Update : CalWORKs Update CalWORKs Eligibility Under Quarterly Reporting

Transcription

1 Santa Clara County Social Services Agency page 1 Date: 06/21/04 References: ACL 03-18, ACIN Cross-References: CalWORKs Update #04-03, Food Stamp Update #04-13 Common Place Update #04-07 Clerical: Handbook Revision: Distribution: Yes Yes CalWORKs and CWES Update Distribution List Update : CalWORKs Update CalWORKs Eligibility Under Quarterly Reporting Background Assembly Bill (AB) 444 (Chapter 1022) requires the replacement of the current Monthly Reporting/Retrospective Budgeting system (MR/RB) with a Quarterly Reporting/Prospective Budgeting (QR/PB) system for the CalWORKs program. Statewide implementation of QRPB is targeted for completion by July 1, 2004, as counties transition on a staggered basis. Due to the magnitude of the impact on CalWORKs, QR/PB has had some unintended consequences to various areas of eligibility and to other related assistance programs. The California State Department of Social Services (CDSS) and State management staff will release policy information to provide clarity, instructions and to answer questions as issues are resolved. Policy Changes State policy changes were made to the CalWORKs program in order to apply Quarterly Reporting And Prospective Budgeting (QR/PB) principles. CalWORKs Handbook chapters will be revised on a flow basis. This Update includes revisions to various Chapters which affect: Beginning Date of Aid, Deprivation, Adding a Person, AU Composition, Senior Parent/Minor Parent, and Reduced Income Supplement Revisions The principles of quarterly reporting and prospective budgeting:

2 page 2 Update : CalWORKs Update Eliminates the Reduced Income Supplemental Payment (RISP). (MPP , MPP ) Eliminates the application of a zero grant suspense month. (MPP ) Eliminates the recalculation of the first two initial months of aid. Eliminates the readjustment period. Limits Property eligibility determination to one time per quarter. Limits Deprivation determination to one time per quarter. Changes the treatment of Lump Sum monies from income to property. Eliminates the application of discontinued/terminated income. Eligibility Determination CalWORKs eligibility must be established at the: Time of application, Redetermination, and Once per quarter, when the Quarterly Eligibility Status Report (QR 7) is received. (MPP ) Reminder: The applicant/recipient must complete the appropriate Statement of Facts when it is determined that additional eligibility factors need review and/or the redetermination is due. [See Chapter 9, and 11] Beginning Date of Aid (BDA) The Beginning Date of Aid (BDA) for applicants remains the same. The mandatory inclusion rules have not changed. QR/PB has changed the BDA when adding a person to an active AU. (MPP ) New Applications The Beginning Date Of Aid (BDA) must not precede the date of application. Aid begins on whichever date is later: The date of application and aid has been authorized, or The date on which the applicant meets all eligibility conditions. [See CalWORKs Handbook Section 3]

3 Update : CalWORKs Update page 3 Adding A Person The Beginning Date Of Aid (BDA) for persons being added to the AU is based on the date the person is reported to be in the home, and the affect adding the person has on the amount of the grant. There are two potential BDA for CalWORKs benefits when adding a person to an existing AU. If otherwise eligible, and ALL verifications are provided, cash aid begins as follows if the proposed budget calculation results in: 1. INCREASE IN CALWORKS GRANT AMOUNT: The BDA is the first of the month AFTER the change is reported. 2. DECREASE OR NO CHANGE IN CALWORKS GRANT AMOUNT: The BDA is the first month of the next payment quarter AFTER the change is reported. Proposed Budget The EW must determine, by completing a proposed budget, if adding the person to the AU will result in: Increase to the CalWORKs grant amount, Decrease to the CalWORKs grant amount, or No Change to the CalWORKs grant amount. If otherwise eligible and after all verifications are provided, the BDA is based on the results of a proposed budget computation when adding the individual as follows: If the CalWORKs Benefits.. Then the BDA is the... Increase First of the month following the reported change Decrease First of the month following the QR submit month, or Do Not Change First month of the next payment quarter. Adding a Newborn The following rules apply when adding an otherwise eligible newborn to an AU, [excluding a newborn subject to Maximum Family Grant (MFG)] for cash aid: If the... Then... Newborn is otherwise eligible, and the grant will increase, Mother has been receiving a Pregnancy Special Need (PSN) payment, Obtain necessary verification Add the newborn to the AU the first of the month AFTER the birth is REPORTED Discontinue the PSN at the end of the month the birth is REPORTED, and Add the newborn to the AU the first month AFTER the PSN has ended.

4 page 4 Update : CalWORKs Update If the... Then... Newborn has income (e.g., child support paid on behalf of the child) that would render the AU ineligible or would result in decreased benefits, Recipient reports the birth for the first time on the QR 7, Continue the PSN payment through the end of the quarter. Add the newborn the first month of the next payment quarter. Reminder: A 10-day NOA is required when discontinuing the PSN. Father and the Newborn If otherwise eligible, when the father of the newborn is living in the home, but is excluded from the AU until the child is born, the father and the newborn will be added to the AU at the same time as follows: Add to AU on the first of the month AFTER the REPORT of the birth when: All verifications have been received, and If the grant will increase. If adding them to the AU would result in a decrease in benefits, add the first month of the next payment quarter. If the mother has been receiving a PSN payment, the EW must: Discontinue the PSN at the end of the month the birth is reported, and Add the father and the newborn to the AU the first month after the PSN payment is discontinued. Adding an MFG Newborn Aid for a newborn subject to the MFG rule begins the first month of the next payment quarter AFTER the birth is REPORTED, as there is no change to the Cash Aid amount. When the current payment quarter includes the PSN payment, the PSN must be discontinued at the end of the payment quarter. Add the MFG child to the AU the first month after the PSN payment is discontinued. Adding An Optional Person The SAWS 1, QR 2 or the QR 7 is considered an application/request for adding an optional person. (MPP )

5 Update : CalWORKs Update page 5 Reminder: The applicant/recipient must complete the appropriate Statement of Facts form when it is determined that additional eligibility factors need review and /or the annual redetermination is due. Cash-Linked Medi-Cal BDA Cash-linked Section 1931(b) Medi-Cal is approved for the new AU member the first of the month they enter the home, provided the individual meets all CASH eligibility conditions and the AU reported timely. When a new member is eligible but is pending addition to the CalWORKs AU, issue Medi-Cal in the same CalWORKs AU using participation code (PC), [A] for adult, or [C] for child. If the case is discontinued at the end of the current payment quarter, prior to the new member s addition to the CalWORKs AU, this individual will not be eligible for Medi-Cal under Edwards 38 program. Treatment of Income The QRPB principles allow partial alignment of the CalWORKs and Food Stamps program in the treatment of income and property. The following are changes to the CalWORKs program: (MPP ) Lump Sum Payments Lump Sum payments are treated as property in the month of receipt. Separate Income Funds awarded a married person from his/her spouse in a civil action for personal injuries are considered that spouse s separate property. Community Income Funds awarded a married person in a civil action for personal injuries are considered community property except as provided in Section and Availability of Income Monthly recurring unearned governmental benefits (e.g., Social Security benefits, or Veterans benefits, etc.) are considered available in the month the payment was intended or reasonably anticipated, rather than the month actually received. Notice of Action (NOA) A notice of action (NOA) is required when the QR 7 is processed. A NOA is also required when a mandatory mid-quarter report is received and results in: A change to the amount of the grant (increase/decrease), No change to the amount of the grant, Discontinuance due to financial ineligibility, or

6 page 6 Update : CalWORKs Update A change in the recipient s status. No Change NOA CalWORKs QR/PB rules require that a No Change (NC) NOA be sent to the recipient when a Voluntary Mid-Quarter change report proposed budget: Results in no increase to benefits, Results in a decrease to benefits When requested verification, (which will result in an increase to benefits) IS NOT provided within ten (10) days of the reported change. Budget Calculation When a Voluntary Mid-Quarter change affects the budget calculation, CalWORKs QR/PB requires a budget to be completed and attached to the No Change NOA. The proposed budget is documentation that the reported change DID NOT INCREASE the benefits. The automated Scratch Budget was developed to meet this requirement. The AFDC Budget Worksheet (SC 1212) is obsolete and the state has not yet approved the new CalWORKs Budget Worksheet QR 30. Note: The automated Scratch Budget is located on the SSA Intranet under the Handbooks menu. Other The following are other changes or clarifications not related to QR/PB: CalWIN Conversion For CalWORKs, the Case Data System (CDS) requires all of the following entries on the [PDT1] screen: Valid deprivation code for each child, including unborn child, and Social Security Number (SSN) verification code, and When deprivation is based on absent parent, the absent parent s name, date of birth, gender, and SS# using person number (PN) 90-94, and Relationship coding of parents to their children and children to parents, including absent parents. Reminder: Eligibility for the PSN payment does not require that the unborn have deprivation. It is based solely on the pregnancy to maintain the health of the mother and unborn. Note: A deprivation code is not entered when there is no deprivation for the unborn.

7 Update : CalWORKs Update page 7 [See CP Update for detailed instructions] Social Security Numbers Effective January 2004, Social Security Numbers (SSN) are no longer printed on checks issued by the Federal Department of the Treasury. This includes Social Security, Supplemental Security Income (SSI)/ State Supplemental Payment (SSA), and Interim Assistance Reimbursement (IAR) checks. The removal of the SSN from all Treasury checks is part of the Department of Treasury s efforts to protect the privacy of the individual s SSN and help reduce the opportunity for identity theft. Implementation The Quarterly Reporting changes are effective May 1, Documentation QR/PB requires increased interaction between the EW and the recipient. As a result, documentation is critical. The EW must document EVERY INTERACTION, the action taken and why. Documentation in the case record must reflect the applicant's situation. Discrepancies must be clarified. Do not assume what is occurring. Determine what is actually happening and then take appropriate action based on the situation. Regardless of what is occurring, documentation and verification must be in the case record so that the Supervisor, Quality Control Examiner, State Auditor, IEVS Examiner, Appeals Examiner, co-worker, or anyone who reviews the case is able to accurately determine eligibility and grant level. Documentation is critical for the County to maintain federal and state funding and to avoid claiming penalties. QR 7 Report Information reported on the QR 7 must be consistent with other information which the EW has verified to be accurate. When the QR 7 is processed, documentation not found elsewhere in the case record, must be recorded on the Contact Action Summary (SC 163). Case documentation will determine if the action taken is correct. Items to be considered and documented include: Whether anticipated income will be different from income the recipient reported on the QR 7, Income the recipient states they expect to receive in the future, Changes reported, and Whether the changes can be/were verified. Mid-Quarter Report Recipients may report changes verbally (in person or on the telephone) or in writing, outside of the QR 7 process. These reported changes are either Mandatory or Voluntary reports.

8 page 8 Update : CalWORKs Update The Mid-Quarter Summary Report, is a documentation checklist to meet the Mid-Quarter Mandatory and/or Voluntary documentation requirements when changes are received verbally. No additional entry is required on the SC 163 for mid-quarter changes if the SC 163 MQR checklist is completed. Reminder: Mid-Quarter Mandatory and /or Voluntary changes reported on the QR 3 require documentation on the SC 163 if the SC 163 MQR is not used. Data Systems A new member who meets all eligibility criteria when pending addition to the CalWORKs AU is entitled to Section 1931(b) cash-linked Medi-Cal effective the first of the month they entered the home if they report timely. Medi-Cal may be issued in the same CalWORKs AU temporarily using an [A] or [C] participation code (PC). Note: Until CDS is enhanced, the CalWORKs aid-type will be displayed on the MEDS record. The PC must be changed to the appropriate code effective the first of the month the individual is cash eligible and is added to the CalWORKs AU. Scratch Budget The Scratch Budget can be accessed on the SSA Intranet where the CalWORKs and Food Stamps Handbooks are located. Forms The following forms are revised as of May 1, 2004: Number Title Status CW 40 SAWS 2A CalWORKs Reduced Income Supplemental Payment Request Rights and Responsibilities and Other Important Information Obsolete Replaced by SAWS 2A QR SC 1212 AFDC Budget Worksheet Obsolete for District Office EWs. It will be used by ASB for overpayments through March 31, Additional changes to existing forms or new forms required by the implementation of QR/PB will be issued when received from the State using the form change Update process. The obsoleted or prior versions of forms must be recycled per district office procedures.

9 Update : CalWORKs Update page 9 Other Programs In addition to CalWORKs, QR/PB applies to the Food Stamps (FS), Refugee Cash Assistance (RCA), and General Assistance (GA) programs. Supervisors Supervisors must review this material with their unit no later than June 24, Clerical See Forms, Data Systems. Kudos I would like to thank Staff Development trainers, specifically; Moises Martinez, Binh Pham, Lynh Nguyen and Vilay Moth for an outstanding job in training all eligibility staff. The material and charts provided are invaluable. In addition, I would like to thank Gabriel Munoz, Management Analyst in the Administrative Support Bureau who modified and enhanced the Scratch Budget provided by Fresno County that is used to provide the EW with an automated CalWORKs and Food Stamp budget, in order to generate the CalWORKs No Change NOA. KATHERINE BUCKOVETZ, DIRECTOR Department of Employment and Benefit Services Contact Person(s): Sandra Rita Carvalho, Program Coordinator, (408)

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