Training for New Local Departments of Social Services' (LDSS) Workers
Target Audience: LDSS Medicaid eligibility staff who have limited experience with a Medicaid caseload, and other staff as determined by the New York State Department of Health (NYS DOH).
Description: This seven-day training session provides participants with an introduction to New York State's Medicaid program, with a focus on the eligibility for individuals who need community-based medical care.
Key Topics Covered:
• Overview of the Medicaid program
• Program eligibility categories and respective budgeting methodologies including MAGI-like budgeting
• Application process and required documentation (financial and non-financial for each Medicaid category)
• Presumptive Eligibility (PE) for pregnant women and children
• PE for Family Planning
• Description of situations resulting in continuous coverage
• Excess Income program and spend down of income
• Managed care
• Introduction to the Medicaid eligibility system: Welfare Management System (WMS) including MABEL
• WMS sub-systems
• Notice requirements for applicants/recipients
• Introduction to the Medicare Savings and COBRA Continuation Coverage programs
• Reimbursement of Third-party health insurance coverage
Technical Assistance Trainings
Target Audience: LDSS Medicaid eligibility staff and other staff as determined by the New York State Department of Health (Department).
Description: The Health Insurance Training Center for New York State Health Insurance Programs (HITC) provides half- and full-day Technical Assistance (TA) trainings to meet the needs of the Local Departments of Social Services (LDSS). These TA sessions focus on many different Medicaid eligibility topics.
The eight Regional Medicaid Consortia – whose meetings are facilitated by Medicaid Consortium representatives and include Medicaid local district support liaisons – determine the TA training topics for the Consortium. If a LDSS is unable to meet their training needs through their Regional Medicaid Consortium, a district may request on-site agency training days for their staff. If a LDSS requests training and does not have the minimum recommended class size, it is responsible for inviting a neighboring LDSS to participate in the training.
Key Topics Covered: Training topics are identified by Regional Medicaid Consortia based on identified needs. They generally cover more in-depth information than is included in the New LDSS Worker or LDSS Chronic Care Worker curricula, but can include other Medicaid eligibility policies and guidelines. TA topics include but are not limited to: Documentation Requirements, Excess Income, Managed Care, Medicaid Categories, Trusts, Medicaid Continuations, Residency, and the Health Insurance Premium Payment Calculation and topics to be developed based upon request by the NYSDOH and LDSS.
Documentation Requirements (1 day training)
This full-day program reviews the documentation requirements for New York State Medical Assistance Programs. Factors of eligibility that must be documented and those that do not need to be documented are discussed. In addition, Citizenship/Identity policies regarding primary documents and other acceptable levels of documentation are explored. A discussion regarding the Renewal Simplification and Financial Maintenance policies is also included.
eMedNY: Health Insurance Premium Payments (HIPP)& Medicare Insurance Premium Payments (MIPP) Cost Analysis Training (1 day training)
This full-day presentation will encompass all the processes involved with determining whether a Medicaid applicant/recipient's health insurance is cost effective and how to create and authorize health insurance payments using the eMedNY HIPP/MIPP application. An explanation for creating new HIPP/MIPP payees, third party policies, writing and authorizing payments is included. Various MOBIUS reports related to these processes will also be discussed.
Excess Income (1 day training)
This full-day program covers the basic principles of the Excess Income policy and its application. It will review the impact of the six-month accounting period and provide a number of examples illustrating the application of Excess Income policy. The Pay-In Subsystem and the Principal Provider Subsystem will also be briefly discussed.
Immigration Issues (1 day training)
This full-day program will review Immigration categories including the Qualified and Permanently Residing Under Color of Law (PRUCOL) immigration status. The session will also assist workers in determining the documentation that supports each immigration status. Emergency Medicaid coverage will also be addressed.
Medicaid Continuations for Supplemental Security Income (½ day training)
This half-day program will cover Medicaid Continuations that are triggered by the loss of eligibility for Supplemental Security Income (SSI). These situations include Stenson, Pickle, Disabled Adult Child (DAC), 1619(a) & (b), and Widow/Widower cases.
Medicare Savings Program (1 day training)
This full-day program covers eligibility for Qualified Medicare Beneficiaries (QMB), Specified Low-Income Medicare Beneficiaries (SLIMB), and Qualifying Individuals (QI). A brief review of the Qualified Disabled and Working Individuals (QDWI) Category will also be included. The eMedNY system and the entries required by this program will also be addressed in the presentation.
NYSOH Assistor Training (3 day training)
This three-day certification training program covers all of the concepts, policies and practical information that Assistors need to help individuals enroll in Medicaid, Child Health Plus, and Qualified Health Plans through New York State's Health Plan Marketplace, the New York State of Health.
Real Property Issues (½ day training)
This half-day program will review a variety of issues related to homesteads and other non-income producing real property. Included will be the definition of a homestead, Medicaid policy on mortgages held by Applicant/Recipients (A/Rs), life estate issues, reverse mortgages and liens on homesteads and non-income producing real property.
Resource Analysis (1 day training)
This full-day program reviews resources most commonly found in Chronic Care cases, including stocks, bonds, and brokerage accounts. A method for tracking assets moved from one investment instrument to another (selling stock in one brokerage account, moving the resulting funds to a bank account or re- investing the money into other stocks or bonds) will be reviewed for use in identifying transfers during the look-back period. Treatment of Retirement Funds and Annuities as an income or a resource is covered as well as Income Producing Property. Life Insurance, Burial Funds and Irrevocable Pre-Need Funeral Agreements will also be reviewed.
Resource Attestation (½ day training)
This half-day program reviews the Medicaid benefit package available for different levels of resource documentation. A discussion of appropriate application and the Welfare Management System (WMS) coding required for each benefit package will also be included.
Retirement Income and Annuities (½ day training)
This half-day program will review the types of tax-qualified funds (including pensions, supplemental retirement funds and individual retirement accounts) that may be owned by clients applying for Medicaid benefits. The Medicaid policy on these holdings will be discussed including Spousal Impoverishment situations. The program also reviews the basic annuity terms, the types and uses of annuities, Medicaid policy on annuities, and transfer implications.
Self-Employment (1 day training)
This full-day program addresses the treatment of income and resources associated with various self- employment situations, including sole proprietorships, partnerships, S corporations and rental property. The program includes a discussion on income tax schedules associated with the various self- employment situations, allowable income and resource disregards and exemptions for MAGI-Like, SSI- Related, and ADC-Related categories
Spousal Impoverishment (1 day training)
This full-day program reviews the budgeting methodology for Spousal Impoverishment cases. The program includes completion of the Spousal Budgeting forms including the calculation of the Community Spouse Resource Allowance (CSRA), countable resources, Monthly Maintenance Needs Allowance (MMNA), Family Member Needs allowance, and Net Available Monthly Income (NAMI) for the Institutionalized Spouse. Increasing the CSRA to meet a shortfall in MMNA is also discussed
Supplemental Security Income-Related Budgeting (Income) (1 day training)
This full-day program reviews deeming and allocation, Spouse-to-Spouse budgeting (i.e. eligibility for Supplemental Security Incomes (SSI)-Related adults) and Parent-to-Child budgeting (i.e. eligibility for SSI- Related children). The focus will be on the income budgeting and manual Medicaid Eligibility Budgeting Logic (MBL) budgets also will be used in the review. A brief review of the Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD) will also be included.
Transfer of Assets (1 day training)
This full-day program covers the basic Transfer policy: the look-back period, what constitutes a transfer, allowable transfers, Undue Hardship provisions, and resources vs. stream of income, determination of the Uncompensated Value (UV), calculation of the penalty period, and the implementation and impact of transfer penalty. Also included are the new rules and regulations enacted in 2006 from the Federal Deficit Reduction Act of 2005, including Promissory Notes and Life Estates.
Trusts (1 day training)
This full-day program reviews the types of trusts most often encountered in Medicaid caseloads. Definition of common trust terms, the role of trustee and his/her discretion, treatment of trusts where the Applicant/Recipient (A/R) is grantor and/or beneficiary, Medicaid Qualifying trusts, Omnibus Budget Reconciliation Act (OBRA) '93 trusts, and Exception and Supplemental Needs Trusts will be discussed.
Examples of various trusts will be reviewed during the program