Spring into action! SDC Spring Build Medical Assistance, PEAK, and CCUG projects 1

For all March 2016 Build projects, please visit TrainColorado.com for more information. Courses > CBMS Build Training > March 2016 > March 2016 CBMS Build document 2

MA retro close/10-day noticing exceptions update 8601

Project 8601  Updates MA termination noticing functionality in CBMS to current policy

Change 1  Cases will close at the end of the month the change was authorized, rather than the month the change occurred, for:  Not in the home  Not requesting assistance  Whereabouts unknown  Not a Colorado resident

Change 1  10 day noticing does not apply to these cases  Changes authorized the last day of the month will close the case the last day of the following month  March 31 st closures are effective April 30th

Change 1  CBMS will not retro-close for:  Not in the home  Not requesting assistance  Whereabouts unknown  Not a Colorado resident

Scenario 1  Household moved out of state on 07/15/2015  The move was discovered on 2/22/2016  Change Authorized 2/22/2016

Scenario 1  MA Case closes 2/29/2016 (residency)  Med Spans end 2/29/2016

Scenario 2  Person A in a 3-person case leaves the home on 03/27/2016  Change is authorized 03/27/2016

Scenario 2  Person A’s termination date 03/31/2016  Person A’s Med Span Ends 03/31/2016  The rest of the household is re-evaluated for eligibility  10 day noticing would apply to them.

Change 2  MA coverage will terminate the actual date of change for:  Death  Incarceration

Change 2  10 day noticing does not apply  Med Spans close the actual date of change, even in past months

Scenario 1  Client passes away on 01/15/2016  Change is authorized 3/29/2016

Scenario 1  MA case closes 01/15/2016 (death)  Med Span ends 01/15/2016  Retro close is applied

Scenario 2  Person B in a 4-person household dies on 02/26/2016  Change is authorized 2/29/2016

Scenario 2  Person B’s termination date 02/26/2016  Person B’s Med Span ends 02/26/2016  The rest of the household is re-evaluated for eligibility  10 day noticing would apply to them.

18 Questions?

MA Appeals Updates 8605

 CBMS will override closures for continuing benefits related to pending appeals and appeal decisions

8605  Adds to existing MA appeals page in CBMS  Read only for eligibility sites  Improved continuing coverage documentation  Speed letter noticing when continuing coverage is approved

22 Questions?

Build 8991 MAGI Updates 23

24 Income For Ministers Housing Allowance For Ministers In-Kind Income For Ministers Newly added CBMS Fields Newly added PEAK Fields

25 Reminder Earned Income is considered compensation from a business including wages, salary, tips, commissions and bonuses. Self-Employment income is when an individual works for himself or herself instead of working for an employer who pays a salary or a wage.

26 The Employment History page has a newly added value for “MINISTER” under the occupation tab. Additi onal fields will open when Minister is selected.

27 Example As a minster the income would not be considered income from wages, salary, and tips. It would be considered self-employment income. Remember to select Minister as the occupation in the Employment History page.

28 Income For Ministers Housing Allowance For Ministers In-Kind Income For Ministers Newly added CBMS Fields Newly added PEAK Fields

29 Once “MINISTER” is selected as the occupation for the Member a NEW Housing Allowance for Minister field, will become enabled in the Income Received Page. This field will capture the Housing Allowance for the Minister. The Housing Allowance for Minister Compensation will be excluded as income for MAGI calculation.

30 Example: Self-Employed v. Employee Self-Employed Minister - If you have a minister who is self employed, the minister will not receive a housing allowance. Employed Minister- If you have a minister who is an employee, the minister could receive a housing allowance.

31 Income For Ministers Housing Allowance For Ministers In-Kind Income For Ministers Newly added CBMS Fields Newly added PEAK Fields

32 When Minister is selected in the Employment History page as the Occupation this new field will become enabled in the In-Kind Income page. “Is this income for Minister Compensation”? Yes or No In-Kind Income page

33 Income For Ministers Housing Allowance For Ministers In-Kind Income For Ministers Newly added CBMS Fields Newly added PEAK Fields

34 Annualized Earned Income The housing allowance payment will be excluded from the Annualized Earned Income and from the In-Kind Income MAGI calculation for Minister’s Compensation

35 Excluded Income for MAGI Both SSA Title II Payment and Railroad Retirement are exempt IF the individual is a Tax Dependent AND not required to file taxes regardless of age.

36 The Home Care Allowance Payment is exempt for Non-MAGI and MAGI if the individual is identified as “In The Home.” Excluded Income for MAGI

37 Non-MAGI- Minister Compensation including the portion that is not Housing Allowance will be considered income for Non-MAGI programs.

38 Capital Payments from Tribe such as:  Natural Resources  Usage Rights  Leases  Royalties Payments from Natural Resources such as:  Farming  Ranching  Fishing  Leases  Royalties Excluded Tribal Income for Non-MAGI and MAGI

39 Rental Income- Non-MAGI requires verification of rental income  EDBC will pend the Non-MAGI member who has rental income  The member will be given 10+5 business days to provide the verification  The member will be discontinued if the verification has not been received Non-MAGI Updates

40 Income For Ministers Housing Allowance For Ministers In-Kind Income For Ministers Newly added CBMS Fields Newly added PEAK Fields

41 PEAK Updates A Member applying via PEAK will now be asked whether the earned income is Minister Compensation. If the member answers YES, the member will be required to answer the question What portion is used for Housing Allowance. A Member applying via PEAK will now be asked whether the earned income is Minister Compensation. If the member answers YES, the member will be required to answer the question What portion is used for Housing Allowance.

42 PEAK Member’s will receive Gross Pay Instructions This will help clarify most questions about Gross Pay.

43 PEAK will display the annualized income without any deductions

44 PEAK Updates for American Indian or Alaska Native PEAK will display these NEW fields when American Indian or Alaska Native is selected as a race or when the member selects they are a member of a Federally Recognized Tribe.

45 Questions?

CCUG 46

Project CCUG ACP Special Indicator

48 Project 8850 Project 8850 will allow CBMS to accurately identify Address Confidentiality Program (ACP) status. The Case Special Indicators page will have a new Type of Special Indicator, “ACP”, and a new verification Source, “ACP Documents.”

49 ACP Background The Colorado Address Confidentiality Program provides survivors of domestic violence, sexual offenses or stalking/harassment with a way to shield them from being located through public records. ACP participants are provided with the ACP address and an individual apartment number to receive mail; mail received is forwarded to the ACP participant’s actual address. A maximum of two employees per eligibility site have access to ACP cases to comply with privacy requirements. Please view the Colorado Address Confidentiality Program Web Based Training located through the SDC website, TrainColorado.com, for more information about ACP. ACP 1001 East 62nd Ave. Apartment Number Denver CO 80216

50 The new ACP indicator will allow CBMS users to accurately identify ACP clients in CBMS. Previously there was no ACP choice and the case Type was inaccurately labeled “Employee Recipient” or “Employee Related”.

51 CBMS Changes In the Case Special Indicators page:  Type of Special Indicator is “ACP”  Verification Source is “ACP Documents” Note: The “ACP Documents” Verification Source shows only when “ACP” has been selected as the Special Indicator.

52 Entering the ACP Address in CBMS Additionally, after identifying the ACP client* using the approved procedure outlined in the ACP WBT you must enter:  Mailing Address  Home address  Apartment Number Current ACP address: 1001 East 62nd Ave. Apartment Number Denver CO *All ACP clients have an ACP card and County of Residency letter.

53 Where do ACP Participants Apply for Benefits? Although the ACP address is located in Adams County, applicants that are part of the ACP program apply in the county where they reside. ACP clients DO NOT apply in Adams County unless they actually live there. Example: ACP client living in El Paso County correctly applies for benefits in El Paso County, even though the ACP address is Adams County.

54 Links to ACP information listed below are located in the March 2016 Build Document* ACP Brochure ACP Website HCPF Agency Letter CDHS Agency Letter * SDC website: TrainColorado.com/Documents and Resources/Document Library/ CBMS/March 2016 Build More ACP Information

55 Questions?

PEAK Projects 56

Project HCPF Update Effective Begin Date Mapping for RMC

58 Project 8995 PEAK Report My Changes (RMC) will be updated to send the correct Effective Begin Dates to CBMS when a PEAK user submits a change via RMC. This project will accurately map the dates from PEAK to CBMS and ensure accurate eligibility determination. There is no policy change.

59 CBMS Pages Affected Effective Begin Dates will be correctly mapped to CBMS for following information:  Billing and Payment Records  Burial Asset information  Child/Spousal Income  Colorado Residency  Dependent Care Expenses  Disability Determination  Disposing of a resource  Employment History information  Financial Aid  Health Care Coverage  Household Relationships  Income Expenses  In-Kind Income  Insured Individuals  Language  Life Insurance information  Liquid Asset information  LTC institution information  Medical Conditions  Medical Expenses  Medicare Expenses  Medicare Part D Expenses  Phone Number  Real Property  Rental Income  Room and Board Income  Shelter Billing Expenses  Shelter Expense  Shelter Payment  Student Details  Unearned Income  Vehicle Details  Voluntary Striker Information  PEAKPro LTC Level of Care

60 What are the Correct Effective Begin Dates? For information on accurate Effective Begin Dates please reference Online Help in CBMS.

61 Questions?

Project Food Assistance Updates to PEAK Inbox Mapping

63 What is it? When a Change Report is entered into PEAK and contains an application for any new HLPG, it will now appear in the CBMS PEAK Inbox Search page as a initial application. The Application Type field and the App Type column will display the new type: “Change Reports-New Application”.

64 Why is this useful? This change will allow CBMS PEAK Inbox users to immediately identify a Change Report that contains a new application for any HLPG. In turn, it will help CBMS users to meet timely processing standards.

65 Questions?

Project HCPF PEAKPro Security Changes

67 What is it? Please note that while this project enhances current functionality in PEAKPro for Community Based Organizations (CBOs), a pilot program will be implemented in order to phase in the CBO process. With this project, the PEAKPro module update will allow CBOs to assist clients with:  creating accounts  starting and submitting applications  reporting changes on existing cases This functionality will be available for PEAK Accounts with Medical Assistance (MA) only and applications for MA only. If another non- MA program is added, the CBO access is revoked automatically.

68 Questions?

Project HCPF PEAKPro System and Reporting Changes

70 Department of Corrections Inmate Number field A Department of Corrections Inmate Number field will be added to PEAKPro for Department of Corrections (DOC) PEAKPro users so they can locate a record in PEAKPro by inmate number. CBMS users will see a new informational only field, DOC Inmate Number in the Conviction Parole Rehab page.

71 As an extension of previously deployed Project 7363, Single Entry Point (SEP) PEAKPro users will now be able to submit Level of Care (LOC) determinations for non-PEAK applicants [individuals who did not originally use the PEAK Apply For Benefits (AFB), Report My Changes (RMC), or RRR application]. When LOC Assessment Results are submitted by SEP users for a non-PEAK applicant, the results will be sent to CBMS. SEP PEAKPro Users, LOC Determinations, and Non-PEAK Applicants

72 What will the results be? 1. Existing case in CBMS and SEP submits an LOC Assessment via PEAK with the values in green below: Assessment results will be submitted as Change Report and uploaded automatically to CBMS with Real Time Eligibility (RTE). 2. All other LOC decisions: Sent to PEAK Inbox as Change Reports to be processed manually by the CBMS user. Values that support RTE LOC: Undetermined Decision: Pending Verification: Received Source: Self-Declared

73 Other PEAKPro changes  All PEAKPro users can:  upload documents to a specific case for all HLPGs  see all previously uploaded documents  PEAKPro users may generate the following monthly reports in PEAKPro showing application status, determination and type: PEAKPro DOC Monthly Report PEAKPro CBO Monthly Report PEAKPro SEP Monthly Report  PEAKPro security administrators at Agency and Program Area level may switch between inboxes within their organizational branch. Example 1: DOC administrator will be able to see different DOC PEAKPro IDs; they will not be able to see SEP or CBO inboxes. Example 2: HCPF Administrator will be able to toggle between all PEAKPro inboxes within the HCPF branch (SEP, DOC, CBO)

74 Questions?

Project Food Assistance Default to US Mail when E-Notification is Unavailable in PEAK

76 Paper Notifications This project will ensure that if the electronic correspondence (text or ) fails because of a service interruption, paper notifications will be automatically triggered so the household receives their correspondence timely. Note: When service is restored after a service interruption, the client will resume receiving E notifications.

77 Questions?

Project HCPF PEAK Medical Cards Request Updates

79 What’s Changed? The PEAK Medical Card Request process has been updated, and the card has been redesigned and renamed the Health First Colorado card. The Health First Colorado card request process in PEAK will be more user-friendly and reduce requests for mailed cards. Request process updates to PEAK:  Printing a card more prominent  Card requests may be made for more than one person at a time  All individuals’ cards display in single PDF when user clicks on View/Print Card  Request Reason field removed from PEAK and becomes optional in CBMS

80 Health First Colorado Card - English The Health First Colorado card will contain the new Health First Colorado logo to introduce the rebranding of the Colorado Medicaid Program.

81 The second page contains the same information printed in Spanish. Health First Colorado Card - Spanish

82 All new cards printed through PEAK after the March 2016 build will have the Health First Colorado logo. Mailed cards will continue to sport the old logo till the June 2016 build, when the rebranding will be fully implemented. Implementation

83 Questions?

Project HCPF PEAK Update MA Application (Add EPDST and Auth. Org.

85 PEAK Apply for Benefits (AFB) will now contain screening questions for special services, EPSDT (Early and Periodic Screening Diagnostic and Treatment) and Healthy Communities. This will align PEAK with the paper application, which already asks the questions. The questions will only appear if there are household members who meet the following criteria when applying for benefits:  Requesting Medical Assistance  Under 21 years of age  Pregnant New PEAK Screening Questions

86 The questions will appear in a special section on the PEAK application PDF. The PEAK Inbox will have an indicator when these questions have been answered and appear on the PDF. You will still fax the information to Healthy Communities, continuing with the current process for paper applications with the screening questions completed. PEAK PDF

87 Another part of the project is that applicants may choose an organization as their Authorized Representative for PEAK Medical Assistance applications. Changes to the CBMS Authorized Representative page:  Unknown Individual field renamed Unknown Individual/Authorized Organization  Organization text field added Authorized Organization

88 For MA-only applications the applicant can choose an Authorized Representative (Individual) OR Authorized Organization. Note: As is currently in place for CDHS programs, including MA-combo applications, more than one Authorized Representative (Individual) AND an Authorized Organization may be selected for the case. How Many?

89 Questions?

CBMS 90

Project CBMS SVES Interface Request and Response Changes

92 Implementation of project 9242 will begin receipt and posting of SVES data for National Prisoner Match and 40 Qualifying Quarters into CBMS to be in compliance with the SSA requirements for SVES. Those eligibility workers who pull this information will no longer have to access the SVES Mainframe to request and receive said information. New SVES Data Posting to CBMS

93 New columns on the Summary record:  Status Code  Status View SVES NPM Data Page-New Fields

94 New Request for Information button will print the Request for Information letter at the eligibility site for mailing to the client. The request will trigger one of two letters:  18 years of age or older at time of confinement: Request for Information for Facility Name  Under 18 years of age at time of confinement: Request for Information for Case Name for individual from the parent/caretaker guardian View SVES NPM Data Page-New Button

95 Changes to the View SVES 40 Quarters Data page:  New fields on the Summary record: Condition Code and Condition Description CBMS now sums all quarter data received from SSA and posts the data in the Detail record. SSA data will be listed by year; quarter-type income will no longer be populated. View SVES 40 Quarters Data Page

96 SVES Request Page Changes to the SVES Request page:  County and IM14 Sign Date fields removed CBMS will generate the IAR request from Benefit Issuance. Eligibility workers no longer need to manually enter an IAR request on the SVES Request page.

97 Questions?

For all March 2016 Build projects, please visit TrainColorado.com for more information. Courses > CBMS Build Training > March 2016 > March 2016 CBMS Build document 98