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NOTE: The individual to be included may be a newborn, required family unit member, or any other person who chooses to receive Work First. When adding any of these individuals to a pending application, follow instructions in the Application Processing Section.
A. Within 5 workdays of being notified that an individual needs to be added, schedule an interview either in the office, in the home, or by telephone. During the interview, request and set deadlines for any needed verifications. Use the Verification Of Change In Situation form to record verifications. Complete the change within 30 calendar days.
If the individual being added is a required family unit member and the caretaker does not attend the interview, terminate the case. Enter the appropriate termination code on the DSS-8125 to produce a timely notice. Refer to the EIS instructions in the Work First User’s Manual. Authorize the children in the case for Medicaid for the remainder of their 12 months continuous eligibility, if any, and evaluate the caretaker for Medicaid. If the children’s 12 months have expired, and/or if eligibility cannot be determined for either the children or the caretaker, transfer for one month to MAF-C to determine ongoing Medicaid eligibility.
B. If the individual is not a newborn, complete the DSS-8124 screen following instructions in the Work First User’s Manual to determine whether a child is potentially subject to the family cap. The caretaker does not have to sign the DSS-8124.
C. The individual must meet the requirements in Assessment For Work First. If the child is potentially subject to the family cap provision, follow Family Cap instructions to determine whether it applies.
D. When adding this individual, review personal responsibilities with the caretaker. Determine if there is any impact on the Mutual Responsibility Agreement (MRA). The caretaker and the worker must again sign and date the MRA.
E. If the request for the inclusion is made by telephone, mail the Verification Of Change In Situation form (DSS-1662) and the MRA to the family. Give the caretaker a deadline for their return.
If the forms are not returned by the deadline and:
1. The individual being included is a required family unit member; terminate the case by entering the appropriate termination code on the DSS-8125 to generate a timely notice. Refer to the EIS instructions in the Work First Users Manual. Authorize the children in the case for Medicaid for the remainder of their 12 months continuous eligibility, if any, and evaluate the caretaker for Medicaid. If the children’s 12 months have expired, and/or if eligibility cannot be determined for either the children or the caretaker, transfer for one month to MAF-C to determine ongoing Medicaid eligibility.
2. The individual is not a required family unit member; complete a manual adequate notice (DSS-8110) that states:
"We cannot add to your Work First case because ."
F. If appropriate, follow instructions in Child Support Services and in the Work First User’s Manual to complete a child support referral.
G. Effective Date Of Benefits For Inclusions
1. Newborn -- Birth Reported Timely
The effective date of benefits is the newborn’s date of birth if the newborn lived with the family unit on that date. Otherwise, the effective date is the date the newborn began living with the family unit.
2. Newborn -- Birth Not Reported Timely
The effective date of benefits is the date the agency learns the child is living with the family unit.
3. Required Family Unit Member (Other Than a Newborn) -- Change Reported Timely
The effective date of benefits is the date the individual becomes a member of the required family unit.
4. Required Family Unit Member (Other Than a Newborn) --Change Not Reported Timely
The effective date of benefits is the date the agency learns that the individual is a family unit member.
5. Individual Who Chooses To Be Included
The effective date of benefits is the date he requested assistance as long as he qualified on that date. Otherwise, he cannot get Work First.
NOTE: For each of the above scenarios, the effective date is the same for Work First and Medicaid. The family may, however, request up to three months of retroactive Medicaid.
NOTE: If Work First terminates while you are determining whether the individual qualifies, complete an open/shut so the individual can receive benefits for the time the benefits were active. EIS instructions for completing an open/shut are in the Work First User’s Manual.
H. To change the case status of a newborn who is receiving Automatic Newborn Medicaid coverage, follow the EIS instructions in the Work First User’s Manual.
To include any other individual in the ongoing Work First case, follow the EIS instructions in the Work First User’s Manual.
I. Notices
1. If an individual qualifies for Work First, enter the appropriate approval code on the DSS-8125 to generate an automated notice for Work First cash assistance (DSS-8108). Refer to the EIS instructions in the Work First User’s Manual. Automatic Newborn Medicaid coverage will continue.
2. If an individual is not eligible for Work First, enter the appropriate code to generate an automated denial notice (DSS-8109).
3. Notify the Food Stamp Unit of the change via the Work First Information Transmittal Form (DSS-8194).
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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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