . .. ... .... its' •� , . er�,Q : -._....-_..... -- ---- -- - - - -- i 1s�YvE---Ati D- _/ Ali Oro Glel ` .• ��.c1 '�otic �G '� ,� 1 1 64 i IyC 76k AJ ?ll o T .�(1 fl �i.h, 7 7jAIC /Zo A0p.1> 0.tr`tom 7*TVeyj �1 -a cam' _. j,v,�� .e�r� _ .- . is �fl - j�c�°✓-�%`C��7'a�CJ o � �./ r -1 ��Z/�i��'>'�/ P ! .---._._1 . . _..........._.._-- - . ---...._. . .._-.-_.._........... T1s--%7GZ��.�' _ .. &x) aoeotv am/ /J V��r.. Ufa . ....-�_. ... .._. .._.-_.._. .sem---7/VA- ......... ,z Tom-- . r'Q-4 AlbkW C -�k AJ7 Dor', ._..__RGkJT- i� /_So, oo . __ 2 -7A yY*?tir7A ----a . - /9v-COZT-.-/-95,3 ........_......_ 70 Doof ,on 77��--,5- -- - a- r >� l 70 ss u(s-' 71, nl i� /1 -u'�c �7� S�`��- �J`�'��'3 fix.►b ok) RC f7�o r1 /f lS �j;`/z7e '5 7 7,XJ6 �� m o,5'-7-- uuv�pl Co 9 7ZRJ co Da1 . ROPQcZl/ZCi�_.142%�l/G2,� CA �3 y 31 AAA-A-1 r4o 19-02�7- CEO `' 2-51 i 1 ti/bO,i?,cA:7�-� 00() IX i�-may`;77}-k_ 0,4J OC-7-6 - /��'v�� A'Q e)6u,'�c;�SIS/I ol-7ke C, /nc7 ;5 l_J '771e- c7z�p 4,16 -<�. ✓i�- v� l'Cv?7�;.c� �' v c1��%�j s=�ti y��R j— y i / `4.� �T�,C1 �i '•.�i7�;.r1,�.'j ) �`l � C.. C7;_kaSJ,// - � .�,��1 /��=>/Qc_�S.�./�/�� —t c'✓�. j,G/��l'(.� :��1t}��.5 �c C(.�� tll�)�-RL: i nl:i r72��e;;� P LtiD:J�f� //y /I Y.•/�'r-; %1-�?"��ii,��1.J_ /� �_ / I-/•1 jl �. L�if-f�f:i V' �� !�/(:/��i.� iC� j \_/ )L�-j!iC.'i.: ��i.��^'//C/j;"�./,�/�If��J/,��'Tr:J �� .. .'.�•1�.7(; . ,t:.,_ --+ r �� - , a 6o lip �i ,> rf C-3 t ifs✓b `�v%lZ�-:�>rfC' 13 %zr!i' :�'!'. mu 1 /`J% P74 / _- I- , �-��i�_x� C!J�� /'/TZ�i VSE• /3-/v 17 Ci4 IJ in E?�'%.;;2X:L 70 . ( 1 Ccs" >.F SCJ li�i,�rJ ��Rc-7'�-;,,i,.c:E� ?U l ��, 1,v7-icu �l,�c;'� ice' :•(�C�;,.i� G!;;?`{y<Ll �h'!-�;_s cI-� r�t-1„�;L'/�tir,�� C'IAv 7 c,.tJ;7;-:tom•;_G i 1 j) - C) -� - r 03 r— 1 Qcr I 03 oti uj gas cr • `QD . U(V i (-7 C LTJ J 3 f;a�'D• mi C`�L�'xfl7 'C Contra Costa County Socia(Service Departn. GENERAL ASSISTANCE ALTERNATE MAILING ADDRESS REQUEST CASE NAME (/J CAS NUMBER/ /EW P�N! I request that my General Assistance checks and all other mail from the Social Service Department be sent to: ❑ My home address is: 1 I have no home address. REASON FOR REQUEST: """ lS's i Z2 1 � I understand that it is my responsibility to pick up my mail regularly, and that failure to do will not be considered good cause for failure to keep appointments with Social Service. I I understand that if I do not have a current home address, I must contact my Eligibility Worker monthly. When I obtain a home address,I understand that I must report it to my Eligibility Worker right away. i understand that if I do have a home address other than my mailing address, I must include my home address on my monthly income report,and that I must report any change in my home address to my Eligibility Worker right away. I understand that I.must provide verification of my home address (such as rent receipts, utility bills,etc.)to my Eligibility Worker every six months. 1 UNDERSTAND MY RESPONSIBILITIES AND DECLARE THE ABOVE TO BE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. i � f, �J�l 6' n—8— 9-Z L f z I SIGN-TURE DATE COUNTY U.SF:ONI.Y METHOD OF VERIFICATION ❑ APPROVED TICKLER SET FOR ❑ DISAPPROVED Reawn. TO REVIEW ELIGIBILITY WORKER SIGNATURE DATE SUPERVISOR'S SIGNATURE DATE GA 8(New 9/87) Ref: DM 49501 Copy 1: IM Case file fastener 11; Copy 1 Applltant/Rei,ore.' �U + ( cl t z iJ C) �`, • , �cf l/�z ��E t ( Don rvz-Q mo--�_ _ t Lk v s- Social Service Department Contra Please reply to: Perfecto Villarreal 40 Douglas Drive Director Costa Martinez.California 94553-406-:: County N.. r't C(ll`tom ` GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION IN THE MATTER OF: Wesley Cantrell , Claimant County #:515455-W4JA P.O. Box 5541 Date of County Notice:NA Hercules, Ca 94547 Effective Date of Action: 10-1-93 Filing Date:10-8-93 Hearing Date:10-26-93 Aid Paid Pending: no Hearing Officer: Ruby Molinari . - Income Maintenance Representative:Lee Weikert, IM Supervisor Place of Hearing: Richmond, Ca ISSUE I. Whether 10-1-93 is the correct beginning date of aid. II. Whether the claimant is living in a shared living arrangement. COUNTY ACTION AND POSITION Issue I . The claimant applied for General Assistance on 8-31-93 . He attended a gfoup meeting on 9-16-93 . At that time he submitted all verifications which had been identified as necessary to complete his application. He submitted a copy of his vehicle registration and also submitted an estimate of value of the vehicle from Hilltop Ford. Hilltop Ford estimated the value of the claimant's vehicle as $500. 00 . The worker used the registration fee schedule from Department of Motor Vehicles rather than the estimate and determined the claimant's automobile had a value in excess of the maximum. Late in 9-93 she sent the clainant a notice advising him he could submit two more estimates of the value of the automobile if he did not agree with the DMV evaluation. The claimant submitted two more estimates which were under the property limit. The claimant did not submit the second two estimates until after the first day of October so aid was granted effective 10-1-93. Issue II . The claimant completed a General Assistance Statement of Facts and stated that there were three other people living with him. Those people were Mark Cantrell , son; Debbie Cantrell , daughter-in-law; and, Travis Cantrell , grandson. The claimant stated he was renting a room from them and paying $150.00 per month rent. Since the claimant was living in a home with three other people he must be considered living in a shared living arrangement. The county contends the claimant was eligible to a grant of $168.00 which is the allowance for a shared living situation. CLAIMANT'S POSITION Issue I The claimant stated he would have submitted the estimates earlier if he had been notified the worker needed them. He did not get the notice from the worker until 10-1-93. He does not believe he should be penalized for not submitting the estimates earlier. Issue II The claimant moved into his son's three bedroom, one bath house with the agreement he would have one room with kitchen and bath privileges. He agreed to pay rent of $150.00 per month. After he moved in his son and daughter-in-law began having marital problems as his daughter-in-law did not want him there. On 10-6-93 his daughter-in-law told him to get out so he left the house. He has been staying with friends or sleeping in his car since that date. REASON FOR DECISION Department Manual Section 420820, II ,A, provides that ownership is defined as having the right to,.-use, receive proceeds from, and dispose of property; usually the person who holds legal title, or in whose name it stands, owns the property. Department Manual Section 49-208 , IV, 1 , provides that cash, checking or savings accounts , credit union shares , motor vehicles , . . . .with a value in excess of $500 which are owned by the applicant/recipient. Departmental Manual -Section 49-501 , I11 . A. provides the beginning date of aid is the date of application or the first of the month in which aid is authorized, whichever is later. Departmental Manual Section 49-2.07 . III , B. 1 defines shared housing as an individual shares a dwelling with other, whether related or not. Departmental Manual Section 49-501 , VI , D.1. When a recipient's housing situation , changes during the month, and the . housing allowance is increased, the difference shall be supplemented. CONCLUSION Issue I The claimant timely provided all the information he was aware was required 'of him. Since he did not receive the request for the additional estimates on his car until 10-1-93 he cannot be held responsible for the delay in obtaining them. Issue II The claimant was living in a shared living arrangement until 10-6- 93 so the county correctly computed the grant from 10-1-93 through 10-6-93 as a shared living arrangement. Since the claimant's housing changed on , 10-6-93 the county must issue a suppliment for a single housing allowance from 10-7-93 through 10-31-93 . ORDER Issue I The claim is granted. The County shall change the beginning date of aid to 9-1-93 and issue a supplement as appropriate. Issue II The claim is granted in part and denied in part. The county properly determined the claimant was living in a shared living arrangement, however, that changed on 10-6-93. The county shall issue a supplement for the changed housing in 10-93 . Social ervice Appeals Officer Date C. Program Manage , Appeals Date If you are dissatisfied with this decision you may appeal the matter directly tot'the Contra Costa County Board of Supervisors. r i Appeals must be filed in writing with the Clerk of the Board, 651 Pine Street, Martinez , CA, 94553. Appeals must be filed within fourteen (14) days of the date of this Evidentiary Hearing Decision. No further aid paid pending a Board of Supervisors appeal. TO: Board of Supervisors FROM: Perfecto Villarreal, Director Social Service Department DATE: January 18, 1994 SUBJECT: APPEAL OF GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION BY STAN KIELAK SPECIFIC REQUEST(S) OR RECOMMENDATIONS AND BACKGROUND AND JUSTIFICATION RECOMMENDATION: That the Board deny Stan Kielak's appeal of the General Assistance Hearing decision. BACKGROUND: Claimant filed request for Hearing on October 20, 1993 and October 26, 1993. The Hearing was scheduled for November 23, 1993. The claim was granted. There is no issue to appeal. Signature: c _ ACTION OF BOARD ON January 18 , 1994 APPROVED AS RECOMMENDED x OTHER This is the time heretofore noticed by the Clerk of the Board of Supervisors for hearing on the appeal by Stan Kielak from the General Assistance Evidentiary Hearing decision. Jewel Mansapit, GA Program Analyst, Social Service Department, appeared . and advised the Board that the appeal had been resolved in favor of the appellant and requested that the Board dismiss the appeal . IT IS BY THE BOARD ORDERED that the appeal by Stan Kielak from the General Assistance Evidentiary Hearing decision is DISMISSED. VOTE OF SUPERVISORS UNANIMOUS (ABSENTy ) AYES: NOES ABSENT ABSTAIN Contact: Jewel Mansapit, 313-1601 Original: I HEREBY CERTIFY THAT THIS IS A cc: Social Service Dept. TRUE AND CORRECT COPY OF AN ACTION Program Analyst TAKEN AND ENTERED ON THE MINUTES Appeals Unit OF THE BOARD OF SUPERVISORS County Counsel ON THE DATE SHOWN. County- Administrator Stan Kielak ATTESTED January 18 , 1994 PHIL BATCHELOR, CLERK OF THE BOARD OF SUPERVISORS AND CONTY ADMINISTRATOR BY ° , DEPUTY ' Social Service. Department Contra Please reply to: 40 Douglas Drive Perfecto VillarrealCo Costa Martinez,California 94553-4068 Director J County .. ....a January 13, 1994 f _ b� Stan Kielak s� er-�'c'oon's 247 Bailey Road, #31 Pittsburg, CA 93465 Dear Mr. Kielak, I am writing to you about your appeal of your General Assistance hearing decision, which is scheduled to be heard by the Contra Costa County Board of Supervisors on January 18, 1994. It is not necessary for you to appear in Martinez on that date. The hearing decision that was written on November 30, 1993 granted your appeal. Due to a misunderstanding, you did not receive your December, 1993 and January, 1994 General Assistance checks. These will be sent to you next week. I understand that the reason you could not perform your workfare assignments was because you needed glasses. A special need allowance was approved in November so you could buy glasses. Please remember that you will be expected to keep all of your workfare and other appointments in the future. If you have any questions about this letter, please call me at 313-1601. 1 apologize for the delay in getting your General Assistance to you. Sincerely, ewel Mansapit General Assistance Program Analyst cc: GA file Work Programs file Board of Supervisors )!50 PIM CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 15, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT: Hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By Stanislaw Kielak ---------------------------------------------------------- ---------------------------------------------------------- Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by January 11, 1994 plus any information which your department may wish to file for the Board appeal which is set for 2 : 30 p.m. on Tuesday, January 18 , 1994 . Attachment cc : Board members County Administrator County Counsel The Board of SupervisorsContra Phil Batchelor Clerk of the Board } and County Administration Building Costa County Administrator 651 Pine St, Room 106 (510)646-2371 -.' Martinez, California 94553 County Tom Powers,1st District Jeff Smith.2nd District Gayle Bishop,3rd District /� • Sunne Wright McPeak 4th District ;f �.• Tom Tortakson,5th District _ December 14, 1993 V'`*y\ Mr. Sanislaw Kielak 247 Bailey Road #31 Pittsburg, CA 94565 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 18, 1994 . In accordance with Board of Supervisor Resolution No. 92/554, your written presentation and all relevant material pertaining to theappeal must be filed with the Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also isodirected to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure. Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Admin' stra r By me n •Cervelli, Deputy Clerk Enclosure cc: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,CALIFORNIA ' Adopted this Order on August 4, 1992 by the following rote: • AYES: Supervisors Fanden. Schroder, Torlakson, McPeak NOES: None ABSENT: Supervisor Powers ABSTAIN: None sss=ssssssssssss:ss:ss:ss:ss=====:assess=====s=a===_= SUBJECT: General Assistance Hearing } Resolution Number 92/554 and Appeal Procedures } The Contra Costa County Board of Supervisors RESOLVES that the provisions of Resolutions No. 74/365,75/28, 87/4680 and 88/576 which established standards for General Assistance Hearings and Appeals are bereby superseded effective September 1, 1992: Part 1 Hearings 101. General Assistance applicants shall be given written notice of action to deny an application. 102. General Assistance recipients shall be given written notice,mailed at least 10 days prior to the effective date, of proposed action which will reduce, suspend or terminate his or ber General Assistance grant for cause. Prior notice is not required for action resulting from Board of Supervisors' changes in grant levels. 103. A General Assistance applicant or recipient shall receive a Social Service Department bearing upon their timely written request. (a) The applicant or recipient must deliver or mail a written request for a bearing within fourteen days of the date the Notice of Action was mailed.Absent evidence to the contrary,the notice is presumed to have been mailed on the date it bears, and a request for a bearing is presumed to have been delivered on the date it is received and mailed on the date it is postmarked. 104. Where a GA recipient timely requests a bearing challenging a proposed action which will reduce, suspend or terminate his or her General Assistance grant,the proposed action will be stayed until a decision is rendered. (a) Actions implementing Board of Supervisor changes in grant levels are not appealable,and bearing requests based thereon may be summarily denied. 105. Hearings will be scbeduled within thirty days of the date of receipt of a request for a bearing. The Appeals Unit will mail a written notice of the bearing to the claimant at least ten days in advance of the Hearing date. 106. When a request for a bearing has been received,the claim may be reviewed and resolved in the daimanfs favor by a pre-bearing review. (a) Proposed prebearing resolutions shaD be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager. 207. If the claimant is unable to attend the bearing at the originally scheduled date and time, and a timely request for postponement is made,the Hearing Officer will make an evaluation of the request. The bearing will not be continued beyond the bearing date unless authorized by a Hearing Officer on one of the following grounds,which require verification: (a) bearing is continued at request of the Social Service Department, RESOLUTION NUMBER 92/554 (b) mandatory court appearance which cannot be accommodated by adjusting the bearing time, (t) mess which prevents travel, (d) death in the immediate family, (e) other substantial and compelling reason. (as approved by the Appeals Manager) 108. Decision (a) A written decision shall be mailed to the claimant within thirty days after the bearing record is dosed,unless the Department eatunds the time in writing, for cause. (b) Proposed decisions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager prior to notification of the claimant.The Hearing Officer's findings of fact are not subject to change,but the General Assistance Policy Manager may order re- hearing for cause. Part 2 Appeals to the Board 201. The applicant or recipient may appeal an adverse bearing decision to the Board of Supervisors. 202. A written appeal must be received by the Cierk of the Board of Supervisors within fourteen days after the decision bas been mailed to the claimant.Absent evidence showing the contrary, a bearing derision is presumed to have been mailed on the date it bears. (a) An appeal to the Board will not stay the implementation of the Hearing decision, and the recipient shall not be entitled to continue to receive assistance pending further bearing. (b) The appeal will be scheduled for the first available Board meeting,but no earlier than the third meeting following receipt of the appeal. 203. The Administrative Review Panel may review appeals of Hearing decisions and recommend proposed action to the Director. (a) If the Director supports the bearing decision,the Appeals unit will be notified to proceed with the presentation to the Board. (b) If the Director finds in favor of the claimant,the Clerk of the Board will be notified to withdraw the item from the Board agenda The appropriate Social Service District office will be advised to take corrective action. 204. Both the appellant and the Department must file all written materials at least one week before the date set for the Board bearing.New material must be served by ma0 on the opposing party. 205. (a) Upon bearing the appeal, the Board shall make any required fact determinations based on the record on appeal and testimony received by the Board.Ibis record shall include the Department's Hearing Officer's fact findings,plus any papers filed with that Officer. (b) If the facts upon which the appeal is based are not in dispute or U any disputed facts are not relevant to the issue ultimately to be decided by the Board,the Board will proceed immediately to the next step without considering fact questions.The parties may stipulate to an agreed set of facts. RESOUTIO\NU11,MER 42/55 206. (a) Ona the facts are determined, or if there are no fact determinations required by the appeal, the Board will consider legal issues presented by the appeal.Legal issues are to be framed, insofar as possible,before the Hearing and shall be based on the Department's Hearing Officer's decision and such other papers as may be filed. (b) Appealing parties may make legal arguments both by written brief and orally before the Board. If the issues are susceptible of immediate resolution,the board may immediately decide them at the appeal bearing. If the County Counsel's advice is needed on legal questions, the Board may take the matter under submission,reserving its final judgment until it receives such advice. 207. 7be Board may decide an appeal immediately after bearing or tate the appeal under .avbmission. I wow W"vw Y�to and 10,90 00"d Skin old 0 4"" mt�dp" dft Dom of an vv* —M70V( ATi#i Mitea�+e Laos�Adaf� • � � rfGl'll�.O�r RESOLUTION NUMBER 92/ e4 5 <��SICiw / Flab RECEIVED 9 L/5-& s 14X93 1. j'hcrrt G�'G✓G�r F..ic,,,� C'� �y M�BiX B0�1Rp �, �c ,. ! ,.. f — fD r C�-�'.w v'i .r yrs. , f J�-ro1-�'h c-z., 9`�.�'`"�, �.�r�f,�,•, ��/ r •,� /� e� � �i e car of>�� ...�'` e��e �� e ��'1 lyrc.�s� �'j/ ✓f,� ia� �'rt?. l%'f�Ci r . —, n PC 0.6 6174"" r�»u rr Social Service Department Contra Please reply to: Perfecto Villarreal Costa 40 Douglas Drive Director 945 Martinez,California 53-4068 County F. STA coi:tit' GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION IN THE MATTER OF: Stan Kielak 247 Bailey Rd. # 31 Pittsburg, CA 94565 County No. : 07 92-478669-C4FD Notice of Action: 10/04/93; 10/13/93 Effective Date: 10/31/93 Appeal Filing Date: 10/20/93; 10/26/96 Aid Paid Pending: Yes Date of Hearing: 11/23/93 Place of Hearing: Antioch, California Appeals Officer: Kate Quisenberry County Representative: C. Dudley Authorized Representative: None ISSUE: Whether the proposed discontinuance of General Assistance for three months due to Workfare failures on 10/4/93 and 10/11/93 is correct. COUNTY POSITION: Claimant appeared for workfare assignments on both days, but after responding to roll call refused to participate in the assignments, asking to speak with the worker or supervisor. Although he claimed that he could not work at the assignments due to poor eye sight, he provided no medical verification and the failures were not excused. On 10/4 he did go to Merrithew Memorial Clinic in an attempt to obtain verification of his complaint. His visit there was verified by the Nurse who .telephoned the worker to explain that until he was examined by -the doctor on 11/4 he could not be provided with an excuse from workfare. The Merrithew Memorial document was presented in hearing by Claimant and was dated 10/4. i Kielak Page 2 CLAIMANT POSITION• Claimant testified that he cannot see well enough to perform his workfare assignment safely. He testified that he has been assigned outdoor maintenance which involves street-cleaning. He is afraid of being struck by a car. He cannot see well enough to see what to pick up off the ground unless he has glasses. He testified that he cannot see his feet without glasses. Although the County approved $100.00 for eye glasses he testified that the glasses cost $200. and he cannot afford them. The medical forms which Claimant presented in hearing indicated the following: 1) . 10/4/93 from. Nurse showing telephone call to Social Services explaining why no medical excuse can be provided to Claimant who appeared at the Clinic on 10/4 2) . 11/4/93 completed by Dr. Hansen, O.D. , Claimant's doctor, stating that Claimant has a high decree of myopia and that prognosis is good with glasses. The Nurse added the following statement: 11/9/93: Spoke with Dr. Hardy (O.D. ) . States pt. can do work as stated in #1 with or without glasses. 3) . 11/18/93 completed by Dr. Hansen stating that Claimant is employable but has to wear glasses REGULATORY AUTHORITY: Department Manual Section 49-210,II,B,1, provides that an individual who does not have a medically verified physical or mental disability, or who has not been determined to be unemployable by the Vocational Counselor, is considered employable. Board of Supervisors Resolution #92/857 adopted December 15, 1992, provides: Part 7, Section 703: A recipient who fails or refuses to comply with General Assistance Program requirements as expressed in this resolution or in the Social Service Department Manual of Policies and Procedures shall be discontinued aid and sanctions will be imposed as follows unless the recipient shows that the failure or refusal to comply was for good cause. Department Manual Section 49-111,II,F,2, provides that a recipient who fails to cooperate with the Social Service Department by failing to meet any one of his or her enumerated responsibilities without good cause, shall be discontinued aid, and sanctions will be imposed as follows: a. first failure: one month. Kielak ' Page 3 b. second failure: three months. c. third failure: six months. Department Manual Section 49-111,II,G,2, provides that the reasons which establish good cause for a failure to cooperate or comply are subject to verification and include, but are not limited to, the following: a. the failure has occurred by reason of a disability under the Americans with Disabilities Act 1) The burden of proof to establish that the failure occurred because of a disability is on the applicant or recipient 2) The applicant/recipient's showing may be rebutted by the Department b. employment has been obtained, c. scheduled job interview or testing, d. mandatory court appearance, e. incarceration, f. illness, g. death in the family, h. other substantial and compelling reason. These must be reviewed and approved by the Division Manager. Department Manual Section 49-111,II,H,1 provides that a willful act is one that is intentional or without reasonable excuse or cause. It need not be done with a specific purpose to violate program requirements. a. The burden of proof to establish good cause, which may include proof that the failure was not willful is on the applicant/recipient. b. The Department may rebut a showing of good cause by proving that the failure to comply was willful, in which case the Department has the burden of proof. c. In all cases it is presumed, subject to rebuttal, that the ordinary consequences of the applicant/recipient's voluntary acts are intentional, and thus willful. 2. Willfulness cannot be found where the person is mentally disabled to the extent that s/he does not understand his/her responsibilities or is incapable of fulfilling them. 3. Conduct which involves negligence, inadvertence, or disability may or may not be willful. a. Three or more acts of negligent failure of the recipient to follow program requirements, which may include acts for which the recipient previously has been discontinued from aid or sanctioned, evidence willfulness. Kielak Page 4 _ �:.�........a CONCLUSION AND FINDING OF FACT: Although the Nurse, in consultation with a Dr. Hardy, indicated that Claimant can work with our without glasses, Claimant's own physician completed a subsequent report stating that he must wear glasses. Since this is the second report in November which Claimant's doctor, Dr. Hansen completed, it is concluded that the 11/18 statement was to correct misinformation provided by a Nurse on the 11/4 statement. Dr. Hansen modified the Nurse's statement to make it clear that Claimant "has to wear Glasses". Based on this evidence it is determined that Claimant had good cause for failure to perform his Workfare assignment 10/4 and 10/11. Thus, the proposed discontinuance of General Assistance is not sustained. ORDER: Claim Granted. Aid shall be reinstated and the period of ineligibility shall be expunged from the record. Kate Ouisenberry 11/30/93 Social Services Appeals Officer Date A16peals Program Manager Date If you are dissatisfied with this decision you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be filed in writing with the Clerk of the Board, 651 Pine St. , Martinez, CA 94553. Appeals must be filed within fourteen (14) days of the date of this Evidentiary Hearing Decision. No further aid is paid pending a Board of Supervisors appeal. '.. .;. - Contra Costa County ci erv�ce e�pi�rt �. So al S men MEDICAL ASSESSMENT OF .DATEQF'REFERRAL l o ( 9 EMPLOYABILITY STATUS. PATIENT'S NAME EONLY TM -' r SOCIAL SECURITY Il. BIRTH ATE' ❑ NEW APPLTIO N. REf�ALUATION JAN CASE NAME �. $1 PENDING .:: •. ' CLJERKBOARD OF SUPERVISORS - ELIGIBILITY WORKER ITELEPHONE NO.: �;.. CONTRA COSTA.CO. PATIENT'S AUTHORIZATION, x I authorize the release of all information for the purpose continuity of patient care and verification of disability for. .: Public Assistance to Contra Costa County Social Service Department, including information which maybe related to drug, alcohol or psychiatric conditions. This authorization is valid.uhtil- or one ye.r from signing- PATIENT'S. i ning.PATIENT'S.SIGNATURE DATE ..:.:.. ... .. ...ter.. PATIENT'S STATED COMPLAINT/REASON FOR REFERRAL ' DATE LAST WORKED: UU UAL�OCCU ATION: `� 1_7 : TO BE COMPLETED BY PHYSICIAN61 , r' 1. DEGREE OF EMPLOYABILITY EMPLOYABLE WITH WITH NO LIMITATIONS' . .�. . ❑ UNABLE TO.WORK UNTIL ;Y -: . ate .' ❑ EMPLOYABLE WITH THE FOLLOWING LIMITATIONS' ': :�4�{w ❑ .-ERMANENTLY D D f ., LU�(ease eufy)...-' _.: -.`kms.:• � ,x r A , r .2. DIAGNOSIS I .3. PROGNOSIS �. f'/ 4 . 4. . Does hiispatient.have.alcohol/other.substpgceabu�epr..obleg _s?y.j0 OWN'. j If'YES';is patient receiving treatment? .❑ YES .No' F NO j 5.. Does this patient.require a.special dieti*❑ YES ] If'YES�',. Type,of diet Duration t This is to certify that ihi patient was last seen on . Next scheduled appointment is: •l. ... .. to da a. Dogtor's Name/Trtle Hospital/Clinic Location date :. Form Completed a 'date) �:'• Copy 1: ..IM Case N 2 Copy 2: Physician GA 341 (Rev.9/86) Copy 3: Control Ref: DM 49-220 _...... ------------ Contra -----......Contra Costa County Social Service Department MEDICAL ASSESSMENT DATE OfiREFERRAL jp OF EMPLOYABILITY STATUS PATIE T'S NAME COUNTY MEDICAL SERVICES USE ONLY SOCIAL SECURITY# BIRTHDATE NEW APPLICATION CASE NAME ❑ REEVALUATION Q''�`'� ❑ SStPENDING ELIGIBILITY WORKER TELEPHONE NQ. PATIENT'S AUTHORIZATION I authorize the release of all information for the purpose of continuity of patient care and verification of disability for Public Assistance to Contra Costa County Social Service Department, including information which may be related to drug, alcohol or ps chiatric conditions. This authorization is valid until: or ane year from signing. PATIENT'S SIGNATURE DATE PATIENT'S STATED COMPLAINT/REASON FOR REFERRAL DATE LAST WORKED: USUAL OCCUPATION: TO BE COMPLETED BY PHYSICIAN 01. DEGREE OF EMPLOYABILITY ❑ EMPLOYABLE WITH NO LIMITATIONS. ❑ UNABLE TO WORK UNTIL date ❑ EMPLOYABLE WITH THE FOLLOWING LIMITATIONS: PER ANENTLY D��IS/n1A��$L D (Please specify) GIG r/ G�Ci G�tt //19�� • N+�l. 1 N �� W.cc C It Ci'c«�c �avlllam, wv -b-7 •; W 444- At L.Je4-1� DIAGNOSIS I CrL a i l% r ,0°t&11' &44b /h n��r i7 1�Or7/1}�- 3 PROGNOSIS Coo S) use '�' GGA 7vLa 4. Does this patient have akohal/o er substance abuse problems? ❑ YES ❑ NO ( UNKNOWN if'YES', is patient receiving treatment? ❑ YES ❑ NO S. Does this patient require a special diet? ❑ YES NO If'YES', Type of diet Duration This is to certify that this patient was last seen on V /lav S3 Next scheduled appointment is date date �Doctor's Name title Hospital/Clinic Location date Form Completea By date Copy i: IM Case#2 r:n ln i ro,;,, oraGl Copy 2: Physician CODv 3 Control No NIXP ' Contra Costa County Social Service Department `NIEDICALASSESSMENT .j 40F . DATE OF REFERRAL :fQ $'� EMPLQYABlLIT7Y.STATUS PATIE T'S NAME °' COUNTY MEDICAL SERVICES USE ONLY SOCIAL SECURITY# BIRTHDATE NEW APPLICATION . CASE NAME ❑ REEVALUATION ❑.SSI PENDING ELIGIB WORKER TELEPHONE NQ. 70 4/71d :P'ATIENT'S AUTHORIZATION 1 authorize the release of all information for,the purpose of contiquir ofpatiint care.and erif+ tion of.dis4b'li -for.. .. ;Public Assistance to C6htra Costa Cou»ty Sar"iai Service Departure tt,includ`tn informatio which maybe related to drug, alcohol or s chiatric conditions. This authorization is valid until: or one year from signing. PATIENT'S SIGNATURE DATE ---r . r ..:PATIENT'S STATED COMPLAINT/REASON FOR REFERRAL a DATE LAST WORKED: USUAL OCCUPATION: TO BE COMPLETED BY PHYSICIAN = 1 DEGREE OF EMPLOYABILITY EMPLOYABLE WITH NO LIMITATIONS ❑ UNABLE TO WORK UNTIL . date ❑ EMPLOYABLE WITH THE FOLLOWING LIMITATIONS: ❑ PERMANENTLY DISABLED ..:.___.._ (Please specify) '. C L 4, ,C.: a.C� `>�► � ��-ter� . i DIAGNOSIS I G L Z1 !+' Crt rt►�_ rd 1' jet n n i ✓3 l 3� ROGNOSiS G v I ct�... Concord, ��. CA 94521 �4. .<Does this patient have alcohollo er substance abuse problems? YES NO UNKNOW. .... 510)825.3900 -if'YES',is patient receiving treatment? ❑ YES ❑ No � � �p � V (flS�a,� IS . S. Does this patient require a special diet'?" ❑ YES NO .1 If`Y S'; Type of diet Duration .. This is to certify that this patient was last seen on f�/ou Ica Next scheduled appointment is date jPhy Ae�^rH � f-}— row �.� , 5 s"v sc)vm �,Doctor's NamelTrtle Hospital/Clinic Location '.d"m Comp d..fnr tete ....¢.. ;��.._.... _•,.._ te. _ ti,;�,r _. Copy GA34i %Rev.9!$61 Copy,-. Ccpy I:UNIHAC:USIAI:UUNIY HEALTH SERVICES ❑ HOSPITAL ❑ RICHMOND CLINIC �� r• Q I /rpmSBURG CLINIC J REMARKS: 110483 PHC t368 Nu 19 I �� 4 PATIENT I.D.MUST BE READABLE ON ALL COPIES I Y. I E L A KS r,.N I,rj( SPHERE CYLINDER AXIS PRISM BASE 1t 4 / 13/1942 510 459-90 g o.D. , jr —I-AID _ lad /fe 0 0 3 9 619 4 a O.S. 3 A 0 o. D. PIT'S � d .) -- O.S. CLUN16-6 (9/90) OPHTHALMIC PRESCRIPTION SIGNATURE Lt 3 S-3 OPTICIAN CONTRA COSTA COUNTY aPa HEALTH SERVICES J"jI`en'Z ❑ HOSPITAL Cl RICHMOND CLINIC _ �)Z G/►- �L ITTSBURG CLINIC REMARKS: 111893 PATIENT I.D.MUST BE READABLE ON ALL COPIES SPHERE CYLINDER AXIS PRISM BASE KIELAY. STAN 15 zA D �S o.;, �-- t1 4/13/1942 570 450-9 .5 ^7P 1 jd 0 O.S. S��f 0039bl94-3 ' AO = O.D. P rT o.s. c SIGNATJ RE CLUN16-6 (9/90) OPHTHALMIC PRES� OPTICIANRLPTION ll1 3 MATTHEW K. CHAN.O.D. 4669-C CLAYTON ROAD CONCORD,CALIFORNIA 94521 TELEPHONE 45 10)825-3900 PIN#SO 0061800 FOR ,5'��✓�$/ DATE /13 /// EXPIRES ONE YEAR FROM ABOVE DATE ADDRESS SPHERICAL CYLINDRICAL AXIS PRISM BASE FOosD N.V. O.D. O.S. FILLING THIS PRESCRIPTION IN OUR OFFICE OR ELSEWHERE CONSTITUTES AN AGREEMENT TO MODIFY THIS PRESCRIPTION WITHIN 90 DAYS,IF NECESSARY,AT NO ADDITIONAL CHARGE. REMARKS DR. CLERK OF THE BOARD Inter-Office Memo TO: Social Services Department DATE: December 15, 1993 Appeals and Complaints Division and Program Analyst FROM: Jeanne Maglio, Chief Clerk Ann Cervelli, Deputy Clerk SUBJECT: Hearing on Appeal from Administrative Decision Rendered on General Assistance Benefits Filed By Stanislaw Kielak Please furnish us with a board order with your recommendations and a copy of all material filed by both the appellant and the Social Service Department at the time of the Appeals and Complaints Division evidentiary hearing by January 11, 1994 plus any information which your department may wish to file for the Board appeal which is set for 2 :30 p.m. on Tuesday, January 18, 1994 . Attachment cc : Board members County Administrator County Counsel ti Thi Board of Superviers Contra 0 Batchelor Clerk of the Board and County Administration BuildingCOSta County Administrator 651 Pine St, Room 106 (510)646-2371 i.i Martinez, California 94553 County Tom Powers,1st District Jeff SmNh,2nd District Gayle Bishop,3rd District Sunne Wright McPeak 4th District r `; Tom Tortakson,5th District December 14, 1993 roux Mr. Sanislaw Kielak 247 Bailey Road #31 Pittsburg, CA 94565 Appeal to Board of Supervisors General Assistance Benefits In response to your request and pursuant to Section 14-4 . 006 of the County Ordinance Code, this is to advise that a hearing on your appeal from the administrative decision rendered in your case on General Assistance benefits will be held before the Board of Supervisors in the Board Chambers, Room 107, County Administration Building, 651 Pine Street, Martinez, California at 2 :30 p.m. on Tuesday, January 18, 1994 . In accordance with Board of Supervisor Resolution No. 92/554, your written presentation and all relevant material pertaining to the appeal must be filed with the Clerk of the Board (Room 106, County Administration Building, 651 Pine Street, Martinez) at least one week before the date of the hearing. Your attention also is directed to the other provisions of said Resolution (copy enclosed) which set forth the General Assistance Appeal procedure. Very truly yours, PHIL BATCHELOR, Clerk of the Board of Supervisors and County Admin' strar U-t By _ ,'.I Ann Cervelli, Deputy Clerk Enclosure CC: Board Members Social Service Department Attn: Appeals and Complaints Program Analyst County Counsel County Administrator .. ........ .. ... THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,CALIFORNIA �J Adopted this Order on August 4, 1992 by the following vote: . AYES: Supervisors Fanden, Schroder, Torlakson, Weak NOES: None ABSENT: Supervisor Powers ABSTAIN: None ssssssssssssssssssssss:sasssssss====sass:==ss==oss=== SUBJECT: General Assistance Hearing } Resolution Number 92/554 and Appeal Procedures j The Contra Costa County Board of Supervisors RESOLVES that the provisions of Resolutions No. 74/365,75/28, 87/468, and 88/576 which established standards for General Assistance Hearings and Appeals are hereby superseded effective September 1, 1992: Part 1 Hearings 101. General Assistance applicants shall be given written notice of action to deny an application. 102. General Assistance recipients shall be given written notice, mailed at least 10 days prior to the effective date, of proposed action which will reduce, suspend or terminate his or her General Assistance grant for cause. Prior notice is not required for action resulting from Board of Supervisors' changes in grant levels. 103. A General Assistance applicant or recipient shall receive a Social Service Department bearing upon their timely written request. (a) Tae applicant or recipient must deliver or mail a written request for a hearing within fourteen days of the date the Notice of Action was mailed. Absent evidence to the contrary, the notice is presumed to have been mailed on the date it bears, and a request for a hearing is presumed to have been delivered on the date it is received and mailed on the date it is postmarked. 104. Where a GA recipient timely requests a hearing challenging a proposed action which will reduce, suspend or terminate his or her General Assistance grant, the proposed action will be stayed until a decision is rendered. (a) Actions implementing Board of Supervisor changes in grant levels are not appealable, and bearing requests baud thereon may be summarily denied. 105. Hearings will be scheduled within thirty days of the date of receipt of a request for a hearing. The Appeals Unit will mail a written notice of the hearing to the claimant at least ten days in advance of the Hearing date. 106. When a request for a bearing has been received,the claim may be reviewed and resolved in the claimant's favor by a pre-bearing review. (a) Proposed pre-bearing resolutions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager. 107. If the claimant is unable to attend the bearing at the originally scheduled date and time, and a timely request for postponement is made,the Hearing Officer will make an evaluation of the request. The bearing will not be continued beyond the hearing date unless authorized by a Hearing Officer on one of the following grounds,which require verification: (a) bearing is continued at request of the Social Service Department, RESOLUTION NUMBER 92/554 , 1 (b) mandatory court appearance which cannot be accommodated by adjusting the bearing time, (c) illness which prevents travel, (d) death in the immediate family, (e) other substantial and compelling reason. (as approved by the Appeals Manager) 108. Decision (a) A written decision shall be mailed to the claimant within thirty days after the bearing record is closed,unless the Department=ends the time in writing,for cause. (b) Proposed decisions shall be reviewed and approved by the Appeals Manager and the General Assistance Policy Manager prior to notification of the claimant.The Hearing Officer's findings of fact are not subject to change,but the General Assistance Policy Manager may order re- hearing for cause. Part 2 Appeals to the Board 201. The applicant or recipient may appeal an adverse hearing decision to the Board of Supervisors. 202. A written appeal must be received by the aerk of the Board of Supervisors vwithin fourteen days after the decision has been mailed to the claimant. Absent evidence showing the contrary, a bearing decision is presumed to have been mailed on the date it bears. (a) An appeal to.the Board will not stay the implementation of the Hearing decision, and the recipient shall not be entitled to continue to receive assistance pending further bearing. (b) The appeal will be scheduled for the first available Board meeting,but no earlier than the third meeting following receipt of the appeal. 203. The Administrative Review Panel may review appeals of Hearing decisions and recommend proposed action to the Director. (a) If the Director supports the hearing decision, the Appeals unit will be notified to proceed with the presentation to the Board. (b) If the Director finds in favor of the claimant,the Qerk of the Board will be notified to withdraw the item from the Board agenda The appropriate Social Service District office will be advised to take corrective action. 204. Both the appellant and the Department must file all written materials at least one week before the date set for the Board bearing.New material must be served by mail an the apposing party. 205. (a) Upon bearing the appeal.the Board shall make any required fact determinations based on the record on appeal and testimony received by the Board.M record shall include the Department's Hearing Officer's fact findings,plus any papers filed with that Officer. (b) If the facts upon which the appeal is based are not in dispute or U any disputed facts are not relevant to the issue ultimately to be decided by the Board,the Board will proceed immediately to the next step without considering fact questions.The parties may stipulate to an agreed set of facts. RESOLUTION NUMBER 92/85 206. (a) Once the farts are determined,or if there are no fact determinations required by the appeal, the Board will consider legal issues presented by the appeal.Legal issues are to be framed, Insofar as possible,before the Hearing and shall be based on the Department's Hearing t Officer's decision and such other papers as may be filed. (b) Appealing parties may make legal arguments both by written brief and orally before the Board. If the issues are susceptible of immediate resolution,the board may immediately decide them at the appeal bearing. If the County Counsel's advice is needed on legal questions,the Board may take the matter under submission,reserving its final judgment until it receives such advice. 207. The Board may decide an appeal Immediately after bearing or take the appeal under .submission. IwabY or"gat 1*IS•WO rd WISM ae0lta°pf`d a «, 01 w;" fAkV% Wdof beb0 " DOW ofIL en 7 �AMVZtm fr .1L C+ hoard RESOLUTION NUMBER 92/ 554 t KECEIVED e4 P93 0 m of St ''7 e 2-- • / o y Co �--- �� / 117 674 1,7"y Ala /f "z4 1 v Al Social Service DepartrentPlease reply to: Contra 40 Douglas Drive Perfecto Villarreal Costa Martinez,California 94553-4068 s J Director J County Srq c6ffh'�' GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION IN THE MATTER OF: Stan Kielak 247 Bailey Rd. # 31 Pittsburg, CA 94565 County No. : 07 92-478669-C4FD Notice of Action: 10/04/93; 10/13/93 Effective Date: 10/31/93 Appeal Filing Date: 10/20/93; 10/26/96 Aid Paid Pending: Yes Date of Hearing: 11/23/93 Place of Hearing: Antioch, California Appeals Officer: Kate Quisenberry County Representative: C. Dudley Authorized Representative: None ISSUE: Whether the proposed discontinuance of General Assistance for three months due to Workfare failures on 10/4/93 and 10/11/93 is correct. COUNTY POSITION: Claimant appeared for workfare assignments on both days, but after responding to roll call refused to participate in the assignments, asking to speak with the worker or supervisor. Although he claimed that he could not work at the assignments due to poor eye sight, he provided no medical verification and the failures were not excused. On 10/4 he did go to Merrithew Memorial Clinic in an attempt to obtain verification of his complaint. His visit there was verified by the Nurse who .telephoned the worker to explain that until he was examined by -the doctor on 11/4 he could not be provided with an excuse from workfare. The Merrithew Memorial document was presented in hearing by Claimant and was dated 10/4. .. i i Kielak Page 2 CLAIMANT_POSITION: Claimant testified that he cannot see well enough to perform his workfare assignment safely. He testified that he has been assigned outdoor maintenance which involves street-cleaning. He is afraid of being struck by a car. He cannot see well enough to see what to pick up off the ground unless he has glasses. He testified that he cannot see his feet without glasses. Although the County approved $100.00 for eye glasses he testified that the glasses cost $200. and he cannot afford them. The medical forms which Claimant presented in hearing indicated the following: 1) . 10/4/93 from Nurse showing telephone call to Social Services explaining why no medical excuse can be provided to Claimant who appeared at the Clinic on 10/4 2) . 11/4/93 completed by Dr. Hansen, O.D. , Claimant's doctor, stating that Claimant has a high decree of myopia and that prognosis is good with glasses. The Nurse added the following statement: 11/9/93: Spoke with Dr. Hardy (O.D. ) . States pt. can do work as stated in #1 with or without glasses. 3) . 11/18/93 completed by Dr. Hansen stating that Claimant is employable but has to wear glasses REGULATORY AUTHORITY: Department Manual Section 49-210,II,B,1, provides that an individual who does not have a medically verified physical or mental disability, or who has not been determined to be unemployable by the Vocational Counselor, is considered employable. Board of Supervisors Resolution #92/857 adopted December 15, 1992, provides: Part 7, Section 703: A recipient who fails or refuses to comply with General Assistance Program requirements as expressed in this resolution or in the Social Service Department Manual of Policies and Procedures shall be discontinued aid and sanctions will be imposed as follows unless the recipient shows that the failure or refusal to comply was for good cause. Department Manual Section 49-111,II,F,2, provides that a recipient who fails to cooperate with the Social Service Department by failing to meet any one of his or her enumerated responsibilities without good cause, shall be discontinued aid, and sanctions will be imposed as follows: a. first failure: one month. Kielak J Page 3 b. second failure: three months. c. third failure: six months. Department Manual Section 49-111,II,G,2, provides that the reasons which establish good cause for a failure to cooperate or comply are subject to verification and include, but are not limited to, the following: a. the failure has occurred by reason of a disability under the Americans with Disabilities Act 1) The burden of proof to establish that the failure occurred because of a disability is on the applicant or recipient 2) The applicant/recipient's showing may be rebutted by the Department b. employment has been obtained, c. scheduled job interview or testing, d. mandatory court appearance, e. incarceration, f. illness, g. death in the family, h. other substantial and ,compelling reason. These must be reviewed and approved by the Division Manager. Department Manual Section 49-111,II,H,1 provides that a willful act is one that is intentional or without reasonable excuse or cause. It need not be done with a specific purpose to violate program requirements. a. The burden of proof to establish good cause, which may include proof that the failure was not willful is on the applicant/recipient. b. The Department may rebut a showing of good cause by proving that the failure to comply was willful, in which case the Department has the burden of proof. c. In all cases it is presumed, subject to rebuttal, that the ordinary consequences of the applicant/recipient's voluntary acts are intentional, and thus willful. 2. Willfulness cannot be found where the person is mentally disabled to the extent that s/he does not understand his/her responsibilities or is incapable of fulfilling them. 3. Conduct which involves negligence, inadvertence, or disability may or may not be willful. a. Three or more acts of negligent failure of the recipient to follow program requirements, which may include acts for which the recipient previously has been discontinued from aid or sanctioned, evidence willfulness. Kielak ►: Page 4 CONCLUSION AND FINDING OF FACT: Although the Nurse, in consultation with a Dr. Hardy, indicated that Claimant can work with our without glasses, Claimant's own physician completed a subsequent report stating that he must wear glasses. Since this is the second report in November which Claimant's doctor, -Dr. Hansen completed, it is concluded that the 11/18 statement was to correct misinformation provided by a Nurse on the 11/4 statement. Dr. Hansen modified the Nurse's statement to make it clear that Claimant "has to wear Glasses". Based on this evidence it is determined that Claimant had good cause for failure to perform his Workfare assignment 10/4 and 10/11. Thus, the proposed discontinuance of General Assistance is not sustained. ORDER: Claim Granted. Aid shall be reinstated and the period of ineligibility shall be expunged from the record. Kate Ouisenberry . 11/30/93 Social Services Appeals Officer Date A peals Program Manager Date If you are dissatisfied with this decision you may appeal the matter directly to the Contra Costa County Board of Supervisors. Appeals must be filed in writing with the Clerk of the Board, 651 Pine St. , Martinez, CA 94553. Appeals must be filed within fourteen (14) days of the date of this Evidentiary Hearing Decision. No further aid is paid pending a Board of Supervisors appeal. El ED x 2.L1741993 LO Leez Iva l.��.�� d��..-��,..�.�.�f,.�rte-, ��..�.,�-c_.- .�.«-� (7`�^� �• 1 t � e + 1207 Kielak Page 2 CLAIMANT POSITION: Claimant testified that he cannot see well enough to perform his workfare assignment safely. He testified that he has been assigned outdoor maintenance which involves street-cleaning. He is afraid of being struck by a car. He cannot see well enough to see what to pick up off the ground unless he has glasses. He testified that he cannot see his feet without glasses. Although the County approved $100.00 for eye glasses he testified that the glasses cost $200. and he cannot afford them. The medical forms which Claimant presented in hearing indicated the following: 1) . 10/4/93 from Nurse showing telephone call to Social Services explaining why no medical excuse can be provided to Claimant who appeared at the Clinic on 10/4 2) . 11/4/93 completed by Dr. Hansen, O.D. , Claimant's doctor, stating that Claimant has a high decree of myopia and that prognosis is good with glasses. The Nurse added the following statement: 11/9/93 : Spoke with Dr. Hardy (O.D. ) . States pt. can do work as stated in #1 with or without glasses. 3) . 11/18/93 completed by Dr. Hansen stating that Claimant is employable but has to wear glasses REGULATORY AUTHORITY: Department Manual Section 49-210,II,B,1, provides that an individual who does not have a medically verified physical or mental disability, or who has not been determined to be unemployable by the Vocational Counselor, is considered employable. Board of Supervisors Resolution #92/857 adopted December 15, 1992, provides: Part 7, Section 703 : A recipient who fails or refuses to comply with General Assistance Program requirements as expressed in this resolution or in the Social Service Department Manual of Policies and Procedures shall be discontinued aid and sanctions will be imposed as follows unless the recipient shows that the failure or refusal to comply was for good cause. Department Manual Section 49-111,II,F,2, provides that a recipient who fails to cooperate with the Social Service Department by failing to meet any one of his or her enumerated responsibilities without good cause, shall be discontinued aid, and sanctions will be imposed as follows: a. first failure: one month. Kielak Page 3 b. second failure: three months. c. third failure: six months. Department Manual Section 49-111,II,G,2, provides that the reasons which establish good cause for a failure to cooperate or comply are subject to verification and include, but are not limited to, the following: a. the failure has occurred by reason of a disability under the Americans with Disabilities Act 1) The burden of proof to establish that the failure occurred because of a disability is on the applicant or recipient 2) The applicant/recipient's showing may be rebutted by the Department b. employment has been obtained, c. scheduled job interview or testing, d. mandatory court appearance, e. incarceration, f. illness, g. death in the family, h. other substantial and compelling reason. These must be reviewed and approved by the Division Manager. Department Manual Section 49-111,II ,H,1 provides that a willful act is one that is intentional or without reasonable excuse or cause. It need not be done with a specific purpose to violate program requirements. a. The burden of proof to establish good cause, which may include proof that the failure was not willful is on the applicant/recipient. b. The Department may rebut a showing of good cause by proving that the failure to comply was willful , in which case the Department has the burden of proof. c. In all cases it is presumed, subject to rebuttal, that the ordinary consequences of the applicant/recipient's voluntary acts are intentional, and thus willful. 2. Willfulness cannot be found where the person is mentally disabled to the extent that s/he does not understand his/her responsibilities or is incapable of fulfilling them. 3 . Conduct which involves negligence, inadvertence, or disability may or may not be willful. a. Three or more acts of negligent failure of the recipient to follow program requirements, which may include acts for which the recipient previously has been discontinued from aid or sanctioned, evidence willfulness. Social Service Depart Rent Contra Please reply to: 40 Douglas Drive Perfecto Villarreal Costa Martinez,California 94553-4068 Director J County 6----- GENERAL GENERAL ASSISTANCE EVIDENTIARY HEARING DECISION IN THE MATTER OF: Stan Kielak 247 Bailey Rd. # 31 Pittsburg, CA 94565 County No. : 07 92-478669-C4FD Notice of Action: 10/04/93; 10/13/93 Effective Date: 10/31/93 Appeal Filing Date: 10/20/93; 10/26/96 Aid Paid Pending: Yes Date of Hearing: 11/23/93 Place of Hearing: Antioch, California Appeals Officer: Kate Quisenberry County Representative: C. Dudley Authorized Representative: None ISSUE• Whether the proposed discontinuance of General Assistance for three months due to Workfare failures on 10/4/93 and 10/11/93 is correct. COUNTY POSITION: Claimant appeared for workfare assignments on both days, but after responding to roll call refused to participate in the assignments, asking to speak with the worker or supervisor. Although he claimed that he could not work at the assignments due to poor eye sight, he provided no medical verification and the failures were not excused. On 10/4 he did go to Merrithew Memorial Clinic in an attempt to obtain verification of his complaint. His visit there was verified by the Nurse who .telephoned the worker to explain that until he was examined by the doctor on 11/4 he could not be providedwith an excuse from workfare. The Merrithew Memorial document was presented . in hearing by Claimant and was dated 10/4 .