State will use Arkansas Works asset tests to determine income

The state can’t use asset tests to determine if beneficiaries are eligible for Arkansas Works based on their assets, so instead the Department of Human Services will pilot a program using asset tests to see if beneficiaries are ineligible because of unreported income, DHS officials have announced.

The pilot program will review the liquid financial assets of 15,000 Arkansas Works beneficiaries who are also beneficiaries of the Supplemental Nutrition Assistance Program. SNAP beneficiaries already can undergo an asset verification test.

Arkansas Works is the state program that uses federal Medicaid dollars to purchase private health insurance for Arkansans with incomes up to 138% of the federal poverty line. SNAP provides lower-income families assistance in buying food.

Arkansas Works expanded the state’s Medicaid population under the Affordable Care Act, which does not allow states to consider a person’s assets for eligibility. However, DHS Director Cindy Gillespie, State Medicaid Director Dawn Stehle, and Director of County Operations Mary Franklin told reporters that the state can use such a test to determine if a beneficiary has unreported income. Stehle said the federal Centers for Medicare and Medicaid Services has told DHS it can use an asset test in this way. Several other states have done such a test.

The pilot program will test 5,000 beneficiaries in February, 5,000 in March, and 5,000 in April. Looking at a beneficiary’s liquid assets such as a checking account can help DHS determine if he or she inaccurately reported income, which could lead to termination, though not necessarily.

“If their bank account shows that they have $200,000 in it, we’re going to say, ‘OK, we need an explanation. Where did the $200,000 come from?’” Gillespie said.

Gillespie said the program will allow DHS to see if such a test would be effective more broadly for Arkansas Works and SNAP recipients.

The pilot test will cost $87,900 and will be managed by Accuity, which already manages DHS asset tests for traditional Medicaid.

DHS officials also told reporters that all of the 330,000 individuals participating in Arkansas Works will be referred to job training and employment help with the Department of Workforce Services, rather than just those with incomes 50% or above the federal poverty level as required by the state law creating the program. Arkansas Works beneficiaries are not currently required to work to maintain their benefits.

“We didn’t want to be in a position where we were picking winners and losers among Arkansas’ workers,” said Daryl Bassett, DWS director.

Gillespie said that number includes those who are considered part of Arkansas Works’ “medically frail” population that participate in the regular Medicaid program rather than receive private insurance. Gillespie said a person who is “medically frail” has an issue with a daily living activity and isn’t necessarily sickly. Work programs are available for people with disabilities so they can earn an income, she said.

Mass mailings were sent to beneficiaries starting in mid-November explaining changes to Arkansas Works, which this year begins requiring a $13 monthly co-pay by higher-income recipients. Those letters informed recipients of opportunities provided by DWS, such as a link to current job openings and assistance with preparing resumes.

DHS processes 20,000-30,000 new applicants and annual renewals each month. Eligibility approval letters sent to beneficiaries will include information about DWS services and a flyer from DWS explaining its offerings. Franklin said Arkansas Works beneficiaries who participate in SNAP will receive an additional referral.

So far, the referrals sent starting in mid-November have resulted in a “trickle” of people going to DWS offices seeking help, Bassett said. He said his agency expects more participation and has cancelled plans to reduce staff at local offices through attrition.

Qualifying Arkansas Works recipients who receive SNAP benefits also will receive a referral to the SNAP Employment & Training Program. SNAP beneficiaries are required to work if they are able-bodied, ages 18-49 and have no dependents.

Beneficiaries’ activities will be tracked to help determine who is taking advantage of the program, whether they are getting jobs, and to measure the impact of a work referral versus a work requirement, Gillespie said. She said insurance carriers participating in Arkansas Works are supportive of the work referrals because working people tend to be healthier.

Data will be exchanged between the two agencies beginning in February. Gillespie and Bassett said this is the first time the two agencies have worked this closely together.

“That siloing among state agencies is a big part of what we’re all trying to break, and programs like this help us,” Gillespie said.

DHS recently cleared a backlog of more than 140,000 overdue Medicaid eligibility cases. Officials said the department is putting into place processes to ensure its rolls are accurate, including closing cases after receiving returned mail, and expanding a program that identifies enrollees receiving Medicaid services in more than one state.