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WIC Income Webcast 2013 September 26, 2013 WIC Income Webcast 2013 September 26, 2013

WIC Income Webcast 2013 September 26, 2013 - PowerPoint Presentation

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WIC Income Webcast 2013 September 26, 2013 - PPT Presentation

Presenters Linda Dingerson BSN Policy Coordinator Terri Riemenschneider MS Eligibility PAL Intake Policies And revised polices Linda Dingerson WIC Policy Coordinator 2 110 Voter Registration ID: 780850

income client family wic client income wic family medicaid information foster child cert benefits eligibility certification proof eligible screen

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Presentation Transcript

Slide1

WIC Income Webcast 2013

September 26, 2013

Presenters:

Linda Dingerson, BSN, Policy Coordinator

Terri Riemenschneider, MS, Eligibility PAL

Slide2

Intake Policies…

And revised polices

Linda Dingerson,

WIC Policy Coordinator

2

Slide3

1.10 Voter Registration

Acceptable Photo IDs:

Driver’s license/State/Federal ID

Current U.S. passport

Current student ID

Military ID

Tribal ID card

Clients who request to register to vote must have photo ID

If no photo ID, must sign an affidavit

3

NEW!

Slide4

1.10 Voter Registration

Affidavit of Voter not in Possession of Picture ID

Available through E-forms

Arabic and Spanish

translations available

on

the

MDCH/WIC website at:

www.michigan.gov/wic

Attach affidavit to VR Application and send to

clerk

4

NEW!

Slide5

1.10 Voter Registration

5

Ask

the

client at each:

Certification/recertification

When the client changes address

“If you are not registered to vote where you live now, would you like to apply to register to vote here today?”

Slide6

1.10 Voter Registration

6

Give “Declination” (top) portion of form for signature if response is:

No

No, registered at present address

Under age 18

Give Voter Registration application if response is:

Yes

Address change and client wants to register

Address changes over the phone:

Mail the Voter Registration application -OR-

Direct the client to the SOS website at:

www.michigan.gov/vote

Slide7

Voter Registration posters are available for clinic use

Order on E-forms

7

Slide8

1.03 Confidentiality

8

Any information about an applicant or client that individually identifies an

Applicant

Client, and/or

Family member

Restrict use and disclosure of information to:

WIC employees who

need

to know

Slide9

Maintaining confidentiality

9

Insure Privacy

Sign in sheets

Income

determination

Anthropometric and laboratory

procedures

Print Docs

Restrict Access to Client Record

Diminish screens or log off

Notes and Alerts

Saving/Printing Reports

Slide10

Sharing Client Information

10

Memoranda of Understanding (MOU)

Immunization

MDCH Lead Program

MIHP

Head Start

Dept. of Ed (CSFP)

Release of Information

Sharing Appointment Lists

MOU

WIC Client is also client of health center

Slide11

2.01 Eligibility/Certification of Clients

Overview of certification policies

Clients who meet income, residency and categorical eligibility are presumptively eligible.

Use the Short Certification process if a proof is missing

11

Slide12

2.02 Residency

12

Proof of residency required at:

Enrollment

Each certification

Transfer

Short certification if client did not bring proof

NO

Proof required for:

Homeless

Migrant

Transfers who have a VOC

Someone who has recently moved into areaVictim of theft, loss or disasterThese clients sign an Attestation form

Slide13

2.03 Identity

13

Proof required:

For

NEW clients

only

, at initial certification or transfer

For

authorized person/proxy

, at benefit pickup, each certification and transfer

NO Proof required for:HomelessMigrantVictim of theft, loss or disasterThese clients sign an Attestation form

Personal recognition by staff allowed once proof has been established

Slide14

Proofs - How Do I Know What I Need to Do?

Slide15

2.04 Income Policy Revision

–reflects new guidance from USDA

Current income Previous 30 days unless..Current income has changed such as laid off/ unemploymentThen project next 30 days

Source of incomeRecent paycheck or stubCan be electronic or by phone W-2 and current 1040 tax form filed“Per Cap”-payment include as income

Slide16

2.04 Income Policy Revision

–reflects new guidance from USDA

IEVAL & CEVALNo income determination

Review Family info screen and verify current informationIf new address, complete voter registration/declinationIf other family members are certified today and over income, then terminate all family members unless adjunctively eligible

Slide17

2.04 Income Policy Revision

–reflects new guidance from USDA

Migrant familiesDetermine income once every 12 months, even if not currently certifiedUse VOC information to determine last income date

Slide18

2.04 Income Policy Revision

–reflects new guidance from USDA

Verification of incomePublic assistance (FAP/SNAP, FIP, Medicaid)Verbal declaration of other income after verification of current eligibility

VERIFY one adjunct programVerify Medicaid using MI-WIC adjunct eligibility verification (BEST-Infant or PG-makes whole family adjunctively eligible)Verify FIP/FAP using phone or online verification systemUnemployment benefit-use notice or myaccount.chase.com or 1-866-523-2122

Slide19

2.06 Adjunct Income Eligibility

19

Client receives:

FIP (Cash Assistance)

Medicaid/Healthy Kid’s Program/ Plan First

MOMS

Member of a family that:

Receives SNAP (Food Stamps)

Receives FIP

Contains Pregnant Woman or Infant receiving Medicaid

Client is enrolled in one of these programs that has determined their income to be less than 185% poverty level

Children’s Special Health Care Services

Family Planning

MIChild

Other State or Federally funded programs that have determined income eligibility(free or reduced lunch)

Slide20

What if client is

adjunctively eligible?

20

FAST LANE

Verbal statement of income allowed

No other “proofs” are required

90

Slide21

2.08 Family Size

21

Income eligibility based on Total Family Size

Include:

Unborn child(ren)

Adopted child(ren)

Special Considerations

Resident of Institution or group home

Family living in homeless shelter, group residence

Foster child – Family of one

How many people in the household does this income support?

Slide22

2.04 Income Determination

Use current income guidelines (May 17, 2013) for clients paid

only

weekly, biweekly, semi-monthly or monthlyIf reported income is in multiple, varying intervals, use annual income guideline

22

Slide23

2.04 Income Determination

Based on client/applicant’s family size and income

If client has proof but did not bring to appointment

Short

Certification

(30 days)

23

Slide24

2.04 Income

Determination

Self Declaration

Self-declaration (verbal statement) is allowed for:

Clients who are adjunctively eligible

Homeless clients

Migrant workers

Family works for cash

Attestation form signature required if not adjunctively eligibleNO proof of income is required in these cases

24

Slide25

2.04 Income

Determination

Variations

Transfers with current certification – no income determination until next certificationMigrants – once every 12 months

If VOC is expired but shows income determination in last 12 months, don’t assess income

Clients who report

NO

income

Ask questions that pop-up when $0 is entered in grid row and SavedClient signs Client Agreement – NO attestation form required25

Slide26

2.04 Income

Determination

2.04A Military Pay

26

What

DOES

count:

Base pay

Basic Allowance for Subsistence (BAS)

Foreign Language Pay (FLPP)

Family Separation Allowance (FSA)

Jump Pay, Dive Pay, Sea Pay, Flight Pay

Continental United States Cost of Living Allowance (CONUS COLA) May Income Average

:Clothing Maintenance Allowance (CMA) Bonus Pay (Bonus)Special Pay

What

DOES NOT

count:

Basic

Allowance for Housing (BAH or BAQ)

Family

Separation Housing (FSH)

Family

Subsistence Supplemental Allowance (FSSA)

Overseas

Housing Allowance (OHA)

•Overseas

Continental United States Cost of Living Allowance (OCONUS COLA or COLA)

Combat Duty or Combat Zone

Pay

Slide27

2.21 Mid-Cert Income Determination

IF you learn that the client’s income has changed, AND:

The client is NOT adjunctively eligible

The client has more than 90 days left in the certification period

THEN, use current income to determine continued eligibility

If terminating client, use Termination Reason “No Longer Eligible” and issue benefits as system allows

27

Slide28

2.10 Proof of Pregnancy

28

Any woman who claims to be pregnant is eligible if income, residency and identity are confirmed.

If NO Proof Short Certification 60 days

Clients may be enrolled after miscarriage as NPP

IF

proof of pregnancy or miscarriage was provided

Slide29

2.09 Physical Presence

Exceptions

29

Medical condition that requires medical equipment not easily transported

Medical condition that requires bed rest

Serious illness that may be worsened by coming into WIC clinic

Infants under 8 weeks of age

Visit presents

a barrier

if client present at initial cert and has documented health care

Parent/caretaker

work status presents

barrier if client present within last year

Clients

visited and screened at home or in another program –

(all

elements of certification must be

completed)

Slide30

2.20 Ineligibility Notices

Written notice is required when client is:

Ineligible at certification

Terminated at mid-cert for income ineligibilitySanctioned, suspended or disqualifiedA breastfeeding woman who discontinues breastfeeding after 6 monthsWritten notice must include client’s right to fair hearing

30

Slide31

1.09 Civil Rights

New non-discrimination statement

If full statement used on publication before, must be used on reprints

New Discrimination Complaint Form

Available on MDCH/WIC website under 1.09 policy

31

Slide32

Questions

32

Slide33

Now let’s look at the MI-WIC Process that supports these policies…

33

Terri Riemenschneider, Eligibility Policy PAL

Slide34

Family Information Screen

Family Information

Accurate-ask client to give address (including zip!) and phone and verify

Cell # helpful as we are offering TEXT Reminder noticesPrefer

Cell phone

text message

Collect e-mail address

SAVE

34

Slide35

Adjunct Eligibility/Income Info Tab

If PG or IBE, IBP or IFF has current Medicaid, makes

entire family

income eligibleIf C1, C2, C3, C4 has Medicaid, that client is income eligibleVERIFY Medicaid by clicking on Verify button, insert Medicaid ID#System should check “adjunct checkmark” if Medicaid eligibility is verified

Record if client/family participates in Food Stamp/SNAP or FIP programs

35

Slide36

Adjunct Eligibility on Income Info Screen

Start with

Report participation

MedicaidFood StampsFIP/TANF

Search for Medicaid ID

CHAMPS

MI Health

Only VERIFY one program use PG or Infant

36

Adjunct Eligibility

Slide37

Verify Current Medicaid

Click Yes for REP and √ VER (verify)

The Medicaid Verify Adjunct Eligibility box will appear

Input the Medicaid ID if not already shownClick verify

Confirm verification

Adjunct

37

Slide38

Medicaid Verification

A pop-up will let you know if Verified Successfully or Not Found in RID.

If verified, click OK

A pop-up will ask if want to confirm the verification, click Yes

38

Slide39

Adjunct Eligibility

Note Adjunct Eligibility

Record Food stamps or FIP enrollmentOr check if family not participating in programs

Close

39

Slide40

Medicaid Verification-MI Health Plan Benefit

How to FIND Medicaid ID

Input identifiers

System searches and provides results

Medicaid Active and ID #

40

Slide41

Information on How to enroll on MI Health Plan Benefit

WIC E-Notice # 2012-101: MI Health Benefit Plan Medicaid Eligibility Verification - Rejections & Update.

Slide42

Medicaid Verification

CHAMPS

Apply through SSO

Allows verification of Medicaid, lookup by name, date of birth

42

Slide43

CHAMPS

Training

MDCH is excited to announce that Web Based Trainings (WBT) are now available for Providers. These trainings will allow providers to use interactive learning tools to complete CHAMPS training courses.These courses are not required; however, they are an excellent resource for gaining knowledge and understanding on the use of CHAMPS. To access these courses you must have access to Internet Explorer and follow the steps below.

Access the site at http://learning.mihealth.org/SOLO/

Slide44

CHAMPS

- MEMBER SEARCH

44

Search by:

Last Name

First Name

Date of Birth

Submit

Slide45

CHAMPS

- MEMBER SEARCH

45

Slide46

CHAMPS

- Quick Reference

46

Medicaid ID

http://www.michigan.gov/documents/mdch/Eligibility_Quick_Reference_291964_7.pdf

Slide47

Medicaid Verification

MCIR General Information Screen

47

If client has

active

Medicaid

, Health Plan name will be displayed

Blue Cross MI

Slide48

Adjunct Eligibility…

DHS Bridge Card

DHS Bridge Card - 1-888-678-8914

Verify Food Stamps (FAP/SNAP) or FIP (TANF)Call Customer Service # on back of card 1-888-678-8914 Select deposit inquiry #5

Listen for DEPOSIT information for this month

Record last 9 digits of DHS Bridge Card in FS or FIP pop up screen

MI-WIC Adjunct Documentation

Document as YES in MI-WIC Adjunct Screen

Verify-insert family #MI Bridges-client can check benefit statuswww.michigan.gov/mibridges

48

Slide49

WHY Verify Adjunct Eligibility???

Verified Medicaid=

 R

esidency  Income verified  ID if have Medicaid cardClient adjunctively eligible-may make others in family adjunctively eligible

Infant or Pregnant woman with Medicaid makes all eligible

Child with Medicaid, only self

Family with Active Food

stamps or FIP - all eligible in family

49

Slide50

Income Information Screen

Verify Family size-

Update “expected infants” if PG

Update family size if adding infant

Record sources of income for family

Can “reuse” income line if applies or remove and add row

Self Declare source of income if adjunctively eligible or “migrant, homeless or works for cash”

50

Slide51

Income Information

Verify family size

Record expected infants

= Family size + # of infantsRecord IncomeVerification: self declaredAdjunct eligible No income $0Works for cash

Otherwise must review paystub or other income documentation

51

Slide52

Income Info

Year To Date Calculation

Useful when income is variable

Select last pay dateInput pay YTDRecord calculated

income

52

Slide53

Income Info

Hourly Calculation

Select Hourly interval

Record amount of payRecord number of hours/weekRecord VerificationSystem calculates annual income

53

Slide54

Income Information Screen - Foster

Foster designation

Select Foster Child on screenRecord Foster stipend amount for income

All Foster children have Medicaid eligibilityALWAYS family size of 1 Can include PG woman-include the number of expected infants

54

Slide55

Foster Child

Click Foster Child

Select child from dropdown

Click Go

55

Slide56

Foster Child

Family size 1

Can record # of Expected infants if PGComplete income grid with foster stipend amount

Save

56

Slide57

Family Additional Information

Language-notices in Arabic, English or Spanish

Proof of Residency-Medicaid or other proofVoter Registration

ASK “Would you like to update your voter registration?”YES - Complete Voter Registration FormNO - Sign Declination formUnder 18-Not eligible to register Pickup Interval-Defaults to 3 monthsReferred From: Note program that informed client of WICSpecial Needs: Note if client has special needsProof of Auth Person ID-Complete at initial visit ONLY

or when Auth Person changes

57

Slide58

Additional Information Tab

Record

Primary Language

Verify Proof of ResidencyProof of Auth Person’s ID

Designate

Migrant

Homeless

CompleteVoter

Registration or Voter Declination form

58

Slide59

Client Agreement

Click on Client Agreement after client has reviewed hard copy of document

Obtain signature on Client Agreement each cert/recert

Close (takes you back to Household Summary Screen)

CAN ALSO Obtain signature by

Miscellaneous/Signature/

WIC Client Agreement

59

Slide60

Client Agreement-

EACH CERT/RECERT

Ask Authorized Person to read Client Agreement or read it to them

Ask if any questions…Complete client agreementCopy to client at initial MI-WIC cert, offer thereafterNo Client Agreement needed at IEVAL and CEVAL

60

Wanda Wick

Slide61

Client Information Screen

Client Information Tab

Client Name

Proof of ID (Initial cert ONLY)

Proof of Pregnancy

Education Level

Marital Status

REASON for Ineligibility-Complete ONLY when determined ineligible

Additional Information tab

Record/verify race/ethnicity

61

Slide62

Cert Action Screen

Cert Action

Cert recertIf short cert, leave message in notes…update note & remove termination date when proof provided

Category change buttonSystem will calculate cert end date based on category selectedTermination Reason/dateIf Terminating, place reason for term in grid, system will automatically calculate termination date based on the reason

62

Slide63

Cert Action – Infant or Child

Add row for cert period

63

Slide64

Cert Action Screen- PG

Add a row

Add the LMP or EDD

System calculates Cert End DateValidates if pregnant womanSystem checks to ensure that # of expected infants is more than zero if PG

64

Slide65

Cert Action Screen-Short Cert

If short cert, leave message in notes…

When clients bring information…

Remove term reason and date when proof provided& update note

65

Slide66

Category Change

66

Select new category

Align

BE/IBE

BP/IBP

NPP/IFF

Suggest change mom first then infant

Slide67

Cert Action Screen-Termination

Input term reason

System calculates term date

If d/c breastfeeding update BF stats on Infant record

67

IF IBE or IBP to IFF, make sure to term mom! Remember, her recert date is 1 year post partum and she will remain on if not terminated!

Slide68

Ineligibility

Client Information Screen

Complete reason for ineligibility

If determined over-income, record income on income determination screen.Print Ineligibility notice

68

Slide69

Print

Ineligibility

Notice

Print docsSelect ineligibility notice

Must have reason for ineligibility documented on Client Info screen

Notice recorded in Miscellaneous

Communications

69

Slide70

Benefit Issuance & Print Docs…

Benefit Issuance

Schedule next visit

Ask client day & time preferred

Print Docs

NE Plan

VOC (signed)

Shopping List

Client Agreement Provide if new client Offer if ongoing client

Vendor Listing If new or offer to ongoing client

70

Slide71

71

Print Docs

Ineligibility

Ineligibility notice with Fair Hearing notice-must complete Reason for Ineligibility on Client Information screen

Short Certification

Short certification notice

Lists proof needed by what date

Attestation of Identity, Income or Residency

Copy of signed document to client upon request

Ineligibility

Notice

Slide72

Communications Screens

Records print docs in family/client record

72

Slide73

Precert screen…add

new enrollee

Add a row in the applicant fieldsAdd the new client’s information and save

73

Slide74

Dual Enrollment Pop-up

New enrollees only

74

Slide75

Remove dual enrollee row to prevent dual enrollment

75

Slide76

NO dual enrollment…

Or Click

Cancel

to stop record creation

76

Slide77

Resolve Dual Enrollment-WIC

Print Dual Enrollment report to research listings

Select “Miscellaneous”

Select Resolve Dual EnrollmentSelect client from dropdownDetermine if duplicate or dual enrollee or different clientSelect resolutionNote if needed

77

Block

Keep

Not same client

Investigate

Other

Slide78

WIC/WIC Dual Enrollment Reportclinic/reports/participation/WIC dual enrollment

Report lists clients when the following matches

First 4 letters of last name and first name

Same date of birthSame gender

Slide79

Resolve Dual Enrollment-WIC/Focus:HOPE-CSFP

MUST RESOLVE BEFORE WIC CERTIFICATION!

Resolve within 45 days of identification

Determine if client wants CSFP, WIC or is not same personSelect resolutionIf CSFP in area, check every 6 months for dual enrollment

79

Slide80

WIC/CSFP (Focus:HOPE) Dual Enrollment Report

Clinic/reports/participation/WIC -CSFP Dual enrollment

Slide81

Questions?

Slide82

Break

Slide83

Answers

Slide84

Special Circumstances…

Military pay

UnemploymentOvertimeAdoption

Foster ChildrenChildren’s special health care servicesSelf employedTeenImmigrantWorks for cashOver incomeIncome guidelinesMedicaid

Other

84

Slide85

85

Military pay

Client had Coast Guard pay stub, total was over income.

Staff should review 2.04A for allowed and not allowed pay

Client was determined to be income eligible when BAH and FSH were not included

Basic Allowance for Housing (BAH or BAQ)

Family Separation Housing (FSH)

Slide86

86

Military Pay

What

DOES NOT

count:

Basic Allowance for Housing (BAH or BAQ)

Family Separation Housing (FSH)

Family Subsistence Supplemental Allowance (FSSA)

Overseas Housing Allowance (OHA)

Overseas Continental United States Cost of Living Allowance (OCONUS COLA)

Combat Duty or Zone Pay

Hardship Duty, Parachute, Flight Deck, Demolition, Experimental Stress, Toxic Fuel, Dangerous Virus, Chemical Munitions, Maritime Visit, Polar Flight…

Exhibit 2.04A

Slide87

Military Pay

Client with military pay stub from December 2013- can I take YTD?

OutcomeMore accurate-should look at past 30 days income/pay (with military exemptions-Policy 2.04A)

Can ask for electronic pay stub to verify current income

Slide88

88

Unemployment

How to verify Unemployment?

Unemployment benefits now direct deposit to bank account or debit card

Clients receive “Notice of Determination” letter, which should state amount of benefits

Clients can contact CHASE customer service at

1-866-523-2122 to determine current benefits.

Slide89

Adoption subsidy

Caller wants to know if adoption subsidy is to be included in the household income for eligibility.

OutcomeYes. There is no stipulation in regulation/policy for excluding it.

Slide90

90

Adoption-Family Size

Family has 2 foster children and one adopted child, what is the family size?

Mark “foster” on foster children’s client information screen (family size for each foster ALWAYS = 1)

Document family size of

2 parents + 1 adopted child=3

NOTE:

Adopted children

are

considered members of the family and the family’s income supports them.

Slide91

91

Adoption

Infant has just been adopted by family that is over income. Adoption agency has told family that infant will be on Medicaid, but won’t receive card for a couple of weeks. Can we enroll?

Need verification of pending Medicaid

Search MI-Benefit or CHAMPS for ID#

NOTE:

Some children are provided Medicaid, even after adoption.

If the family is in the process of adoption, the child may be considered a “ward of the state” and have Medicaid coverage.

Slide92

Foster Siblings

Has client with 2 foster children who are siblings. Are they a family of one or two?

OutcomeEach foster child is a family size of one.

Slide93

93

Foster Child Income Verification

Having problems entering income for a foster child. Keeps getting a pop-up that says income has not been verified today

Make sure foster child is selected on both client information screen and then on income screen

Input foster stipend amount for child’s income

Slide94

Foster dad

N

ew foster dad - having problems getting him in as Authorized Person. OutcomeIf Foster child moving into new Foster family…

Create new family with Dad as Auth PersonTransfer foster child into Dad’s family using participant transferTrain dad on use of benefits, issue EBT card & benefits for child

Slide95

Create new family for Client Transfer

Search statewide for Authorized Person

If found, update address and proxy information, if new create new family

Keep FAMILY level in active recordSearch statewide for clientSelect client and click TransferClient displays in Foster family, click on “Foster”

Slide96

96

Foster Stipend

Pregnant woman applying for WIC. She has two foster children living with her. Do we count the foster stipend as part of her income?

Each foster child is considered their own household. Exclude the children and their stipends from the applicant's income calculation.

Slide97

97

Foster child

Family is over income but have a foster child with Medicaid. The family is adopting the foster child, but the adoption is not yet final.

The foster child is adjunctively eligible with Medicaid

Report monthly stipend as income

Other children in family are not eligible at this time

If infant adopted with Medicaid, other children eligible

If child adopted without Medicaid, other children not eligible

Slide98

CPS wants info from WIC…

Child Protective Services (CPS) wanted information for a neglect case, as asking if WIC information such as WIC clinic and appointment information be provided?

OutcomeVerified that client information can be released to CPS per MI-WIC Policy 1.03

You could provide a copy of screen shots with Appointment History

Slide99

99

Foster Child Benefits

Agency called to ask when foster child transfers, do benefits go with child?

No, client will need benefits loaded to new family’s account

If possible, void future benefits before transferring client to new family

Slide100

100

Foster Child - Blocked

Foster child is blocked in MI-WIC due to Dual Enrollment. Help!

Child was previously enrolled as foster child under different family number and authorized person.

Select the most current record

Transfer current enrollee into foster family

Slide101

101

Children’s Special Health Care Services

Had quads born at 23 weeks, one died and others with handicaps. Now almost 2 years old. Medicaid has been dropped. Children have CSHCS, does this make them eligible?

No, CSHCS can use WIC for income eligibility, but WIC can

only

use CSHCS if income is calculated at or below 185% of poverty

Slide102

102

Self employed

1040 form can be used for income documentation until the next 1040 is filed

Determine income based on available evidence/information

Tax document probably best if not receiving pay check regularly

Slide103

103

Overtime

We have a client whose hourly wage qualifies for WIC but their YTD is over because he frequently works overtime. Which are we supposed to go by? YTD is at $40,000 now, so it will calculate higher than the max of $51,005 for a family of 5. Not sure how we should handle this.

Options to accurately calculate income:

YTD calculates annual pay to reflect overtime and straight pay from current pay stubs

Most current 1040 income tax form

Slide104

“Per Cap” payments to Tribal members

Are “Per Cap” payments income?

Per capita payments are provided to some tribal members from Casino profitsThis is considered income for the family

May be annualized if paid on a quarterly basis

Slide105

105

Teen

Mother called regarding pregnant daughter eligibility. Parents are supporting and providing insurance to cover pregnancy. Family of 5 (with unborn), parents both work.

Suggest referral to Medicaid/Healthy Kids to cover co-pays and ensure coverage of infant when born (thereby adjunct eligible)

Slide106

106

Immigrant

Pregnant woman applicant eligible for Emergency Medicaid due to immigrant status. Client has ID, proof of residency and appropriate income. Is she WIC eligible?

Yes, client is eligible based on Income, PG and Emergency Medicaid

WIC

does NOT

consider immigration status for eligibility

WIC enrollment does NOT affect immigration status in terms of government support as WIC is a NUTRITION Program

Slide107

107

Works for cash

Client works for cash, doesn’t have proof of income or Medicaid. What to do?

Verify that client does not have Medicaid (MI-Health Plan or

CHAMPS

)

Document client’s income type as gross wages, verification is self declared

Sign attestation form-explaining why no proof of income exists

Slide108

108

Over income-on Medicaid

C1 client in family has Medicaid, C2 does not, family over income. Does C2 qualify if over income?

C1 client IS adjunctively eligible

C2 client NOT eligible/over income

Slide109

109

Self Employed/Farm Income

Had a client whose husband is self-employed farmer and she works. Wants to know how to calculate the income, based on the Schedule C and the 1040, and W-2.

Policy indicates that you use the net income on the Schedule C for husband and, which show loss and gain and then use the wife’s reported income (W-2).

Slide110

110

Joint Custody…

Mother is authorized person and is

not picking up benefits. Dad called,

says he has joint custody, but no paperwork.

He wants WIC card. What can we do?

Contact mother to ask if Authorized person can be changed to allow benefits to be issued.

If client is no longer enrolled, Dad could apply on child’s behalf.

There is NO MDCH/WIC policy regarding who can be Auth. Person or how to change, so it is up to the agency to establish procedure. Just be sure that client is not dually enrolled.

Slide111

111

Transfer-Short stay

Took call from woman who says she is on WIC in another state. She is coming to visit in Michigan for a month before leaving with her husband to go to new base in Japan. Wants her WIC benefits in Michigan for the month. How do we handle her?

Treat her as any other transfer-Require same proofs of residency (can attest), etc. and VOC information from other state.

Issue only one month of benefits at that time.

Slide112

Transfer – Release of Information

What information should be released in a transfer?

Required information includes:

Verification of Certification (VOC) signedOptional information:

Client Information Report

Medical Documentation

Form

112

Slide113

Moved out of state

How to document

ineligibility when

notified that client moved out of state?

Cert Action Screen- Document Term reason, term date is auto displayed. This will remove future benefits.

Place note in client’s record as to who called regarding transfer and what information was provided.

Client has already moved, so don’t need to generate termination notice.

113

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114

Present or Not Present

Has a mom who is refusing to bring the baby in for newborn cert because of mom’s C-section, and staff wanted to know was that ok without a Dr's note.

Allowable - note reason for not present

Need birth data/verification

Could also

have

proxy bring infant

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Physical Presence?

Full term adjusted age infant discharged from NICU with doctor’s note that infant cannot leave home. Can LA certify without physical presence?

Yes, can certify using hospital discharge information noting reason for not present on Cert Action screen

115

Slide116

116

Custody & Eligibility

Mom was on WIC when pregnant, now on as post partum, but lost custody of her infant. Can she still remain on WIC as an NPP?

Yes

Slide117

117

“Frozen” EBT

Client complains that even after receiving new card from ACS the card doesn’t work

If client is INACTIVE in EPPIC,

card must be

issued

OVER THE

COUNTER

at the agency

Slide118

PG woman with infant on Medicaid

PG reports no income but living with family that provides immediate needs. Has 9 month old infant currently receiving Medicaid. Can I document 'no income‘?

OutcomeYes, can document for this certification because the PG mom is adjunctively eligible due to infant receiving Medicaid.

Slide119

Medicaid Verification

Mom does not have Medicaid card with her but number is in the system, do we short cert until she brings in the card?

Outcome

Verify that the Medicaid number is active using the Adjunct Eligibility screen and take a verbal income, no short cert is neededMedicaid verifies incomeMedicaid verifies residency (in Michigan)Identity was confirmed at previous certification

Slide120

16 year old mom

16 year old mom enrolling new baby, grandmother has Medicaid case & another child on WIC. Do we have to make separate WIC account or can she have 2 children from different moms on one EBT acct?

Outcome

Can be separate or together. If in same "family" wichealth.org would apply to both and benefits would be aligned if gma is the shopper-mom could be proxy with own card. If the 16 year old decides to take Authorized person status, just create new family and do participant transfers.

Slide121

Siblings have Medicaid

Triplets being seen in office today, only 2 have Medicaid. What should be done about the 3rd on without Medicaid (can they certify)? (

MMCAA)Outcome

If infants, others with Medicaid will make 3rd adjunctively eligibleIf C1-C4, family income must be determined

Slide122

Mom in Jail

G

randma is proxy, mom is in jail. Mom & infant are on the program. Grandma is trying to get guardianship. Can she have a card issued to her? If mom is in jail, do not issue her benefits correct?

OutcomeGrandma can be issued a second card as a proxy.If grandma gets custody suggest they create a family record with her as authorized person and transfer infant in. No benefits should be issued for mom if she is in jail. Mom is eligible to get her benefits when out of jail.

Slide123

Not Present for Certification…

Could you cert a mother who had recently delivered, no prior WIC activity, but who's culture (Asian) required her to stay home for 30 days.

OutcomeCould certify the infant-with hospital birth information or by coming to the clinicCould certify mom with hospital information or by home visit of WIC qualified staff, document why not present

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124

What if I forget how… HELP

Help screens

Select HELP

Type topic in search box, ENTER

Will provide list of materials in HELP for that topic

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125

What if I forget how… HELP

System HELP and DuJour

1-800-WIC-1636

Press 1 and 1 for 3Sigma for problem with system

Press 1 and 2 for WIC Consultant DuJour – policy

Press 1 and 3 for SSO/Tech Support

Press 1 and 4 for WIC Operations – EBT

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126

MI-WIC Release Process

System changes still occurring

December 12, 2013 Release 5.6

NO MI-WIC after 5 pm to allow

for testing time

Slide127

Wichealth.org

Client inquires if she can complete interim NE on line vs. having to visit the clinic. Asks about how soon completed lesson verification will be posted. Client aware that agency accepts wichealth.org, which client has completed in past.

Outcome

Client notes that she has found more assistance in Michigan than she did in IN where she previously lived. Client informed that her verification of wichealth.org lesson completion should post by end of day of completion, and usually within an hour. Recommended she contact the WIC agency before 4 pm to inquire about benefits loading.

Slide128

EBT Question

Client showing zero benefits on her card.

OutcomeEither not loaded or Card marked as inactive in EPPIC. If “inactive” must issue a new card at the clinic.

Slide129

C1 and C3 client certified yesterday. C1 client verified Medicaid, C3 client had no MA. Family over income per guidelines. Why did system allow adjunct for C3?

Outcome

The system is verifying based on current client status, which is not upgraded until cert action screen –if C1 status was IFF at the time verified, then all in family would be shown adjunctively eligible. C3 is

not adjunctively eligible and should be terminated after ineligibility notice and 15 day benefit given.

Adjunct Eligibility

Slide130

WIC Vendors

Client called asking “Can I use WIC at only the stores listed on my paper WIC gave me?”

Outcome

Can use WIC at any store in MI that accepts WIC. The list is only the stores within your home zip code.

WIC

Slide131

WIC Vendors List by County

Select Miscellaneous

Authorized Vendor then select county, Print

Slide132

Check stub or equivalent??

Can staff use electronic record to verify income or

FAP/FIP

deposits (off phone or computer), or do staff need to have paper copies?OutcomeCan verify using hard copy pay stub or virtual electronic record or balance inquiry phone call (deposits).

Policy 2.04

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Medicaid Pending for infant…

Mother has active Medicaid but is over income. Has applied for Medicaid for infant; status pending. Unable to save adjunct eligibility for infant due to over income status.

Outcome

Informed staff that infant has presumed Medicaid eligibility due to mom's Medicaid status, can manually verify adjunct (based on the mother having Medicaid during pregnancy). Mom recertified as BE/Infant certified as IBE.

Slide134

Dad’s right to WIC info…

Wanted to know if we can provide MI-WIC records to the father of a child in a custody battle.

OutcomeWIC Policy 1.03 A#3 – “A WIC client or the parent or guardian of a minor client shall have access to, and may receive, a copy of the specified individual’s WIC record upon written request.”

We would want to scan the request and note what information was provided in the client’s record.

Slide135

No proof of pregnancy…

Has client who was “short

certed” for no proof of pregnancy and now reports miscarriage. Can she recert as NPP with proof of pregnancy?

OutcomeYes, proof of pregnancy or miscarriage is required to certify as Non-lactating Post Partum woman in this case.

Slide136

PG on Bed rest

A client is 33 weeks pregnant and on bed rest. Can we enroll her in WIC without her in the clinic?

OutcomeThe answer is yes, still need to complete the

certification with proxy or through a home visit/MIHP obtaining the required proof items and using referral bloodwork and anthropometric data

Slide137

Non-US citizen benefits

A mother

(US citizen) signed an affidavit when she married a

non-citizen that they would not receive federal services for 2 years. Is getting WIC breaking that agreement?OutcomeDoes not fall under entitlement program or Federal Services according to USDA/USCIS

.

Benefits Not Subject to Public Charge Consideration

Under the agency guidance, non-cash benefits and special-purpose cash benefits that are not intended for income maintenance are not subject to public charge consideration. Such benefits include:

…Nutrition programs, including the Supplemental Nutrition Assistance Program (SNAP)- commonly referred to as Food Stamps,

the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the National School Lunch and School Breakfast Program, and other supplementary and emergency food assistance programs. Public ChargeFact Sheet-USCIS 4/2011

Slide138

When to schedule I-EVAL

For infant enrolled at 2 months of age, can we do I-EVAL at 6 months of age?

OutcomeYes, Policy allows for MID-cert, evaluation-usually halfway through certification, but usually tied to benefit issuance timeframe.

Slide139

I-EVAL & C-EVAL

Staff have questions about I-EVAL and C-EVAL requirements:

Does client need proof of residency? Outcome

No, update address, and Voter Registration form if moved, but eligibility is not reviewed.

C-EVAL

C-EVAL

I-EVAL

Slide140

BF mom now Pregnant?

Mom is a BE with an

IBE and now pregnant. Keep baby as IBE

?OutcomeYes, keep mom as BE and baby as IBE until one year post partum, or baby is weaned. THEN-certify mom as PG after breastfeeding certification expires.

Slide141

Mom in Hospital, baby at home…

Mother remains in hospital but infant is discharged. Mom did not name proxy at certification. Needs Grandmother to bring infant in for appointment. Can mother write a note and send with Grandmother?

Outcome

Yes - - referred LA staff to Proxy Policy 8.03.

Slide142

Client Agreement

Are proxies allowed to sign

the Client A

greement form?OutcomeYes, proxies are allowed to bring children to certification appointments, sign forms, receive nutrition education and purchase food benefits according to Proxy Policy 8.03.

Slide143

Bloodwork

We recertified a child who had had a blood test done 11 months ago.

Should we have done one at the recert?

OutcomePolicy 2.16 requires that a test be performed at least every 12 months for children over 2 years of age if the previous test was above the cut-off level. It makes sense to obtain the test if it has been 11 months since the previous test and you won’t see the client in a clinic visit

until the

C-EVAL appointment.

Slide144

WIC and Head Start

Does WIC have an MOU with Head Start? I just received a request for blood lead values on children.

OutcomeYes, refer to WIC Policy Manual-Policy 1.03, Confidentiality. The MOU with Head Start does include sharing data and specifies measurements, hemoglobin and lead as some of the items.

NOTE- Head Start may also be a good WIC outreach source!

Slide145

Infant certification period

Added a 9 month old to the program and he was given a 6 month cert period. Is this correct or a bug?

OutcomeAccording to F

ederal Regulations, for infants that are added after 6 months and before 12 months of age, their certification period is 6 months.

Slide146

Certification period alignment

Wanted to know what to do to get family onto simultaneous cert dates. This has become an issue with the 1 year CEVAL. Wondered if they just needed to bring the child in sooner (greater than 30 days) and make a note in the record as to why it was done.

Outcome

You can schedule the CEVAL MID-CERTIFICATION (flexible) to align with benefits and other family members certs/visits.

Slide147

More formula for IBP

Client was made NPP from BP (before 6 months post partum). After a call with Peer Counselor she determined client is still breastfeeding after 6 months.

Outcome

Breastfeeding status can't be changed due to termination. Client would have to be re-certified as BP until 1 year post partum.If breastfeeding but need more formula than IBP package-Keep clients BP and IBP categories – refer client to CPA to…Change FOOD package for BP to NPP (after 6 mos., mom won’t receive food, but will still be BP)

Change FOOD package

for IBP to IFF

Slide148

WIC Overseas Transfer

C4 client transferring from Overseas WIC (Japan). Previously a client at Cheboygan. Documentation presented has cert end date of August 2014. How do I handle this process?

Outcome

Transfer client to current clinicFollow “Out of State Transfer” ProcessSelect MiscellaneousOut of State TransferComplete screen with cert end date from VOC or other transfer information from clientSave

May need referral/referral info

Assign food package

New client information re: WIC Food & EBT card use, vendors, Substance Abuse Assistance, etc.

Slide149

No longer Interested in WIC

Follow-up call after missed EDU appt. Client had lost baby and no longer wanted to participate in WIC-how to document?

Outcome

Add note in NOTE field to record client’s wishesIn MI-WIC, staff had to bring up the client on Cert Action Screen, then select the reason for termination. The system automatically calculates the “termination end date” based on the reason.

IF the “termination end date” is past BVT date, agency can issue one month of additional benefits.

Slide150

No proof of pregnancy short cert

Need to recert a BE client who had been terminated due to no proof of pregnancy, but now had delivered and couldn't change the cert end date.

OutcomeGo to Cert Action screen select “Reinstate" for the PG client, then she would be able to proceed.

End the PG certification period as yesterdayAdd new row with current status, BE, BP or NPP

Slide151

PG mom out of current family

How can you separate a PG mother from the father who is authorized person for her child, but mother would like to utilize another clinic?

Outcome

Create new family on Precert screen for PG mom in desired clinic (don’t add mom as new client)-save and make new family activePerform client transfer of PG mom into new family

Slide152

Frequently Asked Questions

How do I correct client’s Date of Birth?

If Auth Person, can change on Family Info screenIf client, call 3Sigma Helpdesk at 1-800-WIC-1636- press 1 and 1

How do I update EDD for PG client?If EDD is later than the certification end date, please contact 3Sigma Helpdesk at 1-800-WIC-1636- press 1 and 1Otherwise note updated EDD in NotesHow do I change the appointment minutes in my templates (want 30 minutes for NCRD appointment instead of 15 minutes)? Call Kathie Boynton at 1-800-WIC-1636- press 1 and 2 and ask for Kathie

Slide153

Questions?

Slide154

154

Project FRESH

Clients with Project FRESH benefits will be sent a reminder on September 27

th

to use their benefits before October 31, 2013.

Dear WIC Client-

Use Your 2013 Project FRESH benefits by October 31, 2013

Thank you, WIC

WIC is an equal opportunity program

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Thank you!Please complete your evaluations!

Contact information

Linda Dingerson, Policy Coordinator

517-335-9156dingersonl@michigan.govTerri Riemenschneider, Eligibility Policy PAL

517-335-9562

riemenschneidert@michigan.gov