Change of Circumstances - Effective Date
DSHS Home Page
 
Search     for:
DSHS Home    Acronyms    Revisions    WAC Number Index    Site Map    WCCC

Change of Circumstances - Effective Date


Revised September 26, 2013



WAC 388-418-0020How does the department determine the date a change affects my cash and Basic Food benefits?

WAC 388-418-0020
WAC 388-418-0020

Effective October 1, 2013

WAC 388-418-0020 How does the department determine the date a change affects my cash and Basic Food benefits?

  1. Unless otherwise specified, the rules in this chapter refer to cash and Basic Food benefits. 

  2. If you report a change that happened between the date you applied for benefits and the date we interview you under WAC 388-452-0005, we take this change into consideration when we process your application for benefits.

  3. If we learn about a change in your circumstances from another person, agency, or by matching with any number of systems, we determine the impact this change has on your benefits. We may request additional information under WAC 388-490-0005 or update your benefits based on this information.

  4. For cash and Basic Food programs, if you report a change in your income that we expect to continue at least a month beyond the month when you reported the change, we recalculate the income we estimated under WAC 388-450-0215 based on this change.

  5. When a change causes an increase in benefits, you must provide proof of the change before we adjust your benefits.

    1. If you give us the proof within ten days from the date we requested it, we increase your benefits starting the month after the month you reported the change.

    2. If you give us the proof more than ten days after the date we requested it, we increase your benefits starting the month after the month we got the proof.

    3. If you are eligible for more benefits and we have already sent you benefits for that month, we provide you the additional benefits within ten days of the day we got the proof.

  6. When a change causes a decrease in benefits, we reduce your benefit amount without asking for proof.

    1. If you report a change within the time limits in WAC 388-418-0007, and you are not reporting this as part of a mid-certification review, we decrease your benefits starting the first month following the advance notice period. The advance notice period:

      1. Begins on the day we send you a letter about the change, and

      2. Is determined according to the rules in WAC 388-458-0025.

    2. If you do not report a change you must tell us about under  WAC 388-418-0005, or you report a change later than we require under  WAC 388-418-0007, we determine your eligibility as if you had reported this on time.  If you received more benefits than you should, we set up an overpayment as described under chapter 388-410 WAC:

  7. If we are not sure how the change will affect your benefits, we send you a letter as described in WAC 388-458-0020 requesting information from you.

    1. We give you ten days to provide the information. If you need more time, you can ask for it.

    2. If you do not give us the information in time, we will stop your benefits after giving you advance notice, if required, as described in WAC 388-458-0030.

  8. Within ten days of the day we learn about a change, we send advance notice according to the rules in chapter 388-458 WAC and take necessary action to provide you the correct benefits. If you request a hearing about a proposed decrease in benefits before the effective date or within the notice period as described in WAC 388-458-0040, we wait to take action on the change.

  9. If you disagree with a decision we made to change your benefits, you may request a fair hearing under chapter 388-02 WAC. The fair hearing rules in chapter 388-02 WAC do not apply for a “mass change”. A mass change is when we change rules that impact benefits for all recipients and applicants.

  10. When you request a hearing and receive continued benefits:

    1. We keep giving you the same benefits you got before the advance notice of reduction until the earliest of the following events occur:

      1. For Basic Food only, your certification period expires;

      2. The end of the month the fair hearing decision is mailed;

      3. You state in writing that you do not want continued benefits;

      4. You withdraw your fair hearing request in writing; or

      5. You abandon your fair hearing request; or

      6. An administrative law judge issues a written order that ends continued benefits prior to the fair hearing.

    2. We establish an overpayment claim according to the rules in chapter 388-410 WAC when the hearing decision agrees with the action we took.

  11. Some changes have a specific effective date as follows:

    1. When cash assistance benefits increase because a person is added to your assistance unit, we use the effective date rules for applications in WAC 388-406-0055.

    2. When cash assistance benefits increase because you start paying shelter costs, we use the date the change occurred.

    3. When a change in law or regulation changes the benefit amount, we use the date specified by the law or regulation.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

CLARIFYING INFORMATION

*** As a result of implementation of the Affordable Care Act (ACA), this clarifying page may no longer be effective for medical coverage applications received on or after 10/01/2013. Please see the ACA Transition Plan for more information. Clients who need to apply for medical coverage on or after 10/01/2013 should be referred to Washington Healthplanfinder. ***

 

1.      Advance notice:  

See LETTERS to determine advance notice time limits.

2.      Overpayments due to not reporting or reporting late:

See BENEFIT ERRORS and BENEFIT ERRORS – BASIC FOOD OVERPAYMENTS for information on how to set up an overpayment when someone did not report a change timely or when we did not make the change timely.

If someone does not report a change in circumstances required under WAC 388-418-0005, we determine if a client has an overpayment for each program based on that program’s reporting requirements.

·         For Basic Food, the household must report changes as required under WAC 388-418-0005(2)(a).

·         If a Basic Food assistance unit would not have to report the change based on the AU's circumstances, we do not set up an overpayment even if the household had to report a change for another department program. 

3.      Mass changes:

Examples of mass changes include: 

Changes to allotments or payment standards

Changes to income standards

Changes to the Basic Food maximum shelter deduction

Cost of Living Adjustment (COLA) to SSI, Social Security, or VA benefits

Changes to the standard deduction for Basic Food

Changes to utility allowances for Basic Food


WORKER RESPONSIBILITIES

1.    Temporary changes in income:

When a client reports a change in income that we do not expect to last at least a month beyond the month they reported the change, do not change their benefits. This includes having income over the gross income limit for Basic Food. Instead, take the following steps:

a.    Document the reported change, that the change is not expected to last at least a month beyond the date the client reported the change; and

b.    Leave the person's benefits unchanged.

 


NOTE: If you expect the change to last at least a month after the month the change was reported, adjust the person's income for the change. If we averaged this income, you must re-calculate the averaged income based on this new information.

EXAMPLE

On September 19th, Sue reports that her hours have increased because her co-worker is on medical leave through October 15th. We would not re-calculate Sue's income based on this report because the change won't last through the end of October.


EXAMPLE

On November 14th, Dan reports that he will be working full time for the holiday season through January 1st. We re-calculate Dan's income based on this report because we expect the change to last at least through the end of December.


2.      Changes that cause an increase in benefits:

a.      We require proof of a decrease in income before we update benefits based on the reported change if the change will increase the household's benefits.  We decide when to change benefits based on whether or not they provide the proof we asked for within ten days.

If they take more than ten days to provide this proof, we increase benefits starting the month after the month we received the proof even if they request more time to give us the proof.

b.   We require proof of expenses that will increase Basic Food benefits only if the expense is questionable.    

c.   When cash assistance benefits increase because someone starts paying shelter costs, we adjust the cash benefits in the same month that the change was reported if proof was provided timely.  We do this instead of waiting until the following month.  If the proof was not provided timely, then we follow the regular rules for the effective date of the change.

       d.     If a person leaves a community residential facility or a medical institution after the first of the month and they have been receiving CPI monies per WAC 388-478-0045 or 388-478-0040, the effective day for the change in benefits is the day they leave the facility.   

 

Benefits are determined by dividing the grant amount by the number of days in the month.  The remainder is multiplied by the number of days left in the month counting the date of discharge. The CPI is divided by the number of days in the month and the remainder is multiplied by the number of days the person was in the facility.  The two sums are added together and the CPI amount is subtracted from the total.


EXAMPLE

Sam and his family receive TANF assistance.  Up until October 1, Sam had no rent obligation, so the family was receiving a supplied shelter grant.  Beginning October 1, he started paying $200 a month in rent.  He reported and verified this change to the CSO on October 10th.  Instead of waiting to increase his cash benefits in November, the change in the TANF grant standard takes effect in October, which is the beginning of the month that the change was reported and verified.

 

 


EXAMPLE

Tommy is receiving Aged, Blind or Disabled (ABD) cash.  He was receiving a supplied shelter grant because he was living rent free at his brother’s house.  On December 1st, his brother starts charging him $100 a month for rent.  Tommy is not required to tell us about this change due to simplified reporting.  He tells the CSO about the change on February 10th.  He verifies the new shelter obligation on February 15th.  The office makes the changes and supplements Tommy’s February cash grant, instead of waiting until March.  This is because he was not required to report the change, but when he did, he verified timely.


EXAMPLE

Sheri and her child receive TANF assistance.  They were receiving a supplied shelter grant.  In September they moved and started to pay rent.  Sheri reported this on September 5th, but she did not provide proof of the change as requested until October 15th.  Her payment standard for TANF will change from the supplied shelter standard to the full shelter standard beginning in November (the month after the month we received the verification).        


EXAMPLE

Bill is in an ARC (Adult Residential Care facility) and is receiving CPI, $38.84.  He is released from the facility on April 10th and will be responsible for paying shelter costs.  He is eligible for a supplemental payment of $210.11 calculated as follows:

$339 divided by 30 = $11.30

$11.30 x 21 = $237.30

$38.84 divided by 30 = 1.29

$1.29 x 9 = $11.65 

$237.30 + 11.65 = $248.95  which rounds up to $249.00

$249.00 – 38.84 = $210.16  (ACES issues the exact amount for the BEG)

 

If Bill were going into supplied shelter, the same equation applies with the supplied shelter amount being used.

 


NOTE:

If someone reports a change that would increase their benefits, but fails to provide the needed proof, we do not update the case to increase the AU's benefits. We also do not terminate the AU's benefits based on the missing proof. We continue to use the previous income and expenses until the next review / recertification.


NOTE:

A reported one-time medical expense may have a different effective date as a deduction depending upon how the person chooses to have it budgeted. See WAC 388-450-0200 for how to treat medical expense deductions.


3.    Changes that reduce benefits:

When people report a change that will reduce their benefits, make the change to reduce their benefits (with advance notice). Do not require proof of the change. We will verify this information at the next eligibility review / recertification or mid-certification review.

4.    When someone reports multiple changes at one time:

When clients report multiple income-related changes at the same time, review each change separately to decide how the change impacts their eligibility and benefits.

 


EXAMPLE

Rebecca did not receive her March TANF or Basic Food benefits because she moved in February and did not report this change. Her mail was returned, "Moved, left no forwarding address". Her benefits closed without advanced notice on the last day of February.

On March 3rd, she reports her new address. In addition, Rebecca reports a new job. Reinstate her TANF and Basic Food back to March 1st. Give Rebecca 10 day's advanced and adequate notice regarding any benefit changes from the new job. Any reductions to her TANF and Basic Food would be effective in April.

 


EXAMPLE

Charles lost his job. He applied for TANF benefits and was approved. The first change is that Charles lost his job. The second is that he now receives TANF.

·      Charles losing the income from his job is a change that increases benefits. If Charles gives us proof of the change timely, we increase his benefits effective the first of the next month.

·      The second change was that he started to receive income from a new source. This is a change that decreases benefits. We reduce benefits effective the month after the change when this meets advance notice requirements.

 


5.   For Basic Food: When a newborn's date of birth is between the application date and interview date:

The newborn is eligible for benefits in the month of application effective the date of birth.  However, ACES does not correctly prorate benefits in the month of application when the newborn's application date is different than the rest of the household members.  When finalizing the case, you will need to exclude the baby in the first month and manually create a BEG to supplement the newborn's portion.  The supplement amount the difference between what the household is eligible to receive with and without the newborn, prorated from the date of birth.

To determine the BEG amount, take the following steps:

a.    Determine how much the household is eligible to receive if the newborn was in the household at the time of application.

                                        i.        Screen the newborn onto the Basic Food AU.  Use the date of birth as the application date.

                                       ii.        Go through "O" and "P" as usual.

                                      iii.        Go into "Q" and start the finalize process.  Even though you screen the newborn in as of the date of birth, ACES will open everyone (including the newborn) from the original application date.

                                      iv.        Make note of the benefit amount on the FSFI screen for the month of application and F3 out (don't finalize!).

b.    Determine how much the household is eligible to receive without the newborn in the month of application.

                                        i.        Go into "P" in the month of application only and code the newborn as a non-member on the Basic Food STAT screen.

                                       ii.        Go into "Q" and finalize the case.

                                      iii.        The amount for the month of application should exclude the newborn.  The amount for the on-going months should include the newborn.

c.    Take the difference between the amounts in Step 1 and Step 2 and divide by the number of days from the application date through the 30th.

                                        i.        We always assume a 30-day month.

                                       ii.        Count the application date as day "one".

d.    Multiply the result from Step 3 by the number of days from the newborn's date of birth through the 30th, and round down.  This is your BEG amount.

                                        i.        We always assume a 30-day month.

                                       ii.        Count the newborn's date of birth as day "one".


EXAMPLE

A husband and wife apply for Basic Food on 07/10/10.  The wife gives birth on 07/20/10 and reported this information during their interview on 07/25/10.  The worker screens the newborn onto the AU.  After going through Steps 1 and 2, the worker determines that in the month of application, the household is eligible for $250 as household of three (including the newborn) and  $180 as a household of two (excluding the newborn).  The worker finalizes the case and approve benefits as a household of two for the month of application, and a household of three for the rest of the certification period. 

To figure out the BEG amount, the worker follows Step 3 and 4:

  • $250 - $180 = $70
  • $70 ÷ 21 days (from 07/10 through 07/30) = $3.33 per day
  • $3.33 x 11 days (from 07/20 through 07/30) = $36.66
  • The worker creates a BEG for $36.


NOTE:

For information on how to create a BEG, see Benefit Error Group (BEG) in the ACES User Manual.


6.   For Basic Food: When someone (other than a newborn) moves into the household between the application date and interview date:

If someone moves into the household between the application date and interview date, that person is eligible for benefits effective the application date, along with the rest of the household members.


7Return Mail:

If you receive returned mail for someone, take the following steps:

a.       Check the case record to determine if they have reported a change and it has not yet been recorded in ACES.

b.      If the post office returned the letter, take action on the case as described below:

          i. If marked "Moved, left no forwarding address", "Undeliverable as addressed", "Attempted - not known", or "Vacant" and there is no forwarding address:

·         For Basic Food: Take no action on the Basic Food AU until the household contacts you, until the next eligibility review/recertification, or at the mid-certification review.

·         For all other programs: Close the AU(s) without 10-day advance notice.  Send the notice of termination to the last known address.

      ii. If returned with a new address, update the address in ACES and attempt to contact the household either by phone or through the mail to request information about new shelter costs.  Follow procedures under Change of CircumstanceWAC 388-418-0007, "When do I have to report changes in my circumstances?" Worker Responsibilities, #5.

 


NOTE: For all programs:  If the client's new address is out of state, terminate benefits without advance notice as described under WAC 388-458-0030 (3)(b).

c.  If we close a person's cash or medical benefits under (b.) (i.) above and they contact us with their new address at any time during the month following their termination, we reinstate these benefits back to the first of the month with no change. We treat any changes the person voluntarily reports at the time of contact as described in WAC 388-418-0020.

d.  Households receiving medical assistance for children or pregnant women with benefits closed for "loss of contact/whereabouts unknown" may have their benefits reinstated back to the month of termination if they provide the local office with their new address at any time during their original certification period.  Also see clarifying information in WAC 388-462-0015.


ACES PROCEDURES

See Interview
Add a Person: See Add a Person
Add a Program: See Add a Program
Update AU / Client Data: See Update Assistance Unit / Client Data
Terminating an AUs / Client's Benefits: See Close Assistance Unit / Client
Adverse Action: See Update Assistance Unit / Client Data

See Deny an Assistance Unit / Client

Trickling and Sprouting:  See Trickle and Sprout
Modification Date: September 26, 2013