M E M O R A N D U M

TO: EES Program Administrators
FROM: Kathe Decker
DATE: December 30, 2012
SUBJECT: Implementation Instructions - KEESM Revision #53

This memo provides implementation instructions and information for the following January 1, 2012 policy changes in the Kansas Economic and Employment Support Manual (KEESM).

1. All Programs
   
   

   Inter-county Transfers – See Summary of Changes item I, A, 1, and KEESM sections 9220, 9221 and 9222.
   
   Changes are being implemented to streamline inter-county transfers. The office where the change is reported (either by customer or other sources) will initiate the system changes required to make the transfer. This includes updates to address, county of residence, and other reported changes.
   
   If the sending county is the office where the change was reported, they will make the change and update the system with all known changes prior to mailing the transfer notice and sending the case file.
   
   If the receiving county is the office where the change was reported, they will request the file and update the system with all known changes. The sending office will mail the ICT notice. Once the file is received the receiving office will be responsible to update the case location code on ADDR.
   
   Examples:

   1. John comes into the Wichita office and reports he has moved from Garden City. He provides the new address, information on his living arrangement, housing expenses and his new employment. His case is also due for a review the following month, which he states he has not received. The EES worker in Wichita gives John an ES-3100, updates the address, housing expenses, and income. This worker also requests the case file from Garden City. The sending county sends the ICT notice. Once the file is received from the sending county, the case location code is updated on ADDR.
      
      
   2. Carol’s case closed 12/31 due to failure to provide information on new employment. On January 2nd, she calls her worker to complain she has no benefits. At this time, she reports she moved to another county. The worker requests all information regarding her living arrangement, address, income, etc. The worker updates the KAECSES system with all reported information. In addition, the child care case is closed. Both case files will be sent to the new county. An ICT notice is sent and a WOAL is created. Once the receiving county receives the file, they will update the ADDR screen with the case location code.
      
      

2. Food Assistance
   
   
   1. Student Participation Criteria – See Summary of Changes, II, A, 2, and KEESM Section 2531.

      Kansas has been approved for a waiver of the required 20 hours per week work requirement to meet student eligibility. With the waiver, the student can work an average of 20 hours a week (when total monthly hours are divided by 4) to meet the student eligibility criteria. The following examples should help to clarify the intent of the new policy.

      Examples:

      1. Joe Smith works for only 2 weeks each month, but he works 40 hours for each of those weeks. Total hours is 80, and divided by 4 weeks, the average worked per week is 20. He meets student eligibility criteria.
         
         
      2. Jane Smith works at McDonalds. Her last 30 days of pay show the following number of hours worked per week – 30 hours, 10 hours, 5 hours and 20 hours. Her average hours worked per week is 16.25, so she does not meet student eligibility criteria.
         
         
      3. Bill Smith is self-employed as a handy man. His hours vary, and he charges $7.50 per hour for his services. His last month’s weekly wages show, 25 hours at $187.50, 10 hours at $75.00, 20 hours at $150 and 35 hours at $262.50. His average number of hours worked is 22.5 and his monthly income is $675. Eighty hours times minimum wage of $7.25 = $580, so he meets student eligibility criteria.
         
         
      4. Susan Smith works at Taco Bell. Her schedule calls for working 20 hours a week two times a month. The other two weeks, she only works 15 hours a week. Her total hours worked per month is 70 for an average of 17.5 per week. She does not meet student eligibility criteria.

      This change shall be applied to all determinations of student eligibility made on or after January 1, 2012

   2. Excess Medical Deduction – See Summary of Changes, II, A, 3, and KEESM Sections 7223 and 7227.5.
      
      Changes are being made to the treatment of one-time medical expenses for households using the standard medical deduction. This change should simplify the treatment of one-time expenses. The new policy should be applied to all one-time expenses being determined on or after January 1, 2012. Current case situations where the standard medical deduction was averaged prior to January 2012 will remain in place until the end of the averaged time period. The excess medical deduction training materials have been revised and can be found at the EES Training by Topic page. Here are the links:
      
      Medical Expenses as Food Assistance Deductions
      
      Medical Deductions Standards Flow Chart
      
      
   3. Re-establishing Eligibility (For Cash and Food Assistance) – See Summary of Changes, II, B, 2, and KEESM Sections 3522 and 3540.
      
      Since the Declaration of Cooperation and Self-Responsibility form was obsoleted in the October 2011 manual revision, there has been confusion regarding how to cure a food assistance only potential employment violation applied to the month of application. This revision clarifies that the household can cure the violation by doing 20 job contacts. In addition, the household can cure by becoming exempt, including giving birth; and securing employment with weekly gross earnings at least 30 times the federal minimum wage. In addition, a cross reference is added in this section to 3450, Potential Employment. In section 3540, wording has been added to allow a person to cure a food assistance potential employment violation by doing 20 job contacts. If they do not cure the violation, they remain ineligible for assistance, for a maximum of 12 months.
      
      This new policy applies to all applicable situations that are being determined on or after January 1, 2012.
      
      
   4. Interim Report – See Summary of Changes, II, A, 4, and KEESM Section 9122.6.
      
      Confusion has resulted from the October changes to the Interim Report form. Primarily processing of the form when a check of BARI/BASI reflects earnings from a prior quarter that are over $50 different than what is currently being counted and the household has reported on the form that they have had no changes to their income. As a result, the $50 threshold to make changes is being removed with this revision. Staff must use prudent person judgment in deciding if a change has occurred when the household reports no change on the IR. In the absence of contradictory information, when the household reports no change in income on the IR, the current amount being budgeted will continue. The exception to this is income available on The Work Number. The most recent 30 days should be used as it is readily available. The manual is also being clarified regarding the intent of the checking of BARI/BASI at the time of IR processing. The intent of this check is to determine if there is any unreported income or unemployment compensation. The wages reported are at least three months old, which is not current information. However, staff should use prudent person judgment to determine if a change in income reflected on BARI or BASI requires additional follow up. If the apparent change in income is contradictory to case information and appears questionable, then verification of the most recent 30 days of pay can be required. And last, if checking BASI reveals unreported employment from a past quarter, this should be further evaluated/investigated to determine if the employment should have been reported (income put household over the 130% limit).
      
      The manual has also been clarified that a new source of income is considered a change in income and that must be verified.
      
      
3. Successful Families and Child Care
   

Penalties For Fraud – See Summary of Changes item V, A, 1, and KEESM sections11200 and 11221.

Effective January 1, 2012 individuals who are found guilty of committing fraud will render their households ineligible for TANF and child care for their lifetime. Penalties apply across program type, therefore if fraud occurs in the TANF program, the household is also banned from receiving child care.

Fraud is defined as having intentionally made a false or misleading statement, misrepresentation, concealment, or withholding of facts for the purpose of improperly establishing or maintaining eligibility.

There is no monetary threshold for fraud. All suspected cases of fraud will be pursued and a claim will be initiated.

When an individual is believed to have committed fraud, a referral is made to the local fraud investigator or the Administrative Disqualification Hearing department.

No action for collection of the overpayment is to be taken on the part of the EES case manager until a determination is made by the investigator. If it is determined by the fraud investigator that a referral for an Administrative Disqualification Hearing is to be made, then the EES worker will complete the necessary actions for this referral. The fraud investigator may determine court adjudication is appropriate, then EES worker will take no action until a finding is made. Once the EES eligibility worker is informed fraud has occurred, the following action will occur:

Prior to January 1, 2012:

Fraud occurring prior to January 1, 2012 will be handled according to the rules in place at the time of occurrence. (See KEESM, dated 12/01/11).

January 1, 2012 and after:

For fraud occurring January 1, 2012 and after, the following actions will commence:

• All TANF and child care cases will be closed allowing for timely and adequate notice. Use closure code FD on KAECSES and KSCares.
  
  
• Code PRAP FD at the person and case level on all adults (only).
  
  
• Send notice A828 for TANF, notice C917 for child care.
  
  
• On KsCares, code the new CC Fraud field on CHCI with FD for each adult on the CC case. This code will also be displayed on CAMA. The PRAP code of FD for TANF will also be displayed automatically on CHCI and CAMA for each person.

Examples:

1. A person fails to report employment that started in October 2011. The EES worker determines the overpayment and sends the documents to the fraud unit for a fraud determination. The fraud unit requests the EES case manager send to Administrative Disqualification Hearings. A finding from ADH is returned with a finding of guilt.
   
   The overpayment begins November 2011 and goes thru May 2012. Since the time period of the fraud started prior to Jan 2012, the old policies apply and only the individual found guilty of fraud is disqualified.
   
   
2. A person fails to report employment that started in February 2012. The EES case manager determines the overpayment and sends the appropriate documents to the fraud unit for a fraud determination. The fraud unit prosecutes the individual, and the court determines the household is guilty of fraud. The new, permanent fraud penalty applies. Close the TANF and/or the child care case, using the FD code. Code PRAP FD at the person and case level on all adults in the household. Send the A828 and/or the C917. Place the case file in a red file folder so the file is not inadvertently destroyed.
   
   
3. John and Mary Brown were found guilty of committing fraud and their TANF and child care case were closed with a lifetime penalty. John moves out of the home with Mary Brown and moves in with Sally Smith’s household who is receiving TANF assistance. John is identified as a cohabiting partner. Because the penalty follows the individual, Sally Smith’s household is now also ineligible to receive TANF or child care. This is not a lifetime penalty for Sally Smith’s household, and if John ever moves out, Sally’s household may receive benefits again. Send notice A828 to close Sally’s case(s).
   
   
4. Grandma Jo receives TANF for her grandson Timmy. Grandma Jo has been found guilty of fraud by a court of appropriate jurisdiction. Her TANF case is closed and PRAP is coded correctly. Timmy goes to live with his aunt. The aunt may apply and receive assistance for Timmy if otherwise eligible.
   
   
5. Grandma Jo receives TANF for her grandson Timmy. Grandma Jo has been found guilty of fraud by a court of appropriate jurisdiction. Her TANF case is closed and PRAP is coded correctly. Timmy goes to live with his aunt and receives TANF and child care on his aunts’ case. Julie, another grandchild moves in with Grandma Jo. Because Grandma Jo has been found guilty of fraud she and her household is ineligible to receive TANF again and her application will be denied, using FD as a denial code. Send denial notice A228.

4. Successful Families

   Interviews – See Summary of Changes, IV, A, 2, and KEESM Section 9332.
   
   KEESM 9332 is being revised to remove the interview requirement for TANF reviews. Interviews are not required, however contact may be initiated to clarify information. All eligibility requirements remain the same, however, an interview is not mandated on TANF case reviews. In order to keep KAECSES from closing a TANF case for lack of an interview, staff will need to enter the application date as the interview date on the INDA screen. When a TANF review application is received, staff need to register the review application on INDA, and input the date the application was received as the interview date. Place a ‘Y’ in the interview completed section. This will prevent the system from automatically closing a TANF review for no interview. If the caseworker needs additional information to complete the review an ES3105.1 or telephone call may be initiated. Once all information needed is received, the review may be processed.

5. Successful Families, Child Care and Food Assistance
   
   Thresholds for Overpayments and Fraud – See Summary of Changes, item VI, A, 1 and KEESM Sections 11122, 11200, 11230, 11231 and 11232.
   
   The removal of the $125 threshold for establishing a claim on a closed case and the removal of the $501 minimum amount of alleged fraudulent overpayment required to initiate a fraud determination action applies to all overpayments established on or after January 1, 2012.