WIC Income Webcast 2013 September 26 2013 Presenters

WIC Income Webcast 2013 September 26, 2013 Presenters: Linda Dingerson, BSN, Policy Coordinator Terri Riemenschneider, MS, Eligibility PAL

2 Intake Policies… And revised polices Linda Dingerson, WIC Policy Coordinator

1. 10 Voter Registration Clients who request to register to vote must have photo ID If no photo ID, must sign an affidavit Acceptable NEW ! Photo IDs: Driver’s license/State/Federal ID Current U. S. passport Current student ID Military ID Tribal ID card 3

1. 10 Voter Registration NEW ! � Affidavit of Voter not in Possession of Picture ID � Available through E-forms � Arabic and Spanish translations available on the MDCH/WIC website at: www. michigan. gov/wic � Attach affidavit to VR Application and send to clerk 4

5 1. 10 Voter Registration “If you are not registered to vote where you live now, would you like to apply to register to vote here today? ” � Ask the client at each: Certification/recertification When the client changes address

6 1. 10 Voter Registration Give “Declination” (top) portion of form for signature if response is: No, registered at present address Under age 18 Give Voter Registration application if response is: Yes Address change and client wants to register � Address changes over the phone: � Mail the Voter Registration application-OR� Direct the client to the SOS website at: www. michigan. gov/vote

7 � Voter Registration posters are available for clinic use � Order on E-forms

8 1. 03 Confidentiality Any information about an applicant or client that individually identifies an Applicant Client, and/or Family member Restrict use and disclosure of information to: WIC employees who need to know

9 Maintaining confidentiality �Insure Sign Privacy in sheets Income determination Anthropometric and laboratory procedures Print Docs Restrict Access to Client Record Diminish screens or log off Notes and Alerts Saving/Printing Reports

10 Sharing Client Information Memoranda of Understanding (MOU) Immunization MDCH Lead Program MIHP Head Start Dept. of Ed (CSFP) Release of Information Sharing Appointment Lists MOU WIC Client is also client of health center

11 2. 01 Eligibility/Certification of Clients � Overview of certification policies � Clients who meet income, residency and categorical eligibility are presumptively eligible. Use the Short Certification process if a proof is missing

12 2. 02 Residency � Proof of residency required at: � Enrollment Each certification Transfer certification if client did not bring proof NO Proof required for: � Short � Homeless Migrant Transfers who have a VOC Someone who has recently moved into area Victim of theft, loss or disaster These clients sign an Attestation form

13 2. 03 Identity Proof required: For NEW clients only, at initial certification or transfer For authorized person/proxy, at benefit pickup, each certification and transfer NO Proof required for: Homeless Migrant Victim of theft, loss or disaster These clients sign an Attestation form Personal recognition by staff allowed once proof has been established

Proofs - How Do I Know What I Need to Do?

2. 04 Income Policy Revision – reflects new guidance from USDA Current income Previous 30 days unless. . Current income has changed such as laid off/ unemployment Then project next 30 days Source of income Recent paycheck or stub Can be electronic or by phone W-2 and current 1040 tax form filed “Per Cap”-payment include as income

2. 04 Income Policy Revision – reflects new guidance from USDA IEVAL & CEVAL No income determination Review Family info screen and verify current information If new address, complete voter registration/declination If other family members are certified today and over income, then terminate all family members unless adjunctively eligible

2. 04 Income Policy Revision – reflects new guidance from USDA Migrant families Determine income once every 12 months, even if not currently certified Use VOC information to determine last income date

2. 04 Income Policy Revision – reflects new guidance from USDA Verification Public of income assistance (FAP/SNAP, FIP, Medicaid) Verbal declaration of other income after verification of current eligibility VERIFY Verify one adjunct program Medicaid using MI-WIC adjunct eligibility verification (BEST-Infant Verify or PG-makes whole family adjunctively eligible) FIP/FAP using phone or online verification system Unemployment benefit-use notice or myaccount. chase. com or 1 -866 -523 -2122

19 2. 06 Adjunct Income Eligibility � Client receives: FIP (Cash Assistance) Medicaid/Healthy Kid’s Program/ Plan First MOMS � Member of a family that: Receives SNAP (Food Stamps) Receives FIP Contains Pregnant Woman or Infant receiving Medicaid � Client is enrolled in one of these programs that has determined their income to be less than 185% poverty level Children’s Special Health Care Services Family Planning MIChild Other State or Federally funded programs that have determined income eligibility(free or reduced lunch)

20 What if client is adjunctively eligible? FAST LANE �Verbal statement of income allowed �No other “proofs” are required 90

21 2. 08 Family Size Income eligibility based on Total Family Size Include: Unborn child(ren) Adopted child(ren) How ma the ho ny people this in usehold do in come e suppo s rt? Special Considerations Resident of Institution or group home Family living in homeless shelter, group residence Foster child – Family of one

2. 04 Income Determination Use current income guidelines (May 17, 2013) for clients paid only weekly, biweekly, semimonthly or monthly If reported income is in multiple, varying intervals, use annual income guideline 22

23 2. 04 Income Determination � Based on client/applicant’s family size and income � If client has proof but did not bring to appointment Short Certification (30 days)

24 2. 04 Income Determination Self Declaration � Self-declaration (verbal statement) is allowed for: Clients who are adjunctively eligible Homeless clients Migrant workers Family works for cash � Attestation form signature required if not adjunctively eligible � NO proof of income is required in these cases

2. 04 Income Determination Variations Transfers with current certification – no income determination until next certification Migrants – once every 12 months If VOC is expired but shows income determination in last 12 months, don’t assess income Clients who report NO income Ask questions that popup when $0 is entered in grid row and Saved Client signs Client Agreement – NO attestation form required 25

26 2. 04 Income Determination 2. 04 A Military Pay What DOES count: Base pay Basic Allowance for Subsistence (BAS) Foreign Language Pay (FLPP) Family Separation Allowance (FSA) Jump Pay, Dive Pay, Sea Pay, Flight Pay Continental United States Cost of Living Allowance (CONUS COLA) May Income Average: Clothing Maintenance Allowance (CMA) Bonus Pay (Bonus) Special Pay � What DOES NOT count: Basic Allowance for Housing (BAH or BAQ) Family Separation Housing (FSH) Family Subsistence Supplemental Allowance (FSSA) Overseas Housing Allowance (OHA) • Overseas Continental United States Cost of Living Allowance (OCONUS COLA or COLA) Combat Duty or Combat Zone Pay

27 2. 21 Mid-Cert Income Determination � IF you learn that the client’s income has changed, AND: The client is NOT adjunctively eligible The client has more than 90 days left in the certification period THEN, use current income to determine continued eligibility � If terminating client, use Termination Reason “No Longer Eligible” and issue benefits as system allows

28 2. 10 Proof of Pregnancy Any woman who claims to be pregnant is eligible if income, residency and identity are confirmed. If NO Proof Short Certification 60 days Clients may be enrolled after miscarriage as NPP IF proof of pregnancy or miscarriage was provided

29 2. 09 Physical Presence Exceptions � Medical condition that requires medical equipment not easily transported � Medical condition that requires bed rest � Serious illness that may be worsened by coming into WIC clinic � Infants age under 8 weeks of � Visit presents a barrier if client present at initial cert and has documented health care � Parent/caretaker work status presents barrier if client present within last year � Clients visited and screened at home or in another program – (all elements of certification must be completed)

30 2. 20 Ineligibility Notices Written notice is required when client is: Ineligible at certification Terminated at mid-cert for income ineligibility Sanctioned, suspended or disqualified A breastfeeding woman who discontinues breastfeeding after 6 months Written notice must include client’s right to fair hearing

1. 09 Civil Rights New non-discrimination statement If full statement used on publication before, must be used on reprints New Discrimination Complaint Form Available on MDCH/WIC website under 1. 09 policy 31

32 Questions

Now let’s look at the MI-WIC Process that supports these policies… Terri Riemenschneider, Eligibility Policy PAL 33

Family Information Screen � Family Information – Accurate-ask client to give address (including zip!) and phone and verify – Cell # helpful as we are offering TEXT Reminder notices �Prefer �Cell phone �√ text message – Collect e-mail address – SAVE 34

Adjunct Eligibility/Income Info Tab • If PG or IBE, IBP or IFF has current Medicaid, makes entire family income eligible • If C 1, C 2, C 3, C 4 has Medicaid, that client is income eligible • VERIFY Medicaid by clicking on Verify button, insert Medicaid ID# • System should check “adjunct checkmark” if Medicaid eligibility is verified • Record if client/family participates in Food Stamp/SNAP or FIP programs 35

Adjunct Eligibility on Income Info Screen Start with Adjunct Eligibility Report participation • Medicaid • Food Stamps • FIP/TANF Search for Medicaid ID • CHAMPS • MI Health Only VERIFY one program use PG or Infant 36

Verify Current Medicaid • Click Yes for REP and √ VER (verify) • The Medicaid Verify Adjunct Eligibility box will appear • Input the Medicaid ID if not already shown • Click verify • Confirm verification • Adjunct √ 37

Medicaid Verification • A pop-up will let you know if Verified Successfully or Not Found in RID. • If verified, click OK • A pop-up will ask if want to confirm the verification, click Yes 38

Adjunct Eligibility • Note Adjunct Eligibility • Record Food stamps or FIP enrollment • Or check if family not participating in programs • Close 39

Medicaid Verification-MI Health Plan Benefit How to FIND Medicaid ID Input identifiers System searches and provides results Medicaid Active and ID # 40

Information on How to enroll on MI Health Plan Benefit • WIC E-Notice # 2012101: MI Health Benefit Plan Medicaid Eligibility Verification Rejections & Update.

Medicaid Verification • CHAMPS – Apply through SSO – Allows verification of Medicaid, lookup by name, date of birth 42

CHAMPS Training • • • MDCH is excited to announce that Web Based Trainings (WBT) are now available for Providers. These trainings will allow providers to use interactive learning tools to complete CHAMPS training courses. These courses are not required; however, they are an excellent resource for gaining knowledge and understanding on the use of CHAMPS. To access these courses you must have access to Internet Explorer and follow the steps below. Access the site at http: //learning. mihealth. org/SOLO/

CHAMPS- MEMBER SEARCH Search by: • Last Name • First Name • Date of Birth Submit 44

CHAMPS- MEMBER SEARCH 45

CHAMPS- Quick Reference Medicaid ID http: //www. michigan. gov/documents/mdch/Eligibility_Quick_R eference_291964_7. pdf 46

Medicaid Verification MCIR General Information Screen • If client has active Medicaid, Health Plan name will be displayed Blue Cross MI 47

Adjunct Eligibility… DHS Bridge Card - 1 -888 -678 -8914 • Verify Food Stamps (FAP/SNAP) or FIP (TANF) – Call Customer Service # on back of card 1 -888 -678 -8914 – Select deposit inquiry #5 – Listen for DEPOSIT information for this month – Record last 9 digits of DHS Bridge Card in FS or FIP pop up screen • MI-WIC Adjunct Documentation – Document as YES in MI-WIC Adjunct Screen – Verify-insert family # MI Bridges-client can check benefit status www. michigan. gov/mibridges 48

WHY Verify Adjunct Eligibility? ? ? • Verified Medicaid= Residency Income verified ID if have Medicaid card • Client adjunctively eligible-may make others in family adjunctively eligible – Infant or Pregnant woman with Medicaid makes all eligible – Child with Medicaid, only self • Family with Active Food stamps or FIP - all eligible in family 49

Income Information Screen • Verify Family size • Update “expected infants” if PG • Update family size if adding infant • Record sources of income for family • Can “reuse” income line if applies or remove and add row • Self Declare source of income if adjunctively eligible or “migrant, homeless or works for cash” 50

• Verify family size Income Information Record expected infants = Family size + # of infants • Record Income – Verification: self declared • Adjunct eligible • No income $0 • Works for cash – Otherwise must review paystub or other income documentation 51

Income Info Year To Date Calculation • Useful when income is variable • Select last pay date • Input pay YTD • Record calculated income 52

Income Info Hourly Calculation • Select Hourly interval • Record amount of pay • Record number of hours/week • Record Verification • System calculates annual income 53

Income Information Screen - Foster • Foster designation – Select Foster Child on screen – Record Foster stipend amount for income – All Foster children have Medicaid eligibility – ALWAYS family size of 1 Can include PG woman-include the number of expected infants 54

Foster Child • Click Foster Child • Select child from dropdown • Click Go 55

Foster Child • Family size 1 – Can record # of Expected infants if PG • Complete income grid with foster stipend amount • Save 56

Family Additional Information • Language-notices in Arabic, English or Spanish • Proof of Residency-Medicaid or other proof • Voter Registration ASK “Would you like to update your voter registration? ” – YES - Complete Voter Registration Form – NO - Sign Declination form – Under 18 -Not eligible to register • Pickup Interval-Defaults to 3 months • Referred From: Note program that informed client of WIC • Special Needs: Note if client has special needs • Proof of Auth Person ID-Complete at initial visit ONLY or when Auth Person changes 57

Additional Information Tab Record • Primary Language Verify • Proof of Residency • Proof of Auth Person’s ID Designate • Migrant • Homeless Complete • Voter Registration or Voter Declination form 58

Client Agreement • Click on Client Agreement after client has reviewed hard copy of document • Obtain signature on Client Agreement each cert/recert • Close (takes you back to Household Summary Screen) CAN ALSO Obtain signature by Miscellaneous/Signature/ WIC Client Agreement 59

Client Agreement. EACH CERT/RECERT • Ask Authorized Person to read Client Agreement or read it to them • Ask if any questions… • Complete client agreement – Copy to client at initial MIWIC cert, offer thereafter • No Client Agreement needed at IEVAL and CEVAL Wanda Wick 60

• Client Information Tab • Client Name • Proof of ID (Initial cert ONLY) • Proof of Pregnancy • Education Level • Marital Status • REASON for Ineligibility. Complete ONLY when determined ineligible Client Information Screen • Additional Information tab • Record/verify race/ethnicity 61

Cert Action Screen • Cert Action – Cert recert • If short cert, leave message in notes…update note & remove termination date when proof provided – Category change button • System will calculate cert end date based on category selected – Termination Reason/date • If Terminating, place reason for term in grid, system will automatically calculate termination date based on the reason 62

Cert Action – Infant or Child • Add row for cert period 63

Cert Action Screen- PG • Add a row • Add the LMP or EDD • System calculates Cert End Date • Validates if pregnant woman • System checks to ensure that # of expected infants is more than zero if PG 64

Cert Action Screen-Short Cert • If short cert, leave message in notes… When clients bring information… Remove term reason and date when proof provided & update note 65

Category Change • Select new category • Align BE/IBE BP/IBP NPP/IFF • Suggest change mom first then infant 66

Cert Action Screen-Termination • Input term reason • System calculates term date • If d/c breastfeeding update BF stats on Infant record IF IBE or IBP to IFF, make sure to term mom! Remember, her recert date is 1 year post partum and she will remain on if not terminated! 67

• Ineligibility Client Information Screen – Complete reason for ineligibility • If determined overincome, record income on income determination screen. • Print Ineligibility notice 68

Print Ineligibility Notice Print docs • Select ineligibility notice – Must have reason for ineligibility documented on Client Info screen • Notice recorded in Miscellaneous – Communications 69

Benefit Issuance & Print Docs… • Benefit Issuance • Schedule next visit • Ask client day & time • preferred • Print Docs • • NE Plan VOC (signed) Shopping List Client Agreement • Provide if new client • Offer if ongoing client • Vendor Listing • If new or offer to ongoing client 70

Print Docs • Ineligibility – Ineligibility notice with Fair Hearing notice-must complete Reason for Ineligibility on Client Information screen • Attestation of Identity, Income or Residency – Copy of signed document to client upon request • Short Certification – Short certification notice – Lists proof needed by what date Ineligibility Notice 71

Communications Screens • Records print docs in family/client record 72

Precert screen…add new enrollee • Add a row in the applicant fields • Add the new client’s information and save 73

Dual Enrollment Pop-up New enrollees only 74

Remove dual enrollee row to prevent dual enrollment 75

NO dual enrollment… • Or Click Cancel to stop record creation 76

Resolve Dual Enrollment-WIC • Print Dual Enrollment report to research listings • Select “Miscellaneous” • Select Resolve Dual Enrollment • Select client from dropdown • Determine if duplicate or dual enrollee or different client • Select resolution – Note if needed Block Keep Not same client Investigate 77 Other

WIC/WIC Dual Enrollment Report clinic/reports/participation/WIC dual enrollment Report lists clients when the following matches • First 4 letters of last name and first name • Same date of birth • Same gender

Resolve Dual Enrollment. WIC/Focus: HOPE-CSFP • MUST RESOLVE BEFORE WIC CERTIFICATION! • Resolve within 45 days of identification • Determine if client wants CSFP, WIC or is not same person • Select resolution • If CSFP in area, check every 6 months for dual enrollment 79

WIC/CSFP (Focus: HOPE) Dual Enrollment Report Clinic/reports/participation/WIC -CSFP Dual enrollment

Questions?

Break

Answers

Special Circumstances… Military pay Unemployment Overtime Adoption Foster Children’s special health care services • Self employed • Teen • Immigrant • • • Works for cash Over income Income guidelines Medicaid Other 84

Military pay Client had Coast Guard pay stub, total was over income. • Staff should review 2. 04 A for allowed and not allowed pay • Client was determined to be income eligible when BAH and FSH were not included – Basic Allowance for Housing (BAH or BAQ) – Family Separation Housing (FSH) 85

Military Pay What DOES NOT count: Basic Allowance for Housing (BAH or BAQ) Family Separation Housing (FSH) Family Subsistence Supplemental Allowance (FSSA) Overseas Housing Allowance (OHA) Overseas Continental United States Cost of Living Allowance (OCONUS COLA) Combat Duty or Zone Pay Hardship Duty, Parachute, Flight Deck, Demolition, Experimental Stress, Toxic Fuel, Dangerous Virus, Chemical Munitions, Maritime Visit, Polar Flight… Exhibit 2. 04 A 86

Military Pay • Client with military pay stub from December 2013 - can I take YTD? Outcome • More accurate-should look at past 30 days income/pay (with military exemptions-Policy 2. 04 A) • Can ask for electronic pay stub to verify current income

Unemployment How to verify Unemployment? • Unemployment benefits now direct deposit to bank account or debit card • Clients receive “Notice of Determination” letter, which should state amount of benefits • Clients can contact CHASE customer service at 1 -866 -523 -2122 to determine current benefits. 88

Adoption subsidy • Caller wants to know if adoption subsidy is to be included in the household income for eligibility. Outcome • Yes. There is no stipulation in regulation/policy for excluding it.

Adoption-Family Size Family has 2 foster children and one adopted child, what is the family size? • Mark “foster” on foster children’s client information screen (family size for each foster ALWAYS = 1) • Document family size of 2 parents + 1 adopted child=3 NOTE: • Adopted children are considered members of the family and the family’s income supports them. 90

Adoption Infant has just been adopted by family that is over income. Adoption agency has told family that infant will be on Medicaid, but won’t receive card for a couple of weeks. Can we enroll? • Need verification of pending Medicaid • Search MI-Benefit or CHAMPS for ID# NOTE: • Some children are provided Medicaid, even after adoption. • If the family is in the process of adoption, the child may be considered a “ward of the state” and have Medicaid coverage. 91

Foster Siblings • Has client with 2 foster children who are siblings. Are they a family of one or two? Outcome • Each foster child is a family size of one.

Foster Child Income Verification Having problems entering income for a foster child. Keeps getting a pop-up that says income has not been verified today • Make sure foster child is selected on both client information screen and then on income screen • Input foster stipend amount for child’s income 93

Foster dad • New foster dad - having problems getting him in as Authorized Person. Outcome If Foster child moving into new Foster family… • Create new family with Dad as Auth Person • Transfer foster child into Dad’s family using participant transfer • Train dad on use of benefits, issue EBT card & benefits for child

Create new family for Client Transfer 1. Search statewide for Authorized Person 2. If found, update address and proxy information, if new create new family 3. Keep FAMILY level in active record 4. Search statewide for client 5. Select client and click Transfer 6. Client displays in Foster family, click on “Foster”�

Foster Stipend Pregnant woman applying for WIC. She has two foster children living with her. Do we count the foster stipend as part of her income? • Each foster child is considered their own household. Exclude the children and their stipends from the applicant's income calculation. 96

Foster child • The foster child is adjunctively eligible with Medicaid Family is over income but have a – Report monthly stipend as foster child with Medicaid. The income family is adopting the foster • Other children in family are not child, but the adoption is not eligible at this time yet final. – If infant adopted with Medicaid, other children eligible – If child adopted without Medicaid, other children not eligible 97

CPS wants info from WIC… • Child Protective Services (CPS) wanted information for a neglect case, as asking if WIC information such as WIC clinic and appointment information be provided? Outcome • Verified that client information can be released to CPS per MI-WIC Policy 1. 03 • You could provide a copy of screen shots with Appointment History

Foster Child Benefits Agency called to ask when foster child transfers, do benefits go with child? • No, client will need benefits loaded to new family’s account • If possible, void future benefits before transferring client to new family 99

Foster Child - Blocked Foster child is blocked in MI-WIC due to Dual Enrollment. Help! • Child was previously enrolled as foster child under different family number and authorized person. • Select the most current record • Transfer current enrollee into foster family 100

Children’s Special Health Care Services Had quads born at 23 weeks, one died and others with handicaps. Now almost 2 years old. Medicaid has been dropped. Children have CSHCS, does this make them eligible? • No, CSHCS can use WIC for income eligibility, but WIC can only use CSHCS if income is calculated at or below 185% of poverty 101

Self employed • Determine income based on available evidence/information • Tax document probably best if not receiving pay check regularly • 1040 form can be used for income documentation until the next 1040 is filed 102

Overtime We have a client whose hourly wage qualifies for WIC but their YTD is over because he frequently works overtime. Which are we supposed to go by? YTD is at $40, 000 now, so it will calculate higher than the max of $51, 005 for a family of 5. Not sure how we should handle this. Options to accurately calculate income: • YTD calculates annual pay to reflect overtime and straight pay from current pay stubs • Most current 1040 income tax form 103

“Per Cap” payments to Tribal members • Are “Per Cap” payments • Per capita payments are income? provided to some tribal members from Casino profits • This is considered income for the family • May be annualized if paid on a quarterly basis

Teen Mother called regarding pregnant daughter eligibility. Parents are supporting and providing insurance to cover pregnancy. Family of 5 (with unborn), parents both work. • Suggest referral to Medicaid/Healthy Kids to cover co-pays and ensure coverage of infant when born (thereby adjunct eligible) 105

Immigrant Pregnant woman • Yes, client is eligible based applicant eligible for on Income, PG and Emergency Medicaid due to immigrant status. • WIC does NOT consider Client has ID, proof of immigration status for residency and eligibility appropriate income. Is • WIC enrollment does NOT she WIC eligible? affect immigration status in terms of government support as WIC is a NUTRITION Program 106

Works for cash Client works for cash, doesn’t have proof of income or Medicaid. What to do? • Verify that client does not have Medicaid (MI-Health Plan or CHAMPS) • Document client’s income type as gross wages, verification is self declared • Sign attestation formexplaining why no proof of income exists 107

Over income-on Medicaid C 1 client in family has Medicaid, C 2 does not, family over income. Does C 2 qualify if over income? • C 1 client IS adjunctively eligible • C 2 client NOT eligible/over income 108

Self Employed/Farm Income Had a client whose husband is self-employed farmer and she works. Wants to know how to calculate the income, based on the Schedule C and the 1040, and W-2. • Policy indicates that you use the net income on the Schedule C for husband and, which show loss and gain and then use the wife’s reported income (W-2). 109

Joint Custody… Mother is authorized person and is not picking up benefits. Dad called, says he has joint custody, but no paperwork. He wants WIC card. What can we do? • Contact mother to ask if Authorized person can be changed to allow benefits to be issued. • If client is no longer enrolled, Dad could apply on child’s behalf. • There is NO MDCH/WIC policy regarding who can be Auth. Person or how to change, so it is up to the agency to establish procedure. Just be sure that 110 client is not dually enrolled.

Transfer-Short stay Took call from woman who says she is on WIC in another state. She is coming to visit in Michigan for a month before leaving with her husband to go to new base in Japan. Wants her WIC benefits in Michigan for the month. How do we handle her? • Treat her as any other transfer-Require same proofs of residency (can attest), etc. and VOC information from other state. • Issue only one month of benefits at that time. 111

Transfer – Release of Information What information should be released in a transfer? • Required information includes: – Verification of Certification (VOC) signed • Optional information: – Client Information Report – Medical Documentation Form 112

Moved out of state How to document ineligibility when notified that client moved out of state? • Cert Action Screen- Document Term reason, term date is auto displayed. This will remove future benefits. • Place note in client’s record as to who called regarding transfer and what information was provided. • Client has already moved, so don’t need to generate termination notice. 113

Present or Not Present Has a mom who is refusing to bring the baby in for newborn cert because of mom’s C-section, and staff wanted to know was that ok without a Dr's note. • Allowable - note reason for not present • Need birth data/verification • Could also have proxy bring infant 114

Physical Presence? Full term adjusted age infant discharged from NICU with doctor’s note that infant cannot leave home. Can LA certify without physical presence? • Yes, can certify using hospital discharge information noting reason for not present on Cert Action screen 115

Custody & Eligibility Mom was on WIC when pregnant, now on as post partum, but lost custody of her infant. Can she still remain on WIC as an NPP? • Yes 116

“Frozen” EBT • Client complains that even after receiving new card from ACS the card doesn’t work • If client is INACTIVE in EPPIC, card must be issued OVER THE COUNTER at the agency 117

PG woman with infant on Medicaid • PG reports no income but living with family that provides immediate needs. Has 9 month old infant currently receiving Medicaid. Can I document 'no income‘? Outcome • Yes, can document for this certification because the PG mom is adjunctively eligible due to infant receiving Medicaid.

Medicaid Verification • Mom does not have Medicaid card with her but number is in the system, do we short cert until she brings in the card? Outcome • Verify that the Medicaid number is active using the Adjunct Eligibility screen and take a verbal income, no short cert is needed – Medicaid verifies income – Medicaid verifies residency (in Michigan) – Identity was confirmed at previous certification

16 year old mom • 16 year old mom enrolling new baby, grandmother has Medicaid case & another child on WIC. Do we have to make separate WIC account or can she have 2 children from different moms on one EBT acct? Outcome • Can be separate or together. • If in same "family" wichealth. org would apply to both and benefits would be aligned if gma is the shopper-mom could be proxy with own card. • If the 16 year old decides to take Authorized person status, just create new family and do participant transfers.

Siblings have Medicaid • Triplets being seen in office today, only 2 have Medicaid. What should be done about the 3 rd on without Medicaid (can they certify)? (MMCAA) Outcome • If infants, others with Medicaid will make 3 rd adjunctively eligible • If C 1 -C 4, family income must be determined

Mom in Jail • Grandma is proxy, mom is in jail. Mom & infant are on the program. Grandma is trying to get guardianship. Can she have a card issued to her? If mom is in jail, do not issue her benefits correct? Outcome • Grandma can be issued a second card as a proxy. – If grandma gets custody suggest they create a family record with her as authorized person and transfer infant in. – No benefits should be issued for mom if she is in jail. Mom is eligible to get her benefits when out of jail.

Not Present for Certification… • Could you cert a mother who had recently delivered, no prior WIC activity, but who's culture (Asian) required her to stay home for 30 days. Outcome • Could certify the infant-with hospital birth information or by coming to the clinic • Could certify mom with hospital information or by home visit of WIC qualified staff, document why not present

What if I forget how… HELP Help screens • Select HELP • Type topic in search box, ENTER • Will provide list of materials in HELP for that topic 124

What if I forget how… HELP • System HELP and Du. Jour 1 -800 -WIC-1636 • • Press 1 and 1 for 3 Sigma for problem with system Press 1 and 2 for WIC Consultant Du. Jour – policy Press 1 and 3 for SSO/Tech Support Press 1 and 4 for WIC Operations – EBT 125

MI-WIC Release Process • System changes still occurring – December 12, 2013 Release 5. 6 –NO MI-WIC after 5 pm to allow for testing time 126

Wichealth. org • Client inquires if she can complete interim NE on line vs. having to visit the clinic. Asks about how soon completed lesson verification will be posted. Client aware that agency accepts wichealth. org, which client has completed in past. Outcome • Client notes that she has found more assistance in Michigan than she did in IN where she previously lived. Client informed that her verification of wichealth. org lesson completion should post by end of day of completion, and usually within an hour. Recommended she contact the WIC agency before 4 pm to inquire about benefits loading.

• Client showing zero benefits on her card. Outcome • Either not loaded or • Card marked as inactive in EPPIC. If “inactive” must issue a new card at the clinic. EBT Question

Adjunct Eligibility • C 1 and C 3 client certified yesterday. C 1 client verified Medicaid, C 3 client had no MA. Family over income per guidelines. Why did system allow adjunct for C 3? Outcome • The system is verifying based on current client status, which is not upgraded until cert action screen –if C 1 status was IFF at the time verified, then all in family would be shown adjunctively eligible. C 3 is not adjunctively eligible and should be terminated after ineligibility notice and 15 day benefit given.

WIC Vendors • Client called asking “Can I use WIC at only the stores listed on my paper WIC gave me? ” Outcome • Can use WIC at any store in MI that accepts WIC. The list is only the stores within your home zip code. WIC

WIC Vendors List by County • Select Miscellaneous • Authorized Vendor • then select county, Print

Check stub or equivalent? ? • Can staff use electronic record to verify income or FAP/FIP deposits (off phone or computer), or do staff need to have paper copies? Outcome • Can verify using hard copy pay stub or virtual electronic record or balance inquiry phone call (deposits). • Policy 2. 04

Medicaid Pending for infant… • Mother has active Medicaid but is over income. Has applied for Medicaid for infant; status pending. Unable to save adjunct eligibility for infant due to over income status. Outcome • Informed staff that infant has presumed Medicaid eligibility due to mom's Medicaid status, can manually verify adjunct (based on the mother having Medicaid during pregnancy). Mom recertified as BE/Infant certified as IBE.

Dad’s right to WIC info… • Wanted to know if we can provide MI-WIC records to the father of a child in a custody battle. Outcome • WIC Policy 1. 03 A#3 – “A WIC client or the parent or guardian of a minor client shall have access to, and may receive, a copy of the specified individual’s WIC record upon written request. ” • We would want to scan the request and note what information was provided in the client’s record.

No proof of pregnancy… • Has client who was “short certed” for no proof of pregnancy and now reports miscarriage. Can she recert as NPP with proof of pregnancy? Outcome • Yes, proof of pregnancy or miscarriage is required to certify as Non-lactating Post Partum woman in this case.

PG on Bed rest • A client is 33 weeks pregnant and on bed rest. Can we enroll her in WIC without her in the clinic? Outcome • The answer is yes, still need to complete the certification with proxy or through a home visit/MIHP obtaining the required proof items and using referral bloodwork and anthropometric data

Non-US citizen benefits • A mother (US citizen) signed an affidavit when she married a noncitizen that they would not receive federal services for 2 years. Is getting WIC breaking that agreement? Outcome • Does not fall under entitlement program or Federal Services according to USDA/USCIS. Benefits Not Subject to Public Charge Consideration Under the agency guidance, non-cash benefits and specialpurpose cash benefits that are not intended for income maintenance are not subject to public charge consideration. Such benefits include: …Nutrition programs, including the Supplemental Nutrition Assistance Program (SNAP)commonly referred to as Food Stamps, the Special

When to schedule I-EVAL • For infant enrolled at 2 months of age, can we do I-EVAL at 6 months of age? Outcome • Yes, Policy allows for MID-cert, evaluationusually halfway through certification, but usually tied to benefit issuance timeframe.

I-EVAL & C-EVAL AL V I-E • Staff have questions about I-EVAL and C-EVAL requirements: – Does client need proof of residency? Outcome • No, update address, and Voter Registration form if moved, but eligibility is not reviewed. C-E VA L

BF mom now Pregnant? • Mom is a BE with an IBE and now pregnant. Keep baby as IBE? Outcome • Yes, keep mom as BE and baby as IBE until one year post partum, or baby is weaned. • THEN-certify mom as PG after breastfeeding certification expires.

Mom in Hospital, baby at home… • Mother remains in hospital but infant is discharged. Mom did not name proxy at certification. Needs Grandmother to bring infant in for appointment. Can mother write a note and send with Grandmother? Outcome • Yes - - referred LA staff to Proxy Policy 8. 03.

Client Agreement • Are proxies allowed to sign the Client Agreement form? Outcome • Yes, proxies are allowed to bring children to certification appointments, sign forms, receive nutrition education and purchase food benefits according to Proxy Policy 8. 03.

Bloodwork Outcome • Policy 2. 16 requires that a test be performed at least every 12 months for children over 2 years of age if the • We recertified a child previous test was above the who had a blood cut-off level. It makes sense test done 11 months to obtain the test if it has ago. Should we have been 11 months since the done at the recert? previous test and you won’t see the client in a clinic visit until the C-EVAL appointment.

WIC and Head Start • Does WIC have an MOU with Head Start? I just received a request for blood lead values on children. Outcome • Yes, refer to WIC Policy Manual-Policy 1. 03, Confidentiality. The MOU with Head Start does include sharing data and specifies measurements, hemoglobin and lead as some of the items. NOTE- Head Start may also be a good WIC outreach source!

Infant certification period • Added a 9 month old to the program and he was given a 6 month cert period. Is this correct or a bug? Outcome • According to Federal Regulations, for infants that are added after 6 months and before 12 months of age, their certification period is 6 months.

Certification period alignment • Wanted to know what to do to get family onto simultaneous cert dates. This has become an issue with the 1 year CEVAL. Wondered if they just needed to bring the child in sooner (greater than 30 days) and make a note in the record as to why it was done. Outcome • You can schedule the CEVAL MID-CERTIFICATION (flexible) to align with benefits and other family members certs/visits.

More formula for IBP Client was made NPP from BP (before 6 months post partum). After a call with Peer Counselor she determined client is still breastfeeding after 6 months. Outcome • Breastfeeding status can't be changed due to termination. Client would have to be re-certified as BP until 1 year post partum. • If breastfeeding but need more formula than IBP package-Keep clients BP and IBP categories – refer client to CPA to… • 1. Change FOOD package for BP to NPP (after 6 mos. , mom won’t receive food, but will still be BP) 2. Change FOOD package for IBP to IFF

WIC Overseas Transfer • C 4 client transferring from Overseas WIC (Japan). Previously a client at Cheboygan. Documentation presented has cert end date of August 2014. How do I handle this process? Outcome • Transfer client to current clinic • Follow “Out of State Transfer” Process – Select Miscellaneous • Out of State Transfer • Complete screen with cert end date from VOC or other transfer information from client • Save • May need referral/referral info • Assign food package • New client information re: WIC Food & EBT card use, vendors, Substance Abuse Assistance, etc.

No longer Interested in WIC • Follow-up call after missed EDU appt. Client had lost baby and no longer wanted to participate in WIC-how to document? Outcome • Add note in NOTE field to record client’s wishes • In MI-WIC, staff had to bring up the client on Cert Action Screen, then select the reason for termination. The system automatically calculates the “termination end date” based on the reason. • IF the “termination end date” is past BVT date, agency can issue one month of additional benefits.

No proof of pregnancy short cert • Need to recert a BE client who had been terminated due to no proof of pregnancy, but now had delivered and couldn't change the cert end date. Outcome • Go to Cert Action screen select “Reinstate" for the PG client, then she would be able to proceed. – End the PG certification period as yesterday – Add new row with current status, BE, BP or NPP

PG mom out of current family • How can you separate a PG mother from the father who is authorized person for her child, but mother would like to utilize another clinic? Outcome • Create new family on Precert screen for PG mom in desired clinic (don’t add mom as new client)-save and make new family active – Perform client transfer of PG mom into new family

Frequently Asked Questions • How do I correct client’s Date of Birth? – If Auth Person, can change on Family Info screen – If client, call 3 Sigma Helpdesk at 1 -800 -WIC-1636 - press 1 and 1 • How do I update EDD for PG client? – If EDD is later than the certification end date, please contact 3 Sigma Helpdesk at 1 -800 -WIC 1636 - press 1 and 1 – Otherwise note updated EDD in Notes • How do I change the appointment minutes in my templates (want 30 minutes for NCRD appointment instead of 15 minutes)? – Call Kathie Boynton at 1 -800 -WIC-1636 - press 1 and 2 and ask for Kathie

Questions?

Project FRESH • Clients with Project FRESH benefits will be sent a reminder on September 27 th to use their benefits before October 31, 2013. Dear WIC Client. Use Your 2013 Project FRESH benefits by October 31, 2013 Thank you, WIC is an equal opportunity program 154

Thank you! Please complete your evaluations! • Contact information – Linda Dingerson, Policy Coordinator • 517 -335 -9156 • dingersonl@michigan. gov – Terri Riemenschneider, Eligibility Policy PAL • 517 -335 -9562 • riemenschneidert@michigan. gov