Department of Social and Rehabilitation
Daniels, Acting Secretary
Service Delivery - Candy
Shively, Deputy Secretary (785)
and Employment Support -
Bobbi Mariani, Director (785) 296-3349
lives today and tomorrow
EES Program Administrators
All Asst. Regional Directors
September 16, 2005
Bobbi Mariani, Director
Economic and Employment Support
Implementation Instructions -
KEESM Revision 25 Effective October 1, 2005
This memo provides implementation instructions and information for the
following October 1, 2005 policy changes and clarifications in the Kansas
Economic and Employment Support Manual (KEESM):
• Exemption of Veteran’s Educational Income
Foster Care Child in Relative’s Home
TAF Participation Rate Requirements
Special Service Allowance
- MULTIPLE PROGRAMS
Exemption of Veterans Educational Income - See Summary of Changes,
Item I, A, 3. and Section 6400(18).
With this revision, Veterans Educational Income is now exempt for persons
in post secondary education. This exemption applies to all applications
and reviews received or processed on or after October 1, 2005. The exemption
is also effective for all ongoing cases starting with the benefit month
of October 2005.
To help staff identify affected cases, a report has been prepared
that will identify all open FS, GA, TAF, and MS cases with VA OT
on the UNIN or UNIE screens. Persons listed have VA OT income, are
coded IN, DI or DF, and are between the ages of 16-40. Child care
could not be identified as KsCares does not currently have this income
code. These cases shall be addressed at the next case review. Statewide
only 98 cases were identified using the above criteria. Each case listed
on the report must be evaluated to determine if the VA income being
counted is educational income. If it is NOT educational income, then
it is not
exempt. However, if it is VA educational income, then the income should
be coded as EE on UNIE or XA on UNIN for the benefit month of October.
If necessary, supplemental benefits for October will need to be provided
if the change is not made in time to affect the regular monthly issuance.
If cases are later discovered (not identified on the printout) with
Veterans Educational income that should have been exempted, restored
shall be provided back to the benefit month of October 2005. Notify
all households the reason their benefits are increasing. An income
VE - Veteran’s Educational Income (EX) is being added to KsCares
to be used with cases processed on or after October 1, 2005.
Foster Care Child in a Relative’s Home - See Summary of Changes,
Item III B, Section 2210 and Policy Memo 05-07-03.
Policy Memo 05-07-03 was issued in July 2005 replacing EES Policy Memo
01-02-02. The purpose of this Policy Memo was to: Provide EES staff with
guidelines regarding TAF eligibility for children placed with a relative
by a Child Welfare Community Based Service (CWCBS) provider; eliminate
duplicate payments to the household; and emphasize the importance of
communication between Children and Family Service (CFS) social workers
and EES staff. This memo also provided clarification that there can be
TAF eligibility during the interim period before the approval of the
licensed or approved home unless the CWCBS provider is making payments
to the relative during this time.
Section 2210 is modified in Revision 25 to indicate that relatives
working with CWCBS providers may receive TAF during the interim period
before the relative’s home is licensed or approved. This section
is also updated to cross reference Policy Memo 05-07-03.
The following example illustrates the modification to Section 2210:
Jane is in the custody of SRS and placed with her aunt by the CWCBS
provider. The provider explains to Jane’s aunt that the following
options are available: Financial support from the CWCBS provider; TAF;
or become payee of Jane’s SSI/SSA (which is not an available option
in this situation). Jane’s aunt decides that she would like to
receive financial support from the CWCBS provider. The provider encourages
Jane’s aunt to become a licensed or approved foster home through
KDHE. Jane’s aunt may either receive TAF payments or financial
support from the CWCBS provider until she becomes a licensed or approved
foster home. EES and CFS staff need to communicate closely to assure
that there is no duplicate payment during this time.
- MEDICAL ASSISTANCE
MS-2126, Notification of Facility Admission/Discharge - The MS-2126
has been revised and renamed. The primary objective of the revision is
to determine payment eligibility of the facility. Additional elements
have been added to the document to capture relevant information necessary
to make this decision. The previous version of the form required additional
follow-up with the facility in many instances. The new version is also
designed to facilitate change reporting by the facility, including changes
in the level of care. The process is being expanded for use by other
facility types as well, including swing beds and Level VI facilities.
The facility continues to be responsible for initiating the MS-2126, under
the conditions specified in KEESM 8184.1. An MS-2126 is required for a new
admission requesting Medicaid payment, any change in level of care within the
facility, a discharge from the facility or hospital leave in excess of 30 days.
- Section 1: Resident Information - This section has been revised
to capture the name of any responsible agency (for example, a child welfare
contractor) as well as the relationship of the named responsible party
to the facility resident.
- Section II: Facility Information - This section has been modified
to capture the name of the agency or person who placed the resident (
for example, a community based screening team or a court order). All
facilities must include CARE or Screening information. For instances
where one isn’t required (for example, swing bed) the reason must
be stated. The provider number was removed from this section as it is
no longer relevant to payment approval, as long as the provider is a
- Section III: Facility Placement/Discharge - This section has been
expanded to capture detailed information on the level of care provided
in the facility and prior to admission/payment request. Note that State
Hospitals may continue to use forms previously designed for use by the
hospital with the permission of the SRS Regional Service Center.
- Section IV: Hospital Leave - This section has been clarified that
a new MS-2126 is only needed when the hospitalization exceeds 30 days.
- Implementation Issues
The form is to be reproduced locally by the facilities as needed. Nursing
facilities are to be encouraged to discard older versions of the form.
However, older versions of the form may be accepted as long as all critical
information is reported in a timely manner in the case situation.
- Level VI Issues
Earlier this year, Medicaid payment processes were modified to begin
evaluating the level of care present on the MMIS, as passed through from
KAECSES. To ensure information is communicated effectively and timely,
information has been added to the MS-2126 specifically for Level VI facilities.
As with other facility types, the Level VI facility is responsible for
ensuring any screening requirements are met. However, the eligibility
worker is no longer responsible for verifying screening requirements
are met for Level VI facilities, as other SRS staff are responsible for
- Contact Persons
In order to ensure a smooth flow of information between the Level VI facilities
and eligibility staff, specific contact persons have been designated to
handle these issues.
- Facility Contacts
Each Level VI facility has been assigned a specific contact
person within SRS. This individual will serve as the single
contact person and general repository
of information for the facility. The facility will send all new MS-2126
payment requests to the designated individual. The designated
contact will then coordinate
with the assigned eligibility worker to ensure Medicaid eligibility and
eligibility for payment are determined. Because a number
of Level VI residents
may also be foster care recipients, contact with both CFS and JJA staff
as well as eligibility staff will be necessary.
The contact points for the facilities are in the KHPA PTRF Training material.
- Regional Contacts
SRS Region and the HealthWave Eligibility Clearinghouse shall appoint a single
contact person for all general Level VI issues within the region. The regional
Level VI contact point will coordinate all Level VI issues within the region,
including requests from specific facility contact persons.
Regional Level VI contacts are in the
KHPA PTRF Training material.
- Eligibility Process
Eligibility staff have requested additional information in order to
process Level VI requests. The following policies and processes are not
new, but are offered as supplemental material to the new MS-2126.
- Length of Stay - For youth age 18 and younger, it is
necessary to determine the anticipated length of stay in
the facility (KEESM 8183
and specified references). If the stay is NOT expected to last at least
30 days, independent living budgeting applies. Generally, the child is
included in the assistance plan applicable prior to admission. The CI
program is not appropriate for stays which do not exceed 30 days, unless
the individual is age 18 or over.
If the stay is expected to last at least 30 days, long term care budgeting
applies. Generally, eligibility is determined on the CI program in these
situations. Although parental income and resources are not included,
the parent is responsible for completing the application and providing
any necessary documentation.
- Current Recipients - When a current Medicaid recipient
enters a facility the first step is to determine if
the person will remain covered under the
current program. Youth in foster care (SRS or JJA custody) or adoption
support related programs will continue coverage in
these categories. Patient liability
does not apply to foster care youth. However, for youth in adoption
support programs, patient liability is determined and
the subsidy is included in the
determination. An off-system paper budget is required to determine
the patient liability in these cases.
For other current Medicaid recipients under age 18, if the individual
enters a Level VI facility for a stay not to exceed 30 days, no changes
in the case are necessary. Independent living budgeting applies, and
the current program continues. In order to approve facility payment,
an MS-2126 is required. LOTC must be completed, with a patient liability
of $0 unless a spenddown exists. For Medically Needy programs, the spenddown
amount may be used as a patient liability to meet the spenddown.
NOTE: If the child entering the facility is included on an MA CM or
MP case in the HealthWave Clearinghouse, the Clearinghouse is responsible
for ensuring LOTC is properly coded for the child. As the child will
continue with the current assistance plan, no additional action is necessary.
However, for Medically Needy programs the case will be sent to the field
for a full determination.
If the stay is anticipated to last 30 days or more, long term care budgeting
applies. A new application is required and eligibility shall be redetermined
based on LTC rules. The CI program is generally used in these situations. For
cases in the HealthWave Clearinghouse, the Clearinghouse is responsible for
ending participation on the current case. The field is responsible for establishing
ongoing eligibility under the new program, including determination of any patient
liability, completing LOTC and notifying the beneficiary/representative and
If a current HealthWave XXI recipient enters a Level VI facility, a
Medicaid determination must be completed, beginning with the date of
entrance. Coverage of Level VI placements is not included in the HealthWave
XXI plan. Similar to the process outlined for stays exceeding 30 days,
the SRS regional office is responsible for completing the Medicaid determination.
The Clearinghouse is responsible for terminating HealthWave XXI coverage
under the current case number.
- Level V vs Level VI
Level V facilities are not considered medical treatment facilities.
Therefore, long term care budgeting does not apply to residents of Level
V facilities. Independent living rules, including the temporary absence
provisions, are used to determine eligibility for persons living in a
Level V facility. In most cases, the child will be included in the assistance
plan prior to entrance in the Level V facility.
If a spenddown results, the charges of the Level V facility are not
allowable against the spenddown. Patient liability does not apply to
Level V facilities, as long term care is not applicable. These cases
are processed by the SRS regional office or the HealthWave Clearinghouse,
depending on where the application is received.
Special notices are currently in development and will be announced
through SRSTSC when available.
- SUCCESSFUL FAMILIES
- TAF Participation Rate Requirements - See Summary of Changes,
Item IV, B, 1 and Section 3110.
The federal TANF work participation report was modified in June 2005
to consider the following situation as a One-Parent household rather
than a Two- Parent household for federal work participation reporting
Boyfriend/girlfriend (BG Relationship Code) situations where one parent is
under age 18 and not emancipated
The definition of a Two-Parent household is modified to reflect this
change in Section 3110.
The following example illustrates this definition modification:
Bob (age 21), his girlfriend Ann (age 17) and their mutual child, Ben
(age 13 months) receive TAF assistance. Bob works 20 hours per week and
Ann is working on her GED 10 hours per week. This case meets the federal
work participation requirement for a one-parent household. Prior to the
June federal report programming modification this situation would have
been considered a two-parent household, and the household would have
failed to meet the federal participation requirement.
- Special Service Allowance - See Summary of Change, item IV,
B, 2 and Section 3411.2.
EES staff have a great deal of flexibility in the authorization
of work program support services. Clarification is being added
two possible uses of Special Service Allowance funding to promote
the use of work experience and also to provide payment to clients
participating in a “job try-out” as part of a work assessment.
These payments are the Work Experience Reimbursement Allowance and
the Work Assessment Reimbursement Allowance.
- Work Experience Reimbursement Allowance. This procedural
information about the Work Experience Reimbursement Allowance
was originally contained
in the KEESM Revision #14 Implementation Memo (dated April 18, 2003).
That information is being repeated in this memo for ease of reference.
EES staff have the flexibility to issue TAF clients participating in
work experience EES (profit and nonprofit) a Work Experience Reimbursement
Allowance for additional costs associated with work experience participation.
The Work Experience Reimbursement Allowance is considered exempt income
in the determination of cash and food stamp benefit amounts.
NOTE: TAF clients participating in work experience could be eligible
for other support services (i.e., transportation, special services allowance,
etc.) in addition to the Work Experience Reimbursement Allowance if there
is a documented need.
Calculation of the Work Experience Reimbursement Allowance:
Work Experience clients would routinely be assigned 24 to 40 hours
per week. At the end of each month of the work experience assignment,
the total number of work experience hours worked in that month based
on the work site monthly report are multiplied by the federal minimum
wage. The gross amount of the TAF grant and gross amount of the food
stamp benefit for the month including any supplemental payments during
the month, are added together. If the TAF/FS total is greater than the
number of hours worked multiplied by the federal minimum wage, there
will be no Reimbursement Allowance. If the hours worked total is greater,
the TAF/FS total will be subtracted from the hours worked total and the
difference is issued to the client as a Work Experience Reimbursement
This Work Experience Reimbursement Allowance payment would be made
monthly. Payment Type is SS WP (Special Services ) and WP Service for
Payment Code, LR Labor Standard Work Experience Reimbursement Allowance,
are to be used to identify these payments.
EXAMPLE of Reimbursement Allowance Calculation :
The client has worked 160 hours in work experience in February. 160 X $5.15
= $824.00. Gross amount of February cash ( $300.00) and food stamp benefit
($ 141.00) total is $441.00. Since the hours worked at minimum wage is greater
than the gross amount of cash and food stamp benefits, the EES Specialist
will issue the difference of $383.00 ($824.00 - $441.00 = $383.00) as a Work
Experience Reimbursement Allowance and send the W808, Work Experience Reimbursement
Allowance Notice, to notify the client of the payment. A Work Program Activity
code, WXP Work Experience With For-Profit Employer, is available and should
be utilized when a client is assigned to a for-profit work site assignment.
The calculation of the Work Experience Reimbursement Allowance is based
on the information known at the time of the calculation. A Work Experience
Reimbursement Allowance would not be considered an incorrect payment
if information that would have resulted in a different payment amount
is discovered after the calculation and issuance of the allowance. For
example, in the situation above it is later determined in April that
the correct benefits for February cash should have been ($350.00) and
the correct food stamp benefits should have been ($175.00) for a total
benefit of $525.00. The client is issued those additional cash and food
stamp benefits for February in April. Based on those benefits, the client
would have been eligible for a $299.00 ($824.00 - $525.00 = $299.00).
Work Experience Reimbursement Allowance rather than the $383.00 payment
received. The $84.00 difference would not be considered an overpayment
because the Allowance was based on the information known at the time
of the calculation. The supplement issued in April of February cash and
food benefits would be used in the calculation of the April Work Experience
- Work Assessment Reimbursement Allowance.
EES staff have the flexibility to compensate work program clients for
participation on a worksite as part of a work assessment. Following are
a couple of examples of when this payment might be utilized:
- EES is piggy-backing on a VR Community Based
Work Assessment Pay for Performance Agreement. This agreement
provides for compensation
to the client for up to 80 hours of participation at a
as part of a work assessment. At the completion of
the work assessment,
Assessment Reimbursement Allowance may be used to compensate
the client for up to 80 hours of participation at minimum
- A Contracted Employment Service Provider places
EES clients on a worksite as part of the work assessment.
The Work Assessment Reimbursement
Allowance may be used to compensate the client for up to 80 hours of
participation at minimum wage.
Payment Type SS WP (Special Services) and WP Service for Payment Code,
WA, Work Assessment Reimbursement Allowance, are to be used to identify
The Work Assessment Reimbursement Allowance is considered exempt income
in the determination of cash and food stamp benefit amounts.