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11:12:20 AM |
Job and
Family Services - Overview |
Ken Caldwell and
Linda Arthur are present to lead the program of Public
Assistance 101.
The PA programs we work with are
OWF-Cash program, formerly ADC, currently funded with TANF
block grant, more to follow
Medicaid 16 different programs with mini programs included
that range from covering pregnancy, birth, thru death
PRC Prevention, Retention, Contingency funded with TANF
block grant
Foodstamps federally and state
funded program to provide assistance to needy families to
help meet nutritional needs
Childcare also funded thru the TANF block grant, area will
be covered by another unit
CW wear many hats, each CW has additional duties along with
their core duties; intake, redets,
changes, on call(2 people assigned
daily to answer general questions and complete assessments)
Back Up to Fraud, Daycare, Work Activities, 5 also are
responsible for NH, 1 for Group Homes, 1 is the primary PRC
worker, 1 is primary DDU worker
Assessments given to all who want to look at possible
eligibility, could be new or additional services
Referral CW reviews upon receipt in mailbox, talks with
customer regarding their needs. Sometimes a customer just
needs a referral; daycare, child support, or children's
services to meet their need.
The CW reviews income, resources, requirements for programs
to determine type of application needed
You have the 2 most common APPLICATIONS used
The type of application may require an appointment, we
explain verifications needed, schedule appt if application
is completed at that time.
Front Desk screens/scans application
We average 100 assessments per month, the average
10-30 minutes in length
Types of applications
; 7200, CPA, QMB, PRC, daycare,
F/F OWF, FS, ABD medicaid
vs no F/F CFC, QMB, PRC,
Daycare
CRISE (client registry information system enhanced)
is the program in our state computers in which we enter all
information to determine eligibility.
There are 128 screens in the application entry process that
can be accessed/need to be completed. All questions must be
asked
Some questions are personal. ie:
living arrangements, P&P… do you share food,
ssn, income, resources, transfer
of property
Interviews can take from 20 minutes
redet to over 2 hours for resource assessment
3 areas needed to meet eligibility in most program =
non-financial resource - financial
CRISE can usually determine eligibility correctly; how you
enter information , program knowledge, difference in program
rules and regs effects outcome
Questions require verification SS cards, birth cert,
ID, pay stubs, resources, shelter/utility, insurance .
Different requirements for programs.
We averaged 75 new intake applications monthly in
2006, we also averaged 56
applications monthly for additional services requested.
We are audited by feds to make sure we provide correct
benefits. Our 2006 state reviews for FS 99.54%. State of
Ohio must be at or above the national average for accuracy
to continue to receive entire FS allotment of money. Last
year was the second year in a row that Ohio did not reach
that goal. Federal sanctions will result from this.
Tools we use are
:
EZforms are forms we use
on the computer which are basically fill in the blank forms.
i.e. we might need employer
verification so while the customer is here we fill out form.
The customer signs the form on the computer with electronic
signature pad. We Fax the form to the employer from our
computer. Allows for up to date forms, no ordering from
State and all the mailing costs involved along with storage
Right Fax allows any screen to be faxed, incoming are
routed directly to worker then imported into the digital
case file
Hyland Printer allows any screen to be directly
imported into a case file ie:
child support payments imported to case file for
verification
Our manuals, which include rules from the ORC are in the
inner web as well as forms, program info, helpful hints,
training materials
OWF started in 1996 with welfare reform. Under the old ADC
program a person could receive cash assistance as long as
they were eligible. With welfare reform, Ohio said that a
person could only receive cash assistance for up to 3 years.
At that point they would have to be off a year and could
reapply under a hardship criteria.
The FEDS say max 5 years
The W in OWF is for work
SSC contract agreed to and signed by both parties of
their plan. Look at big picture to determine barriers to
employment and how to overcome them. Discuss domestic
violence, drug and alcohol, mental illness, transportation,
daycare, contingency plans, getting to work on time, calling
in sick
Standards set by Feds 90% of OWF population for 2
parent, 50% for single parent HH
20-30 hours per week for single parent households, 35-55
hours per week for 2 parent households
FLSA Add together OWF + FS divided by state min. wage
$6.85 to determine monthly hours.
NW Products
. We contract with them using TANF
dollars. In fiscal year 06 we spent $27,000 with
Quadco (NWP)
Help our customers learn good work ethic, hygiene, job
skills, testing for aptitude, employment placement
WEP always looking for these, need to be supervised
and report hours of work biweekly, tracked in computer
Three tiers Good cause
Payments are made directly from State to providers, such as
hospitals, nursing homes, doctors, pharmacies, and other
health care practitioners. It is a drastically reduced rate,
as much as 80% of normal charge.
Of those recipients, we average about 200 Nursing Home
residents in care monthly
Fulton county residents received $29 million worth of
medical services in SFY 2005
Medicaid brings a lot of revenue to our county
Ken………..Pass out sheets
as you can see by the sheets I'm passing out that
recepients of Fulton Co rec'd
over 29 million of just Medicaid services and local
providers rec'd over 21 million. Most business's I know of
average about 50% of gross in payroll. If the providers are
receving 21 million that means
at least 10 million is going to local payrolls in the county
just from Medicaid alone. That's a lot of jobs and money
brought into the county.
AGED BLIND DISABLED A= 65 or over, B=determined by
SS, D=determined by SS or DDU
7200 with f/f required, 3 month retro, all have same
resource limit
; $1500 single/ $2250 couple (only if both
meet requirement)
12 month redetermination
BUDGETING PROCESS STANDARDS SHEET
Look at income of self and spouse, if spouse is
ineligible a portion of their income may count in budget.
Deduct $65 from earned, then $165, remainder counts as
unearned income to spouse along with their own income.
Compare to the individual / couple need determined and
updated yearly by the state. Currently $543 single, $934
couple
Spendown
is like a deductible if income after deductions exceeds the
state standard. Allowable deductions are medical insurance
premiums including medicare part
B and D premiums, past unpaid medical bills.
ie;
countable income compared to standard is over by $50 The $50
is considered the SD, customer is not eligible for
medicaid in a month until SD is
met. Can be paid in to agency anytime in month and card is
released by CW for 1st day of the month or medical bill can
be incurred, proof of this is presented and card is released
by CW with effective date same as incurred date. This
process must be done each month
medicaid eligibility is needed
PURPOSE
To provide care in the home to help defray NF costs and
allow people to remain in their own homes
TYPES
Passport must be 60 or older, Individual Options, MRDD
must have an MR determined disability, Ohio Home Care for
disabled individuals including kids
Passport - AOA determines if needs can be met in the home
with local agencies and make those arrangements.
Other types of waivers, notified by alerts in computer send
someone from the area to do an assessment to determine if
they can be cared for in own home
An individual must first be medicaid
eligible
BUDGET
The income standard for a single person in a waiver is
$1869, much higher than the regular
medicaid standard. There are no couple waiver cases.
Each is looked at as an individual. If there is a couple and
one needs waiver, a resource assessment is needed. More
later….
A medicaid card goes out
beginning of each month. If income with deductions exceeds
the special income level, there will be a "patient
liability" the customer would need to pay to a provider each
month to go toward services being received.
60% of Ohio's medicaid budget
goes to nursing home care
Can be our most difficult cases
Often requires a lot of research into assets, can go back 5
years from date of application, uncomfortable for many due
to type of questions we are required to ask, may cause/
increase family disagreements, often times children are
unaware of parent's "personal business"
Fulton Manor, Heartland, Fairlawn, Swanton Healthcare,
Harborside.
Applications are taken in county of the NH
REDET
12 months
RESOURCES
Resources same as regular medicaid.
Home is not a resource as long as a spouse/dependent child
lives in it. If no longer place of residence, must be listed
for sale within 13 months of entering the NF
Nursing Homes
GROSS
Normally only unearned income such as SS, pension. $65
deduction given for earned income
DEDUCTIONS
Deductions include medical insurance premiums including
medicare B & D and co-pays
PERSONAL NEEDS ALLOWANCE
$40
MIA (Monthly Income Allowance) HANDOUT
If there is a community spouse another budget is done
using housing costs, spouse's income and compared to the
MMMNA of $1650.(Minimum Monthly
Maintenance Needs Allowance) If it is less, some of the IS
money can be kept by the CS so they can meet their needs in
the community.
Patient Liability
What's left is the patient liability which could be 0
Remainder of their income after the above deductions is
their patient liability
MA L
This program is also called QMB, pays
medicare premiums and
medicare co-pays. Eligibility
begins the month after we authorize the case.
MAUS
MAUS is also called SLMB. This pays the
medicare premium only.
Eligibility can be 3 months retro-active from date of
application
QI 1
QI-1 also pays only the medicare
premium, no retro eligibility. This runs for a calendar
year, each Dec a determination is made by the state
dependant upon available funds
RESOURCE
For the above programs Single $4000 Couple $6000
Food Stamps
Foodstamps are not intended to
be the sole provider of food for a family, they are just a
supplement to the HH
Entitlement means we are required to reach out to
customer to make sure they are aware of their potential
eligibility for foodstamps.
We receive quarterly visits from the
state, the current % of population eligible for FS in
our county is compared to the number of people who are
receiving FS. This is a performance measure set by the state
for each county.
EBT
No actual stamps have been issued for several years, EBT
card works like a debit card at the grocery store,
Walmart, Meijer…
P&P
Everyone in HH that shares food must be certified
together, FS term is Purchase & Prepare
GROSS TEST
All income of each FS AG member is counted in the gross
test and compared to standard
DEDUCTIONS
20% earned income, standard $134, medical for
disabled/over 60, daycare costs, child support, shelter and
utility
NET TEST
Income after deductions is compared to the net test, if
it passes benefit is figured based on the family size and
net income
RESOURCES
$2000 for most HH . $3000 if
aged/disabled No limit if all members in FS AG receive
OWF/SSI
Vehicles no longer count toward resource limit
CERTIFICATION
FS are certified for 2 6 12 months depending on the
situation
WORK REQUIREMENT
Adults with no dependant children under the age of 6 are
required to participate in a work activity unless they meet
a medical exemption, not as stringent as OWF requirements.
TANF 4 purposes
To provide assistance to needy families so that children
may be cared for in their homes or in the home of relatives.
To end the dependence of needy parents on government
benefits by promoting job preparation, work, and marriage.
To prevent and reduce the incidence of out-of wedlock
pregnancies and establish annual numerical goals for
preventing and reducing the incidence of these pregnancies.
To encourage the formation and maintenance of two parent
families.
Prevention, Retention,
Contingency
PRC
Training, job related expenses
ie; uniforms, special shoes
Lice Eradication, It Takes Two (CSEA), Parenting classes
Car repair, job related clothing, job retention bonus
Rent, utilities, home repair
Repayment agreement must be signed prior to issuance of a
contingency service with the hh
making the choice of paying back the total amount issued by:
……
FRAUD
INVESTIGATION
We investigate alleged fraud of all the above programs.
REFERRALS
Referrals come from fraud hotline 800-937-2834 as well
as caseworkers
In 2006 our fraud investigator established $103,623.00 in
overpayments
We received payments amounting to $60,880.00 in 2006
Commissioners thanked the staff for the report and the hard
work they do everyday.
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