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ACT 208 (OWF and Covered Families and Children (CFC) Medicaid: Immediate Rescission of the Non-Recurring Lump Sum Payments Policy)
Action Change Transmittal Letter No. 208
March 9, 2001
TO: ALL PUBLIC ASSISTANCE MANUAL HOLDERS
FROM: JACQUELINE ROMER-SENSKY, DIRECTOR
SUBJECT: OWF AND COVERED FAMILIES AND CHILDREN (CFC) MEDICAID: IMMEDIATE RESCISSION OF THE NON-RECURRING LUMP SUM PAYMENTS POLICY OAC RULES:5101:1-2-20, 5101:1-23-07, 5101:1-23-10, 5101:1-23-20, 5101:1-23-40, 5101:1-5-01, 5101:1-5-40, 5101:1-23-075, 5101:1-40-20

PAM SECTIONS:11560 - 11565

Reason for Change: An administrative decision has been made to rescind the policy regarding the treatment of nonrecurring lump-sum payments. This policy change is effective March 1, 2001 and affects any OWF or CFC Medicaid (including Healthy Start) assistance group that receives a non-recurring lump-sum payment, as well as any OWF or CFC Medicaid assistance group that is currently ineligible, due to prior receipt of a non-recurring lump-sum payment for which a period of ineligibility was computed. All previous periods of ineligibility for OWF and CFC Medicaid assistance groups due to prior receipt of a non-recurring lump-sum payment end as of February 28, 2001.

Prior Policy: Receipt of a non-recurring lump-sum payment by an OWF and/or a CFC Medicaid assistance group was counted as income in the month received and apportioned toward future months. This calculation often resulted in a period of ineligibility, meaning that the assistance group was ineligible to participate in OWF and/or CFC Medicaid for a certain number of months, depending upon the amount of the non-recurring lump-sum payment that was received.

Receipt of a non-recurring lump-sum payment by a DA assistance group was counted as income in the month received and as personal property in the months thereafter. The lump sum became a resource in the month following the month of receipt and was treated in accordance with the provisions set forth in rule 5101:1-5-30.

New Policy: Effective March 1, 2001, receipt of a non-recurring lump-sum payment by a member of an OWF and/or CFC Medicaid assistance group shall not result in the calculation of a period of ineligibility. The lump-sum payment shall be excluded from the determination of continued eligibility for OWF and CFC Medicaid.

Action Required: No desk review is required for OWF, CFC Medicaid or DA.

OWF AND CFC MEDICAID:

Effective March 1, 2001, all non-recurring lump-sum payments received by an OWF and/or a CFC Medicaid assistance group shall be considered to be income in the month received, and a resource thereafter. This means that the receipt of the nonrecurring lump sum payment in a month most often will not affect continued eligibility for OWF and CFC Medicaid in that month, because an assistance group that is eligible on the first day of the month is eligible for the entire month. Changes in income during a month that affect the assistance group's future eligibility are used in calculating the future months' eligibility. Because the non-recurring lump-sum payment is not a recurring source of income, it should not be used in determining prospective eligibility. Since there is no resource limit for the OWF program, treatment of the lump-sum payment after the month of receipt as a resource will not affect OWF eligibility.

No calculation of a future period of ineligibility for OWF or CFC Medicaid shall be made based on receipt of the non-recurring lump sum payment.

When an OWF or CFC Medicaid assistance group for whom a prior period of ineligibility was computed reapplies, the assistance group will pass, and if all other eligibility requirements are met, the assistance group(s) shall be approved and authorized. In those situations where the case is being rerun for another reason, OWF and CFC Medicaid assistance groups will pass; however, the OWF and CFC assistance groups should not be authorized without a new application. Instead, the county is advised to notify the assistance group advising that potential eligibility for OWF and/or CFC Medicaid exists, and that they may reapply for these benefits at the CDJFS.

DA

DA policy is not changing. The policy governing receipt of non-recurring lump-sum payment in the DA program was formerly contained in rule 5101:1-23-07. With the rescission of rule 5101:1-23-07, rule 5101:1-5-40 has been amended to state that a non-recurring lump-sum payment is considered income in the month received and a resource thereafter.

FOOD STAMPS

Food stamp policy is not changing. In accordance with rule 5101: 4-4-07, for food stamps, nonrecurring lump-sum payments are to be counted as resources in the month received, unless specifically excluded from consideration as a resource by other Federal laws. For example, all resources of an SSI or OWF recipient are excluded.

CRIS-E PROGRAMMING CHANGES

The AERLS screen has been modified to prevent a period of ineligibility from being computed for OWF and CFC Medicaid assistance groups as of March 1, 2001. The AERLS screen will predisplay "N" on the "ADC/ ADC RELATED MA:" field. The "N" will be protected and cannot be changed by the user.

The result of this screen change is that any time a case is rerun on or after March 1, 2001, it will prevent the entry of lump sum information for OWF and CFC Medicaid purposes so that a period of ineligiblity will not be computed, and any previous period of ineligibility will also be ended. While the end date for a prior period of ineligibility reflected on AEOIE will reflect the original ineligibility dates, the assistance group's eligibility for OWF and/or CFC Medicaid will not be affected by the previously determined period of ineligibility, i.e., if the assistance group is otherwise eligible for OWF and/or CFC Medicaid, the assistance group will pass and show as eligible.