Closing Sooner Care Referral Cases that have Indian Health Services

Beginning on May 1^st, 2018 we have two new reason codes that we may use to close cases that were opened due to Sooner Care referrals that have Indian Health Services.  Oklahoma Child Support Services (“CSS”) is implementing federally required changes that will impact a significant number of customers.  For many years federal law has required CSS to open a state child support case when a parent and child applied for SoonerCare. CSS is now being required to close any case that opened solely because of a Medicaid (SoonerCare) referral when the child(ren) is also eligible for Indian Health Services (IHS).  The requirement comes from a change in the Code of Federal Regulations announced in OCSE Action Transmittal AT-16-06, “Final Rule: Flexibility, Efficiency and Modernization in Child Support Enforcement Programs,” dated 12/20/2016.

New subsection 45 CFR § 303.11(c) states:

(c) The IV-D agency must close a case and maintain supporting documentation for the case closure decision when the following criteria have been met:

1. The child is eligible for health care services from the Indian Health Service (IHS); and
2. The IV-D case was opened because of a Medicaid referral based solely upon health care services, including the Purchased/Referred Care program, provided through an Indian Health Program (as defined at 25 U.S.C. 1603(12)).

CP requested immediate case closure

When a state child support case meets the new federal closure requirement CSS should be prepared to close the child support case at the CPs request.  CSS should also be aware that ant person may apply for state child support services.  Therefore, the new TI closure reason should only be used when a CP makes the request for case closure and provides sufficient documentation that the case already meets the federal requirements.  CSS staff can use the OSIS Closure reason “TI” for immediate case closure.  The case will close immediately if the requirements are met.

The CSS Child Support case must meet the following requirements:

• Not pending closure
• Case is not in a tribal office code
• Case is not a Texas Redirect case (SIN Office code)
• Case is not an active incoming intergovernmental case
• Medical benefit was M, X, B or J when the case opened
• Case is not a current TANF case
• Case has not been a Foster care case
• Case does not have Daycare assistance
• Less than $500 State owed balance
• Documented proof that the CP has requested case closure
• An active CP with a DCN that a child is tied to

CSS Initiated Case Closure

When an open CSS case meets the new federal requirement of case closure, but the CP has not made a case closure request then CSS may start the case closure process and initiate the 60 day closure notice (S02).

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The T6- 60 day closure must meet the following requirements:

• Not pending closure
• Case is not in a tribal office code
• Case is not a Texas Redirect case (SIN Office code)
• Case is not an active incoming intergovernmental case
• Medical benefit was M, X, B or J when the case opened
• Case is not a current TANF case
• Case has not been a Foster care case
• Case does not have Daycare assistance
• Less than $500 State owed arrears balance
• Active OBL with MED ORD field = I or POLM/POLMEMU has a child updated with HIS
• An active CP with a DCN that a child is tied to

How to use the TI or T6 closure reasons

If the case meets the requirements to close then CSS staff will update the CSTCU screen. This screen must be updated prior to attempting to close the case. This new screen may be accessed by typing CSTCU in the NEXT field.

To update the CSTCU screen:

1. Put a Y in the Case has tribal membership? Field.
2. Enter a case log. This must be done or it will not be updated.
3. Press enter.

There has been a new field added to the CSCU screen to show the Tribal Citizenship. This will automatically update when the CSTCU screen is updated. This field must show a Y to use closure reason codes TI. For the TI immediate closure reason the CP must request case closure and provide CSS documentation that the child is eligible for Indian Health Services.

CP requests to keep State Child Support cases open

After using the T6 closure reason, and sending a Closure Notice (S02) to the CP, the CP may at any time choose to keep their state child support case open.  The CP may request that the case remain open or be reopened. If the CP requests that the case remain open during the 60 day closure period, then CSS must “pull” the Closure Notice using DOCL.  Update case log that the CP has requested that the state child support case stay open.

A CP may also contact CSS and request that the child support case be “transferred” to a Tribal Child Support program.  CSS staff should inform the CP that they need to contact the Tribal Child Support program to apply for their IV-D services.  Since these cases have no state benefits that require a state child support case, the state child support case will still close.  Tribal IV-D programs using OSIS will transfer the OSIS case to their Tribal Office code and keep the case open in their office code.  Tribal IV-D programs may requests copies of orders and/or arrears computations for cases that they open.

Please never send the CSS file to any other IV-D program.  CSS should retain files for 3 years after case closure.

A CP may also request that the state child support case be converted to a non-IV-D case.  To do this, CSS follow the same process as other CP requests to close.  State child support case closure policy provides that when a case is closed, Child Support Services (CSS) terminates the Income Withholding Order (IWO) with the employer unless the applicant requests the IWO continue.  45 CFR 303.11 (b)(8); OAC 340:25-5-123 (e); OAC 340:25-5-123 (f) & ITS 8.  At the applicant’s request, CSS initiates a new IWO in the custodial person’s (CP) name for payments to be sent to the Oklahoma Centralized Support Registry (OCSR) at the time CSS’s IWO is terminated.

To provide a consistent level of customer service, Form 03GN542E, Case Closure Application (Application), has been developed. The Application should be filled out completely and be reviewed carefully by the child support specialist to confirm the case is eligible for closure under federal regulations and state child support case closure policy. Be sure to consult your office management and case closure materials available on the InfoNet for additional guidance.

See New Case Closure Application and Income Withholding Order Process on the InfoNet for more details on this process.