A TEA parent who goes to work can request the cash assistance case to be closed and still receive the Extended Support Services payments (i.e., the employment bonus and transportation payments) without verification of earnings. However, to continue to receive TEA Medicaid or move into Transitional Medicaid, verification of earnings has been required. It has been discovered that some TEA Medicaid cases are being closed, along with the TEA cash cases, due to the client failing to provide verification of earnings. Since the family is actually Medicaid eligible, either for TEA Medicaid or Transitional Medicaid, this procedure is resulting in families losing Medicaid eligibility when they should not.

To find a solution to this problem, we consulted with our federal Medicaid representatives and received an interpretation that should rectify this problem. Therefore, the purpose of this policy directive is to provide new procedures to accept the client’s declaration of earnings for Medicaid purposes when the TEA cash assistance case is closed due to employment.

OLD POLICY An individual’s earned income had to be verified in order for the family to move into Transitional Medicaid when the TEA cash assistance case closed due to employment.

NEW POLICY The client’s declaration of earnings will be accepted to determine continued Medicaid eligibility when the TEA cash assistance case closes due to employment.

Effective immediately, the procedures described below will be followed to determine a family’s continued Medicaid eligibility when the client reports employment to the TEA Family Support Specialist (FSS).

1. Ask the client about the employment (e.g., place of employment, number of hours the client will be working per week, wages, when they have or will receive their first check, and how often they will be paid). Written verification from the employer is preferable, but if no verification is provided, the client’s declaration will be accepted.
2. Based on information received, either by declaration or verification from the employer, the FSS will work a budget to determine if the family is still eligible for TEA Medicaid or should be moved into Transitional Medicaid. If the client does not know what the wages will be so that a budget can be worked, assume that the family is ineligible for TEA Medicaid and move them into Transitional Medicaid. In order to convert to a category 25 on the system, an earnings amount greater than the maximum allowed for the family size in TEA Medicaid must be entered.
3. If the family continues to be eligible for TEA Medicaid, at the next scheduled reevaluation, the FSS will verify earnings. If it is determined that the family is no longer eligible for TEA Medicaid, the FSS will determine when they first became ineligible for TEA Medicaid and start Transitional Medicaid in that month. Any quarterly reports due prior to this determination will be waived.
4. If the family has been converted to Transitional Medicaid, verification of earnings will be required at the first quarterly report. If the FSS determines that the family is still eligible for TEA Medicaid, the case will be converted back to TEA Medicaid.

These procedures are retroactive to July 1, 1999. Any cases closed due to the client not verifying earnings since July 1^st will be reopened as long as the county has a declaration, verbal or in writing, of the client's earnings. Counties may use the client's response on the TEA Job Retention Database letter to work a budget and reactivate coverage. If all eligible family members are already receiving Medicaid coverage under other categories, no action is necessary.

Inquiries to: Jack Tiner, 501-682-8259

Diana Teal, 501-682-1562

                    Carmen Brown, 501-682-8258

                    Lisa Mancieri, 501-682-8254