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A. When a change other than an inclusion occurs, take appropriate action as soon as possible but no later than the second month following the month the change is reported. Enter the appropriate code on the DSS-8125 to generate an automated notice. Refer to the EIS instructions in the Work First User’s Manual. If one or more individuals in the case are ineligible for Work First, 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.
Note: The timely notice (DSS-8110) must be sent within 10 workdays from the first time the individual appears on the Caseworker IV-D Work List. (refer to Work First Policy Section 120). Changes that occur due to non-cooperation with Child Support must be made not later than the second month following the month of change.
Note: The Work First worker must verify that the non-coop field is coded “Y” through the Inquiry Into Data Sent from ACTS screen prior to lifting an IV-D sanction within the 10 days given on the DSS 8110 (timely notice). This rule also applies when the sanction is ending.
B. When any family member is ineligible for Work First, remove this person’s needs and income as soon as possible but no later than the second month following the month the change is reported. Evaluate the ineligible family member for ongoing Medicaid.
If this person remains in the home, follow instructions in the Income and Needs Assessment Section to determine how to count his income. The change in how you count this person’s income begins the month after the month of the change. Enter the appropriate change code on the DSS-8125 to generate an automated notice. Refer to the EIS instructions in the Work First User’s Manual.
C. Recoup any overpayment. If a family was underpaid, issue an adjusted payment for the month following the month of change. Refer to the EIS instructions in the Work First User’s Manual. Do not recoup an overpayment caused solely by a timely notice or processing deadline.
NOTE: When determining the payment, ensure you are using the correct number of persons in the family unit.
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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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