FLORIDA Family Track Screen Guide
Transcription
FLORIDA Family Track Screen Guide
FLORIDA Family Track Screen Guide updated May 13, 2014 1 FLORIDA Family Track Screen Guide / Table of Contents Purpose 6 AISI Alien Sponsor Information 22 FLORIDA Information 7 AIIM Individual Miscellaneous 23 Acronyms 7 AISA School Attendance 24 System References 7 Food Assistance College Student Helpsheet 25 PF Keys 7 Example: AISA Eligible College Student (EA) 26 AICI Case Information 8 Example: AISA Ineligible College Student (XA) 26 AIID Individual Demographics 9 AIAF Armed Forces 27 AILG AKA Names/SSN Registration 10 AIDP Elderly/Incap/Disabled 28 AIVR Voter Registration 11 AIMC Individual Misc. Con’t 29 AIRE Race/Ethnicity 12 AIMM Medicare Information 31 AIPB Application Entry Benefit Selection 14 AIHH Household Relationships 32 ACAC Application Counselor Information 15 AIHH Household Relationships Helpsheet 34 AIIC Individual Living Arrangements 16 Example: AIHH Specified Relative 35 Example: AIIC Relative Caregiver Code 32 17 Example: AIHH Specified Relative (OTR) 35 Example: AIRL Relative Caregiver Screen 17 Example: AIHH Child Living with Non-Relative (FRD) 36 18 Example: AIHH Nonjudicial Boyfriend and Girlfriend (NJB/NJG) 36 AIIA Individual Attributes Example: Identity Citizenship Verf Table TMVR 19 AIOH Household Relationships 37 AICZ Alien Refugee Information 20 AIAP Absent Parent General 38 AISI Alien Sponsor Information 22 AIAE Absent Parent Employment 39 2 AIAC Absent Parent Court Order 40 AALS Lump Sum 60 AFMQ Medical Expense/Insurance Questions 41 AABE Business Assets 61 AFME Medical Expense 42 AAAT Asset Transfer 62 Example: AFME Food Assistance Recurring Medical Expense 43 AFEQ Employment Questions 63 Example: AFME Food Assistance Recurring Medical Expense 43 AFEI Employment Information (Current Ongoing) 64 AFMD Medical Insurance Coverage 44 AFEI Employment Information (Current Ongoing) 64 AFMC Medical Insurance Coverage 45 AFIN Earned Income / Expense Calculator PF19 66 ASEQ SSI Eligibility Questions 46 AFEI Employment Information (Actual/Past Month) 67 ASEV SSI Eligibility Verification 47 AFEM Employer Provided Health Insurance 68 ASPV Protected MA Eligibility Verification 48 AFSE Self Employment Questions 69 ARDT Welfare Reform Data Tracking 49 AFBE Blind Work Expenses 70 ARCA Welfare Reform Cash Data 50 AFIQ Unearned Income Questions 71 ARFS Welfare Reform Food Stamp Data 51 AFMI Monthly Unearned Income 72 AAAQ Asset Questions 52 AFUI Unearned Income Calculator 73 AAVH Vehicle Assets 53 AFBA Income Benefits Applied For 74 AANA Vehicle Model Selection 54 AFIC Unearned Income Questions Continued 75 AANA Vehicle Body Style Selection 55 AFEA Educational Aid 76 AALA Liquid Assets 56 AFEA Educational Aid 76 AARP Real / Personal Property Assets 57 AFAA Educational Aid Applied For 77 AARC Real / Personal Property Assets Continued 58 AFRQ Room And Board Questions 78 AALI Life Insurance Assets 59 AFRQ Room And Board Questions 78 3 AFRE Room And Board Earnings 79 Example: AFUT Standard Utility Allowance (SUA) 96 AFBP Room and Board Paid 80 Example: AFUT Basic Utility Allowance (BUA) 96 AFDQ Dependent Care Expenses 81 Example: AFUT Telephone Standard 97 AFDE Dependent Care Expenses 82 Example: AFUT Multiple AGs Living In The Same Dwelling 97 AFDE Dependent Care Expense Helpsheet 83 Example: AFUT Vendor Payment 98 Example: AFDE Dependent Care (RC, ?) 84 Example: AFDE Dependent Care (RC, SC) 84 AFDP Child Support Payments (Outside The Household) AFSU Shelter Utility Assistance Example: AFSC HUD Rent Subsidy (TCA) 99 100 85 AITR Application Tracking 101 AFDP Child Support Payments Food Assistance Helpsheet 86 AIFP ACCESS Integrity Referral 102 Example: ADFP Child Support Deduction (more than court order) 87 AGCD SFU Composition Display 103 Example: AFDP Child Support Deduction (no court order) 87 AGPY Assistance Group Names 104 88 AGCC TCA SFU Composition Change 105 Example: AFSQ Homeless Income Deduction (FS) 89 AGCC Medicaid 106 Example: ABFN Homeless Income Deduction (FS) 89 AGCC Food Assistance 107 90 AWES Eligibility Summary 108 AFSC Shelter Helpsheet 91 ABFG Food Stamp Gross Income Test Budget 109 Example: AFSC Mortgage (PT, HI, CM paid separately) 92 ABFN Food Stamp Net Income Budget 110 Example: AFSC TCA Specified Relative Child Only 92 ABFB Food Stamp Benefit Determination Budget 111 AFTD Tax Deductions 93 ABAD TCA Miscellaneous Deeming Budget 112 AFUT Utility Costs 94 ABAI TCA Individual Countable Earned Income Budget 113 95 ABAC TCA Payment Standard Budget 114 AFSQ Shelter And Utility Questions AFSC Shelter Cost AFUT Utilities Helpsheet 4 ABAG TCA 185% Eligibility Standard Budget 115 Example: Layering AFEI Screens (Current Ongoing) 136 ABAB TCA Benefit Determination Budget 116 Example: Layering AFEI Screens (Actual/Past Month) 136 ABMG Family Medicaid/Medically Needy Determination Budget 117 ABSB SSI Related MA Eligibility Determination 118 Example: Accessing History / Screens with Begin End MMCCYY fields 138 AAED Asset Eligibility Determination 119 Example: Accessing History / Screens without MMCCYY fields 139 ATED Technical Eligibility Determination 120 AWEC Expected Changes 121 AWAC Application Creation 122 AGBI Assistance Group Benefit Information 123 Example: AOBT PF20 141 AGBI Assistance Group Benefit Information 123 Example: AOBT PF21 142 AGAR Authorized Representative 124 Example: AOBT PF22 142 AGPI Work Programs 125 Example: AWAA Reason Code 051 143 AGTF Application Tracking Food Assistance 126 Example: CLRC Bill Tracking Form 143 AGTC Application Tracking Cash 128 AGTM Application Tracking Family Medicaid 129 AGTS Application Tracking SSI Related 130 AWGV Pending AG Display Screen 131 AGVR Pending Verification Checklist 132 AWAA Assistance Group Authorization 133 Attachment 1: CLRC Running Record Comments 134 Attachment 2: How To Layer Screens BEG MMCCYY and END MMCCYY 135 Attachment 3: How To Access History Attachment 4: “NO PENDING AGS EXIST FOR THIS CASE” Example: AGCD shows no TCA or Medicaid Attachment 5: AOBT Medical Bill Tracking Attachment 6: AMIC Print Emergency MIC / Reissue Hard Card 5 137 140 140 141 144 Purpose Helpsheets appear after certain difficult screens to detail important policy, such as Food Assistance Student Eligibility. The FLORIDA Screen Guide is intended to provide an electronic reference to help staff complete FLORIDA screens. The pages are shown in landscape format for a better view with less scrolling. Examples help explain how to enter specific information, such as completing AFSC for a TCA specified relative child only case. The Table of Contents is linked to each page. Click the heading to go directly to the page. Use “control + home” keys to return to the title page. Attachments cover screens that do not appear in the driver and other important topics related to FLORIDA. Other Screen Guide Sections are available electronically: 1. Family Track Screen Guide http://crconnect.dcf.state.fl.us/famtrackscreenguide/ 2. Inquiry Screens, CRAD Driver Screen Guide http://crconnect.dcf.state.fl.us/inqcradscreenguide/ 3. CLCH Change Driver Screen Guide http://crconnect.dcf.state.fl.us/clchscreenguide/ 4. DSUM Disability Driver Screen Guide http://crconnect.dcf.state.fl.us/dsumscreenguide/ ___________________________________________________________________ The FLORIDA Screen Guide is intended as a supplement to other policy references and does not replace policy manual materials. Example: AFSC Shelter Cost page from the Screen Guide The screen pages contain the following items: Title: Screen Name that appears in the table of contents. Screenshot: A snapshot of a training region case. For clarity and printing purposes, the background is changed from black to white. However, other FLORIDA colors are the same: green = input, red = error, blue = system field. A description in blue text follows most of the screenshots. Important Fields are described from a system view. System / Policy Reminders offer hints and tips for completing the screen or things to remember about policy. This reference is a 2011 ACCESS Leadership Class project by Rodrigue Baly, Terri Caldwell, Burton Cummings, Pauline Glover, Janice E. Johnson, Joyce Kinney, Tom Sallette, and Louella Teague. Thank You to Cathy Kenyon, Jena Grignon, and Kara O’Brien for their guidance and direction in completing this project. 6 FLORIDA Information PF Keys Acronyms FS = Food Assistance, Food Stamps, SNAP PF1 Screen Help TCA = Temporary Cash Assistance, Cash, TANF, AFDC PF7 Page Backward (certain screens only) MFAM = Family Medicaid PF8 Page Forward MSSI = SSI Related Medicaid PF9 Cancel, New Screen ASIA = Application Driver PF13 (SHIFT + F1) Sign off ASRE = Recertification Driver PF 14 (SHIFT + F2) Cancel CRAD = Client Registration Application Driver PF15 (SHIFT + F3) Exit Table EDBC = Eligibility Determination Benefit Calculation PF16 (SHIFT + F4) New Screen AABC = Tran Code to run EDBC PF19 (SHIFT + F7) Income Calculator; Update tracking screen entry. SFU = Standard Filing Unit AG = Assistance Group ACCESS Home Page http://eww.dcf.state.fl.us/ess/ FLMMIS = Florida Medicaid Management Information System Technology Page http://eww.dcf.state.fl.us/ess/technology/ PIN = Personal identification Number Policy Manual http://eww.dcf.state.fl.us/~ess/policy/policy_manual_index.shtml Knowledge Bank http://accessweb2.dcf.state.fl.us/PolicyManual/Home.aspx ASIA/ASRE Driver Flow http://eww.dcf.state.fl.us/~ess/florida/DRIVERASIA.pdf RFDI Tables http://eww.dcf.state.fl.us/~ess/florida/fl_ref_tables.shtml Help Desk (850) 922-3099 Technical Help Desk: (850) 487-9400 Links System References Press PF1 to view Screen Help for a detailed description of the fields. Type # (pound sign) in the field. Press enter. The table, if any, will display. Type RFDI in NEXT TRAN and the 4 letter table name in PARMS. Press enter. NEXT TRAN: rfdi__ PARMS: 4 letter table name_____ 7 Important Fields AICI Case Information PIP: Name of the Primary Information Person (PIP) LANG: C = Creole, E = English, S = Spanish LIVES IN HH: Enter “Y’ if PIP resides in the household. HOUSEHOLD LIVING ADDRESS: Separate fields are used for each segment. Use the 2nd line for address continuation, such as “in care of”. CNTY: See Florida County Listing Table TCTY. EMAIL: Enter the PIP’s email address. Do not enter any other information. System / Policy Reminders 1. The Location Date is not the RFA or date of application. 2. When transferring cases to closed files, update the Case File Location and Date: IN = Intake, CF = Closed Files, ON = Ongoing 3. An incorrect address or phone information may cause processing delays. Be sure to review and update address, phone, and cellphone contact information from the web application or during the phone interview. 4. The PIP may not necessarily reside in the household. Example: Samuel’s address and telephone information are shown here. 5. A change of address may indicate other changes in household composition, shelter or utilities. AICI is used to collect and display case address information for the household. 6. Enter P.O. Box addresses in the Street/Rural field. 7. “DC” fields are used to delete the entire address. 8. A homeless AG with no available mailing address may receive mail marked General Delivery at the post office. (This situation must be explained to the AG.) 8 Important Fields AIID Individual Demographics SSN: Enter the individual’s Social Security Number. Leave blank if unknown. Proof of application for SSN is entered on AIIA. S: Enter the individual’s sex code. “T” is used for the presumptively eligible newborn (PEN) cases. R: Enter the individual’s race code. See Ethnic Class Codes Table TETC. AL N/S: Enter any alias/other names (such as a maiden name) or SSN for the individual. BU: Born/Unborn indicator used for presumptively eligible newborn (PEN) cases. System / Policy Reminders 1. Review AIID carefully to ensure each individual’s demographics are entered correctly including the name, SSN, date of birth, sex, and race. 2. Use the individual’s legal name. The customer’s statement “CS” is accepted for SSN and date of birth unless questionable. 3. To be eligible, each individual must have a SSN or proof of application for an SSN. The individual’s SSN is electronically verified with an “NU” code through DENU Numident data exchange alerts. 4. When adding a new individual, check the FLORIDA inquiry screens first. If the individual is already known to FLORIDA or FLMMIS, use the same demographics even if there is an error or the SSN is missing. After clearance is complete, go back to AIID and update the demographics. AIID is used to collect and display demographic information for each individual in the household. Adding an individual will start the clearance process similar to CRAD. . 5. If the message “SSN ALREADY EXISTS IN SYSTEM” appears, check CRPC for the demographics and PIN linked to the SSN. Check FLMMIS to determine which PIN should be used. If you cannot fix the problem, get help or contact the help desk. Problems can occur with EBT or FMMIS if you change the pin after authorization. 9 AILG AKA Names/SSN Registration Important Fields AKA NAMES, TYPE: M = Maiden Name, A = Other Alias Name. AKA SSNs, TYPE: AO = Alias SSN, IS = IRS SSN, PR = Prior SSN. See SSN Type Codes Table TSST. System / Policy Reminders 1. Delete any misspelling errors. 2. When the name or SSN fields are updated, the old information is sent to AILG. For example, when the demographics on a PEN case are updated, the “BABYAOFPARENT’SFIRSTNAME” is added to AILG. 3. Delete any SSNs entered in error. If the real owner of the SSN applies for benefits, it will create processing problems. Example: Samuel’s name was entered as “Sam” in his first case. When AIID was corrected, his old name was automatically added to AILG. AILG is used to collect and display information about alias names and/or social security numbers. This screen is displayed for each individual when “Y” is answered to the AKA NM/SSN question on AIID. 10 System / Policy Reminders AIVR Voter Registration 1. This screen is displayed during the ASIA/ASRE drivers and after AICI Case Information Address fields are updated. 2. Only one “X” entry is allowed for each voter registration activity. 3. If the PIP does not make a selection, they are declining the opportunity to register to vote. 4. The Voter Registration form cannot be printed online but can be mailed from Tallahassee. Public contact staff should have manual forms from the Elections Office available for customers. Example: Samuel’s web application indicates he wants to register to vote. AIVR is used to enter the PIP’s voter registration information from the application. 11 Important Fields AIRE Race/Ethnicity ETHNICITY: Enter "Y" if the individual is Hispanic or Latino. Enter "N" if the individual is not. This is a mandatory field. A = Hispanic/Latino B = Not Hispanic/Latino RACE: Enter “Y” in one or more of the fields to indicate the individual’s Race. The other fields are left blank. Other/Unknown is entered if no selection was made. 1 – American Indian or Alaskan Native, 2 – Asian, 3 – Black or African American 4 – Native Hawaiian 5 – White AMERICAN INDIAN OR ALASKA NATIVE: A “Y” entry will prompt the AIAN American Indian/Alaska Native screen. System / Policy Reminders Race and Ethnicity information is found on the customer’s application. AIRE is used to collect and display the race/ethnicity of individuals in the household. 12 AIAN Application Entry Benefit Selection System / Policy Reminders 1. For medical assistance applications, the individual’s tribal affiliation and tribal services information is collected in case the application is forwarded to the Federally Facilitated Marketplace (FFM). 2. If “MORE” is shown in the lower right corner, press PF8 to view the next individual. 3. This information is found on the application. AIAN is used to collect additional details for American Indian/Alaska Native individuals. 13 Important Fields AIPB Application Entry Benefit Selection IS ANYONE IN YOUR HOUSEHOLD INTERESTED IN APPLYING FOR: Enter “X” to select a single benefit type or a combination of benefit types for the household. SUBMITTED THROUGH A CERTIFIED COUNSELOR: Answer “Y” if the application was submitted through a certified counselor. The ACAC Application Counselor Information screen will appear next. RELATIVE CAREGIVER: Enter “X” to schedule relative caregiver screens. This program requires specific criteria to be eligible. KIDCARE: Driver used by Kidcare processing unit. EMERGENCY FOOD STAMPS: Emergency Food Stamps is now known as the Food For Florida (FFF) program. This selection is unavailable unless activated. System / Policy Reminders 1. CRDE Client Registration Data Exchange selections from CRAD appear here. 2. When recertifying, do not uncheck active benefits. Otherwise, FLORIDA will force the benefits to be closed on AWAA. 3. AIPB functions at the case level. If one AG wants to apply for a benefit but another AG does not, select the benefit on AIPB. Answer “N” in the AGPY "Do You Wish To Apply?" field for the AG that is not requesting benefits. Example: Samuel applied for Food Assistance and Medicaid. AIPB is used to select the benefits the individual applied for and which type of benefits FLORIDA will evaluate. This screen functions at the case level. 14 System / Policy Reminders ACAC Application Counselor Information This information is found on the customer’s application. ACAC shows details for the certified application counselor. 15 Important Fields AIIC Individual Living Arrangements LIVING ARRANG TYPE: Enter the code for the type of living arrangement the individual has. See Living Arrangements Table TLAR. LIVING ARRANG DATE: Enter the date the living arrangement began. The system considers the individual to be ineligible prior to this date. VR: The customer’s statement is accepted as verification unless questionable. TEMPORARILY ABSENT RSN: Enter the reason code for why individual is absent from the household. See Temporarily Absent Reason Table TTAR. BGN DTE: Date the temporary absence began. END DTE: Date the temporary absence is estimated to end. VR: The customer’s statement is accepted as verification unless questionable. System / Policy Reminders 1. Be sure to use the correct Living Arrangement Type and Date to avoid system problems or payment errors. Specific codes are used for boarders (04), unborn PEN coverage (34), PEN coverage (26), relative caregiver (32), homeless (13), battered spouse (12), nursing home coverage (09), if the individual has passed away (22), etc. Do not change Child In Care (CIC) Living Arrangement Types 27, 28, or 29 unless the CIC case is closed. Example: Samuel’s Living Arrangement Type is “01” Independent Living. 2. For retroactive Medicaid, the Living Arrangement Date must include the requested month. AIIC is used to collect and display living arrangement and temporarily absence information for each individual in the household. 3. At recertification, do not change the Living Arrangement Date. The field is updated when Living Arrangement Type changes. 4. Temporary absence criteria vary by program. An individual may be excluded for Food Assistance but included for TCA and/or Medicaid. 16 Example: AIIC Relative Caregiver Code 32 Example: AIRL Relative Caregiver Screen Example: The Relative Caregiver Communication Form was received from Child Welfare showing that Todd and Danielle are approved for Relative Caregiver benefits. Change the child’s Living Arrangement Type to “32” to build the benefit. The following screens must be completed to build Relative Caregiver benefits: AIPB, AIIC, AIRL. Example: AIRL is used to build relative caregiver benefits for each child coded with AIIC Living Arrangement code 32. To be eligible for relative caregiver benefits, specific criteria must be met. See Policy Manual 2020.0400 - 0402 Relative Caregiver Program (TCA). 17 AIIA Individual Attributes Important Fields ID VR: For Food Assistance, see Verification Codes Table TVR4. For Food Assistance and Medicaid, see Identity/Citizenship Verification Code Table TMVR. If ID VR field is pended with a “?”, Food Assistance will not process as expedited. SSN APPL DATE, VR: Use “?” to pend for proof of application for an SSN. EXEMPT CODE: Enter these codes for specific situations, such as processing EMA coverage. See SSN Exemption Table TSSN. A = Adoption Pending, E = EMA application, O = Good Cause Exemption For Food Assistance, U = Unborn Child, Z = Refused Enumeration US CIT, VR: Enter "Y" or “N" to indicate if the individual is a U.S. citizen. An "N" brings up the AICI Alien Refugee Information screen. DEC CIT: Declaration of Citizenship/Lawful Immigrant. If “N” is entered, the individual will fail benefits. POB: Place of Birth. See Country Codes Table TCOU. FL RES, VR: For Broad Based Categorical Eligible Food Assistance household’s, the customer’s statement “CS” is accepted as verification unless questionable. MART ST, VR: Marital Status. See Marital Status Codes Table TMAR. MIGNT: Migrant or Seasonal farmworkers Example: Samuel’s driver’s license is used to verify his identity for Food Assistance. For Medicaid U.S. citizenship and identity verification, his driver’s license information from DMV/DAVE, web attestation (affidavit) for identity for children under age 16, and Michael’s birth certificate are used. FLAGS: Specific codes are entered here to track cases. EMN MNR: An Emancipated Minor is a child under 18 the court has declared to be an adult. AIIA is used to collect and display individual attributes information for each individual in the household. 18 Example: Identity Citizenship Verf Table TMVR System / Policy Reminders 1. For Food Assistance Identity verification, use any readily available source of documentation for the individual applying for benefits and/or the Authorized Representative. DMV/DAVE (electronic source) may be used. 2. The individual’s identity is verified if Customer Authentication requirements are met. 3. For U.S. citizens applying for Medicaid, verification of Identity and Citizenship is required (one time basis). Certain electronic sources, such as DMV/DAVE, may be used. There are many exceptions. This policy does not apply to non-citizens, SSI recipients, or PEN cases. Specific codes must be used. 4. The SSN “Exempt Code” is a required entry when no SSN has been entered on AIID and no entry has been made in the SSN APPL field. 5. For a newborn with an SSN application from the hospital, use the date of application for “SSN Application Date” and “HR” (hospital records) for verification. 6. If no TCA or Medicaid benefits are built, check the child’s marital status to see if they are coded as married or divorced. Example: For Medicaid U.S. citizenship and identity verification, specific codes are used. Otherwise, Medicaid eligibility will not pass. For Samuel’s identity and U.S. citizenship, “DM” (electronic driver’s license information from DMV/DAVE) is used. “DM” is entered in the Identity field. “CV” is entered in the U.S. Citizenship field. For Michael’s identity, “AV” (affidavit for children under age 16) is used. For Michael’s U.S. citizenship, “CV” (birth certificate) is used. 19 Important Fields AICZ Alien Refugee Information COUNTRY CODE: See Country Codes Table TCOU. Code “99” is Other. PR CH: Indicates previous Cuban/Haitian status before current status. ENTRY DATE: Date of entry. ALIEN STAT: Enter the correct non-citizen status code. The current codes start at 39. See Alien Status Codes Table TCTZ. INS DOC. NUMBER: Immigration Naturalization Service (INS) document # used to verify the non-citizen’s information. Required entry, except for non-citizens with no INS status. If not available, enter "9999999". STAT DATE: Document Date appearing on the document. Required entry, except for non-citizens with no INS status. If not available, enter the system date. ALIEN SPNSR: Indicates if the non-citizen has a sponsor. A “Y” answer goes to the AISI Alien Sponsor/VRA Information screen. MED EMERG TYPE, BGN DTE, END DTE, VR: These fields are used to process EMA coverage. 40 QTRS: Indicates if Food Assistance 40 quarters criteria is met. Example: Anna is a non-citizen with a lawful immigration status. Her AICZ status code is 41, which is a Lawful Permanent Resident, admitted on or after 8/22/96, without prior Refugee, Asylee, Amerasian, Victim of Human Trafficking, or Cuban/Haitian code. Her date of entry is June 1, 2005. She is not eligible for benefits except EMA until 5 years have passed or unless other criteria are met. She is potentially eligible for benefits beginning June 1, 2010. System / Policy Reminders 1. For non-citizen policy, refer to the Non-Citizen Guide or Policy Manual. 2. Immigration Naturalization Service (INS) is now known as the Bureau of Citizenship and Immigration Services (BCIS) or United States Citizenship and Immigration Services (USCIS). AICZ is used to collect and display information on non-citizens to determine their country of origin and non-citizen status. The screen is also used to process Emergency Medical Assistance (EMA) for non-citizens. 3. Complete SAVE as required by policy. 4. Certain non-citizens are sponsored as shown by the individual’s status code. 20 5. If Emergency Medical Assistance for Non-Citizens (EMA) dates are already processed, delete the information to avoid getting archive restore message in EDBC (041). 6. Code 53 “Granted Asylum under section 208” requires completing the Asylum Date field. 21 System / Policy Reminders AISI Alien Sponsor Information 1. For non-citizen policy, refer to the Non-Citizen Guide or Policy Manual. 2. For certain situations, the non citizen’s sponsor is listed in the case. Enter the AIIC Living Arrangement Type field with the following codes: 15 = Sponsor Living in Home 16 = Sponsor Not Living in Home 3. If deeming is not required, do not enter sponsor information, such as when the sponsor is the parent of a minor child (sponsored person). This creates problems with the SFU. 4. If you receive the message “No Alien Sponsor Found” go back to AICZ, enter “Y” to sponsor, press enter, and delete the AISI screen with “AE”. The driver will allow you to proceed. 5. For MSSI, if the non-citizen was sponsored and the Affidavit of Support was signed before 12/19/97, sponsor deeming did not apply. If on or after 12/19/97, 100% of sponsor and sponsor’s spouse’s income and assets are considered available to the non-citizen until they attain citizenship. AISI is used to collect and display information about individual sponsors or voluntary resettlement agencies to determine standard filing units for the household. . 22 Important Fields AIIM Individual Miscellaneous ELDERLY/DISAB/INCAP: Enter “Y” if the individual is disabled, applying for disability, or incapacitated. EPSDT: Child Health Checkup services are available for children under 21. PREG, DUE DATE, PREGNANCY BEGIN, END: These fields build pregnancy based Medicaid coverage groups. WRK DEFER: If “Y” is entered, FLORIDA will build TCA for the pregnant woman with no other children. The pregnant woman must be in the 3rd trimester and physically unable to work or participate in work activities. Verification is required such as doctor’s statement. UNBORN CNT, VR: The # of unborn children and verification provided. System / Policy Reminders 1. The unborn child is included in the Medicaid SFU of the household. A pregnant woman who is expecting twins (with no other children) will have an income limit of 3 for Medicaid. 2. The Pregnancy Begin field determines the 9th month or 3rd trimester for TCA starts on FLORIDA. Example: Michael attends school. Samuel wants Child Health Checkup (formerly EPSDT) screening services for Michael. AIIM is used to collect and display miscellaneous information for each individual in the household. 23 Important Fields AISA School Attendance EDU CDE: EL = Elementary School, MS = Middle School, HS = High School/Equiv, IH = Institute of Higher Education. See Education Codes Table TEDC. ATT CDE: FU = FULL-TIME, HA = 1/2, LH = LESS THAN HALF, TT = 3/4. See School Attendance Status Table TSAC. CMPLTN/QUIT DATE: This field is required only for individuals in high school. HALF CARE: For EL, MS, HS children, enter “N”. Enter “Y” to indicate the college student meets criteria to be eligible (EA) based on a dependent child. System / Policy Reminders 1. For TCA, Learnfare policy applies to school age children age 6 to 18. 2. For Food Assistance, “college” students (age 18 to 49, mentally/physically fit, attending an institution of higher education at least ½ time) must meet certain criteria to be counted as an Eligible Adult (EA). If not met, the individual is an Excluded Adult (XA). The following AISA fields must be completed: EDU CDE = IH, ATT CDE = at least ½ time. The individual must be age 18 to 49. The following screens will make the individual an Eligible Adult (EA): AISA with “Y” to ½ Care Example: Michael attends school at Orlando Elementary. AIDP completed (even if not disabled) AISA is used to collect and display information about school attendance. Enter information on individual(s) with Y answered to the school attendance question on the individual miscellaneous screen (AIIM). AFEI with 80 or more monthly hours AFEA with work study (WS) 24 6. assigned to or placed in an institution of higher learning through the Job Training Partnership Act, the Food Stamp Employment and Training Program (FSET), Regional Workforce Board coalition/contract provider, the Trade Act, or state or local government employment and training program where components are the same as required components in the FSET Program. or Food Assistance College Student Helpsheet See Policy Manual 2210.0320.01-04 or memo C–10-03-0003 Students In Institutions of Higher Education http://eww.dcf.state.fl.us/~ess/policysearch/c10030003.pdf 2210.0320.02 Student Eligibility Test (FS) 7. participating in an on-the-job training program. The exemption applies only while the employer is training the individual. or Complete the student eligibility test for students in institutions of higher education to determine if they meet a student exemption. Testing for student eligibility does not apply to individuals attending high school, individuals not attending school at least half-time, or individuals enrolled full-time in schools and training programs that are not institutions of higher education. Individuals pass the student eligibility test and are eligible to participate in the Food Stamp Program if they are: 8. enrolled in the school because of participation in the JOBS Program or its successor programs through the Agency for Workforce Innovation under Title IV of the Social Security Act. or 9. single parents enrolled in school full-time and responsible for care of a dependent child under age 12 when there is only one natural, adoptive, or step-parent in the same food stamp SFU. or 1. age 17 or under or 50 or older. or 2. physically or mentally unfit. Individuals are physically or mentally unfit if they are receiving temporary or permanent disability benefits from government or private sources or are obviously physically or mentally unfit. Individuals meet the obviously unfit criteria if the impairment is so severe that they are not only unable to do their previous work but cannot, considering their education and experience, hold any other kind of job in the national, state, or local economy. If the unfitness is not obvious, get written or verbal verification from a physician, physician’s assistant, nurse, nurse practitioner, designated representative of the physician’s office, licensed or certified psychologist, social worker, or other medical personnel. Assist the individual in providing the verification. or 10. working average work hours that total 80 hours per month and be paid for the work (with no allowance for substitution of wages equal to 80 times the federal minimum wage), or self-employed average work hours that total 80 hours per month and receiving payment for the work at least equal to the federal minimum wage multiplied by 80 hours per month. or 11. participating in a state or federally financed work-study program during the regular school term. The student must have approval for the work-study when they apply for food stamp benefits and anticipate actually participating in work-study during the school term. This exemption does not apply to students working in hospitals or as student teachers who must get actual experience as part of their course work or cooperative education students who attend classes full-time one semester and work at curriculum related jobs full-time the next semester. This workstudy exemption does not continue during term breaks of more than a full month unless the student participates in work-study during the break. 3. responsible for the care of a dependent standard filing unit (SFU) member under age six. or 4. households with two parents or members acting as the parents responsible for the care of a dependent SFU member age six but under the age of 12, for whom adequate child care is not available to allow the student to attend class and comply with the requirements of working an average number of work hours that total 80 hours per month or attend class and participate in a state or federally financed work study. or Students in the Road to Independence Program (former foster children) are also eligible. See memo C-10-10-0011 Students in the Road to Independence Program http://eww.dcf.state.fl.us/~ess/policysearch/c10100011.pdf 5. receiving Temporary Cash Assistance benefits. or 25 Example: AISA Eligible College Student (EA) Example: AISA Ineligible College Student (XA) Laura, age 28, attends college full time. She lives with her husband and 3 year old son. She is subject to the Student Eligibility Test for Food Assistance. Laura is an Eligible Adult (EA) for Food Assistance because she is responsible for the care of a dependent SFU member under age 6. Answer “Y” to the Half Care question. Laura, age 33, attends UCF full time. She lives with her husband and 7 year old son. She is subject to the Student Eligibility Test for Food Assistance but does not meet any of the criteria. Laura is an Excluded Adult (XA) for Food Stamps. Answer “N” to the Half Care question. Laura’s is an Excluded Adult (XA). Her needs, income, and assets are excluded from Food Stamp eligibility. Laura is an Eligible Adult (EA) for Food Stamps. Her needs, income, and assets are counted in the Food Stamp eligibility. 26 System / Policy Reminders AIAF Armed Forces 1. AIAF is used for recording purposes only. Document CLRC with complete information, such as branch of service, service number and dates served. 2. In the 1970’s, the military switched to SSN’s as the service number. AIAF is used to collect and display information about military service. 27 AIDP Elderly/Incap/Disabled Important Fields IS INDIV ABLE TO PURCHASE AND PREPARE MEALS?: An “N” answer will build a separate Food Assistance AG per 165% Elderly And Disabled Test policy. See Policy Manual 2210.0308 Elderly and Disabled Individuals Living with Others (FS). FS DISAB?: Answer “Y” if the individual meets Food Assistance disability criteria to uncap the shelter costs and allow excess medical expenses if disabled. HAS DISABILITY ALREADY BEEN ESTABLISHED?: Enter “Y” if already approved or receiving disability from SSA or ODD, etc. VR, SOURCE OF DISAB DET.?: Enter the source, such as SSI or SSA. See SRC Disability Determination Table TSDD. DISAB INTERV: Enter “Y” to start the DSUM Disability Driver. INCAP/DISAB CNFM/DENY RSN: CM = INCAP/DIS CRITERIA MET, CN = INCAP/DIS CRITERIA NOT MET, MI = MEDICAL INFORMATION INSUFFICIENT ND = NO DECISION A/B/D/I/E INDICATOR?: D = Disabled, I = Incapacitated, B = Blind, A = Aged, E = Elderly System / Policy Reminders 1. AIDP is used for entering disability information. The Disability Determination driver starts here. Example: Robert has received Social Security Disability since 2005. 2. Disability is based on Social Security criteria. Verification is required. AIDP is used to collect and display information for elderly, aged, blind, disabled and incapacitated individuals. 3. FLORIDA knows an individual is elderly or aged based on the AIID Date Of Birth field. 4. Incapacity is limited to building ADCI / MAI coverage groups for TCA and Medicaid. It may impact Family Cap policy. 28 AIMC Individual Misc. Con’t Important Fields OUT U.S. LAST 30 DAYS: Enter “N”. This MSSI policy is obsolete as of April 2011. AGED OUT FC (AGED OUT OF FOSTER CARE): Enter “Y” if the individual was verified through Florida Safe Network (FSFN) system to be a child under age 26 who aged out of foster care in the state of Florida. If the individual cannot be verified, enter “N”. Once verified, and a “Y” is entered, the field is protected during redetermination. Enter “?” for pending. If the case is a Child In Care (CIC), the field is pre-populated with "C" and protected. REQ MA: Enter “Y” if the individual is applying for Medicaid. MEDICARE ELIG: Enter “Y” if the individual receives Medicare. Medicare is federal health insurance. A qualified individual must be age 65 or receiving Social Security Disability for 2 years with certain exceptions. Medicare recipients cannot receive MMS Medicaid, only NS Share Of Cost. AVS R (ASSET VERIFICATION SYSTEM RELEASE): Indicates whether the individual has signed the financial release. "?" = Pending for financial release “Y" = Financial release returned "N" = Financial release not returned "D" = Deferred AVS P (ASSET VERIFICATION SYSTEM RELEASE): Indicates whether the individual’s financial information has been processed and returned by the AVS. "?" = Pending for verification of assets from AVS; "Y" = information received and processed; "D" = deferred. AIMC is used to collect and display miscellaneous information for each individual in the household related to MSSI Related Medicaid, Medicare, Asset Verification System (AVS), or former foster child who aged in the state of Florida. TERM ILL, HOSP ELEC. STMT, ESRD, WAIVER TYP, EVAL GRP: These fields are used to build coverage for MSSI programs such as nursing home, hospice, waivers, etc. For MSSI Related Medicaid (not applicable for Medicare Buy In coverage groups), be sure to follow Asset Verification System policy requirements. 29 System / Policy Reminders 1. The Medicare Buy In coverage groups QMB, SLMB, QI1 pay for the individual’s Medicare Part B premium, if eligible. QMB covers Medicare deductibles and co pays as well. Retroactive coverage may be requested for SLMB or QI1 but not QMB. 2. Certain SSI recipients may receive Medicare. It is not necessary to open QMB because the Medicare premium is already covered. 3. AVS applies to SSI-Related Medicaid only except Medicare Savings Program (MSP) coverage groups QMB, SLMB, QI1. See memo I-13-01-0001 Asset Verification System (SSI-Related Medicaid only) http://eww.dcf.state.fl.us/~ess/policysearch/i13010001.pdf 30 Important Fields AIMM Medicare Information MEDICARE #: Enter the individual’s Medicare claim # from SOLQ or DEBB Bendex. Do not use any spaces, dashes or slashes. The claim # may belong to a spouse or parent. WHO IS PAYING THE PART A PREM?: Part A may be free (FR). See Premium Paid By Table TPPB. WHO IS PAYING THE PART B PREM?: See Premium Paid By Table TPPB. System / Policy Reminders 1. Check State Online Query (SOLQ or DES0) for the individual’s Medicare information. 2. See Policy Manual Appendix A-9 SSI Income Limits for QMB, SLMB, and QI1: http://eww.dcf.state.fl.us/~ess/policy/manual/a_09.pdf 3. Check the income and asset limit chart to determine if the individual or couple qualify for one of the Medicare Buy In coverage groups. If they qualify, enter “ST” State To Pay in the Medicare Part B field. If they do not qualify, enter “SE” Paid By Self or another code to use the premiums as an as an excess medical expense for Food Assistance or as a Medically Needy SOC deduction. 4. The following information will be sent to FLMMIS: Medicare Number, Medicare Part A and/or Medicare Part B, Coverage Begin/End Dates for Medicare Part A and/or Part B, Premium Paid By for Medicare Part A and/or Part B. Example: Robert receives $1150 Social Security Disability and Medicare. His Medicare Part A is free but his Part B costs $96.40 monthly. If he qualifies for any of the Medicare Buy In coverage groups (QMB, SLMB or QI1), the state of Florida will pay for his Part B premium. AIMM is used to collect and display information about Medicare coverage for individuals in a household. 31 Important Fields AIHH Household Relationships TARGET INDIVIDUAL: System displayed. FILING TAXES: Enter "Y" if the target individual intends to file federal taxes. Required entry if Medicaid case. FILING JOINTLY: Enter "Y" if the target individual intends to file federal taxes jointly with spouse who lives in the household. Required entry for married couples and if Medicaid case. OOTH INDIVIDUALS: Enter "Y" if the targeted individual claims any tax dependents that live outside of the household to prompt the AIOH Out Of The Household screen. RELAT: Enter the code to indicate the individual's relationship to the targeted individual. See Relationship Code Table TREL. VR: The customer’s statement is accepted as verification unless questionable. P+P?: Answer to “Y” to indicate the individual purchases and prepares food with the target individual. Enter “Y” for mandatory SFU members. For optional members, answer “Y” or “N” to build the correct Food Assistance SFU. CARETAKER: Enter "Y" if the individual is the caretaker relative (other than a parent) of the targeted individual. If the individual is not related to the targeted individual, enter "Y" for the caretaker of a child living with non-relatives. See Caretaker Values Table TCTV. Example: Samuel is the Target Individual. He files taxes, is not filing jointly, and is not claiming any tax dependents outside of the household. Michael is Samuel’s son. Michael is dependent (Food Assistance purposes) and tax dependent (Family Medicaid) on his father. DEP: Enter “Y” if the individual is dependent (mandatory SFU member) on the target individual for Food Assistance purposes. TAX DEP: Enter “Y” if the individual is claimed as a tax dependent by the target individual Family Medicaid purposes. This field can impact the Family Medicaid budgets. AIHH is used to collect and display relationships, caretaker, and tax dependent information for each individual in the household. 32 System / Policy Reminders 1. FLORIDA creates one AIHH screen per individual if there are 2 persons or more in the case or when Family Medicaid is selected. 2. Use the expected tax information for the household. Minor children or adult children under age 22 are considered to be dependent on both parents. Spouses are dependent on each other. Do not code a parent as caretaker of their own children. 3. If the biological father is not the legal father, a non-judicial determination of paternity must be completed. 33 Tax Dependent AIHH Household Relationships Helpsheet Tax dependent is used for Family Track Medicaid to determine the number of individuals counted in the Family Medicaid SFU. See Relationship Code Table TREL. OTR (Other) = A relative within the degree of relationship for TCA and Family Track Medicaid but doesn’t meet any other code like first cousin once removed or biological father when a legal father exists. The relative is potentially TCA/Medicaid eligible based on this child. FRD (Friend) = A relative or non-relative outside the degree of relationship for TCA and Family Track Medicaid. The non-relative is not TCA/Medicaid eligible based on this child. NJG/NJB (Non-Judicial Girlfriend/Boyfriend) = The unmarried parents of a child or unborn child where paternity is not an issue. (The NJB admits he is the father of the child or unborn child.) EXG/EXB (Expectant Girlfriend/Boyfriend) = The unmarried parents of an unborn child where paternity is an issue. (The NJB denies he is the father of the unborn child.) This code is not commonly used. Caretaker For specified relative situations (including OTR), answer Y to caretaker to build TCA and Medicaid. For non-relative situations (FRD), answer Y to caretaker to build Medicaid. The child will be the target individual with the specified relative or non-relative listed below. A parent is never the caretaker of their own child. Dependent Dependent indicates if the individual is a mandatory Food Stamp SFU member. Spouses are dependent on each other. Children (under age 22) are dependent on both parents. 34 Example: AIHH Specified Relative Example: AIHH Specified Relative (OTR) Example: William applied for TCA and Medicaid for his niece and nephew. As the paternal uncle of the children, he meets the definition of a specified relative. They are potentially eligible for TCA and Medicaid. Example: Ted applied for TCA and Medicaid for his wife’s first cousins once removed. As the spouse of a blood relative with five degrees of kinship to the children, he meets the definition of a specified relative. They are potentially eligible for TCA and Medicaid. Williams is coded as “UNC” to the children. Answer “Y” to caretaker when the child is the target individual. Ted is coded as “OTR” to the children. Answer “Y” to caretaker when the child is the target individual. 35 Example: AIHH Child Living with Non-Relative (FRD) Example: AIHH Nonjudicial Boyfriend and Girlfriend (NJB/NJG) Example: Debra applied for benefits for her 2nd cousin Steven. As a 2nd cousin, she is outside five degrees of kinship to the child and does not meet the definition of a specified relative. They are not eligible for TCA but she can receive Medicaid for a child living with a non-relative for Steven only. Example: Donna applied for benefits for her herself, her boyfriend Eric, and their son. Donna and Eric are not married. Eric is the father of the child. They are potentially eligible for TCA and Medicaid. Eric is coded “NJB” Non-Judicial Boyfriend to Donna. He is a mandatory member of the SFU. Debra is coded as “OTR” to Steven. Answer “Y” to Caretaker to build Medicaid for a child living with a non-relative. 36 Important Fields AIOH Household Relationships TAX DEPENDENT’S EARNED INCOME: Enter the dependent’s taxable earned income, if any. The earned income of a child may not be taxable. Do not enter excluded earned income. Use monthly amounts. TAX DEPENDENT’S UNEARNED INCOME: Enter the dependent’s taxable unearned income, if any. Do not enter excluded unearned income such as child support. Use monthly amounts only. PREG: Enter "Y" if the tax dependent is pregnant. UNBRN CT: If the tax dependent is pregnant, enter the number of unborn. System / Policy Reminders 1. Enter monthly amounts only. Do not list excluded income. 2. The Family Medicaid SFU and income limit will be increased by the number of OOTH individuals and unborn listed on the AIOH screen. Example: Angela files taxes and claims her son Jonathan as a tax dependent. She also claims her daughter Jenny who lives outside of the home (OOTH) as a tax dependent. Jenny receives Social Security sruvivor’s benefits $175 which is taxable income. AIOH is used to collect and display information for tax dependents who are outside of the household. 37 Important Fields AIAP Absent Parent General ABSENT NAME: Enter the name of the absent parent. SSN: If the absent parent’s SSN is unknown, a pseudo SSN starting with “99” is assigned. ABSENCE REASON: Deprivation reason. See Absence Reason Code Table TABR. Code “DT” Parent Deceased requires confirmation since it closes the CSE case. GOOD CAUSE: The individual is claiming or approved for good cause not to cooperate with CSE. They are still referred to and must upfront cooperate with CSE. Do not contact the absent parent REFERRING LINE NUMBER: Enter the Custodial Parent’s member #. CO-OP: Enter “Y” if the CP provided is cooperative and provided NCP information: first name, last name, race, sex, date of birth, and/or SSN. Enter “U” if the CP provided is cooperative but does not have the needed information or if uncooperative. See policy concerning upfront CSE cooperation. NBR: Enter the child’s member #. P: Enter “Y” if paternity is an issue, such as if the parents were not married or the father did not sign the birth certificate. Answer “N” on the mother’s screen. System / Policy Reminders 1. Be sure to enter children on the correct AIAP screen. Look for “01 of 02” etc. in the lower right hand corner to see if more AIAP screens are found. If AIHH or other screens are not correctly coded, AIAP is also incorrect. Example: Samuel’s is divorced from his ex-wife Mary Jones. AIAP is used to collect and display absent parent demographic data, address, and other information. AIAP screens are not completed for a pregnant woman without any other children or intact families. 2. Only one AIAP screen is completed for the child’s mother. More than AIAP screen may be completed for the child’s father. Press PF16 to bring up a blank screen. Do not create a new AIAP screen if adding a child to the same absent parent. For the child of a teen parent, the Referring Individual is the teen parent. 38 System / Policy Reminders AIAE Absent Parent Employment Absent parent employment and insurance information may be entered here. AIAE is used to collect and display absent parent employment and insurance information. 39 Important Fields AIAC Absent Parent Court Order DATE OF LAST PAYMENT, AMOUNT OF LAST PAYMENT: Display Only. This field shows the date of the last child support payment if paid through the state of Florida Department of Revenue. Check IICM, FMCH, or FMCS to see if the income should be budgeted. COMMENTS: Do not make any entry in this field. System / Policy Reminders 1. Do not make any entries on this screen. The screen may be protected. 2. If needed, use QUPC Potential Changes screen to send information to Child Support Enforcement (CSE). AIAC is a display only screen that shows absent parent court order, date of last payment, and amount of last payment information. 40 Important Fields AFMQ Medical Expense/Insurance Questions FIRST QUESTION: This question goes to the AFME Medical Expenses screen. Answer “Y” if the customer is elderly or disabled and reports excess medical expenses. Answer “Y” if retroactive Medicaid is requested for any of the 3 months prior to the month of application. Make sure the expense is Medicaid reimbursable. Remember to enter actual income and assets for any retroactive Medicaid months. SECOND QUESTION: This question goes to the AFMD Medical Insurance Coverage screen. Answer “Y” if the customer reports any other insurance or coverage except Medicare. Other third party liability (TPL) coverage may include health care insurance, supplemental policies, or medical coverage provided by the NCP. System / Policy Reminders For the Part B Medicare Buy In coverage groups SLMB and QI1, retroactive coverage may be requested. QMB is not included because deductibles and co pays are covered. If the customer qualifies for SLMB or QI1 in any of the 3 retro months, they will be reimbursed. If not covered, Medicare Part B premiums paid in the 3 months prior to date of application may be used for billing and tracking or as an excess medical expense for Food Assistance. AFMQ is used to collect medical expenses and insurance coverage information for the household. 41 Important Fields AFME Medical Expense TYPE: See Medical Expense Type Codes TMEE Table. TOTAL BILLED: Enter the billed amount. SERVICE DATE: Enter the date of service. RECURRING MA FS: Enter “Y” if this is a recurring monthly expense for Medicaid or Food Assistance. SOURCE PROVIDER: Enter the provider name. VR: For Food Assistance, verify excess medical expenses at application. For recertifications or changes, verify if new source or an increase of $25 or more. Exception: For Food Assistance Elderly/Disabled applications, “RC” may be used as verification for excess medical expenses. System / Policy Reminders 1. Complete AFME to create retroactive months for Medicaid budget, enter allowable medical expenses for Medically Needy billing and tracking or budget Food Assistance Excess Medical expenses for elderly or disabled individuals. 2. There are several ways to budget Food Assistance excess medical expenses. See Policy Manual for the following passages: Example: In April, Samuel applies for retroactive Medicaid for his son’s hospital bill from February. AFME is completed to build Medicaid coverage for February as part of the ASIA driver. A passing date is not required. 2410.0357 Normally Recurring Medical Expenses (FS) 2410.0358 Fluctuating Medical Expenses (FS) AFME is used to collect and display information about past or current, paid or unpaid, one-time or recurring medical expenses for individuals in the SFU. 2410.0360 One-Time Medical Expense (FS) 42 Example: AFME Food Assistance Recurring Medical Expense Example: AFME Food Assistance One Time Medical Expense Example: Robert (age 55) pays $62.50 a month for a drug supplies that are not covered by Medicare. The drug supplies are entered as a monthly recurring expense in his Food Stamp budget. After $35 is deducted, $27.50 is allowed as an Excess Medical Expense. The deduction continues throughout the 12 month entitlement period. Example: Robert (age 55) paid $300 for a new pair of eyeglasses on April 15th. The expense was not covered by Medicare. Instead of prorating the bill over his 12 month entitlement period, the bill is entered as a onetime expense for April. After $35 is deducted, $265 is allowed as an Excess Medical Expense for the month of April only. Robert’s Food Assistance benefits increased to $194 for the month of April. Beginning with May and for the rest of the entitlement period, his recurring Food Assistance benefits are $75. 43 Important Fields AFMD Medical Insurance Coverage EMPLOYER PROVIDED: Enter "Y" if there is employer provided medical insurance for the policy owner. If yes, information is collected on the AFEM Employer Health Insurance Details screen. PREMIUM: The monthly insurance premium which is deducted prior to the net SOC amount counted. This amount may be counted as a Food Assistance excess medical expense for an elderly or disabled individual. INSURANCE COMPANY: To search, enter # in first space of the Insurance Company Name field. See Insurance Company Table TCCA. CARRIER CODE: To search for an insurance provider carrier code, enter # in first space of the Carrier Code field. See Carrier Code Table TCCN. System / Policy Reminders 1. Generally, an individual with private medical insurance can be Medicaid eligible and may receive Medicaid services not covered by private medical insurance. 2. Medicare information is entered on the AIMM Medicare Coverage screen. 3. If AFMD is deleted, the related AFMC screen is also deleted. Example: Henry reports medical insurance coverage through his employer. AFMD is used to collect and display information about private medical insurance policies for the household. Additional information on covered individuals under each policy is entered on AFMC Medical Insurance Coverage screen. 44 Important Fields AFMC Medical Insurance Coverage NUMBER: Enter the individual’s list #. REL: See 3rd Party Relationship Table TMCR. A B 1 2 3 4 5 8 9 Legal Guardian HRS Child Spouse Grandparent/Brother/Sister/Uncle/Aunt Self Guarded Individual Other Parent VR: Enter 1 in this field unless already verified by the Third Party Liability (TPL) unit. System / Policy Reminders 1. Generally, an individual with private medical insurance can be Medicaid eligible and may receive Medicaid services not covered by private medical insurance. 2. Medicare information is entered on the AIMM Medicare Coverage screen. 3. If AFMD is deleted, the related AFMC screen is also deleted. Example: Both Samuel and his son are covered under his medical insurance. AFMC is used to collect and display information about individuals who are covered by a medical insurance policy entered on the AFMD Medical Insurance Policy screen. 45 Important Fields ASEQ SSI Eligibility Questions FIRST QUESTION: This question goes to the ASEV SSI Eligibility Verification screen. Answer “Y” if the individual receives SSI. If the individual has applied for but has not yet received SSI, answer N to the first question. Instead, complete AFIQ Unearned Income Questions and AFBA Benefits Applied For. SECOND QUESTION: This question goes to the ASPV Protected MA Eligibility Verification screen. Answer "Y" if the individual is meets specific criteria and is entitled to receive protected Medicaid coverage. System / Policy Reminders 1. An SSI recipient may become overincome for SSI when Social Security disability income is approved. An exparte is required. 2. Children who have lost SSI disability due to the change in the definition of childhood disability are eligible for Medicaid. To build this coverage, see Workaround # 91: http://eww.dcf.state.fl.us/~ess/florida/workaroundguide.pdf Example: Bruce is an SSI recipient. Answer “Y” to the first question to go to the ASEV SSI Eligibility Verification screen. ASEQ is used to collect Supplemental Security Income (SSI) eligibility information of individuals in the SFU for the purposes of determining protective Medicaid eligibility. 46 Important Fields ASEV SSI Eligibility Verification SSI APPLICATION DATE, SSI ELIGIBILITY BEGIN DATE, BEGIN MMCCYY: Complete all 3 fields for active SSI recipients. An SSI recipient is an Excluded Adult (XA) or Excluded Child (XC) for TCA and Medicaid coverage groups. SSI ELIGIBILITY END DATE, END MMCCYY: Complete both fields when SSI ends. RETROACTIVE MEDICAID: SSI applicants may request retroactive Medicaid for any of the 3 months prior to the month of application even if SSI was denied. An SSI application is also an application for Medicaid. The Begin MMCCYY field determines the three months of retroactive Medicaid coverage. If the individual applies for retroactive Medicaid and all factors of eligibility for the retroactive months have been explored, answer Y to build MS. System / Policy Reminders 1. FLORIDA builds MS C as the Medicaid coverage group for an SSI recipient if ASEV is filled out correctly. MS C is non-functional and always denied on AWAA with reason code 255. 2. An SSI recipient may become overincome for SSI when Social Security disability income is approved. A Medicaid exparte is required. 3. An SSI recipient may receive SSI, Social Security income or Medicare. Generally, it is not necessary to open Medicare Buy In coverage groups (QMB, SLMB, and QI1) for an SSI recipient. Example: Bruce is an SSI recipient. The SSI Application Date, SSI Eligibility Begin Date, and Begin MMCCYY fields are completed. He is an Excluded Adult for TCA and Family Medicaid. 4. SSI benefits are included as income for Food Assistance. ASEV is used to collect and display information about verification of SSI certification and eligibility begin / end dates for current and former SSI recipients. The screen may be redisplayed when AFMI unearned income type SI (SSI) is entered for the first time. 5. The ASEC driver is used to create or add months of Medicaid coverage for an eligible SSI recipient. When the ASEC driver is completed, the ASEV End Month field is auto updated in the ongoing case and must be removed. 6. The State Online Query System (SOLQ) or DESD State Data Exchange screens are used as verification of SSI. No further verification is required. 47 System / Policy Reminders ASPV Protected MA Eligibility Verification 1. When ASPV is completed, FLORIDA may build the following protected Medicaid coverage groups: MT C, MT A, MT W, MT S, or MT D. 2. MT D is the most common AG and relates to individuals who were receiving SSI as a child and lose SSI due to receipt of or an increase in SSA benefits as a result of a change in circumstance of their parent(s) such as death or an increase in benefits. 3. MT C is for individuals who received SSI and SSA at the same time, and the SSI benefit was terminated due to an SSA cost of living adjustment (COLA). 4. MT A was originally created for a group of widows who lost benefits, but is now used to cover children who lost SSI when the childhood definition of disability changed in 1996. 5. Individual can only be eligible for protected Medicaid coverage under MT W or MT S (widows/Widowers II and III) if they are not entitled to Medicare Part A. If MT S or MT W passes and client is entitled to Medicare Part A, worker must deny on AWAA. System passes even if AIMM completed. ASPV is used to collect and display SSI and SSA eligibility verification data for protected medical assistance. 48 ARDT Welfare Reform Data Tracking Important Fields TCA TME LMT: For each TCA time limited parents or specified relative only, answer Y to go to the ARCA TCA Time Limits screen. If both parents are time limited, enter Y for each parent. For children, leave blank. FS TME LMT: For each time limited Able Bodied Adult Without Dependents (ABAWD), answer Y to go to the ARFS Food Assistance Time Limit screen. Note: Food Assistance ABAWD Time Limits are currently waived. Do not complete ARFS at this time. FSET services are currently available on a voluntary basis statewide to work registrants ages 16 through 39. 40 DE RQ: Answer Y to request SSA employment history to determine if the individual can be credited with 40 quarters of wage credits for Food Assistance noncitizen criteria. FAMILY CAP: Enter F = Full, H = Half; N = None to show if the children are capped for TCA. This field is completed for all children born after 5/31/97 even if they are not receiving TCA. FAMILY CAP RSN: The TFCE table codes are used to show if the capped child meets a policy exception. Certain codes are temporary. IMMZ REQ MET: Enter Y = Yes, N = No (does not meet requirements), C = Complete, or E = Exempt to show if TCA children under age 5 meet immunization requirements. An N entry will make the child technically ineligible (Financial Child) for TCA. Example: Ruth applies for Food Assistance, TCA, and Medicaid. For TCA, Ruth is subject to time limits. For TCA, her 3 year old daughter is an F (Full) child and meets TCA immunization requirements. DTE NXT IMMZ DUE: Enter the date the next immunizations are due. ARDT is used to collect, display, and maintain welfare reform data for the household. IMZ VR: Enter verification used for immunization (IR = immunization Record). System / Policy Reminders TCA Time Limits, Family Cap, and Immunizations do not apply to Food Assistance or Medicaid. FS Time Limits do not apply to TCA or Medicaid. 49 Important Fields ARCA Welfare Reform Cash Data TIME LIMITED: Do not use 24/60 or 36/72 fields. Instead, type 48/48 in the OTHER field for the number of months. PERIOD BEGIN MONTH: The first month to be counted for time limited benefits. Prorated months, such as the first month of TCA benefits, are not counted. REGULAR MONTHS: Enter the # of TCA time limited months received to date. SANCTION MONTHS: Enter the # of TCA time limited months received for children under age 16 while under a TCA work sanction. FTP MONTHS: Enter the # of months received under the Family Transition Program (FTP) Only counties in the FTP project should make entries in this field. EXTENSION MONTHS: This is the # of months of TCA received due to an extension for earned income months, pending SSI/SSDI application, or hardship given by the RWB. THRU PAYMENT MONTH: Enter the last month included in the time limits calculation. MONTHS RECEIVED IN ANOTHER STATE: Enter the number of months received in another state. This amount is included in the lifetime total. System / Policy Reminders Example: Ruth is a time limited TCA recipient. She has used 22 months (4 from another state and 18 in Florida) of her 48 month lifetime limit. ARCA is updated at each recertification. 1. Florida uses a 48 month lifetime limit. Certain households are exempt from TCA time limits. Benefits received in other states count towards the 48 month time limit. ARCA is used to collect, display and maintain information for each TCA time limited adult in the household. 2. For all TCA time limited adults, enter ARCA at application. Update ARCA at each complete eligibility review. Use the IQCH Cash History screen to determine the number of TCA time limited months. 50 System / Policy Reminders ARFS Welfare Reform Food Stamp Data Food Assistance ABAWD time limits are currently waived. Do not complete ARFS at this time. FSET services are currently available on a voluntary basis statewide to work registrants ages 16 through 39. ARFS is used to collect, display and maintain Food Assistance time limit information for Able Bodied Adults Without Dependents (ABAWD). 51 Important Fields AAAQ Asset Questions VEHICLES: Vehicles include cars, truck, motorcycles, boats, campers, recreational vehicles, jet skis, ATVs, and aircraft. IR IRA, KE KEOGH: Individual Retirement Account (IRA) and Keogh are excluded as an asset for all programs until they become available. Keogh is similar to an Individual Retirement Account for a self employed individual. REAL PROPERTY: Real property includes home, rental property, condominium, vacation home, vacant land, holding a mortgage or property listed for sale. System / Policy Reminders 1. The assets of each SFU member, including children, must be reviewed. 2. Assets can include cash, checking account, savings account, credit union account, certificate of deposit, savings bonds, stock, mutual funds, trust funds, burial contracts, etc. 3. Food Assistance Broad Based and Categorically Eligible households are not subject to any asset limit but continue to enter all assets reported on the web application. See memo Food Assistance Broad Based P-10-06-0009 http://eww.dcf.state.fl.us/~ess/policysearch/p10060009.pdf. Example: On the Web Application, Sam reports his 2000 Chevrolet S10 pickup truck, savings account, checking account, home, life insurance policy, and self employment business assets. 4. Other Food Assistance households, TCA, and most Medicaid coverage groups have an asset limit which varies by program. 5. Life insurance and business assets are counted for TCA and Medicaid but not Food Assistance. AAAQ is used to collect asset information for the household. A “Y” answer will bring up detail screens to collect additional information. 52 Important Fields AAVH Vehicle Assets TYPE: Vehicles include cars, trucks, motorcycles, boats, motor homes, recreational vehicles, and airplanes. See Motor Vehicle Type Codes Table TMVT. USAGE CODE: For TCA and Medicaid, usage codes (HA, ET, IP, HT, OT, etc.) determine if the licensed vehicle is excluded (HA) or if the $8500 exclusion can be applied. See Table TMVE. If the vehicle is used as the individual’s home, enter this information on the AARP Real Property screen instead of AAVH. VEHICLE ID NUMBER: This information is often unknown. Do not pend. MAKE: This is the vehicle’s manufacturer. See Table TVMK. Domestic trucks must be entered as “FORD TRUCK” or “DODGE TRUCK”. Chevrolet cannot be shortened to Chevy. Motorcycles, recreational vehicles, custom car and vehicles more than 20 years old are entered as OTHER or CUSTOM CAR. The market value is obtained from other sources. MODEL: This field is selected from the AANA Online NADA Valuation screen. MARKET VALUE: System updated from AANA along with “ON” VR field. AMOUNT OWED: This amount is deducted from the market value to calculate the vehicle’s equity value. System / Policy Reminders 1. For Food Assistance, all vehicles are excluded but continue to enter all assets reported on the web application. For other programs, vehicle policy varies. Example: Sam’s vehicle is excluded for Food Assistance but included for TCA and Medicaid. 2. Complete an AAVH screen for each member of the case who is a joint owner. Press PF16 (shift + F4) to get a new screen. If the vehicle is jointly owned, enter “Y” in Joint Owner. Use code 99 if the owner is not listed in the same case. AAVH is used to collect and display vehicle asset information for the SFU. 3. Leased vehicles are not counted since they are not owned by the customer. 4. NADA values vary depending on the vehicle body style. If the SFU is failing due to the asset value of the vehicle, they can provide a dealer’s assessment (DA). See Policy Manual 1620.0590. 53 System / Policy Reminders AANA Vehicle Model Selection 1. If you cannot find the correct model, especially for a domestic truck or SUV, go back and insert the word “truck” in the AAVH Make field. Cars and trucks are often listed in separate tables. 2. The AANA tables only cover cars up to twenty years old and trucks up to ten years old. Motorcycles, boats, custom cars, and RVs are not listed here. Other sources (dealers, newspaper) are used to determine the value of these vehicle types. 3. To access AANA for inquiry purposes, type AANA in NEXT TRAN and the vehicle make/year in PARMS. From AANA, select the Body Style. The AANA screen with the vehicle value is now displayed. Press enter to the menu. Example: To find Samuel’s S10 pickup truck, the specialist entered “Chevrolet Truck” in the AAVH Make field. AANA Vehicle Model (1 of 2 screens) shows the vehicle model prompted by an entry in the MAKE field on AAVH. Once a selection is made, the AANA Vehicle Body Selection screen is next. 54 System / Policy Reminders AANA Vehicle Body Style Selection 1. NADA values may vary depending on the vehicle body style. Clarification concerning this information may be required if the AG is over the asset limit due to the vehicle value. If the SFU is failing due to the asset value of the vehicle, they can provide a dealer’s assessment (DA). See Policy Manual 1620.0590 Increases/Decreases to Value (TCA) and 1630.0590 Increases/Decreases to Value (MFAM). 2. When running ASRE, pay attention to the Make, Model, and Body Style already listed before continuing to the AANA screens. Example: The Model and Body Style values can vary. AANA Vehicle Body Style Selection (2 of 2 screens) shows the vehicle body style prompted by the vehicle model selection. Once a selection is made, the system returns to AAVH and updates the vehicle value field with the NADA value and “ON” in the verification field. 55 Important Fields AALA Liquid Assets TYPE: See Liquid Assets Codes Table TLQA. ACCOUNT NBR: If the # doesn’t fit, document CLRC. TOTAL AMOUNT: Whole dollars and cents are used with a decimal. VR: “RC” is accepted unless questionable or within $100/asset limit (if limit applies). J, %, WITH, VR: For joint bank accounts or other assets, one line is needed for each owner listed in the case. Enter information for the 1st owner only: FLORIDA automatically completes information for the 2nd or other owner when enter is pressed if the individual is listed in the case. If not listed in the case and applicant/recipient of TCA, SSI, or Medicaid (including share of cost), type 98 in the WITH field. For TCA and Medicaid, the asset is split between the joint owners. If not listed in the case and not an applicant/recipient of TCA, SSI, or Medicaid (including share of cost), type 99 in the WITH field. For TCA and Medicaid, the asset is counted in full for each joint owner. Rebuttal of ownership is allowed. BURIAL, VR: Most asset screens include a Burial field. For MSSI Medicaid, an individual and the individual's spouse may set aside funds of up to $2,500 each for burial expenses. These funds are excluded as assets as long as the individual shows that they are clearly designated as being set aside for burial. Under this policy, the Burial field is completed to exclude up to $2500 of the asset’s value. System / Policy Reminders Example: Samuel owns a joint savings account with his sister Clara. Because she is an SSI recipient, enter “98” in the WITH field to split the asset value for TCA and Family Medicaid. 1. AALA does not display the complete name of the financial institution and account #. Document CLRC with this information. AALA is used to collect and display information about the household’s liquid assets. 2. For Food Assistance, joint bank accounts set up as “or” are considered entirely available to the customer unless it is a convenience account. 3. For Unavailable assets, enter N in the AV field. 4. For assets no longer owned, complete the END MMCCY field. 56 Important Fields AARP Real / Personal Property Assets TYPE: See Real Property Type Table TROP. EXEMPT: See Exempt Property Table TEXM. MARKET VALUE: Use the county tax assessed value. System / Policy Reminders 1. Enter all property including home, rental property, vacant land, or holding a mortgage. 2. Unless excluded, the property’s equity value is counted. To determine the property’s equity value, use the county tax assessed value minus any indebtedness. For Food Assistance, the county tax assessed value is accepted as the fair market value. 3. Improved property includes a structure. Unimproved property does not. 4. An individual’s home (as a principle place of residence) is excluded for all programs (except MSSI Long Term Care). 5. For Food Assistance, income producing property consistent with its fair market value is excluded. Example: Samuel’s home is excluded as an asset for Food Assistance, TCA and Family Medicaid. AARP is used to collect and display information about the household’s real or personal property. 57 Important Fields AARC Real / Personal Property Assets Continued INCOME AMT, VR, EXPENSES, VR: Enter rental property income and expenses. Deductions allowed from rental property income vary by program. SELF MANAGE, HRS/MONTH: Determines if rental property income is earned or unearned. System / Policy Reminders 1. The member # and type of property type from AARP is shown at the top of the screen. 2. For Food Assistance, income from rental property is earned if the individual manages the property at least 20 hours a week. For TCA and Medicaid, income from rental property is earned if the individual manages the property. 3. For Food Assistance, TCA, and Medicaid, real property listed for sale at fair market value is excluded. For TCA and Medicaid, the real property agreement must be signed. Example: AARC is a continuation of information about Samuel’s home. AARC is used to collect and display additional information about the household’s real or personal property entered on AARP. 58 System / Policy Reminders AALI Life Insurance Assets 1. For Food Assistance, life insurance is excluded. 2. For TCA and Medicaid, the cash value of any life insurance policies is included. Generally, universal or whole life insurance policies may accrue cash value while term or group life insurance policies do not have any cash value. 3. For MSSI, the cash value of the life insurance policies is included when the total face value of all life insurance policies on an eligible individual or an eligible/ineligible spouse whose assets are deemed to the eligible individual exceed $2,500. 4. For the insurance policy to be considered as available, the policy owner and insured must be part of the same SFU/AG. 5. The face value of the policy is not the cash value. 6. The customer may have a loan against the cash value. The loan is deducted from the cash value until repaid. Example: Samuel owns a whole life insurance policy with a cash value of $321.50 - $50 loan = $271.50. He also has a term life insurance policy with no cash value. AALI is used to collect and display information about the SFU’s life insurance policies. 59 System / Policy Reminders AALS Lump Sum 1. AALS is used for SSI-Related Medicaid only. Lump Sum policy varies by program and asset type. 2. For Food Assistance, lump sums are asset in the month of receipt. (For Food Assistance Broad Based and Categorically Eligible SFUs, assets are not applicable.) 3. For MSSI programs, lump sums are income it the month of receipt, except SSI. SSI is considered income for the months it is intended to cover (limited to OSS). 4. For MSSI programs, lump sums are assets in the month following month of receipt. 5. For MSSI programs, lump sum SSI, Social Security, Earned Income Tax Credit and Child Tax Credit payments are excluded for nine consecutive calendar months following the month of receipt or until funds are spent, whichever occurs first. This exclusion applies only to the extent that funds are kept separate and identifiable from other assets. 6. AALS amounts do not appear in the asset budget. Enter the lump sum asset on AALA including excluded assets coded as unavailable. Enter counted lump sum income on AFMI as income in the month of receipt only. 7. For all programs, exclude all federal tax refunds as income and assets in the month of receipt, regardless of whether the refund is a refundable tax credit (EITC and Child Tax Credit), an over-withholding (tax refund), or both. Continue to exclude these payments as an asset for 12 months from receipt. This new policy remains in effect until December 31, 2012. Effective January 1, 2013, reinstate the current policy for treatment of these payments. See memo P-11-020002 Exclusion of Federal Tax Refunds and Credits as Income and Assets - All Programs http://eww.dcf.state.fl.us/~ess/policysearch/p11020002.pdf AALS is used to collect and display information about lump sums received or due to be received by an individual in the household along with any deductible expenses. 60 Important Fields AABE Business Assets TYPE: See Business Asset Type Table TBEA which may include equipment, inventory, bank accounts, livestock, etc. System / Policy Reminders 1. For Food Assistance and MSSI Medicaid, business assets are excluded. 2. For TCA and Family Medicaid, business assets are included. 3. The equity value (fair market value minus any indebtedness) is counted as the asset value. Example: Samuel runs a small lawn business with $350 of equipment. AABE is used to collect and display information about the household’s business assets if they are self employed. 61 System / Policy Reminders AAAT Asset Transfer 1. Transfer of asset policy does not apply to Broad Based and categorically eligible Food Assistance SFUs and Family Medicaid. 2. For MSSI Medicaid: a) If there are multiple transfers in the same month, add them together and enter as one transfer. b) If there are multiple transfers over two or more months, the worker must first manually calculate the transfer penalty period for each individual transfer. For months that the penalty periods overlap, add them together manually and enter as one transfer, using the earliest transfer date. For transfers where the penalty periods do not overlap, enter separately on AAAT. c) For jointly owned assets that are transferred, two AAAT screens should be completed, as with other joint assets. It will apply a concurrent penalty period. d) When “AT” (Asset Transfer) is entered on each separate asset screen for each owner, the AAAT screen will be invoked two times. Do not enter “Y” for jointly owned when both owners are in the case. e) The Amount field is for the amount of compensation the individual received for the transfer, not the amount of the transfer. For example, if life estate is retained, the value of the life estate must be entered in the amount field. f) The most common error is entering the transferred amount (goes in "VALUE") in the compensation amount field (identified as "AMOUNT"). AAAT is used to collect and display information on transferred assets by the household. The compensation amount is subtracted from the transferred amount. If you enter the transferred amount in the compensation amount field, it cancels out the transfer. 62 Important Fields AFEQ Employment Questions FIRST QUESTION: This question goes to the AFEI Employment Information screen. Answer “Y” if the individual is working, on strike, had employment or job training in the last 4 months, or refused work or voluntarily quit in the last 60 days. SECOND QUESTION: This question goes to the AFSE Self Employment Screen. Answer “Y” if the individual is self employed or had self employment in the last 4 months. THIRD QUESTION: This question goes to the AFBE Blind Work Expenses screen. Answer “Y” if individual meets specific policy for the Medicaid coverage group Working Disabled (WD). (Generally, most individuals do not qualify for WD.) policy check System / Policy Reminders 1. At application, income verification is required beginning with for the month of application. For retroactive Medicaid, income verification is required for the month requested. Actual income is used. 2. At recertification, income verification is required for any current, new, or terminated employment. Income verification requirements vary by program. 3. Self employment income from rental property or room and board is not entered on AFSE. Example: Samuel works full time for Wal-Mart and operates a small self employment lawn business. AFEQ is used to ask about employment information for individuals in the household. 63 Important Fields AFEI Employment Information (Current Ongoing) BEGIN MMCCYY: Begin budget month END MMCCYY: End budget month. Leave blank if ongoing employment. EMPLOYER CODE: See Employment Type Table TEMP. R = Regular PAY FREQ: B = Bi-Weekly, M = Monthly, Q = Quarterly, T = Twice A Month, W = Weekly. See Pay/Expense Frequency Codes Table TCYC. # OF PAYDAYS: Weekly = 4, Biweekly = 2, Twice a month = 2, Monthly = 1 INCOME TERMINATED: Answer “N” unless the employment has ended. MO AMNTS: The monthly conversion factors vary by programs: HHIP 4.0, Food Assistance/TCA (Cash) 4.3, Family Medicaid 4.0, and MSSI 4.0 based on weekly pay frequency. VR: At application and recertification, income must be verified. For Family Medicaid, “SH” shows income verified by the FDSH. If income is verified for other programs, enter this amount in the Family Medicaid field. Document CLRC. For adverse reported changes, “RC” is used. System / Policy Reminders Example: Samuel works full time for Wal-Mart. His most recent, consecutive 4 weeks of earned income must be verified to determine his eligibility. 1. The most recent, consecutive 4 weeks of income are totaled, averaged, and converted for current and ongoing months. Press PF19 (shift + F7) to go to Income Calculator. The rules for non-representative pays apply. Nonrepresentative pays, which may include a raise, first/partial pay, or significant break in employment, are not used for the calculation. AFEI is used to collect and display employment information or reasons for refusing quitting work for each individual in the household. Remember to “layer” AFEI screens at recertification or when processing reported changes. 2. Use a separate AFEI screen for new or additional employment. Press F16 (shift + F4) for a new screen. 3. Be careful when selecting the individual’s list #. If the parent’s earned income is loaded under a child, the income may be incorrectly excluded. 64 4. The End MMCCYY field is left blank. PF19 Income Calculator is used. The rules for non-representative pays apply. 5. Actual income must be used for a past month, new/terminated employment, or whenever the customer will not receive or anticipate a full month of income. Actual income may be used when all pays for the month have been received. A past month is any month prior to the month of interview or a retroactive Medicaid month. For example, a customer applies for Food Assistance on March 25th. His interview is held on April 5th. Actual income must be budgeted for March. 6. The End MMCCYY field is completed. PF19 Income Calculator is not used. The rules for non-representative pays do not apply. 7. If “N” is entered for to Good Cause, a penalty is applied. 8. Self employment income from babysitting is entered on AFSE. Do not complete AFEI or the Babysitting Days field. 65 Important Fields AFIN Earned Income / Expense Calculator PF19 PAY/EXPENSE DATE: Enter the paydate MMDDCCYY. GROSS INCOME AMOUNT: Enter the gross pay amount including dollars and cents. REP/NON-REP/GUESS: Enter R for representative, N for non-representative. Do not use G for Guess. Non-representative pays, which may include a raise, first/partial pay, or significant break in employment, are not used for the calculation. SCREEN PRINT: Only a “Y” answer allows you to exit the screen. However, do not screen print this page. Instead, document CLRC. PRESS PF19 TO EXIT: Press PF19 to exit and return to AFEI. The calculation is automatically entered into the MO AMNTS field for each program. System / Policy Reminders 1. Check the frequency, # of pays, and begin month. If the information is not correct, press PF19 and go back to AFEI. 2. Use PF19 Income Calculator for current and ongoing months but not for past/actual months. 3. To show how the average is calculated, document the information in CLRC. This screen is not saved in history. Example: Samuel’s last 4 consecutive weeks of income are entered. All his pays are representative. To show how the average is calculated, document the information in CLRC. Copy and paste may be used. 4. The basis for the income average, if less than 4 weeks of income were used, and any non-representative pays must be documented in CLRC. AFIN is used to average and convert earned income based on information from the individual’s AFEI screen. 66 Important Fields AFEI Employment Information (Actual/Past Month) BEGIN MMCCYY: Enter the beginning budget month END MMCCYY: Enter the ending budget month. MO AMTS: Enter or overtype the total actual income for the past/actual month. System / Policy Reminders 1. A past month is any month prior to the month of interview or a retroactive Medicaid month. For example, a customer applies for Food Assistance on March 25th. His interview is held on April 5th. Actual income must be budgeted for March. 2. For a past/actual month, the BEGIN MMCCY and END MMCCYY fields are completed. PF19 Income Calculator is not used. The rules for nonrepresentative pays do not apply. 3. To “layer” income for a past/ actual month, go to the current income screen and update the BEGIN MMCCYY, END MMCCYY, and MO AMTS fields. Press enter. 4. To review the layered AFEI screen, check history as shown below: NEXT TRAN: AFEI__ PARMS: 7000051396//04292011 Example: Samuel requested retroactive Medicaid for November. His actual income is verified and entered into FLORIDA by “layering” November’s information under the existing screen for February. case number, 2 slashes, today’s date MMDDCCYY By layering, FLORIDA places the screens in chronological order, which helps case processing and prevent potential payment errors. Actual income must be used for a past month, such as retro Medicaid, new or terminated employment, or whenever the customer will not receive or anticipate a full month of income. Actual income may be used when all pays for the month have been received. “Layering” is required for AFEI. Do not use a second screen for the same individual, same job. 67 System / Policy Reminders AFEM Employer Provided Health Insurance This information is found on the customer’s application. AFEM is used to collect and display information about employer provided health insurance. On AFMD, a “Y” to the AFMD Employer Provided Insurance field prompts this screen. 68 Important Fields AFSE Self Employment Questions AMOUNT: Enter only monthly amounts. Annual amounts are divided by 12. TYPE: See Self Employment Income and Expense Codes Table TIEX. The codes are divided into income and expense types. The codes vary by program. System / Policy Reminders 1. Self employment policy varies by program. Certain IRS expenses are not allowable. 2. The self employment records needed as verification depend upon the type of self employment business, how long the business has existed, and whether business is up or down. 3. Enter monthly amounts of income and allowable self employment expenses in the AMOUNT and TYPE fields. Self Employment Income and Expense Codes are found under Table TIEX. 4. FLORIDA calculates the countable self employment earnings. To review, enter and return to AFSE. 5. For Food Assistance, TCA and Family Medicaid, depreciation is not allowed as an expense. 6. Dependent care (for the individual’s children), commuting to/from home to work, and social security/withholding taxes for the self employed individual are not allowable expenses. Example: Samuel provided his 2010 tax return to verify his self employment income and expenses for his lawn business. He earned $3600 and spent $1000 for allowable business expenses. The amounts are annualized and entered with the correct code from the TIEX table: $300 IO (Income / All Programs) and $83.33 GO (Gas). His countable self employment earnings are $216.67 a month. 7. Rental property income and expenses are entered on AARC. Room and Board income and expenses are entered on AARE. AFSE is used to collect and display self employment information for each individual in the household. 69 Important Fields AFBE Blind Work Expenses TYPE: See Blind Work Expense Table TBWE. MONTHLY AMOUNT PAID: Enter the monthly amount of blind work expenses relating to the Expense Type. System / Policy Reminders Do not complete this screen unless specific criteria are met. AFBE is used to collect and display blind work expenses information. 70 Important Fields AFIQ Unearned Income Questions FIRST QUESTION: This question goes to the AFBA Income Benefits Applied For screen. Answer Y if the individual worked for any of the employers listed. SOURCES: Answer “Y” to go to the AFMI Monthly Unearned Income screen. SUPP SECURITY INCOME = SSI SS RSDI = Social Security Retirement, Survivor’s, or Disability Income DISABILITY/SICK BENEFITS = Insurance or other benefits, not SSI or SSDI. LAST QUESTION: This question goes to the AFBA Income Benefits Applied For screen. Answer Y if the individual needs to apply for any of the benefits listed. System / Policy Reminders 1. All types of unearned income must be listed here. For TCA and Medicaid applications, the individual may need to apply for other benefits they may be eligible for. 2. The first and last AFIQ questions refer to the requirement to File For Other Benefits. This policy applies to TCA and Medicaid but not Food Assistance. The individual must apply for other benefits they may be eligible for as a condition of eligibility, such as apply for Unemployment Compensation Benefits (UCB) after a job loss. (The exception is SSI.) Example: Samuel reports Social Security Survivor’s benefits for his son Michael. Check “Y” in the Social Security RSDI field. 3. The following Data Exchange alerts are verified upon receipt. No other verification is required: DEBB Bendex / Social Security, DESD State Data Exchange / SSI, DEUC Unemployment Compensation / UC or UCB. AFIQ is used to ask about unearned income for individuals in the household. 4. Electronic income verification is available through the following systems: State Online Query (SOLQ) for Social Security and SSI, Department of Labor (DLES) State of Florida, child support paid through Child Support Enforcement CSE DOR State of Florida. DES0 is the Tran Code for SOLQ. 71 Important Fields AFMI Monthly Unearned Income TYPE, SUB TYPE: See Unearned Income Codes Table TVIN. If indicated, use the correct subtype. Some codes do not have a subtype. CLAIM NO: Enter the Social Security or SSI claim number exactly as it appears from SOLQ DES0 or Data Exchange without any spaces, dashes, or slashes. INC CALC: Enter Y to go to AFUI Unearned Income Calculator. Answer N for monthly benefits. MO AMTS: Enter the amount in the first field. FLORIDA will automatically complete the other fields. If $0 amounts are needed for certain programs, they must be manually entered in each field. VR: AU refers to Data Exchange Auto Update. The code must be updated from SOLQ DES0. COURT ORDER AMT: Do not complete this field. System / Policy Reminders 1. All types of unearned income must be listed here. Income information may be layered as with AFEI. For TCA and Medicaid, the individual may need to apply for other benefits they may be eligible for. 2. Child support is entered under the child’s list #, not the parent. Use CHDP for the Type Subtype code. Do not use CHPT or CHEP. Example: Although Samuel is the payee, load the Social Security Survivor’s benefits under his son’s list #. The Type / Subtype field code is SSSC for “Social Security Surviving Child”. 3. For child support payments from a biological father when a legal father exists, the income is coded as a MOCO Contribution. AFMI is used to collect and display information about sources of unearned income for the household. 4. When SS or SSI benefits are withheld due to an overpayment, policy varies by program concerning if the net or gross benefit is used. 5. Certain income types are excluded: MO LO Loan. Any “help” the customer receives must be identified as a contribution, loan, or vendor payment. 72 Important Fields AFUI Unearned Income Calculator PAY DATE: Enter the paydate MMDDCCYY. GROSS UNEARNED INCOME AMT: Enter the gross pay amount including dollars and cents. ALLOWABLE EXPENSES: Any entry in this field is deducted from the gross income. This field is generally left blank. REP/NON-REP/GUESS: Enter R for representative, N for non-representative. Do not use G for Guess. SCREEN PRINT: Only a Y answer allows you to exit the screen. PRESS PF19 TO EXIT: Press PF19 to exit and return to AFMI. The calculation is automatically entered into the MO AMNTS field for each program. System / Policy Reminders 1. To show how the average is calculated, screenprint and scan PF19 into document imaging or document the information in CLRC. AFUI is not saved in history. 2. Do not use this screen for monthly benefits. AFUI is used to convert income received weekly, biweekly, semi-monthly, quarterly, and semi-yearly to a monthly amount. 73 Important Fields AFBA Income Benefits Applied For DATE APPLIED FOR: Enter the date they applied for the benefit. VR: Use a “?” to pend TCA and Medicaid. TYPE, SUBTYPE: See Unearned Income Codes TVIN Table. DATE EXP/RCVD: This field will generate CLWA alert 575 “Check Unearned Income Application.” STATUS: See Status Of Benefits Applied For TSBA Table. System / Policy Reminders 1. For TCA and Medicaid but not Food Assistance, the individual need to apply for other benefits they may be eligible for as a condition of eligibility, such as applying for Unemployment Compensation Benefits (UCB) after a job loss. (The exception is SSI.) 2. For UCB, the customer’s statement “RC” is accepted as verification. Check DLES for the status of the application. 3. For a disability determination, an individual may be required to apply for Social Security benefits. 4. The following Data Exchange alerts are verified upon receipt. No other verification is required: DEBB Bendex / Social Security, DESD State Data Exchange / SSI, DEUC Unemployment Compensation / UC or UCB. Example: Ruth lost her job last month. For TCA and Medicaid, she needs to apply for Unemployment Compensation Benefits (UCB) as a condition of eligibility. The customer’s statement is accepted as verification. 5. Electronic income verification is available through the following systems: State Online Query (SOLQ) for Social Security and SSI, Department of Labor (DLES) State of Florida, child support paid through Child Support Enforcement CSE DOR State of Florida. DES0 is the Tran Code for SOLQ. AFBA is used to collect and display information about benefits eligible/applied for by each individual in the household. 74 Important Fields AFIC Unearned Income Questions Continued DOES ANYONE IN YOUR HOUSEHOLD RECEIVE EDUCATIONAL AID?: A “Y” answer will prompt the AFEA Educational Aid screen. HAVE APPLICATIONS BEEN MADE BUT MONIES NOT RECEIVED FOR EDUCATIONAL AID?: A “Y” answer will prompt the AFAA Educational Aid Applied For screen. DOES ANYONE IN YOUR HOUSEHOLD RECEIVE INCOME FROM PER CAPITA PAYMENTS FROM A TRIBE, FROM NATURAL RESOURCES OR FROM SELLING THINGS OF CULTURAL SIGNIFICANCE? Enter "Y" to indicate that money was received from the following sources: per capita payments from a tribe that come from natural resources, usage rights, leases or royalties. payments from natural resources, farming, ranching, fishing leases or royalties from land designated as indian trust land by the department of the interior (including reservations and former reservations). money from selling things that have cultural significance. System / Policy Reminders For all programs except Family Medicaid, educational grants, loans, gifts or scholarships are excluded as income or assets. For programs other than Family Medicaid, it may not be necessary to complete the AFEA or AFAA screens. Instead, document CLRC with all needed information. AFIC is used to ask about educational aid information of individual(s) in the household. 75 Important Fields AFEA Educational Aid TYPE OF AID: See Table TEEI. Enter the code for each scholarship, fellowship, grant and/or expense. TOTAL AMOUNT: Enter the amount of the income/expense. BEGIN MMCCYY END MMCCYY: Enter the month/year for the period of time the income/expense is intended to cover. The amount will be prorated. TITLE IV: Answer “Y” if the income/expense is Title IV. System / Policy Reminders 1. For Food Assistance, TCA, and MSSI related Medicaid, educational grants, loans, gifts, or scholarships are excluded as income. It may not be necessary to complete the AFEA or AFAA screens. Instead, document CLRC with all needed information. 2. For Family Medicaid, scholarships, fellowships and grants are totaled and compared to the qualified educational expenses. The excess amount is counted as income and prorated over the period of time it is intended to cover. On AFEA, enter the correct code and amount for each scholarship, fellowship, grant and/or expense. AFEA is used to collect and display educational income and expenses of each individual in the household. 3. For Family Medicaid, qualified educational expenses include tuition, fees, books, supplies and equipment, which can be excluded. Room/board and travel are not qualified educational expenses. 76 System / Policy Reminders AFAA Educational Aid Applied For For Food Assistance, TCA, and MSSI related Medicaid, educational grants, loans, or scholarships are excluded. It may be not be necessary to complete this screen. Instead, document CLRC with all needed information. AFAA is used to collect and display information about educational aid applied for by each individual in the household. 77 Important Fields AFRQ Room And Board Questions FIRST QUESTION: This question goes to the AFRE Room and Board Earnings screen. Answer “Y” if the customer receives money for room and/or board. SECOND QUESTION: This question goes to the AFBP Room and Board Paid screen. Answer “Y” if the customer pays someone else (in or outside the household) for room and meals. System / Policy Reminders 1. Customers may enter information for situations such as shared living arrangements or expenses that are not actually room and board. Check this information carefully before completing room and board screens. 2. Boarders pay for room and meals and cannot receive Food Assistance independently of the individual providing the room and board. Boarders are coded as Living Arrangement Type “04” on AIIC. Mandatory SFU members cannot be boarders. 3. See 2210.0315.03 Reasonable Compensation determines how the boarder is treated: a. If the boarder does not pay reasonable compensation, they are included as part of the household. The room and board earnings are not included as income but the boarder’s income/assets are included. AFRQ is used to ask about room and board information for the household. b. If the boarder does pay reasonable compensation, they may be excluded at the option of the individual providing the room and board. The room and board earnings are included as income. See 2210.0315.03 Reasonable Compensation (FS). 4. Roomers pay for a room only. They can receive Food Assistance independently. Mandatory SFU members cannot be roomers. 5. Live in attendants are not roomers or boarders and can receive Food Assistance as a separate AG (if not mandatory). 78 System / Policy Reminders AFRE Room And Board Earnings 1. Complete AFRE only when the individual is receiving roomer or boarder income and they do not own the property. If the home is owned, enter the income and expenses on AARP and AARC. 2. Verification of income and allowable expense received from the roomer/boarder is required to determine if reasonable compensation criteria is met. 3. AFRE entries help determine if reasonable compensation criteria is met. AFRE is used to collect and display information about income received by a household member from any roomers or boarders living in the household. 79 System / Policy Reminders AFBP Room and Board Paid 1. Complete AFBP only when the applicant/recipient is paying roomer or boarder income to someone else in the household. 2. AFBP entries help determine if reasonable compensation criteria is met. AFBP is used to collect and display information about household members that are paying room and/or board. 80 Important Fields AFDQ Dependent Care Expenses FIRST QUESTION: This question goes to the AFDE Dependent Care Expenses screen. Answer "Y" to indicate the individual pays for someone to care for a dependent child or disabled/incapacitated adult so they can work, go to school/training, or look for a job. SECOND QUESTION: This question goes to the AFDP Child Support Payments (Outside The Household) screen. Answer "Y" to indicate that the individual makes child support, alimony, dependent care, or other payments for children living outside the household. System / Policy Reminders The second question refers to a Non-Custodial Parent’s (NCP) payments for child support and other types of dependent payments made for children or dependents outside of the household. This information is entered on the AFDP Dependent Payments / Child Support Payments screen. Do not confuse this with child support coming into the household or childcare expenses. Example: Samuel pays dependent care expenses for his son’s afterschool care so he can work. AFDQ is used to ask about dependent care expenses for individuals in the household and for dependent payments like child support paid for children or dependents outside the household. 81 Important Fields AFDE Dependent Care Expenses NBR: Enter the parent’s or caretaker’s member #, not the child’s. VP: If Y is entered to Vendor Payment, no deduction is allowed. PAY FRQ, NO OF PAYDAY: Used for PF19 calculation. HHIP, AFDC/CIC/FS/ADFC MA, SSI MA: Enter the monthly amount of dependent care expenses. Convert weekly/biweekly amounts the same as earned income. VR: “RC” limits Food Assistance deduction to $200/month. If verified, use “SC” or another code. Do not use “NV” Not Verified. PAID TO: Enter “99” for a provider outside of the household. PAID FOR: Enter the child’s #. System / Policy Reminders 1. For Food Assistance, dependent care expenses are allowed if a SFU member is working, looking for work, or attending school or training. 2. For TCA, dependent care expenses are not allowed. 3. For Medicaid, dependent care expenses are allowed only if a SFU member is working. Example: Samuel pays $52.50 weekly for his son’s dependent care while he works fulltime. The weekly expense is converted to a monthly amount: $52.50 x 4.3 = $225.75. Because the monthly amount per child is more than $200, verification other than “RC” is required. A phone call to the provider verifies the information. SC is used as the verification code. AFDE is used to collect and display dependent care expense information for the household. 82 AFDE Dependent Care Expense Helpsheet 1. Who Can Claim Dependent Care Expenses Food Stamps: Dependent care expenses are allowed if a SFU member is working, looking for work, or attending school or training. TCA: Dependent care expenses are not counted. Recipients may receive subsidized child care through the Regional Workforce Board (RWB). Family Medicaid (MFAM): Dependent care expenses are not counted. 3. Things To Remember 2. Verification Requirements Food Stamps: If less than $200 a month per child, use “RC” Reported By Client as verification to allow the billed amount. If more than $200 a month per child, verification other than “RC” is required. Use a “?” to pend for verification. To save time and effort, try calling the childcare provider. If verification is provided, change the “?” to a valid code like “SC” or “AF” to allow a deduction for the full expense amount. If verification is not provided, use “RC” Reported By Client as verification to allow $200 a month per child deduction. Do not use “NV” Not Verified. 83 Type the expense under the parent’s or caretaker’s member #. Load each child separately. Use “as billed” amounts. If unknown, a 4 week/1 month average may be used. Convert weekly, biweekly, or twice a month payments into monthly amounts. Do not allow vendor paid or subsidized dependent care expenses but parent fees are allowable. Answering “Y” (Yes) to the VP field will not allow the dependent care expense. Kindergarten and transportation expenses are not allowable. Layer AFDE screens for past or actual months. For Food Stamps, if the dependent care expense is more than $200 a month per child, remember to pend in writing for verification. A disabled or elderly individual who claims dependent expenses to seek medical care (but not due to working, looking for work, or attending school or training) may claim them as an excess medical deduction. The expense is loaded on the AFME screen. See memo P–08-08-0008 2008 Farm Bill Changes http://eww.dcf.state.fl.us/~ess/policysearch/p08080008.pdf. Example: AFDE Dependent Care (RC, ?) Example: AFDE Dependent Care (RC, SC) Example: Edward pays $52 week childcare for Tim (age 4) and $42.50 week for Randy (age 8) so he can work. Each child’s expense is converted to a monthly amount: Tim $42.50 X 4.3 = 182.75; Randy $52 X 4.3 = 223.60. Tim’s dependent care expense is verified with a phone call to the childcare provider. SC” Source Contact is used as verification. AABC is rerun. For Food Assistance, the total dependent care expense is $406.35 ($182.75 a month for Tim + $223.60 a month for Randy). Since Tim’s expense is $200 a month or less, “RC” Reported By Client is accepted. Since Randy’s expense is more than $200 a month, further verification is required. A “?” is used to generate a written pending letter to Ned. 84 Important Fields AFDP Child Support Payments (Outside The Household) TYPE: Enter "CS" for child support payments or "DC" for dependent care payments. “DC” does not count for Food Assistance. AFDC FC/HHIP, FS, MA/CIC: Enter the monthly amount of child support payments. PF19 may be used. VR: Verification is required. At application/recertification, do not use “RC”. COURT ORDERED: Enter “Y” if court ordered. “N” will not allow the deduction. ORDERED AMOUNT: The court order limits the monthly deduction. Convert weekly, biweekly, or twice a month payments into monthly amounts. Arrearages are allowed if court ordered. VR: Verification is required. At application/recertification, do not use “RC”. REL: Enter the relationship of the dependent child to the parent. DEPENDENT NAME AND ADDRESS: Enter the name and address of the dependent child. MAKING PAYMENTS: Answer “Y” if court ordered payments are being made timely. Example: Gil’s is court ordered to pay $200 a month child support. His payments for the last 3 months are $175 January, $150 February, and $125 March. The amounts are averaged and converted: $175 + $150 + $125 = $450 / 3 = $150. System / Policy Reminders 1. For TCA, verified court ordered support payments that the parent or relative must make outside of the home along with guardianship or power of attorney fees are considered unavailable income and deducted from net income. See 1820.0107 Unavailable Income (TCA) and 1830.0107 Unavailable Income (MFAM). AFDP is used to collect and display information about dependent care or child support payments made for a dependent outside the household. 2. Food Assistance allows a deduction for court ordered child support payments (including health insurance or dependent care payments) to a non-AG member. 85 AFDP Child Support Payments Food Assistance Helpsheet 1. For Food Assistance, a deduction is allowed for court ordered child support payments (including health insurance or dependent care payments) to a non-AG member. 8. The deduction is budgeted only after a request is received from the NonCustodial Parent (NCP) at application, recertification, or as a reported change. 9. Arrearages cannot be counted twice. Do not allow the arrearage payment if counted as a past regular child support payment. 2. A 12 week or 3 month average based on the frequency of payment (weekly, biweekly, twice a month or monthly) of the NCP’s child support payments is used to determine the deduction. 10. If requested verification is not provided, benefits are determined without the deduction. The Specialist may offer to assist in obtaining verification where it is difficult or impossible for the NCP to obtain the necessary verification. 3. Before allowing the deduction, verify the court ordered child support amount, such as a copy of a court or administrative order. If the child support payments are made through the state of Florida CSE, the following FLORIDA screens may be used: AIAC, FMCA, QUAP, QUCP, or IICM. 11. If the child returns to the NCP’s home (as part of the AG) but the NCP continues paying child support, the deduction is not allowed. 4. Verify the child support payments. If the child support payments are made through the state of Florida CSE, the following FLORIDA screens may be used: FMCS, FMCH (CP's case), or IICM. Cancelled checks, NCP paychecks, UCB may be used. A court order does not verify actual child support payments. 5. The same rules for budgeting earned income are used. Be sure to consider any anticipated changes or other changes that may affect the amount paid. If there is less than 12 weeks or 3 months of payment history, use anticipated payments without arrearage payments. 6. Check the custodial parent’s (CP) case to see if the child support income is budgeted. If not, notify the CP’s Specialist and CSE as needed. 7. The deduction cannot exceed the court ordered obligation. Collection fees, alimony, or extra payments (except arrearages) are not allowed. 86 Example: ADFP Child Support Deduction (more than court order) Example: AFDP Child Support Deduction (no court order) Example: Gil is a Non-Custodial Parent (NCP) who is court ordered to pay $200 a month child support for his son Mike. During the past few months, Gil made extra payments: $210 January, $210 February, and $225 March. His last 3 months of court ordered payments are averaged and converted: $210 + $210 + $225 = $645 / 3 = $215. $215 is entered in the monthly amount field. Example: Gil makes voluntary child support payments of $215 a month. They are not court ordered. Because the child support payments are voluntary and not court ordered, no deduction for Food Assistance is allowed in Gil’s case. The payments are counted as income in the CP’s case. The Specialist must check the Custodial Parent’s (CP) case to see if they are receiving assistance and the child support payments are budgeted. The Child Support Payment Deduction is $200. Even though extra payments totaled $215, the court order limits the deduction to $200. (Note: Arrearages are allowed if court ordered.) 87 Important Fields AFSQ Shelter And Utility Questions DOES ANYONE IN YOUR HOUSEHOLD INCUR SHELTER COSTS?: This question goes to the AFSC Shelter Cost screen. Answer "Y" if the household incurs shelter expenses. DOES THE HOMELESS AG WISH TO INCLUDE THE COST AS AN INCOME DEDUCTION?: Answer “Y” to use the Homeless Income Deduction instead of other shelter costs in the Food Assistance budget. DOES ANYONE IN YOUR DWELLING INCUR UTILITY COSTS?: This question goes to the AFUT Utility Cost screen. Answer "Y" if the household incurs utility expenses. DOES ANYONE IN YOUR HOUSEHOLD RECEIVE SHELTER/UTILITY ASSISTANCE?: This question goes to the AFSU Shelter Utility Assistance screen. Answer "Y" if the household receives help with shelter or utility expenses. TX - ALLOWABLE TAX DEDUCTION: Answer “Y” if the household claims allowable tax deductions for Family Medicaid. System / Policy Reminders 1. The $143 Homeless Income Deduction is available for AGs where all members are homeless and do not receive free shelter throughout the calendar month. This deduction is subtracted from net income. Homeless households that incur no shelter costs during the calendar month are not eligible for this income deduction. Example: Samuel pays rent, electric and telephone. He does not receive any shelter or utility assistance. He claims an allowable tax deduction for his IRA. AFSQ is used to ask about shelter and utility information of individual(s) in the household. 2. Verification of shelter costs is not required to receive the Homeless Income Deduction. The deduction is given in place of other shelter costs. Benefits may be higher or lower with the deduction. (Run AABC twice to find out.) 3. To allow the deduction, answer Y to the AFSQ Homeless Income Deduction question. Run AABC. Be sure to check the budget. 88 Example: AFSQ Homeless Income Deduction (FS) Example: ABFN Homeless Income Deduction (FS) Oscar is homeless. He pays $10 a night to stay at the local shelter four nights a week ($10 X 4 X 4.3 = $172). With $172 rent in his budget, Oscar’s Food Assistance benefits are $182. However, using the Home Income Deduction may offer higher benefits. With the $143 Homeless Income Deduction in his budget, Oscar’s Food Stamps benefits are $197, which is higher than counting his rent. Each situation is different. If the benefits were lower, go back to AFSQ and answer “N” to the Homeless income Deduction question. Be sure to document CLRC. Oscar can use the deduction because he is homeless and he does not receive free shelter for the entire month. It is given in place of his $172 shelter costs. To use the Homeless Income Deduction, answer Y to the AFSQ question. Press enter. Rerun AABC. 89 Important Fields AFSC Shelter Cost TYPE: RT = rent, MO = mortgage, HI = homeowner’s insurance, PT = property taxes, CM = condo maintenance fees. (See Shelter Cost Types Table TSCT.) MONTHLY OBLIGATION: Enter the total monthly obligation for each shelter cost. MONTHLY AMOUNT PAID: Information only. PAID TO: Enter “99” if paid to an individual outside the household. VR: The customer’s statement “RC” is accepted as verification unless questionable. System / Policy Reminders 1. Shelter costs are allowed on an as-billed basis rather than as paid. Both whole dollars and cents are used. Late fees and penalties are not allowable. 2. The customer’s statement is accepted as verification, unless questionable. If questionable, the expense must be verified. 3. Vendor payments for shelter expenses reduce or eliminate the amount of shelter costs allowed in the Food Assistance budget. 4. Vendor payments for rent or mortgage, unless HUD rent subsidies, do not affect TCA shelter obligation. Note: Vendor payments can affect Food Stamp budget deductions. Example: Samuel reports that he pays $750 mortgage, which includes property taxes and homeowner’s insurance. The customer’s statement “RC” is accepted as verification unless questionable. 5. Shelter costs are N/A for Medicaid. Do not budget shelter costs for Medicaid only cases. AFSC is used to collect and display information about shelter costs of individuals in the household. 90 AFSC Shelter Helpsheet Homeless and domestic violence situations automatically receive Tier 1. Use AIIC Living Arrangement codes 12 (Homeless) or 13 (Battered Woman Shelter) to generate the obligation. Food Assistance Food Assistance shelter costs include rent (RT), mortgage (MO), property taxes (PT), homeowner’s insurance (HI), and mandatory maintenance fees (CM). Lot rent is considered rent. Second mortgage and/or home equity loans with a lien are mortgages. For specified relative child only cases, the relative can charge the child “rent” to generate T1 or T2, regardless of whether or not they incur shelter costs. An AFSC screen for the child coded as paid to the relative is completed. If the specified relative is included, the relative’s actual shelter obligation is used. This policy applies to specified relative child only cases, but not SSI parent or ineligible noncitizen parent cases. If the mortgage includes PT, HI, or CM, do not separate the costs. If billed separately, the costs are entered separately. Spouses share each other’s shelter obligation, regardless of whose name is on the lease or mortgage. Use the total shelter obligation to determine which tier applies. Spouses cannot charge rent. If there is no shelter obligation, Tier 3 is assigned. Homeowner’s insurance on the structure or the structure and contents are allowed if it is verified that the costs cannot be separated in the premium. (Generally, most insurance companies do not separate these costs.) For double stepparent situations (each parent has their own TCA SFU), divide the total shelter obligation equally between the spouses. Homeless individuals that pay to stay at a shelter are considered to incur shelter expenses. A Teen Parent living with a parent, legal guardian or other adult relative is assigned Tier 3, even if charged “rent”, unless an exception or good cause is met. If met, the TCA obligation is based on the verified shelter obligation. Shelter costs billed as daily, weekly, biweekly or annually are converted to monthly amounts. Both whole dollars and cents are used when determining the amount of the shelter disregard. A shelter cap will apply unless an individual in the assistance group is elderly or disabled. The spouse and/or children of an SSI or ineligible non-citizen parent are assigned the parent’s shelter obligation. TCA HUD rent subsidies affect shelter obligation. The SFU’s actual shelter obligation is used. If the amount is zero, Tier 3 is assigned. TCA payment standards (Tier 1, 2, or 3) are determined by the SFU’s shelter obligation. Only rent (RT) and/or mortgage (MO) generates TCA shelter obligation. Property taxes (PT), homeowner’s insurance (HI), and mandatory maintenance fees (CM) do not. Shelter obligation is based on “as billed” amounts, not as paid. For in-kind or “working in exchange for rent” situations, the shelter obligation is based on the dollar amount assigned for the work by the landlord. Tier 1, 2, 3 Tier 1 = $50.01 and up rent or mortgage, homeless Tier 2 = one cent - $50.00 rent or mortgage Tier 3 = no rent or mortgage, teen parent situation, or shelter cost is not verified (NV) 91 Example: AFSC Mortgage (PT, HI, CM paid separately) Example: AFSC TCA Specified Relative Child Only Example: Edward pays each of the following shelter expenses separately: Example: William applies for his nephew Todd and niece Danielle as a TCA specified relative child only case. He is asked if he wants to charge the children “rent” in order to receive Tier 1 or 2 payment standard. He states he wants charge $60 in order to receive Tier 1. $268.43 mortgage (MO) monthly $993.00 property taxes (PT) annually / 12 = $82.75 $780.00 homeowner’s insurance (HI) annually / 12 = $65.00 $112.50 mandatory maintenance fees (CM) quarterly / 3 = $37.50 A separate AFSC screen is completed showing Todd paying $60 rent to generate $241 TCA Tier 1 for 2 individuals. Under “Paid To”, Bill’s list # is used to ensure the Food Stamp budget is correct. If William’s needs are included, this policy is not applicable. The relative’s actual shelter obligation is used. See 2420.0341 Verification of Shelter Obligation (TCA). Each expense is converted to a monthly amount and loaded separately. Be sure to document CLRC. 92 Important Fields AFTD Tax Deductions TYPE: See Tax Deduction Types Table TATD. AMOUNT: Enter annual amounts which will be prorated over the period of time they are intended to cover. System / Policy Reminders Allowable tax deductions are determined by IRS rules. The term does not refer to allowable self-employment expenses. Example: Samuel reports that he pays $2000 annually into his Individual Retirement Account (IRA). AFTD is used to collect and display tax deduction information from individuals who have indicated that they have allowable tax deductions. This screen requires at least one member of the household to be a tax filer. 93 Important Fields AFUT Utility Costs TYPE: EL = electric, WS = water/sewer, GA = gas, PH = telephone, TR = trash, OT = other. See Utility Cost Types Table TUCT. MONTHLY OBLIGATION: The monthly obligation for each type of utility cost. BEG DATE: Enter the begin month for the utility expense. VR: The customer’s statement “RC” is accepted as verification unless questionable. BILLING CREDIT: Enter “Y” if the customer wants to receive Lifeline phone credit. LIHEAP: Enter "Y" for yes if the household has applied for LIHEAP. See memo Policy Change – Eligibility for the Standard Utility Allowance for Households Receiving Low Income Home Energy Assistance Payments I-14-03-0006 http://eww.dcf.state.fl.us/~ess/policysearch/p14030006.pdf LAST 3 QUESTIONS: These questions determine which standard is budgeted. To budget the SUA, answer Y to the last three questions. To budget the BUA, answer Y, N, Y to the last 3 questions. To budget the Telephone standard, answer N, N, Y to the last 3 questions. System / Policy Reminders Example: Samuel pays $100 electric (with central heat/air) and $75 phone. For Food Assistance, the $340 Standard Utility Allowance (SUA) is budgeted. 1. For Food Assistance, households with utility expenses incurred separately from the rent or mortgage are allowed to use a utility standard as a potential deduction in the budget. AFUT is used to collect and display information about utility costs for the household. 2. Do not budget utility expenses for TCA or Medicaid only cases. 94 AFUT Utilities Helpsheet If all of the AG’s utility expenses are vendor paid, no utility standard is given. Utility expenses incurred separate and apart from the rent or mortgage are allowed as a deduction for Food Assistance. Instead of actual costs, one utility standard is assigned. Partial vendor payments do not affect the AG’s eligibility for the correct utility standard. Client statement is accepted as verification, unless questionable. If questionable, the expense must be verified. The Standard Utility Allowance is allowed for AGs that incur a heating or cooling cost. Cooling refers to air conditioning such as central air or a window unit. Ceiling fans do not qualify as a cooling expense. Heating refers to any billed heating expense. AGs that expect to incur a heating or cooling cost in the next 12 months, receive Low Income Home Energy Assistance Act (LIHEAP), or are billed a flat rate or for excess usage are assigned the SUA. The Basic Utility Allowance is allowed for AGs that do not incur a heating or cooling cost but have utility expenses other than telephone, such as electric or gas with no heating or cooling, water, or garbage. The Telephone Standard is allowed for AGs that only incur a telephone cost. Only the primary telephone (landline or cellphone) qualifies for the standard. If there is no utility expense or if utilities are included in the rent or mortgage, no standard is allowed. Multiple AGs that live in the same dwelling and incur a utility expense are assigned the appropriate utility standard for the dwelling. One telephone and/or cellphone designated as the primary line qualifies as a utility expense. Other multiple lines do not. (See clearance from March 2005 Multiple AGs Sharing Utilities (FS) and Cell phones.) For LIHEAP, see memo Policy Change – Eligibility for the Standard Utility Allowance for Households Receiving Low Income Home Energy Assistance Payments I-14-030006 http://eww.dcf.state.fl.us/~ess/policysearch/p14030006.pdf See Food Assistance Allowances for the utility standard amounts: http://eww.dcf.state.fl.us/~ess/policy/manual/a_03_1.pdf Households that live in separate dwellings but share a utility meter (duplex, trailer, RV, etc.) are assigned a utility standard based on their own utility expense. Cable, satellite, and/or internet service is not a utility expense. HUD Utility Allowances are not considered to be income or a vendor payment and do not affect the SUA, BUA, or Telephone Standard. 95 Example: AFUT Standard Utility Allowance (SUA) Example: AFUT Basic Utility Allowance (BUA) Example: Robert pays $80 electric (A/C), $35 telephone, and $25 water/sewer. Because he incurs a heating/cooling cost, the SUA is given. Robert pays $80 electric (A/C), $35 telephone, and $25 water/sewer. Because he does not incur a heating/cooling cost but is billed for a major utility other than telephone, the BUA is given. To budget the SUA, answer “Y” to the last three questions. To budget the BUA, answer “Y”, “N”, “Y” to the last 3 questions. 96 Example: AFUT Telephone Standard Example: AFUT Multiple AGs Living In The Same Dwelling Example: Robert pays $35 telephone. All other utilities are included in his rent. Because he only incurs a telephone expense, the Telephone standard is given. Example: Robert lives with his sister Angie but they purchase and prepare food separately. Robert pays $80 electric (A/C) and $25 water/sewer. Angie pays the $35 telephone bill, which is the primary telephone for the dwelling. For multiple AGs living in the same dwelling, any AG that contributes toward utilities is given the utility standard for the dwelling. Since they both contribute towards utilities and the dwelling has a heating/cooling expense, Robert and Angie are both given the SUA. An AFUT screen is completed for each AG. To budget the Telephone standard, answer “N”, “N”, “Y” to the last 3 questions. To budget the SUA for Emmitt, answer “Y”, “Y”, “Y” to the last three questions. 97 Example: AFUT Vendor Payment Example: Robert is billed $80 electric (A/C), $35 telephone, and $25 water/sewer. Because his hours were cut, a neighbor vendor pays his electric bill to the utility company. Although his electric bill (cooling expense) is vendor paid on an ongoing basis, Robert can still receive the SUA as long as he is responsible for other utilities (including telephone). He still has an obligation for the telephone and water, so the SUA is given. To budget the SUA, continue to answer “Y”, “Y”, “Y” to the last three questions. The AFSU Shelter/Utility Assistance Screen is completed to document the vendor payment. Enter AFUT with the correct responses to allow the appropriate standard and document CLRC. 98 Important Fields AFSU Shelter Utility Assistance TYPE: See Shelter Utility Assistance Table TSUT. VEND PAMT: Answer “Y” if vendor paid. If “N” is used, the amount is counted as unearned income. MONTHLY PAYMENT: Enter the monthly vendor payment amount. VR: The customer’s statement “RC” is accepted as verification unless questionable. AGENCY / INDIVIDUAL: The agency or individual who is providing the help. SUBSIDIZED HOUSING: Answer “Y” if this is a HUD rental subsidy. This entry affects the TCA shelter obligation. SECTION 8, PUBLIC HOUSING: Answer “Y” to one selection if “Y” was entered for the previous question. System / Policy Reminders 1. A vendor payment is a money payment made for SFU expenses by an individual or agency outside the SFU from funds not legally owed to the SFU. 2. For Food Assistance, vendor payments are excluded as income and any expense which is entirely paid by a vendor payment is not an allowable deduction from income. Example: Ruth lives in Section 8 HUD housing. She receives a $575 HUD rental subsidy, which is vendor paid directly to the landlord. 3. For TCA, vendor payments are excluded as income but HUD rental subsidies reduce the customer’s shelter obligation. “Regular” vendor payments do not. AFSU is used to collect and display information about shelter and utility assistance received by the household. Vendor payment for shelter and utilities are entered here. 4. Do not enter HUD utility payments (unless included in the HUD rental subsidy calculation). 5. The AFSC and AFSU fields (member #, type of expense, monthly obligation) must match for the vendor payment to be budgeted correctly. 99 Example: AFSC HUD Rent Subsidy (TCA) Example: AFSU HUD Rent Subsidy (TCA) Example: Ruth lives in Section 8 HUD housing. She receives a $575 HUD rental subsidy, which is vendor paid directly to the landlord. The landlord charges $600 gross rent. After the $575 HUD rental subsidy is deducted, Ruth pays $25 rent. Enter $600 rent on AFSC. Enter $575 for the HUD rental subsidy on AFSU. Answer “Y” to the Subsidized Housing and Section 8 questions. For TCA, Ruth’s HUD rental subsidy reduces her shelter obligation so she is eligible for $205 based on Tier 2 for 2 persons. For Food Assistance, vendor payments (including HUD rental subsidies) are not counted as income but eliminate or reduce the deduction so Ruth receives credit for $25 shelter costs. 100 Important Fields AITR Application Tracking HAS INTERVIEW BEEN CONDUCTED?: Enter "Y" if the interview has been held, “N” if the interview is not required, or "?" if the interview is required but pending. IF YES, PHONE OR FACE TO FACE?: This field is required if an interview has been conducted. Enter "P" for phone interview or "F' for face to face interview. ACTUAL INTERVIEW DATE: Enter the actual interview date. Leave blank if an interview is not required. FLORIDA uses this field to complete the tracking screens. LAST VERIF RECEIVED DATE: Enter the last verification received date. FLORIDA uses this field to complete the tracking screens. CASE TYPE: This field reflects if the case is "Red" or "Green". If an “X” is entered in fields 1-11, the case is made Red Track. If blank, the case is Green Track. CURRENT DETM TYPE: A = Abbreviated, P = Passive, I = Interim, R = Red, E = Exempt, D= Directed interview. See Application Tracking System TSAS table. This is a required field. NEXT DETM TYPE: A = Abbreviated, P = Passive, I = Interim, R = Red, D= Directed interview. See Application Tracking System TSAS table. "E" cannot be used here. For initial applications, the next review cannot be Red Track due to management. CONTACT LTR: Leave this field blank unless an Interim Contact Letter (ICL) needs to be sent immediately. Enter “X” to send an electronic notice. Example: Samuel’s applied for Food Assistance and Medicaid. His phone interview was held on 5/21 and he provided all needed verification on 5/26. His Current Determination Type is “A” for Abbreviated. The Next Determination Type is “P” for Passive. His case is Green Track. System / Policy Reminders 1. Interview requirements vary by program. An interview is not required for Medicaid. The Application and Redetermination Review Cycles Chart is found on page 15 in the Customer Service Center Guide: http://eww.dcf.state.fl.us/ess/modern/cscguide.pdf AITR is used to collect and display information about the application track for the case. 2. If the customer does not recertify for Food Assistance but receives Medicaid, go back to AITR and update the Next Determination Type field, usually an “I” for Interim. 101 Important Fields AIFP ACCESS Integrity Referral AIP REF: This field is protected and will be populated by the system when PF17 or enter is pressed. An entry of “X” in fields 1 thru 10 will automatically populate the “AIP REF” field with “Y”. ACCESS INTEGRITY REFERRAL NOT REQUIRED: Enter “X” to indicate a referral is not required. An “N” will appear in the AIP REF field. AIP USER ID: When investigation is completed, the investigator will enter their ID in this field. F: An “X” indicates the investigator located findings. NF: An “X” indicates no findings by the investigator. R: An “X” indicates the investigator rejected the referral. System / Policy Reminders 1. Multiple entries can be made on this screen. If the case is referred the “#10 Other Reason” field, specific information is required. 2. AIFP must be completed during the ASIA or ASRE drivers or may be accessed at any other time. The CLPS Caseload/Case Pending Sort screen is also updated with the case referral status. Example: Samuel’s application contains no discrepant information and does not meet any of the AIP criteria. See memo ACCESS Integrity Program Referrals on FLORIDA http://eww.dcf.state.fl.us/~ess/florida/062205aifp.pdf AIFP is used to capture ACCESS Integrity referral information. 102 Important Fields AGCD SFU Composition Display CAT, SEQ: Category and Sequence # for the AG. PARTIPATION STATUS: Indicates the individual’s status in the SFU and how each is budgeted. See Individual Participation Status Table TPTC. System / Policy Reminders 1. If the expected benefits are not shown, check FLORIDA the following FLORIDA screens: AGCD shows the current composition of each SFU. AIPB Application Entry Benefit Selection AIID Individual Demographics Date Of Birth AIIC Living Arrangement Type or Date AIIA Individual Attributes Marital Status AIIM Individual Miscellaneous Pregnancy AIHH Household Relationship AICZ Alien/Refugee Information ASEV SSI Eligibility AIDP Disability 2. TCA is not offered if the individual does not have a minor child in the household. Medicaid is limited to individuals in one of the following groups: children under 21, parent/relative with a child under 18, pregnant women, aged 65 +, disabled or applying for disability. 103 Important Fields AGPY Assistance Group Names CAT, SEQ: Category and Sequence # for the AG. NBR: Enter the payee’s member #. AG NAME: Protected field determined by NBR field. WISH TO APPLY?: Enter “Y” if the AG is applying for this benefit. Enter “N” if they are not applying for this benefit, which will enter code “384” Does Not Wish To Apply” and not allow the AG to be opened on AWAA. DATE SIGNED: The date of application for the AG. Update this field if the wrong CRAD RFA Date was used. MEI/MEC BEGIN DATE: The begin month for Transitional or Extended Medicaid is back dated to the first month of ineligibility for 1931 Medicaid. WK REG VR: Use a “?” to pend for TCA upfront work registration. Do not enter this field for Food Assistance or Medicaid. System / Policy Reminders 1. When a different payee is selected, a new EBT card is issued. Also, program time standards and work registration codes may be affected. 2. Do not select a child as the Payee. Exception: For MSC, The SSI recipient must be selected as the payee. Example: Samuel is the payee for all of his AGs. AGPY is used to determine the payee of each assistance group (AG) for the household. 3. The Date Signed is the date of application. The tracking screens for each program use this date to track time standards. Check this field when new Medicaid coverage groups are built or at redetermination. 104 Important Fields AGCC TCA SFU Composition Change INDIVIDUALS: Indicates who is in the SFU. Individuals can be added in a blank field. PARTICIPATION: Indicates individual's status in the SFU and how they are budgeted. See Individual Participation Status Table TPTC. For children, F/H/N indicates the child's participation status under Family Cap: F = Full, H = Half, N = None. OPTION TYPE: Indicates other options for the individual. See Option Type Codes Table TOPT. DELETE REASON: Enter code to specify the reason to remove the individual. See Fiat Reason Code Table TFRC. System / Policy Reminders 1. TCA SFU rules must be followed when removing or overtyping participation status codes. 2. For TCA, caretaker relatives may be removed with code “001”. Do not separate full or half siblings. Example: To build TCA specified relative child only benefits, William is removed from the SFU with code “001”. AGCC is used to display the composition of the SFU. 105 Important Fields AGCC Medicaid INDIVIDUALS: Indicates who is in the SFU. Individuals can be added in a blank field. PARTICIPATION: Indicates individual's status in the SFU and how they are budgeted. See Individual Participation Status Table TPTC. OPTION TYPE: Indicates other options for the individual. See Option Type Codes Table TOPT. DELETE REASON: Enter code to specify the reason to remove the individual. See Fiat Reason Code Table TFRC. System / Policy Reminders 1. Medicaid SFU rules must be followed when removing or overtyping participation status codes. The workaround for Continuous Medicaid for children under 19 requires overtyping participation status codes. . To build this coverage, see Workaround # 93: http://eww.dcf.state.fl.us/~ess/florida/workaroundguide.pdf Example: The specified relative is an Excluded Adult (XA) in the children’s Medicaid SFU. AGCC is used to display the composition of the SFU. 106 Important Fields AGCC Food Assistance INDIVIDUALS: Indicates who is in the SFU. Individuals can be added in a blank field. PARTICIPATION: Indicates individual's status in the SFU and how they are budgeted. See Individual Participation Status Table TPTC. OPTION TYPE: Indicates other options for the individual. See Option Type Codes Table TOPT. DELETE REASON: Enter code to specify the reason to remove the individual. See Fiat Reason Code Table TFRC. System / Policy Reminders 1. The Indicator field shows certain information about the AG. The “N” indicator displayed “Non Public Assistance”. See SFU Indicator Table TIND. 2. Food Assistance SFU rules must be followed. Generally, do not overtype Food Assistance participation status codes. Instead, check the appropriate FLORIDA screen, make any needed corrections, and rerun AABC. AGCC is used to display the composition of the SFU. 107 Important Fields AWES Eligibility Summary INCOME S, ASSET S, TECH S: Enter "X" to select the month in the Income, Asset, and Technical Results column you want to view. RSLT: Indicates Pass, Fail, Pend status for each benefit or month. System / Policy Reminders 1. Enter “X” in the income, asset, or technical columns to view the budget result. The latest budget months are shown at the top. Multiple months can be selected. 2. At application, a separate line is shown for each month of eligibility, including the retroactive month, application month, current month and recurring month. After AWAA is authorized, only the ongoing month is shown. Select the ongoing month and press PF8 to view any past months. 3. If failing for assets, the amount is listed in the Asset Overage field. If Medically Needy, the SOC AMT is shown. Example: Enter “X” in the income, technical, and asset results to view Samuel’s Food Assistance and Medicaid budgets. AWES is used to display the income, asset, and technical eligibility results for each AG/SFU. Before authorizing AWAA, always check the budget. If it’s not correct, fix it or get help. 108 Important Fields ABFG Food Stamp Gross Income Test Budget CASH/RIVERSIDE: Riverside is a sanctioned TCA benefit amount included to prevent Food Assistance benefits from increasing. TOTAL GROSS INCOME: The total counted monthly gross income for the household. MONTHLY INCOME TEST STANDARD: This is the monthly gross income test standard for the household size. System / Policy Reminders The following references are available: Gross Net Income Limits http://eww.dcf.state.fl.us/~ess/policy/manual/a_01.pdf For additional information, see memo I-13-07-0013 Changes in Simplified Reporting and Broad-Based Categorical Eligibility (BBCE) Income Evaluation http://eww.dcf.state.fl.us/~ess/policysearch/i13070013.pdf ABFG is used to display the test results of comparing the gross income amount to the allowable limit for the AG size. 109 Important Fields ABFN Food Stamp Net Income Budget TOTAL GROSS INCOME: AFEI Earned Income, AFMI Unearned Income, AFSE Self-Employment, TCA/Riverside (system determined) EARNED INCOME DEDUCTION: 20% is deducted from earned income. STANDARD DEDUCTION: Based on AG size, applies to earned / unearned income. TOTAL MEDICAL COSTS: AFME Medical Expenses, AFMD Medical Insurance, AIMM Medicare Information DEPENDENT CARE DEDUCTION: AFDE Dependent Care Expense CHILD SUPPORT PAYMENT DEDUCTION: AFDP Dependent Payments HOMELESS INCM DEDUCTION: AFSQ Shelter Questions SHELTER COSTS: AFSC Shelter Cost, AFSU Shelter & Utility Assistance UTILITY STD: AFUT Utility Cost EXCESS SHELTER DEDUCTION: Uncapped for elderly or disabled AGs, capped for other AGs. ADJ INCOME: The monthly net adjusted income amount after all deductions. Example: For Samuel’s Food Assistance budget, deductions for earned income, dependent care, shelter and utilities are allowed. MAX NET MONTHLY INCOME: This is the monthly net income test standard for the household size. ABFN shows any allowable deductions budgeted by the specialist and the results of the net income budget. System / Policy Reminders The following references are available: Allowances http://eww.dcf.state.fl.us/~ess/policy/manual/a_03_1.pdf 110 System / Policy Reminders ABFB Food Stamp Benefit Determination Budget NET ADJUSTED INCOME: The monthly net adjusted income amount from the previous screen. THRIFTY FOOD PLAN: The monthly maximum amount of benefits for the AG size. BENEFIT REDUCTION: 30% of the monthly net adjusted income amount rounded up to the whole dollar. MONTHLY ALLOTMENT: The benefit reduction is subtracted from the Thrifty Food Plan amount to determine the benefit amount. INITIAL PRORATED BENEFIT is the amount of the first issuance. System / Policy Reminders 1. For applications, the Begin Date field will show the date benefits begin or the date of entitlement. 2. The following references are available: Maximum Benefits http://eww.dcf.state.fl.us/~ess/policy/manual/a_02.pdf Example: Samuel is eligible for $293 a month in Food Assistance benefits. ABFB displays the results of the Food Assistance benefit determination for the size of the AG. 111 Important Fields ABAD TCA Miscellaneous Deeming Budget UNEARNED INCOME: This does not include the unearned income of AG members. CONSOLIDATED NEEDS STANDARD: Do not include AG members in the CNS count, such as spouse or stepchildren. See AIHH Tax Dependent field COURT ORDER PAYMENTS DISREGARD: Deduction allowed for court order payments outside the household. System / Policy Reminders 1. For TCA and Family Medicaid, deeming situations include: Deemed Stepparent (DT) Deemed Parents (DP) Deemed Spouse (DS) 2. Deeming only occurs in specific situations and does not apply to certain Medicaid coverage groups, such as MOD. Example: Nicholas is a Deemed Stepparent in his new wife’s Anna’s TCA budget. After all deductions and disregards, $99 is deemed to Anna as unearned income. ABAD displays the calculations used to determine how much income is deemed from SFU members. The deemed individual is part of the SFU but not part of AG. This is used for stepparent and spouse to spouse deeming. 112 Important Fields ABAI TCA Individual Countable Earned Income Budget STUDENT EARNED INCOME EXCLUSION: The earned income of a child who is a student is excluded if TCA Student Earned Income Disregard criteria is met. $200 LESS $90 STD: If there is counted earned income and this is field is $0, the TCA AG does not qualify for the $200 and ½ Earned Income Disregard. The budget is shown on the next screen. DEPENDENT CARE COSTS DISREGARD: For TCA, dependent care expenses are not allowed. System / Policy Reminders 1. The AG/SFU is tested for the $200 and ½ Earned Income Disregard each time AABC is run. If eligible, there is no time limit on the disregard. 2. Press PF6 to view the next individual with earned income, if any. Example: The $90 Standard Deduction is subtracted from Anna’s monthly gross earned income. ABAI is used to show any allowable earned income disregards for TCA, such as the Student Earned Income Disregard, $90 Standard Deduction or $200 and ½ Earned Income Disregard. 113 Important Fields ABAC TCA Payment Standard Budget COUNTABLE INCOME: Adjusted income for the Payment Standard test. Dependent care is not counted for TCA. PAYMENT STANDARD: TCA payment standard based on household’s rent or mortgage System / Policy Reminders 1. For TCA, to be eligible for the $200 and ½ Earned Income Disregard, one of following criteria must be met: at least one member of the TCA AG must have been eligible for and received TCA in 1 of the previous 4 months. or The AG’s countable income (earned income - $90 + any unearned income) must be below the payment standard. 2. The deduction is not given for unearned income, such as SSI or UCB. Example: Anna’s Countable Income must be below the Payment Standard to qualify for the $200 and ½ Earned Income Disregard income for TCA. ABAC is used to determine if the TCA AG is eligible for the $200 and ½ Earned Income Disregard. 114 System / Policy Reminders ABAG TCA 185% Eligibility Standard Budget 1. To be eligible, the TCA AG must pass the 185% Eligibility Standard test, similar to the Food Assistance Gross Income Limit. 2. The following references are available: TCA Income Standards http://eww.dcf.state.fl.us/~ess/policy/manual/a_05.pdf Example: Anna passes the 185% Eligibility Standard test but this does not mean the household is eligible for TCA. ABAG is used to determine if the TCA AG passes the 185% Eligibility Standard test. 115 Important Fields ABAB TCA Benefit Determination Budget AG/SFU SIZE: The TCA AG size. FAMILY CAP AG/SFU SIZE: The TCA AG size based on the Family Cap indicator entered on ARDT. INCOME STANDARD: The TCA payment standard based on the household’s shelter obligation, such as rent/mortgage and homeless or domestic violence AIIC Living Arrangement Type codes. System / Policy Reminders 1. Make sure the correct TCA payment standard is used. 2. Unearned income reduces TCA benefits dollar for dollar. 3. The following references are available: TCA Income Standards http://eww.dcf.state.fl.us/~ess/policy/manual/a_05.pdf Example: Anna’s household is overincome for TCA. ABAB is used to show the final budget determination for TCA. 116 Important Fields ABMG Family Medicaid/Medically Needy Determination Budget EARNED INCOME: Total countable earned income after disregards. UNEARNED INCOME: Total adjusted unearned income. TOTAL REPORTED INCOME: Total of earned and unearned income. ALLOWABLE TAX DEDUCTIONS: Any claimed allowable tax deductions from AFTD. MODIFIED ADJUSTED GROSS INCOME: MAGI modified adjusted gross income for the filing unit. STANDARD DISREGARD: Income disregard based on the coverage group and # of individuals in the tax filing unit. N/A for children age 6 to under 19. MAGI DISREGARD (5% OF FPL): Income disregard based on # of individuals in the tax filing unit. SFU SIZE: # of individuals in the filing unit which may include unborns or OOTH individuals. INCOME STANDARD: Income limit for the coverage group. COUNT OF OOTHS: # of individuals who are out of the household from AIOH. Example: Mike is eligible for MMC. His father’s earned income is below the income standard for a SFU size of 2. MED INSURANCE PREMIUM, RECURRING MED EXPENSE: Medical premiums or recurring medical expenses deducted from the Share Of Cost ABMG shows the calculations used to determine if the AG has passed or failed eligibility and the results of the MAGI Medicaid eligibility or share of cost calculation. REMAINING SOC: Remaining share of cost amount which still must be met before the AG is eligible for Medicaid. System / Policy Reminders For Family Medicaid, weekly or biweekly income is converted using 4.0 and 2.0. 117 System / Policy Reminders ABSB SSI Related MA Eligibility Determination 1. Different MSSI income standards are used for individuals and couples. 2. The following references are available: MSSI http://eww.dcf.state.fl.us/~ess/policy/manual/a_09.pdf Example: Robert’s is eligible for SLMB which covers his Medicare Part B premium. ABSB is used to show the final budget determination for MSSI Medicaid. 118 System / Policy Reminders AAED Asset Eligibility Determination 1. Asset limits vary by program. Food Assistance Broad Based SFU’s, Food Assistance Categorically Eligible SFUs, and all Family Medicaid coverage groups have no asset limit. 2. The following references are available: Food Assistance Broad Based P-10-06-0009 http://eww.dcf.state.fl.us/~ess/policysearch/p10060009.pdf MSSI Asset Limits http://eww.dcf.state.fl.us/~ess/policy/manual/a_09.pdf AAED is used to display the detailed results of the AG’s asset eligibility. 119 Important Fields ATED Technical Eligibility Determination RESULT: Results of each individual's technical eligibility Pass; Fail; Pend. ELIGIBILITY FACTORS: Reason for the technical eligibility results. System / Policy Reminders Check Technical to determine why an individual is failing. ATED is used to display the technical eligibility factors which caused the individual to fail. 120 Important Fields AWEC Expected Changes LIFELINE ASSISTANCE: A “Y” response is required. The Lifeline Assistance Program is explained in the application. DO YOU EXPECT ANY CHANGES IN YOUR HOUSEHOLD CIRCUMSTANCES? Enter "Y" to indicate that changes are expected. EXPECTED DATE: Enter the date of the expected change. EXPECTED CHANGE: Enter a brief summary of the expected change. FLORIDA creates an alert approximately 2 weeks prior to the expected date. System / Policy Reminders 1. An AWEC is required for proof of application for SSN (TCA, Medicaid) and the last month of Continuous Medicaid for children under 19. 2. Do not set AWEC for age changes or pregnant women since FLORIDA programming already creates the alert. 3. Due to Simplified Reporting rules, do not set expected changes for Food Assistance. 4. Clear AWEC when the alert is worked. When running the driver, clear any overdue alerts that are no longer valid. Example: For TCA and Medicaid, a 90 day partial is set to check if the baby’s SSN was received. 5. Recipients of SSA. SSI, veterans and other pension benefits usually receive an annual cost of living adjustment. AWEC is used to collect and display any expected changes/date in household circumstances. 6. To clear an expected change, clear the date and expected change fields. Press enter. (Be sure to complete the necessary case action.) 121 Important Fields AWAC Application Creation RIGHTS AND RESP: This information is now explained in the application. FACE TO FACE: A face to face interview is no longer required for most benefits. System / Policy Reminders 1. If “N” is answered to these fields, the benefit cannot be opened on AWAA. 2. The fields are protected for certain benefits. AWAC is used to create an application for any benefits the household wants to apply for they are potentially eligible for. 122 Important Fields AGBI Assistance Group Benefit Information ISS SITE: Indicates Food Assistance and TCA issuance site. See County/ServiceSite TABLE TCTY. ORIG CNTY: Enter the individual’s county for residence. See County/District Listing Table TRCL. ISS MTD: Enter “P” for Food Assistance. “M” is protected for TCA and Medicaid. ALT ADR, ATH REP, PRO PAY, ALT PAY, LEG GRD, BEN FIC: Enter “Y” to go to the AGAR screen. These fields are completed for specific case actions. INT MTD: Leave this field blank. DROP SHP: Do not enter this field. System / Policy Reminders 1. If Food Assistance and TCA are received for the same household, the issuance site codes must be the same. 2. The issuance site and method are protected for Medicaid. Example: Samuel wants to his sister Clara to be a secondary cardholder for EBT. AGBI is used to collect and display basic identifying information relating to each AG. 123 Important Fields AGAR Authorized Representative NUMBER: Enter the member # if listed in the case. Enter “99” if outside of household. APPLY: Enter “Y” to indicate that the authorized representative is authorized to apply for benefits on behalf of the AG. RECEIVE/USE (FS only): Enter “Y” to indicate that the authorized representative is authorized to receive/use Food Assistance benefits on behalf of the AG. EBT AR (TCA, FS only): If “Y” is entered, the AR will receive an EBT card with a separate PIN and full access to customer’s benefits. SEND CLIENT NOTICES?: Enter “Y” to indicate that client notices will be sent to the payee shown on the screen as well as to the AG name listed on AGPY or “N” to indicate that client notices will not be sent to the payee showing on the screen. SEND MIC USING AGPY NAME?: Enter “Y” to indicate that the MIC will be sent with the AG name listed on AGPY or “N” to indicate that the MIC will be sent with the name listed on the screen. SEND NOTICES USING AICI ADDR? Enter “Y” to indicate that client notices will be sent to the household address on AICI or “N” to indicate that client notices will be sent to the address on the screen. SEND MIC USING AICI ADDR? Enter “Y” to indicate that the MIC will be sent to the household address on AICI or “N” to indicate that the MIC will be sent to the address on the screen. Example: Samuel’s sister Clara is entered as a secondary cardholder for EBT but not as a Authorized Representative. AGAR is used to collect and maintain demographic information on the AG's: authorized representatives (AR), designated representatives, protective payee (PP), legal guardian (LG), beneficiary (BE) if one exists, and alternate payee (AP). System / Policy Reminders This information must be collected before the AG can be authorized. 124 Important Fields AGPI Work Programs NAME, AGE, CAT, SEQ, AG STAT: Protected fields. Pay attention to this information when determining the individual’s work status. PART STAT: Enter the correct code for each individual. See WP Registration Status Codes Table TWPW. VUL AWD: Enter “Y” if the individual is an ABAWD subject to time limits. Enter “N” if the individual is not an ABAWD or an ABAWD that is not subject to time limits. REF TO: FS = Food Assistance Referral, WT = (TCA) Welfare Transition, TP = (TCA) Teen Parent, RP = RAP Employment And Training. REF DATE: Enter the referral date. Update the referral date annually. WK: Leave blank when completing the initial referral. The field will be updated automatically to indicate if individual completed TCA upfront work registration requirements. System / Policy Reminders Food Assistance ABAWD work requirements are currently waived. For ABAWDs, continue to use code 18 but answer “N” to VUL AWD. Example: Ruth is referred to TCA as code 03 / mandatory head of household to the Welfare Transition program. Laura is exempt as a code 12 / child under 16. AGPI is used to work register Food Assistance and TCA applicants/recipients. 125 Important Fields AGTF Application Tracking Food Assistance APPLICATION/RFA DATE: The date of application for the AG from AGPY. SCHEDULED INTERVIEW: System entered date from CSDS. If blank, enter date from AMS. DATE DRIVER RUN: System entered date when ASIA/ASRE driver begins or a new AG is built in the ongoing case mode. This field cannot be updated. ACTUAL INTERVIEW DATE: Date actual interview is completed from AITR. VERIFICATION DUE DATE: System entered date calculated beginning with the next business day after the driver run date and adding 10 days allowing for weekends and holidays. If pending from date of interview, update the field manually. LAST VERIF. RECEIVED: Last verification date entered on AITR. The field may be updated until authorization. EXPEDITED DISCOVERY: This field is used only when the AG is not screened as expedited and it is discovered at a later date. ISSUANCE DATE: System entered date. If the client has an EBT account, the current date will display. If no EBT account, the system will add three days if authorized before 11:00 am and four days if after 11:00 am. Example: Ruth’s Food Assistance was processed outside of the 30 day time standard due to non-agency delay in providing verification. TOTAL PROCESSING DAYS: System entered date. If there is a date in the expedited discovery date, the total days will be calculated from the discovery date. The tracking screens are used to track the number of processing days between the date of application and the disposal of the application. Information collected here establishes agency and non-agency days within the processing time. REASON: See Agency/Client Delay Reason Code Table TACD. PROCESSING DAYS AGENCY, NON AGENCY: Processing days that belong to the Agency or Non-Agency (Customer). TOTAL: Total # of processing days. 126 System / Policy Reminders 1. The tracking screens do not display unless time standards are not met or if the Food Assistance AG qualifies for expedited benefits. The tracking screen can be updated prior to AWAA authorization. To be correct, AITR Application Tracking, AGPY Assistance Group Names, and EDBC/AABC should be up to date. 2. All days start on the agency side. Use the correct code from Agency/Client Delay Reason Code Table TACD to move Non-Agency days to the Non-Agency column. Press PF19 to update the screen. 3. “AO” Agency Other and “AN” Agency/Non-Agency are the most common codes used. 4. To access the tracking screens, the parameter is: case #/category/sequence. NEXT TRAN: agtf__ PARMS: 7000051311/fs/01___________ 127 System / Policy Reminders AGTC Application Tracking Cash 1. All days start on the agency side. Use the correct code from Agency/Client Delay Reason Code Table TACD to move Non-Agency days to the Non-Agency column. Press PF19 to update the screen. 2. “AO” Agency Other and “AN” Agency/Non-Agency are the most common codes used. 3. To access the tracking screens, the parameter is: case #/category/sequence. NEXT TRAN: agtc__ PARMS: 7000051311/adcr/01_________ Example: Ruth’s TCA was processed with the 45 day time standard but there were 20 non-agency days due to her delay in providing verification. The tracking screens are used to track the number of processing days between the date of application and the disposal of the application. Information collected here establishes agency as well as non-agency days within the processing time. 128 Important Fields AGTM Application Tracking Family Medicaid ENTER Y FOR EX-PARTE: Enter “Y” if this is an exparte (changing Medicaid coverage groups) and not an application. This field appears only on Medicaid tracking screens. System / Policy Reminders 1. All days start on the agency side. Use the correct code from Agency/Client Delay Reason Code Table TACD to move Non-Agency days to the Non-Agency column. Press PF19 to update the screen. 2. “AO” Agency Other and “AN” Agency/Non-Agency are the most common codes used. 3. To access the tracking screens, the parameter is: case #/category/sequence. (Notice a space is used after the second letter.) NEXT TRAN: agtm__ PARMS: 7000051311/ma r/01_________ Example: Ruth’s Medicaid was processed with the 45 day time standard but there were 20 non-agency days due to her delay in providing verification. The tracking screens are used to track the number of processing days between the date of application and the disposal of the application. Information collected here establishes agency as well as non-agency days within the processing time. 129 Important Fields AGTS Application Tracking SSI Related DISAB REQUEST DATE: Displays the date the packet was sent to the medical unit. System entered from the AIDP screen. Display only. DISAB. DECISION DATE: If the AG is disability related, the system will enter the "date disability sent decision" from the AIDD screen. If no disability decision has been requested, the field will be blank. LOC RECEIVED DATE: Information for this field is received from the AIMN screen. NH PLACEMENT DATE: The system will access this date from the AINH screen. ENTER Y FOR EX-PARTE: Enter “Y” if this is an exparte (changing Medicaid coverage groups) and not an application. This field appears only on Medicaid tracking screens. System / Policy Reminders 1. All days start on the agency side. Use the correct code from Agency/Client Delay Reason Code Table TACD to move Non-Agency days to the Non-Agency column. Press PF19 to update the screen. 2. “AO” Agency Other and “AN” Agency/Non-Agency are the most common codes used. Example: Robert’s SLMB was processed within the 45 day time standard. 3. To access the tracking screens, the parameter is: case #/category/sequence. NEXT TRAN: agts__ PARMS: 7000051311/slmb/01___________ The tracking screens are used to track the number of processing days between the date of application and the disposal of the application. Information collected here establishes agency as well as non-agency days within the processing time. 130 Important Fields AWGV Pending AG Display Screen DISPLAY INFORMATION NEEDED FOR ALL PENDING AG"S? Enter 'Y' to display the verification checklist for all pending AGs within the case. DISPLAY VERIF CHECK LIST: Enter 'Y' to display the verification checklist for a specific AG. System / Policy Reminders Enter “Y” for all fields to view any pending information on AGVR. Example: Enter “Y” in all fields to view pending verification for Ruth’s case. AWGV is used to show which AGs are currently pended for information. 131 Important Fields AGVR Pending Verification Checklist EXTEND THE VERIFICATION DUE DATE? Allows user to extend the verification deadline. The EDBC driver must be run prior to extending the deadline. A "Y" response and PF22 are required to extend the deadline. CREATE/PRINT THE CURRENT VERIFICATION CHECKLIST? A "Y" will cause the verification checklist to be created. The user may use CNIN to print the notice, or allow the notice to be mailed out overnight. If the checklist is not created, no notice will go out. System / Policy Reminders 1. The pending verification is listed for each program or coverage group. 2. Go to CNIN to print notices online. 3. It is important to keep the system updated so that the customer’s information is correct in My ACCESS Account. Example: Ruth’s TCA is pending for verification of child support income. AGVR is used to view all entries that cause an AG to pend in the EDBC driver, print or re-print the verification checklist, show the date a "?" was originally placed in the verification field, show the date an assistance group was originally pended, the date originally due, extend the verification due date, the date of any extension, or the date information is currently due. 132 Important Fields AWAA Assistance Group Authorization REVIEW DATE: Indicates the date when the next eligibility review is due. ELIG STAT: Indicates the AG eligibility status determined by ED/BC. Pass, Fail, or Pend will be displayed. AG STAT: Indicates current AG status. See Valid AG Status Codes Table TVAS. CL = CLOSE, DE = DENY, EN = ENROLLED, OP = OPEN, PE = PEND REASON CODES: Specifies the reason(s) for the AG status. Up to 3 reason codes can be entered either by the system or the worker/supervisor. The primary reason should be entered first to support federal reporting requirements. See System Reason Codes Table TSRC http://eww.dcf.state.fl.us/~ess/florida/fl_ref_tables.shtml CR BY: Displays an indicator of how the particular AG was created. S = system generated, P = passing dates, F = fiated, B = both fiat and passing dates, W = worker altered on AGCC, X = worker altered on AGCC and fiated, Y = worker altered on AGCC and passing dates, Z = worker altered on AGCC, passing dates and fiated SUPRESS CN Y/N: This field allows the worker to suppress the notice for the AG. Note: Terminations cannot be suppressed. Notices for when benefits are reduced, closed or denied should not be suppressed. Duplicate notices can be suppressed. AUTH: If all necessary fields are complete, press enter to authorize benefits. Example: Samuel’s benefits are ready to be approved. System / Policy Reminders AWAA is used by the worker or supervisor to open, deny, or close system determined AGs and enter/change the "Review Date". 1. Reason Codes control the message on the customer’s Notice of Case Action. Do not overtype system determined reason codes. A negative reason code is required for when benefits are reduced, closed or denied. 2. Review Dates or Redetermination Cycles vary by program. The Application and Redetermination Review Cycles Chart is found on page 15 in the Customer Service Center Guide: http://eww.dcf.state.fl.us/ess/modern/cscguide.pdf 133 System / Policy Reminders Attachment 1: CLRC Running Record Comments 1. CLRC does not appear in the FLORIDA driver. Remember that if it’s not in CLRC, you didn’t do it. 2. Use the CLRC Power Tool to document any case action. Different CLRC templates are available: CLRC Template EBT Action Form Bill Tracking Form Change/Call Center Template CIC Template Denial/Closure Template Intake Interview Template 3. CLRC is part of the case record. The customer may review CLRC as part of hearing request or other circumstances. A supervisor can clear comments entered in error. 4. See your supervisor if you discover any inappropriate comments. CLRC allows staff to add or look at comments for a specific case. 134 Attachment 2: How To Layer Screens BEG MMCCYY and END MMCCYY Application: 1. Complete the current screen. Press enter. 2. Return to the same screen. Update the BEGIN MMCCYY, END MMCCYY, and MO AMTS fields. Answer “N” to Income Terminated. Press enter. 3. To view the “layered” past month, check history. 4. If changes or updates to a “layered” month are required, use the same steps. Recertification, Reported Change 1. Go to the current screen. Complete the END MMCCYY field with the month prior to the new recertification period or reported change. Answer “N” to Income Terminated. Press enter. 2. Return to the same screen. Update the BEGIN MMCCYY with the first month of the recertification period or reported change. Remove the date in the END MMCCYY field. Update the MO AMTS fields. Answer “N” to Income Terminated. Press enter. 3. To view the “layered” past month, check history. Layering Rules 1. When “layering”, information is placed in history in chronological order by month and member #. 2. Use a new screen when employment has changed or for a new individual. Do not use a second screen for the same individual or same income source. 3. A”?” can be layered. When verification is received, use the steps shown above and “layer” over the “?” screen. 135 Example: Layering AFEI Screens (Current Ongoing) Example: Layering AFEI Screens (Actual/Past Month) Example: To “layer” AFEI screens, return to the current ongoing screen. Example: Update the BEGIN MMCCYY, END MMCCYY, and MO AMTS fields. Use the total actual income received for the month. Press enter. To view the “layered” past month, check history. Remember to “layer” AFEI screens at recertification or when processing reported changes. 136 Attachment 3: How To Access History 1. Screens with “BEG MMCCYY” and “END MMCCYY” fields AICI case #/current date MMDDCCYY. Press PF8 to page forward. NEXT TRAN: afei__ PARMS: case #//today’s date___ AIID AIIC AWAA case #/one day before the effective begin date MMDDCCYY. To go back in history, enter one day before the effective begin date Earlier dates may be used. AIIA N/A AIDP case #/current date MMDDCCYY but does not page forward. AFBA AFEI AFMI AFSE AFSC AFUT AFSU AFRE AFME AFBP AFDE AFDP AFBE AFBA AFEA AALA AALI AAVH AARP AARC AALS AAAT AABE case #//current date MMDDCCYY AFMD case #/current date MMDDCCYY To access history, use the following parameters: 2. Screens without “BEG MMCCYY” and “END MMCCYY” fields To access history, use the following parameters: NEXT TRAN: aici__ PARMS: case #/today’s date___ Earlier dates may be used. 3. Budget Screens NEXT TRAN: abfn__ PARMS: case #/fs/sequence #/today’s date___ Earlier dates may be used. When checking the AWES budgets, press PF8 to page forward to the next budget month. To view a specific individual, use case #/SSN or PIN #/current date MMDDCCYY Budget case #/category/sequence #/MMDDCCYY. Use the first date of the Screens budget month. 137 Example: Accessing History / Screens with Begin End MMCCYY fields Example: AFEI History Begin End MMCCYY fields Example: Samuel requested retroactive Medicaid for February. His actual income was layered under the ongoing AFEI screen for April. History screens appear in blue. If layered correctly, the screen history is in chronological order by member #. Press F8 to view earlier months. To access history, use the following parameters: For cases with several active individuals, use the individual’s SSN between the slashes to go directly to the screen: NEXT TRAN: afei__ PARMS: case #//today’s date___ NEXT TRAN: afei__ PARMS: case #/individual’s SSN/today’s date___ Earlier dates may be used. 138 Example: Accessing History / Screens without MMCCYY fields Example: AICI History (No MMCCYY field) Example: To check Samuel’s prior addresses, check AICI history. Example: History screens are shown in blue. Press PF8 to page forward. Check the Effective Begin Date field to see when the screen was updated. To access history, use the following parameters: NEXT TRAN: afei__ PARMS: case #/today’s date___ Earlier dates may be used. 139 Attachment 4: “NO PENDING AGS EXIST FOR THIS CASE” Example: AGCD shows no TCA or Medicaid Example: TCA and Family Medicaid may not build if the child is coded as “married” on AIIA. (The child will be an Eligible Adult (EA) for Food Assistance.) For specified relative cases, the AIHH Caretaker field may be incorrect. Example: Food Assistance will not build because AIIC Living Arrangement Type is coded as “04” Boarders or some other institution code. AGCD may display this system message if certain FLORIDA screens are incorrect. For FLORIDA to build TCA and Family Medicaid, children must be coded correctly. To correct the problem, check the following screens first: AIPB Benefit Selection, AIID DOB field, AIIC Living Arrangement Type field, AIIA Marital Status field, and AIHH Household Relationships. For TCA, check if the child turned age 18, or is 18 and no longer in high school. For Child In Care (CIC) Medicaid, check if the child is an SSI recipient. If SSI has not ended, see work around #53. For Food Assistance, check AFRE Room Board Earnings, AFBP Room Board Payments, if the certification period expired, or if case is no longer in ASRE mode For MSSI Medicaid, check if the Individual is not aged or disabled or the AIDP Confirm/Deny reason or begin date. If AIMN or AINH are end dated, nursing home coverage will not build. 140 Example: AOBT PF20 Attachment 5: AOBT Medical Bill Tracking Example: Press PF20 to sort the bills. Note that the paid bill for March does not appear. Example: Samuel provided medical bills for the month of May. His SOC is $180. Michael’s $50 paid bill to Family Dentistry not covered by Medicaid. For billing and tracking, allowable medical expenses are medical expenses that are: unpaid and still owed, or paid during the current month, or incurred and paid during the three months before the tracking month but no earlier than the three retroactive application months, and not subject to third party payment. To access the AMIC screen, use the following parameters: case #/category/sequence/month MMCCYY. NEXT TRAN: aobt__ PARMS: 7000051396/na r/01/052011_________ 141 Example: AOBT PF21 Example: AOBT PF22 Example: Any bills used to meet the SOC for May are shown. Note that the paid bill for March now appears. Press PF21 to determine if the SOC is met. If met, the message “SOC MET. BILLS NOW CAN BE TRACKED. PRESS PF22 WHEN READY” will be displayed. Example: The bills are no longer updateable. To see which bills are potentially covered, check the “STATE TO PY” field: “Y” Yes, “N” No, “S” Split. Press enter to go to AWAA. An “S” Split Bill means that more than one bill was used on the date the SOC was met. Any bills used to meet the SOC are not covered. The specialist must send a CF-ES 2902 Medically Needy Billing Authorization form to eligible providers so they can be paid. Previously entered bills may appear. Bills may be deleted by typing “AE” in the DC field. Once PF22 is pressed, it is difficult to change the date the SOC is met in FLORIDA. Make sure all allowable bills have been entered and accounted for and that the date the SOC is met is correct. See DCF Forms CF-ES 2902 Medically Needy Billing Authorization 142 Example: AWAA Reason Code 051 Example: CLRC Bill Tracking Form Example: For the Medically Needy coverage group only, enter reason code 051 MONTHLY SHARE OF COST IS MET. Press enter. Do not make any other changes. Example: Be sure to document CLRC with all necessary details. Use the BILL TRACKING FORM template. 143 Important Fields Attachment 6: AMIC Print Emergency MIC / Reissue Hard Card REISSUE REASON: When a MIC Hard Card reissue is requested, enter the code for reissuance reason. See Table TRHC. DM = damaged LS = lost NR = non-receipt TH = theft/stolen. System / Policy Reminders 1. The customer’s Medicaid Gold Card is issued only when the individual is initially approved. If lost or stolen, the customer must request a new hard card through the Call Center or with My ACCESS Account. 2. Do not request hard card reissuance within 60 days from approval of Medicaid or within 30 days of last request. 3. To print a MIC, the Medicaid coverage group must be open. A MIC cannot be printed for a future month. If FLORIDA does not allow you to print a MIC for emergency SSI Medicaid (ASEC), run a passing date and reauthorize AWAA. 4. To access the AMIC screen, use the following parameters: case #/category/sequence/month. Example: Ruth was recently approved for Medicaid but has not yet received her Medicaid Gold Card. The specialist prints a paper MIC for her to use as proof of Medicaid coverage. NEXT TRAN: amic__ PARMS: case #/category/sequence #/month___ or AMIC is used to print an emergency Medicaid Identification Card (MIC) and/or reissue a Medicaid Gold Card or identification hard card for one or more AG members. NEXT TRAN: amic__ PARMS: 7000051311/MA R/01/052011_________ Note: The category is the Medicaid coverage group. Use a space in the 3rd slot except for NS. 144