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COMBINED MANUAL
ISSUE DATE 09/2016
SPECIAL MEDICAL CRITERIA
0011.36
extended under the ill/incapacitated category, for example, but would not accrue banked months.
As long as someone in the household meets the special medical criteria he/she will accrue months to be used after reaching the 60-month time limit and no longer be eligible for a special medical criteria extension. Participating in Employment Services or working does not affect the participant’s eligibility for banked months or an extension.
Some participants who have been exempt from Employment Services (ES) because they were needed in the home due to the illness or incapacity of another assistance unit member, a relative who lived in the same household, or foster child may be able to accrue time back to 1-1-98 if they met the special medical criteria for an ES exemption during that same period.
No later than the time of the face-to-face interview, explain to any participant with a code of “8” (member is required at home to care for an ill or incapacitated family member) on the “ES Status” field of the STAT/EMPS panel that time can be accrued if he/she can document that the special medical criteria were met for 1 or more months beginning January 1998. If an ES exemption for a person needed in the home was not approved for the participant but it can be documented that he/she should have been exempt, this policy may also be applied. The participant can authorize the county agency to help document the special medical criteria during this period. To track these cases, enter a CASE/NOTE when you discover months that a participant met the special medical criteria exemption between January 1998 and June 2000. The CASE/NOTE should include the months accruing time under the special medical criteria exemption (mm/yy to mm/yy), the household member who met special medical criteria, and the type of documentation provided.
Also see TEMP Manual TE13.041 (Special Medical Criteria – MAXIS Coding Tips).
DWP: If at any time during the DWP application process or during the 4-month DWP eligibility period, the agency determines that a participant is unlikely to benefit from DWP, convert the participant to MFIP. Participants who are determined by a qualified professional to be needed in the home to care for a child or an adult meeting the Special Medical Criteria are considered to be unlikely to benefit from DWP. See 0008.06.24 (DWP Conversion or Referral to MFIP).
SNAP, MSA, GA, GRH: No provisions.