|
|
Department
of Human Services Families
First Online Policy Manual Continuing
Responsibilities |
Revised: |
35.3 |
CHANGES BETWEEN RENEWALS |
|
|
|
Some cases may need more frequent contact than every twelve months
because of changes in the AU’s circumstances that can be expected. In those instances, the caseworker should
set an “expected change” alert to ensure that the changes are investigated
and acted on in a timely manner. The following are cases that might require more frequent contact. ·
Cases in
which the record shows that the recipient has failed in the past to give
accurate information and/or has failed to report promptly when changes occur
in the AU’s circumstances. ·
Cases in
which one or both parents do not have the mental/physical ability to act
responsibly and/or to give accurate, reliable information. Case Adjustments When changes occur between renewals that affect the AU’s eligibility
or benefit level, the caseworker/client rep must adjust the case. The AU’s and the county office’s
responsibilities regarding changes are listed below. ·
Client
Responsibilities The AU must report the following changes
within 10 days of the date that the changes become known to the AU: -
All changes
in source and/or amount of income. -
When cash on
hand, stocks, bonds, and money in a bank account or savings institution
reaches or exceeds the resource limit. -
When the AU
obtains a vehicle. -
All changes
in household composition. -
Changes in
residence. Changes may be reported by telephone, in
person, or by mail using the Change Report Form, HS-047, to their caseworker
or client rep, whichever is in charge of case management. Changes may also be reported by calling the
Family Assistance Service Center (FASC).
The ten-day period will begin with the date the change becomes
known to the AU. The change will
be considered as reported by the AU on the date the report of change is
received by the county/FASC or, if mailed, the date the envelope is
postmarked. Each Change Report Form
will be date stamped immediately when received in the county office. The date that the change was reported or
post-marked must be documented in the eligibility and case management
system. If the AU failed to report a
change and received benefits to which it was not eligible, the caseworker
will refer the case to COTS so that an overpayment claim can be prepared. ·
Caseworker/Client
Rep General Responsibilities -
The county
office will not impose any reporting requirements on the AU. -
The
caseworker/client rep will not treat the submission of changes as a waiver of
the AU’s right to a ten-day Adverse
Action notice unless the recipient indicates in writing that he/she
understands that the report will reduce or terminate assistance. -
The
caseworker/client rep will provide a Change Report Form and “postage paid”
envelope to each AU at approval, at renewal and when a Change Report Form is
returned by the AU. A Change Report
Form will be provided to the AU more often if necessary. The caseworker will encourage the AU to use
the Change Report Form when a change is being reported. -
The
caseworker/client rep will act on the changes reported by telephone and in
person in the same manner as those reported on a Change Report Form. -
The
caseworker must inform the AU of its responsibility to report changes within
ten days at application and at each renewal. -
The
caseworker will take prompt action on all changes to determine if the changes
affect the AU’s eligibility or benefit level.
-
In
accordance with the American with Disabilities Act, if it becomes known to
the Department that an individual is disabled and requires additional
assistance, staff should provide reasonable accommodations. For example, if
the individual has a visual problem and has trouble reading the notices, the
caseworker should provide enlarged print notices. Increasing Families First Benefits The caseworker/client rep will take prompt action when an AU reports a
change that increases the Families First benefits. Once eligibility has been established,
the increase in benefits will be made effective with the month following the
reported change. A change reported
during recurring processing will be effective the second subsequent month,
except when the change is to add an individual. When adding an individual who is required
to be included in the AU, the benefits will be increased effective the date
the individual entered the home or date of birth for a newborn. If the individual is an optional AU member,
the effective date of eligibility will be the date the request was made to
add the individual to the AU. Terminating Families First Benefits
for Cases (with or without a work requirement) Closing for a Non-sanction
Reason When the caseworker/client rep identifies a potential case closure for
a non-sanction reason, he/she will attempt to contact the caretaker by
telephone to: ·
Discuss the
reason for the potential closure. ·
Establish
good cause, if applicable. ·
Attempt to
correct any problems or misunderstanding that may have occurred. Note: If
the caseworker/client rep attempts a call and the line is busy, the
caseworker must attempt another contact for each time the line is busy. If the line is out of order, then no
further attempt to contact by telephone is necessary. In addition, if the client does not have a
telephone, but a message number is listed, the caseworker/client rep will attempt
to reach the participant at a contact number and leave a message. Exceptions: The following closure reasons do not
require a telephone call prior to closure. ·
The
caretaker requests the closure by a verbal request to the DHS supervisor or
in writing. ·
The
caretaker requests the closure by a written request and a DHS supervisor has
reviewed it. ·
The AU’s
income or resources exceed the Families First limits. ·
The entire
AU has moved out of state. ·
There are no
children in the AU within the age limits. ·
All AU
members have died. ·
The only
adult in the AU has died or left home. ·
All AU
children are eligible for benefits in another AU. ·
All AU
children are in foster care or have been adopted. ·
All AU
members receive SSI. Prior to closing the Families First case: ·
Check the
case to ensure that there have been no changes that would affect the case
status. ·
Check to be
sure that there is not a potential sanction closure reason. ·
Check to
ensure that the case has not reached time limits. Do not close a case if a sanction or time limits are potential closure
reasons even if the closure reason is for a reason other than sanction or
time limits. Sanction and time limit
closures take precedence over other closure reasons. Example: A client is a “no show” for a renewal appointment. The caseworker checks the eligibility and
case management system, and finds the case to be at 60 months. A time count review must be completed and
the case closed for both time limits and failure to keep a renewal
appointment. Written and Verbal Requests for
Case Closure DHS staff must not advise individuals about whether or not to close
their AUs. Instead, staff is to
provide accurate policy information so that the caretakers can make informed
decisions about the status of their Families First benefits. Written case closure requests made to individuals other than a DHS
supervisor can be closed if a DHS supervisor has reviewed the case. Whether the closure request is written or
verbal, the DHS supervisor will document in the eligibility and case
management system: ·
The reason
for the closure request; and ·
That the DHS
supervisor discussed the closure with the caretaker, if the request was
verbal; and ·
That the DHS
supervisor reviewed the written request; and ·
That the
client’s decision was based on accurate Families First policy, without
instruction from DHS staff. Note: Check the time count prior to authorizing
closure based on a verbal or written request.
If the case is over the time limit, review the time count prior to
closure. If the count holds, close the
case for time limits and at the client’s request. Advance Notice of Adverse Action If the AU reports a change that will reduce or terminate the Families
First benefits or remove a person from the AU, then action cannot be taken
until the ten-day adverse action notice has expired. The adverse action notice period will allow
the AU to provide any information/verification that will alter the decision
to reduce/terminate the benefits or request an Appeal for a Fair Hearing and
continue the benefits pending the outcome of the hearing. If the AU presents evidence during the
ten-day period that establishes that the AU is still eligible, benefits will
be reinstated without a new application.
The adverse action period is also the conciliation period for cases
closed for sanction. The ten-day adverse action period count begins the day after the day
that the Notice of Adverse Action is mailed to the AU. If the tenth day falls on a weekend or
holiday, the tenth day will end at the close of business on the next working
day. The Notice of Adverse Action must
be mailed to the AU at least ten days prior to the effective date of the
action. If the recipient requests an
appeal of an adverse action within ten days of the notice, he/she must be
given the option of continuing the benefits pending the outcome of the
appeal. If the recipient opts to continue
benefits, the caseworker must authorize the benefits at the pre-change
level. The caseworker must inform the
recipient that if the county is upheld in the appeal decision, the benefits
paid during the period between the hearing request and the decision are
subject to recovery. If the client contacts the caseworker within the 10-day adverse
action period indicating a
willingness to remedy the reason for closure, the case must be reopened immediately and benefits authorized
at the pre-closure level. A new
application is not required. The
reason for closure will be “remedied” after the case is reopened. If appropriate, good cause should be
verified. If the client fails to
correct the problem after the case is reopened, the case will be closed again
with a Final Closure Notice. After the
Final Closure Notice has been issued, the case will not be reopened until the
client reapplies and takes whatever steps are necessary to correct the
closure reason. The client will not
get another 10-day adverse action period.
If the recipient reports a change in circumstances or presents
additional evidence during the advance notice period that changes the
decision on the case, the benefits should be continued at the appropriate
level based on the new information. If
the new information does not affect the decision, the reduction or
termination of benefits should become effective as specified in the notice
originally. Sanctioned Cases In the case of a closure for a sanction due to non-compliance with
work requirements, voluntary quit, or the failure of a minor parent to attend
school, the client must comply for 5 days before the case can be
reopened. There are no exceptions to the requirement to report changes within
ten days of the date the change became known to the AU. However, there are exceptions to the
requirement that the caseworker give a ten-day notice of adverse action. A ten-day notice of adverse action is not
required when: ·
DHS has factual
information confirming the death of the recipient or of a Families First
payee and no person can be named as alternate payee; ·
DHS receives
a clear written statement signed and dated by the recipient that he/she no
longer wants Families First benefits. (Bulletin 4, FA-09-04) Note: DHS
staff must not advise individuals about whether or not to close their
case. Instead, staff will provide
accurate policy information so that the caretakers can make informed
decisions about the status of their cases. ·
The
recipient has been admitted or committed to an institution where he/she is
not eligible receive Families First benefits. ·
The
recipient has entered a skilled nursing home or intermediate care facility
and vendor payments will be authorized through Medicaid. ·
The
recipient’s whereabouts are unknown and agency mail directed to him/her has
been returned by the Post Office indicating no forwarding address (if the
individual’s whereabouts become known during the payment period, however, the
recipient’s checks to which he/she is entitled will be made available). ·
The
recipient moves out-of-state and DHS has established that he/she has been
accepted for assistance in another state. ·
A Families
First child is removed from the house as the result of a judicial
determination or is voluntarily placed in foster care by his/her parents or
legal guardian. ·
DHS has
received notification that a member of the AU has been approved for SSI. ·
Assistance
is to be discontinued or reduced as the result of an appeal decision which
upholds the county office. The caseworker is not required to obtain verification when the AU
reports changes that terminate the Families First benefits. However, any reported change that increases
or decreases the benefits or that is reported by someone other than an AU
member must be verified in accordance with the policies detailed in the
Verification Chapter. Documentation The caseworker/client rep must record all changes on the appropriate
screens and give full explanation of the changes in the eligibility and case
management system. This documentation
should include: ·
When the
change was reported. ·
How the
change was reported. ·
What was
used to verify the change. ·
What action
was taken on the change. ·
If the AU
filed an Appeal for Fair Hearing during the ten-day notice period and whether
or not continued benefits were requested. Eligibility and Case Management
System Documentation for Case Closures ·
Document the
circumstances causing case closure. ·
Document the
attempt to contact the caretaker by telephone (if appropriate) ·
Document the
outcome of the attempt (if the AU has no telephone, document this also). ·
Document the
appropriate eligibility and case management system closure reason codes. ·
Document the
closure date and closure effective date. ·
Document the
explanation that the AU can receive child support and Families First at the
same time, if the caretaker verbally requested case closure because of child
support. Closures Based on Client request The DHS supervisor must document the eligibility and case management
system explaining: ·
The reason
for the closure; and ·
That the DHS
supervisor discussed the closure with the caretaker, if the request was
verbal; or ·
That the DHS
supervisor reviewed the written request and the decision was based on
accurate Families First policy, without instruction from DHS staff. When a change is reported, the caseworker/client rep must: ·
Determine if
the change affects the AU’s Families First eligibility or benefit level. ·
Record all
pertinent information on the appropriate eligibility and case management
system screens. ·
Obtain all
necessary verifications. ·
Authorize
the new benefit level or case closure so that a notice will be sent to the
AU. |
|