ADC Transitional Medical Timeline

468-000-327

ADC grant client calls the case manager in early March to report that she has found a job. The case manager determines that the client is prospectively ineligible for the ADC grant to continue. The client has received or was financially eligible to receive a grant to which she was entitled in three of the previous six months. Following is a "timeline" illustrating Transitional Medical notice and reporting requirements.

Note: While earnings (and cost of child care as appropriate) must be reported on a quarterly basis completion and/or return of Form IM-QRF is NOT an eligibility requirement.

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August 10: The client is determined ineligible due to earnings. The case manager sends notice (Form DSS-78) advising the client that Transitional Medical begins effective 9/1. N-FOCUS sets the TMA Begin Date as 09/01.

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MONTH 1 - September; 1st month of TMA.

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MONTH 2 - October; 2nd month of TMA.

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MONTH 3 - November; 3rd month of TMA; on 15th of the month, the case manager sends Form DSS-78 with the lower portion completed and the Quarterly Report Form due by the 21st day of month 4.

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MONTH 4 - December; 4th month of TMA; quarterly report of earnings due by 21st. No action REQUIRED at this point if not received timely, but the case manager may wish to send a reminder to the client (see month 6).

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MONTH 5 - January; 5th month of TMA

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MONTH 6 - February; 6th month of TMA; on the 15th of the month, the case manager sends the Notice of Eligibility for Additional Transitional Assistance (Form EA-78) and IM-QRF due by 21st day of month 7.

Note: If the first quarter's earnings are received, the closure is lifted and TMA continues. If the first quarter's earnings are NOT RECEIVED, the case is closed for month 8.

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MONTH 7 - March; 7th month of TMA; quarterly report of earnings due by the 21st. The case manager has several possible options at this point:

Note: If the second quarter's earnings are received, the closure is lifted and TMA continues. If the second quarter's earnings are NOT received, the case is closed for month 9.

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MONTH 8 - April; 8th month of TMA

If the 1st quarter's report of earnings is received, the client may claim good cause. TMA is restored if the client has good cause.

If the 1st quarter's report is still NOT received, TMA remains closed.

Note: If the 2nd quarter's report is received, the closure is lifted and TMA continues. If the 2nd quarter's report is NOT received, the case is closed for month 9.

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MONTH 9 - May; 9th month of TMA; on the 15th of the month, the case manager sends Form EA-78 and third Form IM-QRF due by 21st day of month 10.

If the 2nd quarter's report of earnings is received, the client may claim good cause. TMA is restored if the client has good cause.

If the second quarter's report is NOT received, TMA remains closed.

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MONTH 10 - June; 10th month of TMA; 3rd quarter's report of earnings due by the 21st. The case manager has the same options as in month 7.

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MONTH 11 - July; 11th month of TMA

Note: If the third quarter's report is received, the suspension is lifted and TMA continues. If the third quarter's report is NOT RECEIVED, the TMA case is closed for month 12.

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MONTH 12 - August; 12th month of TMA.

At the end of month 12, the TMA case is to be closed. Eligibility for Medicaid (but not TMA) should be determined for all family members under ADC/Medically Needy, CMAP, or Kids Connection. The family cannot receive TMA again until they can meet the "3 of 6" grant test again.

Note: Any time TMA is terminated due to failure to return income and child care verification, before the children in the family may be closed, the case manager must first be certain that they are not covered under the Continued Eligibility provision.

{7/15/2003}