ADDENDUM 109 A

CANO DESK GUIDE

Subject

CANO Guide

RECORD TITLE

• Program(s)

• Initial application or review

 Action taken (pend, approved, or denied)

This field is mandatory. Ensure the title matches the action and purpose of the CANO. For application and reapplication, include the name of the program, date of application, and action.

For example: FS/ME App - 07/05/08 - Approved

APP DATE & BSD:

• Application and benefit start dates.

Omit unless the application received date and benefit start date are different.  If it is different, explain why the application date and benefit start date are different.

For example: FS App rec’d 12/1

                      Benefit start - 11/25/08

                      Fee agent interview - 11/25/08

INTERVIEW DATE:

• Date of caseworker or fee agent interview

• Use of Interpreter Service

Enter the caseworker or fee agent interview date on the ADDR screen. Document if interpreter service was used and the type of interpretation provided such as telephonic with DPA contracted service, or in-person. If the service was in-person, document the name of the interpreter and relation to the applicant (e.g.,family member, third party, state employee, etc.)

R&R:

• Rights and Responsibilities

• Release of Information

• Change Reporting Requirements

• Fraud Penalty Warnings

Document if rights and responsibilities were discussed and understood. If no interview is required, omit documenting R&R.

ADDRESS AND TELEPHONE

• Physical and mailing address

• Home telephone number    

• Message number

• Work number

Document address or telephone only if the information on the ADDR screen is different from what is written on the application or recertification, or if an explanation is needed.

HHC:  

• If there is alien in the household, check ASVS.

• Name, relationship, and age of persons in the household. Address felony convictions (if any)

• Non-MFU persons in household  

• Individuals in household who are considered responsible for the care of the applicant (GA/CAMA)

List only what is different from what has already been entered in EIS.  If there are people in the home who are not on EIS or the application, list who and why they are not included. A reviewer should be able to look at the CANO and EIS and tell exactly who lives in the home and their relationship to the members of the participating household. Document Alien entry date and felony conviction dates. Document student status if it affects eligibility.

ROPD:  

• Permanent documents obtained and how they were verified

• Citizenship

• Proof of Identification

• SPECAT/Categorical Eligibility

For new ME application, create a separate CANO entry for Citizenship and Identity. If there are no changes from the previous identity and citizenship CANO, reference the previous CANO with date of entry and title.

For new FS application, document how identity of the applicant was verified.

PRIOR SUPPORT:  

• Means of family support before applying for assistance; what has changed (job, income, resources, etc.)?

• TANF received in Alaska or from other states (include Tribal TANF).

• Living in a exempt village

• Last date of employment

Document pertinent information received from the applicant that is appropriate to eligibility. Ask how the HH was supporting itself prior to applying for benefits.  Did a job end?  If yes, when did it end, why did it end?  When will/was the last paycheck received?  Is there a job quit issue?  If the HH is new to the state: What brought them to AK?  Were they receiving benefits in the prior state?  If yes, contact the state and verify.  Did a job end?  If yes, when did it end, why did it end? Is the member eligible for UIB from that state?  How did they pay for their travel to Alaska?

RESOURCES:

• Transfer of assets

• Liquid and non-liquid resources

• Individuals in HH who are considered responsible for the care of the applicant (GA/CAMA)

Document information that is not clearly identified on EIS. If information reported on application differs from what is entered on EIS, provide further explanation or clarification on CANO.

Example: If someone in the household owns Native dividends, document the owner’s name, number of shares, and the name of the corporation issuing the dividends.

WORK REQUIREMENTS /DISABILITY

• Exemptions, job quits, existing penalties or sanctions

• Referrals to E&T or Work Services

• TA10, Med11, AD-2, date of SSI application, DDS referrals or decisions, SSI or SS-DS

• Determination of incapacity status

• IA explanation and IAR

Document only if there is penalty information. Also, document if anything else such a penalty, barrier, good cause, or exemption needs further explanation or clarification. Document TA-10 and disability date if necessary.

STUDENT STATUS

• Household members receiving school loans, scholarships, and grants

• Household members working towards High School Diploma or GED, or post-secondary education

• Children under 18 who are working and not attending school - income is countable.

Document if there is a post secondary student in the home. Document the student’s name, if they are eligible student or not, and an explanation. Also, document if the household includes an 18 or 19 yr old high school student.

INCOME

Check DOL, NSTAR, and SOLQ

Unearned income

• Source and amount

Earned income

• Employer name and phone number

• Calculation of prospective income

• Regular/temporary, part-time/full time, seasonal

Self employment income

• Seasonal or annual

• Income and expense

Development of Income

• Pursuit of other income such as UIB or SSI

This is a critical portion of the CANO and documentation must be complete and detailed. Document the type of income, how it was verified, and the calculation (actuals, averages, and conversion factors) used to determine eligibility and benefit amount.

Make sure to document the following:

• Fluctuating income

• Changes in pay rates

• Changes in hours

• Excluded income

Include the following items in the documentation:

• Client’s Name      

• Pay period ends   

• Pay date   

• Gross Pay/Tips   

• Hours   

• Gross Y-T-D

• Verification Code

DEMH:  

• Household expenses (rent, mortgage, child care, child support paid, medical expenses for SPECAT members, utilities, taxes, insurance)

• Are expenses shared?  Be sure to reduce allowable shelter deductions by GA or in-kind income amounts.

• Emergent need for GA

• Heating Assistance

Document information that is not clearly identified in EIS or on the applications. If information reported on application differs from what is entered on EIS or hard copy verification, provide further explanation or clarification on CANO.

MED:  

• TPL/TPR resource information

• Request for Retroactive Medicaid

• If pregnant, indicate estimated due date

• SLMB, QMB

• Medicare Buy-In

• CAMA criteria met/MED 11

Document only if there is TPL/TPR, private insurance or request for retroactive Medicaid coverage. Check previous medical insurance coverage. Provide further explanation or clarification if there is an issue.

CC:  

• Collateral Contacts

• Name and phone number and relationship of collateral contacts

Do not document attempts made. Only document collaterals that are actually contacted and not included elsewhere.   If you call an employer, give the business name, name of the person you spoke to, phone number, and information verified in the income section.   If a landlord, enter the information in the DEMH section.   If you contact a collateral such as a neighbor or relative to verify general household information and it doesn’t fit any other specific category, document it here.

Previous Section

Next Section

2010-01 (5/10)