Department of Human Services
Families First Online Policy Manual
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.
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.
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.
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.