As we move more programs into FAMIS, it is important that conflicting actions be reviewed immediately and resolved quickly to avoid eligibility errors. When the alert “ADVERSE ACTION NEEDS RESOLVING” is displayed review the conflict as soon as possible.
A conflict of actions is created when there is a pending adverse action (AUP) and an eligibility determination for the same program is made creating a new adverse action. The worker receives two alerts, “OUTSTANDING ELIGIBILITY DETERMINATION” and “ADVERSE ACTION NEEDS RESOLVING”. The first (pending) adverse action must be completed or voided before the other adverse action can begin. The action to be taken depends upon which month the adverse actions will affect. Review each situation and determine what actions to take.
Void the adverse action if:
- Both adverse actions affect the same benefit month. This allows the most current (cumulative) information to be used to determine continued eligibility.
EXAMPLE: Ms. A had an increase in her Social Security benefits and an adverse action was sent on September 10. On September 16, Ms. A reports her son moved out of the home. This change could be effective for October 2004, so the appropriate action is to void the first adverse action and run a new eligibility determination.
- The first adverse action closes the case, but with the new information the second adverse action reduces benefits.
EXAMPLE: Mr. B's income exceeds 130% of the Federal Poverty Level (FPL) and an adverse action was sent on September 7 for October 2004. On September 11, mass adjustments were run and the figure for 130% of FPL is increased. The adjustment causes the benefits to be reduced, rather than closed. The appropriate action is to void the first adverse action and run a new eligibility determination.
Access the Action Resolution (FM50) screen and void the pending adverse action. Refer to the user guide “Changing an Adverse Action Status” for instructions. After voiding the pending adverse action (AUP), access the Eligibility Determination Resolution screen by typing EDRES on the command line, and run a new eligibility determination.
Take No Action if:
- The pending adverse action will affect an earlier benefit month than the new adverse action. Allow the pending adverse action to process. FAMIS allows the first adverse action to expire and takes the action, then FAMIS runs an eligibility determination for the second action.
If both actions will affect the same month, and the first action is not voided, it could result in an incorrect determination as the first adverse action was not determined with the most current information.
EXAMPLE: Ms. C is sanctioned from the Food Stamp Program due to noncompliance with DWD. Other members in her EU remain eligible. A notice of adverse action is sent on September 13 for October 2004. On September 20, her husband's income increases and causes the EU to be ineligible for benefits effective in November 2004. Take no action on this case. Ms. C's EU is eligible for reduced October 2004 benefits and is ineligible for November 2004.
|