Understanding Adding a Set of Benefits

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Adding a set of benefits is the process of adding a set of supplemental nutritious food benefits for a participant in the WIC program. A set of benefits can be added for a participant when they are near the end of their certification period and will still be categorically eligible for participation when the certification ends. A set of benefits should only be added to bridge the gap between a participant's current certification and an anticipated subsequent certification when the appointment for the participant's subsequent certification could not be scheduled on time.

The add set of benefits process can be started from the Participant Folder by activating the Add/Replace Set of Benefits menu option on the Benefit Management menu.

Terms

In order to adequately address this advanced concept, it is helpful to begin with a definition of relevant terms that will be used in the explanation.

First Date to Use (FDTU)

A date associated with a benefit that identifies the first date a participant can redeemed it. It is the first day of the established issuance cycle or the current date, whichever is later. (Also referred to as the Expected FDTU.)

Printed First Date to Use (PFDTU)

A date associated with a benefit that identifies the first date a participant can redeem it if it is picked up on time, or the first date a participant could have redeemed it if it is picked up late. It is the first day of the established issuance cycle and is printed on each hardcopy benefit as the FDTU. (Also referred to as the Actual FDTU.)

NOTE: The reason this date is printed along with the calculated Last Date to Use (LDTU) on hardcopy benefits is to show the complete benefit period, which is a minimum of thirty days as mandated by FNS.

Last Date to Use (LDTU)

A date associated with a benefit that identifies the last date it can be redeemed. It is the last day of the established issuance cycle and is printed on each hardcopy benefit as the LDTU.

Current Benefit

A benefit for which the FDTU is equal to or less than the current date and the LDTU is equal to or greater than the current date.

Future Benefit

A benefit for which the FDTU is equal to or greater than the current date.

Follow-up Frequency

A participant's benefit issuance cycle. It is determined by a Competent Professional Authority (CPA) and can be different for each member of a household. It can be set to one of three values:

Monthly -- A participant is issued one set of benefits at a time, which requires the participant to go back to a clinic every month to pick up more benefits.
Bi-monthly -- A participant is issued two sets of benefits at a time, which requires the participant to go back to a clinic every other month to pick up more benefits.
Tri-monthly -- A participant is issued three sets of benefits at a time, which requires the participant to go back to a clinic every three months to pick up more benefits.

Cycle Adjust

An action a staff member can take to adjust the benefit issuance cycle start dates for all members of a household to be the same date. The benefit of cycle adjusting all members of a household is that everyone in the household can pick up benefits at the same time.

Prorate

An action the system can take to provide the appropriate food package size for a current benefit set when the participant is late picking up their benefits.

Late Pickup

Any benefit pickup that occurs after the first date to use for the current benefit.

Adding a Set of Benefits

The most common scenario for adding a set of benefits occurs when a child is still categorically eligible but is near the end of their certification period.

Example

Today = 12/29/2012

Participant is a child whose DOB is 12/20/2010. Their current certification ends on 12/31/2012, but their categorical ineligibility date is 12/31/2015.

When the Add Set of Benefits process is started, the system analyzes the participant to determine whether they are eligible to add a set of benefits. The system takes into account the following factors and allows an additional set of benefits to be added if all of the following conditions are true:

The participant is in a certification period that has not reached its end date.
The participant's current certification has not been terminated.
The participant an additional set of benefits has not been added for the participant's current certification.
The participant can no longer be issued benefits using the normal Benefits (Issue Benefits) process. The system determines this by generating the next benefit set for the participant and validating it. If the result of the validation is one of the following, a benefit set could be added, since the benefit would not be suggested in the Benefits (Issue Benefits) process:
The FDTU of the benefit is past the participant's current certification's end date.
The FDTU of the benefit is past the participant's current certification's termination date.
The FDTU of the benefit is past the participant's categorical ineligibility date.
The participant is not an infant or pregnant, the month of the benefit is the same month as the participant's current certification's end date, and the month of the benefit is not the same month as the participant's categorical ineligibility date.

If the benefit would not be suggested using the Benefits (Issue Benefits) process, the system checks the PFDTU of the benefit to add. If it is not past the end date of the current certification, the system allows a set to be added.

If the system can add a set of benefits for the participant, the following occurs when the Add/Replace Set of Benefits screen displays:

The Add Set (for Late Scheduling of Subsequent Certification Appointment) radio button group is enabled.
The Add Food Prescription button is enabled to allow the addition of a new food prescription for the participant.
The First Date to Use value label is populated with the first date to use of the set of benefits used in the validation process.
The Last Date to Use calendar control control is enabled to allow the selection of an end date for the set of benefits to be added. It is initially populated with the last date to use of the set of benefits used in the validation process.
The Package Size radio button group is enabled to allow the selection of a package size (proration amount) for the set of benefits to be added.

If the system cannot add a set of benefits for the participant, the following occurs when the Add/Replace Set of Benefits screen displays:

The Add Set (for Late Scheduling of Subsequent Certification Appointment) radio button group is disabled and the reason a set of benefits cannot be added is displayed in place of the Last Date to Use and Package Size controls.

Software Version: 2.40.00