SR 11-39 Dated 08/11

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases updates to the Social Security Administration (SSA) Life Expectancy Tables to incorporate the information released in the Director’s Memo dated August 19, 2011, subject line, Resource Tables: SSA Life Expectancy Tables Update. The SSA Life Expectancy Tables are used in the eligibility determination process for the adult categories of financial and medical assistance when determining whether an applicant or recipient’s annuity is actuarially sound and that the expected return on the annuity corresponds with the life expectancy of the individual. This information is then used to:

·   determine if an annuity is countable or excluded in the resource test for the specific program of assistance; and

·   evaluate asset transfers.

The table updates released in this SR reflect the most recent revisions the SSA made to these tables, dated 2007.

This SR additionally releases unrelated revisions to DFA Form 800V, Examples of Acceptable Proofs, and its associated instructions.

POLICY

The male and female SSA Life Expectancy tables have been updated to reflect the most current information available from the Social Security Administration.

UNRELATED FORMS REVISION

DFA Form 800V, Examples of Acceptable Proofs, is a one-page, single-sided form provided when DFA Form 800, Application for Assistance, is mailed to an individual. The form provides information about the most common verifications needed to determine eligibility for all DFA programs. This form was revised to increase clarity and align with recent DFA-initiated changes to the New HEIGHTS-generated CS0001, Interview Appointment Notice, and CS0005, Mail-in Application for Redetermination, as requested by the Error Reduction Advisory Team (ERAT) and Field Operations. The specific revisions to DFA Form 800V were as follows:

·   The language was simplified throughout the form to bring it to an 8th grade reading level.

·   Categories of verification were grouped together for clarity.

·   Formatting tools, such as bolding and bulleting, were introduced to emphasize important information.

·   More types of income and resources have been incorporated into this form to better clarify for the applicant the types of income and resources that the Division considers when determining eligibility and benefit amount.

·   Certain text describing specific proof needed to verify citizenship and identity was removed from the form because changes at the federal level and implementation of the Social Security Administration cross-match in August 2010 removes the burden on most applicants to provide original paper proof of citizenship and identity as a condition of eligibility for financial and medical assistance (see SR 10-31 for more details).

The instructions for DFA Form 800V were updated accordingly. Similarly, the New HEIGHTS-generated CS0002, Interview Appointment Notice, which contains the information from DFA Form 800V on the 2nd page, is also being updated according to the changes identified above. It will be released under separate cover at a later date by New HEIGHTS.

District Office staff must deplete the old version of DFA Form 800V before the new version is printed. Once the current supply of DFA Form 800V is exhausted, the new version will available from the DHHS warehouse in the usual manner, via the Quarterly Forms Order (QFO). The form is also available electronically on the DHHS website and internally, for Department staff only, on the Lotus Notes Family Services Database.

POLICY MANUAL REVISIONS

Revised Adult Assistance Manual Topics

PART 420  RESOURCE TABLES: SSA LIFE EXPECTANCY TABLES: MALE

PART 420  RESOURCE TABLES: SSA LIFE EXPECTANCY TABLES: FEMALE

IMPLEMENTATION

The policy released in this SR is effective upon release.

District Office staff must deplete the old version of DFA Form 800V before the new version is printed. Once the current supply of DFA Form 800V is exhausted, the new version will available from the DHHS warehouse in the usual manner, via the QFO.

CLIENT NOTIFICATION

Notification of the changes to He-W 620.01(j)(3) to support the updates of the SSA Life Expectancy Tables will be published in the NH Rulemaking Register, Office of Legislative Services, in November 2011. A public hearing on the amended Administrative Rules will be held in early December, 2011. No other client notification is planned.

TRAINING

A Director’s Memo dated August 19, 2011, subject line, Resource Tables: SSA Life Expectancy Tables Update, was provided to all Family Services Specialists. No other training is planned or needed.

FORMS MANUAL POSTING INSTRUCTIONS

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective December 5, 2011. Additionally, this SR, and printed pages with posting instructions, will be distributed under separate cover to all internal hard copy holders of the Adult Assistance and Forms Manuals.

DFA/LRB:s