Reporting Requirements

Created on: 
Jan 05 2015

Revised January 12, 2015

Purpose:

WAC 388-418-0005 How will I know what changes to report?

WAC 388-418-0007 When do I have to report changes in my circumstances?


Clarifying Information - WAC 388-418-0005

1.  SSI / SSI-related medical benefits:

  • Reporting requirements for SSI-related medical benefits do not apply to a person who receives SSI medical (S01).  Changes for SSI recipients are reported to the Social Security Administration.
  • If someone receives S01 medical and benefits from another program, they must report based on the requirements for the other program.

EXAMPLE:  A family receives S01 medical, TANF, and Basic Food benefits.  S01 medical does not follow the same reporting requirements as SSI-related medical (i.e., S02).  The family must report changes based on the cash reporting requirements.

2.  Reporting Requirements for Basic Food Simplified Reporting:

Basic Food households must report if their income goes over 130 percent of poverty based on the number of eligible household members in their assistance unit.  Once a household reports a change in income and is certified eligible above the 130 percent poverty level, the reporting requirements under simplified reporting have been met and the household doesn't have to report any other income changes until:

a.  The mid-certification review (MCR);

b.  The eligibility review (ER); or

c.  Until the household income increases to an amount greater than 200 percent of poverty, whichever comes first.

3.  Reporting Requirements for State Supplemental Payment Program (SSP):

We decide if someone is eligible for SSP based on information Social Security Administration (SSA) gives us through the State Data Exchange (SDX). A person does not have to report changes for SSP.

4.  Taking action on changes:

When we receive information about someone's circumstances, we must determine the impact on the person's benefits. This may include contacting them, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.

a.  Client Reports:

  • Take action based on changes the person reports. This includes when someone volunteers information after we contacted them.
  • Get proof of a person's circumstances if they report:
    • A decrease in income that increases their benefits; or
    • Expenses that increase benefits and the expenses are questionable given their income and other circumstances.

b.  Third-Party Reports:

  • If we receive information from a third party about someone, follow-up on the information to decide how it impacts the person’s eligibility and benefits.
  • This may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.

c.  Alerts Verified Upon Receipt:

  • An interface that automatically updates the ACES case record is "verified upon receipt".
  • We do not need to take action on alerts the interface automatically updates in ACES.

d.  Other Alerts:

  • We do need to take action on alerts that are not verified upon receipt.
  • Work alerts that are not verified upon receipt to decide how the information impacts the person's eligibility and benefits.
  • This may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.
NOTE: EXCEPTION TO THIRD-PARTY REPORTS PROCESS: If a financial worker receives potential change information from a WCCC child care worker, the financial worker should: a. Not contact the AU about the change; b. Act on the change only if they have proof of the change from the WCCC eligibility system or child care worker, even if it reduces benefits; and c. Set an alert to get verification of the change at the next recertification if no proof was previously received.

5.  ABAWD reporting requirement / Statewide ABAWD waiver:

Currently, Washington has a statewide waiver of ABAWD requirements. When we no longer have this waiver, people must report when a non-exempt ABAWD receives benefits in the AU and the ABAWD's hours of employment drop below 20 hours per week. This includes when the non-exempt ABAWD is the head of household for Basic Food. See BFE&T Appendix I.

Worker Responsibilities - WAC 388-418-0005

The DMS E001 tickler uses EBT transaction data to identify EBT cash or food clients who may no longer be living in Washington because they are consistently using their benefits out of state.  Out of state EBT transactions are defined as any EBT purchase, ATM withdrawal or manual voucher transaction at a non-Washington site that requires the use of an EBT card as part of the transaction.  W hen this occurs, the residency may be questionable. 

Follow the E001 tickler handling process described in the CSD Procedures Handbook.


Clarifying Information - WAC 388-418-0007

  1. When a change happens:

    Non-Income Changes

    The date of a change is normally the date a change happens. Examples of this include the date:

    • Someone gets married;
    • A newborn comes home from the hospital; and
    • Someone moves to a new home.

    Income Changes The date of an income related change is the date someone receives income based on the change. Examples of this include the date:

    • On the first paycheck that reflects a wage increase; and
    • On the person's first paycheck for a new job.
EXAMPLE:  Sandy is hired for a new job on May 31st. She starts work on June 10th. Her first paycheck is July 5th. Because this is a change in income, we count the date of Sandy's first paycheck on July 5th as the date of the change.   If Sandy must tell us about the change based on her reporting requirement under WAC 388-418-0005, she must tell us about this change by August 10th. · If Sandy reported this change earlier, we would act on the change based on when we expect her to receive the income.
EXAMPLE: Nick is hired for a new job on May 1st. He receives his first paycheck on June 1st. Nick must report this change of employment status and income by July 10th.
EXAMPLE: Stacey receives TANF and Basic Food. She had her employee evaluation on October 1st. Based on this evaluation, Stacey gets a promotion and a $1.25 hourly wage increase. The wage increase takes effect October 15th. She will receive the first check showing this increase on November 10th. Because this is a change in income, we count the date of Stacey's first paycheck on November 10th as the date of the change. - Stacey must report this change to us by December 10th. - If Stacey reported this change earlier, we would act on the change based on when we expect her to receive the income.
  1. Changes a client voluntarily reports:
    • If people report a change, we must act on the change they report even if they didn't have to tell us about the change under WAC 388-418-0005. This includes asking for more information or proof of a change when we can't tell the impact on their benefits.
    • For Basic Food, under simplified reporting rules, clients do not have to report when they move until recertification or until the mid-certification review, whichever comes first. If they voluntarily report a move between mandatory reports or for another program, they must provide their new shelter costs. The new shelter costs do not need to be verified unless questionable. See "Worker Responsibilities" (4.) and (5.) below.
    EXAMPLE Larry receives Basic Food only. He calls and reports that his monthly rent expense went from $300 to $500 monthly. Larry's worker Bob chooses to verify this change as "questionable" because the $500 plus utilities are so close to Bob's monthly income. After he receives proof of the expense, Bob updates the shelter cost for Basic Food.
    EXAMPLE Ian receives TANF and Basic Food. He leaves a message with his worker reporting that he started a job and would like to close his TANF benefits today. Ian's worker closes TANF benefits based on the request. Since Ian reported that he is now employed, his worker must follow up to see how this impacts his medical and Basic Food benefits.
  2. Unverified changes that increase benefits:

    If a client reports a change that would increase their benefits because of a decrease in income, we ask for proof of the change. We only ask for proof of an increase in expenses if the expenses are questionable. We increase the AU's benefits based on the effective date rules under WAC 388-418-0020.

    • If we have asked for verification, and they fail to give us proof of a reduction in income or an increase in expenses, we do not update their case to increase benefits.
    • We also do not close the case based on their failure to give proof of a change that would increase their benefits.

  3. Changes someone reports on an application or eligibility review:

    People may report a change in their circumstances on an eligibility review form or an application for benefits. If you receive an application or eligibility review form:

    1. Before the fifteenth day of the second to last month of their certification period, treat this form as a change of circumstances.
    2. On or after the fifteenth day of the second to last month of their certification period, treat this form as a request for review or recertification. See ELIGIBILITY REVIEWS AND RECERTIFICATIONS for procedures.
    3. In the month before the mid-certification review is due, use the information on the application / review form to complete the MCR for any related programs.
    4. For medical, you may use an application or review at any time to update the medical certification period.
    5. For handling additional applications received before initial application is processed see "Clarifying Information" #4 under WAC 388-406-0010 .
      EXAMPLE Susan's Basic Food certification period ends on July 31st. She turns in an Eligibility Review form for Basic Food only on May 31st. Because Susan turned in the ER before the 15th of the month before the month her certification period ends, we treat the form as a change of circumstance report.
  4. Temporary absence of an AU member: If an AU member is temporarily out of the home:
    • For cash and medical assistance, follow the rules in WAC 388-454-0015 to determine if the person is still eligible for benefits.
    • For Basic Food, follow the rules in WAC 388-408-0035 to determine if the person is still eligible for benefits.

  5. AU member moves out of Washington:

    People must be state residents to be eligible for most programs. If an AU member or the entire AU leaves the state, follow the rules in WAC 388-468-0005 to determine if the person is still eligible for benefits.

WORKER RESPONSIBILITIES - WAC 388-418-0007

  1. During the application, recertification or eligibility interview:
  1. Inform clients what changes they must report and how much time they have to report the changes;
  2. Explain how to report changes either in writing, by phone, or in person. (See RIGHTS AND RESPONSIBILITIES); and
  3. Give them a DSHS 14-076(X), Change of Circumstance form, and a return envelope to report changes. ACES automatically mails the DSHS 22-297, How to Report Changes with the award letter.
  1. When people report a change or when you learn of a change:
    1. Ask for more information or proof if needed. See LETTERS for the rules and the process on asking someone to take an action or give us information.
    2. Take action on the information using the effective date rules in WAC 388-418-0020.
    3. If we averaged their income under WAC 388-450-0215, recalculate this source of income if you expect this change to last at least a month beyond when you learn of the change.
    4. Document:
      • The details of the change;
      • The date we learned about the change or the date the change was reported;
      • The impact on benefits; and
      • The effective date for any change in benefits.
    5. Send written notice about the change based on requirements in LETTERS even if the benefits do not change.
  1. For Basic Food, if the client does not report a change in medical expenses, but you learn about a change:
    1. Do not contact the AU about the change;
    2. Act on the change only if you can get proof of the change from someone other than the AU; and
    3. Set an alert to get proof of the change at the next recertification. Update the MEDX screen in ACES once you get proof of the medical expenses.
    4. Document in the ACES narrative whether or not we should use the medical expense at the next recertification.
NOTE: If you later approve medical assistance that covers a person's medical expenses, delete the medical expenses on the MEDX screen and recalculate the person's Basic Food benefits.
  1. For Basic Food, when the client voluntarily reports a move in person or on the phone:
    1. Ask for the new out-of-pocket share of shelter costs associated with the new residence.
    2. Do not require verification of the new shelter expenses unless questionable.
    3. Make it clear that they do not need to wait for the first regular rental or utility payment to tell us the amount(s).
    4. Update and document the new shelter costs in ACES.
    5. Send notice to the client if there is a change in the benefit amount. Give advance notice if there is a decrease.
  2. If the client reports a move in writing or we receive returned mail with a new forwarding address on the envelope:
    1. First, attempt to contact the client by phone. If successful, follow instructions in (4.) above.
    2. If unable to contact by phone, send the client a general correspondence letter asking for the new shelter costs associated with the move.
      • Include a statement in the letter warning the client that the old shelter deduction will be removed from the budget and benefit will be recalculated using no shelter costs if new expenses are not reported within 10 days;
      • Make it clear in the letter that they do not need to wait for the first regular rental or utility payment to tell us the amount(s); and
      • Do not require verification of the new shelter expenses unless questionable.
    3. If client responds to the letter:
      • Update and document the new shelter costs in ACES; and
      • Send notice to the client if there is a change in the benefit amount. Give advance notice if there is a decrease in benefits.
    4. If client does not respond to the letter:
      • Do not close the BF AU;
      • Remove the old shelter costs; and
      • Send advance notice to the client if there is a change in the benefit amount.
NOTE: Do not use a "Request for Information" letter as this letter requires a BF AU closure if the client does not respond.

Mid-Certification Reviews

For information on mid-certification reviews, please see the Mid-Certification Reviews section.


ACES Procedures

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