ALL	IMA must take appropriate action on all changes, whether reported by the recipient or discovered through other means.    If further information is needed to verify changes that cannot be obtained by collateral telephone contact, the SSR shall notify the customer in writing of the following: ·         what information is needed ·         when the information is due (at least ten days from the date of the notice) ·         the consequences if the customer does not contact IMA.   If a customer does not provide the needed information, IMA must give timely and adequate notice of any adverse action.     Once sufficient information is received, the SSR shall take appropriate action on all changes within 10 days.   For situations where the change was discovered due to a computer matching program, see Section 5.5.1:Information Discovered Through Computer Matching in this Part.   For TANF and FS, if a redetermination results in a reduction or termination of benefits, the SSR shall review the case to see if an overpayment of TANF or an overissuance of FS occurred. The SSR shall take into consideration the reporting requirements the customer was subject to during the months under review.  If a recipient reports a change in a timely manner and the agency takes appropriate action within the next 10 days, there is no overpayment or overissuance.
MA	When a change is reported or is discovered by the agency that renders any member of the group ineligible, the SSR shall re-evaluate his/her eligibility under all other possible categories of Medical Assistance before terminating his/her eligibility.    Note that a newborn who has been deemed to be eligible for Medicaid remains eligible for one year following the month of birth as long as the mother remains eligible (or would have been eligible if she were still pregnant) and the newborn remains in the same household as the mother. Eligibility for the other group members must be redetermined for the remainder of the existing certification period.   Medicaid eligibility for a new member of a household other than a newborn shall start on the latest date of the following: the first day of the month when the report of the new member was made the first day of the month for which the new member meets eligibility requirements, if this is later than the month of the report if the new member is eligible for Medicaid in another jurisdiction, the first day of the first month following termination of Medicaid in the other jurisdiction. If information is received through a data exchange program (such as BENDEX, SDX, interstate computer matches) that could make a customer ineligible for Medicaid, the customer must be given 30 days to respond, clarify or present further information before action is taken by the agency.   If additional information is needed to document a proposed change, the customer must be given 30 days to provide the needed information.
TANF	When information regarding a change is received from any source other than the recipient, the SSR shall send written notice to the recipient that contains the following: the information that the agency has received an opportunity for the recipient to comment, take exception to or provide further information regarding the change At least 15 days for the recipient to provide clarifying information. The 15-day comment period is separate from the 15-day adverse action period.   Example Ms. Jackson receives TANF for herself and two children. The father of the two children, Mr. Williams, calls the SSR on June 2 and claims that the children actually live with Mr. Williams’ mother. The SSR sends a notice on June 3 to Ms. Jackson, telling her about the allegation and giving her until June 18 to provide any clarifying information. She does not contact the worker.  On June 19, the SSR takes action to close the TANF case and sends an adverse action notice to Ms. Jackson. The effective date of the closure will be August 1, the first day of the effective month after 15 days' notice.   When a customer reports a new member of his/her household (other than a newborn) and requests that the person be added to their TANF case, eligibility shall generally begin effective the date the person came into the TANF home, once eligibility for the person is established. However, in the following situations, a later date for initial eligibility may apply: If the new household member was eligible for TANF in another jurisdiction outside of the District, eligibility shall start on the first day of the first month following termination of TANF in the other jurisdiction. If the new household member creates an unemployed parent, two-parent family, the effective date of eligibility will start when the primary wage earner meets the time requirements for being unemployed/underemployed. The limitation on the time period for which supplemental payments may be given still applies (See Part VIII, Section 6.5: Underpayments.)
FS	The SSR shall take prompt action on all reported changes.  The timeframes for making changes depend on whether the change results in an increase to the allotment or a reduction to or termination of the allotment. These time frames are as follows: If the group is eligible for an increase in benefits because of a decrease in monthly income of more than $50 or the addition of group members, the change must be made for the monthly allotment following the report month. For other changes that will result in increases, the effective date of the change depends on the date that needed information is provided.  If no additional information is needed, or if the customer provides any needed information within 10 days of the SSR issuing a request, the SSR shall make the change effective no later than the first monthly allotment issued 10 days after the change is reported.   If the customer provides the needed information later than the 10-day request, the 10-day timeframe for action starts from the date the verification is provided rather than the date the report was received.   Example On June 25, Mr. Wallace reports to the agency that his hours have decreased at work, and his monthly earnings have decreased by $100. The agency contacts the employer and receives verification of the reduced wages on July 10. The decrease in income will be processed for the monthly allotment for August and an underissuance will be given to Mr. Wallace for the month of July.   Example On March 19, Ms. Patterson reports that she has moved and is now paying higher rent, which the SSR determines will increase her food stamp allotment. Although the change in address does not have to be verified until the next recertification, the SSR notifies Ms. Patterson in writing that she needs to provide proof of the change in rent within 10 days. She provides verification on March 23. Since this is within 10 days of the date she reported the change, the SSR processes the increase effective April 1.   Example On September 10, Ms. Mathers reports that she now pays for cooling costs since a window a/c unit has been placed in her unit. The SSR is unable to contact the building manager and notifies Ms. Mathers in writing that she needs to provide verification of the change within 10 days. Ms. Mathers provides a statement from the management company on September 30. Since this is longer than 10 days after the change was reported, the SSR will process the change for November, the first monthly allotment that will be issued 10 days after the verification was provided.   If a change results in a decrease in an allotment or termination of the allotment, the action shall be effective the first month that can be affected following timely and adequate notice.   If a change is submitted by a household on a Change Reporting Form, the agency will mail a replacement Change Report Form to the household.

INFORMATION DISCOVERED THROUGH COMPUTER MATCHING  5.5.1

Federal privacy laws set requirements on how agencies will act on information discovered through a computer matching program. Certain information regarding federal benefits is considered to be verified upon receipt through the computer match, such as Social Security Disability and Retirement and Supplemental Security Income, as well as Unemployment Benefits. Other information is required to be independently verified. This includes reports of unearned income received from the IRS and wages reported by state employment agencies.

ALL	The agency must independently verify needed information by contacting the household and/or the source of the income, resource, or benefit. If the agency chooses to contact the household for verification, it must be done in writing, informing the household of the information that has been received, and requesting that the household respond within 10 days. This notice is not the same as a notice of adverse action. The following information must be verified: the total income and/or total value of owned assets that the applicant/recipient has or did have access to the assets or income confirmation of the period of time when the applicant/recipient owned the asset or earned or received the income.
MA	When taking adverse action on the basis of information received through a computer matching program, notice must be sent to the recipient of the Agency's findings and proposed actions at least 30 days in advance of the effective date.
TANF	See FS
GC	See FS
FS	When taking adverse action on the basis of information received through a computer matching program, notice must be sent to the recipient of the Agency’s findings and proposed actions at least 15 days in advance of the effective date.

ADDING A NEWBORN  5.6

MA	AR :  The effective date for adding a newborn to an MA case is the date of birth if: The mother is eligible for and receiving MA on the date the child is born. The mother is determined retroactively to be eligible for the date the baby was born. This also applies to a child born to a non-qualified alien mother whose labor and delivery are covered by emergency Medicaid services. The newborn is deemed eligible for one year provided: The mother remains eligible or would have remained eligible if she were still pregnant. The child remains in the same household as the mother. The one-year period begins the month following the month of birth. If the child loses his/her deemed eligibility, his eligibility must be redetermined. A newborn who is deemed eligible is not subject to the citizenship verification requirement until the first recertification after the newborn turns one year old (See Part IV, Section 7.12.5: US Citizen or National.)   AX:  See AR   SR :  N/A   QM :  N/A
TANF	The effective date for adding a newborn to an existing TANF case is the date of birth. The date of birth establishes the effective date of eligibility, but the child may not be added to the grant until all factors of eligibility have been verified. Technical factors of eligibility (such as applying for a SSN) are considered to be met retroactively to the date of birth if the person cooperates with the Department when the verification is requested. However, no underpayment can be issued for more than 12 months of lost benefits (see Section 6.5: Underpayments in Part VIII).
GC	N/A
FS	The effective date for adding a newborn to an existing FS unit is the month following the month in which the birth was reported. If the change is reported too late for DHS to affect the normal issuance cycle for the following month, the SSR shall issue supplementary benefits to the household’s EBT card and provide an opportunity for the household to obtain the increase in benefits by the 10th day of the month following the month in which the birth was reported. Households that report the birth by completing the “Request to Add newborns to D.C. Medicaid, Public Assistance, and Food Stamps Rolls" form at a hospital will be considered to have reported the birth to IMA on the date the form is  signed.   If the newborn does not have a social-security number (SSN) and if the family has not already applied for an SSN, the SSR should instruct them on how do so, but should not delay in adding the newborn to the open food stamp case. A household has six months from the date of birth or six months from the last recertification— whichever is later—to apply for an SSN for a newborn. If the newborn has no SSN and the SSR does not know whether an application for an SSN has been filed (and, thus, has no SS-5 date), the SSR should enter a verification code of good cause (GC) on the SSDO screen.   Restoration of lost benefits shall be provided to the household if DHS fails to take timely action on a correctly reported change that increases the household’s benefits. Since the effective date for adding a newborn is the month following the month in which the birth is reported, no proration of FS benefits for the month in which the child is born or the month in which the birth was reported is permitted.   Example A mother completes and signs the hospital-generated request to add her newborn child to her case on March 13. The agency receives the form from the hospital on April 5th. The SSR will adjust EBT benefits to ensure benefits for the full month of April for the added member.    Example A mother completes and signs the hospital-generated request to add her newborn child to her case on June 15. The agency does not receive the form until August 10. The department will initiate restoration of lost benefits to ensure the child received food stamp benefits for the full months of July and August since the household reported the birth in June.