The Kansas Economic and Employment Support Manual (KEESM)

STATE DEPARTMENT OF SOCIAL
REHABILITATION SERVICES
Integrated Services Delivery
Docking State Office Building
Room 681 - West
Topeka, Kansas 66612

Final - Oct. 1, 2004

TO: Area Directors
        Economic and Employment Support Chiefs
        Economic and Employment Support Staff
        Social Service Chiefs
        Other Staff

RE: Summary of Changes for Kansas Economic and Employment Support Manual (KEESM) Revision No. 20 effective October 1, 2004

PURPOSE, BACKGROUND, and REASON FOR CHANGE

The purpose of this document is to transmit Revision No. 20 of the Kansas Economic and Employment Support Manual effective October 1, 2004.

All Programs - This revision corrects an inadvertent error in a previous manual revision regarding the resources which must be verified prior to approving eligibility for cash, food stamps, and medical assistance. Further information is found under clarifications for all programs.

This revision also implements special provisions for the treatment of medical expenses for food stamp and Medicaid recipients with a Medicare Approved Drug Discount Card. These special provisions are mandated by USDA and based on the Medicare Prescription Drug, Improvement and Modernization Act of 2003. Section 1860D-31(g)(6) of this act directs that the availability of negotiated prices or Transitional Assistance received through the Medicare Approved Drug Discount Card “shall not be treated as benefits or otherwise taken into account in determining an individual’s eligibility for, or the amount of benefits under any other Federal program.” To implement this provision, food stamp consumers with a Medicare Approved Drug Discount Card must be allowed the pre-discount price of the prescription drug when determining allowable food stamp medical expenses. Implementation instructions for this new policy will be provided in the Implementation Memo.

Child Care - This revision will introduce several changes related to child care providers. A KsCares system change will be migrated to coincide with this revision.

There will be a new division for relative child care separate from registered child care on PRRA and on the Maximum Hourly Child Care Provider Rate Schedule.
In-home child care will have one flat statewide rate. The rate proposed will be $1.72/hour for all ages. Also, clients who use in-home care (care in the child’s own home) will be required to verify contact with IRS and obtain their own Federal Employee Identification Number (FEIN). Proof of the FEIN will be required at enrollment. KsCares will still require the client’s SSN preceded by a “3" for payment purposes. This additional approval criterion for In-Home subsidy is an attempt to insure that parents and providers are clear on their IRS and Dept. of Labor obligations regarding use of this type of care.
A new category “Older infants” is being added to the child care center rates. Older infants are 13 months through 18 months. Current rates will be populated in this field until the state is able to offer a different rate for this category. A 2004 Market Rate Analysis is currently under way.
A new Tier table will be added to the provider rate structure. A Tier field will appear on PRRA. All providers will have this field blank until Tiers are actually implemented. This will allow SRS to recognize provider efforts to increase the quality of their care by having the ability to pay a higher rate. These higher rates will be implemented as Budget allows.

This revision will also begin to implement child care provider data collection needed for EBT CC. This data will need to be kept in the file for staff to enter onto KsCares when the new screens are available.

This revision will also implement changes on responsibilities for child care costs when a foster child is involved. A new Foster Care contract interpretation was given during the past Legislative session and the change is reflected in section 2833 (2).

This revision also includes several other technical corrections and clarifications applicable to child care policy.

Food Assistance - This revision incorporates the annual adjustments to the Food Stamp Program that are effective October 1 of each year. Increasing are the standard deduction amounts, the excess shelter deduction, the gross and net income limits, and the maximum allotment amounts. These changes were processed with rollover in August effective for October 1, 2004. Further information about these changes was provided prior to rollover in August.

This revision also includes several other technical corrections and clarifications applicable to food stamp policy.

Medical Assistance - House Substitute for SB 272, passed by the 2004 Kansas Legislature, contains four separate provisions related to medical assistance implemented in this revision: Medicaid lien provisions; an expanded definition of estate for Estate Recovery purposes; specific rules for treatment of some property with shared ownership; and provisions for treating some contractual arrangements for provision of long term care services as a resource.

The changes in the Tuberculosis coverage group are being made as a result of an interagency agreement between KDHE and SRS to better provide service to individuals in a more cost effective manner.

Successful Families - The information regarding Welfare to Work (WtW) is being removed from the KEESM as all of the Local Areas (LA) have exhausted their WtW funding.

ALL PROGRAMS
1. CHANGES
  1. Living with a Caretaker - The definition of an eligible caretaker is being expanded to include a step-grandparent, a step-aunt, and a step-uncle. Children and Family Services requested this change to match the definition of a relative used for foster care purposes and to match the definition used by the Kansas Department of Health and Environment (KDHE) when licensing child care providers. See Section 2220(2).
  2. Non-Cooperation with Child Support Enforcement (CSE) - For TAF, children will no longer be penalized when a non-legally responsible caretaker fails to comply with CSE. This is in compliance with federal law. Although the children will continue to receive assistance, the caretaker will not be eligible to receive assistance until he/she cooperates. On the other hand, non-cooperation by a parent, even one who is excluded from the TAF case due to receipt of SSI or who is disqualified due to fraud or being a drug felon or ineligible alien, will continue to result in a full-family sanction. A parent, even if not receiving TAF assistance for himself/herself, remains legally responsible for the children.
    
    For Child Care, the same policy will apply. Children will no longer be penalized (have their child care plans closed) when a non-legally responsible caretaker fails to comply with CSE. Child care plans for affected children are to be closed if a parent fails to comply with CSE.
    
    See Sections 2165 and 2165.1.
  3. Billed Medical Expenses (Food Stamps and Medicaid) - The manual is being modified to provide special medical expense provisions for persons with Medicare Approved Drug Discount Cards as described in the Background. Effective 10/1/04, food stamp consumers with a Medicare Approved Drug Discount Card must be allowed the pre-discount price of the prescription drug when determining allowable food stamp medical expenses. The consumer is only required to provide an adequate description of the prescriptions and the pharmacy where the prescription is filled. The state agency is responsible for obtaining the pre-discount price of the drug to allow as a food stamp medical expense. Detailed information about this new policy, including a definition of what the pre-discount price is, will be provided in the Implementation Memo. This information is being included in a new item, (8), in Section 7227.5, Billed Medical Expenses.
    
    A similar policy is also being implemented for medical assistance. The pre-Medicare Approved Drug Discount Card price of a prescription drug is used when an allowable expense is used to meet a spenddown. In addition, the same principals must be followed when allowing non-covered medical expenses against patient liability for institutional cases or against client obligation for HCBS. The pre-discount drug card price is used in these situations even if the $600 credit was used to help purchase the drug. For medical assistance, the policy is effective 06-01-04.
    
    This policy is only applicable for Medicare Approved Drug Discount Cards and not for any other discount cards.
    
    Sections 7532.3, 8172.1 and 8270.1 are being updated to reflect these changes.
2. CLARIFICATIONS
  1. Drug-Related Convictions (Not Applicable to Medical or Child Care) - The manual is being modified to clarify that a felony drug conviction that has been expunged from the record does not have an effect on eligibility for cash or food stamps. Persons with such expunged convictions are to be treated as though they do not have a felony drug conviction and may participate if otherwise eligible. Section 2183 is being modified to include this clarification. Since some persons with an expunged drug-related felony conviction may currently be disqualified from receiving benefits, additional information about the implementation of this policy will be provided in the Implementation Memo.
  2. Reporting Changes - The manual is being clarified regarding household responsibility to report changes between the time of the initial interview for certification and the date of the notice of approval. Simplified FS reporters are only required to report the two changes listed in 9122.1 that occur between the date of the interview and the date of approval. These changes must be reported within 10 days of the date of the notice of approval. Reporting requirements for change reporters are also being modified to clarify that changes which occur after the interview, but before the date of the notice of approval must be reported within 10 days from the date of the notice of approval. These changes are found in Section 9110.
  3. Mandatory Verification That Affects Eligibility for Program Benefits - Resources - There was an inadvertent error in a previous manual revision regarding the resources which must be verified prior to approving eligibility for cash, food stamps, and medical assistance which is being corrected with this revision. Trust accounts, real property (excluding the home), stocks, bonds, and non-exempt retirement funds must be verified for all programs. For medical assistance, all burial agreements, life insurance, checking accounts, and savings accounts must also be verified. For cash and food stamps, checking and savings accounts must be verified only if resources are close to the resource limit or if questionable. For medical, verification of the home is required if the applicant/recipient is not currently residing in the home. Generally, a copy of the deed will serve as sufficient proof. These corrections are being made in Section 1322.1.
  4. Voter Registration - Requirements of the National Voter Registration Act of 1995 as they relate to EES consumers and staff are being added as a new Section 1731.
  5. Computing the Overpayment - The manual is being clarified regarding the computation of overpayments that are due to agency error. This applies mostly to calculation or mathematical errors when budgeting earned income. In these instances, the overpayment shall be calculated using all income, expenses and deductions that should have been allowed at the time the original benefit was calculated. Actual income for the months in question does not have to be obtained from the client or the employer in determining the amount of the overpayment. Section 11124 is being modified to reflect this clarification.
ADULT SERVICES
1. CHANGES
  
  None
2. CLARIFICATIONS
  1. Intake Process - The fax number, 1-800-221-7973, to report abuse, neglect, exploitation or fiduciary abuse in institutions (Osawatomie, Larned, Rainbow, KNI and Parsons) is being included in Section 12200.
  2. Confirmed Findings and Case Decisions - Clarification that the form, ES-1020, Report to State Regulatory Authority from Adult Protective Services Regarding Findings of Abuse, Neglect, or Exploitation must be used to forward any confirmed finding committed by licensed, registered or otherwise authorized providers to the appropriate state regulatory agency. The form must be sent within five working days of completing the investigation and making the finding. This change is reflected in Section 12430.
  3. Redetermination of Eligibility - The last paragraph of Section 12712 is being deleted because it conflicts with Section 12721.
  4. Medicaid Fraud and Abuse Division of the Office of the Kansas Attorney General - Sections 12820 and 12830 are being revised following a meeting with the Assistant Attorney General of that division. A new section 12821 is being added to show the definition of “board and care” facilities as used by the Medicaid Fraud Division. Section 12840 is being added to incorporate the Memorandum of Understanding Between the Medicaid Fraud and Abuse Division of the Attorney General’s Office and SRS APS Reports.
CASH ASSISTANCE
1. CHANGES
  1. Minors Acting in Own Behalf - A minor, who enters an approved adult-supervised group living arrangement, such as Job Corps, and is not otherwise entitled to act in his/her own behalf, may act in his/her own behalf if the EES program administrator or designee determines it is in the minor’s best interests to do so. Once the minor leaves the approved group living arrangement, the EES program administrator or designee must determine if it remains in the minor’s best interests to continue to act in his/her own behalf. These decisions must be documented in the case record. See Section 2112. Note: Section 2112 is also being reorganized.
  2. Guidelines When Applying a Penalty - The guidelines are being updated to require EES staff to determine if there is good cause for failing to cooperate with work programs or CSE due to domestic violence when a referral has been made to OARS due to domestic violence or when the family is involved with Children and Family Services. See Sections 2165 and 3500. Also, Section 2165 is being updated to reflect that a personal contact to discuss CSE non-cooperation must be attempted and documented in the case file. This was a 1999 policy change for both work program and CSE non-cooperation that was inadvertently left out of 2165.
2. CLARIFICATIONS
  1. Penalties Accrued by Minors - This clarifies that penalties accrued by a minor who is unable to act in his/her own behalf do not count as a first or subsequent penalty when the minor becomes an adult cash or food stamp recipient. PRAP and JOPR codes for such an individual must be changed when the minor becomes an adult. See Section 2551 and 3511.2.
  2. Instances Not Requiring a Claim - This section, 11122, has been modified by removing “Agency and Client” in the title to clarify that this section does not just apply to agency and client error claims. It also applies to potential fraud claims. This section outlines situations when claims shall not be established.
  3. Collecting Overpayments - To collect an overpayment, an adult must be coded “IN” or “DI” on SEPA. An overpayment shall not be collected through benefit reduction or off-setting when the only adult is a non-legally responsible caretaker who is not receiving assistance for himself/herself. See Section 11126.1. This section is also being clarified that timely and adequate notice must be given before recouping an overpayment through benefit reduction.
  4. Social Security Advocacy - A modification is being made to a parenthetical phrase in Section 1724(3) to clarify that parents may choose not to apply for SSI or cooperate with KLS on behalf of their children who may potentially qualify for SSI.
CHILD CARE ASSISTANCE - GENERAL ELIGIBILITY
1. CHANGES
  1. IE EM (Employed Income Eligible) Child Care - A note is being added to Section 2834 stating that the employment criteria for income eligible training/education shall also be waived for plans approved by the KBOR Waiver Program or Loan Program.
  2. Foster Care Child Care - A new Foster Care Contract interpretation was discovered through research that was done during the last Legislative session on an issue related to Foster Care. Based on this new interpretation, policy is being changed regarding responsibility for child care costs when a foster child is involved. Section 2833(2) is being revised to indicate that the Foster Care contractor is responsible for child care expenses for all foster care placement situations - licensed facility/home, licensed relative foster home, and non-licensed (approved) relative homes. EES Child Care Subsidy can still be accessed in situations where a foster parent is in need of child care for a child (not in SRS custody) of a foster child (e.g., a teen foster child with own child). Example - Employed foster parent, teen in high school, teen’s infant needs child care.
2. CLARIFICATIONS
  1. JO Child Care - In Section 2831(2) reference to Applicant Job search is being replaced with EAP to reflect current policy.
  2. ET Child Care - Clarification is being added to Section 2835 to reflect that the IE EM subtype would be used in cases where a minor teen parent drops out of high school with no intention of returning and then needs child care for employment.
  3. SS Child Care - Clarification is being added in Section 2833(2) regarding cases which include an adjudicated juvenile offender in the custody of the Juvenile Justice Authority. The clarification is that if there is a request for child care subsidy for other children in the household, along with the adjudicated juvenile offender, an application for IE EM child care can be made. One case is set up to include all family members.
  4. IE ET Child Care - Clarification is being added stating that the IE EM subtype is used in situations where a minor teen parent drops out of high school with no intention of returning and then needs child care for employment.
CHILD CARE - PROVIDER ISSUES
1. CHANGES
  1. In-Home Child Care (Child Care in a Child’s Home) - Policy is being changed to reflect the need for verification of the client’s contact with the IRS through the receipt of a Federal Employer’s Identification Number (FEIN). Sections 10022 (1), 10036.1 and 10036.3 are being revised to reflect this change.
    
    The client’s Social Security Number preceded by a 3 will still be used to identify the client as the recipient of payment for in-home child care. Sections 10036.3 and 10270 are being revised to reflect this change.
    
    Also, a statewide payment rate of $1.72 /hour for all ages is being established for in-home child care. Sections 10036 and 10270 are being revised to reflect this change.
    
    Clients are expected to pay their provider at least minimum wage. With the current rate payment method, clients in Johnson county, for example, receive greater assistance toward this minimum wage requirement than clients in Elk county. The statewide rate for in-home care is more equitable for all who choose in-home care.
  2. Child Care Provider Rates - The description of how child care provider market rates are collected and analyzed is being updated to reflect a change in procedure. See Sections 10040 and 10240. The possibility for keying zero hours for a child care plan is being eliminated. Section 10220 is being revised to reflect policy of not keying time sheets with zero hours of care provided.
  3. Data Collection - Addendums to the ES-1650, Regulated Provider Enrollment; ES-1651, Unregulated Provider Enrollment; ES-1652, In-Home Child Care Request; and ES-1653, Out of Home Relative Provider Enrollment are being added to collect additional child care provider information. Appendix Items 97, 98, 99, & 100 reflect the addition of these documents.
  4. Provider Responsibilities - An additional responsibility is being added to assure providers are aware of the expectation they will comply with all applicable State and Federal laws, statutes, and regulations. See Section 10034, Appendix Item 97 (ES-1650 Addendum) and Appendix Item 98 (ES-1651 Addendum).
2. CLARIFICATIONS
  1. Child Care Provider Rates - Clarification is being added to describe when Central Office approval is needed for paying an enhanced payment rate for children with disabilities and where to find information to implement the payment. See Section10260(6).
  2. Direct Deposit - A sentence is being added to better describe how direct deposit payments are issued. See Section 10220.
FOOD ASSISTANCE
1. CHANGES
  
  Annual Adjustments to the Food Stamp Program Standards - Effective October 1, 2004, the following changes are being implemented to incorporate the annual federal adjustments to the FSP that increase the standard deduction, excess shelter deduction and gross and net income limits. Also, see Appendix Items 49 and 50.
  1. Standard Deduction - Section 7222 is being modified to increase the standard deduction amounts. The new amounts effective 10/1/04 are $153 for households of 5 and $175 for household sizes of 6 or more. The standard deduction for household sizes of 1-4 remains $134.
  2. Shelter Costs -Section 7226 - is being modified to increase the excess shelter deduction amount to $388.
    
    These amounts were entered into the KAECSES system prior to rollover in August 2004, and were processed automatically when rollover was processed. Further information about the implementation of the annual adjustments has been provided separately.
2. CLARIFICATIONS
  1. Mandatory Verification That Affects Eligibility for Program Benefits - A technical correction is being made to the Note under item (1)(a) that discuss the verification of gross non-exempt earned income. The words “interim report” have been added to the sentence that discusses when the client tries to, but cannot, provide necessary verification and the employer will not provide the necessary information that the agency shall not deny assistance, but rather the interim report/application/review/change shall be processed using all available information. Section 1322.1 is being modified to capture this correction.
  2. Verification of Questionable Information - The requirement to provide a purchase and prepare statement has been expanded to include the purchase and prepare sections of the ES-3100, Application for Cash, Medical, Child Care and Food Stamp Benefits, and ES-3100.6. Welcome to the Kansas Food Assistance Program!. If these sections are completed at application or review, the FP-1013 or V030 is not required. Those forms would be required at the time of an address change or a change in household composition when a claim of purchase and prepare separately from others in the home is made. Section 1322.3(1) is being updated with this clarification.
  3. Establishing Comparable Work Requirement Penalties - Provisions in this section of the manual are being removed due to simplified reporting requirements. These provisions required that staff take certain actions if the household has not cooperated by the 15th day of the second month following the month the TAF case was closed and the household has reported no other income or means of