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, a two-part file folder or a Manila folder depending on the type of program(s) assigned to the applicant or recipient.
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.
Case Number(s)
Cross-reference Case number(s) - optional
Note:
All related case numbers to the PI may be listed for cross-referencing on a separate file label. This includes spouse’s case number and other members in the same household. Cross-reference labels must be placed on the front cover of the case file folder.
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.
A six-part file folder may contain more than one case number.
Denali KidCare cases are filed in two-part file folders.
Senior Benefits and Heating Assistance cases are filed in Manila folders. At the option of the Regional Manager, stand-alone CAMA or GA cases (where the PI has no other program involvement) may also be filed in Manila folders.
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.
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.
Making copies of certain federal, state, and local documents is prohibited and illegal. If any document has a written prohibition of “Do Not Copy” on it, 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".
Returned mail will not be retained in the case file. Staff will document the receipt of returned mail in CANO and shred the document. Refer to MS 109-9I for additional guidance on documenting the receipt of returned mail.
103-1 B. ORGANIZATION OF THE SIX-PART FILE FOLDER
Each six-part file folder will be organized in the following order:
File documents listed under item #1 on the bottom
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
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
Verifications:
Income (including Native TANF , dividends, etc.)
Shelter deductions
Employers / Work Statement
School verification letter
Pregnancy Verification
Proof of Insurance
Purchase and Prepare Statement or Food Stamp Household Statement Agreement (FSP 81 )
PFD Report Form ( PFD 1 )
INGENS Printout (only if used as a verification)
4. Reports of Change
Report of Change Form (GEN 55 )
Note:
File all information attached with GEN 55 to appropriate sections.
Correspondence and letters received from client
5. Native Dividend Tracking Form (GEN 29 )
PART II:
Inter-agency forms and correspondence:
Social Security Administration (SSA)
Office of Children's Services (OCS)
Child Support Services Division (CSSD)
Department of Labor (DOL screen printouts)
Letters sent by DPA to an outside agency, nursing home, housing assistance
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 (GEN 150)
Protective Payee Agreement (APA 14)
Statement of Principal Place of Residence (APA 12)
Agreement to Sell Property (APA 11)
Diversion Agreement (TA 4)
Certification of Medical Status (Med 11)
LTC Form (Med 12)
Authorization for Reimbursement of Interim Assistance (GEN 142)
PART III:
1. Reports of Contact (GEN 56A )
2. INSERT: Confidential Reports of Contact
PART IV:
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
INSERT: Claims and Underissuances
PART V:
Information for other case number(s), 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 50b)
Subsequent worksheets; EIS work screens, eligibility determinations, EIS budget screens, and manual budget sheets.
Authorization for Release of Information (Gen 36).
7. Contact People and Organizations (Gen 37).
103-1 C. ORGANIZATION OF THE TWO-PART FILE FOLDER
Denali KidCare cases are filed in two-part file folders. Each two-part file folder will be organized in the following order:
File documents listed under item #1 on the bottom
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
Consent of Disclosure (GEN 46 )
Vital Statistics Request (GEN 6 ) and verification
Alien Document Verification Request (Form G-485)
INSERT: Record of Permanent Documents
Interagency forms and correspondence:
Social Security Administration (SSA )
Note:
This includes referrals, proof of Social Security, SSI and/or SSDI award and eligibility letter or interface match.
Child Support Services Division (CSSD )
Department of Labor ( DOL screen printouts)
Letters sent by DPA to an outside agency (i.e., housing assistance)
4. INSERT: Interagency Forms
Verifications:
Income (including Native TANF , dividends, etc.)
Shelter deductions
Employers / Work Statement
School verification letter
Pregnancy Verification
Proof of Insurance
PFD Report Form ( PFD 1 )
INGENS Printout (only if used as a verification)
Reports of Change
Report of Change Form (GEN 55 )
Note:
File all information attached with GEN 55 to appropriate sections
Correspondence and letters received from client
Native Dividend Tracking Form (GEN 29 )
PART II:
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)
INSERT: Confidential Reports of Contact
Initial DKC application
EIS benefit authorization screens (MIBW )
Subsequent applications, recertifications, and reviews (GEN 132 or GEN 75
Subsequent worksheets; EIS work screens, eligibility determinations, EIS budget screens, and manual budget sheets
Authorization for Release of Information (Gen 36)
Contact People and Organizations (Gen 37)
103-1 D. ORGANIZATION OF THE MANILA FOLDER
Senior Benefits, Heating Assistance and, at the option of the Regional Manager, stand-alone CAMA and GA cases (where the PI has no other program involvement), will be filed in Manila file folders. The documents in these 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:
Returned Mail
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.
103-1 F. CREATING CASE FILE VOLUMES
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. This process is called "creating case file volumes,” which means to create a new file folder when a case file has reached two inches in thickness.
The procedure for creating case file volumes are as follows:
The documents in the case file are sorted to determine which will be pertinent to an active case. These documents are retained in the active case file (follow steps 3 and 4 for the procedures in retaining documents). The documents which are no longer considered pertinent are transferred in a Manila folder to be sent to Archives.
On the front cover of the Manila folder, mark the file as "Volume 1" and the active file as "Volume 2." Clearly indicate on both files the date the original case file was volumed. Volume 1 will be archived and volume 2 will remain in the DPA office.
Note:
Succeeding case file folders will be numbered accordingly.
3. Sorting Documents in a Six-Part File Folder:
The following documents are pertinent to an ongoing case and will be retained in the active six-part file folder:
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.)
Reports of Change Forms (GEN 55 ) received in the last 12 months
Any correspondence and letters from clients received in the last 12 months.
Part II:
Copy of the CSSD 1603
Intra-agency forms and printouts in the last 12 months
Part III:
Report of Contact (GEN 56A ) forms and any other handwritten case notes
Part IV:
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 V and 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. Sorting Documents in a Two-Part File Folder:
The following documents are pertinent to an ongoing case and will be retained in the two-part file folder:
Part I:
Record of Permanent Documents (this includes all the documents filed under the ROPD section)
Verification provided by the household in the last 12 months (this includes proof of income, resources, insurance coverage, employment statements, school verification letter, etc.)
Copy of the CSSD 1603
Intra-agency forms and printouts in the last 12 months
Reports of Change Forms (GEN 55 ) received in the last 12 months
Any correspondence and letters from clients received in the last 12 months
Native Dividend Tracking Form (Gen 29)
Part II:
Copy of the CSSD 1603
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
Report of Contact (GEN 56A ) forms and any other handwritten case notes
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).
103-1 G. GENERAL RULES FOR CREATING TEMPORARY FILES
1. Creating temporary files when case files are requested by another office:
Use a two-part folder that is a different color from the regular six-part folder. Each office will determine color preference (for example: Fairbanks Office uses bright yellow folders and Central Region Offices use red folders).
Include the following documents in the temporary file:
Copies of necessary ROPD (identification cards, birth certificates and alien documents)
Copy of the most current or latest application or recertification
Copy of documents that goes with the latest application or recertification including verification provided by applicants, screen printouts, etc.
CLPM and CAP2 printout
Organize the documents in the temporary folder following organizational procedures for six-part, two-part or Manila folder.
File label must include the following:
Last Name, First Name and Middle Initial
Case Number(s)
Make note of the following information on the front of the case file folder:
Brief explanation or reason for creating the temporary file
Cases to cross-reference
Handling temporary case files when original file is returned to the DPA Office:
When the original file is returned to the office, merge the temporary file with the original file.
Creating a temporary file when the case file is missing:
Create a temporary file with all documents that are accessible or obtainable.
Offices must continue to actively search for the missing file. If the missing file is still missing after 90 days, the office control clerk will send an email to other control clerks statewide. A list of statewide control clerks is available at: https://reports.dhss.alaska.gov/Reports/Pages/Folder.aspx?ItemPath=%2fDPA%2fCase+Record+Control+Clerks&ViewMode=List
The email must include the following information:
If file is still not found after several days from when the email was sent, the local office will create a new case file.
Make note on the cover of the new case file that “the file is a reconstruction of a missing file.
When the case is up for review, staff must ensure to request any necessary information that needs to be in the case file such as ROPD .
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