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STATE SUPPLEMENTAL PROGRAM 46-430 (Cont.) AID RECOVERIES AND SPECIAL CIRCUMSTANCES Regulations

46-430 SPECIAL NEEDS - FOOD, CARE AND MAINTENANCE 46-430 FOR ASSISTANCE DOGS (Continued)

.3 Application

Upon request the Department shall provide an eligibility application.

.31 For recipients of SSI, SSP, CAPI, or IHSS, application shall be made on Form ADSA 1 (Rev. 6/01) to the California Department of Social Services, Assistance Dog Special Allowance Program. The application shall be signed under penalty of perjury.

.32 For recipients of SSDI, application shall be made on Form ADSA 1B (Rev. 6/01) to the California Department of Social Services, Assistance Dog Special Allowance Program. The application shall be signed under penalty of perjury.

.33 Applicants who claim eligibility based on their SSDI status shall provide CDSS with a proof of income statement from the Social Security Administration.

.34 Applicants shall provide any and all information and documentation requested by CDSS in order to verify compliance with Welfare and Institutions Code Sections 12553 and/or 12554.

.35 The Department will approve or deny every application and notify the applicant of the action no more than 30 days after the date the application is received.

.4 Payments

Eligibility begins the first day of the month in which the application is received. If determined eligible, payments shall be made retroactively to the month in which the applicant was first made eligible.

.41 The monthly allowance shall be $50.

.42 (Reserved)

.5 Redeterminations

Eligibility for this allowance shall be redetermined as follows:

.51 Eligibility for this allowance shall be redetermined at least once every twelve months.

.52 Each recipient shall complete and return the ADSA Renewal Application Form ADSA 1A (Rev. 4/01) to CDSS by the due date shown on the form.

CALIFORNIA-DSS-MANUAL-EAS MANUAL LETTER NO. EAS-03-03 Effective 2/27/03

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