State of Kansas Department of Social and Rehabilitation Services
Laura Howard, Acting Secretary
Integrated Service Delivery - (785) 296-3271
Economic and Employment Support - Bobbi Mariani, Director (785) 296-3349
....Enriching lives today and tomorrow

MEMORANDUM

This memo provides implementation instructions and information for the following January 1, 2011, policy changes in the Kansas Economic and Employment Support Manual (KEESM):

1. Food Assistance Standard Medical Deduction - See Summary of Changes, Section I, A, 1. and KEESM sections 1322.2,7223,7227.5.
   
   Effective January 1, 2011 a standard medical deduction shall be allowed for all households with anticipated ongoing monthly medical expenses greater than $35 and equal to or less than $175. If expenses are in excess of $175, the household may choose to use the standard, or actual. Refer to the Summary of Changes and the manual pages for all details.
   
   Remember, the Standard Medical Deduction is not automatic in KAECSES. The code of ME SM and the dollar amount of $175 must be entered on EXNS by each person who is entitled to use the standard.
   
   This change will apply to all applications received or processed on or after January 1, 2011. For ongoing cases with medical expenses, a printout will be issued in December listing all active cases with medical expenses less than $175. These cases shall be converted to the standard medical deduction for the February benefit month. If the case cannot be changed in time for the February benefit month, lost benefits are to be issued for the February benefit month if appropriate.

Medical Standard Deduction Examples

1. Q: A customer will be on buy-in in the third month of the review period. The first two months they have to pay the Medicare premium of $106. Is the standard deduction allowed?
   
   A: Yes for the two months the customer is responsible for paying the Medicare premium. An alert should be set to remove the standard medical deduction for the third month unless the household has other ongoing medical expenses over $35 per month. The Medicare premium must be verified. The code ME SM and $175 is entered on EXNS by the appropriate elderly or disabled person.
   
   
2. Q: A customer reports a one time expense of $125 for glasses. Is the standard medical deduction allowed each month until the time of the next review?
   
   A: Assuming they have no other expenses, no it is not allowed for the remainder of the review period. The standard medical deduction is only allowed for one month, or averaged over the remainder of the review period whichever is more beneficial. The expense must be verified to be allowed for the one month. If allowed for the one month, the code ME SM and $175 is entered on EXNS by the appropriate elderly or disabled person.
   
   
3. Q: At application a customer reports a $40 pharmacy bill and a $50 doctor bill. They are not ongoing monthly expenses. What do I do?
   
   A: You allow the standard medical deduction for one month since the expenses are less than $175. At least one of the two expenses must be verified. The code ME SM and $175 is entered on EXNS by the appropriate elderly or disabled person.
   
   
4. Q: At the time of application the household reports ongoing medical expenses. $20 a month in copays, a new installment agreement for $50 per month for the next two years, and a monthly expense of $36 for a seeing eye dog. Total monthly expenses are $106. The monthly expenses for the seeing eye dog is verified.
   
   A: The household is allowed the standard medical deduction throughout the new review period. At the time of review, the household only has to declare that they still have the same medical expenses, and the standard is continued to be allowed. No verification at the time of review is required. The code ME SM and $175 is entered on EXNS by the appropriate elderly or disabled person.
   
   
5. Q: A household reports $180 in ongoing monthly medical expenses. Verification is requested. No verification is provided.
   
   A: Neither actual nor the standard is allowed since the household did not provide verification. If the household provided verification of at least one ongoing expense over $35, the standard medical deduction would be allowed. The customer must be notified that the standard was allowed since they did not provide verification of all expenses as requested. The code ME SM and $175 is entered on EXNS by the appropriate elderly or disabled person.
   
   
6. Q: TAF caretaker grandparents apply for TAF and food assistance. The grandfather is 62 and grandmother is 60. Ongoing medical expenses are reported for each. Grandfather has $50 a month in ongoing expenses and grandmother has $45. Appropriate verification is provided.
   
   A: A standard medical deduction is allowed for the grandfather and the grandmother. An expense of ME SM and $175 is placed by the appropriate person(s) on EXNS. NOTE: Both the grandfather and the grandmother are entitled to the $175 standard medical deduction.
   
   Follow up Q: What if the grandmother is 59 and not disabled?
   
   A: The grandmother is not entitled to the standard medical deduction.