The benefit issuance schedules for Temporary Cash ...
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|Department of Human Resources | |
|311 West Saratoga Street |FIA INFORMATION MEMO |
|Baltimore MD 21201 | |
|Control Number: 00-32 |Effective Date: February 1, 2000 |
| |Issuance Date: January 4, 2000 |
TO: DIRECTORS, LOCAL DEPARTMENTS OF SOCIAL SERVICES
DEPUTY/ASSISTANT DIRECTORS FOR FAMILY INVESTMENT
FAMILY INVESTMENT SUPERVISORS
FROM: ROBERT J. EVERHARD, EXECUTIVE DIRECTOR, FIA
RE: OBSOLETE FORMS
PROGRAM AFFECTED: ALL PROGRAMS
ORIGINATING OFFICE: OFFICE OF POLICY, RESEARCH AND SYSTEMS
The Family Investment Administration (FIA) worked with the Standing Policy Committee, Fiscal Unit, and DHMH to develop the attached obsolete form list. Due to the changes that came along with the Family Investment Program (FIP), these forms no longer adequately meet the needs of DHR’s programs, policies and procedures.
The forms will become obsolete effective February 1, 2000. If you have any questions or concerns, please contact Fatmata Khella at 410-767-7585.
Attachment: list of obsolete forms
cc: DHR Executive Staff DHMH Executive Staff
FIA Management Staff DHMH Management Staff
Constituent Services FIA Program Analysts
OBSOLETE FORMS LIST
AS OF FEBRUARY 1, 2000
DHR/IMA FS 1 Application for Food Stamp – Part 1
DHR/FIA AIMS 1 Screening/Inquiry form
DHR/FIA AIMS 1X Screening /Inquiry form
DHR/FIA AIMS 2X Transaction Type – Public Assistance
DHR/FIA RAP2 Notification of Application for Refugee MA Assistance
DHR/FIA AIMS 2.3C Alternate Case Information
DHR/FIA AIMS 7 Public Assistance OTO Authorization
DHR/FIA AIMS 8 Public Assistance Manual Issuance Authorization Form
DHR/IMA AIMS 9 Public Assistance Check Status Change Form
DHR/FIA AIMS 10 Public Assistance Manual Issuance Form
DHR/FIA AIMS 11 Food Stamp OTO Authorization
DHR/FIA AIMS 12 Food Stamp Manual Issuance Form ATP/ATI
DHR/IMA AIMS 13 Food Stamp ATP/ATI Status Change Form
DHR/FIA AIMS 14 Food Stamp Manual Issuance Completion Form
DHR/FIA AIMS 15 Establish Cash Record for EA/EAFE
DHR/FIA AIMS 24 EAFC Issuance Correction Form
DHR/IMA 59 Spend Down Activity Form
DHR/FIA AIMS 103 Division of Data Processing
DHR/IMA 103C Supervisory Review System
DHR/IMA AIMS 153 Request for AIMS PA Check/ATI Cards
DHR/IMA 154 Benefit Inventory Control
DHR/FIA AIMS 155 Stop Payment Request Public Assistance Checks
DHR/FIA AIMS 156 Manual Issuance Daily Tally Sheet – Authorization to Issue
DHR/IMA AIMS 157 Notice of Receipt of Refund
DHR/IMA AIMS 158 PA Overpayment, Recoupment and Refund Record
DHR/IMA AIMS 159 PA Overpayment, Recoupment and Refund Record
DHR/FIA AIMS 174 AIMS Report Packing List
DHR/FIA AIMS S-200A Information for AFDC & FS Clients
DHR/FIA AIMS S-200B Procedures for Fair Hearings
Des 203 Notice of Medicare Beneficiary’s Change in Elig. Status
DHMH 206N Long Term Care Transaction Form
DHR/IMA 369 Verification of Earnings
DHR/IMA 370 Verification of Benefits/Unearned Income
DHR/IMA 371 Verification of Resources/Assets
DHR/IMA 372 Income and Resource Letter
DHR/IMA 373 Income and Resource Letter
DHR/IMA RAP 533 Notice of Decision – RCA
DHR/IMA 534 Notice of Action during Payment Period – RCA
List of obsolete forms (effective 2/1/2000) continues:
DHR/IMA 535 Reminder to Recipients of RCA
DHR/IMA 747 Medical Assistance Extension – Child Care Report
DHR/IMA 1100 Abbreviated Eligibility worksheet – P.A./ Food Stamp
DHR/IMA 1101 Abbreviated Eligibility Worksheet – Medical Assistance
DHR/IMA 1103 AFDC, AFDC-UP, GPA-PW, RCA Calculation worksheet
DHR/IMA 1105 GPA/GPA-E Calculation Sheet
DHR/IMA 1106 PAA Domiciliary Care and Project Home Calculation Sheet
DHR/IMA 1107 PAA DHMH Rehabilitative Residence Calculation Sheet
DHR/IMA 1109 Medical Assistance State Only Calculation Worksheet
DHR/IMA 1110 Medical Assistance Deemed Income Calculation Worksheet
DHR/IMA 1111 MA Spend Down Eligibility Determination
DHR/IMA 1112 Motor Vehicle Resource Computation
DHR/IMA 1113 Life Insurance
DHR/IMA 1114 Countable Resource
DHR/IMA 1116 30 1/3 Tracking Sheet
DHR/IMA 1117 Disqualification Tracking Sheet
DHR/IMA 1118 Lump Sum Tracking sheet
DHR/IMA 1119 Unemployed Parent Determination Sheet
DHR/FIA 1125 Health OTO Tracking Form
DHMH 1158 D-1 PWC – Checklist For Medicaid Applicants
DHMH 1159E Eligibility Determination Worksheet
DHMH 2583 Insurance Reporting Form
MAPA 1 Notice of Determination of Presumptive Eligibility
MAPA 9 PWC Program
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