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I. SOCIAL SECURITY and VETERAN’S CHANGES DUE TO COLA ADJUSTMENT
III. ONGOING CASES AUTOMATICALLY UPDATED IN EIS
IV. ONGOING CASES NOT UPDATED IN EIS
V. APPLICATIONS AND REAPPLICATIONS APPROVED AFTER NOVEMBER 23, 2011
Administrative Letter No. 11- 16, Social Security Cost-of-Living Adjustment (COLA 2012) and VA Cost-of- Living Adjustment (COLA 2012) for Special Assistance Program (Revised)
N.C. Division of Aging and Adult Services, Adult Services Section
Date: |
November 18, 2011 |
Subject: |
Social Security Cost-of-Living Adjustment (COLA 2012) and VA Cost-of- Living Adjustment (COLA 2012) for Special Assistance Program (Revised) |
Distribution: |
County Directors Special Assistance Supervisors Adult Services Supervisors |
Effective Date: |
January 1, 2012 |
A. RSDI/SSI
Effective January 1, 2012, recipients of RSDI and/or SSI will receive a 3.6%
cost-of-living increase in their monthly benefits.
B. SSI Federal Benefit Rate (FBR)
Effective January 1, 2012, the SSI FBR for an individual will increase to $698 per month.
C. Veteran’s Benefits (VA)
Effective January 1, 2012, most recipients of Veteran’s Benefits will receive a 3.6% cost-of-living increase in their monthly benefits.
All SA recipients who are authorized as of the November regular run
November 23, 2011 will be sent a notice with the December 2011 SA checks. This notice satisfies the notice requirements in SA-3330. Please see Attachment 1.
EIS will automatically calculate the January 2012 Special Assistance payments to reflect the 3.6% COLA increase in RSDI/SSI benefits. SA cases in EIS with correct information will be updated on the night of November 23, 2011. The payment effective date will be January 1, 2012.
Note: EIS will not automatically calculate the January 2012 Special Assistance payments to reflect the COLA increase in VA benefits. Income Maintenance Caseworkers will need to evaluate these cases to recalculate the SA payment.
The SA CASE UPDATED - AUDIT RPT is a list of all updated cases and will be available in XPTR on November 28, 2011, under the name ‘DHREJA SA CASE UPDATED-AUDIT RPT’.
This report will show the recipient’s name, listed in alphabetical order by district number, the county case number, the case ID number, the old and new SA payment amounts, the old and new RSDI/SSI amounts, and the adult care home rates. The $20 General Income Exclusion will be included in the new payment calculation for these cases.
Case profiles for each updated case listed on the Audit Report will be generated and displayed in NCXPTR under the name ‘DHREJA SA RSDI COLA PROFILES’. No paper reports will be generated for any other report, but will be displayed in NCXPTR.
A. Cases Updated in EIS
Within 30 days of the update, verify the new RSDI amount through SOLQ. If the amount is different from that on the SA CASE UPDATED-AUDIT RPT, revise the payment amount as soon as the action can be taken and the appropriate notice can be sent.
B. Cases Updated in EIS, but Changes Occur After November 23, 2011 that Affect the Payment
1. Recompute the SA payment amount. When computing the new payment, use the case profile information to determine the revised RSDI/SSI amounts. These cases will have the $20 General Income Exclusion given automatically; do not give another $20 exclusion.
2. Send an adequate notice if the recipient received the notice with the December check.
3. Key the DSS-8125 no later than December 23, 2011 to reflect the correct payment amount effective January 1, 2012 or termination.
4. Verify the new benefits through SOLQ with those shown on the SA CASE UPDATED-AUDIT RPT. If the amounts are different, revise the payment amount as soon as the action can be taken and the appropriate notice can be sent.
A. Reports of Cases Not Updated
The following reports identify cases that were not automatically updated by EIS. Manually update all cases listed on these reports following instructions in B. below.
These reports will be available in XPTR on November 28, 2011. No paper copies will be generated.
1. SA Error Report – Cases Not Updated – These cases could not be automatically updated by EIS due to errors in the case data in EIS. This is displayed in NCXPTR under the name ‘DHREJA SA ERROR: CASES NOT UPDTE’. The error messages include:
a. MAINT NOT $1,228 or $1,561: Cases with the Maintenance Amounts that are not equal to $1,228 or $1,561. This means cases with ambulation codes “E” and “M” and “H” will not be updated and will appear on this report.
NOTE: Do not update the “H” cases until instructed to do so.
b. PAYMT NOT EQUAL DIFF: The Maintenance Amount minus the Total Countable Monthly Income minus the Grant Recoupment Amount does not equal the Monthly Payment Amount.
c. SSI AND RSDI = ZERO: There are no entries for SSI and RSDI in EIS.
d. UNEARN INC = ZERO: Either the Net Unearned Income amount or the Total Countable Monthly Income amount is zero.
e. TOT MO INC NOT BAL: The total of the RSDI, SSI plus other unearned income and case level net earned income does not equal the Total Countable Monthly Income amount plus $20.
f. SSI NOT $674: The SSI amount, which is present in EIS, is not $674, and there is no RSDI amount present.
g. SSI IND Y – NO SSI: The SSI indicator is Y and no SSI amount is entered.
h. RSDI & SSI AMOUNT INVALID: The total of the RSDI and SSI amounts exceeds allowable limit of $694.
i. TOT UNEARN IS < RSDI & SSI: The total unearned income is less than RSDI and/or SSI.
j. CASE PENDING: These are cases that contained a pending DSS-8125 at the time of the mass change.
2. SA Potential Terminated Cases – These are cases in which the Monthly Payment Amount is less than $1.00 as a result of the increased RSDI/SSI. This is displayed in NCXPTR under the name ‘DHREJA SA POTENTIAL TERMINA CASE’. These recipients potentially have income that exceeds the allowable income limit based on their ambulation capacity, and the cases may require termination.
Instructions for Medicaid Passalong for Terminated Cases –
Evaluate cases terminated due to the COLA increase for eligibility for continued Medicaid under passalong provisions. Refer to MA-2110, Passalong for instructions for determining if Medicaid passalong applies. Use DMA-5150, Documentation of Passalong or Eligibility or Ineligibility to document whether the recipient is eligible for Medicaid passalong. If the recipient is eligible for Medicaid passalong, take the following actions in EIS:
a. Key a DSS-8125 to transfer the case to Medicaid. The classification is always “N”.
b. Enter the code “PC” in the Individual Special Use field on the individual level in EIS.
c. An error message will appear. Put the form on hold and call an EIS consultant at 919-855-4000. EIS will contact DIRM to process the case.
d. If changes later occur in a passalong case, follow the same procedure. Key the DSS-8125, put it on hold and call EIS to process the case.
3. SA Potential Zero-Pay Cases
These are cases whose Monthly Payment Amount is $1.00, $2.00, $3.00, or $4.00 as a result of the increased RSDI/SSI increase. This is displayed in NCXPTR under the name ‘DHREJA SA POTENTIAL ZERO PAY CAS’.
It is important when manually updating these cases to record the actual Total Countable Monthly Income in the case record for future budgeting purposes. Enter the ACTUAL payment amount ($1.00, $2.00, $3.00 or $4.00) in the Monthly Payment Amount field. Enter a payment effective date of 012012.
4. VA Error Report
These are all SAA and SAD cases that contain a VA indicator of ‘Y’. Manually update these cases. The report is displayed in NCXPTR under the name: ‘DHREJA SA VA PAYMENT ERROR CASES’.
5. SA In-Home Program Recipients (Ambulation Capacity Code “H”)
SA/IH cases are exempt from counting the COLA until the new Federal Poverty amount is effective in April, 2012 for North Carolina recipients.
6. SA Cases with Ambulation Capacity Code “E”
These cases have variable maintenance amounts and cannot be updated in the mass change. The IMC will need to manually update these cases and key them before December 23, 2011 for the new SA payment to be effective January 1, 2012.
For “E” cases continue to use the SA rate of $1,253.00 for determining continued SA eligibility. If countable income is $1,252.50 or less approve with a $1.00 payment which translates to a zero payment case. Please refer to SA-3220 for budgeting instructions.
7. SA Cases with Ambulation Capacity Code “M”
These cases have variable Maintenance amounts and cannot be updated in the mass change. The IMC will need to manually update these cases and key them before December 23, 2011 for the new SA payment to be effective January 1, 2012. Please refer to SA-3220 for budgeting instructions.
B. Procedures for Manually Updating Ongoing Cases Not Updated By EIS
1. After November 23, 2011 do not key a change in income for any case with RSDI or SSI until the new RSDI/SSI amount is verified.
2. Verify the new benefits from SOLQ.
3. Send a notice to notify the recipient of the change. An adequate notice is sufficient if the recipient was authorized in November and received the notice with the December check.
4. Key a DSS-8125 no later than December 23, 2011 to reflect the correct payment amount effective January 1, 2012 or termination.
A. Payments Effective Prior to January 1, 2012
Use the previous RSDI, SSI and VA amounts and the $20 General Income Exclusion. Key the DSS-8125 and/or DMA-5022 to approve the case and issue benefits. Notify the recipient via the approval notice of the payment amounts prior to and after January 1, 2012.
B. Payment Effective January 1, 2012
Use the revised RSDI, SSI and VA amounts and the $20 General Income Exclusion to determine eligibility and payment amounts from January 1, 2012, forward.
C. Zero-Pay Cases
It is important when manually updating these cases to record the actual Total Countable Monthly Income in the case record for future budgeting purposes. Enter the ACTUAL payment amount ($1.00, $2.00, $3.00 or $4.00) in the Monthly Payment Amount field. Enter a payment effective date of 012012.
If you have any questions regarding this information, please contact the Special Assistance listserv at specialassistance@dhhs.nc.gov .
Sincerely,
Dennis W. Streets, Director
DWS/SPM/bp
Attachment
Attachment 1
IMPORTANT NOTICE TO
RECIPIENTS OF SPECIAL ASSISTANCE FOR ADULTS (SA) LIVING IN RESIDENTIAL FACILITIES
December 1, 2011
If you receive a Social Security check and/or Supplemental Security Income (SSI) check, or Veterans Administration (VA) check, your Social Security/SSI check and/ or VA check will increase effective January 1, 2012 due to the federal Cost of Living Adjustment. This increase in your Social Security/SSI/VA check will have an effect on your SA check because Social Security, SSI, and VA benefits are counted in determining the amount of your SA check. If you reside in a residential facility and your Social Security, SSI, or VA check increases, your SA check will decrease effective January 1, 2012. (If you receive a payment for Special Assistance In-Home, your check will be adjusted when the federal poverty level changes in April 2012. You will be notified of this change in advance.)
Hearing Rights: If you disagree with this decision, you have a right to ask for a hearing. To ask for a hearing, call or write your caseworker within sixty (60) days, which is by January 30, 2012. If you do not ask for a hearing by that date, you cannot have a hearing. A local hearing will be held within 5 days of your request unless you ask for it to be postponed for good reason for an additional 10 days. The hearing will establish whether this action was correct. Then, if you think the decision in the local hearing was wrong, you must call or write your caseworker within 15 days of the local hearing to ask for a second hearing before a state hearing officer.
You may have someone speak for you at your hearing, such as a relative or an attorney obtained at your expense. Free legal services may be available in your community. Contact your caseworker for information on free legal services.
If you ask, your caseworker will show you and the person speaking for you your eligibility record before your hearing. You may ask to see other information used at the hearing.
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office. |
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