Fiscal Year 2011: DHR Documents by Control Number


Control #: 11-01
Subject: Confidentiality and Safeguarding Personally Identifiable Information (PII)
Issue Date: 7/19/2010
Effective Date: 7/19/2010
Program(s) Affected: Temporary Cash Assistance (TCA), Temporary Disability Assistance Program (TDAP), Public Assistance to Adults (PAA), Foster Care (FC)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1101.pdf

The purpose of this Action Transmittal is to provide additional information on the procedures for safeguarding the confidentiality of Interim Assistance Reimbursement (IAR) data, customer personally identifiable information (PII) and the limitations on the use of that data. This AT speaks specifically to IAR information, but is in conjunction with other information on confidentiality and safeguarding information that was previously issued. IAR information is subject to the Privacy Act, the Federal Information Security Management Act (FISMA) (Public Law 107-347, Title III, section 301) as it applies to the electronic storage, transport of records between agencies, and the internal processing of records received by the state under the terms of its agreement with the Federal government. Federal law (e.g., 42U.S.C. subsection 1306(a), 5 U.S.C. subsections 552 and 552a, and implementing regulations 20 CFR Part 401) further protect IAR data.

All employees must properly safeguard PII furnished by SSA under the IAR agreement from loss, theft or inadvertent disclosure. Employees must understand that they are responsible for safeguarding this information at all times, regardless of whether or not the State employee or the contractor/agent is at his or her regular work site.


Control #: 11-02
Subject: Using Telephone Interviews As An Alternative To Face-To-Face Interviews
Issue Date: 7/28/2010
Effective Date: 6/29/2010
Program(s) Affected: All Programs
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1102.pdf

Because of the economic conditions and limited resources, local departments of social services are serving larger numbers of customers. Caseloads have risen drastically, thus case managers are spending increased amounts of time conducting face-to-face interviews. Local departments should use telephone interviews as much as possible. This action transmittal provides brief information on how local departments can use the telephone as an alternative interviewing tool. It also provides information about the CARES migration that will support telephone interviewing. Any local department that wishes to schedule telephone interviewing training should call the University of Maryland School of Social Work, Policy and Skills Training Team at 410-706-4388.


Control #: 11-02 Attachment
Subject: Case Information Form (CIF) Expansion
Issue Date: 1/7/2011
Effective Date: 1/7/2011
Program(s) Affected: All
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1102attach.pdf

As you are aware, the Case Information Form (CIF) is currently used for all programs of assistance in the mail-in redetermination cycle except E-track, G-track, H-track, L-track, X-track, and T-track project categories. Also excluded from this process are medical coverage groups P02, P03, P11, P12, S02, S99, and F99. The CIF prints only the information that is required for the program(s) being redetermined, and the customer level data only prints what is applicable for the redetermination. This eliminates the need for customers to supply information already known to CARES, or that is not relevant to the program(s) being redetermined. This form requires that customers either state that the information provided has not changed, or to supply the new and/or changed information. This streamlines the process for both customers and case managers. CARES CHANGE: Effective with redetermination appointments that will be scheduled during the month of January 2011 with February 2011 end dates, the Case Information Form (CIF) will be generated and mailed to customers that are scheduled for face-to-face and telephone interviews in addition to mail-in redeterminations. This change will further streamline the redetermination process, and will allow customers and case managers more options for conducting redeterminations.


Control #: 11-03
Subject: Puerto Rico Invalidates All Birth Certificates Issued Prior To October 1, 2010
Issue Date: 9/7/2010
Effective Date: 10/1/2010
Program(s) Affected: All Programs
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1103.pdf

Puerto Rico Law 191 invalidates all Puerto Rican birth certificates issued prior to July 1, 2010. On June 28, the Government of Puerto Rico extended the validity of current Puerto Rico birth certificates through September 30, 2010. All birth certificates will remain valid through September 30, 2010. After this date, every birth certificate must have been reissued by the Puerto Rico Health Department Vital Statistics Record Office. The law was enacted to address national security concerns that the U.S. Department of State calculates are the source of approximately 40 percent of its passport fraud cases. Law 191 establishes measures to reduce forgery and fraud, by strengthening Puerto Rico’s vital statistics technology and by making it illegal for any public or private entity to retain an original copy of any Puerto Rico issued birth certificate.


Control #: 11-03 Attachment
Subject: Automated Snap National Directory of New Hires (NDNH) Match
Issue Date: 1/6/2011
Effective Date: 1/6/2011
Program(s) Affected: Food Supplement Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1103attach.pdf

Effective January 2011, the SNAP National Directory of New Hires (NDNH) match process will be automated in CARES. Use of SNAP NDNH data will further assist local departments to reduce the number of incorrect payments caused by unreported income, and will provide information that may help increase work participation rates.


Control #: 11-04
Subject: Continuing Current MCHP Restrictions for Employer-Based Insurance Coverage
Issue Date: 9/8/2010
Effective Date: 9/8/2010
Program(s) Affected: MCHP, Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1104.pdf

Questions have been raised regarding “anti-crowd-out” provisions in the CHIP program. These provisions deny eligibility for P13 and P14 if a child is covered by employer-based health insurance or if the family has voluntarily dropped employer-based coverage within the last 6 months. Current rules continue in effect.

Current rules are found in the MCHP Manual, Section 600, Subsection G (“Health Insurance”), pages 600-13—600-14 (MR 17 issued August, 2005). Case Managers are to continue applying current rules with respect to employer-based insurance and voluntary termination of such coverage.


Control #: 11-04 Attachment
Subject: Maryland Childrens Health Program Manual
Issue Date: 9/8/2010
Effective Date: 9/8/2010
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1104attach.pdf

C. Pregnancy -- In order to be eligible for MCHP benefits, a woman who is age 19 or older must be pregnant or be within the postpartum period. She must provide her expected date of delivery. If an applicant claims to be postpartum, she must provide the date of her delivery. A woman is no longer technically eligible as pregnant once her pregnancy is terminated due to an abortion or miscarriage.


Control #: 11-05
Subject: Compliance Issues From Medicaid Audit Findings
Issue Date: 9/8/2010
Effective Date: 9/8/2010
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1105.pdf

Each year, the Federal Center for Medicaid, CHIP and Survey & Certification (CMCS) conducts, through contractors, a “Single State Agency” Audit (“Medicaid Audit”). Because Maryland’s Medicaid agency was established as a partnership with DHR for purposes of eligibility determination, and because the Medicaid agency itself has taken on direct eligibility duties for certain programs, the Medicaid Audit reviews sample cases from LDSS and LHD offices.

During the most recent audit, there were no strong trends for particular types of errors. However, as we approach the end of our fiscal year, this Information Memo serves as a reminder regarding errors previously noted in the Medicaid auditors’ findings. We hope this document will provide useful “tips” to avoid common errors in these extraordinarily busy times.


Control #: 11-05 Attachment
Subject: Commonwealth of Puerto Rico Department of Health Demographic Registry Birth Certificate Application by Mail
Issue Date: 9/8/2010
Effective Date: 9/8/2010
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1105attach.pdf

1. Applicants living out of Puerto Rico send the application to the following address: Demographic Registry PO Box 11854, San Juan, Puerto Rico 00910

2. If the applicant lives in Puerto Rico can visit any Local Registry near his/her house to complete and application.

3. Applicant must send a photocopy of a recent valid photo-identification card.

4. Applicant in Puerto Rico: Please send $5.00 Internal Revenue Stamp for first copy requested and $4.00 for each additional copy for the same person.

5. Applicant out of Puerto Rico: Please send $5.00 Money Order payable to Secretary of the Tresury.

6. Please send a self-addressed-stamped envelope to mail in your certificate.

7. For rush mail as Fedex, Exp. Mail, Registered, UPS, etc. our address is: 171 Quisqueya Street, Hato Rey, PR 00917


Control #: 11-05 Attachment 2
Subject: Estado Libre Asociado de Puerto Rico Departamento De Salud Registro Demografico Solicitud De Certificado Nacimiento Por Correo
Issue Date: 9/8/2010
Effective Date: 9/8/2010
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1105attach2.pdf

Importante:

1. Si el nacimiento ocurrio despues del 21 de Junio De 1931, Debe Solicitar su certificado A: Departamento de Salud Registro Demografico PO Box 11854, San Juan Puerto Rica 00910 Direccion Fisca: Calle Quisqueya #171 Hato Rey, Puerto Rico 00918

2. Si el Nacimiento Ocurrio Antes Del 21 De Junio De 1931, Debe Solicitarlo al Registro Local Del Pueblo Donde Ocurrio El Nacimiento.

3. Acompane la solicitud con lua copia de una identificacion reciente (con retrato) del solicitante.

4. Residentes fuera de Puerto Rico: enviar giro postal a nombre del Secretario De Hacienda, El Costo Del Certificado es $5.00 la primera copia y $4.00 la copia adicional Solicitada al Mismo Tiempo.

5. Si reside en Puerto Rico: envie sello de rentas internas de $5.00 por la primer copia y $4.00 por la copia adicional ordenada al mismo tiempo.

6. Debe enviar un sobre con sello y pre-dirigido con la direccion bien Clara Donde Recibira El Certificado


Control #: 11-06
Subject: Cost of Living Adjustment
Issue Date: 9/28/2010
Effective Date: 10/1/2010
Program(s) Affected: Food Supplement Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1106.pdf

The Food and Nutrition Service (FNS) has issued Cost of Living Adjustments (COLAs) to the Food Supplement Program (FSP) income eligibility standards and deductions. As a result of the American Recovery and Reinvestment Act of 2009 (ARRA), the maximum and minimum allotments remain unchanged for FY 2011. The FSP income eligibility standards for FY 2011 also remain unchanged.

There were only two changes. The shelter cap value for FY 2011 decreased slightly to $458 and the minimum standard deduction for household sizes 1 through 3 increased to $142 a month. These COLAs are effective October 1, 2011. CARES was modified to support these changes. Attached are the updated Food Supplement Program Manual pages.

CARES automatically generates customer notices for increases and decreases at the time of the mass change. The mass modification takes place on September 11, 2010.


Control #: 11-07
Subject: Categorical Eligibility for the Food Supplement Program
Issue Date: 10/4/2010
Effective Date: 10/1/2010
Program(s) Affected: Food Supplement Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1107.pdf

In an effort to simplify the Food Supplement Program (FSP) eligibility process, we are expanding categorical eligibility to most households with income at or below 200 percent of the poverty level. This policy will also make more households potentially eligible for FSP benefits because there will be no asset test. The only households that are not included in expanded categorical eligibility are those that are excluded by federal rules.

To make this change we are applying federal policy that allows us to use a non-cash Temporary Assistance for Needy Families (TANF) funded program to confer broad based categorical eligibility to FSP households. TANF funds were used to print the brochure, Family Planning, A Guide for You. This meets the criteria for broad based categorical eligibility. With broad based categorical eligibility, there is no requirement that there be minor children in the household.


Control #: 11-08
Subject: Extension of Suspended Time Limits for Able-Bodied Adults Without Dependents
Issue Date: 10/4/2010
Effective Date: 10/4/2010
Program(s) Affected: Food Supplement Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1108.pdf

On February 17, 2009, the President signed into law the American Recovery and Reinvestment Act of 2009. One provision of the law eliminated the special work requirement for able bodied adults without dependents (ABAWDs). FIA issued AT #09-29 to implement this provision effective April 1, 2009 through September 30, 2010.


Control #: 11-09
Subject: New Codes to Track Work Conciliation and Sanction for Minors
Issue Date: 10/7/2010
Effective Date: 10/7/2010
Program(s) Affected: Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1109.pdf

In June 2010, CARES and WORKS 2.0 system updates were migrated to track and monitor the conciliation and sanction process for non-compliance with the Temporary Cash Assistance (TCA) work program requirements. Action Transmittal 10-37 outlined the new process for tracking and monitoring the conciliation process and instances of non-compliance between CARES and WORKS 2.0.

The WORKS 2.0 system captures only customers who are considered federally mandated to participate in a work activity. Minors who are children in the TCA assistance unit (AU) are not federally mandated for the work program and are not tracked in the WORKS 2.0 system. However, according to state mandates minors must comply with work and education requirements and are therefore subject to conciliation and sanction when they do not comply.

Because there is no conciliation and sanction tracking for minors who are children in the TCA AU in WORKS 2.0, case managers must use a workaround to track the number of instances of non-compliance in CARES. This AT gives new codes to use in CARES, to track instances of non-compliance when a non parent minor or a minor parent who is a child in the TCA AU has accrued an instance of non-compliance.

As stated in AT 10-37, please do not use the old tracking codes GU, CZ or VI to track instances of non-compliance for anyone in the TCA AU, including minors who are children in the AU.


Control #: 11-10
Subject: Food Supplement Program Waiver to Postpone the Interview for Certain Expedited Service Cases
Issue Date: 11/3/2010
Effective Date: 11/1/2010
Program(s) Affected: Food Supplement Program (FSP)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1110.pdf

In an effort to help meet application timeliness compliance standards, we requested a Food Supplement Program waiver that will allow us to postpone the required interview prior to issuing expedited service in certain situations.


Control #: 11-11
Subject: A Change to Temporary Cash Assistance Voluntary Quit Policy
Issue Date: 11/10/2010
Effective Date: 11/10/2010
Program(s) Affected: Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1111.pdf

We recently became aware of inconsistencies between TCA policy and the Code of Maryland Regulations (COMAR) for what to do when a customer voluntarily quits a job or reduces work hours.

According to the TCA policy in section 111.4 of the Work Book, when a person voluntarily quits a job or reduces work hours for a job that is included in the customer’s Family Investment Plan (FIP) plan, the case manager closes the case with adverse action for non-cooperation with the FIP plan. The case remains closed for 30 days.

Regulation 07.03.03.07-1H in COMAR requires us to follow the conciliation and sanction process.

This action transmittal gives the correct procedure for applying sanctions when a customer voluntarily quits a job or reduces his or her work hours without good cause.


Control #: 11-12
Subject: Accelerated Certification of Eligibility (ACE) - LDSS and LHD Procedures for Prioritizing and Accelerating the Medicaid Eligibility Process for Pregnant Women Applying to Medicaid
Issue Date: 12/1/2010
Effective Date: 12/1/2010
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1112.pdf

This Action Transmittal clarifies AT 10-31 issued May 21, 2010 effective immediately. The Department of Health and Mental Hygiene (DHMH) and the Department of Human Resources (DHR) have revised the October 30, 2009 instruction to “ACE all pregnant applicants” to recommend a processing alternative that results in quick final determinations of eligibility for pregnant women, and to clarify that ACE must be used only to give accelerated eligibility to pregnant women whose applications have insufficient information to allow an immediate final determination of eligibility. Adding the alternative of immediate MA enrollment further advances the Governor’s initiative to decrease infant mortality, and supports former Secretary Brenda Donald’s statement of core business processes for local departments of social services to process Medical Assistance applications for pregnant women the same day. The procedures set forth in the ACE Manual have been clarified to reflect this transmittal.


Control #: 11-12 Attachment
Subject: Maryland Children’s Health Care Program - MCHP
Issue Date: 12/1/2010
Effective Date: 12/1/2010
Program(s) Affected: Maryland Children’s Health Program Manual MR-12
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1112attach.pdf

Maryland Children’s Health Program Manual MR-12 Issued March 2004 Re-Issued December 2010 Section 1000: Determining Financial Eligibility An applicant is financially eligible for the MCHP if the applicant's countable net family income does not exceed: - for child applicants, 200 percent FPL - for pregnant women applicants, 250 percent FPL - for the family size involved, which includes all unborn children.


Control #: 11-12 Attachment 2
Subject: Section 1000: Determining Financial Eligiblity
Issue Date: 12/1/2010
Effective Date: 12/1/2010
Program(s) Affected: Maryland Children’s Health Program Manual MR-12
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1112attach2.pdf

Section 1000 of the MCHP Manual has been revised to clarify the ACE process for pregnant women with respect to the due date. Remove Section 1000 issued as MR-12 in December 2009 and replace it with the attached revised Section 1000.


Control #: 11-13
Subject: LDSS and DEWS Procedures for Applicants and Recipients Filing for Disability in an ABD Coverage Group
Issue Date: 12/13/2010
Effective Date: 12/1/2010
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1113.pdf

There are two entities that make Aged Blind and Disabled (ABD) disability determinations: the Social Security Administration (SSA) and the State Review Team (SRT) of the Family Investment Administration (FIA). The SSA and the SRT use a 5 Step sequential evaluation process to determine disability as defined by the SSA.

The SRT includes physicians, psychologists, disability specialists, and clerks. SRT determines an applicant’s disability based on the SSA 5 Step evaluation process. Effective 12/1/10, Step 1 of the evaluation process to determine disability is the responsibility of the Local Department of Social Services (LDSS).


Control #: 11-14
Subject: Transitional Food Supplement Benefit Change
Issue Date: 12/21/2010
Effective Date: 1/1/2011
Program(s) Affected: Food Supplement Program (FSP)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1114.pdf

Transitional Food Supplement (TFS) benefit policy was implemented effective January 1, 2003 with Action Transmittal 03-29. This policy was permitted under the Farm Security and Rural Investment Act of 2002. The final rule for this act was published on January 29, 2010. It contained several changes to how we operate TFS. Since some of the changes require system modifications, we have requested a waiver; however, we will implement one provision effective January 1, 2011.


Control #: 11-15
Subject: National Voter Registration Act (NVRA) Tips and Questions and Answers
Issue Date: 12/21/2010
Effective Date: 12/21/2010
Program(s) Affected: All Programs
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1115.pdf

As you know, State and federal laws require local departments of social services to provide every customer who will be 18 years of age on or before the next general election an opportunity to register to vote. These laws require the Family Investment Administration (FIA) to record and track every response given by a customer when voter registration is discussed. The NVRA manual on the FIPNet has been updated. You should refer to the manual for detailed instructions on NVRA procedures; this document provides a summary of the procedures for quick reference. Since the information from the action transmittals have been incorporated into the manual, they will be removed. The following action transmittals and information memos will be removed from the FIPNet:

10-01, 02-04, 08-06, 01-48.


Control #: 11-16
Subject: E-GOV/E-IAR Change in Accessing Interim Reimbursement
Issue Date: 1/5/2011
Effective Date: 11/20/2010
Program(s) Affected: Temporary Cash Assistance (TCA), Temporary Disability Assistance Program (TDAP), Medical Assistance (MA), Public Assistance to Adults (PAA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1116.pdf

The Social Security Administration (SSA) advised us that they implemented the next phase of e-GOV and the Interim Assistance Reimbursement (E-IAR) process on November 20, 2010. We were also told that this phase affects only the actual reimbursement portion of the process. SSA, Finance and those FIA staff who process IAR reimbursements will begin processing the reimbursements electronically.

With this action transmittal (AT), we are providing information on the new E-IAR reimbursement process and reviewing the IAR process in general. We are also including information about the DHR/FIA 340 form to ensure accurate processing of interim reimbursement funds.

We will send out security access registration forms to FIA local department Assistant Directors (ADs) shortly. They are to be completed identifying staff who need E-IAR access and then sent to SSA. We will provide you with the procedures at that time.

SSA created a training PowerPoint to help states through the new IAR process. Because of the number of slides in the training, we placed it on FIPNET under “Training.”


Control #: 11-17
Subject: Child Care Subsidy Waiting List
Issue Date: 2/8/2011
Effective Date: 2/28/2011
Program(s) Affected: Child Care Subsidy
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1117.pdf

Due to recent increases in caseload sizes and a lack of available funding, the Child Care Subsidy program is wait-listing all new Priority 3 applicants, as of February 28, 2011. Priority 1 and 2 applicants, as well as Priority 3 applicants with a disabled child/special needs or an SSI child or parent, will not be wait-listed. CCATS will assist with the process. Letters are available to facilitate notification


Control #: 11-18
Subject: Long Term Care Redeterminations
Issue Date: 3/11/2011
Effective Date: 3/14/2011
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1118.pdf

The Deficit Reduction Act (DRA) extended the look back period for initial long term care applications (LTC) requiring additional time to process cases. Extra work on applications also adversely affected the timely processing of LTC redeterminations. DHMH and DHR in conjunction with long-term care providers and client advocates collaborated to develop a strategy to address the delayed processing of LTC applications and redeterminations and avoid interruption of Medicaid benefits. First we are making changes to processing redeterminations.


Control #: 11-19
Subject: Medical Assistance Eligibility Determinations for Children in and Leaving the Care and Custody of the Department Of Juvenile Services
Issue Date: 3/14/2011
Effective Date: 4/1/2011
Program(s) Affected: Medicial Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1119.pdf

Medical Assistance (MA) does not pay for services to persons in state institutions. Because of this rule, children in Department of Juvenile Services (DJS) detention cannot apply for MA or receive services under prior MA eligibility when they are waiting to be adjudicated by the Juvenile Court. However, the majority of DJS children go on to be placed in a community setting where the state institution rule does not apply. This Action Transmittal clarifies the circumstances under which children committed to and leaving the custody of DJS may become eligible for MA or have MA eligibility restored, and sets forth procedures to expedite eligibility determinations for these children. This transmittal obsoletes AT 00-02. ACTION REQUIRED: The Local Department of Social Services (LDSS), Local Health Department (LHD) staff, and the Division of Eligibility Waiver Services (DEWS) must promptly follow the procedures outlined in this transmittal when processing MA eligibility determinations for children committed to and leaving DJS custody.

The contact at DJS will be a DJS Case Management Specialist (CMS). The DJS CMS may submit MA applications for children pending placement in a community setting prior to placement or applications for children returning to their home upon release from DJS custody 20 to 60 days prior to their release. All applications received from DJS must be pended upon receipt.

Note: An expedited eligibility decision must be made within 10 days from the receipt of all verifications.


Control #: 11-19 Attachment
Subject: DJS Youth in Foster Care
Issue Date: 3/14/2011
Effective Date: 4/1/2011
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1119attach.pdf

DJS Youth in Foster Care

(Form to Accompany Medicaid Application)

DATE:

TO: MA Case Worker

FROM (DJS Case Manager and phone number)

RE (Name of Youth) DOB:

PLACEMENT: (Name of facility) (Address and phone number)

TYPE of PLACEMENT:

DATE of PLACEMENT:

DJS CASE MANAGER (Signature)

MAILING ADDRESS

COMMENTS:


Control #: 11-20
Subject: Aligning Certification Periods for Food Supplement and Temporary Cash Assistance When the Transitional Food Supplement (TFS) Freeze is Broken
Issue Date: 1/1/2011
Effective Date: 1/1/2011
Program(s) Affected: Food Supplement Program (FSP) and Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1120.pdf

Action Transmittal 11-14, “Transitional Food Supplement Benefit Change” provided information on the change in the Transitional Food Supplement (TFS) policy regarding households that return to TCA during the five month TFS period. Effective January 1, 2011 households returning to TCA during the five month TFS period are recertified for Food Supplement Program (FSP) benefits under normal FSP requirements and a new certification period is assigned. This includes all TCA cases reopened for any reason (an Agency error closure, TCA reopened pending an appeal, or the customer reapplies) during the five month TFS period. Wait until the TCA case has been approved to break the TFS freeze and complete a recertification of the FSP case. Upon reopening, the TCA case is assigned a 12 month certification period. In most instances when the TFS freeze is broken, the household is recertified and given new six month certification period. The certification periods for the TCA and FSP may not be aligned. When certification periods are not aligned, the customer must be seen more often than necessary, resulting in poor customer service and an increase in agency workload. The Food and Nutrition Service approved a waiver to allow us to align the certifications by completing an early recertification of the FSP case.


Control #: 11-21
Subject: New Interim Reimbursement Assistance Form
Issue Date: 3/23/2011
Effective Date: 3/23/2011
Program(s) Affected: Temporary Cash Assistance (TCA), Temporary Disability Assistance Program (TDAP), Medical Assistance (MA), Public Assistance to Adults (PAA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1121.pdf

Since 2001, Maryland has had an agreement with the Social Security Administration (SSA) for Maryland to be reimbursed for assistance paid to long term disabled customers from State General Funds. Long term disabled customers must sign an Interim Assistance Reimbursement form (DHR/FIA 340) and apply for SSI. Parents must apply for SSI and sign the DHR/FIA 340 on behalf of their disabled children.

DHR signed a new IAR agreement with SSA in September 2010. We revised the DHR/FIA 340 to include information that SSA requested and simplified the language used in the form. We attached a copy of the revised form to the AT.


Control #: 11-22
Subject: Mailing Address Change for LTC Processor
Issue Date: 4/7/2011
Effective Date: 4/7/2011
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1122.pdf

In January 2010, Action Transmittal 10-17 outlined procedures for submission of the Long Term Care Patient Activity Report (DHMH 257) and the DES 501 for recipients of Community Medical Assistance admitted to a long term care (LTC) facility for less than 30 days or for Medicare co-pay days for recipients of Community Medical Assistance not receiving Waiver services. Currently the forms are mailed to:

LTC Processor

P.O. Box 13066 Baltimore, Maryland 21203


Control #: 11-23
Subject: Decrease in Utility Allowance
Issue Date: 4/8/2011
Effective Date: 5/1/2011
Program(s) Affected: Food Supplement Program (FSP)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1123.pdf

Every year we review the utility and telephone allowances to determine if they should increase, decrease or stay the same. Based on the most recent Consumer Price Index (CPI) for the Baltimore/ Washington area, the standard and limited utility allowances will decrease. A recent survey of telephone service providers indicates that phone rates have gone up this year. The telephone allowance will increase slightly.


Control #: 11-24
Subject: The Work Number Express Service
Issue Date: 4/19/2011
Effective Date: 3/21/2011
Program(s) Affected: Temporary Cash Assistance (TCA), Food Supplement Program (FSP)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1124.pdf

Recently, FIA entered into an agreement with the TALX Corporation to pay the fee for The Work Number Express Service. Verification of employment through The Work Number will be immediate and you are able to search based on a customer’s social security number. The TALX Corporation operates The Work Number Express employment verification service that most case managers are familiar with. The TALX Corporation has an agreement with 2000 employers, including many federal agencies, Target and Wal-Mart. Most of our employed customers are working for a company associated with the TALX Corporation. Please remember the information that is available via The Work Number Express service is protected under State and Federal privacy laws. Access is granted for information and may only be used to determine eligibility for DHR and DHR related programs.


Control #: 11-25
Subject: Informal Provider Creator Procedures
Issue Date: 4/27/2011
Effective Date: 5/2/2011
Program(s) Affected: Child Care Subsidy (CCS)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1125.pdf

Informal child care providers have been processed by the local departments of social services since 1997. Beginning May 2, 2011, the data entry portion for informal providers will be transferred to MSDE.


Control #: 11-26
Subject: Procedural Changes for The Look-Back Period For Long Term Care Applications and Redeterminations
Issue Date: 5/3/2011
Effective Date: 5/2/2011
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1126.pdf

The Deficit Reduction Act (DRA) of 2005 lengthened the 36-month look-back period for initial long term care (LTC) applications to 60 months prior to the month of the initial application. This resulted in an increased workload for case managers when determining an applicant’s initial eligibility. The extra work on the applications adversely affected the timely processing of the LTC applications. DHMH and DHR, in conjunction with long term care providers and client advocates, collaborated to develop strategies to address the delayed processing of LTC applications and redeterminations to avoid interruption of Medicaid benefits.

The initiative, introduced in this Action Transmittal (AT), will streamline the documentation required to evaluate the 60 month look-back period. The intent of the streamlining effort is to maintain program integrity while reducing access barriers related to documentation and verification requirements. The case manager will continue to evaluate the institutionalized individual’s and the community spouse’s assets to determine if a disposal of assets for less than fair market value occurred during the look-back period.


Control #: 11-26 Attachment
Subject: How to Request Tax Returns from the IRS
Issue Date: 5/3/2011
Effective Date: 5/2/2011
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1126attach.pdf


Control #: 11-26 Attachment 2
Subject: Types of Tax Returns Available from the IRS
Issue Date: 5/3/2011
Effective Date: 3/2/2011
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1126attach2.pdf


Control #: 11-27
Subject: Disregarding Federal Income Tax Refunds as Income or Resource
Issue Date: 5/17/2011
Effective Date: 5/17/2011
Program(s) Affected: All Programs
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1127.pdf

The way income tax refunds and Earned Income Tax Credit (EITC) funds are applied to determine eligibility differs from program to program. Some programs count tax refunds and exclude the EITC, while others disregard income tax refunds in their entirety. The difference in policies makes it difficult for case managers to apply program specific procedures which can lead to a wrong eligibility determination. The Tax Relief, Unemployment Insurance Reauthorization, and Job Creation Act of 2010 (P.L.111-312) was signed into law on December 17, 2010. The law includes a provision that disregards federal income tax refunds received after December 31, 2009, as income and as a resource for a period of 12 months for all programs that are funded in whole or in part with federal funds. This does not affect State funded programs such as Temporary Disability Assistance Program (TDAP). Continue to count tax refunds as income and resources according to policy for State funded programs.


Control #: 11-28
Subject: New Medical Report Form DHR/FIA 500
Issue Date: 5/20/2011
Effective Date: 5/20/2011
Program(s) Affected: Food Supplement Program (FSP), Temporary Cash Assistance (TCA), Refugee Cash Assistance (RCA) and Temporary Disability Assistance Program (TDAP), Child Care Subsidy, (CCS) Public Assistance to Adults (PAA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1128.pdf

Action Transmittal 11-13 outlined the referral procedures for applicants and recipients filing for disability in an Aged, Blind or Disabled Medical Assistance coverage group. It also eliminated the DHR/FIA Medical Report form (402 B) for Medical Assistance and State Review Team referrals only. Family Investment Administration (FIA) programs and the Child Care Subsidy program use the 402B to determine a customer’s disability and the need to apply for Supplemental Security Income (SSI) or the customer’s ability to participate in work activities. A new medical report form has been created. The new form incorporates all information case managers need when determining disability for TCA, RCA, TDAP, CCS and PAA applicants or recipients. The DHR/FIA 500 combines several forms and obsoletes the need to use the DHR/FIA 402B, the DHR/FIA 402W and the Physician’s Report of Eye Examination, the DHR/FIA 701 for FIA programs.


Control #: 1128 Attachment
Subject: Medical Report Form 500
Issue Date: 5/20/2011
Effective Date: 5/20/2011
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1128attach.pdf


Control #: 11-29
Subject: Transitional Food Supplement Benefit Changes
Issue Date: 6/9/2011
Effective Date: 7/1/2011
Program(s) Affected: Food Supplement Program (FSP) and Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1129.pdf

The Food and Nutrition Service (FNS) passed the final rule for Transitional Food Supplement (TFS) benefit policy under the Farm Security and Rural Investment Act of 2002 with an effective date of August 1, 2010. Provisions of the act required states to change how TFS cases are processed to; 1. Provide customers notification when the Temporary Cash Assistance (TCA) case closes and they are now eligible for TFS benefits; 2.Ensure customers are notified their TFS benefits end when they return to TCA; 3. Have a determination for continued eligibility for regular FSP benefits when the customer is approved for TCA during the TFS period; and 4.Recalculation of the TFS benefit to exclude the income, resources and deductible expenses when an active member of a TFS case leaves the household to prevent duplicate participation. FIA requested and FNS granted a waiver, which allowed for system modifications to implement the provisions above. However, we were able in January 2011, to implement one provision of the act: procedures for processing cases when a TFS household returns to TCA. To provide good customer service and avoid an increased agency workload, FIA also implemented procedures for aligning the TCA and FSP certification periods. The procedures outlined in A.T. 11-14 for processing TFS customers returning to TCA, and procedures in A.T. 11-20 for aligning certification periods and establishing continued eligibility for regular FSP benefits after the TCA case is approved are obsolete.


Control #: 11-30
Subject: PAA Interim Assistance Reimbursement Calculations
Issue Date: 6/22/2011
Effective Date: 6/22/2011
Program(s) Affected: Public Assistance to Adults
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1130.pdf

Recently, the Social Security Administration (SSA) contacted us about the new IAR process and expressed concerns about our reimbursement calculation method for the Public Assistance to Adults (PAA) program. FIA reviewed the process to determine whether we issued payments correctly. We discovered our methodology needs adjustment. The PAA program helps customers residing in a protective living arrangement such as a Rehabilitative Residence, a Project (CARE) Home or in an Assisted Living facility. Project Home and Assisted Living recipients receive a grant towards their cost of care. Applicants residing in a Project Home or Assisted Living facility are required to apply for the Supplemental Security Income (SSI) program administered by SSA, and enter into an agreement to reimburse the State for benefits received once their SSI benefit is approved. All customers receive a Personal Needs Allowance of $82.00 which is not reimbursable. Rehabilitative Residence customers receive only the personal needs allowance. Local departments explain the Interim Assistance Reimbursement (IAR) process and get applicants to sign the (DHR/FIA 340) form. When a recipient is awarded SSI benefits, the signature on the IAR allows the state to get reimbursed. Staff ensure applicants understand that the state must be repaid once the SSI is approved. Case managers enter the IAR date into the system and Local Finance officers work with SSA to calculate the IAR amount and determine what the state is owed. Rehabilitative Residence customers are not required to apply for SSI or sign the Interim Assistance Reimbursement.


Control #: 11-31
Subject: Assistance to Refugees and Asylees: Public Private Partnership and Medical Assistance Eligibility
Issue Date: 6/30/2011
Effective Date: 6/30/2011
Program(s) Affected: Temporary Cash Assistance (TCA), Refugee Cash Assistance (RCA), Refugee Medical Assistance (RMA), Medical Assistance (MA), Food Supplement Program (FSP)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1131.pdf

We recently received clarification from the federal Office of Refugee Resettlement (ORR) that, when a refugee or asylee assistance unit is found ineligible for TCA and “tag along” MA within their first eight months in the U.S. solely because their income exceeds the TCA income standard, they should then be tested for eligibility for Refugee Medical Assistance (RMA) which, while time-limited, has a higher income threshold. In addition, they should be provided with a notice that they may be able to qualify for Refugee Transitional Cash Assistance (RTCA), a time-limited, privately-administered, monthly payment available only through the private resettlement agency that referred them to the LDSS/DHHS. Refugees and asylees served by a resettlement center, meeting technical and financial eligibility, can receive services and financial assistance for up to eight months. RMA is limited to the first eight months that the refugee is in the U.S. and the first eight months after the asylee is granted status.


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