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You have the right to ask for a hearing if you disagree with any county action. You have only 90 days to ask for a hearing. The 90 days started the day after the county gave or mailed you this notice. If you have good cause as to why you were not able to file for a hearing within the 90 days, you may still file for a hearing. If you provide good cause, a hearing may still be scheduled.

If you ask for a hearing before an action on Cash Aid, Medi-Cal, CalFresh (Food Stamps), or Child Care takes place:

  • Your Cash Aid or Medi-Cal will stay the same while you wait for a hearing.
  • Your Child Care Services may stay the same while you wait for a hearing.
  • Your CalFresh (Food Stamps) will stay the same until the hearing or the end of your certification period, whichever is earlier.

While You Wait for a Hearing Decision for:

Welfare to Work:

You do not have to take part in the activities.
You may receive child care payments for employment and for activities approved by the county before this notice.
If we told you your other supportive services payments will stop, you will not get any more payments, even if you go to your activity. If we told you we will pay your other supportive services, they will be paid in the amount and in the way we told you in this notice.

  • To get those supportive services, you must go to the activity the county told you to attend.
  • If the amount of supportive services the county pays while you wait for a hearing decision is not enough to allow you to participate, you can stop going to the activity.


  • You cannot participate in the Cal-Learn Program if we told you we cannot serve you.
  • We will only pay for Cal-Learn supportive services for an approved activity.


Medi-Cal Managed Care Plan Members:The action on this notice may stop you from getting services from your managed care health plan. You may wish to contact your health plan membership services if you have questions.

Child and/or Medical Support: The local child support agency will help collect support at no cost even if you are not on cash aid. If they now collect support for you, they will keep doing so unless you tell them in writing to stop. They will send you current support money collected but will keep past due money collected that is owed to the county.

Family Planning: Your welfare office will give you information when you ask for it.

Hearing File: If you ask for a hearing, the State Hearing Division will set up a file. You have the right to see this file before your hearing and to get a copy of the county's written position on your case at least two days before the hearing. The state may give your hearing file to the Welfare Department and the U.S. Departments of Health and Human Services and Agriculture. (W&I Code Sections 10850 and 10950.)


  • Fill out and submit this form.
  • Call toll free: 1-800-952-5253 or for hearing or speech impaired who use TDD, 1-800-952-8349.

To Get Help: You can ask about your hearing rights or for a legal aid referral at the toll-free state phone numbers listed above. You may get free legal help at your local legal aid or welfare rights office.

If you do not want to go to the hearing alone, you can bring a friend or someone with you.

Hearing Request


about my (select up to 4):

AID Paid Pending:

Do you want the county to lower or stop your benefits as they proposed before the hearing?

For denial of medical services, treatments, or authorizations, complete the following if you can:

I need the state to provide me with an interpreter at no cost to me. (A relative or friend cannot interpret for you at the hearing.)



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