PM 04-06-00: IES Case Composition and Office Functions in Phase 2

WAG 04-06-00

new textCDB to IES in Phase 2

Under IES Phase 2, in most situations the entire household can remain in the same IES case because an IES case can contain combinations of programs that were not possible in the CDB/legacy system. These new combination cases require changes regarding which office may certify and maintain cases with multiple program EDGs. This also requires new rules about when cases should be split, and when cases can be merged.

After conversion, most cases that have the same head of household (HoH), also known as the 'payee', should be merged into one IES case. Having one case for a family who lives together is easier for the client and promotes good customer service. However, there are still a few situations that require that an application or case be split. And, there are some situations where cases with the same payee should not be merged.

new textCases Maintained by FCRCs

Cases with cash (TANF, AABD cash or RRA) and SNAP EDGs are certified and maintained by DHS FCRCs only. This includes cash or SNAP cases that also contain medical EDGs.

Ongoing, DHS FCRCs maintain:

  • Cases with Cash or SNAP EDGs
  • AABD Community (medical only or with SNAP or cash)
  • AABD Community Spenddown (medical only or with SNAP or cash)
  • Other medical cases when the case includes SNAP or cash

new textSpecialty Offices

  1. Medical Management Unit (office 155) - Medical only cases that contain FHPs (other than All Kids Share or Premium), ACA Adult, Former Foster Care, or AATV EDGs that are not in Cook County are transferred to MMU for case maintenance.
  2. Stroger (office 197) - Maintains medical only cases that contain FHPs (other than All Kids Share or Premium), ACA Adult, Former Foster Care and Medicare Savings Programs that result from applications received from Cook County Hospital for customers who continue to reside in Cook County.
  3. Medical Field Offices (offices 200, 244 & 163) - Maintains Long Term Care-Nursing Home and Supportive Living Program cases.
  4. DHS Central Office 238 -Maintains medical only cases for persons approved for the Medically Fragile Technology Dependent (MFTD) waiver.
  5. HFS Central Offices - Medical only cases that contain an All Kids Share, All Kids Premium, HBWD, VC or BCC EDG will be maintained by an HFS central office as described below.

new textAll Kids Share and Premium Cases with Cash or SNAP

All Kids Share and Premium EDGs can be certified in any DHS FCRC, or in the central All Kids Unit if the application does not request cash or SNAP benefits. If the application contains a request for cash or SNAP, it must be certified by a DHS FCRC. After Phase 2 implementation, an IES case can contain both an All Kids Share or Premium EDG and a SNAP or cash EDG.

The All Kids Unit (AKU) will continue to maintain medical only cases with All Kids Share and All Kids Premium EDGs, even if the case contains other medical EDGs that are normally maintained by FCRCs.

However, if a family with an All Kids Share or Premium case that is being maintained by the AKU applies for cash or SNAP, the case must be transferred to an FCRC for a disposition. If cash or SNAP is certified, the case must remain at the FCRC for case maintenance. A case with cash or SNAP benefits cannot be transferred back to the AKU.

new textAKU Support for All Kids Share/Premium Cases Maintained by DHS FCRCs

FCRC staff may contact the AKU for assistance relating to All Kids Share or Premium cases. Questions can be emailed to All Kids at

hfs.allkidscalendar@illinois.gov

 or by phone at 1-877-805-5312 (select 4).

Contact AKU or refer customers to AKU for the following:

  • Questions about premium payments, or
  • Requests for Prior Coverage when they are made after the AK Share/Premium case is approved.

IES will process Prior Coverage when an applicant requests backdate for a child who is approved for AK Share or Premium Level 1. However, when the applicant requests Prior Coverage after the initial approval is certified, refer the customer to AKU.

new textHBWD, VC or BCC Cases (Cash or SNAP Requests)

  • HBWD can be certified in the HFS Special Programs Office, LO 250 only.
  • Veterans Care (VC) EDGs can be certified in the HFS Special Programs Office, LO 196 only.
  • BCC applications are always medical only applications that are filed directly with the AKU and can be certified in the AKU/BCC office, LO 189 only.

An application for medical benefits that progresses to an HBWD or VC EDG must always be transferred to LO 250 or LO 196. A case transfer message appears on the certification page in IES requiring the worker to transfer the case to LO 250 or 196.

If the application also contains a cash or SNAP request, a message will appear requiring the worker to split the medical component on to a separate case. The cash/SNAP benefits must be certified by an FCRC, and the medical component certified in the HFS Special Programs office.

HFS Special Programs and the AKU/BCC office will maintain medical only cases that contain an HBWD, VC or BCC EDG, even if the case contains other medical EDGs that are normally maintained by FCRCs. However, if cash or SNAP benefits are requested, the case must be split and the cash/SNAP case transferred to the FCRC for a disposition and case maintenance if certified.