103-1 THE CASE FILE FOLDER
Each district office must prepare and maintain a case file for all applicants and recipients of DPA programs. Staff may use a six-part file folder or a four-part file folder depending on the type and number of cases assigned to the applicant or recipient. Staff may also assign more than one EIS case number depending on the program(s) requested by the applicant or recipient. Refer to section 103-3 for information on case numbering rules.
In addition to creating and maintaining case files, there are also specific rules staff must follow in ensuring the documents contained in the case files are kept confidential and retained following the retention of case records or archiving rule. Refer to MS 103-6 for more information on Retention of Case Records.
103-1 A. GENERAL RULES FOR CREATING CASE FILE FOLDERS
The file label
must include the following information:
Last Name,
First Name, M.I. ( SSN optional)
Program
Type(s) and Case Number(s)
Cross-reference
Case number(s)
Programs
and case numbers can only be combined in the same case file when the
Primary Information ( PI ) person
on EIS is the same for each program
and case number.
All related
case numbers with the same PI must
be listed for cross-referencing on the file label. Multiple
case files with the same PI may be
banded and stored together when assigned to the same caseworker.
A six-part file
folder may contain no more than two case numbers. If a client is assigned
more than two case numbers, a separate file folder will be established
to contain the remaining case numbers.
A four-part
folder may contain one or more case numbers:
A four-part
folder may be used for one case number if that case is a Nursing
Home Medicaid, Disabled Child Medicaid, GA
/ CAMA , Family Medicaid, Under
21 Medicaid, or Denali KidCare.
A four-part
folder may contain three case numbers if those cases are APA
/IA, APA -related Medicaid, and
GA / CAMA
cases for the same client.
All other
program combinations will be organized in six-part file folders.
Senior Benefits
cases are filed in two-part manila file folders. At the option of
the Regional Manager, Denali KidCare, CAMA
/ GA cases may also be filed in two-part
manila file folders, instead of the four-part file folder.
Two cash
programs may not be combined in one case file, such as Alaska Temporary
Assistance and Adult Public Assistance/Interim Assistance. A
cash program along with Food Stamps, Family Medicaid, Under 21, APA
-Related Medicaid, CAMA , and GA
may be combined in one file folder. GA
is not considered a cash program.
Note:
Denali KidCare program may not be combined into one file folder with any
other program.
Examples of program combinations:
• Adult Public Assistance/Interim Assistance, Food Stamps, APA
-related Medicaid, CAMA , and GA
may be combined in one file folder.
• Temporary Assistance, Food Stamp, Medicaid (Family Medicaid and Under-21),
CAMA , and GA
may be combined in one file folder.
• At the option of the Regional Manager, CAMA
and GA cases may be filed in a separate
file folder from other programs.
Example 1:
Applicant has applied for Food Stamp benefits for her entire household,
CAMA for herself, and Under-21 Medicaid
for her niece.
• The applicant will be assigned two case numbers - one for FS
and Medicaid, and another for CAMA .
• All programs and case numbers may be combined in a six-part file folder
for this household.
Example 2:
Applicant has applied for Alaska Temporary Assistance and Family Medicaid
for herself and her daughter. She also applied for Denali KidCare
for her nephew and Food Stamps for the entire household.
• Two case numbers will be assigned to this household - one for the TA
, FS and Family Medicaid programs; and
a separate case number for Denali KidCare.
• Two file folders must be created - one for TA
, FS , and Family Medicaid; and a separate
file folder for the Denali KidCare program.
Example 3:
Applicant applies for Alaska Temporary Assistance, Food Stamps, Family
Medicaid, and GA . The household
includes herself and her children. The applicant is also applying
for APA -related Medicaid for her six-year
old son who is receiving SSI and must
be the PI on his own case.
• Three case numbers will be assigned to this household - one for TA
, Food Stamps, and Medicaid; another for GA
; and a third case number for the APA
-related Medicaid for the SSI child.
• Two file folders must be created for this household one case file for
the TA , Food Stamps, Medicaid, and GA
case; and a separate file folder for APA
-related Medicaid for the SSI child.
All applications,
recertifications, reviews, renewals, reports of change, interagency
forms, and other documentation will be placed in the file for the
program to which it pertains. In situations where there is more
than one case file established, the original forms and documents must
be placed in the file containing the main program (
TA , APA , and FS
). Staff may either make copies of the original forms and documents
for the second file, or make a note in the CANO
where the documents are filed.
If there are
duplicate file folders containing the same case number(s) and program(s),
consolidate all the information into one file and destroy any duplicate
copies.
All sections
of the file folder must be filed chronologically unless otherwise
specified in this section.
Material smaller
than 8 ½ x 11" must be stapled to or copied onto a sheet of paper
that size. Material larger than 8 ½ x 11" may be reduced to that
size.
Printing and
retaining EIS screens must be kept
to a minimum, and limited to those screens critical to explaining
a complex policy decision, and to screens that do not retain history
in EIS . EIS
payment screens should be printed and retained because EIS
does not always retain income, resources, and DEMH information which
could cause changes in the payment screens.
Photocopying of certain federal, state, and local documents is prohibited and illegal. After the caseworker determines the appropriateness of the document used to verify one or more eligibility factors, the caseworker must determine whether it is legal to photocopy for retention in the case file. If copying is prohibited, the caseworker must write the information from the document on a blank 8½ x 11" sheet of paper, sign and date it , and file it in Section one. If the document is a permanent document, the sheet of paper must be placed under the Record of Permanent Document ( ROPD ) insert and the caseworker must note on the ROPD under comments, "No copy in file, illegal to copy".
103-1 B. ORGANIZATION OF THE SIX-PART CASE FILE FOLDER
Each six-part case file folder will be organized in the following order: file documents listed under item #1 on the bottom and the subsequent inserts and items on top .
PART I
Permanent Documents:
Birth Certificates
Social Security
Cards
Identification
and Citizenship Documents such as U.S. Passport, U.S. Naturalization
Certificate, drivers license, military card, etc.
Divorce Decree
Marriage Certificates
Death Certificates
Citizenship
Status Declaration (Gen #49)
Alien Registration
Card or immigration documents
Systematic Alien
Verification for Entitlement Record (Gen #47)
Consent of Disclosure
(Gen #46)
Statement of
Relationship (Gen #7)
Vital Statistics
Request (Gen #6) and verification
Alien Document
Verification Request (Form G-485)
Trust Documents and Approvals
for Long Term Care cases
Court Orders
(Court orders,
although legal in nature, could range from any type of issue which could
be simple or complex. Staff need to determine the complexity of the order
and determine if the document must be kept as permanent record. For example,
if the court order is a notification of the date of trial, this will not
be considered permanent record).
INSERT: Record
of Permanent Documents
Native Dividend
Tracking Form (Gen #29)
Verifications:
Income
Shelter deductions
Note:
At the option of the caseworker, forms Gen #36 and Gen #37 included in
the Gen #50B and Gen#72 may be filed in this section as item #4.
PART II:
Inter-agency
forms and correspondence:
Social Security Administration ( SSA
)
INSERT: Interagency
Forms
Intra-agency forms include:
Third Party
Liability forms ( TPL )
Disability
Examination (AD #2)
Health Status
Report Form ( TA #10) with corresponding
doctor's report
Review Report
on Aid to the Blind (AB #3)
Disability
and Vocational Report ( APA #4)
Authorization
to Release Medical Information ( APA
#5)
Statement
of Principal Place of Residence ( APA
#12)
Agreement to Sell Property ( APA #11)
PART III:
Case Staffing
Information
ATAP Extension
Review Form
ATAP Case
File Summary & Recommendations Form
INSERT: Case
Staffing Information
Case Management Information:
Family Self-Sufficiency
Plan
Employment
Planning Information
Health Status
Report Form ( TA #10) with corresponding
doctor's report
Welfare
to Work forms
Grantee and Contractor case management correspondence to/from
PART IV:
Reports of Contact
(Gen #56A)
INSERT: Confidential
Reports of Contact
Reports of Changes
Report of
Change Form (Gen #55)
Note:
File all information attached with Gen #55 to appropriate sections.
Correspondence
and letters received from client
Returned mail from clients
PART V:
Fair Hearing
Information
Requests
Notices
Decisions
INSERT: Fair
Hearing
Corrective Action
Forms:
QA
Review/Feedback
Home Visit
Reports
Fraud Referrals/Reports
Stop Payments
Forgery
Affidavits
INSERT: Corrective
Action Forms
Overpayment
Claims and Underissuances VA
Report of
Claim Determinations (Gen #95)
EIS
Screens pertaining to Over/Underpayments
INSERT: Claims
and Underissuances
Information for second case number program, similar to that contained in Section VI for major programs. (Normally not Alaska Temporary Assistance, APA , or Food Stamp since these programs will go in Part VI.)
PART VI:
Initial applications
for major programs - Alaska Temporary Assistance, APA
, and Food Stamps
Fee agent checklists
(FA #1)
EIS
benefit authorization screens (TAPD, FSAD, MIBW
, APBH )
Subsequent applications,
recertifications, and reviews (Gen 72) or addendums (Gen #50A)
Subsequent worksheets;
EIS work screens, eligibility determinations,
EIS budget screens, and manual budget
sheets.
Diversion Agreement forms and authorizations screen
Note:
At the option of the caseworker, forms Gen #36 and Gen #37 included in
the Gen #50B and Gen#72 may be filed in section I as item #4.
103-1 C. ORGANIZATION OF THE FOUR-PART CASE FILE FOLDER
Each four-part case file folder will be organized in the following order, filing documents listed under item #1 on the bottom and the subsequent inserts and items on the top .
PART I:
Permanent Documents:
Birth Certificates
Social Security
Cards
Identification
Divorce
Decree
Marriage
Certificates
Death Certificates
Citizenship
Status Declaration (Gen #49)
Alien Registration
Card or immigration documents
Consent
of Disclosure (Gen #46)
Statement
of Relationship (Gen. #7)
Vital Statistics
Request (Gen #6)
Alien Document
Verification Request (G-485)
INSERT: Record
of Permanent Documents
Native Dividend
Tracking Form (Gen #29)
Verifications:
Income
Shelter
deductions
INGENS
Employers
or work statements
School verification
letter
Reports of Changes
Report of Change Form (Gen #55)
Note:
File all information attached with Gen #55 to appropriate sections
Correspondence
and letters received from client
Returned mail from clients
Note:
At the option of the caseworker, forms Gen #36 and Gen #37 included in
the Gen #50B and Gen#72 may be filed in this section as item #5.
PART II:
Inter-agency
Forms and correspondence:
INSERT: Interagency
Forms
Intra-agency Forms:
PART III:
Fair Hearing
Information
Requests
Notices
Decisions
INSERT: Fair
Hearing
Corrective Action
Forms:
QA
Reviews/Feedback
Home Visit
Reports
Fraud Referrals/Reports
Stop Payments
Forgery
Affidavits
INSERT:
Corrective Action Forms
Overpayment
Claims and Underissuances
Report of
Claim Determinations (Gen #95)
EIS
Screens pertaining to Over/Under payments
INSERT: Claims
and Underissuances
Report of Contact (Gen #56A)
PART IV:
Initial application
Fee agent checklist
(FA #1)
EIS
work screens; eligibility determinations; EIS
benefit authorization screens
Subsequent applications,
recertifications, and reviews (Gen #72) and renewals (Gen #148)
Subsequent worksheets;
EIS work screens, eligibility determinations,
and EIS budget screens
Documents for
second case, separated by Program Divider sheets
Note:
At the option of the caseworker, forms Gen #36 and Gen #37 included in
the Gen #50B and Gen#72 may be filed in section I as item #5.
Manual budget worksheets should be filed with the corresponding application or recertification.
103-1 D. ORGANIZATION OF THE TWO-PART MANILA FILE FOLDER
Manila file folders are organized chronologically with the oldest document filed on the bottom.
The purpose of purging DPA case files is to eliminate unnecessary documents that are not required in the active case file. The case file must contain only documents essential to verifying an eligibility factor or supporting a determination of eligibility, ineligibility, or benefit amount. When documents are purged from a case file, these documents are destroyed (shredded). Staff may purge case files but must ensure that they are not destroying any necessary documents regardless of the date of the document. If the document was used to support any eligibility determination, this document is considered necessary and must not be purged. Necessary documents will be taken out of an active case file only during the process of ”voluming.”
Examples of unnecessary documents staff may purge:
Duplicate copies of original/copied documents
EIS notice (all are on Notice History)
Case Profile ( CAP ) screens
Case Summary (CASS) screens
Most EIS screens except for benefit authorization screens, self-employment ( SEEI ) screens, and student income (UNIE) work screens.
Accurate case files must be maintained to ensure all required documentation is available for future reference in accordance with state and federal regulations. At the same time, files must be maintained at a manageable size. For DPA , this process is called "voluming,” which means to create a new file folder when a case file has reached two inches in thickness.
The procedures for voluming case files are as follows:
1. Sorting the Case File and Creating a New Case File
The documents in the case file are sorted to determine which will be pertinent to an active case. These documents are transferred into a new case file folder (follow steps 3 and 4 for the procedures in transferring documents). The remaining documents which are no longer considered pertinent will remain in the original case file to be sent to Archives.
On the front cover, mark the original case file as "Volume 1" and the new case file as "Volume 2." Clearly indicate on both case files the date the original case file was purged. Volume 1 will be archived and volume 2 will remain in the DPA office.
Note:
Succeeding case file folders will be numbered accordingly.
3. Transferring Documents to the new Six-Part Folder:
The following documents are pertinent to an ongoing case and will be retained in the new case file:
Part I:
Record of Permanent Documents (this includes all the documents filed under the ROPD section)
Native Dividend Tracking Forms
Verification provided by the household in the last 12 months (this includes proof of income, resources, insurance coverage,
employment statements, school verification letter, PFD 1, FSP 81, etc.)
Part II
Copy of the CSSD 1603
Intra-agency forms and printouts in the last 12 months
Part III
Most current ATAP Extension Review Forms
Most current ATAP Case File Summary and Recommendations
Most current case staffing forms
Most current FSSP and EPI forms
Most current TA 10 forms
Part IV
Report of Contact (GEN 56A) forms and any other handwritten case notes
Case Manager's home visit case notes
Reports of Change Forms (GEN 55) received in the last 12 months
Any correspondence and letters from clients received in the last 12 months (this does not include returned mail to clients)
Part V
Fair Hearing requests, notices, and decisions received in the last 12 months
QA reviews and forms in the last 12 months
Home Visit reports, fraud reports, and referrals
Stop payments and forgery affidavits in the last 12 months
Report of Claim Determinations (GEN 95) completed in the last 12 months and corresponding EIS printouts
Part VI
The latest or most current application forms and recertification, review, or renewal form (regardless of the date it was received) from when the new volume was created.
Printout of EIS payment screens for action taken on the most current application and recertification, review or renewal (EIS does not always retain income, resources, and DEMH information which could cause changes in the payment screens).
4. Transferring Documents to the New Four-Part Folder:
The following documents are pertinent to an ongoing case and will be retained in the new case file:
Part I:
Record of Permanent Documents (this includes all the documents filed under the ROPD section)
Native Dividend Tracking Forms
Verification provided by the household in the last 12 months (this includes proof of income, resources, insurance coverage, employment statements, school verification letter, PFD 1, FSP 81, etc.)
Part II
Copy of the CSSD 1603
Interagency Forms and printouts in the last 12 months (this includes, DOL, SSA, ASVS, etc.)
Intra-agency forms and printouts in the last 12 months
Part III
Fair Hearing requests, notices, and decisions in the last 12 months
QA reviews and forms in the last 12 months
Home Visit reports, fraud reports, and referrals
Stop payments and forgery affidavits in the last 12 months
Report of Claim Determinations (GEN 95) completed in the last 12 months and corresponding EIS printouts
Part IV
The latest or most current application forms and recertification, review, or renewal form (regardless of the date it was received) from when the new volume was created.
Printout of EIS payment screens for action taken on the most current application and recertification, review or renewal (EIS does not always retain income, resources, and DEMH information which could cause changes in the payment screens).
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