Required Action on Mandatory Changes 400-28-125-30
(Revised 1/1/13 ML #3356)
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When a change is reported, the eligibility worker must determine if a change in eligibility is needed:
- If the mandatory changes results in no changes in eligibility and/or the certificate(s), the case file must be documented to reflect the change reported and the reason no action was taken.
- If the certificate needs to be updated as a result of the mandatory change, the start date of the updated certificate is based on the effective date of the change which affects the month the change needs to be implemented and thus determines the start date.
- If the payments made since the change occurred were correct payments:
- If correct payments were made, document the information regarding the change and the change resulted in no change;
- If incorrect payments were made, determine the amount of the correct payment and create overpayments if one exists.
Note: In certain situations, an underpayment may occur.
- If payments were not yet made, how the change will affect future payments not yet processed.
- If a change is timely reported and verified timely
- If the change benefits the caretaker:
- The change is implemented the month the change occurred.
- The certificate must be updated the month the change occurred.
- Payments not yet made for the month the change occurred through the months when the certificate was actually updated will need to be reviewed to see if any payment can or cannot be made.
- If a payment has been made for the month the change occurred, since the change was reported timely, an underpayment may need to be issued.
Example #1: A change occurred that benefited the household on August 25th and was reported and timely verified on September 3rd. August benefits were paid on September 1. The change is implemented and the certificate must be updated for August. September’s payment will be made based on the updated certificate. Since the change was reported and verified timely, August benefits need to be re-determined and an underpayment issued.
Example #2: A change occurred that benefited the household on August 25th and was reported and timely verified on September 3rd. August benefits have not yet been paid. The change is implemented and the certificate must be updated for August. August and September payments will be made based on the updated certificate, since the change was reported and verified timely.
- If the change does not benefit or has a negative impact to the child care assistance unit:
- The change is implemented the month following the month the change occurred.
- The certificate must be updated the month following the month the change occurred.
- Payments made for the month following the month the change occurred will be made based on the new certificate.
Example: A change occurred that does not benefit the household on August 25th and was reported on September 3rd. The change is implemented and the certificate must be updated for September. August payments will be made based on the old certificate. Payments beginning September will be made based on the updated certificate, since the change was reported and verified timely.
- If the change causes ineligibility the case must be closed at the end of the month the closing notice is sent.
2. If a change was reported timely but NOT verified timely:
- If the change benefits the child care assistance unit,
- The change is implemented the month the change was verified.
- The certificate must be updated the month the change was verified.
- Payments made for the month the change was verified will need to be made based on the new certificate.
- Since the change benefits the Child Care Assistance unit, any underpayments that may have resulted for the month the change occurred through the month the certificate was updated are not issued since the change was not reported timely.
Example #1: A change occurred that benefited the household on August 25th and was reported on September 3rd. The eligibility worker sent a closing notice to the caretaker on September 6th. The caretaker did not provide verification of the change until September 23rd. The change is implemented and the certificate must be updated for September. September’s payment will be made based on the updated certificate. Since the change was reported timely but not verified timely, the caretaker is not eligible for additional benefits for August.
Example #2: A change occurred that benefited the household on September 1st and was reported on September 9th. The eligibility worker sent a closing notice to the caretaker on September 12th. The caretaker did not provide the verification of the change until September 28th. The change is implemented and the certificate must be updated for September. September payments will be made based on the updated certificate.
Example #3: A change occurred that benefits the household on March 3 and is reported on March 6 (reported timely). Additional information is needed and the eligibility worker sends a closing notice requesting additional information on March 7. On March 25 the caretaker provides the requested information (information requested is not verified timely). Since the change was not verified timely, the change is implemented the month the change was verified, March. The certificate must be updated the month the change was verified, March. Payments made for March will need to be made based on the new certificate.
- If the change does not benefit or has a negative impact to the child care assistance unit and the case remains eligible:
- The change is implemented the month the change occurred.
- The certificate must be updated the month the change occurred.
- Any payments made for the month the change occurred will need to be made based on the new certificate.
- Any payments made based on the old certificate for months prior to the certificate being updated are subject to overpayments.
Example #1: A change occurred that does not benefit the household on August 25th and was reported on September 3rd. On September 3rd, the eligibility worker sends a closing notice to the caretaker requesting additional information. The requested information was not verified until September 15th. The change is implemented and the certificate must be updated for August. Since the change was not verified timely, August benefits need to be re-determined and an overpayment established. Payments issued beginning September will be based on the updated certificate.
Example #2: A change occurred that does not benefit the household on November 2 and is reported on November 10 (reported timely). Additional information is needed and the eligibility worker sends a closing notice requesting additional information on November 12. On November 26 the caretaker provides the requested information (information requested is not timely verified). Since the change was not verified timely, the change is implemented the month the change occurred, November. The certificate must be updated the month the change occurred, November. Payments made for November will need to be made based on the new certificate.
- If the change causes ineligibility a closing notice must be sent to close the case at the end of the month the closing notice is sent.
- If a change was NOT reported timely:
- If the change benefits the child care assistance unit:
- The change is implemented the month the change was verified.
- The certificate must be updated the month the change was verified.
- Payments made for the month the change was verified will need to be made based on the new certificate.
- Since the change benefits the child care assistance unit, any underpayments that may have resulted for the month the change occurred to the date the certificate was updated are not issued since the change was not reported timely.
Example #1: A change occurred that benefited the household on June 7th and was reported and verification of the change was provided on September 3rd. The change is implemented and the certificate must be updated for September. September’s payment will be made based on the updated certificate. Since the change was not reported timely, the caretaker is not eligible for additional benefits for June through August.
Example #2: A change occurred that benefited the household on June 7th and was reported on September 23th. The eligibility worker sent a closing notice to the caretaker on September 25th. The caretaker did not provide the verification until October 2nd. The change is implemented and the certificate must be updated for October. October payments will be made based on the updated certificate. Since the change was not reported timely, the caretaker is not eligible for additional benefits for June through September.
Example #3: A change occurred that benefited the household on May 1 is reported on May 15 (not reported timely). The eligibility worker sends a closing notice requesting additional information on May 16. On May 23 the caretaker provides the requested information (information requested is verified timely). Since the change was not timely reported, the change is implemented the month the change was verified, May. The certificate must be updated the month the change was verified, May. Payments made for May will need to be made based on the new certificate.
- If the change does not benefit or has a negative impact to the child care assistance unit and the case remains eligible:
- The change is implemented the month the change occurred.
- The certificate must be updated the month the change occurred.
- Any payments made for the month the change occurred will need to be made based on the new certificate.
- Any payments made based on the old certificate for months prior to the certificate being updated are subject to overpayments.
Example #1: A change occurred that does not benefit the household on June 7th and was reported and verification of the change was received on September 3rd. The change is implemented and the certificate must be updated for June. Since the change was not reported and verified timely, June through August benefits need to be re-determined and overpayments established. Payments issued beginning September will be based on the updated certificate.
Example #2: A change occurred that does not benefit the household on January 7 and is reported and verified on January 22 (not timely reported). Since the change was not timely reported, the change is implemented the month the change occurred, January. The certificate must be updated the month the change occurred, January. Any payments made for the month the change occurred will need to be made based on the new certificate.
- If the change causes ineligibility a closing notice must be sent to close the case at the end of the month the closing notice is sent.
For policy regarding the impact of a change when an individual who enters or leaves the child care assistance unit, refer to Section 400-28-35-05 Child Care Assistance Unit.
