Department of Human Services: Chapter 4: Sections 4.1 thru 4.3
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IMA POLICY MANUAL
PART VIII: CASE MAINTENANCE
 
CHAPTER 4: RECERTIFICATION

INTRODUCTION 4.1
 
The time between initial eligibility and the date the SSR must review the case, or the time between required reviews is the certification period. The recertification process involves recipients providing updated information to have their program eligibility recertified or redetermined by IMA for additional periods of time that differ by program. The recertification process must be completed within set time frames. No FS group may participate in the FS program beyond the end of their certification period unless they submit a signed recertification and complete the recertification process. If they do not complete this process within thirty days of the end of their certification period, they must re-apply, unless the delay is due to agency failure to provide the group with an opportunity to recertify. For MA groups, the group may not participate beyond the end of their certification period without a recertification of eligibility unless the agency either fails to provide the group with an opportunity to recertify or is seeking additional information to complete a recertification.
 
MA recertifications are done by mail. However, if a customer meets with his/her SSR for another purpose, the SSR should encourage the customer to recertify MA eligibility at that time if the MA certification period ends within ninety days. Groups categorically eligible for Medicaid do not need to recertify MA eligibility (see Section 12.6: Termination of Categorical Eligibility in Part IV for policy on handling groups who have lost their categorical eligibility).
 
TANF and GC cases must be reviewed once every twelve months. However, benefits in these two programs do not expire if a redetermination is not scheduled prior to the end of the six-month period.

 
LEGAL AUTHORITY 4.2

Area/Topic District Federal
Recertification
 
 
 
 
 
 
 
TANF: D.C. Code 4-205.19a; 4-205.53
 
GC: See TANF and D.C.
Code 4-205.5a
 
 
 
 
MA: 42 CFR 435.916
FS: 7 USC 2012(c); 7 USC
2020(e) (4); 7 CFR 273.2 (f) (8); 273.14
 
 
 
 
 
 
NOTIFICATION OF RECERTIFICATION/REVIEW DATE 4.3
 
MA 
ACEDS will automatically generate a notice 90 days prior to the end of the current certification period. The notice includes the actual recertification form and informs the recipient that it is time to have his case recertified in order to determine continuing MA eligibility. MA recertifications are done by mail. However, if a customer meets with his/her SSR for another purpose during this 90-day period, the customer can (and should be encouraged to) recertify MA eligibility during the office visit. MA cases that are not recertified prior to the end of the current certification period will automatically be terminated by ACEDS.
TANF
For TANF recipients who do not receive FS, the SSR should generate Form A600, the Review Due Notice, at least 10 days prior to the appointment date to inform the recipient that it is time to have his/her case reviewed. Form A600 should indicate the following:
  • time and date his/her review has been scheduled
  • list of needed verifications
  • any adverse action that may be taken if the appointment is not kept.
Failure to attend the scheduled meeting and failure to provide requested information will result in TANF benefits being terminated.
 
For TANF recipients who do receive FS, the Food Stamp Recertification Notice sent by ACEDS informs recipients that their TANF benefits will be reviewed at the same time. When the recipient comes in for the FS recertification, the SSR will also initiate a TANF review. The SSR must give the recipient written notification of any additional information needed. In this situation, the SSR must give the recipient 10 days to return additional information before initiating any adverse action. If the recipient does not come for the FS recertification appointment and does not reschedule, the SSR will initiate action to terminate the TANF benefits after timely and adequate notice.
 
GC 
See TANF
 
FS
ACEDS will automatically generate a notice 60 days prior to the end of the certification period that will inform the recipient of the need to have her case recertified in order to determine ongoing eligibility. The notice gives the recipient a recertification appointment date and indicates that he/she can call to reschedule. The original appointment must be scheduled for a date at least 10 days prior to the end of the certification period. If a customer misses their appointment and calls to reschedule, they must be given a second appointment. This must be documented in the case record. FS cases that are not recertified prior to the end of the current certification period will automatically be terminated by ACEDS. An FS recipient may come in any time within 30 days after the termination of his/her certification period and still be treated as a recertification. However, if she does come in after the effective date of the termination, the benefits for the first month will be prorated from the date she recertifies, unless the failure to recertify is due to agency error. In that case, benefits will be given for the entire month once eligibility is recertified.
 
Mid-Certification Reports
 
In addition to the requirement for recertification, FS households certified for twelve months will be mailed a "Mid-Certification Report" form at the end of the fourth month of their twelve month certification period. Recipients must complete and return the form, along with verifications of changes in household circumstances. if the household fails to comply with this requirement by the end of the fifth month, FS benefits will be terminated effective the end of the sixth month of eligibility. Households who comply will continue to receive benefits, although the Agency will process changes reported by the household and will redetermine the level of benefits.
 
Interim Contact
 
In addition to the requirement for recertification, FS households certified for twenty-four months will be mailed an "interim Contact" notice at the end of the tenth month of their twenty-four month certification period. They must call or contact the Agency and must report any changes in their circumstances. If the household fails to comply with this requirement, FS benefits will be terminated. Households who comply will continue to receive benefits, although the Agency will process changes reported by the household and will redetermine the level of benefits.