Change of Circumstance
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Change of Circumstance

Revised October 28, 2007

Purpose:

Adverse Action

Adverse Action Not Waived

Adverse Action Waived

Benefit Effective Date

Client Deceased

Client in One Assistance Unit Needs to Be Opened in a New Assistance Unit

Income Changes on a P02 Pregnancy Medical Case

Medical Extensions

Paid Through Dates

Previous Calculated Benefit Amount

Reduction and/or Termination Information

Resetting TANF Time Clock - Coding

Remove Pregnancy Information After Baby Born and Added to Assistance Unit

 

Adverse Action

Adverse action is defined as an action to reduce, suspend or terminate grant, food assistance, or medical assistance, or any action to change the manner or form of payment to a protective payee or vendor payment.

See WAC 388-418-0005.

  • When processing changes of circumstance in ACES it is very important to pay attention to the month in which the change occurred and make sure the change is being made in the correct month.

  • Information in ACES in most cases does not copy forward from the historical or current month into the ongoing month.

  • If a change is processed in a historical or current month the information must also be entered in the ongoing month if it is to continue.

  • When processing a change make the change in the ongoing month (if needed) and then any historical and / or current month.

  • When taking adverse action on a case, policy requires the client be given advance notice of the change.

  • Advance notice is letter of a grant, food assistance, or medical reduction, suspension, or termination that is mailed at least ten days before the date of the intended action. In certain situations advance notice is not required.

  • The adverse action and advance notice processes in ACES are used to determine the benefit effective date on the (CAFI), (MAFI) and /or (FSFI).

  • The following reason codes do not require advance notice of adverse action:

Cash 210 213
Basic Food 551 567

See WAC 388-418-0020  and WAC 388-458-0035.

 

Adverse Action Not Waived

The following reason codes require advance notice of adverse action so it is not possible to waive adverse action on the (CAFI), (MAFI) and /or (FSFI):

  • 226 - Institutionalized
  • 249 - Concurrent Receipt - CA / MA
  • 251 - Concurrent Receipt - FS
  • 569 - Child Accepted to Foster Care

When adverse action is not waived ACES calculates the 10-day advance notice period:

  1. Day 1 of the 10-day count begins the first working day following the system date on which a change is made on a case.

EXAMPLE

User takes action to terminate cash AU on Friday 7/19. The system date is 7/19. The first working day that follows is Monday, 7/22.

Day 1 of the 10 day count begins on 7/22; day 10 is 7/31 therefore the BENEFIT EFFECTIVE DATE is 7/31.

Adverse action is not an issue.

  1. Day 1 of the 10-day count cannot occur on a weekend or holiday. This ensures that day 1 of the 10-day count is the first possible day to mail the letter to the client. This is the date that will be printed on the letter.

EXAMPLE

User takes action to terminate cash AU on Friday 2/16. (February has 29 days). The system date is 2/16. The first working day that follows is Tuesday, 2/20 because Monday is a holiday.

Day 1 of the 10 day count begins on 2/20; therefore, the BENEFIT EFFECTIVE DATE is 2/29.

Adverse action is not an issue.

EXAMPLE

User takes action to terminate cash AU on Friday, 11/22. The system date is 11/22. The first working day that follows is Monday, 11/25.

Day 1 of the 10 day count begins on 11/25; therefore the BENEFIT EFFECTIVE DATE is 12/4 unless the user enters a [Y] in the Waive Advrs Act Period field.

If the adverse action period is not waived there is not enough time to give the client 10 days advance notice for the change to be effective 12/1.

The paid through date will be 12/31 and benefits will be issued unchanged for December.

  1. When a change resulting in a decrease in benefits or closure is processed, the benefit effective date initially includes the 10-day advance notice calculation.

  2. If adverse action is not waived the benefit effective date includes the ten day advance notice period.

    This usually means that the change will not be effective until the month following the month in which the change is being processed.

  3. The amount in the Benefit Amount field is effective with the first full month following the benefit effective date.

  4. The benefit amount issued for the month being processed will usually be the amount in the Prev Calc Amt field.

Adverse Action Waived

The following reason codes do not require advance notice of adverse action. ACES automatically waives advance notice if adverse action is taken within the 10 day advance notice period.

  • 213 - Failed Preg. Requirement
  • 235 - Failure to Recertification
  • 290 - Overdue Incapacity Review
  • 304 - AR Change in Circumstance
  • 551 - Whereabouts Unknown
  • 567 - Drug / Alcohol Center Loses Certification

To waive adverse action for all other circumstances:

  1. Enter a [Y] in the Bnft Confirm field on the(CAFI) or (FSFI).

  2. Enter a [Y] in the Waive Advr Act Period field.

  3. Enter a [N] in the Notice Override field. Even if the letter will be overridden, Y cannot be entered here.

  4. If an Y is entered here Edit Message 0853 – Cannot Waive Both Adverse Action and Notice - displays at the bottom of the screen.

  5. <TRANSMIT>.

  6. The Bnft Eff Date field changes to the date the case action is being processed.

  7. The Y in the Waive Advr Act field is now protected and cannot be changed.

  8. If there has been an error made and you need to change the valid value, you must go back to one of the data collection screen and then call (DONE) again.

  9. This forces the system to run eligibility again and resets the dates back as specified in Step 1 above.

  10. The Notice Override field changes back to a red question mark and the valid value in the Notice Override field must be re - entered.

  11. The user can now enter [Y] in the Notice Override field.


NOTE: The only time this should be used is when the notice will not be adequate and the user will be sending a letter.  See Letters.

  1. Because the benefit effective date is prior to the end of the month the change will be effective at the end of the month even though there is not enough time to give the client ten days advance notice.

  2. The paid through date on (STAT) and(ELIG) will be set to the end of the month.
     

Benefit Effective Date

See WAC 388-418-0020.

  • Case actions processed in ACES that result in a recalculation of eligibility also result in the calculation of a new benefit effective date.

  • The Bnft Eff Date, Benefit Effective Date field, is the on the (CAFI) screen, (FSFI) screen, (MAFI) screen and (SPEC) and shows the effective date of the case action just processed.

  • The Bnft Eff Date field on the (CAFI), (MAFI), or (FSFI) is the date the amount in the Benefit Amount field becomes effective.

  • This date is especially important during the adverse action period to determine when a reduction and/or termination will become effective.

  • The system calculates the 10-day advance notice period by determining if the client will receive notification of a reduction / termination prior to month end.

  • Letters are mailed the first working day following case actions in overnight batch.

  • The system starts the day 1 of the 10-day advance notice count with the first working day following case actions.

  • Because advance notice must be mailed at least ten days before the date of the intended action, changes to a case that meet the definition of adverse action processed during the ten day advance notice period will always be effective the next month if adverse action is not waived.

  • The ten-day advance notice period varies from month to month. The exact date the ten-day advance notice period begins and ends each month is published in aces.online on the ACES  Production Calendar. 

  • If processing a case action during the ten-day advance notice period results in a change that meets the definition of adverse action the user must tell ACES whether or not to waive adverse action.  See Change of Circumstance – Adverse Action.
     

Client Deceased

To close a client that is deceased, enter the date of death in the Death Date field on the deceased client's (DEM2) in the ongoing month only.

When a client is closed in ACES due to death, this information is sent to SSA.

This results in the client's SSA benefits being closed and assets frozen.

 

Client in One Assistance Unit Needs to Be Opened in a New Assistance Unit

  • When opening a client previously known to ACES in a different AU make sure the client being screened is matched to the correct client and CLID in name clearance so that they keep the same CLID in the new AU.

  • Complete the Concurrent Receipt field on the appropriate client's (DEM1).

  • Entering information in the Concurrent Receipt field overrides the dual participation Edit Message 0585 – Client Cannot Receive Benefits from Two AUs, Review Client Status - when finalizing the client in the new AU.

  • The dual participation Edit Message 0585 will not be overridden, if the client's status is A – active, in any other cash or food assistance AU in the month being processed.

To process this type of case:

  1. Process the change to close the affected client in the existing AU on the (AMEN) through Option R - Interim / Hist Change. 

  2. Process the change in all affected months, including the ongoing month.

  3. If the client is not closed in all months ACES will not allow the client to be opened in the new AU.

  4. If the client you are trying to authorize assistance for is active in another CSO, contact the other CSO and have someone close the client before finalizing the AU.

  5. Screen a new AU, add a program, or add a person based on the case situation and the client's new circumstances.

  6. Enter [all necessary client data] from the (AMEN) through Option O - Interview.

  7. Do not enter the valid value in the Concurrent Receipt field on the (DEM1) for concurrent assistance here.

  8. An edit prevents entry of the concurrent assistance valid value in the ongoing month as no assistance has been issued for that month.

  9. Enter the [appropriate valid value] on the (DEM1) in the Concurrent Receipt field for the affected client on the (AMEN) through Option P - Process Application Months.

  10. User must code the (UNER) with the income from the previous AU if policy dictates that it should be budgeted.

  11. If there is an active AU associated with the new AU, information entered through Option O – Interview - will not copy back.

  12. The Concurrent Receipt field valid value must be entered in each month, when processing the case, or ACES displays the dual participation Edit Message 0585 – Client Cannot Receive Benefits from Two AUs, Review Client Status - when finalizing the AU.

  13. Finalize the new AU from the (AMEN) through Option Q - Finalize Application.

  14. When an AU has been closed and benefits cancelled, but the AU is actually eligible for those benefits, the previously closed AU should be reinstated.

  15. If the AU is reinstated no entry in the Concurrent Receipt field is necessary.  See Reinstatement.
     

Income Changes on a P02 Pregnancy Medical Case

ACES is programmed to follow the change of circumstance processing rules for P02 AUs once the AU is active.

If a case is being processed as an application and the client is eligible the first month but not eligible because of excess income in subsequent months the AU must first be opened and made active with the lower amount of income in all applicable months.

The next day, after batch runs on the case, the actual income can be entered in any subsequent months. In this situation then the system will ignore the increase in income and the case will remain active.

 

Medical Extensions

A client receiving TANF or SFA cash grant or related medical is eligible for a medical extension when the cash grant or medical is terminated as a result of earned income or collection of child / spousal support.

See WAC 388-418-0025.

Based on policy, ACES will not allow a person to be added to an F02 Transitional Medical AU.

 

Paid Through Dates

When a case action is processed that results in the AU being closed, ACES calculates the effective date of the closure, changes the AU and/or client level status codes and sets the PD THRU DATE on the (STAT).

Following is a chart illustrating how ACES closes a case and what the paid through date will be when adverse action is waived or not waived.

For this example ten-day advance notice period begins 3/22/00 and monthly issuance deadline is 3/25/00:

SYSTEM DATE BEN MONTH WAIVE ADV ACTION CLOSE STATUS CODE BEN EFF DATE PAID THRU DATE
03/21/00 03/00 NO H 03/31/00 03/31/00
03/21/00 04/00 NO C 03/31/00 03/31/00

03/22/00 03/00 N/A H 03/22/00 03/31/00
03/22/00 04/00 NO C 04/01/00 04/30/00
03/22/00 04/00 YES C 03/31/00 03/31/00

03/25/00 03/00 N/A H 03/25/00 03/31/00
03/25/00 04/00 NO H 04/05/00 04/30/00
03/25/00 04/00 YES C 03/25/00 03/31/00
03/27/00 05/00 N/A C 04/06/00 04/30/00
 

Previous Calculated Benefit Amount

The previous benefit amount in ACES does not necessarily mean the benefits the client received the previous month.

The previous benefit amount on the (CAFI) and/or (FSFI) reflects the system computed benefit amount the last time eligibility ran on that AU.

This date is especially important when looking at the benefit amount a client will receive when advance notice has been waived on a case with adverse action.


NOTE:

Pressing <F19> on the (MISC), (CAFI), (FSFI), or (MAFI) will display the (JMEN) where you can inquire on previous benefit amounts.

 

Reduction and / or Termination Information

An entry in the Waive Advr Act Period field outside the Adverse Action Period has no effect on eligibility or benefit reduction.

If a reduction or termination case action is processed during the adverse action period, the following information applies:

  1. Waiving adverse action can mean; the action being taken does not require the client be given 10-days advance notice of the change or the user is able to control notification to the client prior to the end of the month for the reduction and/or termination.

  2. To waive adverse action (advance notice is not required) enter a [Y] in the Waive Advr Act Period field on the (CAFI) or (FSFI) and do not override the notice.

  3. If the user can guarantee client notification prior to the end of the month by generating a letter, the user can waive adverse action and override the system letter on (FSFI) or (CAFI) by using the following steps:

    1. On the (FSFI) or (CAFI), enter [Y] in the Waive Advr Act field.

    2. Enter [N] in the Notice Override field.

    3. <TRANSMIT> and the (CAFI) or (FSFI)  redisplays with the N in the Notice Override field changed to a ?.

    4. To override the letter, enter [Y] in the Notice Override field only.

    5. <TRANSMIT>

  4. When adverse action is waived, ACES sets the Benefit Effective Date to the current system date. The change is effective with the next month's benefit.

If advance notice of the change is required (do not waive adverse action) leave the Waive Advr Act Period field blank.

When 10 days advance notice is required but cannot be given, the change is effective with the second month's benefit.

 

Resetting TANF Time Clock - Coding

At times for various reasons the automatic number of months listed on the (TICS) may not be accurate. More often than not users can correct the count by making historical changes to the AU. Occasionally corrections can not be made this way. Users can increment or decrement the number of months an individual client has received TANF/ SFA or GS-P (5/99 - 7/99) benefits.

Users can increment or decrement the TANF/SFA count that appears on the (TICS) by entering information on the (TICA) (Time Clock Adjustment). 

  • The user enters the adjustment with a valid value indicating the reason for the change and ACES recalculates the count appearing on (TICS). 

  • A history indicating the user, span of dates, and reason code is stored on the (TICA). 

  • ACES  recalculates the 60-month count and the adjusted count appears on the (TICS) with the valid value indicating why the change was made.

  • Letter 008-06, Time Clock Change. is sent to the client.

  • A monthly report "TANF Time Reset Report" is available on aces.online, and includes the following: 

  1. Date of Approval,

  2. USER ID,

  3. CLIENT ID, 

  4. Reason for the Change (Valid Value Code), and 

  5. Number of Months Changed.

 

Remove Pregnancy Information After Baby Born and Added to Assistance Unit

  1. Do not remove the pregnancy information from the mom's (DEM1) until after the baby has been added to the assistance unit.
  2. In an AF-P F01 AU, after a newborn is added as a member to an existing AU make sure that the pregnancy information is removed from the mother's (DEM1).

This will ensure that the assistance unit program type information is correct and that statistical reports regarding pregnancy are accurate.

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Modification Date: October 28, 2007
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