Based on recent federal clarification, a referral to CSE for absent parent cases requesting medical coverage only for children will no longer be required. Families receiving children’s health coverage will still be offered CSE services, but the automated referral process will be eliminated. It is important to note that non-pregnant adult caretakers of children with an absent parent(s) who are themselves receiving medical coverage under the MA CM program must continue to cooperate with CSE as a condition of eligibility. Referrals will continue to be sent for these cases. However, any failure to cooperate shall only impact medical coverage of the adult, coverage for a child is not impacted by the failure of the caretaker to cooperate with CSE. A pregnant woman is exempt from this requirement even if she is also the parent of other children. This change in the referral process is effective with all cases processed on or after May 1, 2001.

Modifications to the KAECSES system to support this change are currently in development. New programming will remove the logic associated with the CSE referral process from the KAECSES system for the MP, SI, MS and CI programs. Once this new programming is in place, the CHSE screen will be removed from the screen sequence for the above programs. SPRD will remain a piece of the KAECSES logic however, as staff must continue to designate a specified relative on each case. When completed, CSE referrals will no longer be generated for these programs. Additional implementation instructions will be released when the new programming is available. Until the new programming is migrated the procedures explained in this memo shall be followed.

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For medical only applications processed on or after 05-01 under the MP, SI, MA (except MA CM), MS or CI programs a CSE referral from KAECSES shall not be sent. If a family is requesting other programs that require or offer an automated referral, the referral will continue to be necessary. For example, a FS and MP family that volunteers for CSE through FS would continue to be referred through KAECSES, as the automated referral process will continue to be utilized for food stamps. Because a medical case with an absent parent cannot be authorized until a referral has been sent, staff must ensure that both SPRD and CHSE are properly coded in order to prohibit a referral from being generated and then allow authorization of benefits. For cases without prior KAECSES involvement this is done by entering a deprivation cause code of ND (no absent parent) for each child on the SPRD screen after the specified relative is designated. The ND code is to be utilized regardless of the status of the absent parent. No other action is necessary in these instances. If there is prior involvement and absent parent(s) have already been designated for children on the case, it is necessary to access CHSE and detach all children from all absent parent(s) on the case by removing (erasing) the POA for all children to prevent a referral. SPRD must be accessed again and an ND deprivation code entered. This step must be completed on CHSE BEFORE the coding change on SPRD is completed.

For ongoing cases, it is recommended that the above procedure to detach children on a medical only case also be followed when a review is being completed for one of the medical programs named above, in order to reduce the number of referrals sent to CSE. When the new KAECSES programming is implemented, this procedure will be discontinued.

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SPECIAL INSTRUCTIONS FOR CASES WITH CHILD CARE

Absent parent cases with child care involvement will continue to be referred to CSE. However, if a KAECSES case also exists for the family, a referral cannot be sent from KsCares. For example, an absent parent case approved for MP and CC must be referred to CSE, but the referral cannot be sent through KsCares. Although consideration is being given to reprogramming KsCares to support current CC policy, local offices must coordinate a procedure to make CC referrals until automated processes are in place. Local CSE and EES should choose one of the options outlined below to make such referrals. Although offices may use different procedures within each area, approval and coordination with both the EES Chief and the CSE Chief is required.

For current open cases, it is not necessary to send a special notification to inform CSE of the existence of a CC case if a referral was originated from KAECSES due to an open medical program. CSE is able to identify all active program involvement for a particular case as well as other pertinent information regardless of which program actually generated the referral. For instance, if a referral was sent from KAECSES for a family receiving MP and CC, involvement for both programs is reflected on the CSE system and no additional action is needed. However, it is necessary to inform CSE when a CC program is being added to a case with only open medical programs or when a change in household membership occurs. For example, a notification must be sent if a new child moves into the household or if a parent leaves a household. If medical remains open, the notification will be through the process elected by the area. If medical has recently closed and child care is the only open program the referral shall be sent through the KsCares system.

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For both changes and new referrals, areas may choose between the following options to make CC referrals:

Option 1 - E-Mail Referral:

EES staff will initiate the referral with an electronic message to appropriate CSE staff. The e-mail must minimally contain the names of the absent parent(s) and their eligible children. Additional content of the referral shall be established locally.

Option 2 - Use of KAECSES Referral:

EES staff will initiate the CC referral through a referral from the KAECSES SPRD/CHSE screens. Both screens will need to be completed and the narrative line must be specifically denoted ‘Child Care Referral’ if this process is used. Coordination with CSE will be necessary to ensure that all incoming referrals are reviewed by CSE to determine if CC involvement exists.

OTHER ISSUES

To allow families the opportunity to access CSE services, approval notices for the MP program are being modified to incorporate the following statement regarding the availability of CSE services: ‘If you need help getting child support for a child who is living with you the State of Kansas Child Support (CSE) program may be able to help you. The CSE program may also be able to help with getting the absent parent to provide health insurance for your child. If you would like information on this program, contact the worker listed above for the location of the nearest CSE office.’ Callers are to be given the name and number of a local CSE contact person. The client will then need to contact CSE on their own to access CSE services.

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Staff will be notified and provided with additional instruction upon full completion of the programming described above. Until then, CSE will no longer process any referral (initial, reopen or change referral) that is made for only one of the medical programs listed above. Because EES staff cannot rely on the automated referral process to inform CSE of key information, it is critical that alternative methods are established locally when important information must be communicated to CSE staff. Areas may consider expanding on the local method established for child care referrals to accomplish this. Please note that separate notifications do not have to be made for address changes as KAECSES will continue to generate an alert for CSE if there is also an open CSE case. Unless the family is actively participating and seeking services, CSE staff will begin the process of closing all open medical-only referrals after May 1.

2. KEESM 2165.1- NONCOOPERATION WITH CSE (SCL #11)

When CSE makes a finding of non-cooperation on a case, that information is communicated to the EESS. Policy is being clarified to clearly indicate when future applications for assistance are impacted by such a finding of non-cooperation. In order to make this decision it is necessary for the EESS to determine if the non-cooperation occurred as a result of a referral that required cooperation with CSE as a condition of eligibility (TAF, MA CM or CC). This change will require staff to carefully review all non-cooperation indicators present on the system when processing a new application for one of these programs to determine the program associated with the failure. Communication with CSE may be necessary if the case file and/or system do not provide adequate information to make this determination. For situations where there is participation in different or additional programs than were present at the time the referral was sent, the failure will be associated with the program in which the client was participating when initially referred. However, if a follow up referral was made due to assistance under the TAF, MA CM or CC program(s), the failure will be associated with that program.

When the decision to delay processing based on an existing finding of non-cooperation is made, it is important that local procedures be in place to ensure CSE is notified of the reapplication. The client must be given adequate opportunity to comply before denying assistance.

If a family participating only in programs which do not require cooperation fails to cooperate with CSE it is no longer necessary to enter an 'NC' code on PRAP. For ongoing cases, all such PRAP codes should be evaluated at review. If it is determined that the code was based on a program without a cooperation requirement the code shall be removed.

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Consider the following examples:

Example 1: In 05-00 a referral was sent to CSE as a result of an MP approval for children’s medical coverage. The caretaker did not cooperate with CSE and a finding of non-cooperation was communicated to EES and noted on KAECSES. In 07-01 the family is applying for TAF cash assistance and the finding of non-coop is noted by the EESS. The EESS would not delay processing the TAF application because of the previous non-coop as it occurred as a result of program involvement that did not require cooperation.

Example 2: In 03-00 a TAF, FS, medical case was referred to CSE. The TAF and FS programs closed 06-00 for no MR, leaving only an ongoing MP, which remains open. In 08-00 EES was notified of non-cooperation. The family is now requesting MA CM. Because the existing non-coop was associated with a TAF program, which requires cooperation, the family must cooperate with CSE before MA CM can be approved. The local procedure requires the EESS to notify CSE of the new application by e-mail. MA CM cannot be processed until CSE staff have notified EES of the results of the referral. However, if there is a pregnant woman requesting coverage expedited processing time frames must be met. Consideration shall also be given to processing the children and/or others whom could receive under another medical category.