Change of Circumstances
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Change of Circumstances


Revised June 23, 2014



Processing a Change of Circumstance

 

Adverse Action

 

Previous Calculated Benefit Amount

 

Changes in Household Composition

 

Medical Extension

 

TANF Pregnancy Change

 

Reset the TANF Time Clock

 



processing a change of circumstance

 

What do I need to consider when processing a change of circumstance?

 


 

What do I need to consider when processing a change of circumstance?

 

·         When processing a change of circumstance, it is very important to pay attention to the month in which the change occurred and verify that the change is made in the correct month.

 

o    When processing a change, make the change in the ongoing month (if needed) and then any current and/or historical month.

 

o    Information in ACES, in most instances, does not copy forward from the current or historical month into the ongoing month.

 

·         If a change of circumstance results in an underpayment or overpayment, see

Benefit Error Group (BEG) chapter for information about processing a BEG.

 

·         See EAZ Manual – Change of Circumstances chapter for policy information regarding client change of circumstances.

 


 

Adverse  Action

 

What is adverse action?

 

What is advance notice?

 

How is the ten-day notice period calculated?

 

What is waiving adverse action?

 

What reason codes do not allow adverse action to be waived?

 

What reason codes automatically waive adverse action?

 

How do I process a change to reduce, suspend or terminate benefits during the adverse action period?

 

How do I waive adverse action after monthly issuance?

 

What is the paid thru date?

 

What is the benefit effective date?

 


What is adverse action?

 

·         An action to reduce, suspend or terminate cash, food or medical assistance or an action to change benefit issuance to a protective payee or vendor.

 

o    Adverse action is only applied at the assistance unit (AU) level, never the client level.

 

o    When making changes, process the change in the ongoing month first, then any historical and/or current month.

 

·         See EAZ Manual - WAC 388-418-0005 How will I know what changes I must report?, EAZ Manual - WAC 388-418-0020 How does the department determine the date a change affects my benefits? and WAC 182-504-0125 Effect of changes on medical program eligibility.

 

What is advance notice?

 

·         Advance notice is a letter sent to clients at least ten days prior to a reduction, suspension, or termination of benefits.  See EAZ Manual - WAC 388-458-0030 We send you a termination letter when your benefits stop. and EAZ Manual WAC 388-458-0035 Why do you give me ten days notice before you reduce or stop my benefits?

 

How is the ten-day notice period calculated?

 

·         Day 1 of the ten-day count begins the first working day following the system date on which a change is made on a case.  (weekends and/or holidays are not counted as working days).

 

·         The ten day notice period varies from month to month.  See the ACES Production Calendar for the exact date of the ten day notice period each month.


EXAMPLE

Action is taken to terminate an AU on Friday 9/19/08.  The first working day that follows is Monday, 9/22/08. Day 1 of the 10-day count begins on 9/22/08; therefore the Benefit Effective Date is 10/1/08.  To allow for advance notice, the date of closure would be 10/31/08.


What is waiving adverse action?

 

·         Waiving adverse action means the action being taken does not give the client 10-days advance notice of the change to reduce, terminate or change benefit issuance.

 

What reason codes do not allow adverse action to be waived?

 

·         When closing an AU for one of the following reason codes, adverse action cannot be waived.

 

o    226 – Residing in Inpatient Psychiatric Institution

 

o    249 – Receipt of Benefits from Another State During Month

 

o    251 – Already Received Food Assistance

 

o    569 – Child Accepted to Foster Care

 

What reason codes automatically waive adverse action?

 

·         When closing an AU for one of the following reason codes, ACES automatically waives the adverse action period:

 

o    213 – Failed Pregnancy Requirement

 

o    235 – Review Not Complete

 

o    290 – Overdue Incapacity Review

 

o    304 – Additional Requirements Change

 

o    551 – Whereabouts Unknown

 

o    557 – AU Requests Closure

 

o    567 – Drug/Alcohol Center Loses Certification

 

How do I process a change to reduce, suspend or terminate benefits during the adverse action period?

 

·         To process a change to reduce, suspend or terminate benefits during the adverse action period, take the following steps:

 

1.    Select AMEN, option R – Interim/Hist Change.

 

2.    Process updates to reduce, suspend or terminate benefits.

 

3.    On the ELIG screen, in the Confirm field enter [Y] – Yes.

 

4.    On the CAFI screen or FSFI screen:

 

o    In the Bnft Confirm field enter [Y] – Yes.

 

o    In the Waive Advr Act Per field enter [N] – No or [Y] – Yes.

 

¨        If [N] is entered, adverse action is not waived. 

 

When adverse action is not waived, the benefit effective date in the Bnft Eff Date field on the CAFI screen or FSFI screen includes the 10-day advance notice period. 

 

¨        If [Y] is entered, adverse action is waived.

 

When adverse action is waived, the benefit effective date in the Bnft Eff Date field on the CAFI screen or FSFI screen is equal to the date the action is taken.

 

¨        The benefit change is effective the month following the month of the benefit effective date.

 

o    In the Letter Override field enter [N - No].  Even if the letter will be overridden, [Y] – Yes cannot be entered. 

 

o    Press <Transmit>.

 

o    In the Letter Override field, enter [N] – No or [Y] – Yes.

 

¨        If the letter is overridden, it is mandatory that a user generated letter be sent providing the client with adequate notice of change in benefit amount.

 

How do I waive adverse action after monthly issuance?

 

·         After monthly issuance occurs, adverse action can only be waived through the Pending Void process.  See Pending Void – Void/Cancel Benefits.

 

What is the paid thru date?

 

·         The paid thru date is the last date for which benefits were issued.

 

What is the benefit effective date?

 

·         The benefit effective date is the date when a reduction and/or termination of benefits is effective.

 

·         The benefit effective date displays on the CAFI screen, FSFI screen or MAFI screen in the Bnft Eff Date field.

 

o    The chart below illustrates how ACES closes a case and what the paid thru date and benefit effective date will be when adverse action is waived or not waived.

 

o    In this example, ten-day advance notice period begins 7/22/08 and monthly issuance/deadline is 7/26/08.

 

SYSTEM DATE

BENEFIT MONTH

WAIVE ADVERSE ACTION

CLOSE STATUS CODE

BENEFIT EFFECTIVE DATE

PAID THRU DATE

07/21/08

07/08

No

H

07/31/08

07/31/08

07/21/08

08/08

No

C

07/31/08

07/31/08

 

07/22/08

07/08

N/A

H

07/22/08

07/31/08

07/22/08

08/08

No

C

08/01/08

08/31/08

07/22/08

08/08

Yes

C

07/31/08

07/31/08

 

07/26/08

07/08

N/A

H

07/25/08

07/31/08

07/26/08

08/08

No

H

08/05/08

08/31/08

07/26/08

08/08

Yes

C

07/31/08

07/31/08

07/26/08

09/08

N/A

C

08/05/08

08/31/08


NOTE:

An entry in the Waive Advr Act Per field outside the adverse action period has no affect on eligibility or benefit reduction.



 

Previous Calculated Benefit Amount

 

What is the previous calculated benefit amount?

 


 

What is the previous calculated benefit amount?

 

·         The previous calculated benefit amount is the system computed benefit amount from the last time an action was taken that changed the benefit amount.

 

·         The previous calculated benefit amount in ACES is not always the amount that the client received in the previous month.

 

·         The previous calculated benefit amount is displayed on the CAFI  screen or FSFI screen in the Previous CALC Amt field.

 


 

Changes in household composition

 

How do I close a client off an AU before the adverse action period?

 

How do I close a client off an AU during the adverse action period but before monthly issuance?

 

How do I change an active client to a different AU?

 

How do I close a deceased client?

 

How do I change the head of household (HOH)?

 


 

How do I close a client off an AU before the adverse action period?

 

·         To close a client off an AU, see Manually Close an AU/Client.

 

·         If the client is currently active in another CSO, contact that CSO to have someone close the client from the current AU in all months that the client will be on a different AU.

 

How do I close a client off an AU during the adverse action period but before monthly issuance?

 

·         Adverse action is only applied at the AU level, never the client level.

 

·         To remove a client without waiving adverse action, see Manually Close an AU/Client.

 

·         If it is appropriate to waive adverse action when closing a client off an AU and monthly issuance has not occurred, take the following steps:

 

1.     Select AMEN, option R – Interim/Hist Change in the Selection field.

 

2.    On the STAT screen, enter the appropriate [500 level reason code] at the AU level.

 

3.    On the ELIG screen, in the Confirm field enter [Y] – Yes.

 

4.    On the CAFI screen or FSFI screen:

 

o    Enter [Y] – Yes in the Bnft Confirm field.

 

o    Enter [Y] – Yes in the Waive Advr Act Per field.

 

o    Enter [N] – No in the Letter Override field.

 

o    Press <Transmit>, the CAFI screen or FSFI screen redisplays the Letter Override field with a [?].

 

o    Enter [Y] – Yes in the Letter Override field.

 

5.    After the entire AU is closed in the ongoing month, reinstate the AU in the ongoing month but do not include the person who is being removed from the AU.

 

6.    Complete the reinstatement process.  See Reinstatement.

 

How do I change an active client to a different AU?

 

·         If possible, client should first be removed from the current AU in the ongoing month.

 

·         Based on the case situation and the client’s new circumstances, follow the instructions for: Screening  a client,  Add a Program,  Re-open, or Add a Person.

 

·         If a client has already received assistance for a month that they are being opened on the different AU, take the following steps:

 

1.    From AMEN, complete Option O – Interview.

 

2.    From AMEN, select option P – Process Appl Months. 

 

3.    On the client’s DEM1 screen, enter [the concurrent indicator] in the Concurrent Receipt field under CA, FS and/or MA. See <F1> Help.

 

o    The Concurrent Receipt field must be entered in each month that the client already received assistance. 

 

o    An edit prevents entry in the Concurrent Receipt field in the ongoing month as no assistance has been issued for the ongoing month.

 

4.    If the previously received benefit should be budgeted in the different AU, on the UNER screen:

 

o    Enter [the code to show which program the income affects] in the Client Srce field.

 

o    Enter [the income method] in the Inc Mthd field.

 

o    Enter [the client unearned income frequency code] in the Freq field.

 

o    Enter [the amount] in the Amt 1 field.

 

5.    Call DONE, verify and commit the data.

 

6.    Press <F13> to return to AMEN.

 

7.    From AMEN, select option Q – Finalize.

 

8.    Verify and commit the data.

 

How do I close a deceased client?

 

·         If the deceased client is currently the head of household and there is another adult household member, first change the head of household in the ongoing month.  See Head of Household (HOH) chapter.

 

·         To code a client as deceased take the following steps:

 

1.    From AMEN, select Option R – Interim/Hist Change.

 

2.    On the DEM2 screen:

 

o    Enter [the date of death] in the Death Date field.

 

o    Enter [the death state] in theDeath State field.

 

3.    Call DONE, verify and commit the data.

 

4.    The client shows closed with Reason Code 244 – Death.

 

How do I change the head of household (HOH)?

 

·         To change the head of household on an AU see Head of Household (HOH) chapter.

 


 

Medical Extension

 

What changes affect F02 or F03 Medical Extensions?

 

How do I add a person to a medical extension AU?

 

How do I close a person off a medical extension AU?

 

What if an F02 household no longer has earned income?

 

Note: As a result of implementation of the Affordable Care Act (ACA), effective benefit month 10/2013 this medical program is no longer valid. Any current active AUs with this medical coverage type will continue through the AUs current certification period and AUs will no longer trickle, sprout or spawn. Clients would then need to apply for medical through the healthplanfinder.


 

What changes affect F02 or F03 Medical Extensions?

 

·         See EAZ Manual – WAC 388-523-0110 Medical extensions – Reporting requirements.

 

·         See EAZ Manual – Medical Extensions, Worker Responsibilities - Effect of Changes During F02 or F03 Medical Extensions section.

 

How do I add a person to a medical extension AU?

 

·         See EAZ Manual – Medical Extensions, Worker Responsibilities – Effect of Changes During F02 or F03 Medical Extensions section.

 

·         To add a person to an F02 or F03 medical extension AU, see Add a Person.

 

How do I close a person off a medical extension AU?

 

1.    From AMEN, select Option R – Interim/Hist Change.

 

2.    On the STAT screen, enter [the appropriate 500 level reason code] in the Rsn field for the client being removed, or process the action that will close the client off the F02 or F03 AU.

 

3.    Call DONE, verify and commit the data.

 

What if an F02 household no longer has earned income?

  

·         When a client reports that they no longer have earned income, their medical eligibility should be redetermined.  See Medical Re-Determination.

 


TANF Pregnancy Change

 

How do I add a newborn to a TANF AU?

 

How do I add a spouse/co-parent to a TANF AU?

 


 

How do I add a newborn to a TANF AU?

 

·         To add a newborn to a TANF AU, see Temporary Assistance for Needy Families (TANF) chapter.

 

How do I add a spouse/co-parent to a TANF AU?

 

·         To add a spouse/co-parent to the TANF AU, see Temporary Assistance for Needy Families (TANF) chapter.

 


 

Reset the TANF Time Clock

 

When should I reset the TANF time clock?

 

How do I reset the TANF time clock?

 


 

When should I reset the TANF time clock?

 

·         In some cases, the number of TANF months listed on the TICS screen may not be accurate. When this number cannot be adjusted with historical changes to the TANF/SFA AU, the changes can be made on the TICA screen.  

 

·         For information about TANF time limits see EAZ Manual - WAC 388-484-0005 There is a five year (sixty-month) time limit for TANF, SFA and GA-S cash assistance

 

·         For information about time limit extensions see EAZ Manual - WAC 388-484-0006 TANF/SFA Time Limit Extensions.

 

How do I reset the TANF time clock?

 

1.    From AMEN, select Option R – Interim/Hist Change.

 

2.    On the TICA screen under New Adjustments:

 

o    Enter [the first month/year in the range to be adjusted] in the Range Begin field.

 

o    Enter [the last month/year of the range to be adjusted] in the Range End field.

 

o    Enter [the adjustment reason code] in the Reas field.

 

o    In the Del field, if deleting a range, enter [Y – Yes] to delete the range. Press <F24> to delete.

 

3.    Call DONE, verify and commit the data.

 

Modification Date: June 23, 2014