STATE DEPARTMENT FOR CHILDREN
12/30/14
AND FAMILIES
Family Services
Docking State Office Building
Room 581 - West
Topeka, Kansas 66612
To: |
Regional Directors
Economic and Employment Services Program Administrators
Economic and Employment Services Staff
KDHE-HCF Staff, including the KanCare Clearinghouse
Prevention and Protection Services Administrators
Other Staff |
Re: |
Summary of Changes for Kansas Economic and Employment Services Manual (KEESM) Revision No. 70 effective January 1, 2015 |
OVERVIEW OF CHANGES
A brief overview of the major changes is described below. Other clarifications and technical corrections are also included and described in the next section. Additional technical corrections not mentioned here are being incorporated in KEESM as needed.
Child Care and Successful Families – TANF Fraud policies have been changed identifying only those adults in a household where fraud has been determined are ineligible for assistance. The adults remain ineligible for their lifetime, and fraud committed in either TANF or child care results in ineligibility for both programs. Child(ren) remain eligible to receive TANF and child care, however, the household is now required to name a protective payee to administer their benefits.
Verification requirements have been changed adding verification of identity for the person making application for child care, verification of citizenship for individuals requesting TANF and/or child care, and verification of date of birth for each child for whom child care assistance is requested.
Medical Assistance – The PACE program has expanded into several additional counties effective January 1, 2015. The annual cost of living increase in the minimum and maximum community spouse resource allowance and the maximum community spouse income allowance is being transmitted with this revision. These amounts will increase effective January 1, 2015 pursuant to federal law and are based on the annual change in the federal consumer price index (CPI). The substantial home equity limit for individuals applying for long term care assistance is increasing effective January 1, 2015. The resource standards for the Medicare Savings Programs (MSP – QMB, LMB and ELMB) are also increasing effective January 1, 2015. Costs related to Medicare Part D and the Subsidy program are changing. The benchmark premium amount for Kansas and the amount of prescription co-payments are changing effective January 1, 2015.
DESCRIPTION, PURPOSE, AND DETAILS OF POLICY CHANGE
- Child Care
- Changes
- Verification Provisions – KEESM 1322.1 (5) is being changed to reflect revised policy to include child care in the programs requiring verification of identity for the person making application for child care. KEESM 1322.1(14) is being changed to reflect the new requirement that documentation of date of birth be provided for each child for whom child care assistance is requested.
- Clarifications
- Flint Hills Job Corps – KEESM 2850 is being modified to clarify that this policy applies not only to parents, but also to caretakers who might be applying for or receiving child care assistance.
- Child Care and Successful Families
- Changes
- TANF and Child Care Penalties – KEESM 11221.2 and 1515 Protective Payees are being changed to reflect the revised policy that allows children to continue receiving benefits when the adult(s) in the household have been found guilty of fraud. Fraud in one program continues to affect both child care and TANF even if fraud is only committed in one program. Households that are determined to have committed fraud (see KEESM 11200 and following sections) are required to have a protective payee administer their benefits.
- Verification Provisions – KEESM 1322.1 (11) and 2145 are being changed to reflect that verification of citizenship is now required for each individual requesting assistance for all programs except Food Assistance.
- Clarifications
None
- Food Assistance
- Changes
None
- Clarifications
- Special Provisions for Matches Obtained Via the eDRS – KEESM 1434.1 is being clarified to respond to secondary verification requests within 20 days and if documentation from the other state is not received within 20 days, the agency must determine eligibility and cannot apply the disqualification period.
- Low Income Energy Assistance Program (LIEAP)
- Change
None
- Clarifications
- Payment Mechanisms – The policy allowing checks to be paid directly to households with a primary heating account or prepaid situation was changed in a previous revision. Item (c) (3) is being removed from 13422, Check Payable to Household, to reflect current policy.
- Medical Assistance
- Changes
- PACE Expansion – The PACE program has expanded into several additional counties. Midland Care Connections in Topeka has expanded into Lyon, Marshall and Nemaha counties. Via Christi HOPE in Wichita continues to serve Sedgwick county. Effective January 1, 2015, Midland Care Connections will serve the following counties:
Shawnee
Douglas
Jackson
Jefferson
Lyon
Marshall
Nemaha
Osage
Pottawatomie
Wabaunsee
KEESM section 8310 will be updated with this revision.
-
COLA Mass Change – Effective January 1, 2015, the minimum community spouse resource allowance will increase from $23,448 to $23,844 and the maximum resource allowance will increase from $117,240 to $119,220. In addition, the maximum community spouse income allowance is increasing from $2,931 to $2,981. Neither the minimum income allowance nor the dependent family member allowance is changing.
Because the SSI income level is changing, the Presumptive Medical Disability – SI related eligibility level is also changing. The income level is changing from $721 to $733 for a single individual and from $1,082 to $1,100 for a couple.
KEESM sections 8144 and 8244 are being updated with this revision. The ES-3162 (Resource Assessment and Allowance Determination Form), the ES-3163 (Income Allowance Determination Form), the ES-3104.6 (determination worksheet for Pickle Eligibles and Other Protected Medical Groups) and the Appendix Item F-8 (Kansas Medical Assistance standards) are also being updated with this revision.
- Substantial Home Equity – The substantial home equity limit for individuals applying for long term care coverage is increasing from $543,000 to $552,000 effective January 1, 2015. This increase is mandated by federal law and is based on the annual change in the consumer price index (CPI).
KEESM section 5331.1 is being updated with this revision.
- Medicare Savings Programs – The resource limit for the Medicare Savings Programs (MSP – QMB, LMB, ELMB) is increasing from $7,160 to $7,280 for a single individual and from $10,750 to $10,930 for a couple. The increase is mandated by federal law and is based on the annual change in the consumer price index (CPI).
KEESM sections 2671, 2672 and 5130 are being updated with this revision.
- Medicare Part D Subsidy – Costs related to the Medicare Part D prescription drug coverage are changing for 2015.
The following co-payments for dual eligible Medicare Part D beneficiaries are effective January 1, 2015:
- For individuals eligible for QMB, LMB or ELMB, the co-payments will increase from $2.55 to $2.60 per generic and from $6.35 to $6.60 per brand name.
- For full Medicaid eligibles with income at or below 100% of FPL, the co-payment will remain $1.20 per generic and $3.60 per brand name.
- For full Medicaid eligible with income above 100% of FPL, the co-payment will increase from $2.55 to $2.60 per generic and from $6.35 to $6.60 per brand name.
The benchmark subsidy premium for Kansas is also changing from $34.21 to $30.32 effective January 1, 2015. This figure impacts the amount of Medicare Part D subsidy a beneficiary can receive. The subsidy will provide coverage of the lowest premium a Part D plan offers, up to the basic premium level for the state. A beneficiary receiving the subsidy may elect an enhanced or high cost plan, but he/she is responsible for the difference between the benchmark and the actual premium amount.
KEESM section 2675.4 is being updated with this revision.
- Clarifications
- Due & Owing Expenses – Clarification is being added that the allowance of medical-only related due & owing assisted living expenses also applies to a nursing home patient liability. KEESM section 8172.1(2) will be updated with this revision.
- Successful Families
- Changes
None
- Clarifications
- KANSASWORKS/WorkKeys (KWK) – KEESM 2251 is being clarified to require all TANF adults who request assistance for themselves to complete KWK before eligibility for TANF is determined.
FORMS (Explanation provided if not mentioned previously in this summary.)
Medical Assistance
ES-3104.6, Determination Worksheet for Pickle Eligibles and Other Protected Medical Groups
ES-3162, Resource Assessment and Allowance Determination Form
ES-3163, Income Allowance Determination Form
APPENDIX (Explanation provided if not mentioned previously in this summary.)
-
Medical Assistance
F-8, Kansas Medical Assistance Standards
-
Child Care
C-15, Out of Home Relative Provider Enrollment: Language was added to the Background section indicating there is no eligibility for those appearing in the Adult Abuse, Neglect or Exploitation Registry.
-
Child Care and TANF
P-3, Protective Payee
Agreement and Attachment: Language was added to include the use of this item for child care.
MISCELLANEOUS FORMS (Explanation provided if not mentioned previously in this summary.)
None
EFFECTIVE DATE
Polices for this revision are effective January 1, 2015.
EFFECT ON LOCAL STAFF (No significant effect if not explained below.)
MATERIALS OBSOLETED BY THIS REVISION
None
COORDINATION EFFORTS
This change was coordinated with staff in Economic and Employment Services, Executive Leadership, and the EES Program Administrators.
Sincerely,
Jaime Rogers, EES Director
Economic and Employment Services
JR:am |