340:65-3-4. Investigation of eligibility conditions and services planning
(1) Home visits. Home visits are sometimes necessary for Adult and Family Services (AFS) staff to provide services and benefits and promote safety and stability for families. All home visits are planned and coordinated with the client.
(A) AFS staff makes home visits or other client contacts during normal work hours whenever possible. Home visits may be made outside of normal business hours when planned with the client and approved by appropriate supervisory personnel. • 3
(B) The AFS worker makes a home visit when:
(i) he or she is unable to obtain necessary documentation from other sources;
(ii) a face-to-face interview is required and an office visit creates a hardship for the household;
(iii) a Temporary Assistance for Needy Families (TANF) benefit closes due to failure to cooperate, per Oklahoma Administrative Code (OAC) 340:10-2-2; • 4
(iv) it is the best method to complete or review the TANF employability plan;
(v) protective services are needed; or
(vi) the worker deems it necessary for another reason and the supervisor concurs.
(2) Collateral contact. A collateral contact is a person outside of the household that confirms the household's circumstances. The collateral contact may be made in person or over the phone.
(A) A collateral contact is not restricted to a particular person, but may be anyone able to provide an accurate third party confirmation of the household's circumstances. Examples of acceptable collateral contacts are:
(ii) agencies, businesses, or community action groups;
(iii) migrant service agencies;
(iv) neighbors of the household;
(v) landlords; or
(vi) other persons outside of the household with knowledge of the household's circumstances.
(B) The client's signature on the application or renewal authorizes the worker to secure the required information or verification from collateral contacts. When the collateral contact requires additional written authorization before supplying information to Oklahoma Human Services (OKDHS) the client or the affected adult household member signs Form 08AD060E, Request for Release of Information, to give authorization.
(C) The worker informs the person contacted for information how OKDHS plans to use the requested information and the reason it is needed.
(i) worker contacts a collateral contact for information or someone contacts the worker with information related to the household's eligibility and the collateral contact requests anonymity, the worker does not record the person's name in the case record or reveal the person's name to the client.
(ii) When the collateral contact requests anonymity, information obtained from the collateral contact cannot be used to reduce or close benefits unless the worker is able to verify the information by another source.
(D) When the collateral contact provides information related to the client's eligibility that conflicts with information provided by the client, the worker gives the client the opportunity to resolve the inconsistency. • 5
(3) Public records. The worker may obtain information from public records that affects the person's eligibility without obtaining the person's consent.
(4) Data exchange. Automated data exchange with other agencies provides OKDHS with information regarding household members' benefits, wages, taxes, Social Security numbers, and current addresses. The system compares information obtained electronically with data stored within OKDHS electronic records to determine if there are discrepancies that need to be addressed. Automated data exchange information is also available within the OKDHS system to determine discrepancies. • 6 Refer to OAC 340:65-1-2 for information regarding practices for safeguarding case information and raw tax data. The worker is responsible for:
(A) reviewing data exchange information at application and eligibility renewal. Available data exchange information screens include:
(i) Beneficiary and Earnings Data Exchange System (BENDEX); • 7
(ii) Buy-In Data Exchange (BIL); • 8
(iii) Supplemental Security Income (SSI)/State Data Exchange System (SDX); • 9
(iv) Social Security Administration (SSA) Beneficiary Earnings Exchange Record (BEER/BWG); • 10
(v) New Hire Employee list (NHL); • 11
(vi) Social Security Number (SSN) Verification - SSN Enumeration; • 12
(vii) Wage Data Exchange; • 13
(viii) Unemployment compensation; • 14 and
(ix) Unearned Income Eligibility Verification System (IEVS) income report (IEVS-IRS) and resource data from the Internal Revenue Service (IRS); • 15
(B) initiating appropriate queries; and • 16
(C) resolving data exchange discrepancy messages within 45-calendar days of the date the message is posted on the data exchange inquiry screen. • 17
(5) Systematic Alien Verification for Entitlement (SAVE). All applicants and recipients of the TANF, SoonerCare (Medicaid), Supplemental Nutrition Assistance Program (SNAP), Low Income Home Energy Assistance Program (LIHEAP), State Supplemental Payment (SSP), and Child Care Subsidy Program benefits are required to declare their citizenship status. Persons who declare themselves or their minor child non-citizens must present documentation of their legal alien status from the United States Citizenship and Immigration Services (USCIS) or other acceptable source. The status, as determined from the documentation, must be verified through the Alien Status Verification Index (ASVI) maintained by USCIS. • 18
(6) Workers' compensation. AFS staff reviews copies of all Workers' Compensation Commission documents by matching SSNs with OKDHS records. Any court action that appears to potentially impact eligibility is forwarded to the applicable OKDHS office for clearance. • 19
(7) Birth verification. For persons born in Oklahoma, OKDHS has an agreement with the Oklahoma State Department of Health to electronically verify birth for persons with an open SoonerCare (Medicaid) benefit. • 20
(8) Food stamp disqualification (FSD). When a client is disqualified for SNAP food benefits due to fraud, the FSD screen shows the date the disqualification began and the length of the disqualification period. • 21
INSTRUCTIONS TO STAFF 340:65-3-4
1. When the client requests help with social service needs, the worker may give or send the client Oklahoma Human Services (OKDHS) Publication No. 09-454, Statewide Helpline Numbers, containing statewide hotline numbers. There is space on OKDHS Publication No. 09-454 for the worker to enter contact information regarding appropriate local community services and the statewide 211 information and referral phone number.
2. (a) When the client fails to present complete or consistent proof needed to determine eligibility, the worker attempts to contact the client to:
(1) resolve the remaining questions; and
(2) decide if the worker or the client will obtain necessary proof.
(b) When the client is unwilling to help resolve the question or permit the worker to seek necessary information, the worker denies or closes the benefit, per Oklahoma Administrative Code (OAC) 340:65-3-1 or OAC 340:65-3-8.
(c) The Office of the Attorney General administers the Address Confidentiality Program (ACP) to assist victims of domestic violence.
(1) Per Section 60.14 of Title 22 of the Oklahoma Statutes, the ACP prohibits state agencies from requiring an ACP participant to provide his or her finding address.
(2) The ACP provides victims of domestic violence with an ACP authorization card. The ACP authorization card includes the:
(A) participant's name, date of birth, authorization number, and substitute address; and
(B) the ACP toll-free phone number.
(3) The substitute address may be used as the participant's residence, school, and work addresses. It may also be used when applying for public utilities, registering to vote, or transferring school records. The substitute address is a post office box number assigned to all participants.
(4) When the client presents an ACP authorization card, the worker:
(A) does not require the client to provide his or her actual address or make a home visit; and
(B) uses the substitute address as the client's address when inputting information into the OKDHS system, sending OKDHS forms or notices to the client, or making service referrals.
(5) For more information concerning ACP refer to the Oklahoma Office of the Attorney General - Victim Services.
3. When the worker needs to contact a client outside of normal business hours because of an emergency, the worker obtains permission from his or her immediate supervisor or the county director or designee prior to contacting the client. When the immediate supervisor and county director or designee are not available, the worker takes care of the client's emergency need and notifies appropriate supervisory personnel of the situation as soon as possible.
4. Per OAC 340:10-2-2, the worker makes a home visit to determine the family's circumstances and social service needs following Temporary Assistance for Needy Families (TANF) benefit closure due to a sanction.
5. (a) The worker documents in the Family Assistance/Client Services (FACS) case notes, information obtained from collateral contacts and the client's explanation regarding inconsistencies.
(b) When the worker unsuccessfully attempts to contact the client to explain inconsistencies, the worker documents what attempts were made and the action taken in FACS case notes.
6. (a) Data exchange information is obtained by matching the client name, Social Security number (SSN), Social Security claim number, date of birth, and address from OKDHS records with other state and federal agency records. The results of the match are posted to the Information Management System (IMS) and are viewed by using various transactions. An online description of any IMS transaction is viewed by entering M space and the transaction name. For example, M space PY.
(b) PY is an index of data exchange information and case data for a particular person.
(1) To access the information, the user enters PY space and the SSN of the person being queried or enters PY space case number and person code.
(2) The user may also access PY from the EF page of the PS-2 for the person being queried by typing PY at the bottom of that page and pressing the enter key.
(A) The upper portion of the PY screen lists records from the PS-2 database for the SSN queried.
(B) The middle portion of the screen lists records from the ALFX client database.
(C) The lower portion of the screen lists types of data exchange information available for the person.
(3) The user may also enter the PY transaction code at the bottom of any data exchange screen and return to the PY screen.
(4) The worker views data exchange information by:
(A) moving the cursor to the line of information desired, typing in the transaction code, and pressing the enter key; or
(B) entering a transaction code and SSN of the person at the top of a blank IMS screen.
(c) DXL is a history screen of all data exchange discrepancy messages found on a particular person. The user may access this screen by entering DXL space SSN. The DXL screen lists the:
(1) error type;
(2) date the error was discovered;
(3) date the worker resolved the error;
(4) system code; and
(5) comparison between case income and income shown on the data exchange system.
(d) The worker is able to obtain AXL/G1DX, G3, Case Scan and case worker activity (CWA) reports from the automated caseload evaluation system (ACES) on Quest under Applications & Tools. Review Quest articles "How to Access ACES from the Infonet" and "How to Access/Upload ACES Case Scan from FACS".
(1) AXL generates a list of all cases assigned to the worker by case name, case number, Zip code, open benefits, and the phone number listed on the case. Review Quest article "AXL Report" for more information.
(2) G1DX shows the differences between information reported to OKDHS and information reported to agencies that share information with OKDHS through data exchange, including the Oklahoma Employment Security Commission, Social Security Administration (SSA), the Internal Revenue Service (IRS), and the United States Post Office.
(A) G1DX generates a report showing a list of discrepancies on cases assigned to the worker by case number. The report shows the name and SSN of the person with discrepant information, the type of discrepancy, the date the discrepancy posted, and the number of days pending. Review Quest articles "G1DX Report", Types of G1DX Edits", "How to Check G1DX Edits", "G1DX Standardized Procedures" for more information.
(B) After analyzing the discrepancy and updating case information as needed, the worker clears the discrepancy using DXL.
(3) G3 messages are alerts to notify workers of information. Review Quest article "G1 Report" for more information. Examples of G3 alerts available through ACES are a:
(A) message instructing the worker to close the client's TANF cash assistance benefit because Child Support Services received child support in excess of the TANF benefit; and
(B) child protective services alert instructing the worker to contact Child Welfare Services immediately. It also instructs the worker not to inform the client of the alert. This alert is posted to the client’s person information section of the Case Scan Report. Review Quest article "Protective Services Alert (PSA" for more information.
(4) When the worker clicks on case scan, he or she may select up to six CWA reports to view or may request a case scan on up to six cases. Review Quest articles "Case Scan Report" and "CWA Report" for more information. The case scan shows the:
(A) case number, name, status, address, phone number; and
(B) SSN, date of birth, age, gender, and any data exchange information available for each person on the case.
(5) When the worker clicks on CWA, he or she may enter the OKDHS office number, supervisor number, worker number, check all reports, and types ok to view current CWA reports available for his or her caseload.
(6) When the worker clicks on MICAL, he or she can calculate income for a person and print the results for the case record.
7. Beneficiary and Earnings Data Exchange System (BENDEX). BENDEX provides verification of Social Security benefits and Medicare entitlement. To view, enter BEN space Social Security claim number. Review Quest article "IMS: BENDEX Income Codes." Field B07 contains the Social Security claim number.
(1) When using BENDEX to verify Social Security benefits, the worker drops any cents from the gross benefit amount in BENDEX Field B27 and uses only the whole dollar figure. For example, round $349.50 to $349.00.
(2) When a person is dually entitled to receive Social Security benefits under two Social Security claim numbers, the person may receive benefits under one or both claim numbers.
(A) When the person receives a combined benefit, BENDEX displays two records for the person. Each record displays a "D" for dual entitlement in Field C21 and the cross referenced Social Security claim number in BENDEX Field B20.
(i) The worker counts the income displayed under the BENDEX record with a "CP" payment status code in Field B20. The CP means current pay. The person receives the combined Social Security benefit amount under this Social Security claim number.
(ii) The worker does not count the income displayed in the BENDEX record with the "AD" in payment status code Field B20. The AD means adjusted for dual entitlement and the person does not receive income under this BENDEX record.
(B) The benefit issuance process used by the SSA may cause a $1 or $2 difference in the actual payment made to a person who receives combined benefits.
(C) When the person receives benefits under both Social Security claim numbers, each BENDEX record displays a CP in the payment status code Field B20. The worker adds the whole dollar figures in Field B20 together and drops the cents to arrive at the person's Social Security benefit. For example, when one record shows $202.51 and the other shows $361.23, the worker adds $202 to $361 to arrive at the person's countable income of $563.
8. Buy-in data exchange (BIL). To view buy-in data for Part A and Part B Medicare, enter BIL space Social Security claim number. BENDEX uses the Social Security claim number, Field B07, instead of the Medicare number. Review additional buy-in information in Quest articles "Aged, Blind, Disabled (ABD): Buy-In – What is Buy-In?"; "Aged, Blind, Disabled (ABD): Buy-In – How Does the Buy-in Work?"; and "Aged, Blind, Disabled (ABD): Buy-In – Medicare Buy-in Problems and Solutions."
9. (a) SSI/State Data Exchange System (SDX). The SDX file contains data for Supplemental Security Income (SSI) applicants and recipients that is viewed by entering SDX space SSN. When using SDX to verify SSI income, the worker rounds the amount shown to the nearest dollar. For example, 1¢ to 49¢ is rounded down and 50¢ to 99¢ is rounded up. Review Quest articles "How to Read SDX Screens", "State Data Exchange (SDX) Payment Status Codes", "State Data Exchange (SDX) Resource Codes", "State Data Exchange (SDX) Miscellaneous Codes", and "Resolving a SDX Discrepancy."
(b) SDX list (SDL). The SDL transaction is a shortcut that reduces keystrokes and provides a history list of the current and previous SDX records. To view, enter SDL space SSN. To view a particular record, move the cursor to the line of the record date selected, type SDX, and press the enter key.
10. SSA Beneficiary Earnings Exchange Record (BEER/BWG). AFS staff accesses the SSA earnings record file through the BENDEX system for all applicants by entering BWG space SSN. SSA earnings record data is from 18 to 24 months old when received.
11. New Hire Employee list (NHL). The NHL transaction provides information obtained from employers reporting new hires to the Oklahoma Employment Security Commission (OESC). AFS staff enters NHL space SSN to view new hire data. Refer to Quest article "Resolving an NHL Discrepancy."
12. SSN enumeration (ENU) transaction. ENU sends the client's name, birth date, and reported SSN to SSA to match with SSA records when the person is required to have a SSN and the SSN is not shown or is shown but not verified. SSA returns one of 12 possible messages to indicate the results of the match. The message is posted to ENU, G3, and PY. When the SSN is verified, ENU updates the FACS Interview Notebook/Household tab/SSN field, PS-2 block F42, with Y. Detailed information regarding ENU is available in Quest articles "IMS: Social Security Number (SSN) Enumeration (ENU) " and "Resolving a Social Security Number (ENU) Discrepancy."
13. Wage Data Exchange (OWG). OKDHS receives wage data from OESC and compares it to case data. Discrepancies are posted to the G1DX screen. When a discrepancy exists, the worker contacts the client or employer to confirm the employment, wages earned, and available medical insurance information on the employee and his or her dependents. To view available data, enter OWG or OWC space SSN. Review Quest article "Resolving an Employment History (OWG) Discrepancy."
14. Unemployment Compensation (UIB). A computer match is made weekly of OKDHS cases in active or application status with Unemployment Insurance Benefits (UIB) files. To view, enter UIB space SSN. Review Quest article " Resolving an Unemployment Compensation (UIB) Discrepancy."
15. Federal Tax Information (FTI). Select AFS staff, designated as FTI specialists, may view certain FTI received through IRS matched records by using the income eligibility verification (IEV) transaction. Refer to OAC 340:65-1-2 for information regarding safeguarding FTI.
(1) The IEV transaction displays unearned income as reported by the tax payer on a federal income tax return. The unearned income may include income types not considered on the case or income already reported and used in determining benefit amounts.
(A) The worker must not delay processing application and renewal determinations because of an IEV discrepancy.
(B) The FTI specialists may view more detailed information on the FTI, such as the payer's address and a brief explanation of the document type code by using the WGD transaction.
(C) FTI specialists are responsible for clearing IEV discrepancies. Until the client provides independent verification of FTI shown on the IEV screen, the FTI specialist does not:
(i) document or reference anything about FTI in FACS case notes, imaged documents, or the physical case record; or
(ii) reference FTI on any form or notice sent to the client.
(D) Once the client provides independent proof of the unearned income, it is no longer considered FTI and staff may document the income in FACS case notes and the case record.
(E) When the worker must prepare an overpayment referral, hearing documents, or an investigative report that includes FTI, the FTI specialist assists in preparing and securing necessary documents as appropriate. The case record must indicate that such documents were secured by the FTI specialist and do not reference the specific FTI.
(2) Workers no longer have access to quarterly wage information (QTRI) from SSA as it is considered FTI. QTRI information may be used to determine if an alien is qualified and eligible to receive Supplemental Nutrition Assistance Program, Low Income Home Energy Assistance Program, or SoonerCare (Medicaid) benefits due to 40 qualifying quarters of coverage under Title II of the Social Security Act.
(A) The client may obtain this information online after creating an account at SSA.gov and clicking on My Social Security. To create an account, the client must provide basic demographic information and an email address. Once the client creates an account, he or she is sent a security code and can then access his or her earnings record.
(B) The earnings record shows yearly earnings. OKDHS Appendix C-1, Schedule XII, Maximum Income, Resource, and Payment Standards, shows the SSA minimum earnings for a quarter of coverage.
16. Online query transactions available on IMS for requesting specific types of data on a person are:
(1) Oklahoma Wage Link (OWL). The OWL transaction is an online query received from OESC that lists the last two quarters of employment and current UIB information. The worker MUST access available data at initial application and at each renewal by entering OWL space person's SSN.
(2) Third Party Query (TPQYC/TPQYI). Verification of SSI, Social Security benefits, Medicare, and the person's SSN may be obtained through the automated Third Party Query procedure. This procedure accesses the same file that produces SDX and BENDEX data. A SSA verification record may also be requested by using the TPQYC transaction.
(A) To access this online transaction, type TPQYC, space, and case number, enter the SSN when prompted, and confirm the information entered.
(B) When no response is received within 48 hours of the request, repeat the process.
(C) The TPQYC transaction generates online data that is returned to the requester electronically.
(i) Information verified with this procedure is generally the most current because SSA records may be updated at various times during any given month. Therefore, data on TPQYC responses may or may not agree with data appearing on the SDX or BENDEX file for the same person.
(ii) To view the returned data, the worker enters TPQYI space SSN or enters the TPQ transaction code while on the PY screen. Review Quest articles "IMS: How To Initiate a TPQYC Request" and "What is TPQYC?" for more information.
(iii) When using TPQYC to verify:
(I) Social Security benefits, the gross benefit amount is rounded down to a whole-dollar figure; or
(II) SSI income, net amounts are given. This figure is rounded to the nearest dollar. For example, 1¢ to 49¢ is rounded down and 50¢ to 99¢ is rounded up.
17. Data exchange information is routinely compared with OKDHS records. When discrepant information is detected, discrepancy messages post to IMS automatically. These messages are accessible by using transactions G1DX, G3, and PY. All discrepancy messages must be cleared using the DXD transaction within 45-calendar days of the error posting.
(1) G1DX displays a list of discrepancy messages by OKDHS office number. The worker accesses discrepancies by entering G1DX space OKDHS office number and location code. A more detailed list is obtained by entering G1DX space, OKDHS office number, location code, supervisor number, and district number. Refer to Instructions to Staff # 6 of this Section for more information.
(2) G3 displays an expanded message. The user accesses this screen by entering G3 space case number.
(3) One of the G1DX discrepancies that may appear on a worker's G1DX report is an address discrepancy. An address discrepancy starts with the letters "AD." When an address discrepancy appears, the worker must contact the client to verify the current address before updating the address in FACS and clearing the discrepancy. Review Quest article "G1DX Standardized Procedures" for more information.
(4) The data exchange discrepancies called "prisoners" (PRS) and "date of death" (DOD) are available from SSA. Discrepant information appears as alerts on G1DX. Information may be old or incorrect so the worker must attempt to confirm the information before taking action. SSA receives and sends information to OKDHS for:
(A) PRS from some, but not all prisons, jails, other penal institutions or correctional facilities, certain mental health institutions, and various third parties, including media sources. SSA maintains this data to identify Supplemental Nutrition Assistance Program clients who 'are currently' or 'have been incarcerated'. The worker accesses the incarceration dates by typing PRS next to the SSN on the G1DX results and hitting enter. A detail screen displays with incarceration dates. Review Quest article "Resolving a Prisoner Data Exchange (PRS) Discrepancy" for more information; and
(B) DOD from local State Departments of Health. The G1DX screen displays the date of death for persons that were reported as deceased by SSA but appear to be receiving OKDHS benefits. Review Quest article "Resolving a Date of Death (DOD) Discrepancy" for more information.
(5) The worker uses DXD to clear the data exchange discrepancy after documenting the information in FACS case notes and taking appropriate action. The user accesses this screen by entering DXD space case number. When the screen appears, the user enters his or her SSN, system type, and a reason code to show the error caused a reduction "reason code 7", an increase "reason code 9," or no change in benefits (reason code C) and presses enter. After pressing enter, the system requests confirmation. When the user selects Y, the transaction clears the error from G1DX and G3 and posts a resolution date on the DXL screen.
18. (a) The worker accesses the Alien Status Verification Index (ASVI) through a web-based online system at https://save.uscis.gov/Web/vislogin.aspx?JS=YES. Online responses are returned for the initial and additional verification inquiries. The worker images and files the online verification number or entire verification record in the case record or copies and pastes the information into FACS case notes.
(1) Initial verification responses are returned in three to five seconds. Initial verification is initiated when at least one of the documents in (A) through (J) appears to be valid, is available, and has an A-number of A0000001 through A59999999, A70000000 through A79999999, or A90000000 through A9999999. Documents include forms:
(A) I-551, Permanent Resident Card;
(B) I-797A, Notice of Action, issued to an applicant as a replacement Form I-94;
(C) I-766, Employment Authorization Document;
(D) I-327, Permit to Reenter the United States;
(E) I-571, Refugee Travel Document; or
(F) I-94 or I-94A, Arrival/ Departure Record endorsed, in a foreign passport, for persons younger than 1 year of age.
(2) The worker uses the same website to request additional verification as initial verification or submits Form G-845, Verification Request, to the United States Citizenship and Immigration Services (USCIS). The website method is preferred since a response is returned in three-federal business days as opposed to a 10-business day paper response time using Form G-845. Benefits of persons who are otherwise eligible are not delayed, closed, or reduced due to the non-receipt of a response from USCIS.
(3) The worker initiates additional verification immediately, when:
(A) the person provides documents that appear counterfeit or altered;
(B) there is no A-number on any document;
(C) an A-number in the A60000000 or A80000000 series appears on any document;
(D) any USCIS fee receipt other than I-687, Application for Status as a Temporary Resident, is presented; or
(E) Form I-94 in a foreign passport has an endorsement processed more than one year ago from the current date.
(b) USCIS is responsible for determining immigration status. AFS reports the names and addresses of persons applying for or receiving benefits who are determined to be residing in the U.S. unlawfully to USCIS. The worker reports to AFS program staff the names and addresses of applicants or recipients who:
(1) admit illegal aliens are present in the household and present USCIS information that appears to be forged; or
(2) present a formal order of deportation or removal.
19. The worker images and files the court document in the case record and documents any case action in FACS case notes.
20. The availability of new birth records within a previous five-month period is dependent upon reporting time frames of hospitals, midwives, and birth centers. When a data match occurs, the system updates the "citizenship verification" and "citizenship verification date."
21. Review Quest article "Disqualifications (FSD Transaction)" for food stamp disqualification (FSD) information. To display FSD screen, enter FSD space SSN.
(1) The FSD is indicated on the PY screen so a separate transaction is not necessary when the PY transaction is used first.
(2) When fraud is determined for the Supplemental Nutrition Assistance Program (SNAP) or TANF this information is updated on the FSD screen.
(3) For SNAP rules, refer to OAC 340:50-15-25 and 340:65-9-4 for TANF Program rules.