MR #16.06: Batch Actions and PAL Codes in IES

05/04/16

Summary:

In Phase 2 implementation of the Integrated Eligibility System (IES), there are certain circumstances when IES may automatically process changes and/or generate tasks, and sometimes rerun eligibility and certify a case based on batch action triggers for SNAP, cash and medical programs.
Batch actions may be triggered by case information that affects program eligibility, or by information received from interface files.
- Examples of case information triggers are when a person reaches a specified age or program time limits are reached.
- Examples of interface related triggers are when data is received from the Social Security Administration or the Illinois Department of Employment Security (IDES).
Most batch actions will be run monthly (at or around schedule cut-off) by the eligibility batch process.
Cases in case change or REDE mode will not be included in most batch actions.
Batch actions and related reports will replace some Priority Action List (PAL) processes.
Interim procedures regarding 19 year olds who are aging out of All Kids will be required after IES Phase 2 implementation.

Batch Actions in IES
PAL Codes in IES
Interim Process for 19 Year Olds Aging Out of All Kids
1. 19 Year Old is Included in Tax Unit of Head of Household
2. 19 Year Old Not Included in Tax Unit of Head of Household
MANUAL REVISIONS
Forms referenced

Batch Actions in IES

In Phase 2 implementation of the Integrated Eligibility System (IES), there are certain circumstances when Mass Changes are applied to cases and IES may automatically process changes and/or generate tasks, and sometimes rerun eligibility and certify a case based on batch action triggers for SNAP, cash and medical programs.

In some situations, IES will perform the same automated actions that occurred in the legacy system, such as automatically budgeting SSI income for cash and SNAP programs.

In other situations, IES will automatically rerun eligibility, where previously the worker was required to complete an action. For example, IES will automatically determine whether a woman who received medical benefits based on a pregnancy continues to qualify for medical benefits after the 60 day post-partum period ends.

Most batch actions will run monthly (at or around schedule cut-off) by the eligibility batch process, unless otherwise stated.

Case in Change or REDE Mode

When a case is placed in change mode or REDE mode, batch actions (with the exception of closure of SNAP due to lack of recertification) will not be processed. A case can be put in change or REDE mode through a worker action from the Initiate Data Collection screen only.

It is important for workers to complete and certify a change the same day that it is started whenever possible to prevent the case from being skipped for a mass change. However, if a case pends due to a VCL (Form 267) request, the change or REDE action will not be able to be certified on the same day that the action is opened. In that situation, IES will apply the Batch Action trigger to the case when the change or REDE action is certified.

Triggers that Rerun Eligibility Based on Case Information

Under certain circumstances, when a batch trigger is applied to a case, eligibility is run and the result is systematically certified. No worker action is necessary. This action is referred to as a 'mass change', 'mass update, or 'batch action' in IES. The 'Last Mass Update Date' field on the 'Case Search/Summary' page shows when the last mass change occurred on a case. Staff may also go to the Eligibility Search page and search for a date range to see eligibility results after a mass change is applied to a case.

Programs	Description	IES Action = Rerun Eligibility
Medical	Batch Action Newborn Deemed newborn turns 1 year old. Child must now meet income and SSN (or application for SSN) criteria; written request to add child required if not yet on file.	Generates VCL and 243A-C request, if required. Runs the day after cut-off in the month before 1st birthday. Closes newborn EDG, and determines eligibility for other medical if all criteria are met. Runs 2 days prior to cut-off for month after 1st birthday.
TANF and Medical	Batch Action 19 Year Old Case has a child turning 19 (Replaces PAL Code A)	TANF - removes 19 year old from TANF EDG, may close TANF EDG if last child. Medical - determines eligibility under ACA Adult or other medical EDG, or cancels. Runs the day after cut-off the month before 19th birthday, effective for month after 19th birthday.
TANF	Batch Action TANF 18 Year Old Case has a child turning 18 and not a full time student (Replaces PAL Code B)	Removes 18 year old from TANF EDG if not a full time student, may close TANF EDG if last child. Runs 2 days prior to cut-off for month after 18th birthday.
Medical	Batch Action Medical 18 Year Old Last child turning 18 Note: This affects the caretaker relative's eligibility group; the 18 year old remains eligible as a child until age 19.	Moves parents/caretaker relatives from FamilyCare to ACA Adult if last child. Runs 2 days prior to cut-off for month after 18th birthday.
SNAP	Batch Action ABAWD Time Limit Able Bodied Adults Without Dependents (ABAWD) person reaching the time limit based on program rules. Currently the State is exempt from the time limit for ABAWDS per PM 03-25-00.	Closure of the SNAP EDG Runs 2 days prior to cut-off during the month when the individual will reach their time limit.
Refugee cash	Batch Action Refugee Time Limit Refugee cash recipient reaching end of eligibility period	Closure of the Refugee Cash EDG Runs at cut-off for the month after the certification end date.
TANF	Batch Action TANF Clock Limit Reaching (or passed) the maximum 60 month TANF Clock Limit and no exception was/is granted.	Closure of the TANF Cash EDG Runs at cut-off for the 61st (or next) month.
Medical	Batch Action 60 Day Post Partum Pregnant woman's 60 day post partum period is going to end. (Replaces PAL code P)	Closes pregnant woman EDG, determines eligibility for other medical EDG, or cancels if criteria not met. Runs 2 days prior to cut-off for month after post partum period ends.
SNAP & cash	Batch Action MPR Mid Point Report (MPR) not received - 6 months (due date passed)	Closure Runs at cut-off for the 7th month.
SNAP	Batch Action TSNAP Transitional SNAP (TSNAP) reached 5 months	Closure Runs at cut-off for the 6th month.
Medical	Batch Action Unmet Spenddown Spenddown not met in at least one of the last 3 months, after being in spenddown for at least 6 months	Closure EDG is closed unless it meets one of the exceptions in PM 19-02-02-c or 19-02-03-c Runs at cut-off.
Medical	Batch Action LPR Reaches 5 Years Legal permanent resident (LPR) child (or pregnant woman) reaches 5 years in this status	Sends updated immigration status code to MMIS for federal funding purposes; does not affect eligibility. Runs 2 days prior to cut-off for month individual reaches 5 years in status.
Medical	Batch Action HBWD Age 65 HBWD recipient turning 65	Determines eligibility under AABD Community program. Runs 2 days prior to cut-off for month individual reaches age 65.

Programs

Description

IES Action = Rerun Eligibility

Medical

Batch Action Newborn

Deemed newborn turns 1 year old.

Child must now meet income and SSN (or application for SSN) criteria; written request to add child required if not yet on file.

Generates VCL and 243A-C request, if required. Runs the day after cut-off in the month before 1st birthday.
Closes newborn EDG, and determines eligibility for other medical if all criteria are met. Runs 2 days prior to cut-off for month after 1st birthday.

TANF and Medical

Batch Action 19 Year Old

Case has a child turning 19

(Replaces PAL Code A)

TANF - removes 19 year old from TANF EDG, may close TANF EDG if last child.

Medical - determines eligibility under ACA Adult or other medical EDG, or cancels.

Runs the day after cut-off the month before 19th birthday, effective for month after 19th birthday.

TANF

Batch Action TANF 18 Year Old

Case has a child turning 18 and not a full time student

(Replaces PAL Code B)

Removes 18 year old from TANF EDG if not a full time student, may close TANF EDG if last child.

Runs 2 days prior to cut-off for month after 18th birthday.

Medical

Batch Action Medical 18 Year Old

Last child turning 18

Note: This affects the caretaker relative's eligibility group; the 18 year old remains eligible as a child until age 19.

Moves parents/caretaker relatives from FamilyCare to ACA Adult if last child.

Runs 2 days prior to cut-off for month after 18th birthday.

SNAP

Batch Action ABAWD Time Limit

Able Bodied Adults Without Dependents (ABAWD) person reaching the time limit based on program rules.

Currently the State is exempt from the time limit for ABAWDS per PM 03-25-00.

Closure of the SNAP EDG

Runs 2 days prior to cut-off during the month when the individual will reach their time limit.

Refugee cash

Batch Action Refugee Time Limit

Refugee cash recipient reaching end of eligibility period

Closure of the Refugee Cash EDG

Runs at cut-off for the month after the certification end date.

TANF

Batch Action TANF Clock Limit

Reaching (or passed) the maximum 60 month TANF Clock Limit and no exception was/is granted.

Closure of the TANF Cash EDG

Runs at cut-off for the 61st (or next) month.

Medical

Batch Action 60 Day Post Partum

Pregnant woman's 60 day post partum period is going to end.

(Replaces PAL code P)

Closes pregnant woman EDG, determines eligibility for other medical EDG, or cancels if criteria not met.

Runs 2 days prior to cut-off for month after post partum period ends.

SNAP & cash

Batch Action MPR

Mid Point Report (MPR) not received - 6 months (due date passed)

Closure

Runs at cut-off for the 7th month.

SNAP

Batch Action TSNAP

Transitional SNAP (TSNAP) reached 5 months

Closure

Runs at cut-off for the 6th month.

Medical

Batch Action Unmet Spenddown

Spenddown not met in at least one of the last 3 months, after being in spenddown for at least 6 months

Closure

EDG is closed unless it meets one of the exceptions in PM 19-02-02-c or 19-02-03-c

Runs at cut-off.

Medical

Batch Action LPR Reaches 5 Years

Legal permanent resident (LPR) child (or pregnant woman) reaches 5 years in this status

Sends updated immigration status code to MMIS for federal funding purposes; does not affect eligibility.

Runs 2 days prior to cut-off for month individual reaches 5 years in status.

Medical

Batch Action HBWD Age 65

HBWD recipient turning 65

Determines eligibility under AABD Community program.

Runs 2 days prior to cut-off for month individual reaches age 65.

Triggers that Rerun Eligibility Based on Interface Data

Programs	Description	IES Action = Rerun Eligibility
Medical	Bendex Update Medicare AABD recipient receives Part A Medicare (MSP / ACA)	Determines eligibility for Medicare Savings Plan (MSP)
Medical	Bendex Update Widow(er) Eligible as a Widow(er)	Bendex update file contains a record of an individual receiving widow(er) benefits; provides Widow(er) benefits (PM 06-07-00)
All Programs	Bendex Update SSI Recipient receives SSI	Bendex update file contains a record of an individual receiving SSI. This will trigger a mass change if that individual is eligible in a TANF or SNAP EDG TANF - closure or deletion SNAP - budget the SSI Medical(ACA Adult)- updates code sent to MMIS for federal funding purposes
All Programs	Bendex Update SSA Update to SSA-RSDI Income or Medicare Premium Expenses	Updated income is budgeted.
All Programs	Consolidated Death Match Death Match- Public Health, Bendex, other certified death match	Enters date of death in Individual Information screen, closes case if single person case, or removes from certified group if case has multiple persons. If person is included in the tax filer unit of another person's FHP or ACA Adult EDG size, he will remain in the EDG size until end of tax year. Also creates a task to review case if the person was the head of household for others in the case.
All Programs	IDES UIB Unemployment Insurance Benefits income discrepancy (Replaces PAL code U)	IDES file updates IES with new or updated unemployment insurance income.

Triggers that Generate a Task

The following triggers create tasks in the Changes/Misc EDM queue in the EDM Inbox for each case an individual is on. Tasks also appear on the case. If a task is connected to a person who is on more than one case, both cases need to be reviewed and certified separately.

Example: Mr. T is a component SNAP member on his parents' SNAP case, and receives ACA Adult medical benefits on a separate IES case. An IDES Wage Mismatch task is received indicating that he had unbudgeted earned income. The worker discovers that he is currently employed and enters his income information on the SNAP case. Since income is stored in IES at the individual level, his income is updated on the medical only case as well. The worker runs eligibility and certifies the results on the SNAP case, and must run eligibility and certify the results on the Medical only case as well.

Tasks in IES are closed when updates are made, the worker runs eligibility and the case is certified.

Programs	Description	IES Action = Task	CW Action
All Programs	IDES Wages Wage discrepancy between IES and IDES file; income is not being budgeted (Replaces PAL code C)	Task is 'IDES Wage Mismatch' Wage discrepancy information, runs quarterly and appears on a quarterly report IL-18100502-QTL Priority Action List, generated in February, May, August and November.	CW actions listed in WAG 19-06-01-d Manually generate Form 1721C if appropriate. Document in case notes how discrepancy was resolved.
All Programs	IDES New Hires State New Hire Report (runs weekly)	Task is 'IDES New Hire Match' New Hire information appears on a weekly report IL-50470322-WLY-State New Hire No EI Budgeted, and a notice is sent to client (Instructions to Client New Hire).	CW actions listed in WAG 22-14-02 Document in case notes how discrepancy was resolved.
AABD Medical, TANF	CAU Review CAU Disability Determination Review (Replaces PAL code X)	Task is 'CAU Disability Determination Review' Identifies clients who are due for a review of their CAU determination. AABD medical - for disability determination TANF - for W&T exemption (Medical Barrier) Runs the day after cut-off the month before CAU review due date.	CW actions listed in WAG 19-06-01-l Update CAU questions in IES 'Disability' screen; this will create a task for CAU staff.

Programs

Description

IES Action = Task

CW Action

All Programs

IDES Wages

Wage discrepancy between IES and IDES file; income is not being budgeted (Replaces PAL code C)

Task is 'IDES Wage Mismatch'

Wage discrepancy information, runs quarterly and appears on a quarterly report IL-18100502-QTL Priority Action List, generated in February, May, August and November.

CW actions listed in WAG 19-06-01-d

Manually generate Form 1721C if appropriate.

Document in case notes how discrepancy was resolved.

All Programs

IDES New Hires

State New Hire Report

(runs weekly)

Task is 'IDES New Hire Match'

New Hire information appears on a weekly report IL-50470322-WLY-State New Hire No EI Budgeted, and a notice is sent to client (Instructions to Client New Hire).

CW actions listed in WAG 22-14-02

Document in case notes how discrepancy was resolved.

AABD Medical, TANF

CAU Review

CAU Disability Determination Review

(Replaces PAL code X)

Task is 'CAU Disability Determination Review'

Identifies clients who are due for a review of their CAU determination.

AABD medical - for disability determination

TANF - for W&T exemption (Medical Barrier)

Runs the day after cut-off the month before CAU review due date.

CW actions listed in WAG 19-06-01-l

Update CAU questions in IES 'Disability' screen; this will create a task for CAU staff.

Triggers that Generate a Notice or Redetermination

Redeterminations may go through several batch actions. For medical EDGs, an interface action occurs prior to generating the REDE notice. The interface runs clearances to determine whether a medical EDG qualifies for an auto-REDE (Process A) or a manual REDE (Process B).

After IES determines if the Medical EDG qualifies for auto-REDE, IES sends the appropriate correspondence to the customer.

A third batch action occurs at cut-off in the last month of the certification period when a medical EDG may be automatically recertified under Process A; or a SNAP, cash or medical EDG may be canceled due to not responding to a REDE notice as required.

For more information about the auto-REDE process see the upcoming manual release titled: Auto-REDE for Medical Programs.

Programs	Description	IES Actions =Notice	CW Action
TANF	TANF Newborn Newborn turns 1 year old	Schedules and sends appointment notice; generated when any child turns 1 year old (not just deemed newborn). Also creates task in the WVS Inbox (rather than EDM Inbox). Batch runs the day after cut-off in the month before 1st birthday.	Update the RSP
TANF & SNAP	Child Age 6 Youngest child turned 6 years old	Schedules and sends appointment notice; generated when the youngest child in the SNAP EDG turns 6 years old and the EDG contains an individual that is exempt from Work Participation for having a child under 6 years. Also creates task in the WVS Inbox (rather than EDM Inbox). Runs the day after cutoff in the one month before 6th birthday.	Update the RSP Update work deferral
TANF	TANF 57 Month trigger	Notice to inform them about the process for requesting exemption, and the request form is generated to TANF clients. The batch runs after cut-off of the 56th month.	Respond to exemption request if received
TANF	TANF 54 Month trigger	Notice generated to notify client of their TANF Counter and time limit (Form 4634). The batch runs after cut-off of the 53th month.	Respond to exemption request if received
TANF	TANF 48 Month trigger	Notifies the client of their TANF Counter and time limits (Form 4634). The batch runs after cut-off of the 47th month.	Respond to exemption request if received
Medical	REDE Clearances Runs AWVS, The Work Number (TWN) and Secretary of State clearances for Medical EDGs due for REDE	Determines whether medical EDGs that qualify can be auto-REDE'd or not, based on income & Illinois residence data. Runs after cutoff 2 months before the last month in the certification period.	No action
All Programs	REDE Notices REDE Notices generated	Medical Process A - notifies client about continued medical eligibility. Process B - client must respond to REDE to determine continued medical eligibility. Cash & SNAP - Client must always respond to REDE. Notices mailed about 60 days before last day of certification period. A REDE task is created when a client response to the REDE notice is received and entered into IES.	Process A and no response received - No action. Client Responds to REDE - process REDE and certify results.
All Programs	REDE Auto Actions REDE is certified and new certification period assigned, or benefits canceled by system	Runs all REDEs for which a response has not been received and entered into IES. Recertifies medical benefits for EDGs eligible under Process A Cancels benefits for EDGs that did not respond to cash or SNAP REDE, or to medical REDE for EDGs subject to Process B Runs on cut-off in the last month of the certification period.	No action unless client responds within allowable time limits. (see PM 19-04-02)
Medical	REDE AGE 65 ACA Adult, BCC, Widow(er) or VC recipient turning 65	Generates REDE to determine continued eligibility under another medical program. A REDE task is created when a client response to the REDE notice is received and entered into IES.	Process A and no response received - No action. Client Responds to REDE - process REDE and certify results.
Medical	Medicare VCL ACA Adult or FHP recipient receives Part A Medicare (MSP / ACA) - Bendex Update	ACA Adults - Generates VCL to request resource information to determine AABD and MSP eligibility. FHP - Generates VCL to request resource information to determine MSP eligibility.	ACA - remove from ACA Adult and determine AABD and MSP eligibility. FHP - determine MSP eligibility.
Medical	REDE FFC Former Foster Care (FFC) recipient tuning age 26	Generates REDE to determine eligibility for another medical program. REDE task is created when a client response to the REDE notice is received and entered into IES.	Process A and no response received - No action. Client Responds to REDE - process REDE and certify results.
Medical	REDE AATV Asylum Applicant or Torture Victim (AATV) recipient reaching maximum 36 month limit.	Generates REDE to determine eligibility for another medical program. REDE task is created when a client response to the REDE notice is received and entered into IES.	Client Responds to REDE - process REDE and certify results

PAL Codes in IES

Prior to IES Phase 2 implementation, the monthly Priority Action List (PAL) report was provided to Family Community Resource Centers (FCRCs) and HFS Central Offices. It identified cases that were due for a REDE, or had an error, or a high probability of error. A chart that shows how PAL codes are handled in IES Phase 2 is contained in PM 19-06-00.

Interim Process for 19 Year Olds Aging Out of All Kids

Federal regulations require that a redetermination of eligibility under another medical program must be completed before a person is deleted from an All Kids case due to reaching age 19.

19 Year Old is Included in Tax Unit of Head of Household

Post phase 2, when IES data shows that a person who will turn age 19 is included in the same tax filer unit as the head of household, or is married to the head of household, IES will automatically rerun eligibility for the 19 year old based on existing case information.

Example: Mr. Big receives ACA Adult benefits for himself and All Kids Assist for his son, Joe, who will turn age 19. IES data shows that Mr. Big claims Joe as a tax dependent and that countable income for Joe is under the ACA Adult income limit (138% of the FPL). IES will determine that Joe remains eligible for benefits under the ACA Adult program.

19 Year Old Not Included in Tax Unit of Head of Household

When a child who is aging out of an All Kids case is not part of the IES head of household's tax filer unit and is not married to the head of household, the system sees the 19 year old as an adult who must apply on his own behalf (see PM 02-04-03). In this situation, the 19 year old should receive a REDE notice that lets them know that they will no longer qualify for All Kids and may complete a REDE to determine their continued eligibility under a different program.

However, IES will not begin to automatically generate the REDE notice for the 19 year old in this situation until after Phase 2 is implemented. For this reason, an interim process will be used to send REDE notices to 19 year olds who are not identified as part of the head of household's tax filer.

More information about this process will be provided prior to Phase 2 conversion.