For more information and resources, go to:

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1 For more information and resources, go to: Oregon Health Plan 2014 Frequently Asked Questions Updated: October 4, 2013 This document includes responses to the questions submitted to the DHS Field Operations from Self- Sufficiency Program (SSP) branch offices. It includes questions submitted the week of September 30, 2013 and the week of September 22, If you do not see a question you submitted in this document, it is because it is being researched and will be provided when available. Please submit your questions to Chere LeFore in CW/SSP Field Services at chere.lefore@state.or.us. Change Requests Q1: If a client submits a change request and the case is still in my branch, do I make the change? A: If the DOR is prior to 10/1, then the branch needs to act on the change and transfer the medical case to If the DOR is 10/1 or after, then transfer the medical case to 5503 and report the change on the DOR form or send an to 5503 Case Transfers informing 5503 of the new information. Clients Turning 19 Years Old Coding Q2: Our branch received a medical application for Jane Doe on 09/30/13. On the application she lists in the HH herself, her mother, and her twin brother. Jane requested medical for the brother. They were both on the same case as their mother. Both turned 19 on 09/12/13 and their medical ended. What will the worker do? A: Since the DOR is prior to 10/1, the worker in the branch will determine eligibility for all HH members as they normally would and create a new medical case for each person as necessary. Remember to transfer to 5503 upon completion of eligibility. Q3: If we have a MAA companion case, do we code PA for food stamps? Does that matter anymore? A: PA is Public Assistance and as long as there is TANF or SSI associated, we will still continue to code as PA. Q4: How do we code the disposition for medical applications we receive through CAPI? A: Disposition appropriately for SNAP. Mark the medical as approved after you submit the DOR form. Please remember not to use CAPI to look up case status information on medical applications. 1

2 Q5: For the cases we are sending to 5503, do we change worker to CT or is there a special worker load code they want us to use? A: Continue to use the CT worker load code. Q6: After compute deadline, staff are unable to do a compute action for the first of the following month. Do they use the first of the month after that? For example, working the case 10/28, cannot do a compute for 11/1 so do they do a compute for 12/1? A: Yes, any actions after compute deadline will need a COMPUTE effective date for the following month. Contacts Q7: Who do I contact if I need an answer to an urgent question? A: You can call the following: Questions regarding impact on DHS Field Operations: Chere LeFore at Questions about APD programs: Dale Marande at Help with CM case splitting process: For ERDC: Childcare.Policy@state.or.us For JPI, TA-DVS and TANF: TANF.Policy@state.or.us OCCS Medical questions: Yer Vue-Xiong at Christy Garland at Joyce Clarkson at Michelle Mack at Carol Berg at Vonda Daniels at Jewel Kallstrom at Date of Request Forms Q8: Can we give the customer a Date of Request (DOR) form to complete and submit to 5503? A: No. The DOR is an internal form that must be completed and sent to 5503 by DHS staff. Q9: How do we ensure a customer s DOR is maintained? A: Keep the form (or fax confirmation) in a file in the branch for 45 days to refer back to, if needed. Q10: If a worker is completing the DOR for a customer, how can they send it to 5503? A: Please fax the DOR form to 5503 so it can be picked up by their imaging system. You can fax up to 10 pages at the same time. You also have the option to the form as well. 2

3 Q11: Do staff need to complete a DOR form for each individual or the household? A: Only one per household is needed, the DOR in itself holds the request date and when 5503 follows up, they will capture household individuals. It is OK to note that the one person is applying for other family members. The DOR form has been updated with this new information. Q12: If a client requests medical on 10/1 but has a SNAP case pending, do we send the DOR form for medical? A: Yes. Q13: If a homeless client is requesting medical and we complete the DOR, what do we do about contact information? A: Ask how they currently handle mail. Otherwise, if they are using general delivery then use that address or ask for address where they can receive mail. Also note a number for phone messages if one is available. Deferrals and Extensions Q14: How are cases that expire being extended? A: It is a six-month, rolling extension. If a case expires in October, it will be extended until April, if it expires in December it will be extended until June. Q15: Have medical case renewals been deferred to a later date? A: Cases with medical end dates between October 2013 and March 2014 have had their renewals deferred. Those cases with medical end dates of September 2013 will not have their renewals deferred. Exceptions to the deferral process are: OP6 beneficiaries turning age 6 CEM, CHP, EXT, KCE, OPC beneficiaries turning age 19 MAA, MAF beneficiaries turning age 19 if not caretaker relatives SAC beneficiaries turning age 21 BCCTP beneficiaries turning age 65 OPU beneficiaries turning age 65, but only through 12/31/13 CEM beneficiaries when DUE need/resource item expiring and past end of CEM end date CEC beneficiaries when CDU need/resource item expiring OPP beneficiaries reaching the end of their post-partum protected eligibility EXT beneficiaries with an EMS or AE2 need/resource item ending MAA, MAF, EXT beneficiaries reaching the end of their post-partum protected eligibility and no dependent child MAA, MAF, EXT beneficiaries when only dependent child is turning age 19 OPC, OP6, OPP, MAA, MAF, EXT, CEM assumed eligible newborns turning age one, a 7210 is sent when the medical need/resource and AEN need/resource items both expire in the same month or the later of the AEN need/resource or medical need/resource item medical need/resource 3

4 Fast-track Enrollment Forms Forms MAA Q16: What parts of the Fast-track Enrollment Form do I sent to 5503? A: The Fast Track enrollment form is two-sided and 5503 needs both sides. Please be sure to send both the signature page and the CCO selection page. Q17: What do I do with Fast-track Enrollment Forms submitted before October 1? A: If your office receives a Fast-Track Enrollment Form, even prior to October 1, please date stamp the form with the date of receipt and send to Q18: Are people being directed to call DHS branches when they get a Fast-track Enrollment Form? A: No, they are being referred to the OHA Statewide Processing Center at or Cover Oregon at COVEROR ( ). Q19: If we know the client will be getting a Fast-track Enrollment Form, what do we tell them? A: First, ask the client if they received the form. If not, and the client wants medical, complete the DOR form. Q20: If a client becomes SNAP-eligible between now and January 1 st, will they qualify for OHP starting January 1 st? A: DHS will send a weekly data report of new SNAP participants to OHA will send the new SNAP participants who qualify the Fast-track Enrollment Form. Q21: When are the revised 415Fs landing in offices? A: The 415Fs were to arrive in branches by Wednesday, Oct. 2. Branches that did not receive a shipment of 415Fs should send an to: DHS-OHA.Distribution@dhsoha.state.or.us. Q22: If someone brings in the old 415F with medical questions after October 1, 2013, what do I do? A: Send a copy to 5503 by FAX or . Hard copies of the revised 415F will arrive in branches on or before Oct. 1, The revised 415F will be available online in multiple languages starting Monday, Sept. 30, 2013 at this link: Q23: We have heard that MAA deprivation no longer exists, is that true? A: For those cases that are being updated in the field with DOR prior to 10/1, continue to include deprivation in the eligibility determination. Q24: I noticed the MAA Income changed, how does that impact our work? 4

5 A: It changed on the CM system only. If your applicant is under the MAA income limit please adjust the income to zero so the computer will allow MAA eligibility. Please remember to narrate. Referrals Q25: Where do we refer clients with medical questions? A: Call the OHA Statewide Processing Center at Q26: How do we refer APD medical requests? A: For APD medical requests received in an SSP office, complete the DOR form and fax to the local APD office. Be sure to clearly indicate on the form that it is an APD referral from an SSP office. See the list of APD offices and fax numbers. (Full Link: RT%20JUNE% pdf) Q27: Can we send SNAP cases over to APD if there is an APD medical case and no other companion SSP case? A: If the adult is disabled/unable to work and future JPI eligibility in the future is not likely and no other companion SSP case exists, then you may send the SNAP case to the local APD/AAA. Q28: Is the Jobs Participation Incentive (JPI) considered an SSP companion case? A: Yes, JPI is considered an SSP companion case. SSP will need to keep the SNAP case if there is JPI eligibility or potential future JPI eligibility. Splitting Cases Q29: Can we PSET into 5503 to set-up a new case? A: You can but only if you already have the 5503 PSET. Q30: Will branches get lists of every case that needs to be split and transferred to 5503? A: No. The current expectation is for you to split cases as you are working them. If your branch chooses to proactively split and transfer additional cases earlier, they can do so. Q31. The branch usually processes the split of TANF/MAA cases with DORs before 10/01/2013. After 10/01/2013, who will be responsible for splitting the medical case? A: The current expectation is for branches to split cases as you are working them. If your branch chooses to proactively split and transfer additional cases earlier, they can do so. Q32: In the past we have been told when setting up a new case to look for old UCMS case numbers. We are now being told when splitting that we should generate a new case number. Is there a reason for this change? A: DHS and OHA leadership made the decision to generate brand new case numbers for OHA because it is a faster, cleaner and more accurate process. If we recycle an old case number, it may not have the correct payee which can cause problems, if not caught. It can also be much more work intensive to make all the necessary changes to an old number. CMU has received 5

6 many calls from staff struggling to recycle old case numbers so the decision was made to keep it simple. Transferring Cases TANF Q33: How will the auto transfer of SSP cases to APD/AAA offices work? A: We are still working on the process on which the cases will be transferred however they will be sent to the appropriate local APD/AAA office. Q34: Can 5503 transfer a case back to the branch if we need to make updates based on information provided prior to 10/1/13? A: 5503 can transfer the case back to you or you can have someone with PSET in your office make the update. Q35: How do we handle non-cooperation sanctions on clients when they don t cooperate with DCS? A: If the medical case is still in the branch, split the case, send medical and referral of sanction information to will take the actions and send the notices. 6