Adverse Action (10 day notice)

Created on: 
Jun 19 2015

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.

What is adverse action?

Adverse action is an action to reduce, suspend or terminate cash, food or medical assistance or an action to change benefit issuance to a protective payee or vendor.

What is advance notice?

Advance notice is a letter sent to clients at least ten days prior to a reduction, suspension, or termination of benefits. See EAZ Manual - WAC 388-458-0030 We send you a termination letter when your benefits stop. and EAZ Manual WAC 388-458-0040 Why do you give me ten days notice before you reduce or stop my benefits?

How is the ten-day notice period calculated?

Day 1 of the ten-day count begins the first working day following the date on which a change is made on a case excluding weekends and or holidays. The 10 days run consecutively counting weekends and or holidays.  The ten day notice period varies from month to month. See the ACES Production Calendar for the exact date of the ten day notice period each month.

EXAMPLE: Action is taken to terminate an Assistance Unit (AU) on Friday 7/24/15. The first working day that follows is Monday, 07/27/15 this exclude holidays/weekends.  Day 1 of the 10-day count begins on 7/27/15 this runs consecutively (including weekends and/or a holiday), the 10th day is 8/05/15; therefore the Benefit Effective Date is 09/1/15. This means the actions taken do not take effect until 09/1/15. To allow for 10 day advance notice, the date of closure (paid thru date) for this AU would be 8/31/15. 

What is waiving adverse action?

Waiving adverse action means the action being taken does not give the client 10-days advance notice of the change to reduce, terminate or change benefit issuance.

What reason codes do not allow adverse action to be waived?

When closing an Assistance Unit (AU) for one of the following reason codes, adverse action cannot be waived.

  • 226 – Residing in Inpatient Psychiatric Institution
  • 249 – Receipt of Benefits from Another State During Month
  • 251 – Already Received Food Assistance
  • 569 – Child Accepted to Foster Care

What reason codes automatically waive adverse action?

When closing an Assistance Unit (AU) for one of the following reason codes, ACES automatically waives the adverse action period:

  • 210 – Failed Residency Requirement
  • 213 – Failed Pregnancy Requirement
  • 235 – Review Not Complete
  • 244 – Death
  • 290 – Overdue Incapacity Review
  • 304 – Additional Requirements Change
  • 551 – Whereabouts Unknown
  • 557 – AU Requests Closure
  • 567 – Drug/Alcohol Center Loses Certification

What is the paid thru date?

The paid thru date is the last date for which benefits were issued.

What is the benefit effective date?

The benefit effective date is the date when a reduction and/or termination of benefits is effective.

The benefit effective date displays on the CAFI screen, FSFI screen or MAFI screen in the Bnft Eff Date field in ACES Mainframe.

The benefit effective date displays on the Eligibility Details page, in the Certification section in the Benefit Effective Date field in ACES 3G.

  • The chart below illustrates how ACES closes a case and what the paid thru date and benefit effective date will be when adverse action is waived or not waived.
  • In this example, ten-day advance notice period begins 7/22/15 and monthly issuance/deadline is 7/25/15.
Benefit Effective Dates Before 10 Day Notice

SYSTEM DATE

BENEFIT MONTH

WAIVE ADVERSE ACTION

CLOSE STATUS CODE

BENEFIT EFFECTIVE DATE

PAID THRU DATE

07/21/15

07/15

No

H

07/21/15

07/31/15

07/21/15

08/15

No

C

07/21/15

07/31/15

Benefit Effective Date During 10 Day Notice, but Before Monthly Issuance

07/22/15

07/15

N/A

H

07/22/15

07/31/15

07/22/15

08/15

No

C

08/01/15

08/31/15

07/22/15

08/15

Yes

C

07/22/15

07/31/15

Benefit Effective Date After Monthly Issuance

07/25/15

07/15

N/A

H

07/25/15

08/31/15

07/25/15

08/15

No

H

08/05/15

08/31/15

07/25/15

08/15

Yes

C

07/25/15

08/31/15

07/25/15

09/15

N/A

C

08/05/15

08/31/15

How do I waive adverse action after monthly issuance?

After monthly issuance occurs, adverse action can only be waived through the Pending Void process. See Pending Void – Void/Cancel Benefits

Online Processing

How do I process a change to reduce, suspend, or terminate benefits during the adverse action period?

To process a change to reduce, suspend or terminate benefits during the adverse action period, take the following steps:

  1. From Case Actions page, click Start Changes.
  2. Process updates to reduce, suspend, or terminate benefits.
  3. On the Eligibility page, click on the Details link for each Assistance Unit (AU) to view specific eligibility results:
  • If appropriate, adverse action can by waived by clicking the Waive Adv Act button on the Eligibility Details page.
  • If the Waive Adv Act button is not selected,  adverse action is not waived. When adverse action is not waived, the benefit effective date in the Benefit Effective Date field includes the 10-day advance notice period.
  • If the Waive Adv Act button is selected, adverse action is waived, and the Benefit Effective Date is equal to the date the action is taken. The benefit change is effective the month following the month of the benefit effective date.
  1. Click the Confirm Benefits button to confirm eligibility. 
  2. After the Eligibility Details for all Assistance Unit (AUs) have been reviewed and a green checkmark displays by the Details link, click the Commit Changes button from the Eligibility page to confirm benefits.

Mainframe Processing

How do I process a change to reduce, suspend or terminate benefits during the adverse action period?

To process a change to reduce, suspend or terminate benefits during the adverse action period, take the following steps:

  1. Select AMEN, option R – Interim/Hist Change.
  2. Process updates to reduce, suspend or terminate benefits.
  3. On the ELIG screen, in the Confirm field enter [Y] – Yes.
  4. On the CAFI screen or FSFI screen:
  • In the Bnft Confirm field enter [Y] – Yes.
  • In the Waive Advr Act Per field enter [N] – No or [Y] – Yes.​​​
  • If [N] is entered, adverse action is not waived. When adverse action is not waived, the benefit effective date in the Bnft Eff Date field on the CAFI screen or FSFI screen includes the 10-day advance notice period.
  • If [Y] is entered, adverse action is waived.  When adverse action is waived, the benefit effective date in the Bnft Eff Date field on the CAFI screen or FSFI screen is equal to the date the action is taken.The benefit change is effective the month following the month of the benefit effective date.
NOTE: An entry in the Waive Advr Act Per field outside the adverse action period has no effect on eligibility or benefit reduction.
  • In the Letter Override field enter [N - No]. Even if the letter will be overridden, [Y] – Yes cannot be entered.
  1. Press <Transmit>.
  • In the Letter Override field, enter [N] – No or [Y] – Yes.  If the letter is overridden, it is mandatory that a user generated letter be sent providing the client with adequate notice of change in benefit amount.

 

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.