ADMINISTRATIVE PROCEDURES MANUAL CHAPTER CONTENTS 109 DOCUMENTATION...J DOCUMENTING ON CANO (EIS)...J-2

Transcription

1 CHAPTER CONTENTS Section Page 109 DOCUMENTATION...J DOCUMENTING ON CANO (EIS)...J DOCUMENTING SENSITIVE INFORMATION...J ACCESS AND DISCLOSURE OF INFORMATION IN CANO...J EDITING AND DELETING DOCUMENTATION FROM CANO...J METHODS OF CANO DOCUMENTATION...J CANO FOR SPECIAL CIRCUMSTANCES...J CANO TEMPLATES...J-5 A. CANO TITLES...J-5 1. RECOMMENDED KEYWORDS OR PHRASES...J-6 2. EXAMPLES OF CANO TITLES...J-6 B. CANO FOR REVIEWS AND RECERTS...J-7 C. INCOME INFORMATION AND CALCULATIONS...J-7 D. DISABILITY INFORMATION...J-7 E. RIGHTS AND RESPONSIBILITIES...J-7 F. FAMILY SELF-SUFFICIENCY PLAN...J-8 G. NOTES SUBJECT LINE...J-8 H. NOTICES SENT TO THE HOUSEHOLD...J CANO FOR QUICK-PENDS...J CASE MANAGERS USE OF CANO...J-8 ADDENDUM A INTAKE/MAINTENANCE CANO TEMPLATE...J-11 ADDENDUM B REPORT OF CHANGE CANO TEMPLATE, EXAMPLES, AND REPORT OF CHANGE GUIDE...J-14 ADDENDUM C FAIR HEARING CANO TEMPLATE...J-16 ADDENDUM D FRAUD REFERRAL AND FINDINGS CANO TEMPLATE...J-17 MC #19 (5/07)

2 109 DOCUMENTATION Documentation is a record in a public assistance case file, EIS (Eligibility Information System), or CMS (Case Management System) that explains: Actions taken on a case relating to eligibility for public assistance programs, and the reasons supporting those actions; Actions taken by the agency in assisting a family to become self-supporting; Contacts with partner agencies and contractors/grantees; Factors of eligibility that were verified and how they were verified; Contacts the agency has with the client; and Contacts with third party sources (collateral contacts). Staff must document actions and decisions related to the household s application or receipt of public assistance benefits. This is done by recording information about each action taken, verification used, and contacts made using online case note screen on EIS (CANO) or CMS (Client Notes), or on a Report of Contact sheet (GEN 56A). Clear and concise documentation is always beneficial. Staff must always: Be specific with dates, words, and actions; Make sure notes are unbiased and without generalities; Clearly state action items and timeframes; Address only facts, and do not include any personal opinions or judgments. J-1 MC #19 (5/07)

3 109-1 DOCUMENTING ON CANO (EIS) The CANO screen on EIS allows workers to enter case specific notes. Its primary purpose is for the workers to document only factual information regarding client contacts, changes in the household, and eligibility determination. Asking the following questions may help staff in reviewing their notes to ensure they are meeting the expectations: Have I written anything that would surprise the client or be uncomfortable to share with the client? Since this is a record of the client s participation, documentation should reflect information that staff and client have discussed. Clients should never be surprised by what is in the notes. If it would be uncomfortable to share the case notes with the client, consider whether it should be written in a different way. Do my case notes contain information necessary to another worker? Can another worker pick up the case and have a clear picture of what I did and why? Would I be comfortable asking another staff whether the case notes I have written seem accurate, fair, and helpful? DOCUMENTING SENSITIVE INFORMATION The following client issues are examples of sensitive information that will not be included in the CANO: Domestic Violence Sexual Abuse (including incest, rape, and past abuse) Substance Abuse (including alcohol, illegal drugs, and addictions to prescription drugs) Mental Illness and medical needs Although discussing these issues with the client may be very important in building a relationship of trust, and may be helpful to the client in gaining perspective, recording information about sensitive issues may not be necessary if they do not affect eligibility. J-2 MC #19 (5/07)

4 109-2 Continued To document sensitive information: Address sensitive information in the CANO as: Sensitive Information - See Hard Copy File. Carefully document sensitive information in the hard copy file on the bright colored sensitive information sheet, as it was stated by the client. Include only factual information. Do not document staff s assumptions about the client and their situation. Observations may also be noted, but workers must be thorough and specify exactly what was observed without expressing any assumptions ACCESS AND DISCLOSURE OF INFORMATION IN CANO There are no system restrictions for all Division staff and partner agencies to access the CANO screen. It is available to clients requesting access to their case information or case file. Refer to Administrative Procedures Manual section 103 for further guidance on client s access to case files EDITING AND DELETING DOCUMENTATION FROM CANO Staff may edit and delete CANO entries that they wrote the same day the note is created on EIS. After this day, staff may request to delete CANO entries that they wrote by notifying Systems Operations. To request deletion of a CANO, staff may: Send an to helpdesk and provide the following: case name, case number, date and time, title, and reason for the deletion, or Go online at and fill-out the Request to Delete CANO template. Only supervisors and lead workers may request to delete CANO entries written by another worker. They may request to delete entire CANO entries written by another worker by sending a request to SysOps and following the steps stated above. J-3 MC #19 (5/07)

5 109-4 Continued When EIS helpdesk receives a CANO deletion request, the entire CANO entry will be deleted from EIS METHODS OF CANO DOCUMENTATION Eligibility workers must refer to their supervisor regarding the approved methods of CANO documentation used in their office. Currently, the methods available are: Macro Word Document Cutting and Pasting Free-form CANO Some methods can be good shortcuts and time savers. However, staff must remember that regardless of the selected method of documentation, they own the CANO they write and any errors the case may contain CANO FOR SPECIAL CIRCUMSTANCES For tracking purposes, a separate case note is necessary when documenting special circumstances other than eligibility and benefit determination. Eligibility workers must also include a specific and descriptive title for such case notes. Some examples are: Fair hearing requests Prehearing conferences Fraud referrals ATAP incapacity determination Drug or other felony convictions Unusual alien situations J-4 MC #19 (5/07)

6 109-7 CANO TEMPLATES Addendum A includes the current standardized CANO templates for: Intake/Maintenance Report of Change Fair Hearing Request Prehearing Conference Fraud Referral and Findings Eligibility staff needs to consider each subject in the CANO templates as it applies to the specific program they are processing. Offices and units are given the discretion to either omit or write N/A if the subject line does not apply. Each subject line includes all the possible elements of eligibility an eligibility worker needs to consider when making a decision on the case. However, not all the elements apply to every case. If the element is not needed or necessary, eligibility staff do not need to address it. Although the templates are designed to provide staff with information they need to include in specific CANO entries, below are additional guidelines to further clarify staff expectations in important areas affecting eligibility determination and benefit amount: A. CANO TITLES Eligibility workers are given the freedom to create their own case note titles. In the previous guideline, several recommendations were provided in choosing CANO titles. However, eligibility workers must remember that CANO titles should always reflect what is in the body of the CANO. Titles must also be descriptive and specific. The goal caseworkers want to achieve is clarity when writing CANO titles. J-5 MC #19 (5/07)

7 109-7 Continued 1. Recommended Keywords or Phrases To easily locate information in a CANO, the following wording or phrases are recommended to be included in titles: Change Reported ADDR/EAIN/DEMH TA/FS/ME Intake App Interview TA/FS/ME App PENDED FS/ME Recert No Interview Change Reported Job Changed Change Reported New HH member TA/FS/ME Recert Approved Fair Hearing Request Prehearing Conference Fraud Referral ATAP Incapacity Determination Drug Felony Unusual Alien Situation 2. Examples of Cano Titles Some examples of good CANO titles are provided below: TA/FS/MED APP/FACE TO FACE INTERVIEW FS/ME REVIEW/FACE TO FACE/PENDED FS/ME REVIEW CONT/AUTH BENEFITS FS/ME REVIEW CONT/DENIED FS/AUTH ME J-6 MC #19 (5/07)

8 109-7 Continued TA/ME INTERVIEW/VOL QUIT/PENDED CHANGE/NEW JOB/MOVED CHANGE/UIB ENDED/JOB BEGAN INCAPACITY DECISION FOR SALLY FELONY CONVICTION SET ASIDE FAIR HEARING REQUEST REC D PREHEARING CONFERENCE HELD B. CANO FOR REVIEWS AND RECERTS The Intake/Maintenance CANO template is pertinent to both intake and maintenance processing. The purpose of conducting a review or recertification is to determine continued eligibility and establish a new certification period. Eligibility workers need to address the same information to make an eligibility determination as they did during the initial application. C. INCOME INFORMATION AND CALCULATIONS Clear documentation of income and calculations is pertinent in every eligibility determination. Budget each month separately to show the income the household received or expects to receive during the benefit month. D. DISABILITY INFORMATION The subject of disability is pertinent to all programs (incapacity for ATAP, exemption for FS, disability for APA/IA, CAMA, and Medicaid). Eligibility workers must determine if disability exists in the home and document it accordingly. E. RIGHTS AND RESPONSIBILITIES Supervisors and case reviewers cannot assume that the eligibility worker discussed the Rights and Responsibilities form with the client. Program rules require workers to discuss rights and responsibilities with all applicants and complete the documentation process. J-7 MC #19 (5/07)

9 109-7 Continued F. FAMILY SELF-SUFFICIENCY PLAN Information documented regarding family self-sufficiency plans differs in each office. Offices and units are given the discretion to choose the elements they require staff to document under the FSSP/JAS subject. G. NOTES SUBJECT LINE Eligibility staff are free to add a Notes subject line for important facts about the case/household such as: Retro-Medicaid, SSA information, and information about different offices handling the same case. H. NOTICES SENT TO THE HOUSEHOLD Eligibility workers must list notices they sent to the household under ACTION. This information is necessary for review purposes. This is also a good reminder for the eligibility worker to send notices CANO FOR QUICK-PENDS Offices/Units are given the discretion to develop their own procedure in using and accepting quick-pend CANO. Quickpend CANO is often used when staff reviews the application and determines that several pieces of information are lacking and needed from clients before eligibility can be determined. If a worker decides to do a quick-pend CANO, this must be followed by a full CANO entry in order to complete the application or eligibility determination process CASE MANAGERS USE OF CANO CANO is not intended to replace other tools such as and telephone to ensure clear communication between case managers and DPA eligibility staff. Temporary Assistance case managers have read-access and write-access to CANO, but the use of CANO is limited to the entry of case specific information needed by the eligibility technician (ET) to take action on the case. J-8 MC #19 (5/07)

10 109-9 Continued CANO entries by case managers are limited to: Notifications of Job Start and OJT placements Requests to lift or impose penalties Requests to start or end exemptions from work activities Notifications of extension decisions Notification of home visits conducted and decision to increase an ATAP penalty amount to 75% or full family sanction Case managers must set an alert whenever they make a CANO entry. The alert entry should note the action requested and date the CANO entry was made. Examples of alert entries: Set penalty - CANO 4/15 Job Start - CANO 4/15 Extension Decision CANO 4/15 Note: Client specific entries made in CANO before the implementation of Client Notes will remain in CANO and will not be deleted. REPORTING CHANGES Case managers must not, other than for the circumstances mentioned above, use CANO to report changes for their clients. Clients should be reminded that it is their responsibility to report changes directly to their eligibility technician. Case managers can facilitate the process by: Providing clients with change report forms and/or forwarding forms to eligibility staff, Forwarding client s regarding changes to eligibility staff, and J-9 MC #19 (5/07)

11 109-9 Continued Providing clients with contact numbers so the report of change can be made directly to the eligibility staff. J-10 MC #19 (5/07)

12 ADDENDUM A: INTAKE / MAINTENANCE CANO TEMPLATE Note: EIS Security screens listed under subject headings are for reference only and optional for workers to note. If the subject line does not apply to the program being processed, write N/A. If the element is not applicable, disregard and omit the element. SUBJECT ELEMENTS RECORD TITLE Program(s) (TA, FS, ME, APA, CAMA, GA, etc.); indicate whether application, recert, review, or renewal, and if FS is expedited APP DATE & BSD: Application Date & Benefit Start Date Review/Recert received date and Benefit Start Date INTERVIEW DATE: Date and type of interview conducted (face to face, by phone, or fee agent); who attended the interview; date of last interview held; date of next face-to-face interview. If interview is not held, provide an explanation or reason why R&R: Document if client s rights and responsibilities were explained during the interview, did clients understand them, and note any questions they had Document clearly if change reporting responsibility was explained to client PRIOR CANO s & Indicate whether prior case notes and notices were checked NOTICES: ALERTS & INTERFACES: ADDRESS & TELEPHONE: ADDR HHC/ROPD SEPA SSDO HERC RACE MARS CSSD: APID SPRD CSEA Indicate if ETAL was checked Check all interfaces (INGENS, NSTAR, DOL, INME). Pertinent information from interfaces should be recorded under eligibility criteria such as income, resources, etc. List client s physical and mailing addresses List client s home phone number If mailing address is different from residential address, document the reason or PI s explanation. Indicate Authorized Representative and/or Payee List name, relationship, and age of persons in the household. Address felony convictions (if any) List any non-mfu persons in household List individuals in household who are considered responsible for the care of the applicant List permanent documents obtained and how they were verified Citizenship Proof of Identification SPECAT / Categorically Eligible? Document the following information: Was 1603 completed? Does the client cooperate with CSEA If no, why not; list good cause reason, if applicable If exempt, provide reason Does client receive child support Deprivation DISABILITY: Document TA10, Med11, AD-2, date of SSI application, DDS referrals or decisions, SSI or SS-DS Document determination of incapacity status Document receipt of IAR and if IA is explained Document if HIPAA form was completed and signed by client, if applicable J-11 MC #19 (5/07)

13 PRIOR SUPPORT/JOB STATUS: JOST TLIP WORK REQ/ PENALTIES: WORK RESOURCES: FIAC LIAS OTAS VEHI STUDENT STATUS: UNIE Document how client has been supporting the family; what has changed (job, income, resources, etc.) Verify and list number of TANF months received in Alaska and from other states (include Tribal TANF) Document if household is living in a exempt village Indicate last date of employment List exemptions, job quits, existing penalties or sanctions List which clients are referred to E&T or Work Services Include all liquid and non-liquid resources Lists resources found in INGENS search List individuals in HH who are considered responsible for the care of applicant (GA/CAMA) List household members receiving school loans, scholarships, and grants List members working towards High School Diploma or GED, or postsecondary education Note: Address educational income under unearned income section INCOME: UNIE UNIN EAIN SEEI In a narrative format, list each person with income and document type, source, amount and how verified. Show income calculations: Unearned income Source and amount Earned income Employer name and phone number How prospective income will be calculated Whether job is regular/temporary, part-time/full time, seasonal Self employment income State if seasonalized or annualized List income and expense totals Development of Income Indicate unearned income applied for and pursuing (i.e. UIB, SSI etc.) Note: Include the following items in documenting earned income: Name Payperiod end Paydate Gross Pay YTD Verification Example: Valerie Works F/T at AC Garments. Wage is $12.51 per hour, salaried at $ per month. She is paid once a month on the last day of the month. She states that she anticipates no changes. PPE Paydate Gross Pay YTD Verfication 8/31/04 8/31/04 $ $11, HC 9//30/04 9/30/04 $ $13, HC J-12 MC #19 (5/07)

14 DEDUCTIONS: NOMD DEMH MED: MIBW MIAU MERE MERI List expenses out of household (rent, mortgage, child care, child support paid, medical expenses for SPECAT members, utilities, taxes, insurance) List each expense; how verified (HC, VV, CC) If expenses are shared, explain. Be sure to reduce allowable shelter deductions by GA or In-kind income amounts. Emergent need for GA? List TPL/TPR resource information Retro Med Requested (Mo. and Determination) SLMB, QMB Medicare Buy-In If pregnant, indicate estimated due date Was CAMA criteria met, MED 11 received? FSSP/JAS: Was the FSSP completed? Was JAS involvement registered or opened Case management referral CC: Collateral Contacts List name and phone number and relationship of collateral contacts State information verified and thoroughly document details of contacts made For example: Document verbatim if possible. Do not just write LL verifies all. Instead, state LL Chris Smith ( ) verifies HH05. Rent is $500 plus all utilities including heat; rent is paid by check; one vehicle; Betty is the only HH member who works as far as he knows; HH has rented from him for 3 years. ACTION: State what type of action taken (i.e. authorize, pend, deny) What program and need standard and HH type (i.e. A1E, 2P, seasonal, incap, etc.) Amount of benefits issued, how it was issued (i.e. I, E, R, A), and which months State if FS was expedited, timely issued, and the reason code State certification through date, if applicable. State the notice numbers that were sent State if EBT card was issued or it if active State if client is eligible for subsistence card, if applicable J-13 MC #19 (5/07)

15 ADDENDUM B: REPORT OF CHANGE CANO TEMPLATE, EXAMPLES, AND REPORT OF CHANGE GUIDE REPORT OF CHANGE CANO TEMPLATE SUBJECT ELEMENTS RECORD TITLE: Enter: Change Reported and type of change For example: Change Reported Address Change Note: If multiple changes are reported, caseworkers have the option of using acronyms For example: Change Reported ADDR/EAIN/DEMH DATE RECEIVED AND SOURCE OF REPORT: Document the date the report was received, how it was received, and who reported the change. CHANGE REPORTED: Document change reported. Note: Refer to Change Report Guide for pertinent information to ask when accepting reports of change by phone or face-to-face. ACTION: State what type of action taken (i.e. authorize, deny, requesting more information) If requesting for more information, state the information and/or verification requested (i.e. work statement, proof of utilities) What program Amount of benefits issued, how it was issued (i.e. I, E, R, A), and which months State the notice numbers that were sent (i.e. W102) State if report of change was routed to another worker (WDS, case manager, service provider) or agency EXAMPLES OF REPORT OF CHANGE CANOS: CASE NOTE TITLE: Change Reported Address Change PI called today and reported that she just moved to a new apartment. Her new address is: 4702 Bornclaire Drive, Anchorage, Alaska She moved in on 6/15/05. Her landlord s name is Sherry Miller ( ). Monthly rent amount is $850 including all utilities. Action: Changed ADDR screen to reflect new address. Sent No20 for rent verification. CASE NOTE TITLE: Change Reported ADDR/EAIN/DEMH PI called today and reported that she just moved to a new apartment. Her new address is: 4702 Bornclaire Drive, Anchorage, Alaska She moved in on 6/15/05. Her landlord s name is Sherry Miller ( ). Monthly rent amount is $850 including all utilities. PI also reported that she just was recently hired part-time at Costco and will start work on 7/1/05. Her supervisor is Linda Loe at PI expects to work an average of 80 hours a month at $9/hr. Her work schedule is M F from 1 5pm. She expects to be paid on the 15 th and 30 th of the month. Action: Pend TA/FS/ME for the following (due 7/7/05): 1) work statement to verify new employment. 2) lease agreement to verify rent and shelter expenses Sent N020, ETAL set J-14 MC #19 (5/07)

16 CHANGE OF REPORT GUIDE Refer to the following guide for questions to ask when changes are reported by phone or face-to-face: CHANGE REPORTED: 1) CHANGE IN EMPLOYMENT (INCLUDING SELF- EMPLOYMENT) Did the household member start or end a job? If the household member started a job, document the following information: Employer s/supervisor s name and telephone number Start date of employment Expected hours of work per month or work schedule Full-time or part-time Hourly pay rate Pay period Verification used; if collateral contact was used, list the name and telephone number If the household member ended their job: Employer s/supervisor s name and telephone number Date of job ending Reason for job ending Date and amount of last pay received Verification used; if collateral contact was used, list the name and telephone number If the household member changed employment status from full-time to part-time: Effective date of change Hours of work and schedule Hourly pay rate Full-time or part-time Verification used; if collateral contact was used, list the name and telephone number Change in self-employment Effective date of change Type of self-employment Period of self-employment Monthly gross earnings Monthly allowable deductions/expenses Verification used; if collateral contact was used, list the name and telephone number 2) CHANGE IN ADDRESS New address Household composition Move-in date Landlord s name and telephone number if renting Monthly rent amount / mortgage payment SUD / Anticipated utility payments Verification used; if collateral contact was used, list the name and telephone number 3) CHANGE IN HOUSEHOLD COMPOSITION Name of the person who moved in or out of the home Date the person moved in or out Relationship of the PI to the person Social security number Date of birth Income Resource Purchase and prepare (for FS) Verification used; if collateral contact was used, list the name and telephone number 4) BANK ACCOUNT OR CASH ON HAND EXCEEDS $2000 Name of bank or institution Account number Source of money deposited in the bank or cash on hand Verification used; if collateral contact was used, list the name and telephone number 5) GETTING A VEHICLE Make, model, year of vehicle Value of vehicle Amount owed How is this vehicle used? (i.e., family/basic transportation, going to work, etc.) Verification used; if collateral contact was used, list the name and telephone number 6) CHANGE IN SOURCE OF UNEARNED INCOME OR CHANGE IN TOTAL UNEARNED INCOME OF MORE THAN $50 Source of income Amount of income Effective date of change How long is the change anticipated to last Verification used; if collateral contact was used, list the name and telephone number 7) CHANGE IN THE AMOUNT OF THEIR LEGALLY OBLIGATED CHILD SUPPORT: New amount Effective Date of Change Verification used; if collateral contact was used, list the name and telephone number 8) CHANGE IN MEDICAL INSURANCE COVERAGE Primary holder Insurance company s name, address and telephone number Effective date of coverage for each person covered Name of household members covered Extent of coverage (i.e. medical, dental, vision, accidental only, etc.) Group and policy number Verification used; if collateral contact was used, list the name and telephone number 9) OTHER CHANGES The client may report other changes that are not addressed above. These may include a change in their work hours, change in current shelter costs or the purchase of property. These reported changes must be documented. The caseworker is responsible for redetermining eligibility and benefit amount based on the change reported. J-15 MC #19 (5/07)

17 ADDENDUM C: FAIR HEARING CANO TEMPLATE CANO for Documenting Receipt of Fair Hearing Request SUBJECT ELEMENTS RECORD TITLE Fair Hearing Request REQUEST DATE: ISSUE: ACTION: List date client requested fair hearing List which program(s) fair hearing is requested for Document if the client is requesting continued benefits Summarize the issue or reason for fair hearing request Indicate whether the fair hearing request was forwarded to the supervisor or lead worker for a prehearing conference. CANO for Documenting Prehearing Conference SUBJECT ELEMENTS RECORD TITLE Prehearing Conference REQUEST DATE: ISSUE: FACTS OF CASE: CLIENT CONTACT: STATUS: 1. List date client requested fair hearing 2. List date of pre-hearing conference 3. List which program(s) fair hearing is requested for Summarize the issue chronologically In narrative form, address each of the following: 1. Why was an adverse action taken? 2. Cite all applicable manual sections. 3. Any policy clarification on issue? 4. Was correct notice sent? 5. Conciliation attempted by caseworker? 6. Was policy explained to client? 7. Does good cause apply? Why/Why not? 8. Were continued benefits addressed? 1. Was conference by phone or in person? 2. If unable to contact client by phone, was notice sent to client? 3. Was client advised of their right to legal representation (i.e. AK Legal Services, Disability Law Center, etc.)? 1. Was part of or all issue(s) resolved? 2. Will client receive continued benefits? State date fair hearing request forwarded J-16 MC #19 (5/07)

18 ADDENDUM D: FRAUD REFERRAL AND FINDINGS CANO TEMPLATE Note: Caseworkers must follow the procedure outlined in Administrative Manual section in making referrals of suspected fraud cases. In addition to completing the necessary forms to refer cases to Fraud Unit, caseworkers must also document concisely on CANO all referrals made to Fraud Unit. The documentation must include the following information: SUBJECT RECORD TITLE: FACTS OF CASE: ELEMENTS Fraud Referral In narrative form, address each of the following: Reason for referral Program(s) and eligibility factor(s) affected by the allegation Possible benefit months affected by allegation Form completed and submitted to Fraud Unit (Gen 97a / Gen 40), and date of submission DOCUMENTING FRAUD FINDINGS Caseworkers must also document in CANO the report and findings received from Fraud after an investigation is made. Immediately after receiving the Early Fraud Findings Report (Gen 97b) or FCU#5, the caseworker must take action and document the findings on CANO. The documentation must include the following information: SUBJECT RECORD TITLE: FACTS OF CASE: ELEMENTS Fraud Findings for Referral made on (date of referral) In narrative form, address each of the following: Summary of fraud report Action taken on case resulting from fraud findings Additional forms completed as a result of the fraud findings (ex. Gen 95 form if overpayment occurred) J-17 MC #19 (5/07)