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How to Handle OHCA Referrals with Non-BP Applicants when BP is in Household

When the Oklahoma Department of Human Services Child Support Services (CSS) receives a referral where the applicant for benefits is not the biological parent (BP) of the child(ren) on the case, but the BP is listed as a member of the household on the benefits case, CSS staff builds the child support case with the BP as the custodial person (CP).  When there is an order in place naming the applicant/non-biological parent as the legal custodian of the child(ren), CSS staff builds the case with the applicant listed as the CP.

It is not uncommon for a biological parent (BP) to be on an Oklahoma Health Care Authority (OHCA) SoonerCare case as a child in the household, rather than the applicant for the benefits, even though the BP is caring for his/her child who is also in the household.  In these situations, typically the BP’s parent is the applicant on the SoonerCare case, the BP is listed as a child in the household, and the BP’s child is listed as a grandchild in the household.  When this situation occurs, the in-home biological parent of the child is considered the custodian for the purposes of child support, not the applicant.  The exception to this is if there is an order naming the applicant/non-BP as the legal custodian, per the ITS above.  When the custodian is in the household, he or she may or may not be receiving the SoonerCare services.  It is the applicant on the SoonerCare case who chooses the service level preference, which determines whether or not a referral is sent to CSS.  The question was raised as to how workers should handle OHCA referrals in which the non-BP applicant requests CSS services, but the BP is also in the household and does not want CSS services.

Process:  Outlined below are the best practices you should follow when you encounter referrals such as these.  Please Note that these instructions pertain only to very specific situations.  Only use these two approaches when you encounter referrals with non-BP applicants and the BP is also in the household.
  1. If the BP is receiving non-pregnancy-related SoonerCare benefits on the case, build the FGN with the BP as the CP and pursue the case.  If the CP is receiving non-pregnancy-related SoonerCare benefits, he/she does not have the option to decline CSS services.
  2. If the BP is included in the household, but is not receiving non-pregnancy-related  SoonerCare benefits:
    • Build the case with the BP as the CP.  Make sure the OHCA case is correctly cross-referenced to the FGN.
    • Update the REMOVED field on CHU (for each child) with the current date and update the RSN field with 04.
    • Request case closure using reason code 15.

Simply deleting the referral will allow referrals to continue to be sent in the future.  You must build the case and then close it in order to prevent future referrals.  Do not change the service level preference on the OHCS case.

Both of the above approaches require research to be done on the case.

  • For cases that fall under the second approach, you should contact the BP to ask about his/her service level request.  The BP custodian may or may not want our services.  If he or she does want our services, build the case with the BP as the CP following standard procedures.
  • Be sure to case log the situation and the actions you have taken, especially for cases that fall under the second approach.

Example:

  • Mary is the mother of Thomas.  Mary and Thomas are both included in the household on a SoonerCare case for which Mary’s mother, Martha, is the applicant.  As the applicant, Martha requested full child support services for Thomas.  Mary, however, does not wish to pursue a child support case.
  • The case initiation worker receives the referral for this SoonerCare case and notices that the BP, Mary, is in the household, but is not included in the services.  The worker contacts Mary and finds out that she does not wish to pursue child support.
  • Given that information, the worker follows the process outlined in the second approach above.  Because Mary is in the household, she is considered the CP for child support purposes.  Since she is not included in the services, she has the option to decline a child support case.
  • If Mary had been receiving non-pregnancy-related services or if there were an order granting legal custody to the grandmother, Martha, the first approach outlined above would be appropriate.