IM-159 12/4/03 JANUARY 2004 ADJUSTMENTS TO FAMIS EUS DUE TO INCREASES IN SSA AND SSI and VA BENEFITS

M E M O R A N D U M

IM-159 12/4/03 JANUARY 2004 ADJUSTMENTS TO FAMIS EUS DUE
TO INCREASES IN SSA AND SSI and VA BENEFITS

SUBJECT:

JANUARY 2004 ADJUSTMENTS TO FAMIS EUS DUE TO INCREASES IN SSA AND SSI and VA BENEFITS

DISCUSSION:

In January 2004, all Social Security Administration (SSA), Supplemental Security Income (SSI), and Veterans Administration (VA) participants will receive a 2.1% cost of living adjustment (COLA). A mass adjustment of FAMIS Child Care and food stamp EUs with SSA and SSI income increases will occur the weekend of December 6, 2003. Adjustments will be made by matching to the BENDEX files or by increasing the SSA and/or SSI amount by 2.1%. Veterans Administration benefits will not be adjusted during the mass adjustment. Child Care EU's with an active food stamp participation will have an increase to their SSI income. This income source continues to be excluded when determining the family's child care eligibility.

Please review the following topics carefully as some procedures are changed from previous years due to FAMIS.

NEW AMOUNT OF SSI
ADJUSTING SSA AND SSI BENEFITS
Mass Adjustment Process
Simplified Reporting EUs
Conflict of Actions
Notices
Request for Hearing/Continued Benefits
Managed Reporting/EUs Needing Review
Manual Adjustments by County Staff
ADJUSTING VETERANS ADMINISTRATION BENEFITS

NEW AMOUNT OF SSI

Increases in SSI benefit amounts are as follows:

	NEW AMOUNT	INCREASE
Individual in own household	$564.00	$12.00
Couple in own household	$846.00	$17.00
Individual in household of another	$376.00	$ 8.00
Couple in household of another	$564.00	$11.33
Essential person/own home	$282.00	$ 5.00

The SMI premium increased from $58.70 to $66.60 per month for January 2004.

ADJUSTING SSA AND SSI BENEFITS

EUs containing individuals with SSA and/or SSI income will be included in the mass adjustment. Changes in Temporary Assistance grants resulting from the mass adjustment, will be included in the child care and food stamp adjustments. If the Temporary Assistance case is closed, the grant will be removed from the child care and food stamp budgets.

Mass Adjustment Process

Any EU with SSA or SSI income and that is active by the end of the day on December 5, 2003, with a certification ending January 2004 or later will be adjusted to show the increased benefit amounts.

The FAMIS system will be unavailable during the mass adjustment. If the adjustments are not completed by the morning of December 8, 2003, FAMIS will be unavailable until the adjustments are completed.

For any new Child Care or food stamp application processed after December 5, 2003, the worker must compute the net adjusted income using the new SSA and/or SSI amounts. For pending recertifications, if the child care certification period or LATP is January 2004 or February 2004, the SSA/SSI amount is adjusted by the system. Review each SSI/SSA amount prior to completing the application. If the SSI/SSA amount was not adjusted, follow instructions in the Manual Adjustments by Staff section of this memorandum.

If the new amount of SSA is shown on the BENDEX file, it is used to adjust the EU. If SSA income is shown in FAMIS for the EU but not on BENDEX, the SSA amount is increased by 2.1%. The SSI amount shown in FAMIS is increased by 2.1% for the mass adjustment. Due to rounding, this calculation may end up $1 less than the actual amount of SSA/SSI. Review all income at recertification and adjust if necessary.

If the EU receives both SSA and SSI, the SSA amount is adjusted using the amount shown on the BENDEX file. The SSI amount is adjusted by the difference between the SSA increased benefit and the new SSI maximum plus $20.

FAMIS will be updated with the SMI premium from the BENDEX file only if there is already a medical expense type SM in FAMIS. Medical expense type CV will NOT be updated in FAMIS. Staff must ensure that the medical insurance premium costs are manually adjusted when the family's Medicare premium is coded with an expense type other than SM in FAMIS.

If an active FAMIS EU is adjusted or closed, the EU Action Log (FM40) displays the action taken by the system and the benefit amount for benefit month 012004. To view information that resulted in the action, select the action and press F17=INQAUTH. The Action Authorization (FM3H) screen is displayed. Press F16=BUDSUM to access the Budget Summary (Food Stamps) screen (FM4A). From the Budget Summary screen, press F14=INCSUMM to access the Income Summary Detail screen (FM33). The income types, sources, and gross amounts are displayed for budget month 012004. Press F21=RETURN to return to the Budget Summary screen, and press F15=EXPSUM to view the Expense Summary screen (FM34). The expense classes, types, and amounts are displayed for budget month 012004.

Simplified Reporting EUs (SSA/SSI)

The SSA/SSI COLA is considered a change that must be acted on and all cases are required to be adjusted to accurately reflect all information known at the time of the adjustment. Therefore, simplified reporting EUs with previously disregarded actions (action status DIS) are adjusted using ALL information in the system. If the food stamp benefits for a simplified reporting EU decrease as a result of the cumulative changes, the adjustment is made to decrease the benefits. If there was a previously disregarded Adverse Action to Remove a Person (AARP), the adverse action will be re-generated as a result of the mass adjustment. Do not disregard the action.

Conflict of Actions (SSA/SSI)

FAMIS adjusts the income and expenses on EUs with a pending adverse action at the time of the mass adjustment. This results in a conflict of actions because one adverse action must be completed or voided before the other can be taken. The worker receives the alert "OUTSTANDING ELIGIBILITY DETERMINATION". The conflict can be resolved by the system or by the worker.

To let the system resolve the conflict take no action. FAMIS allows the pending adverse action to expire and takes the required action. If the EU is not closed after the pending adverse action is completed, FAMIS re-runs an eligibility determination with the mass adjustment figures. Because the eligibility determination is done after the mass adjustment, an adverse action notice is generated for the mass adjustment changes.

To manually resolve the conflict access the Action Resolution screen (FM50 or ACTRES) and void the pending adverse action. Refer to the user guide "Changing an Adverse Action Status" for instructions. After voiding the adverse action, access the Eligibility Determination Resolution screen (FM3Y or EDRES) and run a new eligibility determination. If the action is a benefit reduction, authorize the new adverse action. If the action is a closing (AACL), on the Action Authorization screen (FM3H), type a "U" on the command line, change the action code to "WICL", enter the reason code "CAV", and enter the override reason code "SUP".

Notices (SSA/SSI)

Two types of notices are generated as a result of the mass adjustment. An FA-510 ADVERSE ACTION NOTICE is generated when an action is going to be taken for January 2004 after the notice expires. An FA-150 CLAIMANT ACTION NOTICE is generated when an action has been taken that is effective for January 2004.

An FA-510 ADVERSE ACTION NOTICE is generated by the system as a result of the mass adjustment, if

there was a conflict of action, or

there was a previously disregarded action to remove a person.

EUs whose food stamp benefits are adjusted during the mass adjustment, or are closed, receive an FA-150 CLAIMANT ACTION NOTICE giving them advance notice of the January 2004 change in benefits. EUs whose benefits are adjusted, but the food stamp benefits do not change receive a notice of no change in food stamp benefits.

It is anticipated that a low percentage of child care families are affected by this adjustment. However, it is important to note that no adverse action notices will be generated to child care EUs unless there is a pending adverse action at the time of the mass adjustment.

Request for Hearing/Continued Benefits (SSA/SSI)

Any EU receiving an advance notice or an adverse action notice may request a hearing. A hearing may be requested on the mass adjustment action within 90 days from the date of the notice.

If the EU requests a hearing by December 29, 2003, the EU may request child care and food stamp benefits continue at the level before the mass adjustment until the hearing decision is made. County staff should inform the EU that if continued benefits are issued and the agency is determined to be correct, a claim may be established for the overpayment.

To continue the food stamp benefits at the higher amount pending the hearing decision, set a reminder for January 2, 2004, and February 1, 2004. To complete a WIBCA budget for January use the budget information before the mass adjustment and issue the supplemental benefits. If the hearing decision is not received before the February allotment is available, complete a WIBCA for February using the same budget information and issue supplemental benefits.

If a child care family wishes to continue receiving benefits pending the hearing decision, you must update the action status to HOLD (HOL) on the Action Resolution screen, (FM50).

Once the Hearing Decision is rendered, take steps to process the family's eligibility according to the Decision and Order.

If the EU requests a hearing after December 29, 2003, the EU is not eligible for continuation of benefits at the level before the mass adjustment, but is still entitled to the fair hearing.

Managed Reporting/EUs Needing Review (SSI/SSA)

FAMIS will generate reports in the Managed Reporting system of active EUs that are not adjusted. To review the reports:

From the FSD Employee Intranet, under Tools in the right hand lower section of the page click on Managed Reporting.

Click on "OK" when the notice appears and log into the managed reporting area.

Click on the appropriate domain. For example, caseworkers will click on Caseworker Reports and IM SUP I would click on Caseworker/Supervisor Reports.

Click on CC & FS Cost of Living Adjustments Needing Review.

Click on the View box next to Cost of Living Adjustments Needing Review.

Select SSA/SSI Unable to Adjust to request the on-line report for SSA/SSI cases.

Each worker must access the report for his/her primary caseload. An error reason is included for each EU member on the report. More than one reason may appear for each EU on the report. Review all EU information to ensure correct data is entered.

Reasons an EU may appear on these reports include:

SSI/SSA was not adjusted,

Existing BENDEX information does not match FAMIS information (including income, premium amounts or claim IDs do not match),

There is no SSA claim ID in FAMIS, or

An EU member has a vendor level of care on an IM case.

Manual Adjustments by County Staff (SSI/SSA)

If a child care or food stamp application is in the controlled flow, review the SSA/SSI benefit. Determine the correct SSA/SSI benefit amount and manually adjust the SSA/SSI benefit amount for January 2004 and later months when completing the application/controlled flow.

To manually adjust the SSA amount in the child care or food stamp EU, obtain the new SSA amount from the BENDEX printout or the IIVE interface. The new SSA amount can also be computed by multiplying the original SSA amount by 102.1% and rounding down to the nearest dollar.

To manually adjust the SSI amount, the worker adds the amount of increase from the chart near the beginning of this memorandum to the verified SSI amount, or multiplies the original SSI amount by 102.1% and rounds down to the nearest dollar.

Manual adjustments of the SSI, or SSA as a result of the COLA are considered a change that must be acted upon. If the child care or food stamp benefits decrease, or the EU closes, authorize the actions to generate a notice of adverse action.

ADJUSTING VETERANS ADMINISTRATION BENEFITS

The increase in VA income due to the COLA adjustment must be verified. Therefore, the change is not a change that must be acted on for simplified reporting EUs. Do not decrease food stamp benefits for a simplified reporting EU due to the VA increase unless the income exceeds 130% of the poverty level. Review the VA income at the next application. If the EU has both SSI/SSA and VA income the mass adjustment is completed on the SSA/SSA income only unless the change in VA income was verified and disregarded before the mass adjustment.

Non-simplified reporting EUs containing individuals with VA income will be placed on a report in the managed reporting area. For instructions to access COLAs needing review, see the Managed Reporting section of this memorandum. "VA Benefits" is added as a selection under "CC & FS Cost of Living Adjustments Needing Review".

To create an outstanding verification of the VA benefits for non-simplified reporting EUs, multiply the current VA by 102.1% and enter the amount leaving the verification code blank. Generate an FA325 REQUEST FOR INFORMATION, and an FA312 VETERANS ADMINISTRATION LETTER. When the new benefit amount is verified, make any necessary changes and enter the verification code. If the food stamp benefits decrease, FAMIS creates a notice of adverse action (NOAA) ready to authorize. The worker needs to authorize the NOAA action for non-simplified reporting EUs.

NECESSARY ACTION:

Review this memorandum with all staff.

Review EUs not adjusted from the on-line reports to determine if action is necessary.

Ensure that Medicare premiums not adjusted are updated with the correct costs.

NEY/DE

IM-158

[ 2003 Memorandums ]

IM-160