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R.3 & R3.2 Policy Refresher

R.3 & R3.2 Policy Refresher. Hot Spots & Areas of Confusion. Verification. See “Verification Chart.”. Verification (cont’d).

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R.3 & R3.2 Policy Refresher

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  1. R.3 & R3.2 Policy Refresher Hot Spots & Areas of Confusion

  2. Verification • See “Verification Chart.” Office of Child Development

  3. Verification (cont’d) • VERIFICATION is the process of confirming information needed to determine eligibility for subsidy. The term includes documentary evidence or information obtained through collateral contacts, self-certification and self-declaration. • SELF-CERTIFICATION is a written statement provided by the p/c for the purpose of establishing selected factors of nonfinancial eligibility. • SELF-DECLARATION is a written statement provided by the p/c for the purpose of establishing financial or nonfinancial eligibility for a period of time NOT TO EXCEED 30 calendar days. Office of Child Development

  4. Verification (cont’d) • SELF-CERTIFICATION = once and done, permanent verification • SELF-DECLARATION = p/c’s written word; requires follow-up within 30 days • PENDING = waiting for the p/c to obtain; within timeframe required Office of Child Development

  5. Verification Example #1 Application Date-stamp = 1/1/07 Employment and income verification missing Verification Deadline = 1/31/07 Eligibility Determination Deadline = 1/31/07 Steps: • Review Application by 1/11/07. • Set employment and income verifications to “Pending.” • Send Missing Information Letter 1/12/07 requesting income verification by 1/31/07. Office of Child Development

  6. Verification Example #1(cont’d) • P/C calls CCIS in response to letter = 1/15/07 Gave employer EV. Employer is unwilling to complete the EV. Steps: • Discuss options for verification (i.e., collateral contact; continue working with employer on EV; paystubs; other document with income and hours/can compute hours; Self-declaration). • Explain to the P/C that he/she should continue to work on verification as discussed, but if the CCIS does not receive the verification by 1/31/07 the self-declaration period will begin. Office of Child Development

  7. Verification Example #1(cont’d) Steps (cont’d): • Complete the Self-declaration form and change verifications from “Pending” to “Self-declaration.” • Assess and Confirm eligibility. • Send a copy of the Self-declaration form to the P/C with the Eligible Notice and Confirmation Notice (§3041.3 and §3041.63(d)) • Set a tracking date alert for 3/2/07 (1/31+30 days) for additional verification to be submitted. Office of Child Development

  8. Verification Example #2 • Redetermination Packet Sent Date = 12/4/06 Packet received 12/30/07, income verification missing • Redetermination Date = 1/12/07 Steps: • Review Redetermination Packet upon receipt. • Set income verification to “Pending.” • Send Missing Information Letter requesting income verification by 1/12/07. Office of Child Development

  9. Verification Example #2 (cont’d) • P/C calls CCIS in response to letter = 1/5/07 Misplaced last paystub. Next pay date is 1/19/07. Steps: • Discuss options for verification (i.e., collateral contact; submit 1/19/07 paystub; other document with income and hours/can compute hours; Self-declaration). • The P/C states that he can’t obtain verification and the employer will not participate in a collateral contact so he will submit the next paystub following receipt. Explain the P/C must submit the verification by 2/11/07 (1/12 + 30 days). Office of Child Development

  10. Verification Example #2 (cont’d) Steps (cont’d): • Complete the Self-declaration form and change income verification from “Pending” to “Self-declaration.” • Assess and Confirm eligibility. • Send a copy of the Self-declaration form to the P/C with the Eligible Notice and Confirmation Notice (§3041.3 and §3041.63(d)) • Set a tracking date alert for 2/12/07 for additional verification to be submitted. Office of Child Development

  11. Verification Example #3 Redetermination Completed = 12/14/06 P/C reports marriage = 1/12/07 Steps: • Discuss options for verification (i.e., Marriage Certificate). • Send Missing Information Letter requesting verification by 1/25/07 (1/12/07 + 13 days). Office of Child Development

  12. Verification Example #3 (cont’d) P/C calls CCIS 1/15/07 and reports suffered fire, lost Everything and it will take a few weeks to get another Marriage Certificate. Steps: • Discuss Self-declaration and explain that the P/C must submit the verification by 2/14/07 (1/15 + 30 days). • Complete the Self-declaration form and set verification to “Self-declaration.” Office of Child Development

  13. Verification Example #3(cont’d) Steps (cont’d): • Assess and Confirm eligibility. • Send a copy of the Self-declaration form to the P/C with the Confirmation Notice (§3041.3 and §3041.63(d)) • Set a tracking date alert for 2/15/07 for additional verification to be submitted. Office of Child Development

  14. Seasonal Employment • Seasonal employment should be treated the same as involuntary loss of work. • The p/c should be given 60 days from the last date of employment to locate new employment. • The CCIS will pay for the same level of care previously used (within reason) for up to 60 days. Office of Child Development

  15. Seasonal Employment(cont’d) • Income is calculated as follows: • Determine the number of months the p/c works. • Determine the gross monthly income and multiply the monthly income by the number of months the p/c works • DO NOT determine the gross annual income and divide by the number of months the p/c works. CCMIS will incorrectly multiply the monthly amount by 12 to determine annual income. • Enter this amount as annual income in CCMIS on the Employment and Wage screen or the Self-Employment screen, as appropriate. Office of Child Development

  16. Seasonal Employment (cont’d) EXAMPLE #1: P/C is a school teacher that does not opt for pay over a 12- month period, but instead receives her pay over 9 months. She makes $2015.98/month, which equals $18,143.82/annual. CCIS enters $18,143.82 in CCMIS with a frequency of “annual.” Incorrect entry: $18,143.82/annual divided by 9 equals $2015.98/month. CCIS enters $2015.98 in CCMIS with a frequency of “monthly.” CCMIS calculates the annual income to equal $24,191.76. This calculation results in $6047.94 more income than the p/c actually makes. Office of Child Development

  17. Seasonal Employment (cont’d) • CCMIS will adjust the co-payment to the minimum amount or an amount based on the income previously entered in CCMIS when a worker inputs information that a p/c reported the loss of seasonal work. • The CCIS must override the co-payment to the original amount based on the previous employment income and any other income entered in CCMIS. Office of Child Development

  18. Seasonal Employment (cont’d) • P/C receives Unemployment Compensation in the amount of $1500/month beginning the date following the last date of work. • The CCIS must enter this income in ONGOING mode only because of co-payment stabilization rules. • The CCIS must assess and confirm eligibility, and manually generate a Confirmation Notice upon the p/c’s return to work. The p/c must report income from work within 10 days of receipt. The p/c begins to pay the originally assessed co-payment (or less) on the Monday following the date the notice period expires. Office of Child Development

  19. Self-Employment • See “DRAFT” manual chapter. Office of Child Development

  20. Face-to-Face • If the CCIS determines a family eligible for subsidy and if funding is available, the p/c must attend a face-to-face no later than 30 calendar days following the date the CCIS notifies the family of eligibility. • If the CCIS determines a family eligible for subsidy and funding is not available, the p/c must attend a face-to-face within 30 calendar days following enrollment of the first child. Office of Child Development

  21. Face-to-Face • The CCIS may still waive the face-to-face requirement for a family who has left subsidy and returns again within one year. • The face-to-face requirement is an application requirement only. • In a 2-p/c family only one p/c is required to attend the face-to-face. • When a single p/c is receiving subsidy and marries, the spouse is not required to attend a face-to-face. Office of Child Development

  22. Face-to-Face • The CCIS may extend the 30-day timeframe for the face-to-face if, on or before the 30th calendar day, the p/c claims hardship due to conflicts with the p/c’s work hours, transportation problems or illness of the p/c or another family member. • At the time the p/c claims hardship, the CCIS may grant an additional 30 days to complete from the date the hardship is claimed. Office of Child Development

  23. Face-to-Face:Example #1 Eligibility Determination = 1/31/07 FUNDS AVAILABLE; Letter goes out Face-to-Face Deadline = 3/2/07 P/C calls CCIS = 2/5/07; f-t-f scheduled on 2/14/07 P/C doesn’t show up on 2/14/07 Steps: • Attempt to contact the p/c by phone to schedule a face-to-face no later than 3/2/07 Office of Child Development

  24. Face-to-Face:Example #1 (cont’d) CCIS attempts to call p/c Steps: • If ABLE to speak with p/c, attempt to schedule a face-to-face and discuss the availability of an extension if needed • If UNABLE to speak with p/c, send a letter • If the p/c hasn’t completed the face-to-face by 3/2/07, send an AA on 3/3/07 Office of Child Development

  25. Face-to-Face:Example #1 (cont’d) P/C calls CCIS in response to the AA within the notice period Steps: • Schedule a face-to-face or grant an extension if appropriate Office of Child Development

  26. Adjusting Co-payment in Ongoing Mode:Maternity Leave • The CCIS must override the co-payment to the minimum amount when a single p/c reports maternity leave with no income from work. • The CCIS must assess and confirm eligibility, and manually generate a Confirmation Notice 13 days prior to the date the p/c is expected to return to work. The p/c begins to pay the originally assessed co-payment (or less) on the Monday following the date the notice period expires. Office of Child Development

  27. Adjusting Co-payment in Ongoing Mode :Disability Leave • The CCIS must override the co-payment to the minimum amount when a single p/c reports a disability with no income from work. • The CCIS must assess and confirm eligibility, and manually generate a Confirmation Notice upon the p/c’s return to work. The p/c begins to pay the originally assessed co-payment (or less) on the Monday following the date the notice period expires. Office of Child Development

  28. Adjusting Co-payment in Ongoing Mode :Loss of Work • CCMIS will adjust the co-payment to the minimum amount or an amount based on the income entered when a worker inputs information that a single p/c reported the involuntary loss of work. • The CCIS must override the co-payment to the original amount based on the previous employment income and any other income entered in CCMIS. • The CCIS must assess and confirm eligibility, and manually generate a Confirmation Notice upon the p/c’s return to work. The p/c must report income from work within 10 days of receipt. The p/c begins to pay the originally assessed co-payment (or less) on the Monday following the date the notice period expires. Office of Child Development

  29. Adjusting Co-payment, Prospective Work at Application • A single p/c who applies for subsidy and who reports prospective work is not required to pay a co-payment until he receives income from work. • The CCIS must override the co-payment to $0 when a single p/c verifies prospective work with no income at application. Office of Child Development

  30. Adjusting Co-payment, Prospective Work at Application (cont’d) • The CCIS must assess and confirm eligibility, and manually generate a Confirmation Notice using the date the 1st pay is expected for work as the 1st date field (CCMIS date p/c reported not the date p/c submitted income verification) and the Monday following the date 1st pay is expected as the 2nd date field. • EXAMPLE: “…co-payment will be waived until (1st date field). Effective, (2nd date field), you must begin paying…” Office of Child Development

  31. Adjusting Co-payment, Prospective Work at Application (cont’d) • The CCIS must select the appropriate reason code in CCMIS when generating the Confirmation Notice. • The p/c begins to pay the originally assessed co-payment (or less) on the Monday following the date the 1st pay is expected. • See the following examples. Office of Child Development

  32. Adjusting Co-payment :Prospective Work @ Application:EXAMPLE 1 • A single p/c applies on 4/1/05 with prospective employment starting on 4/25/05. • 1st paycheck = 4/29/05: • Send Confirmation Notice increasing co-payment effective the Monday following the date 1st pay is expected (4/29/05) = 5/2/05 Office of Child Development

  33. Adjusting Co-payment: Prospective Work @Application:EXAMPLE 2 • A single p/c applies on 4/1/05 with prospective employment starting on 4/25/05. • 1st paycheck = 5/6/05: • Send Confirmation Notice increasing co-payment effective the Monday following the date 1st pay is expected (5/6/05) = 5/9/05 Office of Child Development

  34. Adjusting Co-payment: Prospective Work/Recipient • A single p/c who receives subsidy, has involuntarily lost work and reports prospective work, is assessed the minimum co-payment based on family size and income until he receives income from work. • The CCIS must override the co-payment to the minimum amount when a single p/c verifies prospective work with no income between redeterminations (in ONGOING mode). Office of Child Development

  35. Adjusting Co-payment: Prospective Work/Recipient (cont’d) • The CCIS must assess and confirm eligibility, and manually generate a Confirmation Notice using the date the 1st pay is expected for work as the 1st date field (CCMIS date p/c reported not the date p/c submitted income verification) and the Monday following the date 1st pay is expected as the 2nd date field. • EXAMPLE: “…co-payment will be reduced until (1st date field). Effective, (2nd date field), you must begin paying…” Office of Child Development

  36. Adjusting Co-payment: Prospective Work/Recipient (cont’d) • The CCIS must select the appropriate reason code in CCMIS when generating the Confirmation Notice. • The p/c begins to pay the originally assessed co-payment (or less) on the Monday following the date the 1st pay is expected. • If a p/c receives other income, the co-payment will be based on that income and the waiver would not apply. • See the following examples. Office of Child Development

  37. Adjusting Co-payment:Prospective Work/Recipient:EXAMPLE 1 • Prospective work to begin on 4/25/05. No other income. Co-payment = $5 until 1st paycheck is received on 4/29/05 • Upon determination of eligibility based on prospective work, send a Confirmation Notice acknowledging the report of prospective work, explaining the waiver of co-payment and notifying the p/c of the date the increased co-payment is effective. The increased co-payment is effective 5/2/05. • Increase co-payment to the original amount or less based upon income entered in CCMIS Office of Child Development

  38. Adjusting Co-payment:Prospective Work/Recipient:EXAMPLE 2 • Prospective work to begin on 4/25/05. • SSI $550/month. • Co-payment is based on SSI income until 1st paycheck is received on 5/6/05. • Upon determination of eligibility based on prospective work, send a Confirmation Notice acknowledging the report of prospective work, explaining the waiver of co-payment and notifying the p/c of the date the increased co-payment is effective. The increased co-payment is effective 5/9/05. • Increase co-payment to original amount or less based upon income entered in CCMIS. Office of Child Development

  39. Conf. Notices: Co-pay Increases • CCMIS considers the following when determining when a co-pay increase will become effective: • 13-day advance notice period. • State holidays that fall on a Monday. • Co-pay increases are always effective on a Monday following the 13-day advance notice period. • See 2006 & 2007 State Holiday Calendar handouts. Office of Child Development

  40. Examples • Co-pay is set to increase and the 13-day advance notice period expires on 5/27-29/06. • 5/29/06 is a state holiday. • Co-pay will increase effective 6/5/06. • Co-pay is set to increase and the 13-day advance notice period expires on 9/2-4/06 • 9/4/06 is a state holiday. • Co-pay will increase effective 9/11/06. Office of Child Development

  41. AA: Failure Reason Codes • See handout. • Gray rows indicate individual failure reason codes ONLY; NOT to be applied as a case failure. Office of Child Development

  42. Ineligible Providers • In-home care initiated by the CAO that does NOTmeet the in-home guidelines. • An Affirmation Statement initiated by the CAO with a provider who DOES NOT want to participate in CareCheck. Office of Child Development

  43. Retro Payment for Former TANF • Effective 9/1/05: • A former TANF parent who meets the eligibility requirements and wants the CCIS to pay for child care must contact the CCIS within 30 days of the TANF closing date.  The face-to-face requirement and hardship exemptions remain unchanged. • The CCIS will pay for child care for up to 30 days following the TANF closing date.  • At the face-to-face meeting, the CCIS must determine whether the parent’s provider is eligible for payment based on the CCIS provider agreement standards.  Office of Child Development

  44. Retro Payment for Former TANF • If at the face-to-face meeting, the CCIS finds that the provider is not eligible by CCIS standards (ex: Affirmation Statement, live-in in-home provider, in-home care being given outside of the in-home care hours), the CCIS will give the parent 30 days to find an eligible provider.  • The CCIS will continue to the pay provider for up to an additional 30 days while the parent looks for a new provider.  Note: under no circumstances will the CCIS pay a provider after (s)he fails CareCheck. • A parent who is not eligible to receive child care from the CCIS agency within 30 days following the TANF closing date has up to 183 days to meet the work requirement and contact the CCIS to access child care under former TANF rules. Office of Child Development

  45. Retro Payment for Former TANF • The CCIS will not guarantee retroactive payments for child care to p/cs who do not contact the CCIS within 30 days of TANF closing. • An eligible p/c who contacts the CCIS between 31 and 183 days after the TANF closing date must have an eligible provider in order to receive retroactive payments.   • If the provider is not eligible by CCIS standards, the p/c will receive 30 days to find an eligible provider.  The CCIS may pay the p/c’s provider for up to 30 days while the p/c finds a new provider. Office of Child Development

  46. Retro Payment for Former TANF • An eligible p/c who provides invoices or receipts for care provided prior to contacting the CCIS may only receive retroactive payment for the period the provider was eligible by CCIS standards.   • The maximum retroactive payment period for an eligible provider is 183 days. Office of Child Development

  47. Ineligible Providers(cont’d) • Steps: • Establish an Interim Agreement with the provider to pay for care as per policy. • Future-suspend the enrollment in CCMIS using the reason “Noncompliance – Agreement” with an effective date of 30 days following today’s date . This will generate a Stop Letter to the p/c informing the p/c that the CCIS will stop paying the provider as of the effective date and that the p/c must enroll the child(ren) with an eligible provider within 30 days from the date of the letter. Office of Child Development

  48. Ineligible Providers(cont’d) • Steps: • Set a tracking date alert for Day 31 to ensure the p/c enrolled the child(ren) with an eligible provider within 30 days from the date of the letter. • If the p/c DOES NOT enroll the child(ren) within 30 days from the date of the letter/tracking date, uncheck cc request using the reason “Child not enrolled;” click save and assess and confirm eligibility. • If the p/c DOES enroll the child(ren), transfer the enrollment to the new provider. Office of Child Development

  49. Ineligible Provider Example – Within 30 Former TANF transfer without provider. TANF ended on 11/30/06. P/C attends the face-to-face with the CCIS on 12/18/06 (within 30 days; 18th day) and states that she has been using an in-home provider since 12/1/06. The in-home provider is the p/c’s mother who lives with the family. P/C submits verification that care was provided. • Establish an Interim with the provider to cover the period from 12/1/06 through 1/17/07 (12/18/06 + 30 days). • Future-suspend the enrollment in CCMIS using the reason “Noncompliance – Agreement” with an effective date of 1/17/07 (12/18/06 + 30 days). Office of Child Development

  50. Ineligible Provider Example – Within 30 (cont’d) • Set a tracking date alert for 1/18/07 (Day 31) to ensure the p/c enrolled the child(ren) with an eligible provider within 30 days from the date of the letter. • If the p/c DOES NOT enroll the child(ren), uncheck cc request using the reason “Child not enrolled;” click save and assess and confirm eligibility on 1/18/07. Office of Child Development

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