Elderly Simplified Application Project (ESAP)

Purpose:

To provide an explanation of the Basic Food Elderly Simplified Application Project (ESAP).

Clarifying Information

• All members of the household must be at least 60 years old or must be an adult with a disability as defined in WAC 388-400-0040.
• No member may have earned income.

• Unearned income must be verified through existing data crossmatches or by verification provided at recertification.
• Nothing on the eligibility review form is questionable. For example, when rent and utilities are self-declared, accept the client’s statement unless the shelter costs are questionable.
• To be allowed, out-of-pocket-medical expenses in excess of $35 per month must be verified. If not verified, recertify the case without the expense.

• ACES sets the certification period to 36 months. This process is fully automated. (Note: The 36-month certification period is effective 12/18/2023. ESAP cases certified or recertified before that date retain the 12-month certification until the next review.)
• If the household becomes ineligible for ESAP during the certification period but remains eligible for Basic Food, Basic Food will continue through the original 36-month timeframe. See “Effect of Changes during the ESAP certification period” below.

• When household income exceeds 130% FPL, and
• If they receive substantial gambling or lottery winnings.

1. ACES removes the X code from the Report Status field and enters the appropriate code for the new circumstances.
2. The certification period is the remainder of the original 36-month certification period, and the household will be sent annual MCRs as appropriate (WAC 388-418-0011 (3)(b).

1. The change occurs in month 7 causing the case to change to regular Basic Food. This is well before the 12th month. ACES sends the MCR in month 11 which is due in month 12 to determine eligibility starting in month 13 of the 36-month certification period.
2. The change occurs in the 15th month. This is well before the 24-month MCR would be due. ACES sends the MCR in month 23.
3. The change occurs in the 23rd month of the 36-month certification period. MCRs are normally sent during that month, due the following month. This is too late for an MCR to be sent to the household; the next report due is the eligibility review, sent in month 35.

1. Andrew is ESAP eligible. During his certification period he reports that his minor grandchild moved in. With the child added, the household is no longer just adults, either 60+ or disabled. ACES removes the ESAP coding; and Andrew remains eligible for regular Basic Food with his grandson.
   • The cert period remains the same, whatever is left of the 36 months.
   • The case is no longer ESAP and may be required to submit annual MCRs. (See Effect of Changes #1 above.)
   • At recertification, the household will be recertified as either ESAP or regular Basic Food, depending on the household circumstances.

1. (Same example) Several months later, the child leaves the home and is removed from this case. The household once again consists of Andrew, who meets ESAP requirements. However, the case does not transition to ESAP during the cert period. The cert period continues for the remainder of the 36 months, and ACES sends annual MCRs for the 12th and 24th months. At the next recertification, if the household is eligible for ESAP, ACES codes Andrew’s case as ESAP.

1. Marta receives Basic Food under ESAP and starts receiving disability retirement benefits. Her reported income exceeds 200%. She is no longer eligible for Basic Food. Update her case with her new income and allow the case to close with advanced and adequate notice. We are not required to interview Marta before closing her active case because she reported the change during her certification instead of at review.

1. Inez, age 45, receives ABD and does not submit updated medical evidence when required. When her ABD closes, so does her eligibility for ESAP, as we cannot assume she still meets ESAP requirements. She remains eligible for Basic Food for the remainder of the certification. She must complete annual MCRs even if she is later reinstated on ABD.

• If the household continues to meet ESAP eligibility and no information is questionable, recertify as ESAP.
• If circumstances reported on the review form are questionable or cannot be verified electronically, and the household hasn’t provided verification with the review, an interview will be required to determine eligibility before recertification.
  • Follow procedures to send the interview letter.
  • When interviewed, if the household:
    • Meets the ESAP requirements, they’ll be recertified as ESAP for 36 months.
    • Does not provide verification of medical expenses that increased by more than $35 but remains otherwise eligible for ESAP, they’ll be recertified as ESAP for 36 months. (If proof is provided later, treat as a reported change.)
    • Is not ESAP eligible but eligible for regular Basic Food, recertify with a 12-month cert period.

1. Before we close or deny ESAP,
2. If the ESAP household’s circumstances no longer qualify as ESAP, or
3. If the client requests one.

• If we receive information, whether from the client or another source, indicating the household is no longer eligible for Basic Food benefits, close the case following normal procedures.