SUBJECT:
2005 PROGRAM CHANGES
DISCUSSION:
Due to the passage of SB 539 and actions taken in the legislature for the Department of Social Services budget, we will have several program changes to implement in the next three months. Some changes are effective July 1, 2005, while others are effective August 28, 2005. The purpose of this memorandum is to outline those changes so staff will know what to expect and when the changes are effective. We do not yet have the final interpretation of changes where, for example, SB 539 requirements differ from the budget. We will note those as each item is discussed.
Medical Assistance for Families Income Limit Reduction
The MAF income limit is being reduced from the current 75% of the poverty level to the 1996 AFDC level. You have already received a memorandum regarding this change, which is effective July 1, 2005. Notices were mailed by May 20, 2005, to affected households.
Elimination of Extended Transitional Medical Assistance
Funding was discontinued for the ETMA program, effective July 1, 2005. Notices will be sent to affected households in the first week of June.
Elimination of General Relief Medical
Funding was discontinued for General Relief Medical, effective July 1, 2005. This affects people who were formerly eligible for a cash grant (discontinued two years ago) and state funded medical. It does not impact the GR/MA population, whose Medicaid was federally funded. Notices will be sent to affected households in the first week of June.
Elimination of Grandparents as Foster Parents
Funding was discontinued for GAFP, effective July 1, 2005. Some households will be eligible for Temporary Assistance as NPCR households, and will be advised to apply in notices sent the first week of June.
Elimination of the MA-WD Program
SB 539 removes this program from state law, effective August 28, 2005. Individuals in this program may qualify through spenddown. Because we do not have enough information in the system to determine eligibility under spenddown, workers will need to review the case record and determine eligibility for any other category of assistance. To assist with this determination and help insure we have accurate information, each recipient will be sent a special review form the first of July.
Reduction of the MA Income Limit for Aged and Disabled
SB 539 removes from state law the provision that the non-spenddown income limit for the aged and disabled populations be set at 100% of the federal poverty level. Based on this, the income limit reverts back to the SSI maximum effective August 28, 2005. This provision also allows for a higher income limit to be set by appropriation. Because the budget is not yet finalized, we do not know if the limit will be set at some higher level. Whatever the outcome, it will not be set at a level higher than 85% of the poverty level. Our plan is to mail notices to affected households by June 20, 2005. (Although the change is not effective until August 28, we must have the change completed before August 1, so spenddown invoices generated August 1st will be correct.)
Premiums for Additional MC+ for Kids Families
SB 539 requires premiums for MC+ for Kids (CHIP) coverage starting with family income above 150% of the poverty level. The amount of the premiums is not yet set, as the budget is not finalized. Premiums cannot exceed 5% of family income. This change is effective August 28th and will be reflected on premiums paid in the month of September. We plan to send notices to affected households by August 5, 2005.
Various Nursing Facility Issues
SB 539 made various changes to eligibility for nursing facility services. We will change the way we consider annuities, we will impose liens on the homes of residents who are unlikely to return home, and we will consider the institutionalized spouse’s income first in hearing decisions determining whether additional resources may be retained by the community spouse. These changes are effective August 28, 2005, and require no notices.
In addition to these policy changes, we will also be addressing the phase out of case management services for TANF recipients and the requirement to be timely with completion of all annual redeterminations.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Take these changes into consideration as you plan your office work for the upcoming months.