Kansas Department of Social
and Rehabilitation Services
|
To: |
EES Chiefs and Staff |
Date: |
March 16, 2005 |
From: |
Dennis Priest |
RE: |
Implementation Instructions for Poverty Level Increases |
This memo provides implementation instructions for the increases
in the federal poverty level standards which take effect
May 1, 2005.
POVERTY LEVEL CHANGES
The poverty level table in KAECSES will be updated on 03-18-05 to incorporate the new poverty level amounts effective 05-01-05. Eligibility for any cases copied into May, 2005 after this date was computed using the new poverty level amounts. The Medicaid poverty level/HealthWave, Working Healthy and QMB programs are affected by this update. Since eligibility for the LMB and QWD programs is determined manually, automated processing for these programs as well as the spousal impoverishment changes, are not affected by this action.
For spenddown cases in which a child(ren) and/or pregnant women is included and meet the Medicaid poverty level or HealthWave criteria, an MP program is to be added in KAECSES with a proration date of 5-01-05 and the current base is shortened to end in April.
Individuals who have not met spenddown previous to the change
are to be notified of the new spenddown amount for the shortened
base. In addition, persons who met spenddown previous to the
poverty level determination are to be notified of the shortened
base and decreased spenddown so they have the opportunity to
have a portion of their spenddown expenses covered.
Eligibility work for any of the above changes must be completed by April
21, 2005 (medical card cutoff for May) in order for eligibility/coverage
to be correct for May.
Such review should occur no later than the next scheduled review. QMB status would be effective the month following the month in which the case is reviewed.
NOTE: For all cases in which QMB or LMB eligibility is changing, care must be taken to ensure the PICK and SEPA codes remain compatible. Consider the following examples:
All cases which may lose QMB coverage must be reviewed to ensure proper eligibility information is entered and the coding remains consistent. To identify these cases, a printout of all MS cases with a QO medical program subtype as well as those with a QS, QM or WQ subtype have been identified. The printout will be sent within the next few days to the Regional Report Distribution List. The cases need to be reviewed beginning with the benefit month of May. A similar printout will be provided in May for final review purposes
To aid in the review process, a printout will be produced based
on KAECSES records and will list all cases in which an AI or
AI/DI code is reflected on EXNS. These codes reflect cases in
which income is being allocated. The printout will be in alphabetical
order by case name and be in caseload by county order. It will
also list the expense code as well as the allocated amount. This
information will be based on KAECSES information as of mid-March
and will be sent separately
.
Income
allowances are
to be adjusted
in some of
the cases
as the community
spouse can
now get at least
$1604 a
month and
any dependent
family member
can get $535
a month
provided his
or her income
is not in
excess of
$1604 per
month. The new
community spouse
standard affects
the outcome
of the
excess shelter
calculation. The
maximum amount
of excess
shelter which
can now be
given is $773.50.
Thus, if
the person’s
shelter payment
equals or
exceeds $993.50
all that can
be allocated
is $773.50.
Any payment
less than $993.50
but more than
$220 would
produce a
varying standard.
These new
guidelines may
decrease or
eliminate the
excess shelter
allowance in some
cases.
Premium adjustments necessary because of the new income levels will not be automated. All Working Healthy premium cases must be reviewed to determine if the premium obligation will be reduced or eliminated based on the new income levels. Countable income shall be compared to the new standard and, if a reduced premium results, the new premium is effective May 1, 2005. A new notice, N743 - Change - WH Premium Levels, has been created for this purpose. Premium cases are identified on the Working Healthy Premium Report (MR410) and is available on SAR, report ID SWYO183T-R04. Please make note that only the premium income levels are changing, the premium amounts are not being adjusted this year.
Staff should be reminded that any time a change has occurred which may effect the family share - income level table changes, adding a household member, removing a household member, changing income - it is necessary to press PF12 in INEL in order to accurately update the case. Once INEL is updated, any pre-existing child care plans will also need to be updated on CHCP accordingly. Cases have been seen where an income change was reported, INEL updated, but the existing child care plans were not updated and continued to show/assign the old family share amount.
With annual poverty level adjustments, changes to existing child care plans will be implemented at the next review (which may be as far as 12 months in the future) unless requested/required earlier. Any cases processed after the table changes will use the new Family Share table on KsCares with the new income levels. This includes new plans with an effective date prior to May 1, 2005 if initial eligibility is completed on or after the date the table changes are made. Poverty level updates are a positive change, so staff need not be concerned that some plans with a start date prior to May 1, but processed after the table changes will use the new income/share amounts. Since there will be no mass change to child care plans, no mass notice is necessary.
DP:NL:JS:jmm
Attachments:
ES-3163 - Income Allowance Determination Form
Medicaid and HealthWave Standards
Monthly Family Income and Share Schedule for Child Care Services