15-100I.†††† TIME ON AID DETERMINATION PROCEDURES

 

Table of Contents

The Time on Aid (TOA) Determination Procedures section includes the following information:

 

Topic

Required TOA Determination Timeframes

TOA Evaluation Criteria Actions

TOA Extender Evaluation Actions

TOA Determination Actions

 

Required TOA Determination Timeframes

 

With implementation of the new CalWORKs 48-month time limit, effective July 1, 2011, TOA evaluations in San Diego County shall be conducted at the following timeframes:

       At the time of CalWORKs application (Intake), and

       At annual redetermination (RRR), and

      Effective 01/01/2012, between the 42nd and 46thmonth of CalWORKs aid, and

      At the time an aided adult is discontinued from an existing CalWORKs case [for whatever reason(s), except for death], and

      At the time an entire CalWORKs case is discontinued (for whatever reason), if a TOA determination was not completed within the previous 6 months [In these cases, all related calculations and documentation shall be imaged into the case file, however, no TOA-related correspondence shall be sent],and

       Upon client request, either verbally or in writing.

o  Note: If clientís TOA request also includes an exemption evaluation request, FRC staff shall complete evaluation and issue a response NOA within 15 calendar days from the date of the request, with certain exceptions, as outlined in CPG 15-100 J., Required Time on Aid (TOA) Determination Timeframes.

 

TOA Evaluation Criteria Actions

FRC staff shall take the following steps when reviewing/evaluating TOA:

 Step

Action

Review all periods of TOA exemption(s) for accuracy, including correct entries in all automated systems [CalWIN and TRAC (MEDS)]; and

Review all corresponding exemption documentation that supports exemptions that have been or are being applied; and

Review automated systems [CalWIN and TRAC (MEDS)] to ensure that correct TOA information is reflected in the adultís TOA history; and

Correct or amend any incorrect or inconsistent data contained in CalWIN or TRAC (MEDS);

 

Incorrect data may include:

         Duplicate records/entries on any of the TOA systems with the same social security number or

         Overlapping periods of CalWORKs receipt on multiple cases which would require resolution to determine the accurate TOA information; and

Complete an Exemption Calculation Grid, includingOverpayment data (if overpayment history exists), or update existing Grid, as a required part of the TOA determination; and

Ensure that related verifications are imaged as part of the electronic case file; and

Issue the appropriate TOA Notice of Action.

Document all actions in CalWIN Case Comments.

TOA Extender Evaluation Actions
 
 
 
 
 
 
 
 
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Human Service Specialists (HSS) are responsible for the application of the CalWORKs 48-month time limit time extenders.

The decision to extend the CalWORKs time limit is based on:

       Verifications obtained from the case record and/or

       Welfare-to-Work (WTW) historical information provided by an ECM, depending on the case situation.

 

At the time an adult recipient is approaching the 48-month CalWORKs lifetime time limit, and the case is active to WTW, FRC staff shall take the following actions:

 

Step

Action

The HSS shall send a CalWORKs Time Limit Extension/Exemption Case History Communication Form

(27-341 HHSA) to the assigned ECM.

The ECM shall:

         Review the WTW participation history of the adult, and

         Indicate if there are qualifying factors that may allow the HSS, when appropriate, to extend the CalWORKs time limit beyond 48 months, and

         Return the 27-341 HHSA extension form to the HSS, within 5 calendar days.

The HSS is responsible to evaluate those cases not active to WTW for the following extender criteria:

         60 years of age or older, or

         Providing in home care, or

         Disabled.

When the adult(s) in the AU meet one of the above criteria the HSS shall:

         Indicate on the 27-341 HHSA extension form which condition qualifies the individual for a time limit extension.

         Refer the individual to WTW only if the individual is able to participate in modified or limited WTW activities.

         The extension shall continue as long as the individual continues to meet the criteria.

When the HSS receives a 27-341 HHSA extension form from an ECM, the HSS shall:

         Conduct an evaluation of the information provided, and

         Determine if the extender criteria apply , and

         Indicate on the 27-341 HHSA form which extender condition is to be applied and the appropriate review date, and

         Return a copy of the 27-341 HHSA extension form to the ECM, within 10 calendar days as notification of whether to proceed with termination of WTW services or extend the WTW service/participation plan with the recipient until the determination review date.

The HSS must review the extension criteria before the end of the extension period, which is 6 months, or at recertification, whichever is later.

 

An exception is the short-term 30-day time limit extension to allow for a LD evaluation.

 

TOA Determination
Actions

The following shall be performed when a TOA determination isrequired:

 

 

Step

Action

 

 

         Review the imaged Exemption Calculation Grid /Time on Aid history in San Diego County) for complete aid history information including aid amounts.

         View case documents or request missing documents (including Subfiles, if needed) from Record Library

 

 

The individualís CalWIN and TRAC system records must be reviewed for comparison of TOA data.If there is no discrepancy in the number of months go to Step 5.

 

 

If a discrepancy is detected in Step 2*,

         Determine if months of CalWORKs aid receipt listed are correct by conducting a thorough review and analysis of CalWIN and TRAC history for consistency, accuracy and completeness.

         Consult with Supervising Human Services Specialist (SHSS), FRC designated TOA liaison, Automation Coordinator (AC) and/or Corrective Action Supervisor (CAS), as needed, in complex or confusing case situations.

         Document in case comments all TOA determination decisions.

 

 

If a discrepancy is detected in Step 2* and determined in Step 3 to reflect incorrect information, update all inconsistent, inaccurate or erroneous information in CalWIN and/or TRAC (MEDS).

 

Note: Only a MEDS Operator with sufficient access can update or correct the TRAC (MEDS) System. FRC staff shall submit a MEDS Network On-Line Request form (14-28 HHSA), outlining the needed correction/update(s), to their FRC Meds Operator for processing.

 

 

Review overpayment (O/P) history in CalWIN and TRAC (MEDS) to determine whether O/Ps are listed on the grid, the exact O/P amount that pertains to each TOA month, and whether the O/P has been repaid

 

 

Complete or update O/P Grid, as needed.

 

 

Complete Exemption Calculation Grid or update Grid if a recent Exemption Calculation Grid is in the case file (within last six months).

 

 

Update CalWIN and/or TRAC (MEDS) with any newly determined months to be exempted for Child Support Collection repayment or O/P recoupment.

 

 

Image all new TOA verifications and documentation. If prior TOA NOAs are not in the case file, the worker must recalculate time on aid exemptions before sending an updated NOA.

 

 

Issue the appropriate TOA Notice of Action with accurate time on aid information to applicant.

 

 

Document all TOA determination activities and outcomes in CalWIN case comments.

 

 
 

 

*Note: A difference in months on CalWORKs between CalWIN and TRAC (MEDS) can be due to aided months received in another California county that will cause the number of TRAC (MEDS) months to be correctly higher than indicated in CalWIN.