9 CCR 2503-5-3.550 - FINANCIAL REDETERMINATION
A. A
redetermination of eligibility shall mean a case review/determination of
necessary information and verifications to determine ongoing eligibility every
twelve (12) to twenty-four (24) months for OAP and at least every twelve (12)
months for AND. The eligibility period for OAP shall be determined by the
statewide automated system based on the following factors:
1. OAP cases shall be redetermined, at a
minimum, every twenty-four (24) months when:
a. There is no earned income; and,
b. The value of the client's countable
resources are at least two hundred dollars ($200) under the client's resource
limit, as defined in Section 3.520.72.A.
2. All other OAP cases shall be redetermined
every twelve (12) months, at a minimum.
B. Clients shall file their redetermination
with the county department by the fifteenth (15th) of the month as specified in
the redetermination packet.
1. A client's
failure to file a redetermination timely may delay the determination of
benefits and grant payments.
2. The
county department must make an eligibility decision on complete,
timely-received forms on or before the last day of the month in which the forms
were due.
3. Complete forms
received between the 16th and the last day of the month the redetermination is
due must be approved or denied as soon as possible. The county department will
have ten (10) days to act on such redeterminations, to include scheduling and
conducting the interview and requesting any necessary verification. The county
must make an eligibility decision on redetermination forms received between the
16th and last day of the month within thirty (30) days from receipt of such
redetermination.
C. The
county department shall schedule and conduct an interview with the client at
each redetermination.
1. The client shall be
offered an in-person interview.
2.
If the client does not elect an in-person interview, the county shall schedule
a phone interview.
3. The client
shall be provided written notice at least four (4) days in advance of the
scheduled interview. The client may provide a written or verbal waiver that
written notice of the scheduled interview is not necessary when the county
department is able to conduct the interview during redetermination processing.
Written notice shall include:
a. The date and
time for the interview;
b.
Identification of any documentation that may be needed; and
c. The opportunity to reschedule the
appointment or make other arrangements in the event of good cause.
4. When the client does not keep
the interview appointment and does not request an alternate time or
arrangement, as described in Section 3.520.4.C, grant payments will be
discontinued following the policies outlined in Section 3.554.
D. To redetermine eligibility a
case review must be conducted and necessary verification must be received to
determine ongoing eligibility.
1. If the
client is approved and is receiving SSI benefits and has no other earned or
unearned income, the income and resources received through the Federal State
Data Exchange (SDX) or the Federal State Verification Eligibility System (SVES)
interface shall be considered verified upon receipt.
a. The county department shall review
non-financial eligibility and verify any changes; and,
b. If the county department has obtained or
received information related to income, resources, or non-financial eligibility
requirements that is contrary to the SDX or SVES interfaces, the county
department shall independently verify the information; and,
c. The county department shall forward such
contrary information to the local Social Security Administration
office.
2. During the
redetermination process and prior to eligibility determination, the county
worker shall:
a. Conduct an
interview;
b. Explain the purpose
of the interview and the use of the information supplied by the client on the
redetermination form and any additional required forms;
c. Inform the client in writing that Social
Security Numbers will be used to request and exchange information with other
agencies as part of the eligibility process, including the Department of Labor
and Employment (State wage and unemployment data), and the Social Security
Administration;
d. Have the client
complete the form(s) or provide assistance to the client in completing the
form(s);
e. Explain the appeal
rights to the client as outlined in Section 3.587;
f. Witness the signature of the client and
sign as a person who helped complete the form(s), when applicable;
g. Review documents, verifications, and any
other information supplied by the client with the client in order to obtain
clarification if needed;
h. Request
updated verifications for income, resources, and non-financial eligibility
requirements which have changed. This may include, but is not limited to:
1) Newly declared, such as a new
vehicle;
2) Previously declared,
such as a change in marital status; and,
3) Changes from the previous redetermination,
such as closure of a bank account.
E. Any time while receiving Adult Financial
program grant payments, if there is questionable information regarding the
circumstances of a household or the county department receives information
about changes in a household's circumstances but cannot determine the effect of
those changes on grant payments, the county worker can request a contact. The
county department shall send a request for contact notice requesting the client
attend an interview appointment. The interview should be in-person unless good
cause applies which would allow for a phone interview in lieu of the in-person
interview. If the client does not attend the interview appointment or request
an alternate time or arrangement, as specified in Section 3.520.4.C, the case
shall be discontinued. The county department shall make a request for contact
when:
1. It receives information that would
contradict eligibility or that is questionable; or,
2. It suspects possible fraud; or,
3. It receives direction to do so from the
State Department; or,
4. It is
otherwise reasonable to do so under the prudent person principle.
F. Forms that the client is
required to complete shall be mailed to the client at least thirty (30)
calendar days prior to the first of the month in which the eligibility
redetermination is due. This is considered the prior notice period. A review of
the case record will indicate the forms required based on individual case
circumstances. Mail-out redeterminations shall be conducted as follows:
1. A redetermination form shall be mailed to
the client;
2. Form(s) shall be
completed, signed by the client, and returned to the county department no later
than redetermination due date; and,
3. When the client is unable to complete the
form(s) due to physical, mental, or emotional disabilities, and has no one to
help, the county department shall assist the client to complete the form(s),
unless there is another available legal or other resource that is willing and
able to assist the client.
4. When
the client is unable to complete the redetermination packet in a timely manner
due to good cause, the county department shall extend the due date up to thirty
(30) calendar days. The assistance or referral action of the county department
shall be recorded in the case record.
G. When the county department receives the
completed redetermination packet, it shall:
1. Date stamp the redetermination form(s) and
corresponding verification.
2.
Thoroughly review the redetermination packet for completeness, accuracy, and
consistency. All factors shall be evaluated as to their effect on eligibility
and payment.
a. If the client failed to sign
the redetermination packet, the redetermination packet shall be returned to the
client for signature with instructions to return the signed packet before the
end of the client's eligibility period. An unsigned redetermination packet
shall be considered incomplete and shall not be processed by the county
department.
b. If the
redetermination packet is incomplete, the county department shall ask
additional clarifying questions and request all necessary
verification.
3. Review
the Redetermination packet for changes to:
a.
Non-financial eligibility requirements, as outlined in Section 3.520.6;
and,
b. Resources, as outlined in
Section 3.520.72; and,
c. Income,
as outlined in Section 3.520.78.
4. Document verifications in the case file,
utilizing the process described in Section 3.520.4.D . The case file shall be
used as a checklist in the redetermination process, and shall be used to keep
track of matters requiring further action. When additional information is
needed:
a. Due to incomplete form(s) or lack
of verification, a notice shall be mailed to the client. The notice shall
specify the items that are required for a redetermination to be completed in
order to determine eligibility and/or payment;
b. Due to inaccurate or inconsistent data,
the client may be contacted by telephone or be requested to make an office
visit, to secure the proper information. Collateral contacts and interfaces
shall be used to gather information whenever possible.
H. If the redetermination form is
timely received but is incomplete, a correction notice shall be sent to the
client advising the client that the redetermination form is incomplete and must
be corrected by the last day of the month in which the forms were due to avoid
termination and/or the county department shall work with the client to complete
the form.
I. When the information
provided on the redetermination form, or otherwise provided by the client, is
the basis for reduction in the amount of assistance or in termination of
assistance follow the policies outlined in Section 3.554.
Notes
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