C. Contact list · Karen Cremer Courtney Nichols Sue Bakke Karen Cremer Sue Bakke 503-945-6642...

FSML – 59C December 3, 2010 Introduction C – Contact List C - 1

C. Contact list

1. Information resources Information Resource Phone Adoption Assistance A – C D – K L – O P – S T - Z

Karen Cremer Courtney Nichols Sue Bakke Karen Cremer Sue Bakke

503-945-6642 503-947-5092 503-947-5312 503-945-6642 503-947-5312

Alcohol & Drug Lisa Buss/Amy Sevdy 503-945-7017 Alternate Formats [email protected] 503-373-7690 FaxAmeriCorps (Teen Pregnancy Prevention)

Tina McCollum

503-945-6906

Breastfeeding (TANF) Amy Sevdy 503-945-7017 CAF SSP Web applications (such as Notice Retention, OHP application tracker, SNAP, and TANF calculation webpage)

Alma Estrada Leslie Potter Lisa Stegmann Service Desk

503-947-5304 503-945-6293 503-945-6725 503-945-5623

CAWEM Joyce Clarkson Carol Berg Vonda Daniels Christy Garland Michelle Mack

503-945-6106 503-945-6072 503-945-6088 503-945-6119 503-947-5129

Child Care Shiela Carter Cassie Day

503-945-6110 503-945-5729

Child Support See Specific Program Area CMS & FSMIS issues Lisa Stegmann

Alma Estrada Leslie Potter

503-945-6725 503-947-5304 503-945-6293

Client Maintenance Unit (CMU) For changes or corrections to eligibility coding

503-378-4369

Confidentiality (Self-Sufficiency) Linda Weight Caroline Burnell

503-945-6952 503-945-6640

DCI (Degree Completion Initiative)

Amy Sevdy Lisa Buss

503-945-7017 503-945-7017

Domestic Violence/TA-DVS Eligibility

Carol Krager Lily Sehon

503-945-5931 503-945-5624

EBT Bill Walker Lisa Stegmann

503-945-6075 503-945-6725

Employed Persons with Disabilities Program

Jeff Stell 503-945-6834

Employment Services Tracey O’Donnell 503-945-6094 Estate Administration Unit (EAU) Inquiries 503-378-2884

FSML – 59C C - 2 Introduction C – Contact List December 3, 2010

Information Resource Phone Exceptional Needs Care Coordinator (specialized case management of complex medical needs of clients in managed health care plans)

Each health plan has its own Exceptional Needs Care Coordinator. Use the OHP 9031A thru OHP 9031Z (Compare Your Health Plan Choices listed by county) to find toll free phone number for the client’s health plan.

Call the health plan’s toll free number to find out who the Exceptional Needs Care Coordinator is.

Family Support and Connections (FS&C)

Stephanie Jernstedt Patrick Ring

503-945-6737 503-945-7006

Forms and Documents Lynette Sylvester (use GroupWise email box: Forms, DHS)

503-378-3505

Fraud Hotline To report potential fraud 1-888-372-8301 1-888-FRAUD01

Health issues (Physical health, intellectual functioning, mental health, SSI)

Disability Analysts: Tom Shores (D3) Janice Norton (D5) Alice McDonald (D5) Bonnie Parypa (D1 & 9) Joy Plummer (D6 & 7) Scott Hampton (D2 & 15) Vacant (D12, 13, & 14) Gary Davidson (D2) Cathy Rhodes (D2) Michael Mallorie (D4) Kathleen Coolidge (D8) Rebecca Smallwood (D10 & 11) Julie Woods (D16) Ed Scott (D16)

503-373-7073 x567 541-726-6644 x2249 541-726-6644 x2311 503-366-8370 541-888-7017 503-731-3299 541-966-0880 971-673-6877 971-673-6886 541-791-5879 541-776-6024 x224 541-815-3223 503-277-6739 503-277-6798

Health Insurance Group (HIG) For assistance with Third Party Liability (TPL)

503-378-6233

Housing Stabilization Program (HSP) HSP Contract

Carol Krager Lily Sehon

503-945-5931 503-945-5624

Investigations John Carter 503-378-3765 JASR payment screen Lisa Stegmann

Alma Estrada Leslie Potter

503-945-6725 503-947-5304 503-945-6293

Job retention/transition SNAP: Dawn Myers Rosanne Richard Sandy Ambrose Eliza Devlin Sarah Lambert

503-945-7018 503-945-5826 503-945-6092 503-947-5105 503-945-6220


Information Resource Phone Child Care: Shiela Carter Cassie Day

503-945-6110 503-945-5729

JOBS Plus (operations & policy) Tracey O’Donnell 503-945-6094 JOBS Microenterprise Lily Sehon 503-945-5624 JOBS Program Patrick Ring

Amy Sevdy/Lisa Buss Lily Sehon Tracey O’Donnell

503-945-7006 503-945-7017 503-945-5624 503-945-6094

Learning Disabilities Patrick Ring 503-945-7006 Mainframe Systems (CMS, FSMIS, JAS, SPL1, BENDEX, TPQY, EBT, Provider, Special Cash Pay)

Lisa Stegmann Alma Estrada Leslie Potter

503-945-6725 503-947-5304 503-945-6293

Managed Health Care Plans issues

See: Prepaid Health Plan Coordinators See: Exceptional Needs Care Coordinators

Medical programs of CAF Self-Sufficiency (OHP, TANF medical, TANF extended medical, CAWEM)

Joyce Clarkson Michelle Mack Carol Berg Vonda Daniels Jewel Kallstrom Audray Hunter

503-945-6106 503-947-5129 503-945-6072 503-945-6088 503-947-2316 503-947-5519

Medical transportation Medical transportation program manager in DMAP

503-945-6493

Medicare Part D and Low Income Subsidy (LIS)

Dale Marande 503-947-5281

Mental Health Lisa Buss/Amy Sevdy 503-945-7017 MHO exceptions Donna Metzger 503-947-5528 Noncitizen policy See specific program analyst Noncustodial parents DCS Program Analyst (Child

Support Issues) 503-986-6166

Notices Content Technical Issues

See Specific Program Area Lisa Stegmann Alma Estrada Leslie Potter

503-945-6725 503-947-5304 503-945-6293

NOTM: Content Technical Issues

See Specific Program Area Lisa Stegmann Alma Estrada Leslie Potter

503-945-6725 503-947-5304 503-945-6293

OHP program See Medical programs OHP (information on medical services covered)

DMAP 503-945-5772 (Salem) 1-800-527-5772


Information Resource Phone Office of Payment Accuracy and Recovery (OPAR) Policy Analysts

Carolyn Thiebes (HIG, PIL, MPR) Karen Collette (FIU, OWU, ORU) Sharon Arrington (CMU, DMU) Rick Mills (EAU, IRS) Barbara Zharkoff (PERM, PAU)

503-378-3507 503-378-3510 503-378-3304 503-378-3289 503-378-3299

OFSET: Supplemental Nutrition Assistance Program – Employment and Training

Dawn Myers Rosanne Richard Sandy Ambrose Eliza Devlin Sarah Lambert

503-945-7018 503-945-5826 503-945-6092 503-947-5105 503-945-6220

OSIPM Michael Avery Selina Hickman Joanne Schiedler Jeff Stell

503-945-6410 503-945-6139 503-947-5201 503-945-6834

Overpayment: Collections Writers Screens/Systems questions

Steve Stover Angela Molthan Lisa Stegmann Alma Estrada Leslie Potter

503-373-7772 503-373-1872 503-945-6725 503-947-5304 503-945-6293

PC JAS Service Desk 503-945-5623 Personal Injury Lien (PIL) Inquiries 503-378-4514 Post-TANF Tracey O’Donnell 503-945-6094 Prepaid Health Plan Coordinators (managed health care plans enrollment issues)

DMAP: Call the 800 number to identify the PHP Coordinator for the health plan you are interested in.

1-800-527-5772

Presumptive Disability/OSIP Brian Kirk 503-373-0271 Pre-TANF Stephanie Jernstedt

Tracey O’Donnell 503-945-6737 503-945-6094

QMB Dale Marande Jeff Stell

503-945-6476 503-945-6834

RACF Monica Allen 503-945-6890 Refugee Programs Tony Scott

Neeru Kanal 503-947-5261 971-673-5774

Repatriate Gloria Anderson 503-945-5700 SSI Brian Kirk 503-373-0271 State Family Pre-SSI/SSDI Program (SFPSS)

Patrick Ring Erika Miller

503-945-7006 503-945-5915

Subpoenas Caroline Burnell 503-945-6640


Information Resource Phone Supplemental Nutrition Assistance Program (SNAP)

Dawn Myers Rosanne Richard Sandy Ambrose Eliza Devlin Sarah Lambert

503-945-7018 503-945-5826 503-945-6092 503-947-5105 503-945-6220

TANF Tracey O’Donnell Amy Sevdy/Lisa Buss Carol Krager Patrick Ring Stephanie Jernstedt Lily Sehon Cassie Day

503-945-6094 503-945-7071 503-945-5931 503-945-7006 503-945-6737 503-945-5624 503-945-5729

TANF Child Support Amy Sevdy/Lisa Buss Carol Krager (Good Cause)

503-945-7017 503-945-5931

TANF Civil Rights Issues Patrick Ring 503-945-7006 TANF Disability Issues Patrick Ring 503-945-7006 TANF Re-engagement or Disqualification

Patrick Ring 503-945-7006

TANF Time Limits Tracey O’Donnell 503-945-6094 TANF Tribal Policy Tribal TANF Agreement

Lily Sehon Tracey O’Donnell

503-945-5624 503-945-6094

Tax credits Tracey O’Donnell 503-945-6094 TRACS Leslie Potter

Alma Estrada Lisa Stegmann Service Desk

503-945-6293 503-947-5304 503-945-6725 503-945-5623

Translation [email protected] 503-373-7690 FaxTribal issues - Indian Child Welfare Act

(ICWA) - Tribal TANF

Mary McNevins Rick Acevedo Lily Sehon

503-945-7022 503-945-7034 503-945-5624

Trusts (OSIP) Bill Brautigam Joanne Schiedler

503-947-5204 503-947-5201

ViewDirect reports (aka Mobius)


503-945-6725 503-947-5304 503-945-6293

Vocational Rehabilitation Services

Ron Barcikowski 503-945-6734

Workforce Investment Act (WIA)

Lily Sehon 503-945-5624

WSIT/WJSS (JOBS child care payment screens)


503-945-6725 503-947-5304 503-945-6293


2. Information resource e-mail groups (Group Wise e-mail addresses for policy questions) Program Name E-mail Address CAF SSP Training Unit (includes SSP/PSU Collaboration)

CAF, SSPTraining

CAF Technical and Child Welfare Training Units

CAF, TrainingServices

Child Care Program Policy, Childcare Supplemental Nutrition Assistance Program Policy, SNAP Medical Program SSP-Policy, Medical Office of Payment Accuracy and Recovery Policy questions related to: HIG, PIL, Overpayments, Fraud, EAU, CMU

Policy, OPAR

TANF Program Policy, TANF

3. Training units (CAF) Unit Resource Phone CAF Child Welfare Training Unit Manager CW Training Specialist CAF Events Coordinator FACIS/ORKids Trainers

Administrative Support Foster Parent Lending Library

Karyn Schimmels Judy Helstrom Sue Ellen Seydel Deborah Martinmaas Adelaid Turner Cynthia Gallegos – NetLink Brian Hebert – NetLink Cynthia Gallegos

503-373-7231 503-945-6681 503-945-6687 503-373-7714 503-378-5817 503-373-7838 503-508-6879 503-373-7838

CAF SSP Training Unit Manager Lead Trainer Administrative Specialist/ Training Support Trainers

Bonnie Murray Darlene Kelly Cori Budrow – Web Design Annette Aylett Douglas Bloom Steve Bradley – NetL:ink Karrie Farrell Darlene Kelly Terry Kester Christina Latham-Brown Sara Reed (PSU Collaboration) Glenda Short Betty Silva

503-569-6472 503-373-1465 503-373-1786 503-373-7893 503-373-7881 503-378-6262 503-373-1711 503-373-1465 503-373-7882 503-378-2776 503-367-8222 503-373-7818 503-373-1754


E. Pat Smith – NetLink Lori Van Dusseldorp Heidi Wormwood

503-373-1707 503-378-2777 503-373-7885

CAF Technical Training Unit Manager Administrative Support Video Conferencing Technical Trainers

Karyn Schimmels Cynthia Gallegos – NetLink Brian Hebert – NetLink Cynthia (‘thia) Evans Jolly Hill Elizabeth Lair – E-Learning/ NetLink

503-373-7231 503-373-7838 503-508-6879 503-378-6337 503-378-2772 503-373-7869

Domestic Violence Training Team

Karrie Farrell Darlene Kelly Lori VanDusseldorp

503-373-1711 503-373-1465 503-373-1707

ERDC Training Team Annette Aylett Lori Van Dusseldorp Heidi Wormwood

503-373-7893 503-373-1707 503-373-7885

Medical Training Team Annette Aylett Terry Kester Glenda Short Betty Silva Lori VanDusseldorp Heidi Wormwood

503-373-7893 503-373-7882 503-373-7818 503-373-1754 503-373-1707 503-373-7885

Noncitizen Training Team Karrie Farrell Terry Kester Glenda Short Betty Silva Heidi Wormwood

503-373-1711 503-373-7882 503-373-7818 503-373-1754 503-373-7885

Supplemental Nutrition Assistance Program Training Team

Douglas Bloom Karrie Farrell Betty Silva Heidi Wormwood

503-373-7881 503-373-1711 503-373-1754 503-373-7885

SSP E-Learning Training Team Annette Aylett Cori Budrow Terry Kester Christina Latham-Brown Betty Silva

503-373-7893 503-373-1786 503-373-7882 503-378-2776 503-373-1754

SSP Essentials and SSP Communication Fundamentals Training Team

Douglas Bloom Sara Reed Glenda Short

503-373-7881 503-367-8222 503-373-7818

SSP Modernization Training Scott Ciullo 503-373-7884 SSP Technical Training Team Steve Bradley

Christina Latham-Brown 503-378-6262 503-378-2776

TANF Training Team Karrie Farrell Darlene Kelly Sara Reed Lori Van Dusseldorp

503-373-1711 503-373-1465 503-367-8222 503-373-1707

TANF Vocational Training Lisa Buss/Amy Sevdy 503-945-7017


4. Other resources Item Resource Phone Children: abused, neglected

CAF Child Welfare (formerly SCF) See “Blue Pages” of a local phone book

Domestic violence Crisis Programs www.dhs.state.or.us/abuse/domestic/gethelp.htm

Early childhood education

Oregon Department of Education or local school district

503-378-5585 See “Blue Pages” of a local phone book

Health insurance for low-income families

Office of Private Health Partnerships 1-800-542-3104

Immigration and Naturalization Service Information

General Information 503-326-5930

Medical coverage information for women, children, and teens not eligible for DHS medical programs

SAFENET – Statewide Metro-Portland/Tricounty Immunization Information Teen Health Infoline

1-800-SAFENET 503-306-5858 1-800-998-9825

Nutrition Information Ellen Schuster 541-737-1017 Rehabilitation for employment

DHS Vocational Rehabilitation (formerly VRD)

503-945-5880 1-877-277-0513 (Toll Free) TTY: 866-801-0130

Specialized services for clients: educational support, I&R, lunch buddy programs, mentoring, recreational activities, resource locations, seasonal programs, socialization programs, special projects, transportation, work experience, AmeriCorps volunteers

DHS Volunteer Services See local DHS Volunteer

FSML – 59C December 3, 2010 Medical Assistance Programs E – Specific Eligibility Requirements E - 33

18. Specific Requirements; Healthy KidsConnect (HKC) Overview HKC provides health insurance to families through the Office of Private Health Partnerships (OPHP). OPHP provides health insurance through HKC insurance carriers or by helping the family pay for employer sponsored insurance (ESI).

• Families with income from 201 percent of the Federal Poverty Level (FPL) up to 301 percent FPL qualify for a subsidy payment from OPHP to help them pay for the cost of the insurance. The subsidy is used to help pay the insurance premium necessary to enroll the child with an HKC insurance carrier or to help pay the ESI premium.

• Families with income from 301 percent FPL and above may choose to enroll their children with an HKC insurance carrier, but must pay for the entire premium amount.

Even though families with income from 301 percent FPL and above do not qualify for any DHS medical program, DHS is responsible for determining the family can be referred to OPHP. HKC families are automatically referred to OPHP when the HKC (KCA/KC3) coding is entered on the family’s CM system case. After being determined eligible for HKC and the HKC coding is entered on the family’s CM system case, an automated referral is made to OPHP. OPHP works with the family to enroll the child in one of the following categories:

(A) Healthy KidsConnect Employer Sponsored Insurance (ESI) subsidy for families with income 201 percent to 301 percent FPL;

(B) Healthy KidsConnect subsidy for families with income 201 percent to 301 percent FPL; or

(C) Healthy KidsConnect full pay for families with income 301 percent and above.

Note: HKC families who do not pass the business $20,000 business entity income test should be referred to OPHP as nonsubsidy (KC3) HKC clients.

HKC Eligibility To be eligible for HKC, a person must be under 19 years of age and must meet the alien status requirement. There is no CAWEM coverage under HKC. Income treatment and availability of income requirements used for determining HKC eligibility are the same as used for CHIP.

FSML – 59C E - 34 Medical Assistance Programs E – Specific Eligibility Requirements December 3, 2010

Budgeting for HKC eligibility follows the same methodologies as those used for CHIP in 461-150-0055.

• Determine eligibility using budget month income, including the $20,000 business entity income test for principals of a business.

• If not eligible using the budget month, the budget month can be floated.

Note: Float the budget month if the family indicates their income is decreasing and they could qualify for OHP Plus or a higher subsidy level using the new budget month.

The countable income standard for HKC is at or above 201 percent of the federal poverty limit. Families eligible for HKC with income 201 percent to 301 percent (KCS) are DHS medical program clients. They qualify for a subsidy paid for with title XXI funds. (Title XXI is also used to fund the CHIP program.) Families eligible for HKC with income 301 percent and above (KC3 coding) or who do not pass the $20,000 business entity income test are not DHS clients, but are referred to OPHP anyway. Some families with income 301 percent and above choose to work with OPHP. They choose to enroll with an HKC insurance carrier and pay the full insurance premium. In order to be eligible for HKC, the child must be a U.S. citizen or meet qualified alien status.

• If a child does not have citizenship documentation but is otherwise eligible for HKC at 201 percent to 301 percent of the FPL, add the KCA coding to the CM case. Also add the CIP coding and send a CMCITPD or other pend notice to the family. Transfer the case to 5503 and mail/shuttle/UPS the application to 5503 using the HKC cover sheet.

• Once the citizenship documentation has been provided. Update the child’s Person Alias/Update citizenship fields, remove (or have 5503 remove) the CIP/CIE coding and narrate.

• If it has been determined the family’s income is 301 percent FPL and above, add the KC3 coding to the CM case but do not add the CIP coding or pend the family for citizenship documentation for the child. (I.e., do not pend when you are going to deny the medical application anyway).

• If the family’s self-employment business does not pass the $20,000 business entity income test, code as KC3 with HPK of $9999. The $9999 HPK income amount is used as a way for OPHP to identify families who do not meet the $20,000 business entity income test. A new case descriptor will be added to the CM system soon that will replace the $9999 identifier. (Notification will be sent via transmittal when the new case descriptor is ready.)

MORE INFORMATION ABOUT HKC CASE CODING IS BELOW IN THIS SAME SECTION.


The eligibility period for HKC is a 12-month period. Once the child is approved as eligible for HKC, the CM system refers the case to OPHP for a subsidized enrollment with an HKC insurance carrier or for an ESI subsidy payment. To be eligible for HKC, the child must not currently be covered by private major medical health insurance or by any private major medical health insurance during the preceding two months. Note: The Kaiser Child Health and Kaiser Transitions insurance programs are not

considered private major medical. Neither program affects HKC (or CHIP) eligibility.

After the private major medical has ended, there is a two-month waiting period before the child can be enrolled by OPHP into HKC. However, if the child qualifies for a waiver of the two-month waiting period, OPHP will ensure the private major medical has ended. Do not delay referring families to OPHP if they are otherwise eligible for HKC and qualify for a waiver of the two-month waiting period. The two-month waiting period after the private major medical has ended is waived if –

a) The person has a condition that without treatment would be life-threatening or cause permanent loss of function or disability (accept the client’s statement);

b) The loss of health insurance was due to a change in employment (includes children whose COBRA coverage has ended or whose parents choose to end COBRA coverage);

c) The person’s private health insurance premium was reimbursed by a HIP payment;

d) The person’s private health insurance premium was subsidized by FHIAP or by the Office of Private Health Partnerships (OPHP);

e) A member of the person’s filing group was a victim of domestic violence and accessing the private health insurance would cause safety concerns.

Note: If a domestic violence situation exists but the perpetrator is not the policy holder of the private health insurance and accessing the private health insurance does not cause any safety concern, then the waiver does not apply.

If an HKC child is receiving private major medical and qualifies for a waiver of the two-month waiting period:

• Code the KCA or KC3 HKC referral on the CM system.

• Send an e-mail to OPHP at “Info, OPHP” in GroupWise with the case number, case name, name of the insurance company, phone number of the insurance company or employer offering the insurance, names of child(ren) covered by the


insurance. A DHS 415H is not required for HKC. The e-mail replaces the DHS 415H.

• OPHP will work with the family and the insurance carriers so that the private health insurance will be closed before the HKC benefits are issued.

SEE B.4 IN THIS CHAPTER FOR MORE INFORMATION ABOUT THE E-MAIL REFERRAL TO OPHP.

Example: John and Mary are applying for medical for their daughter Maria.

Maria has a health condition that without treatment could be disabling. John and Mary have been paying for private TPL for Maria but can no longer afford the premiums. The family’s income is 252 percent of the federal poverty level (FPL) and Maria could qualify for HKC after her insurance ends. Since Maria has a health condition that qualifies her for a waiver of the two-month uninsurance requirement, add the KCA coding to Maria on the family’s CM case. Send an e-mail to Info, OPHP letting OPHP know that Maria qualifies for a waiver of the two-month wait. List the case number, case name, Maria’s name and the name of the insurance company (and the insurance company’s phone number, if known). A DHS 415H is not required.

Example: Sara is applying for medical for her daughter Heather. Sara lost her

job, and has been paying for Heather’s insurance through COBRA. The family’s income is 205 percent FPL and Sara cannot afford to keep paying the COBRA health insurance premium. COBRA coverage is due to a change in employment and qualifies Heather for a waiver of the two-month waiting period. Refer to OPHP by adding the KCA coding to the CM case. Send an e-mail to OPHP letting them know that Heather qualifies for a waiver of the two-month wait. Include the case number, case name and list Heather as the person qualifying for the two-month waiver. Include the name of the health insurance company and phone number (if known). A DHS 415H is not required.

Example: Jennifer is applying for medical for her son Franklin and daughter

Louise. Louise is included on her absent father’s insurance, but Franklin has a different father and does not receive any insurance. Jennifer just separated from Louise’s father because of domestic violence. Jennifer explains that Louise’s father has been very upset about having to pay for Louise’s insurance and continues to threaten Jennifer. Jennifer no longer wants to use the insurance for Louise and wants to receive medical benefits for both Franklin and Louise. The family’s income is at 220 percent FPL.


The two-month wait can be waived because of the domestic violence. Send an e-mail to OPHP letting them know Louise qualifies for a waiver of the two-month wait. Include the case number, case name and Louise’s name. Include the name of the health insurance company and phone number (if known). A DHS 415H is not required.

A child found eligible for HKC becomes ineligible if any of the following occur:

a) Upon reaching age 19: Children aging off of HKC at age 19 are not treated as new applicants for OHP Standard. They do not need to be randomly selected from the reservation list to qualify for OHP Standards as long as they establish a date of request before their HKC ends. If eligible, they may transition into OHP Standard effective the first of the month after the 10-day notice of reduction period.

b) When the child becomes covered by private major medical (see OAR 461-135-1100 for a definition of private major medical) and the insurance is not under contract to OPHP.

c) Upon becoming a resident of another state.

d) When the family does not pay their share of the HKC insurance premium.

e) When OPHP determines the child no longer qualifies for enrollment through OPHP.

f) When the department determines the child does not meet the requirements for eligibility, including, but not limited to, failure to re-enroll before the end of the eligibility period.

After determining eligibility After making the eligibility decision, HKC cases must be transferred to Branch 5503:

• Please transfer the KC3, KCA or KCE CM system case to the OHP Statewide Processing Center (Branch 5503) online.

• Shuttle, UPS or mail a copy of the application to 2850 NE Broadway, Salem OR 97303. Be sure to use the HKC cover sheet. The cover sheet is available on the SSP medical tools Web site.

When to e-mail OPHP

• For HKC families with income from 201 percent of the federal poverty level (FPL) to 301 percent FPL, determine if the child is eligible for a KCA referral to OPHP. After coding the KCA/KCR referral on the CM system, send an e-mail to INFO, OPHP in the following situations:


- When the KCA child is not receiving private major medical but it is available.

- When the child who is otherwise eligible to be referred as a KCA child is receiving private major medical but qualifies for a waiver of the two-month waiting period.

When sending e-mails to INFO, OPHP about Health Insurance, be sure to include the following information:

• Case number.

• Case name.

• Name and phone number of the insurance company, or, for employer sponsored insurance, the name and phone number of the employer.

• The names of child(ren) that are or could be covered by the insurance.

Note: The Info, OPHP e-mail process replaces the DHS 415H process for HKC clients. The DHS 415H is no longer faxed to OPHP. The DHS 415H is still completed and sent to HIG for Medicaid clients.

Reporting Changes KCA and KCE families must report the following changes:

• A change in availability of employer-sponsored health insurance.

• A change in health care coverage.

• A change in mailing address or residence.

• A change in name.

• A change in pregnancy status of any member of the filing group.

Redeterminations Redetermine eligibility whenever an HKC subsidy (KCA or KCE coding) family reports a pregnancy, when the certification period is due to expire, when a KCA/KCE child turns age 19, when the family requests a new child be added to the KCA/KCE benefit group or whenever there is a change reported that affects eligibility. Adding a child to a KCA/KCE benefit group: When a KCA or KCE family requests a child be added to the benefit group, redetermine eligibility for everyone in the family. Review each child for CEC, CEM, EXT, MAA, MAF, OHP and OSIPM eligibility. If not eligible for an OHP Plus program, consider KCA.


• If as a result of the new redetermination to add the child, the new filing group’s countable HKC income increases so that the subsidy would be reduced, add the child to the original HKC certification period using the original HPK income amount. The new benefit group remains eligible at the same subsidy level for the remainder of the original certification period.

• If as a result of the new HKC redetermination to add the child, the HKC filing group’s countable HKC income decreases so that the subsidy would be increased, add the child and establish a new 12-month certification period for every child in the benefit group based on the new HPK income amount.

Converting from HKC subsidy (KCA or KCE coding) to another program: When a KCA or KCE family is found eligible for another DHS medical program, convert the children to the other program effective the first of the next month. Convert the adults to the program effective the DOR.

SEE MA.B 9 FOR MORE INFORMATION ABOUT MEDICAL PROGRAM EFFECTIVE DATES.

Special Branch 5503 Procedures

Branch 5503:

• Works a report of KCA/KCE children turning age 19.

• Processes changes reported by the HKC subsidy client (KCA or KCE coding) to OPHP. For example, when OPHP is notified that someone had moved in or out of a KCA household or there is an address, phone number or other CM system update is needed.

• Redetermines eligibility for all HKC subsidy clients with cases in Branch 5503.

HKC CM System Coding Overview For more information about the HKC CM system coding requirements, see the SSP medical program Web site. For all HKC referred children, regardless of the income or circumstances, do not use the “VP” or “CP” CM case status to determine if the child is receiving medical benefits. HKC referrals in “VP” or “CP” status do not mean the child is receiving any kind of medical. If the child has been referred to OPHP for HKC, the child will have a KCA or KC3 case descriptor.

• KCA children are eligible for DHS medical program benefits. Their family’s income is 201 percent to 301 percent. Once OPHP enrolls the child with an insurance carrier or begins making ESI premium subsidy payments, the KCA case


descriptor will automatically be updated to KCE (HKC enrolled) and a medical start date added or updated.

• KC3 children are not eligible for DHS medical program benefits. They may purchase health insurance, but must pay the full premium amount. DHS benefits must be ended when completing the referral to OPHP. The CM case will remain in “VP” status through the KC3 referral end date. KC3 children include children who are not eligible for DHS medical program benefits because the financial group did not pass the business entity $20,000 income test.

KCA (201 percent to 301 percent HKC referrals) HKC clients eligible at the KCA level are DHS clients. Do not send them a denial or closure notice when converting to HKC.

• Enter the number in the need group (including unborns) in the #OHP field on the UCMS screen.

• Use the HPK income need/resource to list income amounts (instead of the HPI need/resource).

Use a KCA case descriptor and need/resource item to identify each child who is HKC eligible with income 201 percent to 301 percent.

• Once the KCA coding is added, the CM system will automatically refer the KCA child to OPHP. The CM case will display in VP status until the KC3 referral is closed. OPHP has 45 days from the date of the referral to work with the family and issue a subsidy payment.

Note: KCA children referred to OPHP may not have a medical start date on CMUP. The only time a KCA child will have a medical start date on CMUP is if the child is already receiving medical benefits through another program before the referral is made.

• For the KCA need/resource end date, use the month in which the 10-day notice

period ends after the 45-day period.

Example: A decision to refer to OPHP is made on April 15, 2010. Count 45 days from April 15 and add time for a 10-day notice. In this example the KCA end date is 06/10.

• If the KCA referred child is already receiving OHP Plus benefits, add the BED

code as needed to keep the benefits open until OPHP issues HKC benefits. Match the BED end date to the KCA end date.

Use a KCR need/resource to identify each KCA referred child.

• The KCR end date is 12 months from the referral date.


Example: The decision is made April 15, 2010, to refer a KCA child to OPHP. The KCR end date is 04/2011.

Note: KCA-referred children are eligible for a DHS medical program. Do not send

them a denial notice. Also, the CM system will automatically send a referral notice. If the child is BED coded, the computer will add the reduction information to the referral notice. No 10-day notice of reduction is required.

Employer Sponsored Insurance coding: If the family has employer sponsored insurance available for the KCA child but the child is not receiving the insurance:

• Add an ESP need/resource item with a continuous date (ESP C) for each child with the available coverage. (Consider the insurance available even if it is not the employer’s open enrollment period).

KC3 (301 percent and above HKC referrals):

• Enter the number in the need group (including unborns) in the #OHP field on the UCMS screen.

• Use the HPK income need/resource to list income amounts (instead of the HPI need/resource). If the family is eligible for KC3 because the family is self-employed and the business entity income is $20,000 or higher, enter nines (9999) as the HPK income amount.

Use a KC3 case descriptor and need/resource item to identify each child who is HKC eligible with income 301 percent and above. HKC children with family income at or above 301 percent are not DHS medical program clients. Families with children receiving DHS medical program benefits must be sent the CMCNSUB closure notice and a DHS 462A notice. Families with children who are not currently receiving DHS medical program benefits must be sent a CMDNSUB denial notice and a DHS 462A notice.

• Use a KC3 case descriptor and need/resource item for each child needing referral at 301 percent or above.

• For the KC3 need/resource end date, use the month after the referral was made. The CM case will display in VP status until the KC3 referral is closed.

• If the children are currently receiving DHS medical benefits, enter a COMPUTE action and end benefits the end of the month after the 10-day notice (and DHS 462A) is sent. You might need to wait until after the CM system compute deadline before adding the KC3 referral.

Note: KC3-referred clients are not eligible for any DHS medical program. Do not forget to send them a closure or denial notice with the DHS 462A notice. No


notice is required for the KC3-referred children. The CM system will automatically send a referral notice.

Filing Group; HKC, OHP: 461-110-0400

Periodic Redeterminations; Not EA, ERDC, EXT, OHP, REF, REFM, SNAP or TA-DVS: 461-115-0430 Certification Period; HKC, OHP: 461-115-0530

Required Verification; BCCM, EXT, HKC, MAA, MAF, OHP, SAC: 461-115-0705 Specific Requirements; OHP: 461-135-1100

Specific Requirements; Healthy KidsConnect (HKC): 461-135-1101 Income Standard; HKC, OHP, REFM: 461-155-0225

Concurrent and Duplicate Program Benefits: 461-165-0030 Changes That Must be Reported: 461-170-0011

Notice Situations; General Information: 461-175-0200 Effective Dates: Initial Month Medical Benefits: 461-180-0090

FSML – 59C MP-WG #4 December 3, 2010 Contacts for Statewide Verification of Assistance Page - 1

Worker Guide Contacts for Statewide Verification of Assistance

This worker guide is intended to help workers determine if an applicant for assistance in Oregon has already received benefits in another state. This is a list of central phone numbers or fax numbers that workers can use to find out if a person applying for assistance in Oregon has already received benefits in another state or American territory. If the client has a different phone number for a specific worker in another state or territory, use that number. Please notify the policy unit of any changes to the numbers on this list. Note: For fax requests please provide the agency name, program, address, phone

number, fax number and the name, social security number, and date of birth for everyone on the case, as well as the date they moved to Oregon.

State Phone Numbers Fax Numbers Additional Information

Alabama

SNAP: 334-242-1700 MEDICAL: 334-242-5010 TANF: 334-242-1773

TANF: 334-242-0513

SNAP: Phone request only. MEDICAL: Phone request only. TANF: Fax request only.

Alaska General: 907-465-3360 General: 907-465-3651 Phone or Fax request.

American Samoa General: 011-684-633-2609

Arizona General: 602-542-9935 Verifications should now be e-mailed to: [email protected].

Arkansas General: 501-682-8269 General: 800-482-8988 General: 501-682-8978

The receptionist at the general number will forward the caseworker to the appropriate local department.

California General: 916-651-8848 Option 7 General: 916-651-8866

Phone request preferred to general number. If already aware of city or county to contact, call 916-651-8848, then 1, then 7 E-mail: [email protected] Include city name in e-mail so that California will know where to direct you.

Colorado SNAP: 303-866-3860 MEDICAL: 800-221-3943 Phone request only.

Connecticut General: 860-647-1441 General: 860-647-5888 Phone or Fax request.

Delaware General: 800-372-2022 Option 5

General: 302-571-4901 Fax request on agency letterhead preferred.

District of Columbia (DC)

General: 202-535-1104 or 202-535-1182 General: 202-535-1514

Fax request only. (Call General numbers only to update info.)

Florida General: 866-762-2237 Option 2

Phone or e-mail request. E-mail: [email protected]

Georgia General: 800-869-1150 General: 404-463-0093 E-mail, Phone or Fax request. E-mail preferred: [email protected]

Guam General: 671-735-7279

Phone or Email request. email: [email protected] or [email protected] if additional information is required.

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Hawaii

TANF: 808-586-5725 SNAP: 808-586-5735 MEDICAL: E. Hawaii: 808-933-0339 W. Hawaii: 808-327-4970 Maui: 808-243-5780

MEDICAL: 808-933-0344 808-327-4975 Kauai: 808-241-2583 808-243-5788 Oahu: 808-586-5718

Phone request only.

Idaho General: 208-334-5815 General: 208-334-5571 Phone or Fax request.

Illinois General: 217-524-5007 General: 217-524-4174

General: 217-557-1370 Fax request preferred.

Indiana General: 317-233-0826 General: 317-233-0828 Phone or Fax request.

Iowa General: 515-281-6899 General: 515-281-3959

Phone or Email request. email: [email protected]

Kansas [email protected] Kentucky General: 502-564-7514 General: 502-564-4021 Phone or Fax request.

Louisiana General: 225-342-2342 MEDICAL: 225-922-1542

General: 225-342-6996 Phone or Fax request.

Maine General: 207-287-2826 General: 207-287-5096 Fax request.

Maryland

General: 800-332-6347 Option 1, 3 & then option # of benefits department you need to verify Phone request.

Massachusetts

General: 617-348-8500 General: 800-445-6604 MEDICAL: 800-242-1340, Option 1, 5, 1 or 2 (depending on client’s age) Phone request only.

Michigan General: 517-373-3908 General: 517-335-6054 Phone or Fax request. Minnesota General: 651-431-4001 Phone request only.

Mississippi General: 800-948-3050 MEDICAL: 601-961-4361

General: 601-359-4550

Fax or Email request. email: [email protected]

Missouri General: 573-751-3221 General: 573-751-3677 Phone or Fax request.

Montana Gen/Med: 406-444-3050 TANF: 406-444-0640 Phone request only.

Nebraska General: 402-471-3121 General: 402-471-9597 Phone or fax request.

Nevada General: 775-684-0615 General: 775-684-0617 Phone or fax request. Phone request preferred.

New Hampshire General: 603-271-4238

General: 603-271-4637

Phone or Fax request. * plus written auth from client for fax

New Jersey General: 609-588-2283

General: 609-631-4507

Fax request only. Attn: Joyce

New Mexico General: 505-841-7700 General: 800-283-4465

General: 505-841-7754

Phone or fax request.

New York General: 518-473-6110

General: 518-474-8090

Fax request only, on department letterhead, plus reason for info

North Carolina General: 919-334-1224 MEDICAL: 919-855-4000

General: 919-334-1266 Medical: 919-715-0801 Phone or Fax request. Fax preferred

North Dakota General: 701-328-2332 General: 701-328-1060 Phone or Fax request. Ohio N/A 614-466-1767 [email protected] Oklahoma General: 405-521-2779 Phone request only. Oregon General: 503-945-5601 General: 503-373-7032 Fax request only.

FSML – 59C MP-WG #4 December 3, 2010 Contacts for Statewide Verification of Assistance Page - 3


Pennsylvania General: 610-821-6711

General: 610-821-6514

Phone or Fax request. attn: Clerical Dept

Puerto Rico

General: 787-289-7600 x 2613 or x 2609 MEDICAL: 787-765-1230 x 5811

General: 787-289-7614 MEDICAL: 787-250-0900 Phone or Fax request.

Rhode Island General: 401-222-7000 Phone request.

South Carolina General: 803-898-0996 MEDICAL: 888-549-0820

General: 803-898-7156

General: Phone or Fax request. MEDICAL: Phone request only.

South Dakota General: 605-773-3493 MEDICAL: 605-773-4678


Tennessee General: 615-313-5652 General: 615-687-5535 Fax request only.

Texas When written verification is not needed: 877-787-8999 General: 888-780-8099 Fax request only.

Utah General: 801-526-0950 Option 3


Vermont General: 800-287-0589 MEDICAL: 800-250-8427 Phone request only.

Virgin Islands General: 340-773-2323 General: 340-773-5060


Virginia General: 703-324-7500

General: 703-324-3896

Phone request only. Request to speak to supervisor.

Washington General: 360-725-4763 General: 360-725-4904 Phone or Fax request. West Virginia General: 877-716-1212 General: 304-558-1869 Phone request only.

Wisconsin

General: 608-261-6378 Option 3 TANF: 608-261-6317 Option 2 Phone request only.

Wyoming General: 307-777-6079 Phone request only.

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C. Contact list · Karen Cremer Courtney Nichols Sue Bakke Karen Cremer Sue Bakke 503-945-6642...

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