RELATES TO: KRS 205.010, 205.200, 205.245, 605.120(5), 42 U.S.C. 601-619
NECESSITY, FUNCTION, AND CONFORMITY: KRS 194A.050(1) requires
the secretary to promulgate administrative regulations necessary to implement
programs mandated by federal law or to qualify for the receipt of federal funds
and necessary to cooperate with other state and federal agencies for the proper
administration of the cabinet and its programs. KRS Chapter 205 requires the
Cabinet for Health and Family Services to administer public assistance programs
including the Kentucky Transitional Assistance Program (KTAP) and mandatory and
optional supplementation of persons who are aged, blind, and have a disability.
KRS 205.200(2) requires the cabinet to promulgate administrative regulations
concerning the conditions of eligibility for public assistance, in conformity
with the Social Security Act, 42 U.S.C. 601-619 and federal regulations. KRS 605.120(6) requires the Cabinet for Health and Family Services to promulgate
administrative regulations to establish uniform conditions and requirements for
kinship care. This administrative regulation establishes the conditions under
which an application is denied or assistance is decreased or discontinued and
advance notice requirements.
Section
1. Definitions.
(1) "Applicant"
means an individual applying for:
(a) State
Supplementation Program (SSP) benefits;
(b) KTAP benefits; or
(c) Kinship Care Program benefits.
(2) "Application" means the
process set forth in:
(3) "Recipient" means a:
(a) Person who is aged, blind, or has a
disability receiving SSP benefits;
(b) Member of a KTAP assistance group as
defined in
921 KAR 2:016; or
(c)
Member of a Kinship Care Program assistance group as defined in
922 KAR 1:130.
Section
2. Reasons for Adverse Action.
(1) An application shall be denied if:
(c) The
applicant fails to provide sufficient information or clarify conflicting
information necessary for a determination of eligibility despite receipt of
written notice detailing the additional information needed for a
determination;
(d) The applicant
fails to complete an interview;
(e)
The applicant requests in writing voluntary withdrawal of
application;
(f) Department staff
is unable to locate the applicant; or
(g) The applicant is no longer domiciled in
Kentucky.
(2) Assistance
shall be discontinued or decreased if:
(c) The
recipient fails to provide sufficient information or clarify conflicting
information necessary for a redetermination of eligibility despite receipt of
written notice detailing the additional information needed for a
redetermination;
(d) The recipient
fails to complete an interview;
(e)
The cabinet is recovering KTAP or Kinship Care Program overpayments through
recoupment;
(f) Department staff is
unable to locate recipient;
(g) The
recipient is no longer domiciled in Kentucky; or
(h) Change in program policy adversely
affects the recipient.
Section 3. Notification of Denial of an
Application.
(1) If an application is denied,
the applicant shall be given a notice of such action.
(2) The notice pursuant to subsection (1) of
this section shall include:
(a) The reason for
the denial;
(b) Citation of the
applicable state administrative regulation; and
(c) Information regarding:
1. The opportunity to confer with the worker;
and
Section 4. Advance Notice of a Decrease or
Discontinuance.
(1) The recipient shall be
given ten (10) days advance notice of the proposed action if a change in
circumstances indicates:
(a) A money payment
shall be:
1. Reduced;
2. Suspended; or
3. Discontinued; or
(b) An individual shall be removed from the
KTAP or Kinship Care Program grant, even if the grant increases.
(2) The ten (10) days advance
notice of the proposed action shall:
(a) Be
given in accordance with Section 3 of this administrative regulation;
(b) Explain the reason for the proposed
action;
(c) Cite the applicable
state administrative regulation; and
(d) Extend the opportunity to confer with the
worker or to request a fair hearing pursuant to
921 KAR 2:055.
(3) A hearing request received
during the advance notice period may result in delay of the decrease or
discontinuance pending the hearing officer's decision, as provided in
921 KAR 2:055.
Section 5.
Exceptions to the Advance Notice Requirement. An advance notice of proposed
action shall not be required, but written notice of action taken shall be given
in accordance with Section 3 of this administrative regulation, if:
(1) A decrease or discontinuance results
from:
(a) Information reported by the
recipient, if the recipient signs a waiver of the notice requirement indicating
understanding of the consequences;
(b) A clear written statement, signed by a
recipient that the recipient no longer wishes to receive assistance from the
department;
(c) Factual information
received by the department that the:
1. State
supplementation recipient has died; or
2. KTAP payee has died and a new payee is
unavailable;
(d)
Whereabouts of a recipient are unknown and mail addressed to the recipient is
returned indicating no known forwarding address; however, a returned check
shall be made available if whereabouts of the recipient becomes known during
the payment period covered by the returned check;
(e) Establishment by the agency that
assistance has been accepted in another state;
(f) Removal from the home of a KTAP or
Kinship Care Program child by judicial order or voluntary placement in foster
care by his legal guardian;
(g) The
person who is aged, blind, or has a disability and is an SSP recipient, enters
a nursing facility resulting in vendor payment status;
(h) The recipient enters a:
1. Penal institution;
2. Tuberculosis hospital, if under sixty-five
(65); or
3. Psychiatric hospital,
if between twenty-one (21) and sixty-five (65); or
(2) A recipient is granted a
special allowance, or time limited assistance, that is terminated at the end of
a specified period.