Fiscal Year 2010: DHR Documents by Subject


Subject: Accelerated Certification of Eligibility (ACE) - LDSS and LHD Procedures for Prioritizing and Accelerating the Medicaid Eligibility Process for Pregnant Women Applying to Medicaid
Control #: 10-31

Issue Date: 5/21/2010
Effective Date: 5/21/2010
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1031.pdf

This Action Transmittal supersedes AT 10-09 issued October 30, 2009 effective December 1, 2009. 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 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 attached to AT 10-09 are otherwise unchanged.


Subject: Accelerated Certification of Eligiblity (ACE) - LDSS and LHD Procedures for Prioritizing and Accelerating the Medicaid Eligibility Process for Pregnant Women Applying to Medicaid
Control #: 10-09

Issue Date: 10/30/2009
Effective Date: 12/1/2009
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1009.pdf

The Department of Health and Mental Hygiene (DHMH) and the Department of Human Resources (DHR) have developed new procedures for prioritizing Medicaid applications for pregnant women. The procedures will be implemented to assist the State in meeting the Governor’s initiative to decrease infant mortality in Maryland.

When pregnant women apply for Medicaid at either a Local Health Department (LHD) or a Local Department of Social Services (LDSS), their applications will be screened and the eligibility process will be accelerated. This will enable pregnant women to be enrolled quickly and to access prenatal care as soon as possible.


Subject: ACE Certification Section
Control #: 10-09 Attachment

Issue Date: 11/1/2009
Effective Date: 12/1/2009
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1009attach.pdf

Effective December 1, 2009, The (MCHP) Maryland Children’s Health Program Manual has revised section l000 of the manual to be replaced with the attached revised section of 1000. If you have any questions about these policies, contact the DHMH Division of MCHP at 410-767-1463 or 1-800-492-5231 (select option 2 and request extension 1463). Questions regarding CARES processing should be directed to Debbie Simon at

410-238-1247.


Subject: Allowing a Telephone Allowance for a Non-Land Line
Control #: 10-03

Issue Date: 8/24/2009
Effective Date: 8/24/2009
Program(s) Affected: Food Supplement Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1003.pdf

For over thirty years, the Food Supplement Program (FSP) has deducted the cost of telephones in determining a household's eligibility and benefit amounts, either by deducting actual telephone bills or standard telephone allowances. During this time, communications technology has expanded and FSP customers have gone beyond using traditional land-lines and are using new devices and services, like cellular telephones, pre-paid telephone cards, and Voice Over Internet Protocol (VoIP - or internet phone service). The Food and Nutrition Service (FNS) recently provided guidance about allowing the telephone allowance for non-land-line expenses.


Subject: Child Care Subsidy
Control #: 10-11

Issue Date: 10/30/2009
Effective Date: 10/30/2009
Program(s) Affected: Child Care Subsidy Case Record Documentation
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1011.pdf

As of July 1, 2009, the Child Care Subsidy (CCS) program reduced the amount of documentation that is required in a CCS case record. Any documentation that can be viewed through CCATS Documents does not have to be copied and added to the record. Any documentation that is signed or completed by the customer or informal provider must be in case record. Any documents generated outside of CCATS must be in the case record. If you have any questions, please contact Myra White-Gray, Assistant Bureau Chief for the Office of Child Care Subsidy. Ms. White-Gray can be reached by telephone at 410-767-7863 or by email at myra.white-gray@msde.state.md.us.


Subject: Child Care Subsidy (CCS) Regulation Changes
Control #: 10-10

Issue Date: 10/30/2009
Effective Date: 1/4/2010
Program(s) Affected: Child Care Subsidy
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1010.pdf

Effective January 4, 2010, Child Care Subsidy is making regulatory and/or procedural changes to the Child Care Subsidy (CCS) Program. The changes are as follows: 1.Substituting Child Care Subsidy (CCS) for Purchase of Care (POC)

The title Purchase of Care (POC) is replaced by Child Care Subsidy (CCS). 2. Updated and Reorganized Regulations

The regulations are reorganized into like categories to make them easier to use. 3. Increased Weekly Rates to Formal and Informal Child Care Providers

The Formal and Informal Rates are increasing by approximately 2.86%.

4. Transfer of Credentialing Program Quality Regulations

The requirements for Tiered Reimbursement are transferred to the Credentialing Program Regulations.

5. Addition of Hearings and Appeals Chapter in Regulations

A hearings and appeals chapter is included in the Child Care Subsidy regulations.


Subject: Child Care Subsidy Informal Provider Holiday Payments
Control #: 10-19

Issue Date: 1/27/2010
Effective Date: 1/27/2010
Program(s) Affected: Child Care Subsidy
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1019.pdf

Informal child care providers are not automatically paid for the six holidays to which formal child care providers are entitled. The holidays are: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day. However, if an informal child care provider provides care for a child on a holiday and can document that care was provided, payment can be made for that day. Documentation includes, but is not limited to, verification from the customer that he or she participated in their activity on the holiday.


Subject: Child Care Subsidy Waiting List
Control #: 10-21

Issue Date: 2/1/2010
Effective Date: 2/15/2010
Program(s) Affected: Child Care Subsidy
Link to Document: http://www.law.umaryland.edu/marshall/dhr/

DHR REMOVED 051512. Due to recent increases in caseload sizes and a lack of available funding, the Child Care Subsidy program is wait-listing Priority 3 applicants, as of February 15, 2010. Priority 1 and 2 applicants, as well as Priority 3 applicants with an SSI child or parent, or a disabled child who is not receiving SSI, are not wait-listed. CCATS will assist with the process. Letters are available to facilitate notification.


Subject: Child Support Referrals
Control #: 10-18

Issue Date: 1/5/2010
Effective Date: 1/5/2010
Program(s) Affected: Medical Assistance for Families and Children (FAC)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1018.pdf

In 2007, the General Assembly passed legislation expanding Medical Assistance (MA) eligibility to more low income families with dependent children. As a result, more parents began to apply for MA. The expansion increased the number of automated referrals to the Child Support Enforcement Administration (CSEA) through the Client Automated Resource and Eligibility System (CARES) system for children with non-custodial parents (NCPs). A modification in the procedures for child support referrals of new Families and Children (FAC) “Medical Assistance-only” (MA only) cases was instituted on March 20, 2009. This action transmittal clarifies the changes to the automatic system referral process from CARES to the Child Support Enforcement System (CSES). The automatic system referral for Temporary Cash Assistance (TCA) customers and cases referred from the Department of Juvenile Services (DJS) remains the same. The automated system referral for FAC – MA only cases was blocked on March 20, 2009.


Subject: Closure of Medicaid Coverage Groups Due To Enrollment in the Employed Individuals with Disabilities Program
Control #: 10-08

Issue Date: 10/29/2009
Effective Date: 10/29/2009
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1008.pdf

On October 1, 2008 the Maryland Medical Assistance Program implemented the new Employed Individuals with Disabilities (EID) Program. The EID program grants Medical Assistance eligibility to working disabled individuals (and their spouse if living together) if they earn up to 300% FPL and their assets do not exceed $10,000. Certain retirement accounts including 401(k)s, 403(b)s, pension plans, and Keogh plans are not counted. Participants in the program may be billed a monthly premium based on their income.


Subject: Coding for Burial Assistance
Control #: 10-02

Issue Date: 8/27/2009
Effective Date: 8/27/2009
Program(s) Affected: Burial Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1002.pdf

We were made aware of a correction needed in the CARES procedures for Action Transmittal (AT) 10-02 — Coding for Burial Assistance. The corrected procedures are attached. AT 10-02 has been replaced with AT 10-02 Revised. Recently we became aware that some case managers incorrectly set up burial assistance cases in CARES. Burial Assistance is a State program and funding comes from State funds. Incorrect case set up causes the assistance to be paid incorrectly from Federal funding. This Action Transmittal provides the appropriate CARES coding and procedures to use for Burial Assistance.


Subject: Coding For Burial Assistance
Control #: 10-02 Revised

Issue Date: 9/1/2009
Effective Date: 9/1/2009
Program(s) Affected: Burial Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1002rev.pdf

We were made aware of a correction needed in the CARES procedures for Action Transmittal (AT) 10-02 — Coding for Burial Assistance. The corrected procedures are attached. AT 10-02 Revised replaces AT 10-02. Recently we became aware that some case managers incorrectly set up burial assistance cases in CARES. Burial Assistance is a State program and funding comes from State funds. Incorrect case set up causes the assistance to be paid incorrectly from Federal funding. This Action Transmittal provides the appropriate CARES coding and procedures to use for Burial Assistance.


Subject: Coding Works Because Of February’s Inclement Weather
Control #: 10-26

Issue Date: 4/1/2010
Effective Date: 4/1/2010
Program(s) Affected: Temporary Cash Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1026.pdf

In February, the State had record levels of snow that curtailed many services. All State services except for 24/7 services were closed for two days and included liberal leave for four other days. Garrett and Allegany Counties had an additional day of liberal leave because of snow. Customers in work activities must participate for a specific number of hours per month to be countable in the Federal Work Participation Rate (WPR). The snow in February caused problems with the WPR because there was no time to plan. The Federal, Administration for Children and Families (ACF) provided states with policy guidance in TANF-ACF-PI-2007-08 stating they (ACF) did not have the authority to waive Federal law for TANF eligibility. They gave the same information to Family Investment staff this year because of the snow.


Subject: Confirming Citizenship Using SVES
Control #: 10-27

Issue Date: 4/7/2010
Effective Date: 4/1/2010
Program(s) Affected: Medical Assistance, Maryland Children’s Health Insurance Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1027.pdf

Effective April 1, 2010, the Department of Health and Mental Hygiene (DHMH) and the Department of Human Resources (DHR) will have access to a new component of the SVES system. This service will permit case managers to verify citizenship for new MA or MCHP applicants by means of an overnight search of SSA data.


Subject: Electronic Benefits Transfer (EBT) System Vault Card Issuances
Control #: 10-07

Issue Date: 10/19/2009
Effective Date: 10/19/2009
Program(s) Affected: Food Supplement Program (FSP), Temporary Cash Assistance (TCA), Refugee Cash Assistance (RCA) and Temporary Disability Assistance Program (TDAP)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1007.pdf

Action Transmittal 08-16 provides information about the changes to the electronic benefits transfer (EBT) system. One of the most significant changes is issuing vault cards to customers only when a specific emergency situation exists. This action transmittal reiterates the types of emergency situations that justify issuing a vault card and provides a new referral form to be completed by the Case Manager when a vault card issuance is needed.


Subject: Elimination of Optional Verification and Over Verification
Control #: 10-38

Issue Date: 6/28/2010
Effective Date: 6/28/2010
Program(s) Affected: Food Supplement Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1038.pdf

For many years we have allowed local departments to choose verification options as described in the Food Supplement Program Manual section 408.6. Due to concerns about over verification, with this action transmittal, we are eliminating these options. This action transmittal also provides an overview of mandatory verification requirements.


Subject: Elimination of the Asset Test
Control #: 10-25

Issue Date: 4/1/2010
Effective Date: 4/1/2010
Program(s) Affected: Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1025.pdf

Family Investment staff continue to work to simplify TCA and other program eligibility requirements to make the program easier to implement and to reduce the work load on the local department staff. This recent change came at the urging of the advocate community. TCA policy excludes all resources and assets except for cash on hand and money in a savings or checking account. After reviewing available data we found that very few TCA applicants or recipients have countable resources. Fewer still have resources that exceed eligibility limits and those that did, also have income that make their income over scale. The asset test requirement means case managers must request and the customer verify information about bank accounts. In most cases, this does not affect the customer’s eligibility for assistance.


Subject: Elimination of the Asset Test
Control #: 10-25

Issue Date: 4/1/2010
Effective Date: 5/1/2010
Program(s) Affected: Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1025.pdf

Family Investment staff continue to work to simplify TCA and other program eligibility requirements to make the program easier to implement and to reduce the work load on the local department staff. This recent change came at the urging of the advocate community. TCA policy excludes all resources and assets except for cash on hand and money in a savings or checking account. After reviewing available data we found that very few TCA applicants or recipients have countable resources. Fewer still have resources that exceed eligibility limits and those that did, also have income that make their income over scale. The asset test requirement means case managers must request and the customer verify information about bank accounts. In most cases, this does not affect the customer’s eligibility for assistance.


Subject: Elimination of The Eight-Month Time Limit For Iraqi And Afghan Special Immigrants
Control #: 10-24

Issue Date: 3/15/2010
Effective Date: 3/15/2010
Program(s) Affected: All Programs
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1024.pdf

Action transmittals 08-30 issued April 28, 2008 and 09-28 issued March 16, 2009 described the immigration status for certain Iraqi and Afghan immigrants. Under this policy these immigrants were treated on the same basis as refugees admitted under section 207 of the Immigration and Nationality Act (INA) except this period of special eligibility was limited. The Department of Defense Appropriations Act of 2010 (Section 8120, P. L. 111-118) enacted on December 19, 2009, provides that Iraqi and Afghan Special Immigrants (SIVs) are eligible for federal public benefits to the same extent and for the same time period as refugees. The new legislation supersedes the policy in Action transmittals 08-30 and 09-28, which limited SIVs to refugee status for a specified period. The new legislation provides that SIVs are eligible for all available benefits to the same extent and for the same period of time as refugees pursuant to Section 207 of the Immigration and Nationality Act. Provided that other eligibility requirements are met, refugees are eligible for benefits indefinitely.


Subject: End of Federal “Lock-Out” Provisions for Title XXI Maryland Children’s Health Program Coverage Groups: P13, P14, D02 and D04
Control #: 10-29

Issue Date: 5/12/2010
Effective Date: 5/12/2010
Program(s) Affected: Maryland Children’s Health Program (MCHP); Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1029.pdf

This Action Transmittal provides clarification based on advice recently received from the federal Centers for Medicare and Medicaid Services (CMS), regarding the applicability of Title XXI lock-out provisions for children of State employees eligible to participate in the State of Maryland Health Benefits Plan. Maryland’s Children’s Health Insurance Program (MCHP), established under Title XXI of the Social Security Act, is made up of four coverage groups, the P13 and P14 which are free, and the D02 and D04 which carry a premium. Because both the “free” and premium portions of the CHIP program are operated as a Medicaid expansion rather than a stand-alone Title XXI program or a combination program, we are permitted to apply federal MA (Title XIX) rules for CHIP eligibility, as explained below. Federal law and regulation under Title XXI provided that children of State employees with access to State employee health coverage were excluded from eligibility in CHIP. For CHIP programs operated as Medicaid expansions, CMS has determined that Title XIX eligibility rules apply and Title XXI rules do not apply.


Subject: End of the Disability Entitlement Assistance Program (DEAP)
Control #: 10-33

Issue Date: 5/25/2010
Effective Date: 6/30/2010
Program(s) Affected: Temporary Disability Assistance Program (TDAP), Public Assistance to Adults (PAA), Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1033.pdf

The Disability Entitlement Advocacy Program (DEAP) will end June 30, 2010 and will no longer provide any services to customers receiving Temporary Cash Assistance (TCA), Public Assistance to Adults (PAA), or Temporary Disability Assistance Program (TDAP) benefits. All existing DEAP operating procedures are obsolete after June 30, 2010 including the distribution of monthly DEAP reports to local departments. After June 18, 2010 do not call DEAP for updates on your customers or for a copy of the DHR/FIA Form 340.


Subject: Exclusion of Earnings From Temporary Census Employment For Food Supplement Program
Control #: 10-15

Issue Date: 12/18/2009
Effective Date: 1/1/2010
Program(s) Affected: All Programs
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1015.pdf

In November 2008, we issued action transmittal 09-22 — Census Workers and Earnings from Temporary Census Employment. In this transmittal we outlined the policy about temporary Census income, which excluded the income for all programs except for the Food Supplement Program (FSP). The Food and Nutrition Service (FNS) recently informed us of the opportunity to exclude the income for the FSP as part of a demonstration project. Our participation in this demonstration project will help ease program administration by aligning FSP policy with Temporary Cash Assistance (TCA), Purchase of Care and Medical Assistance policies. It will also benefit recipients who get jobs as temporary census workers.


Subject: Exclusion of the Temporary Increase in Unemployment Compensation Payments For The Food Supplement Program
Control #: 10-20

Issue Date: 1/28/2010
Effective Date: 1/28/2010
Program(s) Affected: Food Supplement Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1020.pdf

On June 11, 2009, we issued Action Transmittal 09-42, which provided policy about the American Recovery and Reinvestment Act (ARRA) of 2009 $25 per week temporary increase in unemployment compensation (UC). The ARRA excluded this income for all programs except the Food Supplement Program (FSP). On November 6, 2009, President Obama signed the Worker, Homeownership, and Business Assistance Act of 2009. This Act excludes the $25 per week payments from all calculations of resources and income for the FSP.


Subject: Explanation of Ineligibility Due to Excess Resources
Control #: 10-28 Attachment 2

Issue Date: 5/4/2010
Effective Date: 1/1/2010
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1028attach2.pdf

Name: _______________________________ Spouse Name: _________________________

HOH Client ID Number: __________________ Spouse ID Number: _________________________

AU Number: ________________________________

Dear__________________:

This is to notify you that based on the application/redetermination filed on ___________, you have

been determined ineligible for the Qualified Medicare Beneficiary (QMB) and Special Low-Income

Medicare Beneficiary (SLMB) programs. You are not eligible because your resources exceed the

the maximum allowable amount of $8,100.00 for an Individual or $12,910.00 for a couple.

The amount of excess resources is: $ _____________

You are:

__ Denied Medical Assistance eligibility for ____________________ based on the application filed

on ______________________________.

__ Terminated from Medical Assistance eligibility effective: ____________________________

The following resources were considered:

Type of Resource Amount

_______________________________ $____________

_______________________________ $____________

_______________________________ $____________

_______________________________ $____________

_______________________________ $____________

The Total amount of your Countable Resource is: ___________________________

You may reapply when your resources no longer exceed the maximum allowable amount as of

the first of the month. Your resources may be used for necessary personal or health care needs (e.g., burial plan, nursing facility or other medical bills, home repairs), but may not be given away or otherwise disposed for less than fair market value. When you reapply, you will be required to verify how the resources were used. Keep all receipts for this purpose.

This decision is based on COMAR 10.09.24.08. If you do not agree with this decision, you have

the right to request a hearing within 90 days of the date on this notice. The procedures for requesting a hearing are attached. If you have any questions about this letter, please call your caseworker at the number below.


Subject: Food Supplement Program (FSP) And Temporary Cash Assistance (TCA) Mass Changes – October 2009
Control #: 10-04

Issue Date: 9/14/2009
Effective Date: 10/1/2009
Program(s) Affected: Food Supplement Program and Temporary Cash Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1004.pdf

Each August, the United States Department of Agriculture (USDA) publishes the updated income standards and deductions for the year. Maximum monthly allotment tables are also updated. The income standards increased and the standard deduction for a one person household decreased while the standard deduction for other household sizes increased. The excess shelter deduction increased and the homeless shelter deduction did not change. The maximum food supplement allotments did not change because they were already increased in April with the American Recovery and Reinvestment Act of 2009. TCA grants will stay the same. The attached tables show the changes for the FSP and the current amounts for TCA. The attached FSP manual pages also contain the updates for October 1st. CARES automatically generates all customer notices for increases and decreases at the time of the mass change. The mass modification should take place on September 12, 2009.


Subject: Foster Care Coverage Act—Medicaid for All Independent Foster Care Adolescents Up To Age 21
Control #: 10-13

Issue Date: 11/17/2009
Effective Date: 10/1/2009
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1013.pdf

House Bill 580 requires the Maryland Medical Assistance Program (Medicaid or MA) to provide coverage for “independent foster care adolescents” who are not otherwise eligible for Medicaid benefits and who have annual household incomes up to 300% of federal poverty guidelines (FPG). (Resources are not considered for this population.) Independent foster care adolescents (IFCA) are individuals younger than age 21 who, on their 18th birthday, were in State foster care.

Youth in State foster care receive medical care through Medicaid. However, this coverage generally has terminated when the youth turns 18 and leaves the foster care system. Now, under the authority of House Bill 580, youth continue to qualify for Medicaid up to their 21st birthdays without working with a Foster Care social worker or complying with vocational or educational requirements.

Foster care social workers, known as permanency workers, will include this new Medicaid coverage option when assisting youth with continuing their Medicaid benefits during transition planning. However, qualifying youth who exited foster care prior to implementation of this expanded eligibility will often be unaware of the change. Therefore, a case manager (CM) must check for E-track history for a young MA applicant (18 to 21) to determine whether IFCA E02 coverage is available.


Subject: LDSS, LHD AND DEWS Policy Eliminating Mandatory Face-To-Face Interview for Applicants/Recipients in an ABD Coverage Group
Control #: 10-22

Issue Date: 3/3/2010
Effective Date: 3/3/2010
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1022.pdf

: Relaxation of the interview requirement for Medicaid applications and redeterminations began June 30, 2008 with a regulation change (35:13 Md. R. 1179). The amendment removed mandatory language from COMAR section 10.09.24.04K concerning face-to-face interviews. We announced the change for FAC coverage groups, as enlarged by the Governor’s Expansion, in AT 08-32. For LTC coverage groups, we announced the change in AT 09-19. This announcement for Community ABD coverage groups completes our directions for a more flexible Medicaid interview process.

ACTION REQUIRED: Effective with this issuance, case managers should no longer require all applicants/recipients, or their representatives, to participate in a face-to-face interview. Face-to-face interviews should only take place if determined necessary by the case manager on a case-by-case basis, or if requested by an applicant/recipient. DHMH expects that the majority of face-to-face interviews will result from customer requests. If, after reviewing the application, the case manager needs additional information or further explanation of information submitted, the case manager is encouraged, for the applicant’s convenience, to conduct a telephone interview before requiring a face-to-face interview.


Subject: Long-Term Care Facility Stay for Less Than 30-Days Or Medicare Co-Pay Days
Control #: 10-17

Issue Date: 1/5/2010
Effective Date: 1/5/2010
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1017.pdf

In April 2009, action transmittal 09-34 informed local department staff of the new procedures for processing Long-Term Care Patient Activity Reports (DHMH 257) and submission of the DES 501 for recipients of Community Medical Assistance who were admitted to a Long Term Care Facility (LTCF) for less than 30 days or for Medicare Co-Pay days in a LTCF for recipients of Community Medical Assistance who are not receiving Waiver Services. This process would remain in effect until the opening of the Bureau of Long Term Care Eligibility (BLTCE). Effective October 16, 2009, this process is now conducted at the BLTCE. This transmittal obsoletes action transmittal 09-34 and updates procedures for processing DHMH 257 forms for customers on Medicare Co-Pay days. There are no procedural changes for local department staff.


Subject: MA/MCHP Requirement to Lift 5-Year Bar for Children Up To 21 And Pregnant Women; Elimination of The X01 Coverage Group
Control #: 10-14

Issue Date: 11/17/2009
Effective Date: 12/1/2009
Program(s) Affected: Medical Assistance Maryland Children’s Health Program (MCHP) State Funded Medical Assistance for Ineligible Qualified Children And Pregnant Women Immigrants
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1014.pdf

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) gives states the option to furnish federal CHIP and MA to pregnant women and children who are lawful permanent residents with less than 5 years’ continuous residency in the U.S. This basically lifts the “5-year bar” that abolished federal benefits for pregnant women and children who were legal permanent residents. Therefore, the 100% State-funded X01 coverage group that Maryland created to maintain health care coverage for this population will no longer be necessary.

In addition, the CHIPRA expansion authority makes two changes to the former X01 population. First, Maryland is required to cover eligible lawful permanent residents who qualify as children under the MA standard, which means children aged 19 and 20, who were not included in the X01 coverage group, will be able to apply.


Subject: Mail-In Application for Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) Programs
Control #: 10-28 Attachment

Issue Date: 5/4/2010
Effective Date: 1/1/2010
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1028attach.pdf

In this packet is the mail-in application to apply for the Qualified Medicare Beneficiary (QMB) and the Specified Low-Income Medicare Beneficiary (SLMB) Programs. To apply for these benefits, you will need to do the following things:

• Fill out this form

• Mail pages 1, 2, 3, and 4 of your completed form to the local department of social services in the county (or Baltimore City) where you live. You will find their addresses on the inside back cover.


Subject: Maryland Senior Nutrition Assistance Program (MSNAP) -A Combined Application Demonstration Project
Control #: 10-36

Issue Date: 6/11/2010
Effective Date: 7/1/2010
Program(s) Affected: Food Supplement Program
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1036.pdf

The Maryland Combined Application Project, called the Maryland Senior Nutrition Assistance Program (MSNAP), is a 5-year demonstration project approved by the Food and Nutrition Service that will improve the way food assistance is delivered to elderly individuals, age 60 or older, who receive Supplemental Security Income (SSI). MSNAP will simplify the application process for both participants and local department staff.


Subject: National Voter Registration Act of 1993 Update
Control #: 10-01

Issue Date: 9/1/2009
Effective Date: 9/1/2009
Program(s) Affected: All Programs
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1001.pdf

The National Voter Registration Act (NVRA) of 1993 became effective on January 1, 1995. The intent of NVRA is to increase the number of citizens registered to vote and establish safeguards that ensure voter¡¦s rights for all citizens. State and Federal laws require all state agencies to offer 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. Staff may review on the FIPNet the following FIA Information Memo and FIA Action Transmittal for comprehension and compliance with the requirements of the National Voter Registration Act of 1993:

„« FIA Information Memo, National Voter Registration Act of 1993, Control Number 02-04, Issued August 10, 2001

„« FIA Action Transmittal, National Voter Registration Act of 1993, Control Number 08-06, Issued September 13, 2007


Subject: New QMB/SLMB Resource Standards
Control #: 10-28

Issue Date: 5/4/2010
Effective Date: 1/1/2010
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1028.pdf

The Medicare Improvement for Patients and Providers Act (MIPPA) mandated changes to match the resource limits for individuals eligible for the full Low-Income subsidy (LIS) program benefits under Medicare Part D with those allowed for individuals who are also eligible for medical assistance eligibility under the QMB/SLMB Program. (See 2010 Income/Assets Guidelines chart, and revised QMB/SLMB application, attached.) Effective January 1, 2010, resource limit amounts for QMB/SLMB Program increased to $8100 for an individual and $12,910 for a couple (includes a standard $1500 burial credit). In addition, the cash value of life insurance is disregarded.


Subject: No Change in 2010 Federal Poverty Level (FPL) For MA Coverage Groups
Control #: 10-23

Issue Date: 3/17/2010
Effective Date: 3/17/2010
Program(s) Affected: Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1023.pdf

Each year, the Federal Poverty Level (FPL) is determined by the Department of Health and Human Services. This number is adjusted annually for inflation, using the Consumer Price Index (CPI). The CPI freeze for 2010 will result in no change in the FPL for all MA coverage groups. Effective January 1, 2010, all income standards based on multiples of the FPL will remain the same as 2009 income standards. Monthly Income and other MA schedules released in 2010 will indicate that there is no change this year.


Subject: No Change in Utility Allowances or Telephone Allowance
Control #: 10-12

Issue Date: 11/16/2009
Effective Date: 11/16/2009
Program(s) Affected: Food Supplement Program (FSP)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1012.pdf

Although the most recent Consumer Price Index (CPI) for the Baltimore/Washington area reflects a decrease in fuel costs, the standard and limited utility allowances will not change for the 2010 calendar year. The telephone allowance will remain the same as well.

„« The Standard Utility Allowance (SUA) is $414 per month.

„« The Limited Utility Allowance (LUA) is $250 per month.

„« The telephone allowance is $37.

Actual utility expenses are used only when a household is billed for just one utility, which does not include heating or cooling, and does not have a telephone expense. All other households are to receive the appropriate SUA or LUA or the telephone allowance. Households with heating or cooling expenses can receive no more than the SUA. Do not enter actual billed amounts for heating or cooling on CARES even if the amount is higher than the SUA. (Section 214.4 in the Food Supplement Program Manual)


Subject: QMB/SLMB Resource Worksheet
Control #: 10-28 Attachment 3

Issue Date: 5/4/2010
Effective Date: 1/1/2010
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1028attach3.pdf

Date: ____________

Name: _______________________________ Spouse Name: _______________________

HOHClient ID Number: _____________________ Spouse ID Number: __________________

AU Number: __________________________

List Total Assets owned by applicant and/or spouse. Remember to exclude all

Life Insurance policies for QMB and SLMB. Do not enter Life Insurance on CARES.

OWNER

TYPE

VERIFICATION

VALUE

(Full, Face, Cash)

Unavailable/

Encumbered

Countable

Value

TOTAL: $_____________ - $___________= $___________

Countable Total Resources: $ ___________

Resource Limit for Individual = $8,100: - $ ___________

Resource Limit for Couple = $12,910: or - $ ___________

Excess Resource: = $ ___________

Note: If over Resource Standard, enter excess amount onto the AST1 screen.

DHMH/OES 008 (QMB/SLMB) 05/10


Subject: Sanction Process for Cares and Works 2.0
Control #: 10-37

Issue Date: 6/25/2010
Effective Date: 7/1/2010
Program(s) Affected: Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1037.pdf

The conciliation and sanction process is an involved procedure that requires the case manager to take many action steps and can be error prone. Our systems were not equipped to track and monitor the conciliation and sanction process when it was initially implemented; therefore several workarounds were created to help case managers in day to day case management tasks. System changes have been added to both CARES and WORKS 2.0 to help implement and track the conciliation and sanction process. However, conciliation and sanction policy has not changed. This action transmittal outlines the new system process for implementing work sanctions in CARES and WORKS. All prior procedures which make reference to the old conciliation and sanction system process (i.e. recording instances of sanction with the codes: GU, VT, or CZ) are now obsolete.


Subject: Section 1000: Determining Financial Eligibility
Control #: 10-09 Attachment 2

Issue Date: 11/1/2009
Effective Date: 11/1/2009
Program(s) Affected:
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1009attach2.pdf

An applicant is financially eligible for the MCHP if the applicant's

countable net family income does not exceed:

„X for child applicants, 200 percent FPL

„X for pregnant women applicants, 250 percent FPL

for the family size involved, which includes all unborn children


Subject: Shelter Cost Verification
Control #: 10-34

Issue Date: 6/3/2010
Effective Date: 7/1/2010
Program(s) Affected: Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1034.pdf

TCA applicants and recipients must verify the type of housing in which they live to prevent having the $60 housing subsidy counted. We consider customers as living in subsidized housing when they do not verify housing type. We are revising the policy on housing verification requirements.


Subject: Systematic Alien Verification for Entitlements (SAVE) Verification
Control #: 10-30

Issue Date: 5/14/2010
Effective Date: 5/1/2010
Program(s) Affected: Temporary Cash Assistance (TCA), Food Supplement Program (FSP)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1030.pdf

The United States Department of Homeland Security, Citizenship and Immigration Services (USDHS CIS) recently sent a reminder letter to all Systematic Alien Verification for Entitlements (SAVE) user agencies reminding them that all additional verification procedures must be completed when prompted by the system. Failure to continue may deny an immigrant customer benefits they may be eligible for.


Subject: Telephone Lifeline (Tel-Life) Program
Control #: 10-32

Issue Date: 5/21/2010
Effective Date: 5/21/2010
Program(s) Affected: Tel-Life
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1032.pdf

This purpose of this transmittal is to provide information regarding the Telephone Lifeline Program or Tel-Life in Maryland. Tel-Life is a program that offers low-cost telephone service to eligible low-income individuals. Telephone Lifeline Service in Maryland is authorized by the Public Utility Companies Article, Title 8, Subtitle 2, Section 8-201. The Lifeline program, however, is nationwide. Lifeline is a federal program created by the Federal Communications Commission (FCC) in 1984 and enhanced by the Telecommunications Act of 1996. The FCC’s Low Income Program of the Universal Service Fund, which is administered by the Universal Service Administrative Company (USAC), is designed to ensure that quality telecommunications services are available to low-income customers at just, reasonable, and affordable rates. Lifeline support reduces monthly charges for basic telephone service for eligible low-income consumers. The funding is administered by the Universal Service Administrative Corporation (USAC). USAC administers the telecommunications universal service fund providing communities across America with affordable telecommunication services. The fund is comprised of fees collected from customers and paid to USAC by telecommunication companies. Companies participating in Lifeline programs are reimbursed by USAC for some costs associated with the program.


Subject: Temporary Cash Assistance Closures Due To the Child Support Interface
Control #: 10-35

Issue Date: 6/7/2010
Effective Date: 6/7/2010
Program(s) Affected: Temporary Cash Assistance (TCA)
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1035.pdf

Frequently, the CARES Help Desk receives calls about TCA cases that close when Child Support Fiscal enters child support payments on the TCA case. The payments exceed the TCA grant amount, triggering the closing for the next month. The CARES system is programmed to send the customer an Adverse Action notice, allow 10 days adverse action and close the case. This action allows the customer to receive the child support that was collected. The family is also screened for F05 Medical Assistance (MA). If the family is not eligible for F05, the Assistance Unit’s (AU) MA is extended for four months.


Subject: Web Enhancements for the Systematic Alien Verification for Entitlement (SAVE) Program System
Control #: 10-05

Issue Date: 9/9/2009
Effective Date: 9/9/2009
Program(s) Affected: Temporary Cash Assistance (TCA), Food Supplement Program (FSP), Medical Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1005.pdf

The Systematic Alien Verification for Entitlement (SAVE) Program is an intergovernmental information sharing partnership developed to help case managers determine immigration status for eligibility for federal benefits. SAVE is an online system which allows case managers to directly access and verify information on a customer’s citizenship and immigration status. Effective July 12, 2009, the United States Department of Homeland Security (DHS) implemented enhancements to the SAVE program. These enhancements improve the speed and efficiency of the SAVE system and provide additional data sources that case managers can use. The conversion will transfer all data entered by the user and retain active and historical case data. This action transmittal informs local departments about the enhancements and provides a guide to accessing the system.


Subject: Work Activities
Control #: 10-06

Issue Date: 9/28/2009
Effective Date: 9/28/2009
Program(s) Affected: Temporary Cash Assistance
Link to Document: http://www.law.umaryland.edu/marshall/dhr/1006.pdf

Local department staff has requested updated information on federal core and federal non-core work activities and state defined activities. This action transmittal provides details on the description of the work activities, and the appropriate coding for entering data on both CARES and WORKS 2.0.


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