ELIGIBILITY AND DETERMINATION FOR BURIAL ASSISTANCE

A. A burial benefit shall be available to cover all or part of reasonable and necessary costs for burial services when: 1. A deceased client was receiving Old Age Pension (OAP), Aid to the Needy Disabled (AND-SO OR AND-CS), Home Care Allowance, and/or Colorado Medicaid assistance at the time of death; and, 2. The deceased client's estate is insufficient to pay all or part of the burial services; and, 3. The resources of the legally responsible person(s) for the support of the deceased client are insufficient, even with contributions from the client's estate, to enable the legally responsible person(s) to pay all or part of such expenses; and, 4. The total cost for all burial services does not total more than two thousand five hundred dollars ($2,500), except that the cost of a burial plot shall not be included in the $2,500 maximum cost limit when: a. The client has a prepaid burial plot valued at two thousand dollars

($2,000) or less at the time of purchase; or, b. A burial plot was purchased by someone other than the deceased client and donated to the deceased client; and, B. The total burial benefit shall not exceed the current burial benefit rate. 1. Effective March 1, 2020, the burial benefit shall not exceed one thousand five hundred dollars ($1,500). 2. The reimbursement rate shall be adjusted by the State Department as needed to stay within the available appropriations. There shall be no appeal granted for this adjustment. C. When assistance for funeral, burial, or cremation services is requested within thirty (30) days from the date of death on behalf of a deceased client as described in Section 3.570.43.A, by any interested party; an application requesting a burial benefit shall be completed and submitted to the county department for eligibility determination. Requests made after 30 days shall be evaluated by the county department and an extension may be given if good cause exists, not to exceed one (1) year from the date of death. Good cause shall exist for any application filed within one year of the date of death of the client, if the client’s date of death preceded the effective date of this rule. The client's family or friends, or the county department when there are no known family or friends, shall make arrangements for disposition of the client's body in a reasonable, dignified manner which approximates the wishes and the religious and cultural preferences of the client or family, to the extent possible within the burial benefit rules and burial grant payment funds. 1. The county department shall ensure that a choice of disposition by the client is made in writing. The choice of disposition may be made on the client's most recent application for benefits, in the client's will, or by any other document which the county department deems credible. If there are conflicting documents expressing the client’s choice of disposition, the county department shall utilize the most recent document containing the client’s choice. If the client has not expressed a choice of disposition, the client’s disposition shall be determined respectively by the client’s spouse, adult children, parents, or siblings. 2. The county department shall coordinate with the client's family or interested parties to explain the burial benefit rules, including: a. Options in the event the client's or family's burial preferences cannot be met within the limitations of the burial rules or burial grant payment maximum; and, b. If the family's burial preference is in opposition to the client's preference, as noted on the client's most recent application for benefits or other documentation, the burial grant payment shall be used to meet the client's preference, unless all options for meeting that preference have been exhausted within the limitations of the burial grant payment; and, c. The legally responsible person's responsibility to pay the cost of burial services that exceed the approved burial grant payment; and, d. That voluntary contributions from family, friends, or other interested parties, may be used to cover some or all of the legally responsible person's costs that exceed the approved burial grant payment up to the maximum cost limit. 3. The county department shall use the following procedures when the deceased client's burial preferences are unknown and a family member cannot be located: a. If a family member has not been located within twenty-four hours after the client dies, the county department shall have the body refrigerated or embalmed. b. If a family member has not been located within seven (7) days, the county department shall make the determination to bury or cremate the body based on the best option available. c. The county department shall complete and send written authorization to the appropriate funeral home or crematorium. D. The county department shall reduce the burial grant payment by applying the following monies toward the full burial costs in the order listed: 1. First, subtract monies due from any insurance policy of the deceased client to a legally responsible person or any other person who makes a contribution to burial services and is named as beneficiary or a joint beneficiary; then if costs remain, 2. Subtract the value of the deceased client's estate as of the date of death that are available, including any cash or property of any kind which the deceased client owned or proportionate share of resources held in joint ownership at the time of death; then if costs remain, 3. Subtract monies from the legally responsible person(s) for the client, as follows: a. Social Security lump sum death benefits payable to a legally responsible person shall be exempt. b. If the legally responsible person(s) has resources below the SSI resource limit of $2,000 for an individual or $3,000 for a couple any resources would not be used to reduce the burial grant payment. These limits are consistent with the provisions of Federal Regulations found at 20 CFR 416.1205 (2019), which are herein incorporated by reference. This rule does not contain any later amendments or editions. These regulations are available for no cost at https://www.ecfr.gov/. These regulations are also available for public inspection and copying at the Colorado Department of Human Services, Director of the Employment and Benefits Division, 1575 Sherman Street, Denver, Colorado, 80203, or at any State publications library during regular business hours. 1) If the legally responsible person is the widow(er), the individual resource limit shall apply. 2) The legally responsible person(s) may voluntarily contribute monies toward the cost of the burial services. c. If the legally responsible person(s) has resources over the SSI limit, the amount of resources over the limit shall be used to reduce the burial grant payment; then if costs remain, 4. The county department shall issue a written authorization for the amount of the burial grant payment, up to the burial grant payment limit, as set forth in Section 3.570.43.B.1. E. Once the application and choice of burial services is determined, the family or county department shall contact the appropriate provider(s) to obtain a written estimate of the provider's proposed charges for burial services. If more than one provider is involved, a separate written estimate from each provider shall be obtained. F. Once the proposal(s) from the provider(s) is received, the county department shall determine if a burial grant payment is appropriate. 1. If the combined charges from the provider(s) exceed two thousand five hundred dollars ($2,500), no burial grant payment shall be paid. 2. The county department shall allow the provider(s) to resubmit a written estimate within ten (10) calendar days of notification that the charges exceeded the burial grant payment maximum. G. All payments from a decedent's estate, payments from legally responsible persons, and contributions from any other person persons who make a contribution to burial services shall be paid directly to the provider(s) of services. After the provision of all services, the providers shall bill the county department directly for reimbursement for appropriate costs that have not been covered by the resources from or contributions made by the decedent's estate, legally responsible persons, or any other person persons who make a contribution to burial services. The county department shall reimburse the appropriate providers directly, based upon the statement of agreement. H. The county department of residence of the deceased client shall authorize the approved burial grant payment through the statewide automated system. The burial grant payment shall be paid directly to the provider(s). The burial application must be processed as soon as possible but no later than thirty (30) days from submission. I. The county department shall have a statement of agreement between the providers, which ensures that the distribution of burial grant payment is proportional to burial services provided or as the providers otherwise determine. The agreement shall be signed by all provider(s) and shall be approved and signed by the county department before the burial grant payment is authorized in the statewide automated system. J. The county department will seek recovery of resources if: 1. The resource was reported to the funeral director after the deadline date, and the funeral director does not collect from them. 2. The resource becomes available only after the county department has paid for burial services.