Fault Determination and Proration – Recertification

 

When a recertification closes because it was not processed timely, BEACON will automatically determine whether the closure was due to Department or client fault. The Benefit Effective Date will be based on what action or inaction has taken place during the recertification process.

The fault reason and classification is displayed in the Interview Wrap up EBC Results page. To ensure accuracy of this process it is critical that staff follow recertification processing timeframes.

 

Department Fault

If the processing delay is determined to be Department fault, BEACON will automatically set the Benefit Effective Date to the day after the closing date and the fault type to Department delay with one of the following classifications outlined below. This applies only when the recertification was initiated on BEACON by the closing date, not the release date.

No recertification appointment was scheduled

A recertification appointment was scheduled for a date that is at least 10 days before the closing date. The interview is not held and a NOMI is not sent.

The recertification appointment is scheduled to take place after the closing date

An interview was conducted, mandatory verifications are needed, but a VC-1 was not sent or was sent late.

A recertification appointment is scheduled for a date at least 10 days before the closing date. An interview has been conducted and a verification checklist is due by the closing date but the case is not wrapped up and authorized by the closing date.

 

Client Fault

When a SNAP case closes at the end of the certification period it will be determined to be client fault in the following situations.

The recertification form was submitted after the closing date. This will be treated as a new application and all application rules apply.

The recertification form was initiated less than 12-days before the closing date that is listed on the recertification form.

An appointment was scheduled timely. A NOMI was sent (SNAP-only) or the case was closed for Failure to keep reevaluation interview (combination cash/SNAP case) and the client did not respond to the NOMI or the closing notice.

A NOMI was sent after the first scheduled interview is missed and the interview has since been conducted but is too close to the closing date (less than 10 days) and there are outstanding mandatory verifications on the closing date so the recertification could not be approved.

The recertification interview was completed and mandatory verifications are outstanding on the closing date.

 

Fault and Benefit Effective Date

When a case is reinstated and wrapped up, BEACON will apply proration rules to determine if fault needs to be reset.  If the fault determination is incorrect, a supervisor or manager must override it.

 

 

  Last Update:  September 29, 2017