IM-121, September 11, 2017

MHABD recipients are required to report changes in circumstances affecting eligibility factors within ten calendar days of the change. Any necessary action resulting from a change must be taken within ten calendar days of the date the claimant reports the change. If the change in circumstances (address, income, resources, etc.) indicates a change in category, change in level of care, ineligibility, etc. notify the claimant of any action precipitated by the change.

NOTE: While the date of the change is usually considered as the date that the change happened, when the change is obtaining employment or a change in rate of pay, the change date is considered to be the date of receipt of the first paycheck or first paycheck with the changed rate of pay.

If the action results in increased coverage or a better benefit, it shall be effective the month of the report. If the system does not adjust the appropriate months, the Eligibility Specialist should complete necessary actions to ensure that the correct benefits are issued for those months.

NOTE: If the change is not reported timely and would result in an increase in coverage or better benefit, the change is still effective the month of report, not the month in which the change actually occurred.

NOTE: This policy does not refer to changes in level of care as a result of optional choices made by the participant when there is a choice between mutually exclusive levels such as choosing Ticket to Work versus spend down or when choosing spend down versus SLMB2. Refer to the Ticket to Work and SLMB policies for those timeframes.

An Advance Notice of Adverse Action is required before any adverse action can be taken (See Legal Aspects for when an Advance Notice of Adverse Action is required). The following are examples of results of changes in circumstances that would require an advance notice (this list is not all-inclusive):

If the reported change requires a Notice of Adverse Action, the notice must be sent within ten calendar days from the date the change is reported. The Eligibility Specialist must monitor actions to ensure that the advance notice was sent with the correct reason and that the corresponding Action Notice is issued when the adverse action notice expires. If the system generated adverse action notice or action notice is issued with an incorrect reason or effective date, the Eligibility Specialist must take action to issue a corrected notice immediately.