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Integrated Services Delivery
Docking State Office Building                                                             Final January 2, 2003
Room 681 - West

Topeka, Kansas 66612

TO:  Area Directors
        Economic and Employment Support Chiefs
        Economic and Employment Support Staff
        Social Service Chiefs
        Other Staff

Re: Summary of Changes for Kansas Economic and Employment Support Manual (KEESM)
       Revision No. 13 effective February 1, 2003.


The purpose of this document is to transmit Revision No. 13 of the Kansas Economic and Employment and Support Manual effective February 1, 2003. This revision adopts the changes described below largely through pen-and-ink modifications to the current manual.

In November 2002, Governor Graves released a plan to assist in addressing the state fiscal year 2003 shortfall. This included a 3.9% reduction to all agencies except K-12, Blind School, Deaf School, BIDS, Legislature and Judiciary. The SRS allotment reduction, including state hospitals, equaled $26.6 million.

As a result of this allotment, changes have been made in Child Care Subsidy Program income eligibility, Home and Community Based Services (HCBS) Waiver Protected Income Level (PIL), and HealthWave Premiums.

A correction in the Low Income Energy Assistance Program (LIEAP) income levels has also been made. This is a correction and not a result of the November allotment.

Child Care Program:  Effective February 1, 2003, the income eligibility threshold for child care subsidy will change from 185% to 150% of the federal poverty level (FPL). Households with income above 150% of FPL will not qualify for child care subsidy.

The following manual sections have been revised to reflect this change - 2835, 2840, 7440, Appendix #78 Definition of Common Terms, and Appendix #48 Family Income and Share Schedule for Child Care Services. A separate implementation memo regarding this change was issued on December 9, 2002.

Medical Programs:  For HCBS participants, the monthly income standard (also called the protected income level) is reduced from $716.00 to $645.00. This change is effective for benefit months beginning 02-01-03. For benefit months prior to 02-03 the PIL remains $716.00. This change also impacts participants in the PACE program.

For HealthWave/Title XXI participants, monthly premium amounts will be increased. Premiums for households with income levels of 151% through 175% of FPL will change from $10.00 to $30.00. Households with income levels of 176% through 200% of FPL will increase from $15.00 to $45.00. Households with incomes below 151% of FPL do not pay premiums. The new premiums are effective for benefit months beginning 02-01-03. For benefit months prior to 02-03 the current premium schedule will apply.

The following manual sections are revised to reflect these changes: 2770, 8260, Appendix Item #55 - Medicaid and HealthWave Standards.

Implementation memos for both of these changes will be issued separately.

Low Income Energy Assistance Program:  Several of the monthly income figures listed in the Income Guidelines, KEESM Section 13362, are incorrect and are to be modified as noted in the attached Revision Summary document.


The changes in the Child Care Program eligibility threshold, HCBS income standard, and HealthWave premiums will have a substantive impact on staff in regards to both implementation and ongoing case work. Staff will need to manually review and take action on over 1200 families who currently exceed the new standard in order to terminate child care benefits by February 1. This change is also expected to result in substantial consumer contact over the course of the next few months at the local office level.

Both the changes in the income standard for HCBS cases and the premium increase for HealthWave cases are expected to be automated to as great as extent as possible. Nonetheless, those automated changes will need to be reviewed for accuracy and may require further modification. In addition, both of these changes are also expected to result in increased consumer contact in both the local offices and the HealthWave Clearinghouse. Over 5300 HCBS consumers will be impacted by the change and require adjustments to their ongoing obligation as well as their care plans. Approximately 5800 families will be impacted by the HealthWave premium change and may become delinquent on their premium obligation or unable to continue coverage based on the increases.


The material in this letter and manual revision has been coordinated with staff in the Economic and Employment Support Section, Health Care Policy-Community Supports and Services, Medical Policy, and Kansas Department on Aging.


Sandra C. Hazlett, Director
Economic and Employment Support


KEESM Rev. No. 13
February 1, 2003

This revision includes changes to the Child Care Subsidy Program, Home and Community Based Services, HealthWave, and the Low Income Energy Assistance Program.

Instructions for Changes

In the outside margin beside each pen and ink correction, draw a vertical line to denote the change and write in "Rev. #13, 2-03" beside the line.

Pen and Ink Corrections
2-129 2770 In the first paragraph, change ‘$10.00' to $30.00' in the third sentence and change ‘$15.00' to ‘$45.00' in the fourth sentence.
2-140 2835 In the seventh sentence of the second to the last paragraph on the page, change "185%" to "150%".
2-143 2840 In the fifth sentence and the seventh sentence from the top of the page, change "185%" to "150%".
7-38 7440 In the second sentence of section 7440, change "185%" to "150%".
8-54a 8260 In the second sentence of the first paragraph, change ‘$716' to ‘$645'.
13-13 13362 In the chart, in the "One Month Income at 130% of Poverty Level" column, make the following changes:
  3 Persons in Household, change $1628 to $1627
  6 Persons in Household, change $2629 to $2628
  9 Persons in Household, change $3630 to $3629
12 Persons in Household, change $4631 to $4630
Appendix Item Correction
#55 Medicaid and In Item (2), HealthWave Premium Table, change HealthWave ‘$15.00' to ‘$45.00' in the heading of the middle Standards column and change ‘$10.00' to $30.00' in the heading of the third column.

In Item (5), Standards for Long Term Care/HCBS, in the second paragraph, change ‘$716.00' to ‘$645.00' in the last bullet.

Definition of Common Terms
1) In the Employed Income Eligible (EM) Child Care Subtype definition on page 10
     of 25, change "185%" to "150%".

2) In the Income Eligible definition on page 14 of 25, change "85%" to "50%".

3) In the Low Income definition on page 16 of 25, change "185%" to "50%".

New Pages


Appendix item #48 rev. 5-02 Monthly Family Income and Share Schedule for Child Care Services

Appendix item #48 Rev. 2-03 Monthly Family Income and Share Schedule for Child Care Services

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