Original signed by

.. .

Medi-Cal Section 1'93 1 (b)

MEDI-CAL ELIGIBILITY PROCEDURES MANUAL

APPENDIX A '

H A N D B W K BEGINS HERE

CHART FOR DETERMINING RELATEDNESS OF CARETAKER RELATIVES

An: All pyurar listed q ttQ dart am r h 1~ thCu relat~mbip to Lbe AW- child. lor u ~ l p l e penpa b t g d u ' f ln t cuasiy''ue hnt amsm Co the Amc child.

Stepther Stcpfatber

1 i

Aunt Pamt I uncle

I I

1st Cousi3 Lt Comin

I

1st Cousin Once-rmved

I I

WOC Sister CEIU) Brother

r I r t

Gmdparent

>

Great Aunt -

1) The caretiiker relative also includes the spouse or folxrr spouse of Lbe n l a t i y listed above.

- Cmt b l e

2) The caretaker relative also inclcdes the adoptire parentrr and their n lat ivu u listed above.

-=---=--_ HANDBOOK ENDS HERE -

CALIFORNIA-DSS-MANUAL-EAS MANUAL LEITER NO.EAS9&03 Effective 7/1/98

Page 919

SECTION NO : 50226 MANUAL LETTER NO.: 231 DATE: 10/30/00 ..-..A< 2.-