STATE DEPARTMENT OF SOCIAL
State Commissioner's Letter -
AND REHABILITATION SERVICES
Integrated Services Delivery
September , 2000
Docking State Office Building
Room 681 - West
Topeka, Kansas 66612
(Code 1)
TO: Area Directors
Economic and Employment Support Chiefs
Economic and Employment Support Staff
Social Service Chiefs
Other Staff
Re: Kansas Economic and Employment Support Manual (KEESM) Revision
No. 3
PURPOSE OF LETTER
This letter transmits Revision No. 3 of the Kansas Economic and
Employment Support Manual. This revision incorporates changes regarding individuals
applying for prior medical assistance, good cause for failure to cooperate with CSE or
work related requirements, time-limited assistance, family continuous eligibility period,
removing/adding a child to a plan (HealthWave, Poverty Level Medicaid and MA CM), TAF
participation requirements, updated component terminology, effective date of AJS and EAP
assignments, and expanded eligibility for Welfare-to-Work. This revision also incorporates
changes regarding the severing of parental rights, countable income from exempted trusts,
self-employment changes, an increase in the Standard Telephone Allowance, responsibility
for suspending NF payments, SED waiver changes, a change in the reporting requirements for
non-monthly reporting households, and clarifications to claims and repayment processes.
This revision also includes mandatory increases in the Food Stamp Program's maximum
benefits, maximum excess shelter deduction, gross income limits and net income limits
effective October 1, 2000. This revision incorporates numerous clarifications to policy
and other technical corrections. Finally, several forms and items in the Appendix have
been revised.
BACKGROUND AND REASON FOR CHANGE
The changes in the HealthWave and Medicaid Poverty Level programs
were made at the recommendation of participants in the HealthWave Policy Summit. This
group, consisting of field and central office staff from EES and HCP, convened in January
2000 to review a series of recommendations aimed at simplifying and streamlining current
eligibility processes and procedures. The most substantive change is the implementation of
the family continuous eligibility period. This will allow most family members to carry a
consistent continuous eligibility period. This change also makes it possible to eliminate
the review requirement when adding a child to a current plan and when determining ongoing
eligibility at the end of a pregnant minor's postpartum period. The child's situation will
be evaluated at the time of the request for coverage and, if eligible, will be added onto
the plan for the remainder of the family's continuous eligibility period.
The changes in the HealthWave application form, although minor, were
made at the recommendation of a federal review of the HealthWave program. In addition, an
abbreviated, one page review form and review letter are also being included.
The 1999 Welfare-to-Work (WtW) Amendments allow for expanded
eligibility for WtW services and expanded component assignments for WtW participants.
These changes are incorporated in the manual section which describes the WtW component.
This section is further expanded to include additional WtW coding, change coding
instructions so that 30 hours of participation is considered for WtW participation, and
clarification of WtW coding instructions. Additional clarification which was contained in
the WtW Implementation Memo is also being incorporated into the manual at this time.
The development and issuance of the EES Contracted Employment
Services Handbook has required that some work program components be redefined, added or
deleted to promote consistency between the terminology in the Handbook and the KEESM.
The change to count months of TAF assistance received by the family
toward the 60 months lifetime limit when the family group contains a disqualified adult is
being made in response to recommendations from field staff.
The changes in the CSE good cause and work related requirement good
cause sections are being made to promote consistency in wording for situations of
noncompliance when the client is a victim of domestic violence. The wording that was
adopted for the Domestic Violence pilot in Topeka has been incorporated into the KEESM.
The clarifications regarding treatment of children in the protected
SSI class comes as a result of guidance from the Health Care Financing Administration
(HCFA) in April 2000. Previous instructions have been released regarding the treatment of
these children, but HCFA's recent guidance sets forth additional requirements, which have
been strengthened and clarified in this revision.
The change in the earned income reporting requirements for
non-monthly reporting households from $80 to $100 is being made to simplify the
requirement for clients and staff. This change is possible due to an initiative by USDA to
enhance program access for low-income working families.
The change to the Standard Telephone Allowance is a result of the
annual review of telephone costs which have increased since the amount was last
determined.
CHANGES AND REQUIRED ACTIONS
- KEESM 1421 - Provisions
Specific to Cash and Food Stamp Eligibility - This section has been corrected by
removing the word "cash" in the second line of the item. This was an oversight.
- KEESM 1432 - Adequate Notice
Only - A new item has been added to this section for clarification. This statement
was only found in the overpayment section and was inadvertently not included in 1432 when
the new manual was issued. Adequate notice only is required when a client fails to respond
to a written repayment agreement within 10 days and benefit reduction is invoked.
- KEESM 1513.3 - Replacement
of Lost or Stolen Benefits - This item has been clarified to state that no
provisions are available for replacement of lost or stolen food (purchased with food stamp
benefits). Food destroyed in a household disaster can, however, be replaced. A cross
reference to the EBT System Guide in the Appendix has been included to direct readers to
this item for instructions.
- KEESM 2112 - Minors - Item
(1) of this section has been modified to allow individuals who meet the criteria to apply
for prior medical assistance on behalf of a minor child to apply even if the individual
did not meet the criteria in the prior period. This includes instances where the caretaker
did not meet the definition of caretaker in the prior period, but currently does and
situations where the child was not living with the current caretaker in the prior period.
Eligibility is determined based on the child's circumstances during the month assistance
is being determined for (e.g., consideration of the needs and income of LRP's, residency,
living arrangement in the month). Further information is being provided in the
Implementation Memo.
- KEESM 2141 - Legal Alien
Status - Item (5) of this section has been corrected to match the Alien
Eligibility Chart (No. 1) in the Appendix. Item (5)(a) has been corrected to indicate that
aliens meeting this criteria are only eligible for food stamp and medical benefits. Item
(5)(b) has been corrected to indicate that aliens meeting this criteria are only eligible
for food stamp benefits.
- KEESM 2160 - Cooperation With
and Referral to Child Support Enforcement (Not Applicable to HealthWave or Food Stamps)
- This section has been clarified to indicate that cooperation is required for JO or
Income Eligible child care programs. Income Eligible includes IE EM, IE ET, and IE TC
subtypes.
- KEESM 2162 - Good Cause for
Failure to Cooperate - This section has been changed to state that an individual's
statement and one piece of corroborating evidence will meet the burden of proof of a claim
for good cause not to cooperate in establishing paternity and securing support payments.
The definition of other corroborating evidence can include physical evidence of domestic
violence or a statement from any other individual who has knowledge of the circumstances.
- KEESM 2183 - Drug-Related
Convictions (Not Applicable to Medical or Child Care) - This section has been
modified to clarify that documentation to deny or terminate assistance is only needed if
the report of a drug related conviction comes from a source outside of the household. If
the household reports the conviction, action can be taken without documentation.
- KEESM 2210 - Child in Family
- This section has been changed to clarify that working toward attainment of a high
school diploma or its equivalent includes students attending a home school that is
registered with the Kansas State Department of Education.
- KEESM 2240 - Time-Limited
Assistance - This section has been expanded to indicate that the time on
assistance for the family of an adult who is ineligible for benefits due to being an
ineligible legal alien, illegal alien, fugitive felon, or in fraud disqualification status
will count as a month on assistance toward the family's 60 calendar month lifetime limit.
This section has also been modified to remove the reference to months on assistance in
similar programs in other states.
- KEESM 2510 - Categorically
Eligible Households - This section has been reorganized and slightly rewritten for
purposes of clarification. No policy changes have been made to the content of this
material.
- KEESM 2512 - Eligibility
Factors and Verification Deemed for Food Stamp Eligibility Purposes - A technical
correction and a cross reference have been added to item (1)(a). Item (2)(c), Excess Gross
Income, has been modified to state that a food stamp benefit computation form must be
completed to determine if the household will be eligible for a benefit if a categorically
eligible household's income exceeds the gross income limit.
- KEESM 2531 - Student
Participation Criteria - The note in item (2) has been modified to clarify that
the student does not have to be approved for work study at the time of application and
be approved for work study for the school term. If the student is not approved for work
study at the time of application, but later is approved for work study, eligibility starts
at the time the student is approved for work study. A new sentence has also been added to
clarify that eligibility under this criteria continues during vacation and break periods
as provided in 2532.
- KEESM 2552 - Treatment of
Income and Resources and Special Procedures - A new item (4), Re-establishing
Eligibility, has been added to this section. This section establishes procedures for
re-establishing FS eligibility for a person who has been penalized under the comparable
provisions of 2550.
If the person reapplies for TAF and FS, they must cooperate as
established for TAF purposes. If the person reapplies for FS only and lives in an FS
E&T county and they are exempt from work-related requirements, he or she may
re-establish eligibility by signing the Declaration of Cooperation and Self-Responsibility
Plan (ES-4311). If the person is not exempt from work related requirements, he or she may
sign the ES-4311 or by other means as established by the worker.
If the person reapplies for FS only in a non FS E&T county and
is exempt from work related requirements, he or she may be re-added to the case without
any additional requirements. Non-exempt individuals may re-establish eligibility by
completing the ES-4311.
- KEESM 2639 - Special
Provisions for Children Terminated from SSI Due to Changes in Disability Criteria -
This section has been clarified to state that children who fall into the HealthWave
category must have a Medicaid determination completed under these provisions. Information
on the KAECSES PRAP code has also been included.
- KEESM 2642 - Age/Pregnancy
Determination - This section has been clarified to reflect children are eligible
under the Medicaid poverty level program through the month of their 19th
birthday.
- KEESM 2644 - Continuous
Eligibility for Pregnant Women - This section has been reformatted to streamline
manual material. This section was formerly 2644.1. It has been modified to reflect
methodologies applied when an individual who is eligible under another medical program
loses categorical eligibility under that program. It has also been modified to reflect a
change in policy that removes the formal review requirement at the end of a postpartum
period for an individual under the age of 19. Further information will be provided in the
Implementation Memo.
- KEESM 2644.1 - Postpartum
Period for Pregnant Women - This section, formerly 2644.5, has been renumbered but
has not been modified.
- KEESM 2645 - Continuous
Eligibility for Children - This section, formerly 2644.2, has been renumbered. It
has also been modified and clarified to provide for the establishment of a family
continuous eligibility period. Further information will be provided in the Implementation
Memo.
- KEESM 2645.1 - Continuous
Eligibility Period - This section, formerly 2644.2 (1), has been renumbered.
Further, items (1) through (10) replace former sections a. through j.. Statements in item
(7) have been removed to support the new policy which no longer requires a review when
adding a child to an assistance plan. Item (8) has been updated to include a reference to
the SSI protected class.
- KEESM 2645.2 - New
Continuous Eligibility Period - This section, formerly 2644.2 (2), has been
renumbered. Further, sections (1) and (2) replace former sections a. and b. Section c. has
been removed and general information regarding optional MP reviews has been included. The
policy has been clarified to allow a review to be completed when an application or review
is received for another program if it is in the family's best interest to complete the
review. Section d., which made a reference to a required review when adding a child to a
current plan has also been removed. Further information on this change will be provided in
the Implementation Memo.
- KEESM 2646 - Continuous
Eligibility for Newborns - This section, formerly 2644.3, has been renumbered. A
reference to Policy Memo 00-04-02 has also been included.
- KEESM 2647 - Inpatient Care
Period for Children - This section, formerly 2644.4, has been renumbered. The
content has not been modified.
- KEESM 2648 - Changes in the
Family Unit - This section is new and establishes rules for dealing with
continuous eligibility periods when there are changes in household composition. Further
information on this section and subsections will be provided in the Implementation Memo.
- KEESM 2648.1 - Removing a
Child From an Existing Plan - This new section establishes procedures for removing
a child from an existing plan when he/she is no longer part of the household. The child
shall remain on the case through the month following the month of report to ensure the
family is given adequate time to notify the agency of the child's new address.
- KEESM 2648.2 - Adding a
Child to a Plan - This section and two subsections have been added to reflect
requirements when adding a child to a plan. Item (1), Adding a Child to an Existing
Plan, establishes rules when a child is being added to an active MP program. A formal
review is no longer required and the child can be added based upon the request of the
caretaker. If the child is a current recipient, the child will be eligible through the end
of the family's continuous eligibility period. However, a determination of eligibility
will be done to determine the type of coverage (HealthWave or Medicaid) the child will
have. The income amounts budgeted on the program will be used for this determination,
including determinations for months in which prior coverage is requested.
Item (2), Adding a Child to a New Plan, establishes rules for
adding a recipient child to a plan without an active MP program. A formal review
application is required to be completed, but cooperation is not required. A determination
shall be completed to determine the type of coverage the child will have (Medicaid or
HealthWave) through the end of the child's original continuous eligibility period. If the
family does cooperate with the review process, and the child remains eligible, continuous
eligibility will be reset.
- KEESM 2671.3 - QMB Income
and Resource Methodologies - This section has been modified to reflect the
exemption of the SSA COLA increase until the new poverty level standards become effective.
Previous language limited the exemption to the first quarter of the year.
- KEESM 2673 - Partial LMB
Program - This section has been modified to allow for the establishment of prior
medical assistance under the eligibility group as set forth in a previously released
Implementation Memo.
- KEESM 2691 - Emergency Service
Coverage for Aliens - This section has been modified to state that a new MS-2156
is required to be submitted for each emergency situation, even if the emergencies occur in
the same month. It also provides for upcoming changes in the Kansas Medical Services
Manual regarding the locations where emergency services may be provided. Further
information will be provided in the KMSM and an Implementation Memo.
- KEESM 2710 - HealthWave
General Program Information - This section has been clarified to reflect the
correct poverty level percent for the establishment of a premium and replaces an old
reference to the Adult and Medical Services Commission.
- KEESM 2730 - Age -
This section has been clarified to reflect children are eligible under the HealthWave
program through the month of their 19th birthday.
- KEESM 2741 - Uninsured Status
- This section has been amended to reflect a change in policy which excludes health
insurance that is not accessible to the child from being considered under this provision.
This would involve situations where the only available providers in the plan are not
accessible due to the distance the child must travel to be seen. Further instructions will
be provided in the Implementation Memo.
- KEESM 2742 - Period of
Ineligibility for Voluntarily Dropping Health Insurance Coverage - This section
has been clarified by correcting a typographical error and adding a reference to the
changing policy of 2741.
- KEESM 2750 - State Employee
Status - This section has been clarified to state that children of employees of
Unified School Districts participating in the state group health plan are NOT eligible for
HealthWave benefits.
- KEESM 2770 - Premium
Requirement - This section has been amended to provide that coverage changes will
no longer be made solely because all children in the household moved from a premium status
to a Medicaid range. Although the premium will be removed when the poverty level percent
falls below 151%, coverage will not change until the end of the continuous eligibility
period. Also, premiums must be paid in full when a review is completed but optional
reviews will not be completed if due and owing premiums exist on the case.
- KEESM 2780 - Continuous
Eligibility Period - This section has been modified and clarified to provide for
the establishment of a family continuous eligibility period. Further information will be
provided in the Implementation Memo.
- KEESM 2781 - Continuous
Eligibility Period - Items (7) and (8) have been modified to remove statements to
support the new policy which no longer requires a review when adding a child to an
assistance plan and to reflect an SSI recipient includes individuals eligible under the
protected class.
- KEESM 2782 - New Continuous
Eligibility Period - This section has been clarified to allow a review to be
completed when an application or review is received for another program if it is in the
family's best interest to complete the review. Item (4) has been removed which made
reference to a required review when adding a child to a current plan. It further states
that coverage will not switch based on premium status changes of the entire household.
Further information on this change will be provided in the Implementation Memo.
- KEESM 2783 - Changes in the
Family Unit - This new section has been added to establish rules for dealing with
continuous eligibility periods when there are changes in household composition. Further
information on this section will be provided in the Implementation Memo.
- KEESM 2783.1 - Removing a
Child From an Existing Plan - This new section has been added to establish
procedures for removing a child from an existing plan when he/she is no longer part of the
household. The child shall remain on the case through the month following the month of
report to ensure the family is given adequate time to notify the agency of the child's new
address.
- KEESM 2783.2 - Adding a
Child to a Plan - This section has been added to reflect requirements when adding
a child to a plan. Item (1), Adding a Child to an Existing Plan, establishes rules
when a child is being added to an active MP program. A formal review is no longer required
and the child can be added based upon the request of the caretaker. If the child is a
current recipient, the child will be eligible through the end of the family's continuous
eligibility period. However, a determination of eligibility will be done to determine the
type of coverage (HealthWave or Medicaid) the child will have. The income amounts budgeted
on the program will be used for this determination, including determinations for months in
which prior coverage is requested.
Item (2), Adding a Child to a New Plan, establishes rules for
adding a recipient child to a plan without an active MP program. A formal review application
is required to be completed, but cooperation is not required. A determination shall be
completed to determine the type of coverage the child will have (Medicaid or HealthWave)
through the end of the child's original continuous eligibility period. If the family does
cooperate with the review process, and the child remains eligible, continuous eligibility
will be reset.
- KEESM 2793 - Newborn Coverage
- This section has been amended to remove the new application requirement when adding
a newborn child that is not born to a Medicaid or HealthWave eligible mother.
- KEESM 2794 - Pregnant Women
- This section has been modified to reflect a change in policy that removes the review
requirement at the end of a postpartum period for an individual under the age of 19.
Further information will be provided in the Implementation Memo.
- KEESM 2831 - JO (TAF) Child
Care - Item (7) has been clarified to indicate that following TAF case closure,
Welfare-to-Work participants who need child care may apply and have eligibility determined
for Income Eligible child care, which may include IE EM, IE ET or IE TC subtypes.
- KEESM 2912 - Health Insurance
Premium Payment System (HIPPS) - This section has been clarified to indicate that
HIPPS referrals are not necessary when the only eligible family member is eligible under
the SOBRA provisions. It also now specifies that referrals should not be made when the
employed individual is not authorized to work in the country.
- KEESM 3110 - TAF Participation
Rate Requirements - This section has been modified to update the wording from Two
Adult to Two Parent. This section has also been expanded to indicate that up to 30% of the
total TAF individuals counted in a month as meeting the work participation requirements
may be participating in Vocational Education.
- KEESM 3111 - Special Rules for
Households with Teen Parents - The wording in this section has been modified to
clarify what activities count toward Federal participation requirements for teens.
- KEESM 3112 - Definition and
Special Rules for Two-Parent Families - The wording has been clarified in this
section to indicate that 35 hours of participation by one parent meets the Federal
participation requirement in situations where SRS paid child care is not received. This
section has also been modified to clarify that "disabled" in this section
includes situations where the individual self-declares a disability or incapacity.
- KEESM 3113 - Component
Assignment for Federal Work Participation Purposes (TAF) - This section is being
modified to update component terminology that is consistent with the EES Contracted
Employment Services Handbook. These changes will also be reflected in Section 3310.
- KEESM 3151 - Employability
Status - This section is being deleted and reserved. Local areas have had the
option of indicating the Employability Status on KsCares when the status is determined
during the assessment. No area is currently utilizing that information. The Employability
Status field will not be on SESP when the screen is redesigned in the fall of 2000.
- KEESM 3310.2 - Alcohol and
Other Drug Assessment and Treatment (AODAT) - This section has been modified to
indicate that the RADAC will provide feedback to the EES staff on the clinical
interpretations of the SASSI. This section has been further modified to remove the
reference to the six-week limit on the component assignment and to indicate that the
length of participation in the component is based on the treatment plan.
- KEESM 3310.3 - Applicant Job
Search (AJS) TAF (and FS in Designated Counties) - This section has been changed
to indicate that the assignment of this activity begins with the date of the application
for assistance. This change is consistent with the expectation on the application for
assistance and will promote consistency in reporting TAF participation for partial months
of assistance.
- KEESM 3310.5 - Community
Service - This component has been expanded to allow the forced community service
requirement for individuals on parole or probation to count as work program participation.
- KEESM 3310.7 - Disability
Employment Services - This section has been modified to indicate that provisions
related to assigning TAF or FS referrals to other Work Program components pending
acceptance by RS should be worked out locally when RS is in Order of Selection status.
- KEESM 3310.9 - Employment
Assessment Process - This section has been changed to indicate that the assignment
of this activity begins with the date of the application for assistance. This change is
consistent with the expectation noted on the application for assistance and will promote
consistency in reporting TAF participation for partial months of assistance.
This section has also been modified to remove the requirement that
the ES-4309 needs to be submitted weekly in order to count 30 hours of participation. The
case record should document the participation.
- KEESM 3310.10 - Employment
Counseling - This section is being eliminated. The issuance of the EES Employment
Contracted Services Handbook created another component which replaces this component. Job
Readiness Case Management is the new component and the description of this component can
be found in KEESM 3310.17. 3310.11 through 3310.17 have been renumbered accordingly.
- KEESM 3310.18 - Job
Development and Placement - This section is being re-named to Job Retention Case
Management and redefined as one-on-one job retention services.
- KEESM 3310.23 - On-the Job
Training - This section has been modified to remove the reference to contracted
providers establishing OJT's. Terminology has also been updated in this section to replace
JTPA with the Workforce Investment Act(WIA).
- KEESM 3310.25 - Pilot
Projects - This section has been added to the manual to promote consistency with
the EES Contracted Employment Services Handbook. This designation should be entered on
KsCares when a client is participating in an approved Pilot Project. Current 3310.25
through 3310.31 have been renumbered accordingly.
- KEESM 3310.29 - Special
Projects - The definition of Special Project has been modified to be more
consistent with the definition in the EES Contracted Employment Services Handbook.
| Next Part II |
