Sneede vs. Kizer Medical
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Sneede vs. Kizer Medical


Revised June 20, 2014



NOTE:  As a result of implementation of the Affordable Care Act (ACA), effective with applications received on or after 10/01/2013 this medical program is no longer valid. Any current active AUs with this medical coverage type will continue through the AUs current certification period. Clients would then need to apply for medical through the healthplanfinder.

 

What is Sneede vs. Kizer?

 

When do I apply Sneede vs. Kizer rules?

 

How do I screen an AU using Sneede vs. Kizer rules?

 

How do I process a pending Sneede vs. Kizer F06 AU?

 

How do I process a pending Sneede vs. Kizer F04 AU?

 

How do I process a pending Sneede vs. Kizer P02/P04 AU?

 

Can I apply Sneede vs. Kizer rules for S02 medical?

 

Sneede vs. Kizer Examples



What is Sneede vs. Kizer?

 

·         Sneede vs. Kizer is the name of a Ninth Circuit Court of Appeals class action settlement. It specifies how the separate income or resources of family members who are not financially responsible for other family members affects the medical assistance eligibility of other family members. 

 

·         See WAC 182-506-0010 Medical Assistance Units (MAU) for MAGI-based Washington Apple Health programs.

 

When do I apply Sneede vs. Kizer rules?

 

·         If a family is not eligible for a CN (Categorically Needy) program as one medical assistance unit (MAU), separate MAUs must be established when the household meets Sneede vs. Kizer criteria.

 

·          See  WAC 182-506-0010 Medical Assistance Units (MAU) for MAGI-based Washington Apple Health programs for other information about when Sneede vs. Kizer rules must be applied and separate MAUs established. 


NOTE:

Separate Medical Assistance Units (MAU) must be established to process Sneede vs. Kizer. For each separate MAU, a separate AU must be screened in ACES.  See SNEEDE vs. KIZER EXAMPLES.


How do I screen an AU using Sneede vs. Kizer rules?

 

1.      The first step is to determine eligibility for CN medical for all household members together. Refer to the Categorically Needy Family Medical Chapter (F04) for instructions on how to screen, process, and finalize F04 medical. If the family is eligible for F04, process the application as one MAU.

           

2.      If the F04, trickles to F06 --- STOP! Do not finalize the AU. If Sneede vs. Kizer criteria exists, press <F3> to return to the AMEN.

 

3.      Do Add a Program in aces.online to establish a separate F06 AU for each child who meets Sneede vs. Kizer criteria.

 

How do I process a pending Sneede vs. Kizer F06 AU?

 

1.      From the AMEN screen, select Option O – Interview.

 

2.      On the STAT screen, enter the following financial responsibility codes for each separate MAU:

         

o        ST – Sneede Parent Financially Responsible to the Applicant Child for the adult parent(s).

 

o        PN – Applicant for the child that this MAU is being established for.

 

o        CA – Child Included in Parent's AU for any child who is a member of their parent’s MAU (does not qualify for a separate MAU).

 

o        CX – Common Child of Unmarried Parents Living Together for a child in common of unmarried parents who is on his/her own separate MAU.

 

o        SN – Child with Income or Excess Resources Who is Not a Common Child for any other child (not the PN) who qualifies for their own MAU.

 

o        NM – Not Related and Not Financially Responsible to the Applicant for an adult who is not the parent or step-parent of the child listed as PN on the STAT screen.


NOTE:

Do not use FINL RESP code SC – SSI Child/Child of SSI Related Parents/Child used to determine Family Size for Sneede vs. Kizer cases.  If SC is used the income allocation and budgeting will not be correct.


3.      Complete the interview following the instructions in the Interview chapter. 

 

4.      After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.

 

5.      After all pending months have been processed, follow the instructions in the Finalize Application chapter to complete the F06 eligibility determination.

 

How do I process a pending Sneede vs. Kizer F04 AU?

 

1.      Once the F06 MAUs have been established and processed, go back to the pending F04 AU to establish a MAU for the parent(s) and any children who must be included in their MAU.

 

2.      From the AMEN screen, select Option O – Interview.

 

3.      On the STAT screen, enter the following financial responsibility codes for each separate MAU:  

  

o        PN – Applicant for the married parents and any child(ren) who do not qualify for a separate MAU.

 

o        NM – Not Related and Not Financially Responsible to the Applicant for the unmarried co-parent of a child in common with the PN parent above.

 

o        SN – Child with Income or Excess Resources Who is Not a Common Child for any child(ren) who qualify for a separate MAU.

 

o        CX – Common Child of Unmarried Parents Living Together for a child in common of unmarried parents who is on his/her own separate MAU.

 

o        NM – Not Related and Not Financially Responsible to the Applicant for any adult not related and not financially responsible to the applicant.

 

4.      Add an F04 AU if the household contains an unmarried parent of a common child. Follow steps in #1 above to establish a separate MAU for this adult and any of that parent’s children who do not qualify for separate MAU status.

 

5.      Complete the interview following the instructions in the Interview chapter. 

 

6.      After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.

 

7.      After all pending months have been processed, follow the instructions in the Finalize Application chapter to complete the F04 eligibility determination.

 

o        If the case is active F04 then all MAU members will receive CN medical coverage.

 

o        If the case trickles to F06 then only the children coded PN – Applicant on this MAU will receive CN medical coverage.  The parents would not be eligible for medical coverage unless you could relate them to another program such as pregnancy or SSI-related.

 

How do I process a pending Sneede vs. Kizer P02/P04 AU?

 

·         If a household which contains a pregnant woman is not eligible for CN medical and Sneede vs. Kizer criteria exists, the user needs to Add a Program in aces.online to establish a P02/P04 AU for the pregnant woman.

 

1.      From the AMEN, select Option O – Interview.

 

2.      On the STAT screen, enter the following financial responsibility codes for each separate MAU:   

 

o        PN – Applicant for the pregnant woman.

 

o        SP – Ineligible Spouse for the spouse (if there is one).

 

o        NM – Not Related and Not Financially Responsible to the Applicant for the unmarried father of unborn.

 

o        CX – Common Child of Unmarried Parents Living Together for a child in common of unmarried parents who is on his/her own separate MAU.

 

o        SN – Child with Income or Excess Resources Who is Not a Common Child for any other child (not the PN) who qualifies for their own MAU.

 

o        SC – SSI Child/Child of SSI Related Parents/Child used to determine   Family Size for child (ren) with no Sneede characteristics (used only when no one in the household has Sneede characteristics).

 

3.      Complete the interview following the instructions in the Interview chapter. 

 

4.      After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.

 

5.      After all pending months have been processed, follow the instructions in the Finalize Application chapter to complete the P02/P04 eligibility determination.

 

Can I apply Sneede vs. Kizer rules for S02 medical?

 

·         Do not apply Sneede Kizer rules when determining eligibility for S02 medical.

 

·         If an aged, blind, or disabled (A,B,D) adult or child applies for medical and is not eligible for CN Family (F04) or Children’s (F06) medical, screen an S02 AU.  See EA-Z Manual – SSI Related Medical Chapter.

 


Sneede vs. Kizer Examples

EXAMPLE 1:

A mother and her two children apply. The mother has earned income of $2,200 a month and receives child support of $300 a month for one of the children. The family has no countable resources.

Establish 2 separate MAUs:

MAU 1:

The mother and child without income

MAU 2:

The child with income

MAU 1 F04      

MAU 2 F06

PN – Mother

ST – Mother

PN – Child without income

PN – Child with income

SN – Child with income 

CA – Child without income

 

EXAMPLE 2:

A mother and one child apply. The total income to the family is $550; $400 is child support and $150 is veterans benefit payments for the child. All of the income is the child's.

Establish 2 separate MAUs:

MAU 1:

Mother

MAU 2:

Child

MAU 1 F04

MAU 2 F06

PN – Mother

ST – Mother

SN – Child with income

PN – Child with income

 

EXAMPLE 3:

A mother and her two children apply. The mother has UC income of $400. One of the children has $2500 in a savings account, established by her grandmother. The mother has $900 in a savings account.  The child’s savings makes the HH ineligible as a family for F04.

Establish 2 separate MAUs:

MAU 1:

Mother and child without resources

MAU 2:

Child with resources

MAU 1 F04

MAU 2 F06

PN – Mother

ST – Mother

PN – Child without resources

CA – Child without resources

SN – Child with resources

PN – Child with resources

 

EXAMPLE 4:

A family applies for F04 family medical. The family includes the mother, the father, and two children. The father is working part-time and his income is $900. The mother receives SSI and is active on S01 medical program.

Establish 2 separate MAUs:

MAU 1:

The father and 2 children

MAU 2:

Mother

MAU 1 F04

MAU 2 S01

SI – Mother

RE – Mother

PN – Father

NM – Father

PN – Child without income

NM – Child without income

PN – Child without income

NM – Child without income

 

EXAMPLE 5:

A family applies for F04 family medical. The family includes the mother with earned income of $800, a child with $300 child support, a child without income, and a child that receives SSI benefits. The child is already active on S01 (MAU 1).

Establish 3 separate MAUs:

MAU 1:

The SSI child

MAU 2:

The mother and child without income

MAU 3:

The child with income

MAU 1 S01

MAU 2 F04

MAU 3 F06

RE – SSI Child

PN – Mother

ST – Mother

NM – Mother

PN – Child without income

CA – Child without income

NM – Child without income

SN – Child with income

PN – Child with income

NM – Child with income

SC – SSI Child

SC – SSI Child

 

EXAMPLE 6:

A family applies for family medical coverage. The mother and both children are citizens. The father is undocumented. He earns $1250 per month. Only the citizen mother and children are eligible for F04.

Establish 1 MAU:

MAU 1 F04

PN – Undocumented father (The system will change the father to UC in finalize)

PN – Mother

PN – Child

PN – Child

 

UNMARRIED PARENTS EXAMPLES

 

EXAMPLE 7:

Unmarried parents with a common child live together.   The mother has no income.  The father receives $3,200 earned income.  The parents have no resources.  The family is ineligible for F04 as one MAU.

Establish 3 separate MAUs:

MAU 1:

Mother

MAU 2:

Father

MAU 3:

Their common child

MAU 1 F04   

MAU 2 F04

MAU 3 F06  

PN – Mother

NM – Mother

ST – Mother  

NM – Father

PN – Father

ST – Father

CX – Common Child

CX – Common Child

PN – Common Child

 

EXAMPLE 8:

Unmarried parents with a common child live together and they each have a separate child. The mother has earnings of $1000 and her child receives $300 of child support. The father receives $1150 UC and his child has no income or resources.  Neither parent has resources.

Establish 4 separate MAUs:

MAU 1:

Mother

MAU 2:

Father and his child

MAU 3:

Their common child

MAU 4:

The mother's child with income

MAU 1 F04       

MAU 2 F04

MAU 3 F06   

PN – Mother      

NM – Mother

ST – Mother   

NM – Father

PN – Father

ST – Father

NM – Father’s child

PN – Father’s child

CA – Father’s child 

CX – Common Child

CX – Common child

PN – Common child

SN – Mother’s child with income 

NM – Mother’s child with income

SN – Mother’s child with income

 

 

 

MAU 4 F06

 

 

ST – Mother

 

 

NM – Father

 

 

NM – Father’s child

 

 

CX – Common child

 

 

PN – Mother’s child with income

 

 

 

EXAMPLE 9:

Unmarried parents with a common child live together and they each have a separate child. The mother has earnings of $1000 and her child receives $300 of child support. The father was receiving $1150 UC.  His UC has ended and now he receives Social Security disability of $1,150 per month.  His child has no income or resources.  Neither parent has resources.

Establish 5 separate MAUs:

MAU 1:

Mother

MAU 2:

Father and his child (trickles to F06 due to income)

MAU 3:

Their common child

MAU 4:

The mother's child with income

MAU 5:

Father  - disabled S02

MAU 1 F04

MAU 2 F06   

MAU 3 F06  

PN – Mother  

PN – Father 

ST – Mother  

NM – Father

NM – Mother

ST – Father 

NM – Father’s child 

PN – Father’s child

CA – Father’s child

CX – Common Child

CX – Common child

PN – Common child

SN – Mother’s child with income 

NM – Mother’s child with income

SN – Mother’s child with income

 

 

 

MAU 4 F06

MAU 5 S02/S99

 

ST – Mother 

NM – Mother

 

NM – Father

PN – Father

 

NM – Father’s child

SC – Father’s child

 

CX – Common child

SC – Common child

 

PN – Mother’s child with income

NM – Mother’s child with income

 

 

NON-RESPONSIBLE RELATIVE EXAMPLE

 

EXAMPLE 10:

Grandmother and her two grandchildren. One child receives $600 of child support. The grandmother is not financially responsible for either grandchild. The children are not financially responsible for each other.

Establish 3 separate MAUs:

MAU 1:  

The grandmother

MAU 2:

The child with income

MAU 3:

The child with no income

MAU 1 F04  

 MAU 2  F06

MAU 3 F06

PN – Grandmother

NM – Grandmother

NM – Grandmother

NM – Child with income

PN – Child with income

SN – Child with income

NM – Child without income

SN – Child without income

PN – Child without income

Modification Date: June 20, 2014