Department of Human Services: Chapter 1: Sections 1.1 thru 1.5

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IMA POLICY MANUAL
PART VIII: CASE MAINTENANCE

CHAPTER 1: CASE RECORD DOCUMENTATION STANDARDS

INTRODUCTION 1.1

The department is accountable for validating the information used to determine program eligibility. Case records provide written documentation of the actions taken by the Department and the reasons for those actions. The Department is accountable for maintaining accurate records.

Case records must contain the most recent application and recertification forms for each program and documents in support of the eligibility determination.

All program records should be labeled and retained in an organized fashion for audit and review purposes including:

Application, re-certification forms, and related documents;
Verification documentation submitted by the applicant/recipient;
Customer responses to agency actions;
Copies of correspondence with the applicant/recipient that are not ACEDS-generated;
Copies of all correspondence from the customer to the agency; and
Copies of fair hearing requests and fair hearing outcome documentation.

All agency case records should be uniformly organized (see Appendix C-2: Case Record Organization).

LEGAL AUTHORITY 1.2

AREA/TOPIC	DISTRICT	FEDERAL
Standard for Case Record Documentation	TANF: 29 DCMR 5803, 5820-5821 See TANF and D.C. Code 4-205-5a	MA: 42 CFR 431.17, 431.40, 435.913 7 USC 2020 (a); 7 CFR272.1 (f)

STANDARDS FOR CASE RECORD DOCUMENTATION 1.3

ALL

All eligibility criteria and clarifying information are documented on the Record of Case Action, Form 1052. The case record should speak for itself. An outside reviewer shall be able to follow the chronology of events in the case by reading the narrative. All application documents including verification and correspondence must be date-stamped. For working recipients, the record should include the dates pay is received and how often the recipient is paid. When the recipient’s statement is the best available source, the record should include both the applicant/recipient’s and the agency's efforts to verify the information. All address changes should be documented.

RETENTION OF DOCUMENTS 1.4

ALL

All case documents needed to document eligibility must be retained as long as the case remains open. Verification documents related to an overpayment must be retained until the overpayment is paid off or it is determined that no further action to obtain payment is appropriate.

RECEIPT OF VERIFICATION DOCUMENTS THAT CANNOT BE RETAINED OR COPIED 1.5

ALL

When an applicant/recipient provides verification documentation that cannot be retained or copied, the SSR must record in the case file the type of documentation that has been seen by the SSR to verify an eligibility criteria. The following information about such documentation should be recorded in the case file:

Date documentation seen,

Any title of the document,

Source of document,

Date on the document, and

content of the document that relates to the applicable eligibility criteria.

Example 1

Ms. Littlejohn has an appointment to meet with her assigned SSR to complete the application process. She only needs to provide the Department with verification of her daughter Liza's relationship. Ms. Littlejohn has an original copy of the birth certificate. The SSR discovers that the photocopier in the service center is broken. The SSR should record in the case file that s/he has seen a copy of the birth certificate, the date seen, and other pertinent information such as the serial number on the certificate, Liza's date of birth, and Liza's parents' names. Ms. Littlejohn is considered to have met the verification requirement once this information is properly documented in the case file.

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