CHANGES MR A QMB Only, SLIB Only, or QI-1 case cannot be SWAPPED to an AABD Medical, Parent Assist, KidCare Assist, or Cash case.

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1 CHANGING BETWEEN MEDICAL ONLY AND CASH (SWAP) 09/01/00 Cases are SWAPped when a Cash case is closed and an AABD Medical, Parent Assist, KidCare Assist, QMB Only, SLIB Only, or QI-1 case is opened or when an AABD Medical, Parent Assist, or KidCare Assist case is closed and a Cash case is opened. A QMB Only, SLIB Only, or QI-1 case cannot be SWAPPED to an AABD Medical, Parent Assist, KidCare Assist, or Cash case. Cases cannot be SWAPped between TANF Cash or KidCare Assist and KidCare Share, KidCare Premium, and KidCare Rebate. To change the case status from TANF Cash or KidCare Assist to KidCare Share, KidCare Premium, or KidCare Rebate, the TANF Cash or KidCare Assist case must first be canceled. Then set up a new KidCare Share, KidCare Premium, or KidCare Rebate case. To change the case status from KidCare Share, KidCare Premium, or KidCare Rebate to TANF Cash or KidCare Assist, first cancel the KidCare Share, KidCare Premium, or KidCare Rebate case. Then set up a new TANF Cash or KidCare Assist case Medical Only Client Requests Cash 07/01/02 When an AABD Medical or Parent Assist client requests Cash benefits, they must cooperate in the child support enforcement process (see WAG ). For TANF Cash cases which contain an adult, an assessment must be completed and the client must cooperate in developing, signing, and following through on their Responsibility and Services Plan. LO 1. Give the following forms to a Medical Only client who requests Cash benefits. Request For Financial Assistance (Form 2905). Tell the client to complete, sign, and return the form. Family Accountability (Form 3609) to any Parent Assist or KidCare client who requests Cash benefits. Write in the case record that the client was given Form Answers to TANF Questions (Form 4047) to clients requesting TANF Cash. == Domestic Violence Exclusion brochure (Form 4710) to clients requesting TANF Cash. 06/03/02 WAG

2 LO 2. Check the case record to see if it includes an application for cash. An application for cash is a form other than: Request for Medical Assistance - Hospital/Nursing Home Application (Form 2378H); or KidCare Application (Form 2378KC); or KidCare-Health Insurance for Illinois Children (Form 2378KC or Form 2378MC). If there is an application for cash in the case record, the client only has to complete a Form If a Form 2378H, Form 2378KC, or Form 2378MC is the only application in the case record, the client must complete a Mail-in Request for Cash Assistance - Medical Assistance - Food Stamps (Form 2378B) and Form a. Check the case record to see if an assessment has been completed. If not and the request is for a SWAP to TANF Cash and there is an adult in the case, an assessment is required. Schedule an assessment appointment for the client. 2b. If requested by the client, waive the appointment when a hardship prevents them from coming to the LO. See PM b and WAG b for hardship situations. NOTE: If only Form 2905 is needed, an interview is not needed. Client 3. Returns the completed Form LO/ 4. For TANF Cash requests which contain an adult, complete a Client Responsibility and Services Plan (RSP) (Forms 4003 through Form 4003C). If the client is receiving intact family services from DCFS, don t schedule the client for times or activities which conflict with their DCFS obligations (see PM a and WAG a for further instructions concerning DCFS Intact Family Services). 4a. From the information obtained during the assessment process, identify any barriers to work and set specific goals and activities to move the client past those barriers. Work with the client in deciding which goals and activities will best meet their specific situation. WAG (1) 06/03/02

3 LO 4b. When setting goals, determine if the client is job-ready. If a client is job-ready, you can immediately refer the applicant to existing job possibilities present in the community (see WAG b). 4c. If the client has a barrier to work (e.g. domestic violence, substance abuse, mental illness), set goals and activities that address these barriers. Be prepared to make appropriate referrals to go along with the activities. For example, refer clients identified as potentially having a substance abuse problem for a substance abuse evaluation. 4d. If the client is a teen parent who has neither a high school degree nor a GED, set an education and training goal of having the teen parent complete high school or a GED program. Upon approval of the SWAP request for a case containing a teen parent, make an immediate referral to Teen Parent Services (TPS) and forward a copy of the RSP. 4e. For each goal set, help the client develop activities which, when achieved, help them reach their goal. Activities must reflect specific accomplishments on the way to achieving the goal and have an expected completion date. When assigning activities to be completed for the RSP, allow a sufficient amount of time for the client to complete the activity. 4f. On the client s RSP, clearly indicate the time allotted for the client to complete the activity. Give the client a copy of the RSP. 5. Enter the date received on Form Date stamp forms received by mail. Approve or deny the request for cash benefits and process the request within 45 calendar days from the date Form 2905 was received. 6. Establish a control to make sure Form 2905 is processed within the 45-day time limit. 7. Complete ANQR and ARS inquiries. 7a. Complete an ACID inquiry when ANQR shows a matching record to another case. 7b. If there is a matching record on the ARS inquiry and the case number doesn't match the case number in ARS, send Change of Overpayment Information (Form 2404C) to the Bureau of Collections (BOC). 06/03/02 WAG (2)

4 LO 8. Inform the client of their responsibility to cooperate in obtaining support and right to claim good cause for noncooperation (see PM ). 9. Verify the following eligibility factors only if they are related to the change: income, employment, and assets (if not previously verified). 10. For TANF, review the case to make sure each person who must be included in the cash unit is added at the time of the SWAP (see PM ). If the payee requests the addition of a person who is not required to be included in the unit, the caretaker relative must complete and sign Request for Assistance for Additional Family Member (Form 243). Review the status of each child in the case for eligibility under the Family Accountability policy. NOTE: If the client completed a Form 243, notify the payee of the decision using Notice of Decision on Request for Financial Assistance (Form 1934). Review the case and Form 552 to make sure that all necessary information is available including marital status, work experience, education completed, Veteran s status, and if the client has ever lived outside the State of Illinois. 10a. Complete an AWVS inquiry for every person being added who is age 16 and older. 11. Explain Health Insurance Premium Payment (HIPP) Program (PM ) if a family member has a high cost medical condition and has health insurance available to them. 11a. Give the client HIPP Information Sheet (Form 3459) and help them complete Health Insurance Premium Payment (HIPP) Referral (Form 3459B). 12. Determine eligibility for both TANF Cash and AABD Cash after verifying the factors that caused the change from AABD Medical, Parent Assist, or KidCare to Cash. For TANF Cash, also review work and training cooperation status. Example: A client receives Unemployment Insurance (UI). The benefits run out and the client requests cash benefits. Verify that UI ended. No other eligibility factors need to be verified. WAG (3) 06/03/02

5 LO 13. For TANF Cash, determine if the case should be in quarterly reporting (see WAG ). 14. If a SWAP request to TANF Cash is to be denied, record the denial by completing the current Form 552 for the 94/96 case as follows: Item 2 - Enter the regular roll effective month. Item 3 - Enter TA 31. Item 33 - Enter TAR 61. Item 80 - Enter the following 2 codes: 333 DCR Date of Cash Request In the AMOUNT column, enter the 6-digit date the SWAP request was received. 334 DENY Date of Denial In the AMOUNT column, enter the 6-digit date the SWAP request was denied. In the PERSONS column, enter the 2-digit denial code that represents the reason the SWAP request was denied. NOTE: Codes 333 DCR and 334 DENY must be entered together for the action to process. If the Cash request is denied, complete and send the Denial Cash and/or medical section of Form 360I showing the reason for the denial. 15. When approving a SWAP to Cash, complete the current Form 552 as follows: Item 1 - Category: Enter the new category code above the current category. Do not line out the printed category code. Local Office: Do not change this item. If an inter-office transfer is involved, process the transfer action before the SWAP. Basic Number: Do not change this item. If there is a change in payee, process the change as a separate action before the SWAP. For a change in payee, see WAG /03/02 WAG (4)

6 LO NOTE: To process a SWAP from 94R to TANF Cash, first change the case number from the 94R case number to a 94 case number. After the number is changed, process the SWAP. Item 2 - Effective Date: Line through the printed date and enter the 6-digit date that is the 30th day following the date that Form 2905 was received in the local office, or for TANF, the date of initial eligibility after the 30th day following the date that Form 2905 was received. This date is the Cash approval date. The Medical case is centrally canceled for the month following the processing month. NOTE: For AABD, if the client resides in a sheltered care home, enter the date that Form 2905 was received or the date the client entered the sheltered care home, whichever is later. If the client entered the sheltered care home after the 30th day following the date Form 2905 was received, enter the 30th day following the date Form 2905 was received. Item 3 - Type Action: Enter code 81 or 82 as follows: Item 4 - Enter Enter when opening the case under the new category as a new approval. TA 11 is centrally entered on the Form 552 printout. The case is automatically registered by the system as a new application, TA Enter when the case was previously authorized under the new category and assistance is to be restored. TA 12 is centrally entered on the Form 552 printout. The case is automatically registered as a reapplication, TA 02. Item 5 - Item 6 - Items Complete, as needed. Complete (caseworker). Complete as needed. WAG (5) 06/03/02

7 LO Item 30 - For TANF Cash, record completion of a REDE, entering the calendar month that the determination of cash eligibility was made. But, do not complete a REDE, or TANF Eligibility Information (Form 4002). Items 31, 32 - Complete as needed. Item 33 - Enter the correct opening TAR. The TAR appears on the Cash opening printout. One of the following closing TARs is automatically generated and printed on the Medical closing printout: SWAP from Medical Closing Reason 90 to to to to to to Item 35 - Item 36 - Item 39 - Complete as needed. When a case meets quarterly reporting criteria, enter the correct code. Enter code 90 to suppress the central notice (Form 360C). Complete and send the Form 360 series. Send the first page, Form 360D, and the appeals rights page, Form 360P. Complete and send any other pages and sections that apply to the program(s) where a determination was made. For AABD cases, complete and send AABD/Food Stamp Computation (Form 4050). Always complete the following information on Form 360D: Date of Notice; Local office name, address, and telephone number; and Date of application. This date must always be the date the LO received the completed Form /03/02 WAG (6)

8 LO Item 42 - Complete as needed. CHANGES MR Item 44 - Complete Items Complete as needed. Item 60 - For TANF Cash, reenter or enter QMB status indicator as needed. For clients enrolled in State Buy-In, reenter status indicator 6 to continue Buy-In. Also reenter HIB status indicator 2. Enter a work and training code, as appropriate. For AABD, reenter or enter QMB status indicator as needed. For clients enrolled in State Buy-In, reenter SMIB status indicator 6 to continue Buy-In. Also reenter HIB status indicator (SI) 2, HIB SI 3, HIB SI 4, SMIB SI 5, SMIB SI 7, or SMIB SI 9 when already present. Items Complete as needed. Item 77 - Item 78 - Item 79 - Item 80 - Enter as the beginning medical eligibility date, the first day of the month in which the SWAP took place. See Item 2. If the case was in spenddown, determine eligibility for backdated medical. For TANF Cash, review the code for every child in the case to determine if the unit is eligible for an increase in the Payment Level under Family Accountability policy. Complete as needed. Revise as needed. See Step 16a for the entry of code 100 and the IPE. When a case is SWAPPED from Medical to TANF Cash, enter code 333 DCR. Under AMOUNT enter the 6-digit date the request for the SWAP was made by the client. When a case is SWAPPED from Medical to TANF Cash and the case contains an adult, enter code 675 CAF. For AABD Cash, enter the Needs codes that apply to the case. Item 90 - Enter any budgetable monthly income. WAG (7) 06/03/02

9 System 16. If eligible, authorizes an Initial Prorated Entitlement (IPE) to meet needs until receipt of the first regular roll check. LO 16a. Compute and authorize the IPE as an exception to central prorate when: income/deductions are applied to the IPE that are not used for the regular monthly benefit; income/deductions not applied to the IPE period are deducted from the regular monthly benefit; needs included in the IPE period are not continued in the regular monthly benefit; or the IPE period is for more than 60 days. To authorize an exception to central prorate, enter Item 80 code 100 and the prorated amount(s). Round down the IPE. For TANF Cash, enter any regular monthly needs to be authorized in addition to the Payment Level. NOTE: The system issues an IPE check in the amount entered for code 100. If code 100 is not rounded down, the system rounds down automatically. See WAG c for TANF and WAG b for AABD, to calculate the IPE amount as an exception to central prorate. Start cash benefits effective: the 30th day following the date Form 2905 is received in the local office; or for TANF Cash, the date of initial eligibility after the 30th day following the date Form 2905 was received; or for AABD Cash, if the client resides in a sheltered care home, the date Form 2905 was received or the date of entry into the sheltered care home, whichever is later. If the client entered the sheltered care home after the 30th day following the Form 2905 receipt date, start cash benefits effective the 30th day following the Form 2905 receipt date. NOTE: If the unit receives nonexempt earned/unearned income, determine the amount of the IPE check by budgeting income (see PM for TANF; see PM for AABD) anticipated to be received during IPE period against the IPE amount. 06/03/02 WAG (8)

10 LO When a KidCare Assist or KidCare Moms and Babies client requests a SWAP to Cash and is eligible for the first 30 days and IPE period, but is ineligible for the first regular roll month because earnings are too high: SWAP to Cash; issue IPE; and cancel the case with the TAR that provides a medical extension. Processing a SWAP with FS for the same effective month for both Cash and Medical is important to prevent duplicate FS benefits or no FS benefits. The system calculates and issues gap/overlap benefits when both actions are processed for same effective month. A limited time is available to do a SWAP for the same effective month. The amount of available time depends on the schedule number of the cash case. The later the cash schedule, the less time there is to do the SWAP for the same effective month. For help in determining time available, see the Schedule of Authorization Due Dates and Availability Dates. Use the following procedures regarding the client's eligibility for FS benefits. Eligible For Cash - Active FS Case LO 1. If the client has separate Medical and FS (Category 08) cases, cancel the Category 08 case effective the first regular roll month of the Cash benefit. Authorize FS on the same Form 552 for the first regular roll month of the Cash case. Do not extend the approval period past the original 24-month period. 2. If the client gets Medical and FS on the same case, authorize benefits under the Cash case number starting with the first regular roll month of the cash benefit. For AABD, the FS approval period ends the same month it was approved for under the AABD Medical case number. For TANF Cash, change the approval period end date to correspond to the TANF Cash REDE cycle. For TANF: Review the end date of the FS approval period. If the period ends before the next face-to-face TANF Cash REDE, have the client complete an FS REDE application. Authorize the new period to end with the next face-to-face TANF Cash REDE. If the approval period ends after the next face-to-face TANF Cash REDE is due, do not change the period. When the face-to-face TANF Cash REDE is done, have the client complete an FS REDE application. The new approval period ends with the next face-to-face TANF Cash REDE. WAG (9) 06/03/02

11 LO For AABD and TANF: When necessary, issue gap/overlap benefits that may be required due to the change in fiscal months (see PM ). Include a copy of the latest FS application with the case record. Make sure copies of the correct FS documents are put in the case record (see WAG a). Ineligible For Cash - Active FS Case LO Review the case to make sure the eligibility factors reported in the cash benefit determination are reflected in the FS amount. Eligible For Cash - No Active FS Case LO 1. When a client submits Form 2905, ask if they want to apply for FS. If the client is interested in getting FS, check the case record for an application for cash. An application for cash is a form other than a Request for Medical Assistance - Hospital/Nursing Home Application (Form 2378H), or KidCare Application, or KidCare-Health Insurance for Illinois Children (Form 2378KC or Form 2378MC). 2. If the case record contains an application for cash, have the client complete Application for Food Stamps (Form 683). If the client must complete a cash application for the cash request, do not have the client complete Form Register the application and, if necessary, issue FS on the Cash case number. 4. If the client is eligible for Cash benefits and an FS application is pending under a Category 08 number, process a TA 62 to transfer the pending Category 08 registration to the Cash case number. Process the transfer after the SWAP to Cash. 5. If the client is determined eligible for Cash, and an FS application is pending under the Medical number, process the SWAP to Cash. Then approve the FS application under the Cash case number. 6. Send the correct pages and section(s) of the Form 360 series to notify the client of the decision on the FS request and approval of the Cash request. For AABD, include with Form 360 series the AABD/Food Stamp Computation (Form 4050). 06/03/02 WAG (10)

12 Ineligible For Cash - No Active FS Case CHANGES MR LO 1. When a client submits Form 2905, ask if they want to apply for FS. If the client is interested in getting FS, check the case record for an application for cash. An application for cash is a form other than a Request for Medical Assistance - Hospital/Nursing Home Application (Form 2378H), or KidCare Application, or KidCare-Health Insurance for Illinois Children (Form 2378KC or Form 2378MC). 2. If the case record contains an application for cash, have the client complete Application for Food Stamps (Form 683). If the client must complete an application for cash for the cash request, do not have the client complete Form Register the FS application under the Medical number. If eligible, issue FS. If eligibility for expedited services exists, issue within expedited timeframes. 4. Complete and send the correct pages and sections of the Form 360 series, showing the reason for the Cash denial and the FS approval, if eligible. 5. If expedited FS are issued and there are postponed verifications, establish a one or 2-month approval period (see PM ). Complete Form 360M, advising the client when to reapply for FS. 6. Deny the application and notify the client of the decision on the FS request, if eligibility doesn't exist. Transfer-In and SWAP To transfer-in and SWAP a case, take the following actions in this order. LO 1. Transfer-in and cancel the existing case using the current Form 552, entering TA 45. The submittal must be made by the cut-off date of either the sending or receiving office for the same processing month, whichever comes first. 2. Register an application or reapplication for the new case using a blank Form 552. The effective date of the application is the actual month, day, and year that the client made the SWAP request and the TA must be either 01 or Open or restore assistance on the new category case completing the Form 552 used to register the application. WAG (11) 06/03/02

13 LO 4. Authorize the case as follows: CHANGES MR To authorize Cash, see WAG a for TANF or WAG a for AABD. When completing Form 552, complete these items as follows: Item 2 - Enter the 6-digit month, day, and year for which cash is to be authorized under the new category. Item 3 - Enter either TA 11 or 12. Item 4 - Enter 1. If the case is eligible for an IPE, authorize the IPE and the regular roll action on the same Form 552. Start cash benefits effective the 30th day following the date Form 2905 is received in the local office, or for TANF Cash, the date of initial eligibility after the 30th day following the date of the written request. To authorize Medical, see WAG b for TANF or WAG b for AABD. When completing Form 552 enter in Item 2, the month and year for which medical is to be authorized under the new category a Financial Help For Clients When They Find a Job (TANF) 02/10/99 Use Form 2151 to connect these applicants to the community partner. The community partner returns the Form 2151 to the local office indicating each item provided and its cost Changing an Ineligible Cash Case to a Medical Only or S/P/R Case 01/01/02 LO 1. When you learn that an AABD Cash or TANF Cash case is ineligible for Cash benefits, review eligibility for a Medical Only program. If eligible for a medical program, SWAP the case to AABD Medical, Parent Assist, KidCare Assist, or KidCare Moms and Babies. The client does not have to complete a written request, if eligible just SWAP the case. If eligible for KidCare Share, KidCare Premium, or KidCare Rebate, cancel the existing case and set up a new KidCare Share, KidCare Premium, or KidCare Rebate case. 1a. Complete and send Notice of Change (Form 157) or Notice of Benefit Change Resulting From Status Report (Form 357). 06/03/02 WAG

14 LO 1b. If income makes the Cash benefits stop, complete and send a manual computation form with the cancellation notice. For TANF Cash, use TANF/Food Stamp Computation - Work Pays (Form 553J) and, when needed, Attachment to Computation of TANF Grant/Food Stamps (Form 553G). For AABD Cash, use AABD/Food Stamp Computation (Form 4050). 2. SWAP the case to AABD Medical, Parent Assist, KidCare Assist, or KidCare Moms and Babies by completing the current Form 552 as follows. Item 1 Item 2 Item 3 - Category: Enter the new category code above the current category. Do not line out the printed category code. Local Office: Do not change this item. If an inter-office transfer is involved, process the transfer action before the SWAP. See WAG for transfer-in and SWAP. Group Number: If the Medical case does not have FS on the same Form 552, enter 00 for the group number. If the Medical case has FS on the same Form 552, enter 22 for the group number. Basic Number: Do not change this item. - Effective Date: Line through the printed date. Enter the effective date (2-digit month and 2-digit year) of the Cash cancellation. The Medical case is approved for the same month. - Type Action: Enter code 81 or 82 as follows: Item 4 - Enter Enter when opening the case under the new category as a new approval. TA 11 is centrally entered on the Form 552 printout. The system automatically registers a new application, TA Enter when the case previously under the new category and benefits are restored. TA 12 is centrally entered on the Form 552 printout. The system automatically registers a reapplication, TA 02. WAG (1) 06/03/02

15 LO Item 5 - Complete as needed. CHANGES MR Item 6 - Complete (caseworker). Items Complete as needed. Item 33 - Enter the correct SWAP TAR (see WAG s for TANF or WAG q for AABD). The TAR appears on the Cash cancellation printout. One of the following opening TARs is automatically generated on the Medical opening printout: SWAP from Medical Opening Reason 00 to to to to to to Item 35 Item 39 Item 42 Item 44 - Complete as needed. - Enter code 80 or code 92, if the SWAP includes Food Stamps. For the Medical opening, complete and send Form 458 or Form 458SP and the correct food stamp notice. - Enter a date when necessary. - Complete. Items Complete when needed. Item 60 - For TANF, reenter or enter QMB status indicator as needed. For clients enrolled in State Buy-In, reenter SMIB status indicator 6 to continue Buy-In. Also reenter HIB status indicator 2. For AABD, reenter or enter QMB status indicator as needed. For clients enrolled in State Buy-In, reenter SMIB status indicator 6 to continue Buy-In. Also reenter HIB status indicator 2, 3, or 4, or SMIB status indicator 5, 7, or 9 when already present. 06/03/02 WAG (2)

16 LO Items Complete as needed. Item 78 Item 80 - For KidCare Assist and KidCare Moms and Babies, keep code C for a child, unless the child is MANG(P) eligible. If MANG(P) eligible, enter code G or H based on the client s situation. - Revise as needed a SWAP of Sanctioned TANF Cash/FS Case 01/01/02 System Retains code 512 and its amount from the TANF Cash/FS case for reentry on the KidCare Assist/FS or KidCare Moms and Babies/FS case when the LO SWAPS a TANF Cash/FS case to KidCare Assist/FS or KidCare Moms and Babies/FS after a case is centrally placed in zero grant status for the 4th month of a sanction due to noncompliance with one or more of the following cash program initiatives, and the FS benefits are on the same Form 552 as the sanctioned TANF Cash: Child Support the School Attendance Initiative the Activity Requirement NOTE: Local office staff can add, change, or delete code 512 on Medical cases. Reenters the correct Item 80 sanction code(s) on the KidCare Assist/FS or KidCare Moms and Babies/FS case and changes the reason code to 92 (inactive). Budgeting System Uses the code 512 amount to budget the full TANF Cash benefit amount for food stamps. Code 512 remains in Item 90 until the case is no longer coded for participation in the Food Stamp program or LO changes the reason with the Item 80 sanction code to end the sanction. WAG a 06/03/02