MEMORANDUM

DATE:             March 30, 2000

TO:                   ALL MEDICAL ASSISTANCE MANUAL HOLDERS

THROUGH:   Jim Nordlund, Director

                          Division of Public Assistance

FROM:             Bob Labbe, Director

                          Division of Medical Assistance

RE:                   Medical Assistance Manual Change #23

Manual Change #23 marks a major turning point in the evolution of the Medical Assistance Eligibility Manual.  With this change, significant sections of the AFDC Aid to Families with Dependent Children are incorporated directly into the text of the Medical Assistance Eligibility Manual.  There are still many sections of the AFDC Aid to Families with Dependent Children manual that have not been incorporated yet, so you still need to keep and refer to AFDC Aid to Families with Dependent Children manual.  Manual Change #23 implements a number of policy changes and clarifications, including:

• Withdrawal from CSED cash support enforcement;

• Counting PFD Permanent Fund Dividend of someone no longer in the household;

• Elimination of the AFDC Aid to Families with Dependent Children conversion guide;

• Defining the “Household” for eligibility purposes;

• Alaska residency;

• Specified relative;

• Working Disabled Medicaid Buy-In

Here is a summary of the most substantial changes in Manual Change #23:

Cooperation with Child Support Enforcement -- 5016

A CSED referral is no longer required if a child is eligible for IHS Indian Health Service services that are reasonably available or if the child is already receiving medical support.  Referrals are not required for Denali KidCare applicants under age 21 who are applying only for themselves.  Denali KidCare does not satisfy a parent’s obligation to provide medical support.  Updated information on case processing is also provided.

A new form has been developed, the MED 10, on which a custodial parent applying for medical assistance only may elect to have CSED not enforce a cash support order.  A small supply of these forms is included with this manual change to get you started.

Permanent Fund Dividend -- 5031

In this section we clarify that PFD Permanent Fund Dividend money does count as a resource to an individual if that individual is retaining the PFD Permanent Fund Dividend originally received by someone else and the original recipient is no longer in the Medicaid eligibility or financial unit.  We also clarify that in certain situations the PFD Permanent Fund Dividend does count as income for APA Adult Public Assistance related Medicaid.

Family Medicaid -- 5100 through 5195

The AFDC Aid to Families with Dependent Children /Family Medicaid Conversion Guide is eliminated.  It is replaced with new manual sections that either (1) entirely replace the corresponding AFDC Aid to Families with Dependent Children manual section, or (2) refer to the appropriate section of the AFDC Aid to Families with Dependent Children manual that describes the Family Medicaid policy.  Almost all previous Family Medicaid related manual sections have been renumbered.

Household Eligibility - 5104

This new section attempts to simplify the whole process of determining who is considered to be in the “household” and whose income and resources are counted for the purposes of determining Family Medicaid eligibility.  This is a major changed in that it combines former policy on mandatory filing unit, economic unit, and assistance unit into one “household” policy.  

Alaska Residency - 5110

This section refers to AFDC Aid to Families with Dependent Children Manual Section 322, but allows a temporary absence for education purposes regardless of whether similar schooling is also available in Alaska.  Our plan is to include a comprehensive rewrite of state residency policy in the next manual change.

Living in Home of Specified Relative - 5120

This new section replaces AFDC Aid to Families with Dependent Children Manual Section 324.  This is generally the same policy everyone is used to except that nontemporary absences are addressed.  Guidelines are provided to determine when a child should be considered living independently.

Countable Resources - 5152

This section refers to AFDC Aid to Families with Dependent Children Manual Section 351, but also includes the Motor Vehicle Exemption formerly in Section 5115.

Earned Income Disregards -- 5164

This new section replaces AFDC Aid to Families with Dependent Children Manual Section 362.  It includes the earned income deduction for recipients policy formerly in Section 5115 and the child and dependent care disregard policy.

Working Disabled Medicaid Buy-In -- 5587

This new eligibility category was implemented with the June 24, 1999, broadcast.  This manual change does not add any new policy, but does provide more information on premium calculation, payment, and collection.

MANUAL CHANGE INSTRUCTIONS

Remove old pages and replace with new pages as indicated below:

A supply of the MED 10 forms are provided for use under Section 5016-5.