43-107 COOPERATION REQUIREMENTS

.1 Mother and Unrelated Adult Male Living in the Home

This section applies only to the unrelated adult male living with an AFDC family in which the mother is included as the needy caretaker.

.11 The mother of a child for whom she is applying for or receiving AFDC shall present to the Income Maintenance System a statement signed by her and by an unrelated male living with the family, other than a bona fide lodger, roomer or boarder, which shall set forth:

.111 The actual amount of the financial payment(s) made by the unrelated adult male for his share of the family's cost of housing, utilities, food, household operations and special needs which are shared by the family group;

.112 The actual amount of the financial contribution made by the unrelated adult male in cash or in kind for needs of the members of the family budget unit allowed by the AFDC standard of assistance; and

.113 The amount of the unrelated adult male's monthly earnings and other income, if known.

For the purposes of this requirement, both discussion and the written statement shall be limited to the fiscal and monetary arrangements between the mother and the unrelated adult male.

See Section 43-109 for "Required Financial Contribution" and definitions.

.12 The statement shall be signed by the mother and the unrelated adult male under penalty of perjury. For this purpose, the statement shall include the following:

"I certify through my signature that each of the statements given is true and correct to the best of my knowledge and belief. I make this statement under the penalty of perjury and understand that any willful concealment or misstatement of material fact in this statement of which I have been given notice subjects me to the penalties prescribed for perjury in the Penal Code by the State of California. I agree to tell the county welfare department at once when there are any changes in the facts presented in this statement."

RESPONSIBLE RELATIVES

43-107 COOPERATION REQUIREMENTS (Continued) 43-107

If the mother or the unrelated adult male do not understand English, the above statement shall be provided by the county welfare department written in a language which each understands, before it is signed.

.13 Failure of the mother to cooperate in the presentation of the required statement shall be considered the mother's decision to withhold information essential to the determination of the eligibility of the child, except that if she appears unable to comprehend or enter into the procedure for establishing eligibility, action shall be taken by the Income Maintenance System in accordance with Sections 40-128.3 and 40-157.213. If the exception does not apply, aid shall be denied, or discontinued.

.14 Refusal by the unrelated adult male to sign the statement is a violation of W&IC 11351.5 and information regarding such refusal shall, with the prior knowledge of the mother and the unrelated adult male, be sent to the district attorney.

Refusal by the unrelated adult male to sign the statement shall not relieve the mother from submitting a statement signed by her setting forth the facts specified in Section 43-107.51 above.

.2 Unwed Minor Parent

Aid shall be denied or discontinued to the unwed minor parent if he/she refuses to provide necessary information which can be verified regarding his or her parents' ability to support, or in lieu of such information refuses to consent to having his or her parents contacted for the purpose of determining their ability to provide support of their child. Unwed minor parents who refuse to provide necessary information or to consent to parental contact under this section may be eligible for Medi-Cal benefits despite their refusal. The county welfare department should ensure that the Medi-Cal eligibility of such individuals is considered.

NOTE: Authority cited: Sections 10553 and 10554, Welfare and Institutions Code. Reference: Sections 10553 and 10554, Welfare and Institutions Code.

RESPONSIBLE RELATIVES