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- Written by: DENNIS FORDHAM
Since Jan. 1, 2024, when the asset test for Medi-Cal was abolished in California (only), many more people now qualify for Medi-Cal.
Unless a person receives Supplemental Security Income (“SSI”) or intends to leave California, the need to put assets into an irrevocable Special Needs Trust is not relevant to receiving Med-Cal where eligibility is not linked to SSI benefits.
What, however, is now relevant, for many widely used Medi-Cal programs, is one’s available, countable income as determined under California regulations (22 CCR 50500-50517 et seq.); except for the Affordable Care Act and the 250% Working, Disabled Program Medi-Cal
Programs where eligibility is computed using one’s adjusted gross income reported on one’s income tax return.
Thus, if an applicant were able to control their available, countable income they might qualify for the Aged or Disabled (no share of cost) Medi-Cal if their available, countable income was under $1,732 per month (2024).
Otherwise, if their income presently exceeds $1,732/month, they would still benefit by reducing their share of cost by lowering their income for purposes of the Medically Needy (share of cost) Medi-Cal.
Share of cost is what a Medi-Cal beneficiary must first pay on a monthly basis before Medi-Cal pays anything.
California Medi-Cal trust income regulations (22 CCR 50489 to 50489.9) provide a planning opportunity because income received by most revocable and irrevocable trusts is not considered available, countable income for eligibility and share of cost computation purposes for purposes of certain types of Med-Cal, excluding MAGI Medi-Cal, Working, Disabled Medi-Cal and SSI-categorically linked Medi-Cal.
However, distributions by a trust for the benefit of, or directly to, a Medi-Cal applicant or beneficiary may count as income at the time of distributions and then subject to special income rules regarding what is available, countable income.
That is, distributions to the Medi-Cal beneficiary do count as income as many distributions to others to pay for shelter, utilities and food for the Medi-Cal beneficiary’s benefit.
However, distributions to a third party vendor of goods or services, other than shelter, utilities and food, do not count as available, countable income. This is based on an interpretation of California’s trust income rules that is presently accepted by the Department of Health Care Services (“DHCS”) who administers California’s Medi-Cal programs (see All County Wide Director’s Letter’s “ACWDL” #’s 23-20, 23-21, and 23-22E (https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Pages/2023ACWDLs.aspx).
Accordingly, if a Medi-Cal beneficiary were to receive, whenever possible, all of his or her income, other than social security and retirement income, by owning all income producing assets (e.g., investments and rental properties) inside a trust for their benefit, then the income earned by such trust owned assets would not count when received by the trust.
However, any distributions (whether of trust income or principal) by the trustee to the Medi-Cal beneficiary would count as income when distributed, as might distributions for shelter, utilities and/or food, collectively referred to as ‘in kind support and maintenance (“ISM ”).
That said, however, such ISM payments only count when one-hundred percent is paid by the trustee (or by any third party provider) and so do not count if the Medi-Cal beneficiary were to pay even a small portion of such support payments (e.g., by using their social security income). Also such ISM payments count at a much reduced rate.
The terms of the Trust may determine whether or not the Medi-Cal eligibility worker counts the trust’s own income as available, countable income. That is, does the Trust require the Trustee to make distributions to or for the benefit of the beneficiary? If so, the eligibility worker may, perhaps, say that income generated by the trust assets is available and countable income for purposes of Medi Cal eligibility and share of cost computations.
A possible solution is to amend (or modify) the trust distribution standard to allow the Trustee discretion over whether to make distributions to or for the benefit of the beneficiary. The desired result is to allow the trustee to make non support payments at the trustee’s discretion.
Much yet remains to be seen as to how DHCS applies the income trust rules to different trust distribution standards. Also, it remains to be seen whether the new president rescinds the federal consent that allowed California to remove its asset test when all other states still have asset tests.
The foregoing discussion is not legal advice. Anyone confronting Medi-Cal issues should consult with a qualified attorney.
Dennis A. Fordham, attorney, is a State Bar-Certified Specialist in estate planning, probate and trust law. His office is at 870 S. Main St., Lakeport, Calif. He can be reached at
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- Written by: Grace Jacobs Corban
The discovery
A Neptune-sized planet, TOI-3261 b, makes a scorchingly close orbit around its host star. Only the fourth object of its kind ever found, the planet could reveal clues as to how planets such as these form.
Key facts
An international team of scientists used the NASA space telescope, TESS (the Transiting Exoplanet Survey Satellite), to discover the exoplanet (a planet outside our solar system), then made further observations with ground-based telescopes in Australia, Chile, and South Africa.
The measurements placed the new planet squarely in the “hot Neptune desert” — a category of planets with so few members that their scarcity evokes a deserted landscape.
This variety of exoplanet is similar to our own Neptune in size and composition, but orbits extremely closely to its star. In this case, a “year” on TOI-3261 b is only 21 hours long.
Such a tight orbit earns this planet its place in an exclusive group with, so far, only three other members: ultra-short-period hot Neptunes whose masses have been precisely measured.
Details
Planet TOI-3261 b proves to be an ideal candidate to test new computer models of planet formation.
Part of the reason hot Neptunes are so rare is that it is difficult to retain a thick gaseous atmosphere so close to a star. Stars are massive, and so exert a large gravitational force on the things around them, which can strip the layers of gas surrounding a nearby planet. They also emit huge amounts of energy, which blow the gas layers away.
Both of these factors mean that hot Neptunes such as TOI-3261 b might have started out as much larger, Jupiter-sized planets, and have since lost a large portion of their mass.
By modeling different starting points and development scenarios, the science team determined that the star and planet system is about 6.5 billion years old, and that the planet started out as a much larger gas giant. It likely lost mass, however, in two ways: photoevaporation, when energy from the star causes gas particles to dissipate, and tidal stripping, when the gravitational force from the star strips layers of gas from the planet.
The planet also might have formed farther away from its star, where both of these effects would be less intense, allowing it to retain its atmosphere.
The remaining atmosphere of the planet, one of its most interesting features, will likely invite further atmospheric analysis, perhaps helping to unravel the formation history of this denizen of the “hot Neptune desert.”
Planet TOI-3261 b is about twice as dense as Neptune, indicating that the lighter parts of its atmosphere have been stripped away over time, leaving only the heavier components. This shows that the planet must have started out with a variety of different elements in its atmosphere, but at this stage, it is hard to tell exactly what.
This mystery could be solved by observing the planet in infrared light, perhaps using NASA’s James Webb Space Telescope — an ideal way to see the identifying fingerprints of the different molecules in the planet’s atmosphere. This will not just help astronomers understand the past of TOI-3261 b, but also begin to uncover the physical processes behind all hot, giant planets.
Fun facts
The first-ever discovery of an ultra-short-period hot Neptune, LTT-9779 b, came in 2020. Since then, TESS discoveries TOI-849 b and TOI-332 b have also joined the elite ultra-short-period hot-Neptune club (with masses that have been precisely measured).
Both LTT-9779 b and TOI-849 b are in the queue for infrared observations with the James Webb Space Telescope, potentially broadening our understanding of these planets’ atmospheres in the coming years.
The discoverers
An international science team led by astronomer Emma Nabbie of the University of Southern Queensland published their paper on the discovery, “Surviving in the Hot Neptune Desert: The Discovery of the Ultrahot Neptune TOI-3261 b,” in The Astronomical Journal in August 2024.
Grace Jacobs Corban writes for NASA.
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- Written by: Elizabeth Larson
Until the official canvass — the process of counting all of the ballots — is complete, the general election results are not final.
The Lake County elections office had more than 19,000 ballots still to count after election night, as Lake County News has reported.
Last week’s update put the unprocessed ballots still to be counted at 11,097.
In the latest update, the Registrar of Voters Office said the total number of ballots remaining to be counted as of Wednesday was 1,805.
That includes 1,453 provisional or conditional ballots, and 352 vote-by-mail ballots that require further review, the registrar’s office reported.
Specifics of the races have not been released, and are not expected to be until the final vote tally is completed.
The official canvass must be completed by county election offices by Dec. 3 so that the Secretary of State can certify the state’s election results by Dec. 10.
Email Elizabeth Larson at
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- Written by: LAKE COUNTY NEWS REPORTS
In March 2024, Californians passed Proposition 1, the Behavioral Health Services Act, to transform the way we address mental health and substance use disorders, collectively known as behavioral health.
The California Department of Public Health, or CDPH, will receive a portion of the Proposition 1 funding, tailoring strategies to specific populations to better reduce the prevalence of mental health and substance use disorders and resulting conditions.
“As a department, our mission is to advance the health and well-being of California’s diverse people and communities, CDPH will leverage its experience with behavioral health programs and initiatives to develop an effective prevention strategy,” said CDPH Director and State Public Health Officer Dr. Tomás Aragón. “We know Californians are seeking better mental health support, resources, tools, awareness, and education and we’re working to make that happen with urgency.”
Prevention efforts, particularly those that support young people, can be an effective way to reduce negative behavioral health outcomes for the state population — leading to a healthier California for all.
Proposition 1 funds included a provision to direct a minimum of four percent to general statewide mental health and substance use population-based prevention programs.
At least half of Proposition 1 prevention and early intervention funds will be dedicated to strategies for people aged 25 or younger.
CDPH is seeking input from a wide range of partners and interested parties to support the planning, development and implementation of its strategy for prevention programs.
On Nov. 13, CDPH presented an update on its planning efforts at a meeting of the California Health and Human Services Agency’s Behavioral Health Task Force.
The meeting included a question-and-answer session and an exercise to provide Task Force members and public participants the opportunity to provide feedback and input. Materials from the meeting can be viewed online.
On Dec. 11, CDPH is hosting an expert advisory panel titled, “Population-Based Behavioral Health Prevention Strategies.” The meeting will include panel discussions with experts. The online meeting is open to the public and includes time for participant questions and feedback. Attendees can register online.
Visit the state website at CDPH Transforming Behavioral Health to receive updates. Sign up for updates online and share your feedback, comments and thoughts at
CDPH’s population-based prevention strategy is one part of California’s Behavioral health transformation.
Behavioral health transformation complements and builds on California's other major behavioral health initiatives including, but not limited to, California Advancing and Innovating Medi-Cal initiative, the California Behavioral Health Community-Based Organization Networks of Equitable Care and Treatment Demonstration proposal, the Children and Youth Behavioral Health Initiative, Medi-Cal Mobile Crisis, 988 expansion and the Behavioral Health Continuum Infrastructure Program.
Californians voted to pass Proposition 1 to modernize the behavioral health delivery system, improve accountability and increase transparency, and expand the capacity of behavioral health care facilities for Californians.
More information about the ongoing implementation of Proposition 1 and Gov. Gavin Newsom’s broader efforts to transform California’s mental health and substance use disorder system can be found at mentalhealth.ca.gov.