|SSA/SSI/VA COST OF LIVING ADJUSTMENTS IN FAMIS|
| In January 2005, all Social Security Administration (SSA), Supplemental Security Income (SSI), Veterans Administration (VA), and Railroad Retirement (RR) participants will receive a 2.7% cost of living adjustment (COLA). A mass adjustment of FAMIS Child Care, food stamp, and converted Temporary Assistance EUs with SSA, SSI, VA, and/or RR income increases will occur the weekend of December 11, 2004. This year the adjustments will be made entirely by increasing the SSA, SSI, VA, and/or RR benefit amount by 2.7%. Child Care EU's with an active food stamp EU will have an increase to their SSI income. This income source continues to be excluded when determining the family's Child Care eligibility.
Please review the following topics carefully as some procedures are changed from previous years due to FAMIS.NEW AMOUNT OF SSI
ADJUSTING SSA, SSI, AND VA BENEFITS
Mass Adjustment Process
Simplified Reporting EUs
Conflict of Actions
Request for Hearing/Continued Benefits
Managed Reporting/EUs Needing Review
Manual Adjustments by County Staff
For Temporary Assistance cases not yet converted to FAMIS, refer to Memorandum IM-#126, dated December 2, 2004, for information regarding Legacy adjustments.
Increases in SSI benefit amounts are as follows:
The SMI premium increased from $66.60 to $78.20 per month for January 2005. Any medical expense with type SM in FAMIS of $66.60 will be adjusted to $78.20.
FAMIS EUs containing individuals with SSA, SSI, VA, and/or RR income will be included in the mass adjustment. Changes in Temporary Assistance grants resulting from the mass adjustment will be included in the Child Care and food stamp adjustments, regardless of whether the Temporary Assistance is in Legacy or FAMIS. If the Temporary Assistance case is closed, the grant will be removed from the Child Care and food stamp budgets.
Most EUs with SSA, SSI, VA, or RR income that are active by the end of the day on December 10, 2004, with a certification ending January 2005 or later will be adjusted to show the increased benefit amounts. FAMIS will identify any EU that has been adjusted by the worker if there is a January 2005 budget with an increased SSA, SSI, VA, or RR income and will not adjust the case.
The FAMIS system will be unavailable during the mass adjustment. If the adjustments are not completed by the morning of December 13, 2004, FAMIS will be unavailable until the adjustments are completed.
For any new Child Care, food stamp, and Temporary Assistance application processed after December 10, 2004, the worker must compute the net adjusted income using the new SSA, SSI, VA, and/or RR amounts. For pending Child Care or food stamp recertifications, if the child care certification period or last month of certification is January 2005 or February 2005, the SSA/SSI amount is adjusted by the system. For all cases in the controlled flow, including Temporary Assistance cases which have been converted into the controlled flow, review each SSA, SSI, VA, and RR amount prior to completing the application. If the SSA, SSI, VA, and RR amount is not correct, follow instructions in the Manual Adjustments by Staff section of this memorandum. If any application or converted case remains in the controlled flow, all FAMIS programs for that EU are not adjusted. The adjustment will be made for all programs when the controlled flow is complete.
All SSA, SSI, VA, and/or RR amounts are increased by 2.7%, unless the amounts were adjusted by the worker for January 2005 budgets. Due to rounding, this calculation may end up $1 different than the actual amount of SSA, SSI, VA, or RR. Review all income at recertification or interim change and adjust if necessary.
If the EU receives total maximum SSA and SSI maximum, the SSA amount is adjusted by 2.7%. The SSI amount is adjusted by the difference between the SSA increased benefit and the new SSI maximum plus $20.
If there is a medical expense type SM for $66.60, FAMIS will update the SMI premium from $66.60 to $78.20. Medical expense type CV will NOT be updated in FAMIS. If the medical expense type SM is less than $66.60, FAMIS will not update the premium. A report is being generated for staff to review individual SMI when the medical expense type SM is less than $66.60. Staff must ensure that the medical insurance premium costs are manually adjusted when the family's Medicare premium is coded with an expense type other than SM in FAMIS.
When the 2.7% COLA adjustment is less than the increase in the SMI premium, the SMI premium is adjusted so that the individual’s net Social Security benefit does not decrease. For cases where FAMIS adjusts the SSA amount, the SMI premium is adjusted:
It is important to review IIVE interface or BENDEX at the next contact to verify the correct amounts as a lower medical expense will result in a decrease of food stamp benefits.
If an active FAMIS EU is adjusted or closed, the EU Action Log (FM40) displays the action taken by the system and the benefit amount for benefit month 012005. To view information that resulted in the action, select the action and press F17=INQAUTH. The Action Authorization (FM3H) screen is displayed. Press F16=BUDSUM to access the Budget Summary screen for each program type. From the Budget Summary screen, press F14=INCSUMM to access the Income Summary Detail screen (FM33). The income types, sources, and gross amounts are displayed for budget month 012005. Press F21=RETURN to return to the Budget Summary screen, and press F15=EXPSUM to view the Expense Summary screen (FM34). The expense classes, types, and amounts are displayed for budget month 012005.
Eligibility determinations which have not been run prior to the mass adjustment will be completed during the mass adjustment. This may result in creation of an RTA (ready to authorize) status. An alert "OUTSTANDING ELIGIBILITY DETERMINATION" will be generated and must be resolved.
The SSA/SSI/VA/RR COLA is considered a change that must be acted on and all cases are required to be adjusted to accurately reflect all information known at the time of the adjustment. Therefore, simplified reporting EUs with previously disregarded actions (action status DIS) are adjusted using ALL information in the system. If the food stamp benefits for a simplified reporting EU decrease as a result of the cumulative changes, an FA-510 ADVERSE ACTION NOTICE will be generated and the adjustment will be made to decrease the benefits or close the case. If there was a previously disregarded Adverse Action to Remove a Person (AARP), the adverse action will be re-generated as a result of the mass adjustment. Do not disregard the mass adjustment action.
FAMIS adjusts the income and expenses on EUs with a pending adverse action at the time of the mass adjustment. This results in a conflict of actions because one adverse action must be completed or voided before the other can be taken. The worker receives the alert "OUTSTANDING ELIGIBILITY DETERMINATION". The conflict must be resolved by the worker.
To resolve the conflict:
Two types of notices are generated as a result of the mass adjustment for food stamps. An FA-510 ADVERSE ACTION NOTICE is generated for any food stamp simplified reporting EU whose benefits are reducing due to the mass adjustment and previously disregarded changes. An FA-150 CLAIMANT ACTION NOTICE is generated for all other EUs adjusted in the mass adjustment. EUs whose SSA, SSI, VA, or RR benefits are adjusted, but the food stamp benefits do not change receive a notice of no change in food stamp benefits.
Two types of notices are generated as a result of the mass adjustment for Child Care. An FA-510 ADVERSE ACTION NOTICE is generated for any Child Care EU whose benefits are reducing. An FA-150 CLAIMANT ACTION NOTICE is generated for all EUs whose case was adjusted but the Child Care benefits do not change.
Only the FA-150 CLAIMANT ACTION NOTICE is generated for a Temporary Assistance EU due to the mass adjustment, unless there is a pending adverse action at the time of the mass adjustment.
Any EU receiving an FA-510 ADVERSE ACTION NOTICE or FA-150 CLAIMANT ACTION NOTICE may request a hearing. A hearing may be requested on the mass adjustment action within 90 days from the date of the notice.
If the EU requests a hearing on the food stamp or Temporary Assistance adjustment by December 23, 2004, the EU may request that food stamp or Temporary Assistance benefits continue at the level before the mass adjustment until the hearing decision is made. County staff should inform the EU that if continued benefits are issued and the agency is determined to be correct, a claim will be established for the overpayment.
The EU may not receive Child Care benefits at the level before the mass adjustment while the hearing is pending. Follow current procedures that allow payments to be back-dated via the corrective payment screen in FAMIS.
To continue the food stamp benefits at a higher amount for EUs who received an FA-510 ADVERSE ACTION NOTICE pending the hearing decision, update the action status to HOLD (HOL) on the Action Resolution (FM50) screen. Refer to Changing an Adverse Action Status user guide for instructions.
To continue the food stamp benefits at the higher amount for EUs who did not receive a notice of adverse action pending the hearing decision, set a reminder for the issuance availability dates in January 2005 and February 2005. To complete a WIBCA budget for January, use the budget information before the mass adjustment and issue the supplemental benefits. If the hearing decision is not received before the February allotment is available, complete a WIBCA for February using the same budget information and issue supplemental benefits.
To continue the Temporary Assistance benefits at the higher amount pending the hearing decision, complete a WIBCA budget to issue supplemental benefits. Set a reminder for January 3, 2005, and February 1, 2005. To complete a WIBCA budget for January, use the budget information before the mass adjustment and issue supplemental benefits. If the hearing decision is not received before the February benefit is available, complete a WIBCA for February using the same budget information and issue supplemental benefits.
Once the Hearing Decision is rendered, take steps to process the family's eligibility according to the Decision and Order.
If the EU requests a hearing after December 23, 2004, the EU is not eligible for continuation of benefits at the level before the mass adjustment, but is still entitled to the fair hearing.
Because the BENDEX file is not being used for the mass adjustment, there will be very few cases that will not be adjusted. FAMIS will generate reports in the Managed Reporting system of active EUs that are not adjusted. To review the reports:
Each worker must access the report for his/her primary caseload. An error reason is included for each EU member on the report. More than one reason may appear for each EU on the report. Review all EU information to ensure correct data is entered.
If a child care, food stamp, or Temporary Assistance application or converted Temporary Assistance EU is in the controlled flow, review the SSA, SSI, VA, or RR benefit. Determine the correct SSA, SSI, VA, or RR benefit amount and manually adjust the benefit amount for January 2005 and later months when completing the application/controlled flow.
To manually adjust the SSA amount in the Child Care, food stamp, or Temporary Assistance EU, obtain the new SSA amount from the BENDEX printout or the IIVE interface. The new SSA amount can also be computed by multiplying the original SSA amount by 102.7% and rounding down to the nearest dollar.
To manually adjust the SSI amount, the worker adds the amount of increase from the chart near the beginning of this memorandum to the verified SSI amount, or multiplies the original SSI amount by 102.7% and rounds down to the nearest dollar.
To manually adjust the VA or RR amount, the worker multiplies the original VA or RR amount by 102.7% and rounds down to the nearest dollar.
Manual adjustments of the SSA, SSI, VA, or RR as a result of the COLA are considered a change that must be acted upon. If the child care, food stamp, or Temporary Assistance benefits decrease, or the EU closes, authorize the actions to generate an FA-510 ADVERSE ACTION NOTICE.