Kansas Department of Social and Rehabilitation Services Homepage

STATE DEPARTMENT OF SOCIAL
REHABILITATION SERVICES
Integrated Services Delivery
Docking State Office Building
Room 681 - West
Topeka, Kansas 66612

FINAL

May 1, 2004

TO:

Area Directors
Economic and Employment Support Chiefs
Economic and Employment Support Staff
Social Service Chiefs
Other Staff

RE:

Summary of Changes for Kansas Economic and Employment Support Manual (KEESM) Revision No. 18 effective May 1, 2004

PURPOSE, BACKGROUND, and REASON FOR CHANGE

The purpose of this document is to transmit Revision No. 18 of the Kansas Economic and Employment Support Manual effective May 1, 2004.

Child Care and Medical Assistance - New poverty level guidelines have been published by the Department of Health and Human Services. These guidelines affect the eligibility standards in the child care, MP, QMB, LMB and QWD programs as well as increase the minimum community spouse income allowance under the spousal impoverishment provisions.

Food Assistance - This revision implements a major change to food stamp policy to improve the efficiency of the program and reduce errors. This change mandates that food stamp consumers who have utility expenses use either the Standard Utility Allowance (SUA), or the Limited Utility Allowance (LUA). Households will no longer be allowed to use actual utility expenses in lieu of the SUA, except as noted below. Persons who have a heating or cooling expense will be entitled to the SUA of $262. If the household does not have a heating or cooling expense, but incurs at least two of the following: water/sewer/garbage; (counts as one expense for purposes of this provision); telephone ;or electricity (not used to heat or cool), the household is entitled to the LUA of $168. If the household has only water/sewer/garbage, or electricity (not used to heat or cool), the household is not entitled to the SUA or LUA, but must use actual expense(s) that are incurred. This is the only instance when actual expense(s) will be allowed. In addition to the above, the SUA will no longer be prorated when households share in utility costs. Each household that incurs expenses will be entitled to the full SUA or LUA as appropriate. And, households in public housing which have central utility meters and which are charged only for excess heating or cooling costs WILL now be entitled to the SUA. It is anticipated that the majority of households will be entitled to the SUA, thus this change will simplify policy for staff and consumers. Households who currently have a prorated SUA will be changed automatically for the June benefit month. This change is a state option allowed under the Food Stamp Reauthorization Act of 2002. Additional implementation information for this policy change will be provided in the Implementation Memo.

To provide program consistency, this revision also implements the exemption of two resource types for purposes of the Food Stamp Program that are not counted under the TANF or Medicaid programs. Although not many households will be affected by these changes, they do simplify the program and allow for some consistency. The two new resource exemptions for food stamp purposes are escrow accounts established for families participating in the Family Self-Sufficiency Program through HUD and the exemption of Americorps income as a resource. Both of these exemptions are allowed under Section 4102 of the Food Stamp Reauthorization Act of 2002 which allows States to exempt certain types of income and resources that are not counted under the TANF or Medicaid programs. At this time, Kansas has maximized the resource (and income) exemptions allowable under this provision for purposes of the Food Stamp Program.

This revision also incorporates Policy Memo 04-01-01 into the manual material. This Policy Memo mandates the use of the Income/Expense Worksheet (ES-3103) for all food stamp cases with countable earned income. This change is necessary due to the food stamp payment error rate in Kansas exceeding the national average. Earned income has consistently been the primary source of agency caused quality control errors and the lack of adequate documentation to support the income determination is a contributing factor. The statewide worksheet was mandated to improve the calculation and documentation of earned income to help lower the food stamp payment error rate.

This revision also incorporates numerous policy clarifications and technical corrections as noted later in this material.

Medical Assistance - An initiative from Children and Family Services is expanding Medicaid coverage for persons who age off of the Foster Care program. Changes to the NF Level of Care assessment process is due to changes brought on by the Kansas Department on Aging.

Successful Families - Loss of the TANF Waiver - Federal law requires states to have at least 90% of all two-parent TAF families and 50% of the all-families group meeting specific work participation requirements. In order to meet these federal participation requirements, consumers must be engaged in employment and/or certain types and combinations of primary and secondary work activities. Consumers may receive job readiness or job search services to help prepare them for employment or resolve barriers, although those activities are limited by law to six weeks per year, and only four of the weeks may be consecutive.

In 1996, Kansas was granted a federal waiver which lifted the four/six-week time limit on job readiness/job search activities. However, the Kansas waiver expired on September 30, 2003. It had allowed case managers additional time to work with consumers in resolving barriers and preparing for employment. The waiver had provided flexibility and allowed case managers the ability to tailor services according to individuals’ needs which was helpful for persons with difficult barriers which required assessment and services.

With expiration of the TANF waiver, Kansas is now subject to the four/six week time limit on job readiness/job search efforts. In order to receive the federal TANF funding and avoid significant fiscal penalties, the state must meet the work participation rates which would not be possible under the previous program design. In determining how to adjust the program to meet federal participation rates, the following priorities were identified:

Retain flexibility where possible to address wide variations in client barriers and needs;
Minimize policy changes for field staff;
Achieve 50% All Families work participation rate and 90% Two-Parent rate; and
Minimize system changes.

In order to accomplish these goals without redesigning the entire program, existing work components and activities have been redefined and repackaged as allowable under federal regulation.

EES and RS Coordination - The EES and RS Coordination Team, comprised of EES and RS field staff, recently explored ways that staff could better integrate services and improve efficiencies for both consumers and staff. The team’s recommendations included policy changes and updates for the EES and RS manuals. The policy changes are being incorporated into the KEESM at this time. The team’s recommendation also included best practice strategies and forms for consideration by local teams.

ALL PROGRAMS
1. CHANGES
  
  None
2. CLARIFICATIONS
  1. Citizens of Micronesia, Palau and the Marshall Islands - The KEESM is being modified to clarify that citizens of Micronesia, Palau and the Marshall Islands have the right to enter, work, and establish residence as a non-immigrant in the United States. They are not considered citizens of the United States and must meet the qualifications of 2142 to receive cash, child care or medical, or 2143 to receive food stamps. A note is being added to section 2141 to reflect this.
  2. Date of Discovery for a Claim - The manual is being clarified to state that the date of discovery for purposes of tracking claims establishment shall be the date the case is identified as potentially having an overpayment either by the worker, quality control or by other means. Once discovered the agency must prepare the claim and initiate recovery or attempt to initiate recovery by the end of the calendar quarter following the calendar quarter in which the overpayment is first identified. Section 11123 reflects this clarification.
  3. Countable Income - Section 6220(12) is being modified by listing the examples of “other” countable income in bullet form instead of paragraph form. A clarification is also included that royalty payments made to tribal members from casino profits are also known as per capita payments. In addition, a cross reference to 6410 for exempt income is being corrected.
  4. Eligibility Periods for Cash, Child Care, and Food Stamps - This section is being modified to clarify that if the month of application for cash/food stamps is denied, the first month of the review period shall be the first month of eligibility. To simplify and streamline, sections 7310 and 7320 have been combined into one section. 7320 is now reserved. Section 7340 is being clarified to reflect this same policy for child care. For child care, if no child care plan is written for the month of application (i.e., family share exceeds cost of care), the first month of the review period shall be the first month a plan is written.
  5. Maintenance Payments by Kansas Rehabilitation Services - The manual is being clarified to state clearly maintenance payments made by Kansas Rehabilitation Services are considered a reimbursement and are thus exempt for all programs. Section 6315 is being modified to reflect this clarification.
  6. Methods of Collecting Payments - A minor clarification is being made to the section of the manual that explains offsetting claims with restored benefits. Under the note, it is explained that a repayment plan must be entered on OVCA before a claim can be offset with lost benefits. The two repayment plans that will allow offsetting are “MA” and “PA”. The code of “PE” has been removed from the manual. Although this code has not been invalidated, it is not recommended that it be used by staff due to potential errors with the amount of the recoupment. “PE” is also being removed from the KAECSES code cards as a valid code for staff to use. This change is being made to KEESM 11126.1(3).
    A new item has is being added to provide that claims can be collected now via EBT repayments. For cash and food stamps, consumers can make payments on a claim using their EBT account. A reference to item (24) of the EBT System Guide (Appendix Item #79) is included. This new item is (5) under KEESM 11126.1.
  7. Poverty Level Changes - New federal poverty level guidelines will be published by the Department of Health and Human Services that will reflect approximately a 3.5% increase from last year for a single individual. These guidelines affect the eligibility standards in the Child Care, Medicaid Poverty Level, HealthWave, QMB, LMB, and QWD programs as well as increases the minimum community spouse income allowance under the spousal impoverishment provisions. The increases will take effect May 1, 2004 and separate instructions will be issued to the field regarding implementation of these standards.
  8. Prospective Budgeting for Semi-Monthly Income - Recommendations for budgeting semi-monthly income contained in Policy Memo 04-01-01 are being included in section 7110 of the manual.
  9. Verification at the Time of Review - The manual is being modified to clarify that at the time of review, the verification requirements at the time of initial application apply, except that non-citizen status, providing an SSN, residency and identity do not have to be reverified unless a change in any of these elements has been reported or is questionable. Section 9333 is being modified to reflect this.
ADULT PROTECTIVE SERVICES
1. CHANGES
  1. Response Time - With the resumption of the abuse hot line service, a reference to the answering service is being deleted in section 12220. Response time begins with the day the voice mail or hot line report is retrieved.
  2. Mental Health Field Staff - Section 12230(2)(a) is being changed to reflect a name change from Mental Health Quality Enhancement Coordinator to MH Field Staff. This is in keeping with ongoing service delivery redesign in the field.
  3. Accessing Adult Abuse Registry - Section 12522 is being changed to permit access to information in the Adult Abuse Registry to any agency which provides services to adults age 18 and above.
  4. Filing the Petition for Voluntary, Involuntary and Temporary Guardian/Conservator - The option of finding a proposed guardian/conservator through a non-KGP (Kansas Guardianship Program) referral is being amended in section 12714 to state that such an option may be used at the discretion and agreement of the APS Supervisor and Area Attorney.
2. CLARIFICATIONS
  1. Several typographical errors are being corrected in the following sections: 12122; 12150(5); 12420(2)(c); 12420(4) and 12430.
  2. Courtesy Investigations and Interviews - A new paragraph is being added to section 12360(4) to clarify that the area responsibility lies with the area where the incident occurred whenever law enforcement is involved because law enforcement files charges where the crime occurred.
  3. ES-1008 Reports - Section 12420(2) is being clarified that this report is not sent to the alleged perpetrator when the alleged perpetrator was not contacted during the investigation.
  4. Corrective Action Plans - A reference to section 12443 has been added to section 12440 for clarification purposes.
CASH ASSISTANCE
1. CHANGES
  1. Paternity of Alleged Father in the Home - For a child born on or after July 1, 1994, the father is determined to have voluntarily acknowledged paternity if he is listed as the father on a child’s official birth certificate, issued by Vital Statistics. The birth certificate may not be used to verify paternity for children born prior to July 1, 1994. See KEESM Section 2167.
  2. Good Cause for Failure to Cooperate with CSE - The length of time a good cause determination may pend is being expanded from 30 to 60 days. This is because it is often difficult to obtain appropriate substantiation of good cause within a 30 day time frame. See KEESM 2162.
  3. Hardship for Persons Who Have Received 60-Months of Cash Assistance in Another State - A family applying for TAF cash assistance in Kansas who has already received 60-months of cash assistance in Kansas or another state or states may qualify for hardship in Kansas if they meet any of criteria 1-4 of KEESM Section 2243, which are age, disability, care of a disabled household member, or time to overcome the effects of domestic violence. See KEESM Section 2241 and 2243.
2. CLARIFICATIONS
  1. Time-Limited Assistance - A clarification is being added that months of cash assistance received by an adult while living on an Indian Reservation of at least 1,000 people with an unemployment rate among adults of at least 50 percent do not count toward the 60 month time limit. Currently, no Reservations in Kansas meet this criteria, but someone moving into Kansas who had lived on such a reservation could be affected by this rule. See KEESM 2240.
  2. Counting Cash Assistance Received from Other States Toward the 60 Month Time Limit - This clarifies that in determining if months of cash assistance received in another state should be applied to the 60-month time limit in Kansas, the decision of the other state in whether to count the assistance toward its time limit shall also be followed in Kansas. This excludes diversion or other short-term lump sum TANF payments. See KEESM 2241.
  3. Child in Family - A clarification is being added that a non-relative foster parent may receive TAF for the dependent child of a foster care child if the dependent child and foster care recipient live together in the same foster home and the dependent child is not in the custody of SRS. See KEESM 2210.
CHILD CARE ASSISTANCE
1. CHANGES
  1. Income Guidelines - Due to new 2004 federal poverty level guidelines, the Family Income and Share Schedule for child care services is being updated effective May 1, 2004. To be eligible, the total countable gross income must not exceed 185% of the current federal poverty guidelines based on the household size. Appendix Item #48 is being updated due to this change. This item is available in Spanish and English.
  2. Income Eligible Training - Employed (IE TC) Child Care - This revision implements changes as to how child care plans are authorized for income eligible employed-training clients. Until now, two plans were set up to support this activity - one for the training under TC, and one for the employment under EM. When this support service was originally offered, there was a need to track expenditures for training as a designated amount of funds was allocated to the Child Care Program budget to support this policy. At this point, we believe that this service has become part of the child care program as a whole and does not need to be tracked separately any longer.
    Per field staff request and EES Chief recommendation, the authorization procedure for the services offered under the TC subtype are being changed. Actual policy will not be changing, however, all hours needed (for both employment and training) will be authorized on one plan under the EM subtype.
    
    Since this is more of a procedural change, and not an actual policy change, staff were allowed to implement this change in plan authorization early. It is anticipated that this will save time and work for staff. Procedures previously listed in KEESM 2835 are being blended into KEESM 2834 with this revision. IE ET (Income Eligible Education and Training) Child Care policies previously located in KEESM 2836 can be found under KEESM 2835.
    
    Appendix Item #111, Education/Training Assistance Desk Aide, is being updated with this revision to reflect the procedural change.
2. CLARIFICATIONS
  1. JO Child Care - Clarification is being added to section 2831 to provide a cross-reference to 4420(2). This provides clarification that JO child care is only used for caretakers receiving TAF for their own needs. JO child care is not used in child-only TAF situations. The same cross-reference to 4420(2) is being added to section 2834, IE EM (Employed Income Eligible Child Care).
  2. Personal Need - Clarification is being added to KEESM section 2820. Examples have been added to better clarify whom in the household is required to provide child care to support a personal need. In general, non-legally responsible household members can, but would not be required to, provide child care to support the activity of another adult in the home.
  3. Foster Care Child Care - Clarification is being added to section 2833(2). This section is being split into two parts - one describing responsibilities of Foster Care Contractors and one describing when EES Child Care Subsidy may be utilized.
  4. Family Share - Clarification is being added to section 7541 to better describe the purpose of the family share and how a family share assignment will impact a provider payment. The definition of Family Share is being revised in Appendix Item #78, Definition of Common Terms. Other clarifications are also being made to some definitions in this document.
  5. Determining Scheduled Hours - Clarification is being added to section 7620, to remind staff that lunch time should also be figured into a client’s work day and may effect the number of hours of child care needed. A cross-reference to Policy Memo 04-03-02 is being added which will provide guidance to staff in determining scheduled hours when sleep time is involved.
FOOD ASSISTANCE
1. CHANGES
  1. Mandatory Standard Utility Allowance (SUA) and Limited Standard Utility Allowance (LUA) - Effective May 1, 2004, households will no longer be allowed to claim actual utility expenses (with one minor exception as noted below). Households entitled to the Standard Utility Allowance who have a heating or cooling expense must use the SUA of $262. Households who do not have a heating or cooling expense but who have at least two other utility expenses (either water/sewer/garbage, telephone or electricity (not used to heat or cool) must use the LUA of $168. If the household incurs only one of the following: water/sewer/garbage or electricity (not used to heat or cool) the household is not entitled to the SUA or LUA and must use actual expense(s).
    In addition to mandating the use of a utility standard, this policy change also eliminates the proration of the SUA. The SUA will no longer be prorated when households share utility costs. Each household is allowed the full SUA. KAECSES has been modified by removing the field that prorates the SUA.
    
    With this revision, households in public housing which have central utility meters and which are charged only for excess heating or cooling costs WILL now be entitled to the SUA.
    
    Changes were made to the following KEESM Sections to incorporate these changes: 1322.2, 1322.3, 1415.1, 7226.3 and 7227.1. Additional implementation information for this policy change will be provided in the Implementation Memo, and training on this policy change will be provided at the end of April.
  2. Resources Exempt for Food Stamp Program Purposes - Two new resource exclusions are being implemented effective May 1, 2004. Effective with this revision, escrow accounts established for families participating in the Family Self-Sufficiency Program through the Department of Housing and Urban Development are exempt for food stamp purposes. In addition, Americorps income is now exempt as a resource as well as exempt as income. Both of these changes now match the TAF policy and are allowed under the Food Stamp Reauthorization Bill of 2002. The following sections of the manual are being modified to reflect these changes: KEESM 5430(6) and 6410(5).
  3. Mandatory Use of the ES-3103, Income/Expense Worksheet - As previously implemented via Policy Memo 04-01-01, this revision incorporates the ES-3103, Income/Expense Worksheet. This new form is mandatory for all food stamp cases with countable earned income. As noted above, this change is necessary due to the food stamp payment error rate in Kansas exceeding the national average. Earned income has consistently been the primary source of agency caused quality control errors and the lack of adequate documentation to support the income determination is a contributing factor. The statewide worksheet was mandated to improve the calculation and documentation of earned income to help lower the food stamp payment error rate. Since the form and instructions for use of the form are now included in the manual in section 7100, Policy Memo 04-01-01 is obsolete upon the effective date of this revision.
2. CLARIFICATIONS
  1. Verification of Child Support Payments - The manual is being revised to clarify that acceptable verification of legal obligation to pay child support includes documentation of the court order from the KAECSES-CSE screens. CSE always obtains a hard copy of the court order prior to entering it on the system. The court order must be active with no end date reflected on the system. KEESM 1322.2(3) is being modified to reflect this clarification.
  2. Verification of Questionable Information - In Item (1), Household Composition, a clarification is being added that the KAECSES V030, Purchase and Prepare Statement, is also an acceptable form to substantiate a claim of separate household status. 1322.3(1) has been changed to reflect this.
  3. Verification of Shelter Expenses - The manual is being clarified to indicate the type of shelter expenses that require verification. Shelter expenses include, but are not limited to, rent, mortgage (including second mortgages), lot rent, real estate taxes and homeowner’s insurance. This clarification is reflected in 1322.2(5).
  4. Verification of Entitlement to the Standard Utility Allowance, Limited Utility Allowance or the Telephone Standard Allowance - This section is being modified to clarify that entitlement to any of the utility standards shall be verified if questionable. A new item (4) has been added to 1322.3 to reflect this.
  5. Non-citizen Qualification Using 40 Quarters - The note explaining the use of 40 qualifying quarters is being modified to include another example of when qualifying with 40 qualifying quarters is applicable. That is when a non-citizen who has not been in the country for 5 years is using the 40 qualifying quarters of spouse to qualify for food stamps. KEESM 2143.2 is being modified to reflect this clarification.
  6. Cooperation with CSE - Since the FSP no longer has a comparable disqualification for failure to cooperate with CSE, two technical corrections are being made to 2165.1.
  7. Removing Reference to Monthly Reporting - Several sections of the manual are being corrected by removing references to monthly reporting. Sections being modified are: 2510 and 6220(9).
  8. ABAWD Clarifications - A note is being added to the ABAWD section to clarify that an individual employed by VISTA an average of 20 hours a week would meet the work requirement even if the income is not counted. In addition, the manual is being clarified to state that in-kind income counts for meeting the ABAWD work requirement as long as the person is working an average of 20 hours a week and receiving in-kind value of at least minimum wage. KEESM 2520 is being modified to reflect these clarifications.
    
    An additional clarification of the ABAWD policies is contained in 2527, under the definitions of an ABAWD and non-ABAWD. When this section refers to a non-ABAWD, also included is the statement “or an ABAWD meeting the work requirement”. For example, if a change in situation makes a non-ABAWD (or an ABAWD meeting the work requirement) an ABAWD, the individual gets 3 months of food stamps without meeting the work requirement if they have not already used the 3 months in the first 36 month period. This clarification is included in several sentences in this item under KEESM 2527.
  9. Student Eligibility Clarification - A clarification is being added to this section to state that persons attending an institution of higher education through Kansas Vocational Rehabilitation are considered physically or mentally unfit for employment, thus they can participate in the FSP if otherwise eligible without meeting the student criteria of 2531. KEESM Section modified: 2530.
  10. Documentation of Vehicles - A note is being added to the vehicle section of the manual to recommend that all vehicles be listed on the KAECSES system VEHI screen even if exempt. Listing all vehicles allows other staff working with a family or individual to know if they have reliable transportation. KEESM 5500 is being modified to reflect this recommendation.
  11. Late Fees - A clarification is being added to 7226.1 to state that late fees on rent, mortgage payments, property taxes and the like, are not to be allowed as part of the shelter expenses.
  12. Simplified Reporting - Several clarifications are being included in this section of the manual.
    - A note is being added to clarify that an application (food stamp or combined application with FS sections completed) can be accepted in lieu of an IR if it is received in the month the IR is due, or the following month. If an application in lieu of an IR is used to reinstate benefits, an interview is not required, and all verification rules applicable to IR processing instead of application processing apply. Benefits are also not prorated. This clarification is included in KEESM 9122.6.
    - A clarification has been added to 9120 to state that a change in reporting requirements that results in the household changing from simplified reporting to change reporting shall be processed at the time of the next review or IR, whichever comes first. A change in reporting requirements that results in the household changing from change reporting to simplified reporting shall be processed for the month following the month the change was reported. The following examples are being included in the manual to illustrate this policy:
      Example A: Household consists of SSI mother and 20 year old son. The case is subject to simplified reporting and the next IR is due September 5th.The mom reports on June 5th that the son moved out on June 2nd. The son is removed from the FS case effective for the month of July. Mom will stay a simplified reporter until the IR is processed. When the IR is processed in September, she will change reporting requirements to a change reporter effective October 1.
      
      Example B: Household consists of 62 year old getting SSA. Subject to change reporting. She reports on June 5 that her 32 year old employed daughter and grandchild moved into the home on June 4th. They all purchase a prepare together. The daughter and grandchild are added to the case effective for July, AND the reporting requirements are changed from change reporting to simplified reporting effective July 1.
      
      Reasoning for this clarification - it is to the State agency’s benefit (in regard to the error rate) to have as many households as possible to be simplified reporters and to stay simplified reporters as long as possible.
    - A clarification has been added to 9122.5 regarding the 130% reporting requirement. The last sentence of this section currently states the following: “This number shall be determined at the time the application or review is processed, based on the most current information.” An example illustrating this policy has been added to the manual to help clarify this policy. For example, a household applies in January. The case is approved in February. The household size is 5 and January and will be 4 in February. Since the household size is 4 at the time of approval, that is the 130% reporting threshold that is included on the notice to the consumer.
    - Under 9122.6(1)(c), Action Required if Verification Not Provided, the word "shall" is replaced with "may". The sentence in the third paragraph now reads: "...that with the exception of verification of earned income, the agency may pend a household’s case (instead of terminating eligibility) if information necessary to determine continued eligibility is being requested from the household." Pending the case is not required, nor is it prohibited when information necessary to determine continued eligibility is being requested. The decision to pend or terminate must be made on the basis of the case situation at hand and depends on numerous factors, including when the IR was received, if subsequent changes have been reported, if verification was requested timely, etc. It is recommended that staff review newly available training material on processing of the interim report form.
    - Under 9122.8, Processing Reported Changes That Are Required to be Reported, item (1), 130% Reporting Threshold is being modified to clarify that the 130% reporting threshold established at the time of certification, IR or review will remain the same until the next IR or review is due, whichever comes first. If the household has a change which puts them at or over the original 130% reporting threshold, but remains eligible, no further reporting requirements regarding income is required until the next IR or review is due, whichever comes first.
  1. Terminating Food Stamp Claims - The manual is being modified to clarify when food stamp claims are to be terminated. Food Stamp claims shall be terminated when the balance due is less than $1.00. It is important that these claims be terminated so that collection can start on any remaining claim balances. Local staff or Central Office TOP can terminate claims for death or remaining balance due under $1.00. Any other claim terminations must be done by the Central Office TOP unit. KEESM 11127 reflects this clarification.
MEDICAL ASSISTANCE
1. CHANGES
  1. Former Foster Care Youth - A new Medicaid group covering youth formerly in foster care is being implemented. The new group will provide extended coverage to youth, born on or after 07-01-1985, who are in foster care in an out-of-home placement at the time of their 18th birthday. Coverage is available through the month of the individual’s 21st birthday.
    Coverage under this group begins 07-01-03. Staff in Children and Family Services (CFS) will have application and case maintenance responsibilities for the program. Specific program requirements are located in the Children and Family Services Policy and Procedure Manual. Other EES or HCP staff processing medical applications must recognize a potential eligible and refer the individual to appropriate CFS staff for a determination.
    
    KEESM Section 2611(1) is being modified to reflect this change. Separate implementation instructions will be issued to staff.
  2. Poverty Level Changes - New federal poverty level guidelines have been published by the Department of Health and Human Services. These guidelines affect the eligibility standards for several Medicaid groups:
    1. Income standards for the Medicaid poverty level and HealthWave programs; Income standard for QMB, LMB, Expanded LMB and QWD programs;
    2. Income standards and premiums for Working Healthy (premium levels will remain constant); and
    3. For spousal impoverishment, the minimum community spouse income allowance increases from $1,515 to $1,562, the excess shelter deduction changes from $193 to $207, and the dependent family member allowance increases from $505 to $521.
    The following KEESM sections, forms and appendix are being updated because of this change:8144.2, 8244.2; form ES-3104.5, Determination of Need; form ES-3163, Income Allowance Determination Form; form ES-3165, Working Healthy and Premium Information; Appendix Item #55, Medicaid and HealthWave Standards. Separate implementation instructions will be issued to staff for these changes.
2. CLARIFICATIONS
  1. Working Healthy Premiums - A premium is adjusted prior to the end of a 6 month period if the premium amount was incorrectly determined. A correctly determined premium amount is not increased until the end of the 6 month period. For example, unreported income which results in an understated premium should be corrected as soon as possible given timely and adequate notice. However, an income increase during the 6 month period is not acted upon, so the premium is correct. KEESM 2664.5(1) is being updated and 2664.5(5) is being rewritten to better reflect this policy.
  2. Working Healthy Temporary Unemployment Period - Extended eligibility for persons temporarily unemployed is only available to persons who were actually employed during a regular eligibility period. Persons employed only during a prior medical period are not eligible for a temporary unemployment period. KEESM 2664.7 is being updated with this clarification.
  3. NF Level of Care/CARE Requirements - Updates and clarifications have been incorporated to reflect requirements for establishing functional eligibility criteria for nursing home care. The establishment of functional eligibility continues to be the responsibility of KDOA. This is generally accomplished with a level of care score obtained through conducting a CARE assessment. However, other instruments aside from the CARE may be used to determine level of care, as established by KDOA. A CARE assessment continues to be required for persons prior to admission, except when specifically exempt by KDOA. When a CARE is required, Medicaid reimbursement for nursing facility expenses is not available until the CARE is completed. NF payment may not begin until the day the CARE has been completed except for persons admitted under a provisional admission. A delayed CARE is permitted in these instances. Provisional admissions are emergency admissions, such as an APS referral, natural disaster or loss of care giver or admissions not expected to exceed 30 days. Each provisional admission is approved by KDOA for a specific period of time. If otherwise eligible, NF payment may be approved during the provisional time period only. A CARE must be completed for payment to continue beyond the duration of the provisional period. All provisional admissions, and associated time frames, are reported on the ES-3164. If a CARE is subsequently completed outside of the specific time period, no payment to the NF would be available between the expiration date and the date the CARE is completed. Specific requirements regarding the provisional admission may be found in the KDOA Field Services Manual section 2.1.
    Consider the following examples. Janice enters the NF on 02-15-04 based on a doctor’s order for immediate placement. The NF completed the necessary paperwork and KDOA determined this met the criteria for a provisional admission and allowed the NF 7 days to complete the CARE. A CARE is completed on 02-20-04 and Janice has a level of care score of 40. The EES worker receives the ES-3164 indicating a provisional admission was made and the CARE was completed within this window of time. If Janice meets all other Medicaid criteria, NF payment may begin effective 02-15-04. However, if the NF had not followed up timely and Janice’s assessment was not completed until 03-01-04, payment to the NF would not be available between 02-22-04 and 02-29-04. The LOTC screen must be updated to reflect the interruption in payment.
    
    A separate clarification involves payment responsibilities when a denial of payment occurs due to a delayed CARE. Apart from the exceptions noted, NF payment may not begin until the actual date the CARE is completed. Because the NF is responsible for ensuring a CARE is completed, persons otherwise eligible for Medicaid are not responsible for any unpaid NF bill incurred as a result of the delayed CARE. This information is being formally incorporated into KEESM.
    
    KEESM Section 8114.1 and 8114.2 are being updated with this information. The ES-3164, Request For CARE Information/ Level of Care Score, is also being updated to better capture and communicate this information.
  4. Exempt Retirement Accounts - Clarification regarding exempt retirement accounts for the non-applicant/recipient spouse or parent of an MS, QMB, LMB and QWD applicant/recipient is being added. Only IRA's and work related pension funds (including Keough accounts for the self-employed) which are owned by a non applicant/recipient spouse or parent are exempt. Other types of retirement funds, such as private annuities owned by a community spouse, are not exempt.
    KEESM section 5430(15)(c) is being updated with this clarification.
WORK PROGRAMS
1. CHANGES
  1. Applicants - Effective January 1, 2004, all TAF applicants will start the EAP process with the date of the application unless exempt from work program requirements or victims of domestic violence or sexual assault. This change is reflected in 3100.1, 3100.2, 3310.2, and 3310.4(4).
  2. Job Search Components - Applicants will generally initially be assigned to the Employment Assessment Process rather than job search activities from the date of application. This change is being incorporated into KEESM 3310.2.
  3. Disability Employment Services - Changes recommended by the EES and RS Coordination Team are being incorporated into KEESM 3310.4 (3). In addition, an EES/RS Coordination Procedure/Best Practice has been added in Appendix Item 113. The following forms have been modified: ES-4308, Assessment Referral; ES-4315, EES Referral to Rehabilitation Services. The following Best Practice tools have been added to Appendix: Item 114, Definitive Medical Report; Item 115, EES Screening Tool for Referral to Rehabilitation Services; and Item 116, EES/RS Monthly Communication Report.
  4. Employment Assessment Process (EAP) - EAP is being redefined as Community Service for federal reporting purposes. While in the EAP component, participants will undergo an initial assessment of employment barriers within 90 days of application approval; receive follow-up assessment and services when appropriate; and undertake a prospective goal of performing 20 hours of community service. Combining the 20 hours of community service with assessment activities, which may include such job training skills directed to employment as developing resumes, filling out job applications, interviewing skills, getting to work on time, etc. will total the federally required 30 hours per week to meet participation requirements. KEESM 3310.4(4) contains these modifications. The ES- 4309, Employment Assessment Process, document is also being revised to reflect the goal of 20 hours per week in community service.
  5. Orientation, Assessment, Referral, Safety (OAR) - If a state fails to meet the federal work participation rate, the state may receive reasonable cause if it demonstrates that it met the rates when domestic violence cases are removed from the calculation. KEESM 3310.4(11) is being modified to indicate that case managers need to code TAF clients working on domestic violence issues in the OAR component for “0" hours per week. The need to continue the OAR assignment is assessed minimally at 6 month intervals is also being added to this section.
2. CLARIFICATIONS
  1. TAF Participation Rate Requirements - An expectation is being added to section 3110 that each SRS management area is responsible for maintaining a 50% all families work participation rate and a 90% two-parent work participation rate. In addition, a note is also being added in 3110 that single parent families with a child under age 6 will meet the federal participation requirement if the parent is engaged in work or work activities for at least 20 hours per week.
  2. TAF Only Work Related Exemption - Clarification is being added in section 3220 to indicate that the exemption for caring for a child under age one cannot be claimed by one parent or caretaker in households that do not meet the two-parent definition for federal reporting purposes contained in 3110 when the other parent or caretaker is in the home and available, capable and suitable to provide care. Additional clarification is also being added to the availability of the child under age one exemption when at least one of the adults has reached the 48th month of TAF cash assistance.
  3. Work Components - Work program progress reviews need to minimally occur every 6 months, and SRS Management areas have flexibility in establishing progress review procedures. An individual client will not be assigned to work components in excess of 40 hours per week. These clarifications are being added to 3310.
  4. Miscellaneous Changes - Numerous minor clarifications are included. Sections affected are: 3130.2; 3310.3; 3411.2(4); and 3421

FORMS (Not previously discussed in this Summary)

Adult Protective Services
1. The ES-1000, Adult Protective Services Intake form is being revised to reflect that the Kansas Department on Aging is responsible for reports in an adult care home.
2. The ES-1017, Adult Protective Services Case Activity Log is being revised to reflect changes in format requested by field staff.
3. Two APS brochures were updated in September, 2003 due to statute changes in July, 2003 and are being incorporated into the KEESM with this revision. These brochures are the ES-2003, What happens if you are accused of abuse, neglect, exploitation or fiduciary abuse of an adult; and ES-2004, SRS Adult Protective Services for vulnerable adults at risk living in their own homes or licensed residential homes in Kansas are provided by the Department of Social & Rehabilitation Services for the purpose of preventing or alleviating abuse, neglect, exploitation, or fiduciary abuse.
Food Assistance
The ES-3103, Income/Expense Worksheet is being added to the forms section. There is a WordPerfect version of the form and a Quattro Pro version of the form. In addition to the forms themselves, Instructions for completion of each of the forms is being included immediately following each form. NOTE: Only the WordPerfect version is being included in the online KEESM.

MISCELLANEOUS FORMS (Not previously discussed in this Summary)

Authorization for Release of Protected Health Information form is being added to the Miscellaneous Forms section. This form meets HIPAA compliance requirements and was issued in 2003 by the state’s Office of HIPAA Compliance.

APPENDIX (Not previously discussed in this Summary)

Item 58 - Components to Meet Work Requirements/Participation - This chart is being updated to reflect changes due to the loss of the TANF Waiver.
Item 79 - EBT System Guide - SRS ceased converting EBT benefits to stamp coupons effective 1-1-04. The EBT Security profiles are being modified to reflect this change. Modifications are being made to reflect the change in 12/03 allowing cash benefits (TAF, GA, RE) to be expedited via the (Field Issuance) FIIS screen on KAECSES. Also, the program cost account benefit codes are being updated in item 11 of the guide to reflect the addition of two work program (WP) cash benefit type codes.
Item 117 - Community Service Report - This optional form is being added for those areas that plan to monitor participation in community service activities.
Item 118 - IR Set Up Schedule for simplified reporting food stamp households is being added with this revision.

EFFECTIVE DATE

The Work Program changes related to the loss of the TANF waiver were effective December 16, 2003 with the issuance of Policy Memo 03-12-03. All policies in this revision are effective May 1, 2004. All new applications and reviews processed on or after May 1, 2004 shall be completed using these revised policies. All open cases should be updated using the new policies when the case is being worked on to process other changes.

It is expected that the changes in this revision will free staff from nonessential work and allow staff to focus efforts on other more critical areas. The change to mandate the utility allowances should simplify food stamp case processing for staff. The work program changes allow management areas more flexibility.

Clarifications are intended to provide greater understanding of program expectations in order to allow faster and easier administration at the local level. Efforts continue to be made to allow area discretion and flexibility in order to make prudent decisions given basic guidelines. Clarifications included in this manual revision should help staff with interpretation of policy and procedure and insure that it is consistently applied.

MATERIALS OBSOLETED BY THIS REVISION

Policy Memo 01-10-05, TAF Work Program Payments, is obsolete. The information in this Policy Memo had previously been incorporated into KEESM 3400.
Policy Memo 03-12-03, Policy Changes Necessary to Meet Federal Participation Rates After Loss of the TANF Waiver, is obsolete. The May 2004 KEESM Revision incorporates the information contained in this Policy Memo.
Policy Memo 04-01-01, Income/Expense Worksheet, is obsolete. The May 2004 KEESM Revision incorporates the information contained in this Policy Memo.

EFFECT ON LOCAL STAFF

Work program changes required staff to review a number of Two Parent cases during January 2004 and One Parent work program cases between January 1 and June 30, 2004. In addition, these changes may require local procedural modifications and work with contracted employment service providers and other community partners.

COORDINATION EFFORTS

Within SRS, the material in this letter and manual revision have been coordinated with staff in the Economic and Employment Support, Child Support Enforcement, Children and Family Services, Health Care Policy, the EES Chiefs, The Policy Development Team, The Implementation Planning Team, EES Program Training Unit, the EES and RS Coordination Team, the Income/Expense Workgroup Team and other EES field staff. This material has also been coordinated with the Kansas Department on Aging and the Kansas Coalition Against Domestic Violence and Sexual Assault (KCSDV).

Sincerely,

Bobbi Mariani, Director
Economic and Employment Support

BM:MSW:jmm