What is a mid-certification review, and do I have to complete one in order to keep receiving benefits?
WAC 388-418-0011
WAC 388-418-0011
Effective October 1, 2007
WAC 388-418-0011 What is a mid-certification review, and do I have to complete one in order to keep receiving benefits?
A mid-certification review (MCR) is a form we send you to ask about your current circumstances. We use the answers you give us to decide if you are still eligible for benefits and to calculate your monthly benefits.
If you receive cash assistance, family-related medical, or Basic Food benefits, you must complete a mid-certification review unless you meet one of the exceptions below:
You do not have to complete a mid-certification review for cash assistance if you:
Only receive Refugee Cash Assistance as described under WAC 388-400-0030; or
Have a review period of six months or less.
You do not have to complete a mid-certification review for Basic Food if:
Your assistance unit has a certification period of six months or less; or
All adults in your assistance unit are elderly or disabled and have no earned income.
When we send the review form:
If you must complete a MCR...
We send your review form...
For one program such as Basic Food or Family Medical.
In the fifth month of your certification or review period. You must complete your review by the 10th day of month six.
For two or more programs, and all programs have a 12-month certification or review period.
In the fifth month of your certification or review period. You must complete your review by the 10th day of month six.
For Basic Food and another program when either program has a certification or review period between six and twelve months.
In the fifth month of your Basic Food certification period when you receive Basic Food and another program. You must complete your review by the 10th day of month six of your Basic Food certification.
If you must complete a mid-certification review, we send you the review form with questions about your current circumstances. You can choose to complete the review in one of the following ways:
Complete the form and return it to us. For us to count your mid-certification review as complete, you must take all of the steps below:
Complete the review form, telling us about changes in your circumstances we ask about;
Sign and date the form;
Give us proof of any changes you report. If you report a change that will increase your benefits without giving proof of this change, we will not increase your benefits;
If you receive family medical benefits, give us proof of your income even if it has not changed;
If you receive Temporary Assistance for Needy Families and you are working or self employed, you must give us proof of your income even if it has not changed; and
Mail or turn in the completed form and any required proof to us by the due date on the review.
Complete the mid-certification review over the phone. For us to count your mid-certification review as complete, you must take all of the steps below:
Contact us at the phone number on the review form, telling us about changes in your circumstances we ask about;
Give us proof of any changes you report. We may be able to verify some information over the phone. If you report a change that will increase your benefits without giving proof of this change, we will not increase your benefits;
If you receive family medical benefits, give us proof of your income even if it has not changed;
If you receive Temporary Assistance for Needy Families and you are working or self employed, you must give us proof of your income even if it has not changed; and
Mail or turn in any required proof to us by the due date on the review.
Complete the application process for another program. If we approve an application for another program in the month you must complete your mid-certification review, we use the application to complete your review when the same person is head of household for the application and the mid-certification review.
If your benefits change because of what we learned in your mid-certification review, the change takes effect the next month even if this does not give you ten days notice before we change your benefits.
If you do not complete your required mid-certification review, we stop your benefits at the end of the month the review was due.
Late reviews. If you complete the mid-certification review after the last day of the month the review was due, we process the review as described below based on when we receive the review:
Mid-certification reviews you complete by the last day of the month after the month the review was due: We determine your eligibility for ongoing benefits. If you are eligible, we reinstate your benefits based on the information in the review.
Mid-certification reviews you complete after the last day of the month after the month the review was due: We treat this review as a request to send you an application. For us to determine if you are eligible for benefits, you must complete the application process as described in chapter 388-406 WAC.
We use the information someone gives us on the Mid-Certification Review (ACES letter 022-07 – Change Report Form or form DSHS 14-467- Mid-Certification Review) to:
Determine if someone is still eligible for cash assistance, family medical, and Basic Food benefits; and
Calculate monthly benefits for cash and Basic Food.
When someone will receive a mid-certification review:
One AU requires a MCR:
If someone receives benefits from one type of benefit that requires a mid-certification review, ACES generates the review form the day after the monthly issuance in month five of the certification/review period. The AU must complete the review in month six.
More than one related AU requires a mid-certification review:
Eligibility review periods / beginning months match:
If all AUs that require a mid-certification review have a matching 12-month certification, ACES generates the review form the day after the monthly issuance in month five of the certification/review period. The AU must complete the review in month six.
Beginning months do not match - When ACES synchronizes MCRs and end dates:
If we approve cash, family medical, or Basic Food in different months, and matching the cash or medical end dates to the end date for Basic Food would give cash or medical a review period of at least six months, ACES matches the cash / medical review the certification for Basic Food.
ACES sends a single mid-certification review to be completed by the 10th day of month six for the Basic Food assistance unit.
We use this single review to determine ongoing eligibility for all programs that require a mid-certification review.
Beginning months do not match - When matching reviews would create a review / certification period of less than 6 months:
If matching the cash or medical review period to the end of the Basic Food certification would give cash or medical a review period of less than six months, the system will not match the review period end date to match the end of the certification period for Basic Food:
The cash / Family Medical will have the standard certification or review period and will receive a separate mid-certification review.
Certification / review periods will be matched up if the user initiates a review for the Basic Food AU.
When ACES will not match review periods / mid-certification reviews:
ACES will not match eligibility review periods or mid-certification reviews at times when matching these dates it is not feasible or appropriate. This includes:
Reinstatements;
Transitional Medical (These have Quarterly Reports);
Adding a person to an active case;
TANF closures that sprout a new medical assistance unit; and
Cases exempt from mid-certification reviews. These include:
Transitional Food Assistance
WASHCAP
TANF Adoption Support
Basic Food with an active ABAWD
AUs where all adults are elderly or persons with disabilities
Basic Food or cash with a migrant or seasonal farm worker
Basic Food with related ADATSA
Basic Food or cash with a homeless AU member
GA - Living arrangement HS, MR, NF
When we process a related application in the month the mid-certification review is sent or due:
Processing an application for a related assistance unit in the month a review is due or the month the MCR would be mailed meets the requirement for someone to complete a mid-certification review.
If we process an application for a related assistance unit in the month the MCR is sent before the date we send the form, we do not sent a mid-certification review.
If we process an application for a related assistance unit after we sent the MCR, but before the review is due, the system will consider the mid-certification review as complete.
NOTE:
If we approve an application on a related AU after deadline for the month a mid-certification review is due, the benefits covered in the MCR will still close. Even though processing the application meets the requirement for the review, the worker must reinstate the benefits that closed for no mid-certification review.
5. Required proof for the mid-certification review:
What proof a person must give us for us to count a mid-certification review as complete depends on the benefits they receive:
If someone receives cash or Basic Food, they must give us give proof of changes they tell us about on the MCR, except increases in deductions.
If a person reports an increase in their deductions, we will only use this higher deduction to increase their benefits if they verify the change.
If someone receives TANF or Family Medical benefits, they must give us proof of their income on mid-certification review even if their income hasn't changed.
If you are processing a mid-certification review where the person reports no changes for Basic Food and TANF or Family medical benefits and the person did not give proof of their income, process the review as complete for Basic Food.
NOTE:
Even though we do not require TANF households to verify employment hours as a condition of eligibility, we must still verify and record employment hours.
See Income Budgeting for information on how to record income and employment hours for TANF households.
NOTE:
The no-change function in ACES online will process the MCR as complete for all associated AUs. If you do not have the required proof for the medical portion of the review to be counted as complete, you must use the mainframe system to process the MCR for each AU.
NOTE:
If someone reports an increase in expenses on their MCR, but does not give the necessary proof of the expense, we continue to allow the previously verified expense.
Treat the mid-certification review as complete(provided you have all of the mandatory verification), and add text to the letter informing the person that to give proof of the change if they want it to be counted for their benefits.
6. Mid-certification reviews completed late:
If someone does not complete the mid-certification review on time, ACES closes the benefits covered in the MCR at the end of the month the review was due. We treat mid-certification reviews completed after the month the review was due as described below:
Completed by the last day of the month after the month the MCR was due: Reinstate benefits and process the revew to determine ongoing eligibility for benefits.
Received later than the month after the month the MCR was due: Document that you received the MCR after the end of the month after the month the review was due and send the person an application for benefits.
EXAMPLE
Dee receives her MCR for Basic Food and TANF due on August 10th. She does not complete review as required. Dee's benefits end on August 31st. On September 8th, Dee completes her mid-certification review over the phone and her worker gets proof of the changes she reports. Her worker reinstates Basic Food and TANF benefits effective September 1st.
EXAMPLE
January 10th. They do not return the review form or complete the review over the phone. ACES closes Basic Food and medical benefits on January 31st.
On March 4th, Mr. Smith turns an MCR stating that there were no changes in their circumstances. He has also attached proof of their income.
Because they completed the review later than the end of February, we treat the MCR as a request for an application and send them a new application.
The AU is not eligible for benefits for February. To receive benefits, the AU must complete the application process as described under chapter 388-406 WAC.
7.Applications received after benefits are closed for no MCR, but before the end of the seventh month:
If we close benefits for no mid-certification review and the AU turns in an application for benefits, they may:
a.Complete their mid-certification review as described under WAC 388-418-0011 and withdraw their application for benefits; or
b.Have us process the application as normal. This may include receiving expedited service for Basic Food under WAC 388-406-0015
See WORKER RESPONSIBILITIES below for information on screening the application to allow clients the choice of how to treat the application.
EXAMPLE
Steve's Basic Food benefits closed June 30th because he did not complete and return a MCR. On July 20th, he turns in a new application for Basic Food.
When Steve's worker Doug receives the application on July 21st, he contacts Steve with the option to complete mid-certification review instead of going through the application process.
Steve chooses to complete the MCR and Doug gets proof of Steve's changes over the phone. Doug reinstates Basic Food back to July 1st.
NOTE:
If someone wants to complete the application process, or we cannot complete the mid-certification review with the information we have available, we must act on the application for benefits.
Requests to add a person on the mid-certification review:
The MCR asks about people moving into the household and whether or not they want benefits for this person. See below to decide if you need an application or Eligibility Review (ER) form to add the new person to the current benefits:
Cash assistance:
If someone asks to add an adult to their cash benefits, have the person complete an application or ER.
·For cash, the responsible adult members of the AU must sign the application or ER.
·We do not need a new application / ER form to add a child to TANF/SFA AU.
Medical Assistance:
We do not need a new application / ER form to add someone to the AU.
Basic Food:
We do not need a new application / ER form to add someone to the AU.
Requests to add a program / program change on the MCR:
For all programs, a person must complete a new application or ER form to add a program or change programs.
Completing the mid-certification review over the phone:
a.The requirements for the MCR vary by program. See below for elements that must be reviewed and updated (and verified if changes are reported) at MCR:
CASH/MEDICAL
BASIC FOOD
·Address
·Address
·Deductions (legally obligated child support)
·Deductions (medical expenses, child support, child care, shelter expenses)
·Disability
·Household Composition
·Household Composition
·Income (new source, start, stop, change in rate or hours, etc.)
·Income
·Insurance
·Pregnancy
·Resources
Get the required proof to complete the review;
Update the case record; and
Document the actions you took.
WORKER RESPONSIBILITIES
1.Applications received when benefits are closed for no mid-certification review:
If you receive an application for benefits the month after we closed benefits because the person didn't complete a mid-certification review (ACES Reason Code 141 or 142) take the following actions:
a.Screen in a new assistance unit for the application;
b.Contact the person to offer them the choice to:
i.Withdraw their application and complete the MCR; or
ii.Complete the application process.
c.Based on their choice, process the application for benefits as described in Applications for Assistance or process the MCR as described in Clarifying Information under the heading Mid-certification reviews completed late.
2.Verification of income and hours of work for TANF:
At mid-certification review, verify income and hours of employment for TANF households who have income from employment or self employment. Do not re-verify income and hours that have already been verified for the month of the mid- certification review.
EXAMPLE
Bill's mid-certification review is due in June. Sandy, his WorkFirst Program specialist verified his income and hours of work recently when Bill reported that his hours were reduced.
If Sandy verified the income and hours to impact June benefits, we do not need to re-verify this information to complete the June MCR.
If she verified the income and hours to impact an earlier month, we must re-verify the income and hours to complete the June MCR for TANF.
