Change of Circumstances
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Change of Circumstances


Revised December 31, 2013


A. REPORTING REQUIREMENTS


Purpose:

WAC 388-418-0005How will I know what changes to report?
WAC 388-418-0007When do I have to report changes in my circumstances?

WAC 388-418-0005
WAC 388-418-0005

Effective January 1, 2014

WAC 388-418-0005 How will I know what changes to report?

1.  You must report changes to the department based on the kinds of assistance you receive. We inform you of your reporting requirements on letters we send you about your benefits.  Follow the steps below to determine the types of changes you must report :

(a.) If you receive cash benefits, you need to tell us if: 

(i.)  You move; 

(ii.) Someone moves out of your home;

(iii.) Your total gross monthly income goes over the:

(A) Payment standard under WAC 388-478-0033  if you receive ABD cash; or

(B) Earned income limit under WAC 388-478-0035 and WAC 388-450-0165 for all other programs;

(iv) You have liquid resources more than four thousand dollars; or

(v) You have a change in employment. Tell us if you:

  1. Get a job or change employers;
  2. Change from part-time to full-time or full-time to part-time;
  3. Have a change in your hourly wage rate or salary; or 
  4. Stop working.

 

b.  If you are a relative or non relative caregiver and receive cash benefits on behalf of a child in your care but not for yourself or other adults in your household, you need to tell us if:

(i) You move;

(ii) The child you are caring for moves out of the home;

(iii) Anyone related to you or to the child you are caring for moves into or out of the home;

(iv) There is a change in the earned or unearned income of anyone in your child-only means-testing assistance unit, as defined in WAC 388-450-0162 (3)(b). You do not need to report changes in earned income for your dependent children who are in school full-time (see WAC 388-450-0070 ).

(v) There is change in the recipient  child's earned income or unearned income (see WAC 388-450-0070  for how we count the earned income of a child);

(vi) The recipient child has liquid resources more than four thousand dollars;

(vii) A recipient child in the home becomes a foster child or is no longer a foster child; or

(viii) You legally adopt the recipient child.

(2) If you do not receive cash assistance, but you do receive Basic Food benefits, you must report changes for the people in your assistance unit under chapter 388-408 WAC. You need to tell us if:

(a) Your household is a categorically eligible household as defined under WAC 388-414-0001, tell us if your total gross monthly income is more than two hundred percent of the federal poverty level; or

(b) For all other households tell us if your total monthly income is more than the maximum gross income as described in WAC 388-478-0060; or

(c) Anyone who receives food benefits in your assistance unit and who must meet work requirements under WAC 388-444-0030 has their hours at work go below twenty hours per week.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

CLARIFYING INFORMATION

  1.    

*** As a result of implementation of the Affordable Care Act (ACA), this clarifying page may no longer be effective for medical coverage applications received on or after 10/01/2013. Please see the ACA Transition Plan for more information. Clients under 65 years of age who need to apply for medical coverage on or after 10/01/2013 should be referred to Washington Healthplanfinder. Applications for medical coverage for households where all members are 65 years of age and older should be referred to Washington Connection. ***

  1.    
  2. SSI / SSI-related medical benefits:
  • Reporting requirements for SSI-related medical benefits do not apply to a person who receives SSI medical (S01).
  • If someone receives S01 medical and benefits from another program, they must report based on the requirements for the other program.

EXAMPLE

A family receives S01 medical, TANF, and Basic Food benefits. Because the S01 medical is not SSI-related, they must report based on the cash reporting requirements.


2.   Reporting Requirements for Categorically Eligible (CE) Basic Food:

Households who are categorically eligible under WAC 388-414-0001 must report if their income goes over 200% of poverty based on the number of eligible household members in their assistance unit. 

3.     Reporting Requirements for State Supplemental Payment Program (SSP):

We decide if someone is eligible for SSP based on information Social Security Administration (SSA) gives us through the State Data Exchange (SDX). A person does not have to report changes for SSP.

4.     ADATSA reporting requirements:

We count ADATSA as a medical program when looking at what changes someone must report. A person who receives ADATSA benefits must report changes based on the SSI-related medical reporting requirements.

5.    Medical Coverage Group codes included in “children’s/family medical”:

F04

TANF Related

F06

Categorically Needy (CN) for Children

F07

Children's Health Insurance Program (CHIP)

F99

Medically Needy Spenddown

F09

Undocumented Family and Children

6.    Medical Coverage Group codes included in “other medical programs”:

F02

TANF Related

F03

TANF Related

F05

Newborns

F10

TANF Related

R03

Refugee Categorically Needy

7.    Elderly persons / Persons with Disabilities:

      Elderly persons and persons with disabilities are people who meet the definition of elderly or disabled for purposes of the Washington Basic Food Program under WAC 388-400-0040.


8.   Taking action on changes:

When we receive information about someone's circumstances, we must determine the impact on the person's benefits. This may include contacting them, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.

Client Reports:

 

  • Take action based on changes the person reports. This includes when someone volunteers information after we contacted them.
  • Get proof of a person's circumstances if they report.
    • A decrease in income that increases their benefits; or
    • Expenses that increases benefits and the expenses are questionable given their income and other circumstances.

 Third-Party Reports:

  • If we receive information from a third party about someone, follow-up on the information to decide how it impacts the person’s eligibility and benefits.
  • This may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.

 Alerts Verified Upon Receipt:

 

  • An interface that automatically update's the ACES case record is "verified upon receipt".
  • We do not need to take action on alerts the interface updates in ACES.

 Other Alerts:

 

  • We do need to take action on alerts that are not verified upon receipt.
  • Work alerts that are not verified upon receipt to decide how the information impacts the person's eligibility and benefits.
  • This may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.

NOTE: EXCEPTION TO THIRD-PARTY REPORTS PROCESS:  If a financial worker receives potential change information from a WCCC child care worker, the financial worker should:

a.    Not contact the AU about the change;

 

b.     Act on the change only if they have proof of the change from the WCCC eligibility system or child care worker, even if it reduces benefits; and

 

c.    Set an alert to get verification of the change at the next recertification if no proof was previously received.


     9.  ABAWD reporting requirement / Statewide ABAWD waiver:

Currently, Washington has a statewide waiver of ABAWD requirements.  When we no longer have this waiver, people must report when a non-exempt ABAWD receives benefits in the AU and the ABAWD's hours of employment drop below 20 hours per week. This includes when the non-exempt ABAWD is the head of household for Basic Food. See BFE&T Appendix I.


WAC 388-418-0007
WAC 388-418-0007

Effective October 1, 2013

WAC 388-418-0007 When do I have to report changes in my circumstances?

  1. If your household has a change of circumstances you are not required to report under  WAC 388-418-0005, then you do not need to contact us about this change. If you tell us about this change, we take action based on the new information. This includes: 

    1. Asking for more information we need to determine your eligibility and benefits under WAC 388-490-0005;

    2. Increasing your benefits when we have proof of a change that makes you eligible for more benefits; or

    3. Reducing or stopping your benefits based on the change.  

  2. If you are applying for benefits and have had a change:

    1. After the date you applied but before your interview, you must report the change during your interview; or

    2. After you have been interviewed, you must report changes that we require someone who receives benefits to report as described under WAC 388-418-0005 You must report this change by the 10th day of the month following the month the change happened.

  3. If you receive cash assistance or Basic Food, you must report changes required under WAC 388-418-0005 by the 10th day of the month following the month the change happened.

  4. For a change in income, the date a change happened is the date you receive income based on this change. For example, the date of your first paycheck for a new job, or the date of a paycheck showing a change in your wage or salary.

  5. If we require you to complete a mid-certification review you must complete the review as described under WAC 388-418-0011 in order to keep receiving benefits.

  6. If you receive TANF / SFA, and you learn that a child in your assistance unit (AU) will be gone from your home longer than one hundred eighty days, you must tell us about this within five calendar days from the date you learn this information.

    1. If you do not report this within five days, the child's caretaker is not eligible for cash benefits for one month; and

    2. We continue to budget the ineligible person's countable income as described in WAC 388-450-0162 to determine the benefits for the people still in the AU.

  7. If you report changes late, you may receive the wrong amount or wrong type of benefits. If you receive more benefits than you are eligible for, you may have to pay them back as described in Chapter 388-410 WAC.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

CLARIFYING INFORMATION

1. When a change happens:

 Non-Income Changes

The date of a change is normally the date a change happens.  Examples of this include the date:

·         Someone gets married;

·         A newborn comes home from the hospital; and

·         Someone moves to a new home.

Income Changes

The date of an income related change is the date someone receives income based on the change. Examples of this include the date:

·         On the first paycheck that reflects a wage increase; and

·         On the person's first paycheck for a new job.

 


EXAMPLE

Sandy is hired for a new job on May 31st. She starts work on June 10th. Her first paycheck is July 5th.

Because this is a change in income, we count the date of Sandy's first paycheck on July 5th as the date of the change.

·         If Sandy must tell us about the change based on her reporting requirement under WAC 388-418-0005, she must tell us about this change by August 10th.

·         If Sandy reported this change earlier, we would act on the change based on when we expect her to receive the income.

 


EXAMPLE

Nick is hired for a new job on May 1st. He receives his first paycheck on June 1st. Nick must report this change of employment status and income by July 10th.


EXAMPLE

Stacey receives TANF and Basic Food. She had her employee evaluation on October 1st. Based on this evaluation, Stacey gets a promotion and a $1.25 hourly wage increase. The wage increase takes effect October 15th. She will receive the first check showing this increase on November 10th.

Because this is a change in income, we count the date of Stacey's first paycheck on November 10th as the date of the change.

  • Stacey must report this change to us by December 10th.

  • If Stacey reported this change earlier, we would act on the change based on when we expect her to receive the income.


2.    Changes a client voluntarily reports:

  • If people report a change, we must act on the change they report even if they didn't have to tell us about the change under WAC 388-418-0005. This includes asking for more information or proof of a change when we can't tell the impact on their benefits.
  • For Basic Food, under simplified reporting rules, clients do not have to report when they move until recertification or until the mid-certification review, whichever comes first.  If they voluntarily report a move between mandatory reports or for another program, they must provide their new shelter costs.  The new shelter costs do not need to be verified unless questionable.  See "Worker Responsibilities" (4.) and (5.) below.

EXAMPLE

Larry receives Basic Food only. He calls and reports that his monthly rent expense went from $300 to $500 monthly.

Larry's worker Bob chooses to verify this change as "questionable" because the $500 plus utilities are so close to Bob's monthly income.  After he receives proof of the expense, Bob updates the shelter cost for Basic Food.


EXAMPLE

Ian receives TANF and Basic Food. He leaves a message with his worker reporting that he started a job and would like to close his TANF benefits today.

Ian's worker closes TANF benefits based on the request. Since Ian reported that he is now employed, his worker must follow up to see how this impacts his medical and Basic Food benefits.

 


  1. Unverified changes that increase benefits:

If a client reports a change that would increase their benefits because of a decrease in income, we ask for proof of the change.  We only ask for proof of an increase in expenses if the expenses are questionable.  We increase the AU's benefits based on the effective date rules under WAC 388-418-0020.

  • If we have asked for verification, and they fail to give us proof of a reduction in income or an increase in expenses, we do not update their case to increase benefits.
  • We also do not close the case based on their failure to give proof of a change that would increase their benefits.

  1. Changes someone reports on an application or eligibility review:

People may report a change in their circumstances on an eligibility review form or an application for benefits. If you receive an application or eligibility review form:

a.      Before the fifteenth day of the second to last month of their certification period, treat this form as a change of circumstances.

b.      On or after the fifteenth day of the second to last month of their certification period, treat this form as a request for review or recertification. See ELIGIBILITY REVIEWS AND RECERTIFICATIONS for procedures.

c.      In the month before the mid-certification review is due, use the information on the application / review form to complete the MCR for any related programs.

d.      For medical, you may use an application or review at any time to update the medical certification period.

e.   For handling additional applications received before initial application is processed see "Clarifying Information" #4 under  WAC 388-406-0010 .


EXAMPLE

Susan's Basic Food certification period ends on July 31st. She turns in an Eligibility Review form for Basic Food only on May 31st.

Because Susan turned in the ER before the 15th of the month before the month her certification period ends, we treat the form as a change of circumstance report.


5.               Temporary absence of an AU member:

If an AU member is temporarily out of the home:

·        For cash and medical assistance, follow the rules in WAC 388-454-0015 to determine if the person is still eligible for benefits.

·         For Basic Food, follow the rules in WAC 388-408-0035 to determine if the person is still eligible for benefits.

6.               AU member moves out of Washington: 

People must be residents of the state in order to be eligible for most programs. If an AU member or the entire AU leaves the state, follow the rules in WAC 388-468-0005 to determine if the person is still eligible for benefits.  


WORKER RESPONSIBILITIES

  1. During the application, recertification or eligibility interview:

  1. Inform clients what changes they must report and how much time they have to report the changes;

  2. Explain how to report changes either in writing, by phone, or in person. (See RIGHTS AND RESPONSIBILITIES); and

  3. Give them a DSHS 14-076(X), Change of Circumstance form, and a return envelope to report changes. ACES automatically mails the DSHS 22-900(X), How to Report Changes with the award letter.

  1. When people report a change or when you learn of a change:

    1. Ask for more information or proof if needed. See LETTERS for the rules and the process on asking someone to take an action or give us information.

    2. Take action on the information using the effective date rules in WAC 388-418-0020.

    3. If we averaged their income under WAC 388-450-0215, recalculate this source of income if you expect this change to last at least a month beyond when you learn of the change.

    4. Document:

      • The details of the change;

      • The date we learned about the change or the date the change was reported;

      • The impact on benefits; and

      • The effective date for any change in benefits.

    5. Send written notice about the change based on requirements in LETTERS even if the benefits do not change.

  2. For Basic Food, if the client does not report a change in medical expenses, but you learn about a change:

    1. Do not contact the AU about the change;

    2. Act on the change only if you can get proof of the change from someone other than the AU; and

    3. Set an alert to get proof of the change at the next recertification. Update the MEDX screen in ACES once you get proof of the medical expenses.

    4. Document in the ACES narrative whether or not we should use the medical expense at the next recertification.


NOTE:

If you later approve medical assistance that covers a person's medical expenses, delete the medical expenses on the MEDX screen and recalculate the person's Basic Food benefits.


4.      For Basic Food, when the client voluntarily reports a move in person or on the phone:

a.       Ask for the new out-of-pocket share of shelter costs associated with the new residence.

b.      Do not require verification of the new shelter expenses unless questionable.

c.       Make it clear that they do not need to wait for the first regular rental or utility payment to tell us the amount(s).

d.      Update and document the new shelter costs in ACES.

e.       Send notice to the client if there is a change in the benefit amount.  Give advance notice if there is a decrease.

5.      If the client reports a move in writing or we receive returned mail with a new forwarding address on the envelope:

a.       First, attempt to contact the client by phone.  If successful, follow instructions in (4.) above.

b.      If unable to contact by phone, send the client a general correspondence letter asking for the new shelter costs associated with the move.

·   Include a statement in the letter warning the client that the old shelter deduction will be removed from the budget and benefit will be recalculated using no shelter costs if new expenses are not reported within 10 days;

·   Make it clear in the letter that they do not need to wait for the first regular rental or utility payment to tell us the amount(s); and

·   Do not require verification of the new shelter expenses unless questionable.

c.       If client responds to the letter:

·   Update and document the new shelter costs in ACES; and

·   Send notice to the client if there is a change in the benefit amount.  Give advance notice if there is a decrease in benefits.

d.      If client does not respond to the letter:

·   Do not close the BF AU;

·   Remove the old shelter costs; and

·   Send advance notice to the client if there is a change in the benefit amount.


NOTE: Avoid using a "Request for Information" letter as this letter suggests a mandatory BF AU closure if the client does not respond.

Mid-Certification Reviews

For information on mid-certification reviews, please see the Mid-Certification Reviews section.


ACES PROCEDURES

See Basic Food - Medical Expenses as a Deduction 

Modification Date: December 31, 2013