Policy & Policy & Regulatory Regulatory
TrainingTraining VERIFICATIONVERIFICATION
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Table of ContentsTable of Contents
Verification/Self-Certification/Self-Verification/Self-Certification/Self-DeclarationDeclaration Definitions (p. 4)Definitions (p. 4) Types of Verification within PELICANTypes of Verification within PELICAN
(p. 5)(p. 5) General Requirements (p. 6)General Requirements (p. 6) Collateral Contact (p. 8)Collateral Contact (p. 8)
Utilization (p. 9)Utilization (p. 9) Process (p. 10)Process (p. 10) Reliable Source (p. 11)Reliable Source (p. 11) Methods (p. 13)Methods (p. 13)
Self-Certification (p. 14)Self-Certification (p. 14) Process (p. 15)Process (p. 15)
Self-Declaration(p. 16)Self-Declaration(p. 16) Utilization (p. 17) Utilization (p. 17) Process (p. 18)Process (p. 18)
Verification Chart Hyperlink to LMS (p. Verification Chart Hyperlink to LMS (p. 19)19)
PELICAN Implications (p. 20)PELICAN Implications (p. 20)
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Table of ContentsTable of Contents
Income Verification Income Verification Procedures (p. 21)Procedures (p. 21)
Prospective Work (p. 22)Prospective Work (p. 22) Initial Application (p. 27)Initial Application (p. 27) Redetermination (p. 28)Redetermination (p. 28)
Initial Application Examples (p. 29)Initial Application Examples (p. 29) Ongoing Reduction of Income Ongoing Reduction of Income
Examples (p. 32)Examples (p. 32) Redetermination Examples (p. 35)Redetermination Examples (p. 35)
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Verification,Verification,Self-certification &Self-certification &Self-declaration:Self-declaration:
DefinitionsDefinitions§ 3041.3§ 3041.3
VerificationVerification is the process of is the process of confirming information needed to confirming information needed to determine eligibility for subsidy. The determine eligibility for subsidy. The term includes documentary evidence or term includes documentary evidence or information obtained through collateral information obtained through collateral contacts, self-certification and self-contacts, self-certification and self-declaration.declaration.
Self-certificationSelf-certification is a written is a written statement provided by the p/c for the statement provided by the p/c for the purpose of establishing selected factors purpose of establishing selected factors of nonfinancial eligibility.of nonfinancial eligibility.
Self-declarationSelf-declaration is a written is a written statement provided by the p/c for the statement provided by the p/c for the purpose of establishing financial or purpose of establishing financial or nonfinancial eligibility for a period of nonfinancial eligibility for a period of time time NOT TO EXCEEDNOT TO EXCEED 30 calendar 30 calendar days.days.
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Verification:Verification: Types within Types within
PELICANPELICAN VerificationVerification = documentation or = documentation or
collateral contactcollateral contact Self-certificationSelf-certification = once and = once and
done, permanent verificationdone, permanent verification Self-declarationSelf-declaration = p/c’s written = p/c’s written
word; requires follow-up within 30 word; requires follow-up within 30 daysdays
PendingPending = waiting for the p/c to = waiting for the p/c to obtain; within timeframe requiredobtain; within timeframe required
Not Available (N/A)Not Available (N/A) = p/c has = p/c has not submitted and the timeframe not submitted and the timeframe has expiredhas expired
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General Verification General Verification Requirements Requirements §3041.61§3041.61
The p/c is the primary source of The p/c is the primary source of verification in establishing and verification in establishing and maintaining eligibility.maintaining eligibility.
The CCIS may not require a p/c to re-The CCIS may not require a p/c to re-verify information unless the CCIS has verify information unless the CCIS has information that indicates the subsidy information that indicates the subsidy status of the family has changed and the status of the family has changed and the family may be ineligible. family may be ineligible.
The CCIS may not impose requirements The CCIS may not impose requirements for verification beyond the requirements for verification beyond the requirements established in the regulations.established in the regulations.
The CCIS must inform each p/c that the The CCIS must inform each p/c that the CCIS is available to assist in obtaining CCIS is available to assist in obtaining verification that the p/c is unable to verification that the p/c is unable to obtain.obtain.
The CCIS must assist a p/c who requests The CCIS must assist a p/c who requests assistance or is struggling in obtaining assistance or is struggling in obtaining verification.verification.
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General Verification General Verification Requirements Requirements
(cont’d)(cont’d) At initial application, the CCIS must At initial application, the CCIS must
emphasize that the p/c should call emphasize that the p/c should call for help with missing verification.for help with missing verification.
As verification deadlines draw near As verification deadlines draw near for applicants and recipients who for applicants and recipients who have not been working for 4 weeks have not been working for 4 weeks prior to application or prior to application or redetermination, the CCIS must redetermination, the CCIS must contact the p/c whenever possible contact the p/c whenever possible to offer assistance and explore the to offer assistance and explore the need for self-declaration.need for self-declaration.
The CCIS may not deny or The CCIS may not deny or terminate subsidy when the p/c has terminate subsidy when the p/c has cooperated in the verification cooperated in the verification process and needed verification is process and needed verification is pending or cannot be obtained due pending or cannot be obtained due to circumstances beyond the p/c’s to circumstances beyond the p/c’s control.control.
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Collateral ContactCollateral Contact §3041.62§3041.62
The CCIS must use a The CCIS must use a collateral contactcollateral contact as a tool to as a tool to help a p/c who is struggling help a p/c who is struggling with verification as follows:with verification as follows: The CCIS must use a The CCIS must use a
collateral contact when collateral contact when appropriate.appropriate.
A collateral contact is A collateral contact is considered verification and considered verification and requires no additional or requires no additional or follow-up documentation.follow-up documentation.
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Collateral Contact:Collateral Contact:UtilizationUtilization
§3041.62§3041.62
The p/c has made a reasonable The p/c has made a reasonable effort to obtain documentary effort to obtain documentary evidence without success.evidence without success.
Documentary evidence is Documentary evidence is unavailable.unavailable.
The eligibility determination The eligibility determination process must be expedited to avoid process must be expedited to avoid unnecessary hardship to the p/c or unnecessary hardship to the p/c or to ensure the timeframe for an to ensure the timeframe for an eligibility determination is met.eligibility determination is met.
The verification provided by the p/c The verification provided by the p/c requires additional clarification.requires additional clarification.
The CCIS suspects the p/c is The CCIS suspects the p/c is withholding information or has withholding information or has falsified the information given.falsified the information given.
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Collateral Contact:Collateral Contact:ProcessProcess
§ 3041.62(d), (e) & (f)§ 3041.62(d), (e) & (f)
Obtain from the p/c a list of Obtain from the p/c a list of reliable sources of reliable sources of information who would serve information who would serve as collateral contacts.as collateral contacts.
Cooperate with a source who Cooperate with a source who acts as a collateral contact.acts as a collateral contact.
Avoid contacting an alleged Avoid contacting an alleged abuser or former abuser in a abuser or former abuser in a domestic violence situation.domestic violence situation.
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Collateral Contact:Collateral Contact:Reliable Sources Reliable Sources
§3041.62(c)§3041.62(c) The following are reliable sources of The following are reliable sources of
information:information: Public records, such as domestic Public records, such as domestic
relations or other courthouse relations or other courthouse records.records.
An employer, friend, neighbor, An employer, friend, neighbor, relative, landlord, government relative, landlord, government agency, community social service agency, community social service agency or child care provider.agency or child care provider.
The determination of whether an The determination of whether an individual is a reliable source of individual is a reliable source of information should be made based information should be made based on the specific eligibility factors to on the specific eligibility factors to be verified by the source.be verified by the source.
ExampleExample: : A friend is NOT a reliable A friend is NOT a reliable
source to verify income or source to verify income or employment.employment.
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Collateral Contact: Collateral Contact: Reliable Sources (cont’d)Reliable Sources (cont’d)
§3041.62(g)§3041.62(g)
A reliable source of information used A reliable source of information used to verify care and control in a family to verify care and control in a family headed by an aunt, uncle or headed by an aunt, uncle or grandparent are any of the following grandparent are any of the following with knowledge of the circumstances:with knowledge of the circumstances: A school teacher or principal.A school teacher or principal. A regulated child care provider.A regulated child care provider. A health care professional.A health care professional. A social service worker or A social service worker or
counselor.counselor. A religious professional.A religious professional. An attorney.An attorney.
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Collateral Contact :Collateral Contact :Methods Methods
§3041.62(b)§3041.62(b)
In person.In person. By consulting public By consulting public
records.records. By mail.By mail. By electronic By electronic
communication.communication. By facsimile.By facsimile. By telephone.By telephone.
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Self-certificationSelf-certification §3041.63(b)§3041.63(b)
Citizenship status.Citizenship status. Immunization status or exemption Immunization status or exemption
from immunization.from immunization. Face-to-face timeframe extension Face-to-face timeframe extension
based on hardship.based on hardship. Former TANF status/CIS Former TANF status/CIS
download within the first 60 days.download within the first 60 days. After day 61 = self-declarationAfter day 61 = self-declaration
Hours/days for which the former Hours/days for which the former TANF child needs care.TANF child needs care.
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Self-certification:Self-certification:ProcessProcess
When a p/c calls to report a change which When a p/c calls to report a change which requires self-certification, the CCIS must:requires self-certification, the CCIS must:
Complete and sign the self-Complete and sign the self-certification form.certification form.
Note the date and time of the call, the Note the date and time of the call, the name of the person making the call name of the person making the call and what requirement is being and what requirement is being addressed.addressed.
Read the perjury/fraud statement to Read the perjury/fraud statement to the p/c.the p/c.
Mail a copy of the form to the p/c (for Mail a copy of the form to the p/c (for the p/c’s record, the p/c’s record, NOTNOT for signature for signature and return).and return).
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Self-declarationSelf-declaration §3041.64§3041.64
If a p/c’s attempts to verify eligibility If a p/c’s attempts to verify eligibility by documentary evidence are by documentary evidence are unsuccessful and the CCIS is unable to unsuccessful and the CCIS is unable to make a collateral contact, the CCIS make a collateral contact, the CCIS shall proceed without delay to shall proceed without delay to determine a family’s eligibility based determine a family’s eligibility based upon self-declaration.upon self-declaration.
The CCIS must accept the p/c’s The CCIS must accept the p/c’s self-declaration statement, unless self-declaration statement, unless evidence contradicts the statement.evidence contradicts the statement.
If the p/c uses self-declaration as If the p/c uses self-declaration as verification, the CCIS must require the verification, the CCIS must require the p/c to provide another form of p/c to provide another form of acceptable verification within 30 acceptable verification within 30 calendar days following the date the calendar days following the date the written self-declaration written self-declaration is accepted by the CCIS.is accepted by the CCIS.
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Self-declaration: Self-declaration: UtilizationUtilization
The CCIS must use The CCIS must use self-declarationself-declaration as a tool as a tool to help a p/c who is struggling with to help a p/c who is struggling with verification as follows:verification as follows: Allow the p/c to self-declare (if Allow the p/c to self-declare (if
acceptable, SEE VERIFICATION CHART), acceptable, SEE VERIFICATION CHART), when a collateral contact is not available when a collateral contact is not available and the p/c reports difficulty in obtaining and the p/c reports difficulty in obtaining verification.verification.
Self-declaration is used as a last resort Self-declaration is used as a last resort and will not be used unless the and will not be used unless the verification deadline is drawing near.verification deadline is drawing near.
The p/c must submit follow-up The p/c must submit follow-up verification no later than 30 calendar verification no later than 30 calendar days following the date of the self-days following the date of the self-declaration.declaration.
The verification date is the date the p/c The verification date is the date the p/c self-declares. The CCIS WILL NOT wait self-declares. The CCIS WILL NOT wait an additional 30 days to process the case.an additional 30 days to process the case.
The CCIS must send an AA on the 31The CCIS must send an AA on the 31stst day when a p/c who has self-declared day when a p/c who has self-declared fails to submit follow-up verification on or fails to submit follow-up verification on or before the 30before the 30thth day following the date of day following the date of the self-declaration.the self-declaration.
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Self-declaration:Self-declaration:ProcessProcess
When a p/c calls to report a change which When a p/c calls to report a change which requires self-declaration, the CCIS must:requires self-declaration, the CCIS must:
Complete and sign the self-Complete and sign the self-declaration form.declaration form.
Note the date and time of the call, the Note the date and time of the call, the name of the person making the call name of the person making the call and what requirement is being and what requirement is being addressed.addressed.
Read the perjury/fraud statement to Read the perjury/fraud statement to the p/c and explain that the p/c must the p/c and explain that the p/c must follow-up with additional verification follow-up with additional verification of the change self-declaration.of the change self-declaration.
Mail a copy of the form to the p/c (for Mail a copy of the form to the p/c (for the p/c’s record, the p/c’s record, NOTNOT for signature for signature and return) along with a Missing and return) along with a Missing Verification Letter.Verification Letter.
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VerificationVerification
See Verification Chart for See Verification Chart for acceptable forms of acceptable forms of verification for each eligibility verification for each eligibility factor.factor.
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Verification:Verification:PELICAN PELICAN
ImplicationsImplications SS#SS#
Not a required field.Not a required field. Only enter the SS# if you Only enter the SS# if you
have documentation.have documentation. Child’s ageChild’s age
P/C may self-certify.P/C may self-certify. Head Start Child’s citizenship Head Start Child’s citizenship
statusstatus Consider the child to be a Consider the child to be a
citizen as the child meets the citizen as the child meets the Head Start requirements.Head Start requirements.
Consider the citizenship Consider the citizenship status to be “verified.”status to be “verified.”
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Income Verification:Income Verification:Procedures Procedures §3041.65§3041.65
For more information regarding For more information regarding using the Employment & Wage using the Employment & Wage screen in PELICAN, see LMS R2-R3 screen in PELICAN, see LMS R2-R3 Intake Result and Wage Pages pdfIntake Result and Wage Pages pdf
The CCIS must require 4 out of the most The CCIS must require 4 out of the most recent 6 (NOT NECESSARILY recent 6 (NOT NECESSARILY CONSECUTIVE) weeks income CONSECUTIVE) weeks income verification at initial application and verification at initial application and redetermination. redetermination.
The CCIS must require a p/c who The CCIS must require a p/c who reports prospective employment to reports prospective employment to submit initial verification of estimated submit initial verification of estimated income followed by 1 week’s verification income followed by 1 week’s verification of income within 10 days of the date the of income within 10 days of the date the p/c receives income for work.p/c receives income for work.
See the following slides regarding See the following slides regarding procedures for prospective work.procedures for prospective work.
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Income Verification:Income Verification:Procedures for Procedures for
Prospective Work Prospective Work §3041.65§3041.65 The CCIS must require a p/c who reports The CCIS must require a p/c who reports
prospective employment to submit initial prospective employment to submit initial verification of estimated income (i.e., an EV or verification of estimated income (i.e., an EV or employer’s statement) followed by 1 week’s employer’s statement) followed by 1 week’s verification of income within 10 days of the verification of income within 10 days of the date the p/c receives income for work.date the p/c receives income for work. The CCIS The CCIS MAYMAY NOTNOT delay an eligibility delay an eligibility
determination when a p/c submits an EV or determination when a p/c submits an EV or employer’s statement, but does not submit employer’s statement, but does not submit income verification.income verification.
In this case, the co-payment is based on In this case, the co-payment is based on the EV and the CCIS is simply confirming the EV and the CCIS is simply confirming via 1 week of income verification that the via 1 week of income verification that the EV information has not changed. Due to EV information has not changed. Due to co-payment stabilization, gathering 4 co-payment stabilization, gathering 4 weeks of income verification makes no weeks of income verification makes no difference because the co-payment may difference because the co-payment may only be decreased.only be decreased.
If the 1 week of income verification does If the 1 week of income verification does not reflect the EV information originally not reflect the EV information originally submitted, the CCIS must require 4 weeks submitted, the CCIS must require 4 weeks of income verification.of income verification.
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Prospective Employment:Prospective Employment:PELICAN Process PELICAN Process using using the Initial Verificationthe Initial Verification
1.1. Use the verification of Use the verification of prospective employment and prospective employment and income until the p/c submits income until the p/c submits verification of the amount of verification of the amount of the 1the 1stst pay. pay.
2.2. Enter the following Enter the following information in the “If no” information in the “If no” income section on the income section on the Employment & Wage Detail Employment & Wage Detail screen:screen:
Income frequencyIncome frequency Estimated incomeEstimated income Number of hours worked Number of hours worked
per week per week
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Prospective Employment:Prospective Employment:PELICAN Process PELICAN Process upon upon
receipt of Verification of 1receipt of Verification of 1stst paypay
P/C has 10 days from the date 1P/C has 10 days from the date 1stst pay is received to submit pay is received to submit verification of 1verification of 1stst pay. pay.
When the p/c submits the When the p/c submits the verification of the amount of the verification of the amount of the 11stst pay, the CCIS must: pay, the CCIS must:
1.1. Clear the information in the “If Clear the information in the “If no” section on the no” section on the Employment & Wage Detail Employment & Wage Detail screenscreen
2.2. Enter in the “If yes” income Enter in the “If yes” income section, the verified incomesection, the verified income
3.3. When the paystub does not When the paystub does not reflect 1 full week of pay, reflect 1 full week of pay, prorate the hourly salary and prorate the hourly salary and number of hours number of hours
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Income Verification:Income Verification:Initial Application/Initial Application/
Prospective Employment Prospective Employment Example #1Example #1
P/C has a job and will start within 30 days P/C has a job and will start within 30 days of application. Funds are available.of application. Funds are available.
1/3/051/3/05 – P/C applies for child care and – P/C applies for child care and submits verification of prospective work submits verification of prospective work beginning 1/20/05 and 1beginning 1/20/05 and 1stst pay is expected pay is expected on 1/27/05. on 1/27/05.
1/15/051/15/05 – P/C submits all necessary – P/C submits all necessary verification and eligibility is established on verification and eligibility is established on 1/3/05. Child may be enrolled as of 1/3/05. Child may be enrolled as of 1/20/05. 1/20/05.
1/20/051/20/05 – P/C begins work and child is – P/C begins work and child is enrolled in care. enrolled in care.
1/27/051/27/05 – P/C receives 1 – P/C receives 1stst pay. pay.
2/4/052/4/05 – P/C submits income verification – P/C submits income verification reflecting 1 week of work.reflecting 1 week of work.
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Prospective Employment:Prospective Employment:EXAMPLEEXAMPLE
11stst pay pay DOESDOES NOTNOT reflect 1 full reflect 1 full weekweek
The initial verification the p/c The initial verification the p/c submitted states the following submitted states the following information:information:
Paid weeklyPaid weekly Works 5 days/week, 8 Works 5 days/week, 8
hours/dayhours/day Earns $320/week at $8/hour Earns $320/week at $8/hour
The p/c submits the 1The p/c submits the 1stst paystub paystub for 3 days/24 hours in the for 3 days/24 hours in the amount of $192 . amount of $192 .
The CCIS must pro-rate the The CCIS must pro-rate the hourly salary if the pay stub does hourly salary if the pay stub does not reflect a full week of pay. not reflect a full week of pay. The CCIS must enter $320 and The CCIS must enter $320 and 40 hours/week40 hours/week
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Income Verification:Income Verification:Procedures at Initial Procedures at Initial
ApplicationApplication The CCIS must give a p/c who is The CCIS must give a p/c who is
recently employed but has not been recently employed but has not been working 4 weeks at the time of working 4 weeks at the time of initial applicationinitial application the opportunity the opportunity to provide 4 weeks of income to provide 4 weeks of income verification as follows:verification as follows: Accept available income Accept available income
verification.verification. Send the p/c a Missing Send the p/c a Missing
Information/Verification Letter Information/Verification Letter requesting the p/c submit the requesting the p/c submit the remaining weeks of income remaining weeks of income verification no later than 30 days verification no later than 30 days from the date the application was from the date the application was received/date-stamped.received/date-stamped.
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Income Verification:Income Verification:Procedures at Procedures at
RedeterminationRedetermination The CCIS must give a p/c who is recently The CCIS must give a p/c who is recently
employed but has not been working 4 employed but has not been working 4 weeks at the time of weeks at the time of redeterminationredetermination the opportunity to provide 4 weeks of the opportunity to provide 4 weeks of income verification as follows:income verification as follows: Accept available income verification Accept available income verification
for the new job.for the new job. Establish eligibility for the next 6 Establish eligibility for the next 6
months.months. Do Do notnot use income verification from a use income verification from a
job the p/c has left.job the p/c has left. Send the Missing Send the Missing
Information/Verification Letter Information/Verification Letter requesting the p/c to submit the requesting the p/c to submit the remaining weeks of income remaining weeks of income verification by the redetermination verification by the redetermination due date.due date.
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Income Verification:Income Verification:Initial Application Initial Application
Example #1Example #1 P/C started a job 1 week prior to P/C started a job 1 week prior to
application.application.
1/3/051/3/05 – P/C applies for child care and – P/C applies for child care and submits verification of work beginning submits verification of work beginning 12/27/04. P/C has no income 12/27/04. P/C has no income verification. verification.
1/7/051/7/05 – CCIS reviews the information – CCIS reviews the information and sends a Missing and sends a Missing Information/Verification Letter Information/Verification Letter requesting 4 weeks of income requesting 4 weeks of income verification by 2/2/05. verification by 2/2/05.
2/2/05 2/2/05 – P/C submits all necessary – P/C submits all necessary verification and eligibility is verification and eligibility is established on 1/3/05. Child may be established on 1/3/05. Child may be enrolled or placed on the waiting list enrolled or placed on the waiting list as of 1/3/05.as of 1/3/05.
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Income Verification:Income Verification:Initial Application, Example Initial Application, Example
#2#2 P/C started a job 1 week prior to P/C started a job 1 week prior to
applicationapplication. . 1/3/05 1/3/05 – P/C applies for child care and – P/C applies for child care and
submits verification of work beginning submits verification of work beginning 12/27/04. P/C has no income verification. 12/27/04. P/C has no income verification.
1/7/051/7/05 – CCIS reviews information and – CCIS reviews information and sends Missing Verification Letter requesting sends Missing Verification Letter requesting 4 weeks of income verification by 2/2/05. 4 weeks of income verification by 2/2/05.
1/28/051/28/05 – Worker receives tracking date – Worker receives tracking date alert reminding worker that income alert reminding worker that income verification is due on 2/2/05 and contacts verification is due on 2/2/05 and contacts p/c who indicates the employer held 2 p/c who indicates the employer held 2 weeks pay and p/c cannot get the full 4 weeks pay and p/c cannot get the full 4 weeks verification by 2/2/05. Worker weeks verification by 2/2/05. Worker advises p/c to self-declare and submit the advises p/c to self-declare and submit the last week’s verification within 30 days. last week’s verification within 30 days. Worker completes self-declaration form and Worker completes self-declaration form and dates it 1/28/05. Worker establishes dates it 1/28/05. Worker establishes eligibility date of 1/3/05. Child may be eligibility date of 1/3/05. Child may be enrolled or placed on the waiting list as of enrolled or placed on the waiting list as of 1/3/05. 1/3/05.
2/18/05 2/18/05 – P/C submits final income – P/C submits final income verification.verification.
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Income Verification:Income Verification:Initial Application, Example Initial Application, Example
#3#3 P/C started a job 1 week prior to application.P/C started a job 1 week prior to application. 1/3/051/3/05 – P/C applies for child care and submits – P/C applies for child care and submits
verification of work beginning 12/27/04. P/C verification of work beginning 12/27/04. P/C has no income verification. has no income verification.
1/7/051/7/05 – CCIS reviews information and sends – CCIS reviews information and sends Missing Verification Letter requesting 4 weeks Missing Verification Letter requesting 4 weeks of income verification by 2/2/05. of income verification by 2/2/05.
1/28/051/28/05 – Worker receives tracking date alert – Worker receives tracking date alert reminding worker that income verification is reminding worker that income verification is due on 2/2/05 and contacts p/c who indicates due on 2/2/05 and contacts p/c who indicates the employer held 2 weeks pay and p/c cannot the employer held 2 weeks pay and p/c cannot get the full 4 weeks verification by 2/2/05. get the full 4 weeks verification by 2/2/05. Worker advises p/c to self-declare and submit Worker advises p/c to self-declare and submit the last week’s verification within 30 days. the last week’s verification within 30 days. Worker completes self-declaration form and Worker completes self-declaration form and dates it 1/28/05. dates it 1/28/05.
1/28/05 1/28/05 – Worker establishes eligibility date – Worker establishes eligibility date of 1/3/05. Child may be enrolled or placed on of 1/3/05. Child may be enrolled or placed on the waiting list as of 1/3/05. the waiting list as of 1/3/05.
2/28/05 2/28/05 – P/C fails to submit final income – P/C fails to submit final income verification within 30 days. CCIS sends an AA verification within 30 days. CCIS sends an AA to p/c citing missing income verification.to p/c citing missing income verification.
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Income Verification:Income Verification:Ongoing/Income Ongoing/Income
Reduction Example #1Reduction Example #1 5/31/055/31/05 – Redetermination is – Redetermination is
completed and the co-payment is completed and the co-payment is assessed at $20/week. assessed at $20/week.
7/18/057/18/05 – P/C calls the CCIS and – P/C calls the CCIS and reports a reduction in work hours that reports a reduction in work hours that results in less earned income. P/C results in less earned income. P/C self-declares information and CCIS self-declares information and CCIS completes and mails the self-completes and mails the self-declaration form along with a Missing declaration form along with a Missing Verification Letter. Verification Letter.
7/18/057/18/05 – CCIS lowers co-payment – CCIS lowers co-payment based on the p/c’s self-declaration and based on the p/c’s self-declaration and generates a Confirmation Notice generates a Confirmation Notice indicating a lower co-payment indicating a lower co-payment effective the following Monday. effective the following Monday.
8/1/05 8/1/05 –P/C submits 1 week of income –P/C submits 1 week of income verification.verification.
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Income Verification:Income Verification:Ongoing/Income Reduction Ongoing/Income Reduction
Example #2Example #2 5/31/055/31/05 – Redetermination is completed and – Redetermination is completed and
the co-payment is assessed at $20/week. the co-payment is assessed at $20/week.
7/18/057/18/05 – P/C calls the CCIS and reports a – P/C calls the CCIS and reports a reduction in work hours that results in less reduction in work hours that results in less earned income. P/C self-declares earned income. P/C self-declares information and CCIS completes and mails information and CCIS completes and mails the self-declaration form along with a the self-declaration form along with a Missing Verification Letter. Missing Verification Letter.
7/18/057/18/05 – CCIS lowers co-payment based on – CCIS lowers co-payment based on the p/c’s self-declaration and generates a the p/c’s self-declaration and generates a Confirmation Notice indicating a lower Confirmation Notice indicating a lower co-payment effective the following co-payment effective the following Monday. Monday.
8/18/058/18/05 – P/C fails to submit required – P/C fails to submit required verification within 30 days.verification within 30 days.
8/18/058/18/05 – CCIS sends a Confirmation Notice – CCIS sends a Confirmation Notice increasing the co-payment back to the increasing the co-payment back to the original amount starting the Monday original amount starting the Monday following the date the notice period expires. following the date the notice period expires. CCIS makes arrangements with the p/c to CCIS makes arrangements with the p/c to repay the overpayment that resulted.repay the overpayment that resulted.
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Income Verification:Income Verification:Ongoing/Income Ongoing/Income
Increased Example #3Increased Example #3 5/31/055/31/05 – Redetermination is – Redetermination is
completed and the co-payment is completed and the co-payment is assessed at $20/week. assessed at $20/week.
7/18/057/18/05 – P/C calls the CCIS and – P/C calls the CCIS and reports a promotion resulting in $2 reports a promotion resulting in $2 more per hour. more per hour.
7/18/057/18/05 – CCIS enters the increase in – CCIS enters the increase in income, but informs the p/c that the income, but informs the p/c that the co-payment will be stabilized until co-payment will be stabilized until the next redetermination.the next redetermination.
7/18/057/18/05 – CCMIS stabilizes co- – CCMIS stabilizes co-payment. payment.
12/2/05 12/2/05 –Redetermination completed. –Redetermination completed. The CCIS sends a Confirmation The CCIS sends a Confirmation Notice increasing the co-payment Notice increasing the co-payment starting the Monday following the starting the Monday following the date the notice period expires. date the notice period expires.
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Income Verification:Income Verification:Redetermination Redetermination
Example #1Example #1 P/C is employed at same P/C is employed at same
job as at application.job as at application. 4/19/054/19/05 – Redetermination – Redetermination
packet is printed and sent to packet is printed and sent to the p/c.the p/c.
5/10/055/10/05 – P/C submits all – P/C submits all required required information/verification information/verification including 4 weeks of income including 4 weeks of income verification.verification.
5/13/055/13/05 – CCIS assesses – CCIS assesses eligibility and the family eligibility and the family remains eligible.remains eligible.
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Income Verification:Income Verification:Redetermination Example Redetermination Example
#2#2 P/C has new job that started 1 week P/C has new job that started 1 week
prior to redetermination.prior to redetermination. 4/19/054/19/05 – Redetermination packet is – Redetermination packet is
printed and sent to the p/c. printed and sent to the p/c. Redetermination due date is 5/31/05.Redetermination due date is 5/31/05.
5/10/055/10/05 – P/C submits Redetermination – P/C submits Redetermination Summary but does not submit current Summary but does not submit current income verification.income verification.
5/10/055/10/05 – CCIS reviews information and – CCIS reviews information and sends a Missing Verification Letter sends a Missing Verification Letter requesting 4 weeks of income verification requesting 4 weeks of income verification by 5/31/05.by 5/31/05.
5/29/055/29/05 – P/C submits 3 weeks of income – P/C submits 3 weeks of income verification and explains he is having verification and explains he is having difficulty obtaining the 4difficulty obtaining the 4thth week of income week of income verification. CCIS accepts self-verification. CCIS accepts self-declaration and informs p/c that the 4declaration and informs p/c that the 4thth week of income verification must be week of income verification must be submitted by 6/28/05. CCIS assesses submitted by 6/28/05. CCIS assesses eligibility and the family remains eligible.eligibility and the family remains eligible.
6/28/056/28/05 – P/C fails to submit 4 – P/C fails to submit 4thth week of week of income verification. CCIS sends an AA income verification. CCIS sends an AA terminating care in 13 days unless the p/c terminating care in 13 days unless the p/c submits the 4submits the 4thth week of income week of income verification.verification.
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Income Verification:Income Verification:Redetermination Redetermination
Example #3Example #3 P/C quit job 2 weeks prior to P/C quit job 2 weeks prior to
redetermination; no new redetermination; no new employment.employment.
4/19/054/19/05 – Redetermination packet is – Redetermination packet is printed and sent to the p/c. printed and sent to the p/c. Redetermination due date is 5/31/05.Redetermination due date is 5/31/05.
4/21/054/21/05 – P/C contacts CCIS to report – P/C contacts CCIS to report that she quit her job on 4/5/05 and is that she quit her job on 4/5/05 and is not currently working.not currently working.
4/21/054/21/05 – CCIS sends an AA – CCIS sends an AA terminating care in 13 days unless terminating care in 13 days unless the p/c meets the work requirement the p/c meets the work requirement on or before the date the notice on or before the date the notice period expires. CCIS explores the period expires. CCIS explores the possibility of an overpayment for the possibility of an overpayment for the time the p/c was not working.time the p/c was not working.
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Income Verification:Income Verification:Redetermination Redetermination
Example #4Example #4 P/C involuntarily lost job 2 weeks P/C involuntarily lost job 2 weeks
prior to redetermination; no new prior to redetermination; no new employment.employment.
4/19/054/19/05 – Redetermination packet is – Redetermination packet is printed and send to the p/c. printed and send to the p/c. Redetermination due date is 5/31/05.Redetermination due date is 5/31/05.
4/21/054/21/05 – P/C contacts CCIS to report – P/C contacts CCIS to report that she was laid off on 4/5/05 and is that she was laid off on 4/5/05 and is not currently working.not currently working.
5/1/055/1/05 – P/C submits all required – P/C submits all required verification including verification of verification including verification of involuntary job loss.involuntary job loss.
5/1/055/1/05 – CCIS assesses eligibility and – CCIS assesses eligibility and determines the family eligible for determines the family eligible for continued child care. Worker sets a continued child care. Worker sets a tracking date to remind him the p/c tracking date to remind him the p/c must meet the work requirement by must meet the work requirement by 6/3/05 (60 days from job loss).6/3/05 (60 days from job loss).
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Income Verification:Income Verification:Redetermination,Example Redetermination,Example
#5#5 P/C on maternity/disability leave at redet.P/C on maternity/disability leave at redet. 4/1/054/1/05 – P/C reports maternity/disability leave. – P/C reports maternity/disability leave. 4/1/054/1/05 – CCIS notes decrease in income in case – CCIS notes decrease in income in case
notes, overrides co-payment and generates notes, overrides co-payment and generates Confirmation Notice advising p/c that the Confirmation Notice advising p/c that the decreased co-payment will begin the following decreased co-payment will begin the following Monday. Monday.
4/19/054/19/05 – Redet. packet is printed and sent to – Redet. packet is printed and sent to the p/c. Redetermination due date is 5/31/05.the p/c. Redetermination due date is 5/31/05.
5/1/055/1/05 – P/C submits all required verification. – P/C submits all required verification. Worker leaves the old income, sets a tracking Worker leaves the old income, sets a tracking date to check that p/c returned to work and date to check that p/c returned to work and overrides co-payment until the date the p/c overrides co-payment until the date the p/c returns to work.returns to work.
5/31/055/31/05 – Worker completes redetermination. – Worker completes redetermination. 6/20/056/20/05 – P/C verifies return to work. CCIS end – P/C verifies return to work. CCIS end
dates leave, assesses eligibility and generates a dates leave, assesses eligibility and generates a Confirmation Notice advising p/c that the Confirmation Notice advising p/c that the increased co-payment will begin the Monday increased co-payment will begin the Monday following the date the notice period expires.following the date the notice period expires.