MEMORANDUM

 

DATE:         June 1, 2004

 

TO:               Adult Public Assistance Manual Holders

 

FROM:         Ellie Fitzjarrald, Chief

                      Policy and Program Development Team

 

SUBJECT: Adult Public Assistance Manual Change #8

 

This manual change implements three new APA policies: changes to the date that eligibility for APA may begin; a new payment standard for persons residing in assisted living homes; and ending the replacement of SSI Supplemental Security Income benefits that are reduced because of in-kind income.  This manual change also clarifies the policy for counting VA Department of Veterans Affairs payments as income, makes numerous technical changes and corrections, and includes a new index.

 

These policy changes are effective July 1, 2004.  More information about each of these changes and how to implement them is included below. EIS Eligibility Information System changes needed to implement these changes are scheduled to be in place on June 1, 2004, and will be announced by broadcast.

 

If you have any questions, please contact any member of the Policy and Program Development Team at 465-3347 or e-mail us at dpapolicy@health.state.ak.us.

 

NEW APA POLICIES

 

1. NEW BENEFIT START DATE FOR APA CASH BENEFITS

 

Effective July 1, 2004, the APA benefit start date for an applicant who is not eligible for SSI Supplemental Security Income, or who needs a disability determination, will begin the first day of the month after the Social Security Administration issues written notice of the applicants eligibility for SSI Supplemental Security Income or Disability Insurance benefits.  For state-only determinations, the APA benefit start date will begin the first day of the month after the Disability Determination Service (DDS Disability Determination Service) notifies the Division that the applicant is disabled.

 

 

 

 

Implementation:  APA Adult Public Assistanceworkers will need to begin using the new APA benefit start date policy for all APA applications that are received on or after July 1, 2004.  APA Adult Public Assistanceapplicants who applied before July 1, 2004 are still entitled to receive APA benefits under the old rules and will need to have their eligibility determined accordingly (back to the date the APA application is received, the date the applicant meets all APA eligibility requirements, or the date of beginning SSI Supplemental Security Income eligibility, whichever is later).

 

The following EIS Eligibility Information System notices have been updated to reflect the new APA benefit start date policy:

 

Notice #

Notice Title

Situation

P021

Authorization for Reimbursement Needed

Requests a completed Authorization for Reimbursement of Interim Assistance.

P101

APA Personal Needs Approved

Gives APA and Medicaid start dates for APA recipients in long term care.

P102

APA Application Approved

Gives the APA and Medicaid benefit start dates for APA approvals.

P302

APA Held for Disability Decision

Advises applicants that their application is being held while waiting for a state-only disability determination.

 

 

 

 

2. NEW APA PAYMENT LEVEL FOR APA RECIPIENTS RESIDING IN ASSISTED LIVING HOMES

 

Beginning July 1, 2004, the need and payment standards for residents of assisted living home homes are as follows:

 

Living Arrangement

Need Std.

Max. Pymt.

Individual, In Assisted Living Home (H1E Individual, Living in an Assisted Living Home (APA Household Type)APA Household Type))

$1,047

 $664

Couple, One Eligible, In Assisted Living Home (H2S Couple, One Eligible, Living in an Assisted Living Home (APA Household Type)APA Household Type))

$1,259

$664

Couple, Both Eligible, In Assisted Living Home (H2C Couple, Both Eligible, Living in an Assisted Living Home (APA Household Type)APA Household Type))

$1,551

$1,046

 

   

The Assisted Living Home payment standard equals the current SSI Supplemental Security Income Payment plus $100 for personal needs.  The monthly payment is limited to no more than $100.

 

Individuals who have countable income that is higher than the new maximum payment standard, but less than the need standard will still qualify for a $1 APA payment.  This $1 payment allows the resident to qualify for Medicaid as an APA recipient.

 

Implementation.  We are matching recipient data with the Division of Senior and Disability Services and the Division of Behavioral Health, and expect approximately 550 APA recipients to be impacted by this change.  A list of affected recipients will be provided to APA offices by June 1.  APA Adult Public Assistanceworkers will need to review each case, redetermine the payment using the new payment standard, and send notice of adverse action about any reduction.  A new EIS Eligibility Information System notice, P712, APA Decrease Assisted Living Home, has been created for this purpose.  Cases affected by this change must have payments adjusted as soon as possible, but no later than August 2004.

 

Note:  In the near future, the personal needs allowance for Medicaid home and community based waiver recipients living in assisted living homes will also be aligned with this policy, and reduced to $664. We are waiting for the necessary EIS Eligibility Information System programming and notice changes to be completed. Once this occurs, Long Term Care caseworkers will be provided with additional implementation instructions.

 

3. ENDING THE REPLACEMENT OF FEDERAL SSI Supplemental Security Income BENEFITS THAT ARE LOST DUE TO IN-KIND INCOME

 

Beginning July 1, 2004, the APA program will no longer replace SSI Supplemental Security Income benefits that are reduced or ended because of in-kind income.

 

Currently, APA recipients who have their SSI Supplemental Security Income benefits reduced or ended because of in-kind income receive a higher APA payment to make up for the lost SSI Supplemental Security Income benefits.   These persons will need to have their APA payment recalculated.  We expect that about 450 APA recipients will be affected by this change.

  

Implementation.  

 

A list of APA cases that may be affected by this new policy will be provided to APA offices by June 1.  APA Adult Public Assistanceworkers will need to review each case, recalculate the benefit by subtracting the applicable SSI Supplemental Security Income income standard from the APA payment standard, reauthorize the payment, and send notice of adverse action about the benefit reduction.  A new EIS Eligibility Information System notice, P713, APA Decrease SSI Supplemental Security Income Replacement Ends, has been created for this purpose.  Cases affected by this change must have payments adjusted as soon as possible, but no later than August 2004.

 

OVERVIEW OF CHANGES

 

Section 410-10, Period Covered by Application Makes technical changes to accommodate new policy on when APA and Medicaid benefits may begin.

 

Section 410-11, Initial Month Benefits Adds a new section to explain when APA and Medicaid benefits may begin.  References to three-month retroactive Medicaid coverage that were previously contained in manual section 410-10 and 420-2C are now included in this new section.

 

Section 410-12, Notice of Finding on Application This section is renumbered from 410-11 to 410-12 (to make room for new section 410-11, Initial Month Benefits).

 

Section 420-2C, Benefits to APA Applicants Pending an SSI Supplemental Security Income Decision Removes policy regarding benefit start dates for APA and Medicaid.  These policies are now included in manual section 410-11, Initial Month Benefits.

 

Section 420-3C, Social Security Administration (SSA ) Insurance Clarifies the age at which Social Security retirement benefits are available.

 

Section 425-2B, Presumptive Disability Decisions Clarifies that APA and Medicaid benefits may be authorized retroactive to the month that SSI Supplemental Security Income benefits are resumed from suspended or non-pay status.

 

Section 425-2C, SSA Blindness or Disability Adds a cross reference to new manual section 410-11, Initial Month Benefits.

 

Section 425-3A, Blind or Disabled Applicants Who Have Been Found Eligible for SSA , but Do Not Appear Eligible for SSI Supplemental Security Income Removes language regarding APA and Medicaid benefit start dates.  This information is now described in the new manual section 410-11, Initial Month Benefits.

 

Section 425-3B, Blind or Disabled Applicants Who Appear Eligible for SSI Supplemental Security Income Removes policy that lists eligibility requirements for Interim Assistance and adds a cross reference to manual section 426-2, Eligibility Requirements for Interim Assistance.

 

Section 425-3C, Blind or Disabled Applicants Who Do Not Appear Eligible for SSI Supplemental Security Income and Have Not Been Determined Eligible for SSA Disability Adds a cross reference to manual section 410-11, Initial Month Benefits.

 

Section 426-2E, IAR Interim Assistance Reimbursement Authorization Requirement Eliminates reference to retroactive APA benefits.

 

Section 426-3B, IAR Interim Assistance Reimbursement Authorizations Updates the distribution list to say, copy to (as shown on current version of form), instead of yellow copy and pink copy.

 

Section 426-3C, Interim Assistance Reimbursement Process Replaces SYSM with E-mail.

 

Sections 426-7, Converting Interim Assistance to Regular Adult Public Assistance Clarifies when APA benefits may begin after the Interim Assistance ends, and removes policy on retroactive APA /Medicaid benefits.

 

Section 433-3, Permanent Fund Dividend Removes Medicaid policy on the treatment of PFD Permanent Fund Dividend payments.

 

Section 440-1, Income Defined Eliminates the references to Alaska Longevity Bonus (ALB Alaska Longevity Bonus) payments.

 

Section 440-2, When Income is Counted Eliminates policy on retroactive APA benefit calculations.

 

Section 441-2C, Department of Veterans Affairs Payments Clarifies how augmented portions of VA Department of Veterans Affairs Pension, Compensation, or Educational Assistance payments are treated as income.

 

Section 450-1, APA and SSI Supplemental Security Income Living Arrangements Adds Assisted Living Home to the list of living arrangements, and clarifies that the SSI Supplemental Security Income living arrangement policy is not the same as APA policy for an individual residing in an assisted living home.

 

Section 450-2, Living Independently (SSI Supplemental Security Income A Living Arrangement) Replaces the term Adult Residential or Foster Care Facility with assisted living home, and clarifies that while the SSI Supplemental Security Income program considers an assisted living home resident to be living independently, the APA program does not.  Instead, the APA program applies the assisted living home payment standard to these individuals.

 

Section 450-4, Living in an Assisted Living Home Adds a new section to describe new APA living arrangement for assisted living home residents.  Manual sections 450-5 and 450-6 are renumbered to make room for new manual section 450-4.   

 

Section 452-2, Budgeting Exception for SSI Supplemental Security Income Cases in Which an Ineligible Spouse Receives Income Removes policy regarding replacement of SSI Supplemental Security Income benefits lost due to in-kind income.  Reformats the section to clarify the budgeting exception for SSI Supplemental Security Income cases in which an ineligible spouse receives income.

 

Section 452-5, Computation of Benefits Removes policy on the replacement of SSI Supplemental Security Income benefits that are lost due to in-kind income, and adds a new subsection for APA payments to assisted living home residents.

 

Section 452-6, Case Controls During the SSI Supplemental Security Income Appeal Process Removes policy on initial month APA benefits and retroactive Medicaid benefits.  These policies are now included in manual section 410-11, Initial Month Benefits.

 

Section 452-7B, Payment to a Third Party Adds reference to optional use of APA #14 form, Adult Public Assistance Protective Payee Agreement.

 

Section 452-12, Retroactive APA Benefit Calculations Revised to clarify when an applicant is eligible for retroactive APA and how the retroactive APA benefit is calculated.

 

Addendum 1, Program Standards Updates the APA Need Standards table to show the need standards that apply to persons residing in assisted living homes.  Revises the APA Maximum Payment Standards table to show the new APA payment standards for persons residing in assisted living homes.

 

Index Revised to accommodate location of new and/or revised policies.

 

 

REVISED FORMS

 

Listed below are the DPA forms that have been updated to support these policy changes.  Revisions to the Gen 50B Application for Services application are underway, and will be included in the next distribution to offices in July.  The revised Interim Assistance Reimbursement Authorization (Gen 142 ) form is available on-line, and should be used with all APA applications received on or after July 1, 2004.  A supply of the revised Gen 142 will also be mailed to offices.

 

Form #

Form Name

Changes

Gen 5B

APA Budget Worksheet

Allows workers to indicate if recipient lives in an assisted living home, and removes references to Alaska Longevity Bonus and in-kind income in the eligibility and payment calculations.

Gen 50B Application for Services

Application for Services

Advises applicant that APA benefits may not start from the date of application.

Gen 52

Information You Need to Know When Applying for Assistance

Corrects the description of Chronic and Acute Medical Assistance (CAMA Chronic and Acute Medical Assistance) and advises applicant that APA benefits may not start from the date of application.

Gen 142

Interim Assistance Reimbursement Authorization

Removes the sentence advising applicant that he or she will not be eligible for retroactive APA if they sign the form.

 

 

MANUAL CHANGE FILING INSTRUCTIONS

 

Remove Old Pages
 

Insert New Pages
 

Chapter Contents (Chapter 410)

Chapter Contents (Chapter 410)

B-9 through B12

B-9 through B14

C-5 through C-6

C-5 through C-6

C-9 through C10

C-9 through C10

H-3 through H-8

H-3 through H-8

Chapter Contents (Chapter 426)

Chapter Contents (Chapter 426)

I-7 through I-12

 I-7 through I-12

I-15 through I-20

I-15 through I-18

M-13 through M-14

M-13 through M-14

N-1 through N-2

N-1 through N-2

O-5 through O-6

O-5 through O-6

O-9 through O-10

O-9 through O-10

Chapter Contents (Chapter 450)

Chapter Contents (Chapter 450)

R-1 through R-4

R-1 through R-4

Chapter Contents (Chapter 452)

Chapter Contents (Chapter 452)

T-3 through T-22

T-3 through T-22

Addendum 1

Addendum 1

Old Index

New Index