GIS 10 MA/003: Tracking Group II Disability End Dates

To: Local District Commissioners, Medicaid Directors

From: Judith Arnold, Director, Division of Coverage and Enrollment

Subject: Tracking Group II Disability End Dates

Effective Date: Immediately

Contact Person: Local District Liaison Upstate: (518)474-8887, NYC: (212) 417-4500

The purpose of this General Information System (GIS) message is to notify local departments of social services (LDSS) of the need to track Group II disability end dates in the Welfare Management System (WMS) and of a change in the BICS report for Group II disability end dates.

Currently, upstate districts track Group II disability end dates in different ways. Some districts use a tickler file/paper method while others data enter the date in WMS, using an Anticipated Future Action (AFA) code, and rely on a BICS report to alert them of the end date for disability. In preparation for recertification of SSI-related Medicaid cases through the Enrollment Center, it is necessary that all upstate districts track the end date for Group II disability through WMS by using the AFA code 414 and entering the Group II disability end date in the date field. This applies to all disability determinations with a Group II approval, whether the review is performed by the State Disability Review Team or a local Disability Review Team.

Currently, when the AFA code 414 and the disability end date is entered in WMS, a BICS report is generated one month prior to the date entered. The report serves as an alert to the district to begin the Continuing Disability Review (CDR) process. Because the CDR process is often lengthy, a system change was implemented to alert districts of the end date earlier than one month prior to the disability end date. Effective with the October 2009 systems migration, the BICS report is generated four months prior to the disability end date, giving local districts additional time to gather medical evidence, have the disability determination performed and enter the new Group II disability end date in WMS if applicable.

Additionally, the AFA code 414 may be used for tracking the disability end date for an MBI-WPD program recipient who is in an SSDI 36-month Extended Period of Eligibility or who has transitioned to the MBI-WPD program from the SSI 1619(b) program. In both cases, there is a disability end date, the Social Security Administration (SSA) medical diary date, that requires tracking for the CDR process.

Upstate districts are advised to begin data entering the Group II disability end date in WMS at recertification for any Medicaid-Only SSI-related or MBI-WPD case with a State or local Disability Review Team Certificate that is approved Group II or for MBI-WPD recipients with an SSA disability end date as described in the previous paragraph. Districts are to use AFA code 414 and enter the Group II disability end date in the appropriate field.

For New York City, SSI-related and MBI-WPD recipients with a Group II disability end date as described above, will have Employability Code 74 entered in WMS and the Group II disability end date entered in the associated date field.

In the event of a county-to-county move (Luberto) from upstate to New York City, when the individual's data is transferred to the new county, WMS will translate the AFA code 414 to the downstate Employability Code 74 and auto-fill the associated disability end date. For an individual moving from New York City to upstate, WMS will translate the Employability code 74 to the AFA 414 code and auto-fill the associated date. For moves from one upstate county to another upstate county, the AFA code 414 and associated date will transfer.