KEES does not have a means to “suspend” eligibility for a month if a consumer is ineligible. The method for processing this scenario in KEES is to NOT run EDBC for months in which the consumer is not eligible for benefits.
Example: Consumer had a spenddown from 08/15 – 01/16. The consumer reported a move out-of-state in October. The case was closed 10/31/2015. The consumer returns to Kansas and reapplied for benefits in December. The user updates the data collection records and runs EDBC for December. The user would NOT run EDBC for November as the consumer was not a state resident in that month.
NOTE: If the user did run EDBC for November in the scenario, the case would be “Discontinued” for no state residency. The user would then need to Rescind the application and Run EDBC for December.
Due to the inability to suspend months during a base period, the following process should be followed.
Access the case through Person Search or enter the Case Number in the quick search field from Task Navigation and click Go.
Enter/Update appropriate data collection records.
Process Application; Run EDBC for the first month the consumer is eligible.
NOTE: Rules sets a new SD base period (ex. 12/15-05/16) and amount beginning with the application month. The spenddown is incorrect since we have a previously established spenddown base period and amount.
Click the Medical hyperlink with a Run Status of Not Accepted on the EDBC List page. The Medical EDBC Summary page displays.
Click the Medically Needy hyperlink to check the spenddown base period dates.
If the dates are incorrect, the spenddown begin and end dates need to be overridden to the correct (existing) base period.
Click the Close button. The Medical EDBC Summary page displays.
Click the Override Medical Summary button at the bottom right corner of the page. The Medical EDBC Override List page displays.
This allows the user to manually set the correct spenddown amount and base period start and end dates.
Click the Override button for the Medically Needy Test Category. The Medical EDBC Override Detail page displays.
Enter the correct spenddown amount in the Premium/LTC Liability/Spenddown field (if not auto-populated).
Enter the first day of the first month of the Spenddown Base Period in the Start Date field using the <mm/dd/yyyy> format or the calendar icon.
Enter the last day of the last month of the Spenddown Base Period in the End Date field using the <mm/dd/yyyy> format or the calendar icon.
Click the Save and Return button. The Medical EDBC Override List page displays.
Select EDBC Override Reason of Administrative Decision; then click the Save and Return button. The Medical EDBC Summary page displays.
Click the Medically Needy hyperlink to check the spenddown base period dates. Click the Close button. The Medical EDBC Summary page displays.
Click the Accept button, if the result is correct. The EDBC List page displays.
Click the Save and Continue button. The Case Summary page displays.
Since the EDBC result is overridden a notice (NOA) is not created and the user is automatically navigated to the Case Summary page.
Send notification to the consumer using the V008.
See Generating a Form for detailed instruction.
Enter the appropriate information explaining the benefits, including suspended month(s) or month(s) with no eligibility and the KEESM/KFMAM references.
See Standard Text for Copy and Paste for Spenddown Suspend a Month notification verbiage.
Click the Save and Print Centrally button.
Run EDBC for the following month.
The base period should produce correctly for any EDBC months following the first overridden month.