M E M O R A N D U M

IM-95  07/26/99  SEPARATION OF MAF AND TEMPORARY ASSISTANCE


SUBJECT:
SEPARATION OF MAF AND TEMPORARY ASSISTANCE
 
DISCUSSION:
The Personal Responsibility and Work Act (PRWORA) of 1996 separated Medicaid from Temporary Assistance eligibility.  A family receiving cash on a C1 case is actually on two separate programs, Temporary Assistance and Medical Assistance for Families (MAF).  Families may continue to qualify for MAF when losing eligibility for Temporary Assistance.  Simplified eligibility criteria for MAF include:
  • mail in reinvestigations,
  • reduced verification requirements,
  • interviews may be conducted by phone or waived,
  • no resource limit,
  • no deprived of parental support requirement, and
  • work participation requirements and sanctions do not apply.
COMBINATION MAF/TEMPORARY ASSISTANCE CASES

When action is being taken on combination MAF/Temporary Assistance cases, recipients need to clearly understand what is required to continue cash and what is required to continue MAF.  The difference in the eligibility criteria must be addressed on adverse action notices, correspondence, and information requests.  Taking action on MAF at the same time action is being taken on Temporary Assistance is no different than taking action on Food Stamps at the same time.  Sometimes it will be possible to take action on Temporary Assistance and MAF at the same time, but there are times when it will be necessary to implement the Temporary Assistance eligibility decision prior to determining what action to take on the MAF.  When a recipient fails to complete a reinvestigation for Temporary Assistance, take action to close the cash and change to MAF only.  After taking action to close the cash, send an IM-1U if a MAF reinvestigation is needed.

EXAMPLE:  A Temporary Assistance recipient is sent a letter scheduling an appointment for an interview to complete a reinvestigation.  If the recipient keeps the appointment, completes the reinvestigation, and remains eligible on all factors, Temporary Assistance and MAF remain active.  If the appointment is not kept, send an IM-80 to discontinue Temporary Assistance.  When the IM-80 expires, complete an IMU5 transaction closing cash and change to MAF.  Notify the client accordingly.

Since a face-to-face interview is not a requirement for the reinvestigation of the MAF case, the MC+ healthcare coverage cannot be discontinued.   An IM-1U can be mailed to the recipient for completion of the MAF reinvestigation.  The MAF case can only be closed if she fails to complete and return the IM-1U within the prescribed time frames, and a notice of adverse action has been sent advising of the proposed closing of the MAF case.

NOTE:   The IM-1U is currently being revised.  Use the IM-1UA with the income guidelines until the IM-1U revision is completed.  

TRANSITIONAL MEDICAL ASSISTANCE 

Prior to taking any action to close MAF, eligibility should always be explored for Transitional Medical Assistance and all other MC+ healthcare programs.   It is not necessary to verify earnings or beginning date of employment to put the members on Transitional Medical Assistance.  Accept the client's statements for both.  A new hire match or IMES can be used to confirm the information provided is within reason.  Whenever a new hire report is received, use this information to determine eligibility for Transitional Medical Assistance.  If the client is not placed on Transitional Medical Assistance and it is discovered later they did qualify,  change the case to transitional by reopening as a MAF, then close to transitional.

OPTION TO RECEIVE MAF ONLY:  

Since there is a time limit for Temporary Assistance, families eligible for a small cash grant may wish to only receive MAF so as not to use up their Temporary Assistance five (5) year lifetime limit.  Explain this choice to the family.

VOLUNTARY WITHDRAWALS:  

If a written request for closing says "close my Temporary Assistance case", the MAF should remain open and the notification to the family should indicate that medical coverage will continue.  A voluntary  withdrawal for MAF/MC+ must be in writing and specify that the individual is not interested in pursuing MC+ healthcare coverage.  If a client calls and requests their Temporary Assistance and/or MAF be closed, the worker must:

  1. attempt to discern the reason for the closing.  The worker should explain that even with the change, there is a possibility the family can remain eligible for MC+ healthcare coverage;
  2. explain how MAF/MC+ eligibility differs from Temporary Assistance eligibility;
  3. explain the availability of Transitional Medical Assistance to individuals who have found employment; and
  4. inform the individual of all available MC+ healthcare options.
 
NECESSARY ACTION:
  • Review this memorandum with appropriate staff.

  •  
  • Evaluate MAF eligibility separately on Temporary Assistance/MAF cases based on simplified eligibility criteria.

  •  
  • Effective immediately, address eligibility issues for Temporary Assistance and MAF separately on correspondence pertaining to eligibility.
CSW
Distribution #6

[ 1999 Memorandums ]