Combination Cases 430-05-67-15-15

(Revised 07/01/18 ML3528)

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Combination Medicaid Cases

The worker must determine if a change reported for Medicaid results in an increase or decrease in SNAP benefits using the following procedures:

1. Enter the verified changes on the benefit calculator or do a hand budget.
2. If the changes result in an increase in benefits, the changes must be made to the case in TECS.

Exception:

In combination SNAP/Medicaid cases when processing the cost of living adjustment changes in December of each year, if the client share is being averaged, do not change the amount allowed as a medical expense deduction for SNAP purposes. The change is not acted on until review.

3. If the changes results in a decrease in benefits, the changes are not acted on until review and benefits continue as previously authorized.  A copy of the benefit calculator or hand budget must be retained in the casefile.

Exception:

If the change meets the criteria to decrease benefits, the change must be acted on within 10 days from the date the change was reported and a 10 day advance notice must be sent.  If the change is reported in writing and signed by the household, a 10 day advance notice is not required.  Adequate notice is required.

Examples:

1. In a combination SNAP/Medicaid case if the entire client share is being allowed as a medical expense deduction and it changes as a result of a change in income reported by the household, change the amount of income being used and allow the new client share if it results in an increase in benefits.  

If the change in income reported by the household and resulting change in client share results in a decrease in benefits, the change is not acted on until review.

If Medicaid closes for client share not being met, and this results in a decrease in benefits, do not remove the client share amount until review.    

2. Ongoing SNAP/Medicaid case.  Client is paid weekly and provides four of the five pay stubs from the base month.  The fifth pay stub is not required by Medicaid.  The worker must use the four pay stubs to convert the income.  If the change results in an increase in benefits, the change must be acted on.  

If the change results in a decrease in benefits, the change is not acted on and the benefits stay the same.  

3. Ongoing SNAP/Medicaid case.  Client resides in a group home and each month the case manager provides a listing of earnings for individuals in the group home to the county office.  If the change results in an increase in benefits, the change must be acted on.

If the change results in a decrease in benefits the change is not acted on until review.  

4. Ongoing  SNAP/Medicaid case. Household provides prior month and all of the current month's pay stubs. The current month's pay stubs must be used to determine the effect on the benefit, as it is the most current information.
5. Ongoing SNAP/Medicaid case.  The household provides pay stubs for Medicaid and the income is not over the gross income limit for SNAP. The worker converts the income because the individual is paid biweekly which results in the converted income exceeding the gross income limit.  

If the household is eligible for a benefit, no change is made, as it would result in a decrease in benefits.  The worker must send the F741- HH Over GIL and Eligible - Reporting Requirement - Ongoing Case to the household.   

If the household is not eligible for a benefit, the worker must send the F419 - Request for Information - Simplified Reporting to determine if the income will continue.  

1. If the household responds and indicates the income will continue or the household does not respond, the case must be closed for excess income.
2. If the household responds and states they do not know if the income will continue to exceed the gross income limit for the household size, the case must be closed.  

If the household verifies by the last working day of the current month their gross income is below the gross income limit for the household size, the worker must revert the case to open and determine eligibility and level of benefits based on the newly verified income.

3. If the household responds and states they do not expect the income to continue, the household must provide verification other than client statement that their income will not continue to exceed the gross income limit for their household size.  If the household does not provide the verification, the last reported converted income is used to close the case.

If the household provides the verification and the newly verified income results in an increase in benefits, the change must be acted on

If the household provides the verification and the newly verified income results in a decrease in benefits, the change must not be acted on until review.

Combination TANF Cases

When a new application for TANF, TANF Diversion or TANF Pay After Performance is approved in an ongoing SNAP case, the information used in determining the grant along with the grant must be acted on for SNAP regardless of the effect on the benefit.

In an ongoing case, when changes are reported for TANF that result in a change in the TANF grant, the changes along with the change in the TANF grant must be acted on regardless of the effect on the benefit.

When changes are reported for TANF that do not result in a change in the TANF grant, the changes are not acted on unless they result in an increase in benefits.

Exception:

If the change meets one of the other criteria to reduce benefits, the change must be acted on within 10 days from the date the change was reported and a 10 day advance notice must be sent.  If the change is reported in writing and signed by the household, a 10 day advance notice is not required.  Adequate notice is required.

When multiple changes are reported and some but not all result in a change in the TANF grant, they are acted on as follows:

• If using the multiple changes including the change in the TANF grant results in an increase in SNAP, act on all the changes.
• If using the multiple changes including the change in the TANF grant results in a decrease in SNAP, then only the changes that result in the change in the TANF grant and the changed TANF grant must be acted on.

Exception:

If the change meets one of the other criteria to reduce benefits, the change must be acted on within 10 days from the date the change was reported and a 10 day advance notice must be sent.  If the change is reported in writing and signed by the household, a 10 day advance notice is not required.  Adequate notice is required.

Changes reported for Diversion, Transition or ineligible caretaker cases do not result in a change in the grant.  For SNAP, these changes are not acted on unless they result in an increase in benefits.  The grant continues to be used for SNAP at the same amount.

Exceptions:

1. If the change meets one of the other criteria to reduce benefits, the change must be acted on within 10 days from the date the change was reported and a 10 day advance notice must be sent.  If the change is reported in writing and signed by the household, a 10 day advance notice is not required.  Adequate notice is required.

2. If the children in an ineligible caretaker case have income that changes and these changes result in a change in the grant, the change in income and the change in the grant must be acted on regardless of the effect on the benefit.

3. In an ineligible caretaker case, if the parent of the children moves into the home, this will result in a change in the grant and must be acted on regardless of the effect on the benefit.  

Examples:

1. Ongoing TANF/SNAP case. The household reports a change in income.  The change in income results in a decrease in the TANF grant.  The increased income and the decreased TANF must be acted on for SNAP regardless of the effect on the benefit, as they meet the criteria to decrease benefits.

2. Ongoing TANF Diversion/SNAP case. The household reports a change in income.  The change in income does not result in a change in the TANF Diversion grant.  The change in income does not meet the criteria to decrease benefits.  If the change in income results in an increase in SNAP, the change must be acted on.  If the change in income results in a decrease in benefits, the change must not be acted on as it does not meet the criteria to decrease benefits.

3. Ongoing TANF/SNAP case. The household reports a change in income and a change in rent.  The change in income results in a decrease in the TANF grant.  The change in rent does not affect the TANF grant.  If the change in income, the change in the TANF grant and the change in rent results in an increase in benefits, all of the changes are acted on.  If the change in income, the change in the TANF grant and the change in rent result in a decrease in benefits, the change in income and the change in the TANF grant must be acted on as they meet the criteria to decrease benefits.  The change in rent is not acted on until review.  

   In this scenario, the change in rent would be acted on if the household moved into or out of subsidized housing as it affects the TANF grant and meets the criteria to decrease benefits.

4. Ongoing SNAP/TANF case. The household received a grant of $328 in January.  The household files their monthly report in February for March benefits.  Based on the monthly report, the household would have received a grant of $328 for March also.  

   However, mom is sanctioned for March so the March TANF grant without mom’s needs is $163.  Since mom is not exempt from the work requirements for another reason, mom is disqualified for SNAP.  SNAP benefits cannot be increased as a result of a sanction for TANF so the full $328 grant must be used.

5. Ongoing SNAP/TANF case. The household received a grant of $300 in February.  The household files their monthly report in February for March benefits and reports and verifies a change in income.  Based on the monthly report, the household would have received a grant of $375 for March.  

   However, mom is sanctioned for March so the March TANF grant without Mom’s needs is $163.  Mom is not exempt from the work requirements for another reason, so mom is disqualified for SNAP.  Since the change in income reported on the monthly report resulted in a change in the TANF grant, the change in income must be acted on for SNAP.  SNAP benefits cannot be increased as a result of a sanction for TANF so the full $375 grant must be used.  

6. Ongoing SNAP/TANF case.  Mom is sanctioned on 12/24/08 for January benefits due to her failure to comply with JOBS.  As mom is not exempt from the work requirements for another reason, an adequate notice to impose the disqualification for SNAP must be sent on the same day as the TANF adequate notice.  Mom also failed to complete a TANF monthly report for December and as a result, the TANF case closed the end of December.  The full TANF grant must be  anticipated for January as there is a history of late reporting for TANF.

7. Ongoing SNAP/TANF case.  Mom is an eligible student due to receipt of TANF.  TANF is closing the end of January due to excess income as a result of an increase in unearned income.  

   For SNAP, since the income change resulted in the change in the TANF grant, the change in income must be acted on and the TANF grant must be removed for February benefits.

   Mom remains an eligible student for SNAP as we cannot determine if mom would be eligible as a student for a reason other than receipt of TANF until review.

8. Ongoing SNAP/TANF case. The household consists of mom, her kids, boyfriend and their child in common.  Mom reported she started a job in November and received 2 pay checks in November.  However, the job does not meet the employability plan and as a result TANF is closing the end of December due to the JOBS sanction progressing to close.  As mom is not exempt from the SNAP work requirements for another reason, mom was disqualified and remains disqualified for SNAP.  Mom also reported that boyfriend had an in increase in his wages in November.

   For SNAP, if the change in income for mom, the change in income for boyfriend and removing the TANF grant results in an increase in benefits, the changes must be acted on.

   If the change in income for mom, the change in income for boyfriend and removing the TANF grant results in a decrease in benefits, then only the TANF grant is removed.  Since the changes in income do not result in a change in the TANF grant, the changes in income do not meet the criteria to decrease benefits and are not acted on until review.  

9. Ongoing SNAP case. The household applies for TANF and is approved as an ineligible caretaker case.  Since the ineligible caretaker’s income is not used in determining the TANF grant, the caretaker’s income does not meet the criteria to decrease benefits.  If the ineligible caretaker’s income is provided at the time of application for TANF, and using the caretaker’s income along with the TANF grant results in an increase in benefits for SNAP, the income and the grant are acted on.  If using the caretaker’s income results in a decrease in benefits, only the TANF grant is used for SNAP.

   For ongoing months, if the ineligible caretaker reports income on the monthly report, the income is only used if it results in an increase in SNAP as the income does not change the TANF grant.

10. Ongoing SNAP/TANF case. A source other than the household reports the household moved out of state in December.  TANF is closed the end of December as the household did not file a monthly report.  Since the change in the TANF grant was due to failure to monthly report, the TANF grant is removed in determining January benefits as there is no history of late reporting.  The SNAP case continues until review.

11. Ongoing SNAP/TANF case. The caretaker reports fluctuating income monthly and is also paying child support for a child outside of the home.  The amount of the child support changes monthly as it is based on her earnings (withholding cannot be more than ½ of net income).  The base month child support withheld is allowed as an expense for TANF and affects the amount of the TANF grant each month.  Since the fluctuating income and the child support expense result in a change in the TANF grant, the change in income, the child support and the change in the TANF grant must be acted on regardless of the effect on the benefit.

    In January, the caretaker reports missing one pay check in the base month due to the holidays in December but anticipates receiving a full month’s income in February.  A full month’s income and child support expense must be anticipated when determining February benefits.  

12. Ongoing SNAP/TANF case. The household has a history of late monthly reporting and did not file a monthly report by 12/27/08.  The 12/08 grant of $328 is anticipated when working 01/09 SNAP benefits.

    On 12/31/08 the household files a monthly report and reports a new job with verified partial month income of $442 received in 11/08.  The 01/09 TANF grant of $197 is issued on 01/05/09.

    The household has not filed their monthly report by advance notice deadline in January, the $197 grant must be anticipated for 02/09 benefits as the household continues to have a late history of monthly reporting for TANF. A full months income from the new job must be anticipated for February as the new income results in a change in the TANF grant and SNAP benefits are prospectively budgeted.  

13. Ongoing SNAP/TANF case. The household reports new employment beginning in January on the monthly report filed in January.  As the new income is retro budgeted and will not result in a change in the TANF grant for February, the change in income cannot be used for SNAP.

    In February when working TANF, the base month income from January is used in determining the TANF grant for 03/09.  As the change in income results in a change in the TANF grant, the change in income and the change in the grant are used in determining SNAP for 03/09.  A full months income is used as SNAP benefits are prospectively budgeted.

Whenever a change results in the reduction or termination of a household’s TANF benefits within the household’s SNAP review period, the worker must make a separate determination for SNAP eligibility.  A worker must not terminate a household’s SNAP benefits solely because the TANF case has closed.

When a household has not submitted a completed TANF monthly report by the third to the last working day of the month, the TANF grant must not be counted prospectively to determine SNAP benefits.

Exception:

If there is a two immediate prior consecutive month history, which could include the processing month, of late or incomplete monthly reporting for TANF, the TANF grant must be counted prospectively to determine SNAP benefits.  Monthly reports for TANF are due on the fifth of the month or the first working day after the fifth of the month if the fifth falls on a weekend or North Dakota Department of Human Services holiday.  A TANF monthly report received after the due date is considered a late report.

Example:

Ongoing TANF/SNAP case. The household files a monthly report for TANF on August 10 and September 20.  As of October 29, the TANF monthly report has not been filed.  On October 29 the worker is processing November SNAP benefits.  The TANF grant must be anticipated for November.  

When a TANF household changes from TANF Diversion to TANF or from TANF to TANF Diversion, a TANF grant is anticipated as follows:

1. A household received four months of TANF Diversion Assistance and a closing notice is sent in month four. The household submits a TANF monthly report in month four and a Request for Benefits.  A TANF grant must be anticipated and counted for month five.

2. A household received four months of TANF Diversion Assistance and a closing notice is sent in month four. The household submits a TANF monthly report in month four but does not submit a Request for Benefits.  A TANF grant is not anticipated or counted for month five.

3. A household received four months of TANF Diversion Assistance and a closing notice is sent in month four. The household does not submit a TANF monthly report in month four but does submit a Request for Benefits.  A TANF grant is not anticipated or counted for month five.

4. A household received four months of TANF Diversion Assistance and a closing notice is sent in month four. The household does not submit a TANF monthly report or a Request for Benefits in month four.  A TANF grant is not anticipated or counted for month five.

5. A household received two months of TANF.  The household submits a Request for Benefits and a TANF monthly report in month two to be changed to TANF Diversion.  A TANF grant must be anticipated and counted for month three.

If a change is made to the TANF case after authorizing SNAP and it results in the TANF case closing, the worker must revert TANF to close and reauthorize the SNAP case as the household is no longer considered categorically eligible.

If a change in household circumstances requires a reduction or termination in the TANF grant and the worker has sufficient information to determine how the change affects the household’s SNAP eligibility and benefit level, the worker must take the following actions:

1. If the change requires a reduction or termination of SNAP benefits, the worker must issue adequate notice or advance notice for both the TANF and SNAP actions on the same day. If the household requests a fair hearing within the period provided by the notice, the worker must continue the household’s SNAP benefits on the basis authorized immediately prior to sending the adequate or advance notice.

   If a fair hearing is requested for both programs, the hearing must be conducted according to TANF procedures and timeliness standards.

   If the SNAP review period expires before the fair hearing process is completed, the household must reapply for SNAP benefits.

2. If the change will result in an increase in benefits as a result of the reduction or termination of the TANF grant, the worker must issue the TANF advance notice, but must not take any action to increase the household’s SNAP benefits until the household decides whether it will appeal the TANF advance notice.

   If the household appeals and the TANF grant is continued, the household’s SNAP benefits must continue at the previous level.

   If the household does not appeal, the worker must act on the changes along with the change in the TANF grant. The 10-days for the worker to act on the increase is calculated from the date the TANF advance notice period expires.

Examples:

1. Ongoing TANF/SNAP case. The household reports an increase in earned income on the TANF October 5 TANF monthly report.  The change results in a decrease in the TANF grant.  The increased earned income and the decreased TANF grant must be acted for November benefits allowing for adequate notice as the change meets the criteria to decrease benefits.  
2. Ongoing TANF/SNAP case. The household reports a household member left the home on October 25.  Since the change will result in a decrease in TANF and requires advance notice for both TANF and SNAP, the household member must be removed and the decreased TANF grant must be anticipated for December benefits.  The TANF advance notice and the SNAP advance notice must be issued on the same day.

Whenever a change results in the reduction or termination of the TANF grant and the worker does not have sufficient information to determine how the change affects SNAP eligibility and benefit level (such as an absent parent returning to the household and the household asked to have its TANF case closed without providing any information on the income of the new household member), the worker must take the following action:

1. If the situation requires a reduction or termination of the TANF grant and requires a TANF advance notice, the worker must issue F419 - Request for Information at the same time it sends a TANF advance notice giving the household 10 days from the mail date to provide the needed information. Before taking further action, the worker must wait until the TANF advance notice period expires, or until the household requests a fair hearing, whichever occurs first.

1. If the household requests a fair hearing and elects to have the TANF grant continue pending the appeal, the worker must continue SNAP benefits at the same level.
2. If the household does not request a fair hearing and provides the information requested, the worker has 10 days to act on the changes and the change in the TANF grant allowing for advance or adequate notice.  
3. If the household does not request a fair hearing and fails to provide the information, only the change in the TANF grant is acted on allowing for advance or adequate notice.   

2. If the situation does not require a TANF advance notice, the worker must send F419 giving the household 10 days from the mail date to provide the needed information. If the household provides the requested information within the 10 days, the worker has 10 days to act on the information allowing for advance or adequate notice.

   If the household fails to provide the requested information, only the TANF grant is removed when determining SNAP benefits.

Example:

Ongoing TANF/SNAP case. Household reports on October 5 the absent parent returned to the household and asked to have their TANF case closed.  The worker must send the F419 on the same day the TANF advance notice to close is sent allowing the household 10 days to provide the information for the absent parent.  

The household provides the information on October 10.  The worker must not act on the changes until October 15.  If the household does not request a fair hearing for TANF, the change to add the absent parent and remove the TANF grant must be acted on.