STATE DEPARTMENT OF SOCIAL                                        04-27-12
REHABILITATION SERVICES                                              
Integrated Services Delivery
Docking State Office Building
Room 581 - West
Topeka, Kansas 66612

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.

Adult Protective Services - This material is being removed from KEESM because it is now being administered by CFS.

Child Care - New poverty level guidelines have been published by the Department of Health and Human Services. These guidelines affect the eligibility standards in the Child Care program.

Two new reasons are being added for terminating agreements with child care providers without giving 30 days’ notice. Agreements will be terminated effective immediately when a provider’s license is expired or revoked, and when child abuse or neglect has been confirmed.

Medical Assistance – The new federal poverty levels are being adopted, including an increase in the minimum community spouse income allowance, the dependent family member allowance, and the excess shelter deduction.

Successful Families – Time limits for TANF families with hardships will be determined at the local level with the exception of hardship number 5. Hardship number 5 will be determined by the Executive Review Committee. Once a family has received over 48 months and fails to cooperate with work programs or Child Support Enforcement, the household loses the hardship provision, and the case is to remain closed.

Special Provisions for households with conservators or guardians are being removed for TANF assistance.

DESCRIPTION, PURPOSE, AND DETAILS OF POLICY CHANGE

1. Child Care
   
   
   1. Changes
      
      
      1. Requirements to Approve Regulated Providers – KEESM 10032 is being revised to require immediate termination of a child care provider’s agreement with SRS in the following situations:
         
         
         1. when an emergency suspension of a child care provider’s license has been ordered by KDHE.
            
            
         2. when a provider’s license is expired or revoked.
            
            
      2. Requirements to Approve Unregulated Legally Exempt Providers – KEESM 10033 is being revised to require immediate termination of a child care provider’s agreement with SRS in the following situations:
         
         
         1. when an emergency suspension of a child care provider’s license has been ordered by KDHE.
            
            
         2. when a provider’s license is expired or revoked.
            
            
         3. when child abuse and/or neglect by a child care provider (or anyone living in the provider’s home where care is provided) has been confirmed.
            
            
      3. Actions Which Warrant Termination or Denial of Provider Enrollment – KEESM 10037.1 is being revised to indicate that there are three exceptions to the rule that requires a 30 day written notice be given to a provider when terminating a child care provider’s agreement with SRS. Those exceptions are:
         
         
         1. when an emergency suspension of a child care provider’s license has been ordered by KDHE
            
            
         2. when a child care provider’s license is expired or revoked, and
            
            
         3. when child abuse and/or neglect by a child care provider (or anyone living in the provider’s home where care is provided) has been confirmed. In these instances, the provider’s agreement will be terminated immediately.
            
            
   2. Clarfications
      
      None
      
      
2. Medical Assistance
   
   
   1. Changes
      
      
      1. Poverty Level Changes – New federal poverty level guidelines have been published by the Department of Health and Human Services. The guidelines affect the eligibility standards for the following medical groups:
         
         
         1. Income standards for the Medicaid poverty level and HealthWave XXI programs, and premium standards for the HealthWave XXI program;
            
            
         2. Income standards for the QMB, LMB, Expanded LMB, and QWD programs;
            
            
         3. Income standards for the TransMed program;
            
            
         4. Income and premium standards for the Working Healthy (WH) program;
            
            
         5. For spousal impoverishment, the minimum community spouse income allowance increases from $1,839 to $1,892. The dependent family member allowance increases from $613 to $631. The excess shelter deduction increases from $199 to $215.
         
         

         The following KEESM Sections, Forms and Appendix items are modified with this change:

         Sections 8144.2 and 8244.2
         
         ES-3104.5, Determination of Need
         
         ES-3163, Income Allowance Determination
         
         ES-3165, Working Healthy Premium Information Appendix Item
         
         F-8, Medicaid and HealthWave Standards.

         Separate implementation instructions will be issued to staff for these changes.

   2. Clarifications
      
      None
      
      
3. Successful Families
   
   
1. Changes
   
   
   1. Special Needs – KEESM 7412 and item 57 in 6410 are being removed. Special allowances are no longer available to households with Conservators or Personal Representatives and Temporary Foster Care.
      
      
   2. Hardship – KEESM 2243 and 2243.2 is being revised to clarify only hardship number 5 needs executive level review in order to be extended to 60 months of assistance. Clarification is also being made regarding case closures after 48 months. If a household fails to cooperate with work programs or CSE and a penalty ensues, the case loses their hardship designation and the case may not be reopened.
      
      
2. Clarifications
   
   
   1. Cash Excluded Members – KEESM 4113 is being revised to accurately depict policy in regards to strikers and households found guilty of fraud. Households containing a striker or a person found guilty of committing fraud are not eligible for assistance and the entire case is closed.

FORMS (Explanation provided if not mentioned previously in this summary.)

1. Medical Assistance

   1. ES-3104.5, Determination of Need
      
      
   2. ES-3163, Income Allowance Determination
      
      
   3. ES-3165, Working Healthy Premium Information
      
      
2. Successful Families
   
   ES-4308, Hardship Exemption Calculator. This form has been developed to provide an objective method of determining whether or not to grant a hardship exemption.

APPENDIX (Explanation provided if not mentioned previously in this summary.)

1. All Programs
   
   
   1. T-2, County Group Assignments, has been updated to reflect the current region numbers for each county.
      
      
   2. X-8, ICT Check List – The item "Add to Tracker" is being added to the Receiving County Checklist. The sending county will mark this when sending a case to alert the receiving county if additional work is required when the file is received.
      
      
2. Child Care
   
   
   1. C-26, Referral for Child Care Provider Enrollment Application, has been added to the KEESM Appendix.
      
      
   2. F-1, Monthly Income and Family Share Deduction Schedule for Child Care Services is being updated to reflect the new poverty level income limits.
      
      
3. Medical Assistance
   
   F-8, Medicaid and HealthWave Standards

MISCELLANEOUS FORMS (Explanation provided if not mentioned previously in this summary.)

EFFECTIVE DATE

All polices in this revision are effective May 1, 2012. Additional information is being included in the Implementation Memo.

EFFECT ON LOCAL STAFF

Child Care

The changes and updates included in this revision will have minimal impact on staff.

Medical Assistance

The medical changes contained in this revision will likely result in a slight increase in staff effort to incorporate the new poverty level changes.

Successful Families

The changes in this revision will require little effort by field staff to learn and implement. The changes in processes are intended to simplify the complexities used to process cases.

MATERIALS OBSOLETED BY THIS REVISION

COORDINATION EFFORTS

Within EES, the material in this letter and manual revision has been coordinated with staff in Economic and Employment Support, the EES Program Administrators, the Implementation Planning Team, and the Training Advisory Team.

Sincerely,
Kathe Decker, Director
Economic and Employment Support
KD:am