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Revised September 30, 2011 |
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How does ACES use financial responsibility codes?
What financial responsibility codes are set by ACES? How do I code the STAT screen for Long Term Care (LTC) medical?
How do I code the STAT screen for a TANF applicant when the only child receives SSI?
How do I code the STAT screen for a non-citizen applicant?
How do I code the STAT screen when the AU contains a sponsored immigrant?
How do I code the STAT screen for medical applications?
Financial Responsibility Codes Chart
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How does ACES use financial responsibility codes?
· ACES uses financial responsibility codes to determine which members of the assistance unit are financially responsible for other members. ACES divides financial responsibility codes into 3 categories:
o Recipient codes PN – Applicant or RE – Recipient: Individuals included in the AU and financially responsible for a household member. Income and resources count toward the needs of the client(s) with recipient codes.
o Non-member code NM: Individuals not financially responsible for anyone in the AU. Non-member’s income and resources do not count when determining eligibility for client(s) with recipient codes.
o Deemor/Allocator codes such as ST – Sneede Parent Financially Responsible to the Applicant Child, or UA – Undocumented Alien Adult: Individuals excluded from the AU but financially responsible for a household member. Income and resources may count toward the needs of the client(s) with recipient codes.
· ACES determines who to include in the Assistance Unit (AU), and eligibility for those persons, based on the relationship and financial responsibility of each member to the head-of-household.
· ACES determines eligibility for assistance based on the program type and medical coverage group established during screening, and client data entered during interview.
· Certain assistance unit types can only have one member with financial responsibility code RE – Recipient. Two examples of this are Supplemental Security Income (SSI) Medical (S01) and Pregnancy Medical (P02/P04). For eligibility to be determined correctly, the head of household should be the person receiving SSI for S01 or the pregnant woman for the P02/P04.
What financial responsibility codes are set by ACES?
· Certain financial responsibility codes are set by the system. ACES displays an error message if the user enters one of the following codes:
o BA – Budgeted Adult
o BC – Budgeted Child
o CS – Community Spouse
o DI – CA/MA Sanctioned
o FD – FS E&T Disqualified (FS)
o ID – IPV/Drug Felon Disqual (FS)
o IS – Institutional Spouse
o ND – Non IPV Disqualified (FS)
o OS – CL Inc/Assets/Exp treated as Recipient but Active in Another AU
o RC – Recipient of Cash only
o RE – Recipient
o RM – CA Sanctioned Receiving MA Only/FAP Recipient
o RN – CA Sanctioned Receiving MA Only/FAP Recipient
o UA – Undocumented Alien Adult
o UC – Undocumented Alien Child
How do I code the STAT screen for Long Term Care (LTC) medical?
· Financial responsibility codes for LTC medical AUs determine who will be included or excluded from the AU, and how income and resources (if any) are counted in the benefit calculation.
o [PN] – Applicant for the applicant.
o [SP] – Ineligible Spouse/Non-Applying Spouse for the applicants’ spouse.
· The marital status of both the applicant and spouse must be coded as S- Legally Separated, P – Separated, A – Married Living Apart or M – Married for the system to recognize the couple as married. This information is needed for the system to determine if the spouse is a “community spouse” or an “institutional spouse” and correctly calculate the spousal allocation.
· Dependents are coded on the LTCX screen under the Family Member Allowance section. This allows the correct post-eligibility allowance calculation for the dependents.
How do I code the STAT screen for a TANF applicant when the only child receives SSI?
· When the only eligible child in a TANF AU receives SSI, code the child as PN – Applicant on the STAT screen. If the child is originally coded as SC – SSI Child/Child of SSI Related Parents/Child used to determine Family Size, ACES denies the adult because it does not recognize the AU includes a child.
How do I code the STAT screen for a non-citizen applicant?
· When the AU contains non-citizens, code the non-citizen members as PN – Applicant. Ensure the citizenship information on the client’s DEM2 and ALAS screens is entered correctly.
· When the AU is finalized, the financial responsibility code for the ineligible members changes to:
o UA – Undocumented Alien Adult or UC – Undocumented Alien Child on a TANF AU. o ND – Non IPV Disqualified on a FS AU.
· When processing a TANF application and the AU contains citizen and non-citizen children, follow the procedures in Processing Alternatives (PAL) – Cash Assistance Deeming from Citizen Child to Undocumented Child (PR 145312).
How do I code the STAT screen when the AU contains a sponsored immigrant?
· When the household contains a sponsored immigrant, the sponsor must be included as part of the household. Code the sponsor as AL – Alien Sponsor and PN – Applicant for all others. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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· For information on how income and resources are counted, see EAZ Manual – WAC 388-470-0060 How does the department decide how much of my sponsor's resources affect my eligibility for cash, medical, and food assistance? and WAC 388-450-0155 How does being a sponsored immigrant affect my eligibility for cash, medical, and food assistance programs?
How do I code the STAT screen for medical applications?
· Financial responsibility codes for medical AUs determine who will be included or excluded from the AU, and how income and resources (if any) are counted in the benefit calculation.
· When all household members are applying, code everyone as PN – Applicant. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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· Based on case circumstances, ACES may deny some of the members and trickle to a different medical coverage group. See Trickle and Sprout.
· When a non-needy caretaker relative requests medical only, code the non-needy caretaker relative as PN – Applicant and CA – Child Included in Parent's AU for the child(ren).
· The chart below indicates the Financial Responsibility code used when a client has 2 reasons to be sanctioned/disqualified/ineligible. To use this chart:
1. Find the financial responsibility code in the top row for one of the reason codes from the Financial Responsibility Codes Chart.
2. Find the financial responsibility code for the other reason code in the left-hand column.
3. The financial responsibility code used is the one listed where the row and column meet. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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· If a client has more than 2 reasons to be sanctioned/disqualified/ineligible, the system uses the codes with the highest priority. The priority order when using the above chart is:
1. UA/UC – Undocumented Alien Adult/ Undocumented Alien Child
2. RC – Recipient of Cash Only
3. DI – CA/MA Sanctioned
4. RN – CA Sanctioned Receiving MA Only/FAP Recipient
5. IP – Ineligible Person
6. RM – CA Ineligible Person Receiving MA Only
7. RE – Recipient | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Financial Responsibility Codes Chart · When the client is ineligible or meets one of the sanction/disqualified reason codes listed below, use the following chart to determine the benefits a client is eligible for and the income budgeting method used. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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