The computer system will identify clients whose ORS/DDD community-based service cost equals or exceeds their spenddown amount. The system centrally takes appropriate action to put the case in met status. This match is done monthly at schedule
Report #R8450469-03 is produced each month and identifies Notice of Determination of Spenddown Met (Form 458SP-2) and Form 3358A central notices sent when cases change centrally between met and unmet status. Use the listing as verification the notices
When the system determines that spenddown is met with ORS/DDD community-based services:
- (System) Changes the met/unmet indicator with Item 80 code 390 to a 4. Code 4 acts the same way as code 3 (spenddown met - no split bill day).
Once the system has entered a 4, the worker cannot change the met/unmet indicator to a 1, 2, or 3. The worker can still change the spenddown amount and delete the code 390.
- (System) Deletes Item 80 code 396, if necessary, since code 4 does not require one. Spenddown remains met until the system changes the case to unmet.
- (System) Reduces the amount following Item 80 Code 392 to zero, if necessary.
- (System) Changes Item 30 code 16 to a 17 or 18.
- (System) Sends Form 458SP-2 to the client.
When the system determines that spenddown is no longer met with ORS/DDD community-based services, the system:
- (System) Changes the met/unmet indicator with Item 80 code 390 to a 2.
- (System) Sends Form 3358A to the client.
- (System) Sends a listing to the Family Community Resource Center to let them know that either services have terminated or the amount of the services is no longer enough to meet spenddown.
- (System) Changes Item 20 to a 16 if the person is no longer receiving ORS or DDD community-based services.