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CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL
_______________________________________________________________________________ Date: 5-10-10 Transmittal: UP-10-03 0100 _______________________________________________________________________________
PURPOSE AND SCOPE
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL
PURPOSE AND SCOPE _______________________________________________________________________________ Date: 05-10-10 Transmittal: UP-10-03 0100 _______________________________________________________________________________
Need is the eligibility requirement common to all programs administered by the Department of Social Services.
Purpose
The general purpose of the financial assistance programs is to provide to the individual or family, whose income and assets are insufficient, a standard of living which the Department considers compatible with health and decency.
The general purpose of the medical assistance program is to assure adequate medical care and services for as many persons as who are eligible. This includes persons whose income and assets are sufficient to meet basic maintenance needs but inadequate to meet medical needs, as well as persons receiving financial assistance money payments for basic needs.
The general purpose of the Supplemental Nutrition Assistance Program (SNAP) is to raise the nutritional level among low income households whose limited food purchasing power contributes to hunger and malnutrition among member of such households. Effective October 1, 2008 the name of the Food Stamp Program was changed to the Supplemental Nutrition Assistance Program (SNAP). This name change is in accordance with the Food, Conservation and Energy Act of 2008 (Public Law 110-246).
Scope
The areas covered in this policy manual are the guidelines for determining eligibility for specific programs and basic calculations of benefits. It also contains policy and procedures regarding benefit issuance and benefit error, recovery of assistance, special programs and special benefits. This manual does not contain policy or procedural material pertinent to other aspects of the Department.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL
_______________________________________________________________________________ Date: 1-1-89 Transmittal: UP-88-55 0200 _______________________________________________________________________________
INSTRUCTIONS FOR USE
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL
INSTRUCTIONS FOR USE
_______________________________________________________________________________ Date: 1-1-89 Transmittal: UP-88-55 0200 _______________________________________________________________________________
BASIC COMPONENTS
The Uniform Policy Manual (UPM) has two basic components, POLICY and PROCEDURES, which serve distinct purposes and should be used according to their particular function.
POLICY pages have the power of regulation and should be used by DIM staff as a legal basis upon which to make decisions on eligibility issues and related matters in a consistent and uniform manner. Legislators, attorneys, and other interested parties should use the POLICY pages as a reference book which reflects the laws governing the Department’s administration of its various programs.
PROCEDURES pages are for the exclusive use of the DIM staff. They provide a guide to implementing DIM’s policies. PROCEDURES pages are written on buff-colored paper to set them apart from POLICY pages. PROCEDURES pages have a “P” before their numerical index number to further distinguish them from their corresponding POLICY pages. They generally follow the POLICY pages to which they pertain by chapter. PROCEDURES pages contain instructions regarding what forms the worker completes and how various units within the Department should interact in implementing policy.
Where DIM staff should use the POLICY pages to insure statewide uniformity in making decisions, they should exercise flexibility in using the PROCEDURES pages when implementing those decisions. As noted above, PROCEDURES pages are only a guide to implementing policy. If a PROCEDURES page seems to conflict with a POLICY page, the user should seek an amendment to the procedure, as appropriate, in order to implement the corresponding policy. A PROCEDURES page should not be used as a basis for an eligibility decision.
ORGANIZATION OF MATERIAL
The information contained in the UPM is divided into general categories or sections. Within each section there are chapters which separate the general category into its most important sub-sections. The chapter, in turn, is divided into subjects which provide specific items of information pertinent to their particular chapter. At the beginning of each section there is an alphabetically-organized list of definitions containing key terms used in the section. The final chapter of each section contains policy and procedures describing whatever verifications are required with regard to the information contained in the section.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL
INSTRUCTIONS FOR USE _______________________________________________________________________________ Date: 1-1-89 Transmittal: UP-88-55 0200 _______________________________________________________________________________
ORGANIZATION OF MATERIAL (cont.)
The first three sections of the UPM provide basic information concerning the rights and responsibilities of applicants for and recipients of assistance, a detailed description of the eligibility process and an explanation of the concept of the assistance unit.
The next eight sections describe the factors used to determine eligibility. These include the non-financial criteria (categorical, technical and procedural requirements) and financial criteria (treatment of assets, standards of assistance, treatment of income, income eligibility, and calculation of benefits).
The next three sections describe how benefits are issued, how errors are corrected, and how benefits are recovered by the Department.
The final two sections describe the special programs the Department administers and the special benefits certain recipients may receive.
Those readers who use the UPM extensively and are familiar with the organization of the manual should use the Table of Contents when trying to locate a particular subject. The Table of Contents lists the title of every section, chapter and subject in the UPM, and the corresponding index number. Because of the complexity of some of the material, the reader may need to refer to more than one subject to understand the total concept underlying a particular policy. For this reason, cross-references are included when appropriate.
UPM also contains an alphabetical index for those who are not as familiar with the material or who do not use the UPM extensively. A glossary of terms and an index of cross-references are also included.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL
Date: 1-1-89 Transmittal: UP-06-17 0300
TABLE
OF
CONTENTS
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 5-1-97 Transmittal: UP-06-17 0300 _______________________________________________________________________________
Purpose and Scope - - - - - - - - - 0100 Instruction for Use - - - - - - - - - 0200 Table of Contents - - - - - - - - - 0300 Glossary of Abbreviations - - - - - - - - 0400 Glossary of Terms - - - - - - - - - 0500 Index - - - - - - - - - - - 0600 AFDC Program References - - - - - - - - 0800
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 7-1-97 Transmittal: UP-06-17 0300 _______________________________________________________________________________ Rights and Responsibilities 1000 _______________________________________________________________________________
Definitions - - - - - - - - 1000.01 Rights of Applicants and Recipients - - - - - - 1005 Right to Participate in Application Process - - - - 1005.05 Right to Fair Treatment - - - - - - 1005.10 Right to a Hearing - - - - - - 1005.15 Right to Fair Treatment - - - - - - P-1005.10 Responsibilities of Applicants and Recipients - - - - - 1010 Responsibilities in Relationship with the Department - - 1010.05 Departmental Responsibilities - - - - - - - 1015 Determining Eligibility in a Timely Manner - - - - 1015.05 Informing the Assistance Unit - - - - - - 1015.10 Maintaining Case Records - - - - - 1015.15 Keeping Information Confidential - - - - 1015.20 Voter Registration - - - - - - - 1015.25 Informing the Assistance Unit - - - - - - P-1015.05 Maintaining Accurate Case Records - - - - - P-1015.10 Voter Registration - - - - - - - P-1015.25 Disclosure of Information - - - - - - 1020 Types of Information to be Safeguarded - - - 1020.05 Releasing Information - - - - - - - 1020.10 Release of Information to Law Enforcement Officers - - - 1020.12 Release of Information to the Department of Children and Families - 1020.13 Publicizing Safeguarding Requirements - - - 1020.15 Distributing Information to the Assistance Unit - - - 1020.20 Explaining the Department's Disclosure Policy - - - P-1020.05 Disclosing Information to the Assistance Unit - - - P-1020.10
Definitions - - - - - - - - 1500.01PRIVATE Application Process - - - - - - - 1505 Agency Responsibilities - - - - - - 1505.05 Filing an Application - - - - - - - 1505.10 Individuals Qualified to Make an Application - - - - 1505.15 Completing the Application Form - - - - 1505.20 Head of the Assistance Unit - - - - - - 1505.25 Application Interviews - - - - - - - 1505.30 Application Processing Standard - - - - - 1505.35 Eligibility Determinations - - - - - 1505.40 Reopening Denied Applications - - - - - 1505.45 Identification Cards - - - - - - 1505.50 Department Issued Debit Cards - - - - - 1505.55 Primary Steps in the Application Process - - - - P-1505.05 Initiating the Application - - - - - P-1505.10 Contacting the Wrong District Office - - - - - P-1505.15 Telephone and Mail Inquiries - - - - - - P-1505.20 Changing the Head of the Assistance Unit - - - - - P-1505.22 Application Interviews - - - - - - - P-1505.25 Completing the Interview - - - - - - P-1505.30 Processing Standards - - - - - - - P-1505.35 Determining Eligibility - - - - - - P-1505.40 Fraud Early Detection System (FRED)- - - - - P-1505.42 Reopening Denied Applications - - - - - P-1505.45 Issuing Identification Cards - - - - - P-1505.50 Replacement of EBT Debit Cards - - - - - P-1505.55 Assessment of Spousal Assets - - - - - - - 1507 Assessment Process - MCCA Spouses (MAABD) - - - 1507.05 When to Complete an Assessment - - - - - P-1507.05 Assessment Process - - - - - - - P-1507.10 Categorical Eligibility Processing Requirements - - - 1510 Special Processing Requirements - - - - 1510.05 Reevaluating Denied Cases - - - - - - 1510.10 Handling of Applications - - - - - - P-1510.05 Expedited Service - - - - - - - - 1515 Identifying Eligible Assistance Units - - - - - 1515.05 Processing Requirements - - - - - - 1515.10 Procedures for Expediting Service - - - - 1515.15 Certification and Entitlement to Benefits - - - 1515.20 Limitations - - - - - - - - 1515.25 Procedures at the Time of Application - - - - - P-1515.05 Processing Requirements - - - - - - P-1515.10 Expedited Eligibility for Pregnant Women - - - - - 1520 Identifying Eligible Assistance Units - - - - - 1520.05 Processing Requirements - - - - - - 1520.10 Determining Eligibility for Pregnant Women - - - - P-1520.05 Verifying Postponed Information - - - - - P-1520.10 Applications from Outreach Locations - - - - - P-1520.12 Authorized Representatives - - - - - - - 1525 General requirements - - - - - - - 1525.05 Who Can Be an Authorized Representative - - - - 1525.10 Responsibilities - - - - - - - 1525.15 Disqualification - - - - - - - 1525.20 Agency Requirements - - - - - - - 1525.25 Signature on Documents - - - - - - 1525.30 General Requirements - - - - - - - P-1525.05 Application Procedures - - - - - - P-1525.10 Disqualification of the FS Head of Household - - - - P-1525.15 Certification - - - - - - - - 1530 General Requirements - - - - - - - 1530.05 Food Stamp Certification Periods - - - - 1530.10 Notification - - - - - - - 1530.15 General Requirements - - - - - - - P-1530.05 Cases with Zero Benefit Level - - - - - - - 1535 Processing Requirements - - - - - - 1535.05 Changes to Issuance Status - - - - - 1535.10 Notification - - - - - - - - 1535.15 Processing Requirements - - - - - - P-1535.05 Verification Requirements - - - - - - 1540 Requirements and Penalties - - - - - - 1540.05 Unit and Agency Responsibilities - - - - 1540.10 Methods of Verification - - - - - - 1540.15 Determining the Requirements and Penalties - - - - P-1540.05 Using the Methods of Verification - - - - - P-1540.10 Evaluating the Evidence - - - - - - P-1540.15 Verification through IEVS - - - - - - P-1540.20 Determining the Appropriate Action - - - - - P-1540.25 The Redetermination Process - - - - - - - 1545 General Requirements - - - - - - - 1545.05 Redetermination Periods - - - - - - 1545.10 Redetermination Periods - TFA related Assistance Units - - 1545.11 Redetermination Notices - - - - - - 1545.15 Redetermination Interviews - - - - - - 1545.20 Redetermination Form - - - - - - - 1545.25 Qualified Individuals - - - - - - - 1545.30 Timeliness Requirements - - - - - - 1545.35 Processing Redeterminations - - - - - - 1545.40 Special Processing Requirements - - - - 1545.45 Determining the Length of the Redetermination Period - - P-1545.05 Issuing the Redetermination Notice - - - - - P-1545.10 Interviewing and Interview Waivers - - - - - P-1545.15 Completing the Redetermination Form - - - - P-1545.20 Redetermining Eligibility - - - - - - P-1545.25 Processing Incomplete FS Cases - - - - - P-1545.30 Processing Incomplete AFDC, AABD or MA Cases - - - P-1545.35 Monthly Reporting - - - - - - - 1550 Implementation - - - - - - - 1550.01 Units Required to Report Monthly - - - - - 1550.05 Reporting Requirements - - - - - - 1550.10 Processing Monthly Reports - - - - - - 1550.15 Units Required to Report Monthly - - - - - P-1550.05 Reporting Requirements - Completeness - - - P-1550.10 Reporting Requirements - Timeliness - - - - - P-1550.15 Interim Activity - - - - - - - - 1555 Reporting Changes - - - - - - 1555.05 Good Cause - - - - - - - 1555.10 What Must Be Reported - - - - - - 1555.15 Change Report Form - - - - - - - 1555.20 Notification - - - - - - - 1555.25 Processing Changes - - - - - - 1555.30 Effective Date of Change - - - - - 1555.35 Recording Information - - - - - - - P-1555.05 Taking Timely Action - - - - - - P-1555.10 Processing Changes - - - - - - - P-1555.15 Determining the Effective Date - - - - - P-1555.20 Beginning Dates of Assistance - - - - - - 1560 Financial Assistance Beginning Dates - - - - 1560.05 Medicaid Beginning Dates - - - - - 1560.10 Food Stamp Beginning Dates - - - - - - 1560.15 Additions to the Assistance Unit - - - - 1560.20 Determining the Beginning Date of Assistance - - P-1560.05 Adding a Member to the Assistance Unit - - - - P-1560.10 Ending Dates of Assistance - - - - - - - 1565 Basic Provisions - - - - - - - 1565.05 Determining the Ending Date of Assistance - - - - P-1565.05 Fair Hearings - - - - - - - - - 1570 General Provisions - - - - - - 1570.05 Notice of Action - - - - - - - 1570.10 Resolution of Dispute Prior to Fair Hearing - - - - 1570.15 Eligibility Pending Fair Hearing - - - - - 1570.20 Hearing Procedures - - - - - - 1570.25 Appeals - - - - - - - - 1570.30 Notifying the Assistance Unit - - - - - - P-1570.05 Procedures Prior to the Hearing All Issues Except Emergency Housing - - - - P-1570.10 Preparing for Emergency Housing Hearings - - - - P-1570.12 Procedures During the Hearing - - - - - P-1570.15 Procedures Subsequent to the Hearing - - - - - P-1570.20 Calculation of CSPA - - - - - - - P-1570.25 Adjustment of MMNA – Exceptional Expenses/Significant Financial Duress - - - - - - P-1570.26 Adjustment of the CSPA - - - - - - P-1570.30 Calculation of CSA - - - - - - P-1570.35 Adjustment of CSA - - - - - - - P-1570.40 Verification - - - - - - - - 1599 Qualifications of Individuals - - - - - - 1599.05 Qualifications of Individuals - - - - - - P-1599.05 Good Cause Circumstances - - - - - - 1599.10 Good Cause Circumstances - - - - - - P-1599.10
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS ______________________________________________________________________________ Date: 09-1-03 Transmittal: UP-06-17 0300 ______________________________________________________________________________ Eligibility Process 1500 ______________________________________________________________________________
Definitions - - - - - - - - 2000.01 Assistance Unit Requirements - AFDC - - - - - 2005 General Provisions - - - - - - - 2005.05 Who Must Be Included - - - - - - 2005.10 Who May Be Included - - - - - - 2005.15 Who is Excluded - - - - - - - 2005.20 The Assistance Unit of One - - - - - - 2005.25 Penalty for Noncooperation - - - - - - 2005.30 Three Generation Household - - - - - - 2005.35 Basic Steps in Creating the AFDC Assistance Unit - - - P-2005.05 Stepparent Household - - - - - - P-2005.10 Special Steps for Individuals Away from Home - - - P-2005.15 Special Steps for SSI Children When Residing With Other Siblings - - - - - - P-2005.17 Special Steps for Children Receiving Adoption Assistance Payments - - - - - - P-2005.18 Creating the Assistance Unit in a Three Generation Household - P-2005.20 Adding Mandatory Inclusions - - - - - P-2005.25 Living in the Same Household - - - - - P-2005.30 Family Medical Assistance Unit Requirements - - - - 2010 General Principles - - - - - - - 2010.05 The Assistance Unit of One - - - - - - 2010.10 The Assistance Unit of Two or More - - - - 2010.15 Special Guidelines For Certain Medicaid Groups - - - 2010.20 Determining the FMA Unit - - - - - - P-2010.05 Dividing The Assistance Unit into Sub-units - - - - P-2010.10 AABD and MAABD Assistance Unit - - - - - - 2015 Basic Requirements - - - - - - - 2015.05 Determining AABD and MAABD Requirements - - - P-2015.05 Food Stamp Assistance Unit Requirements - - - - - 2020 General Requirements - - - - - - 2020.05 Who Must be Included - - - - - - 2020.10 Who May be a Separate Unit - - - - - 2020.15 Optional Members of the Assistance Unit - - - - 2020.20 Assistance Unit in Institutions - - - - - 2020.25 Who is Excluded from the Assistance Unit - - - - 2020.30 Determining the Basic Food Stamp Unit - - - - P-2020.05 Determining Separate Units - - - - - P-2020.10 Assistance Units in Institutions - - - - - P-2020.15 Verification Requirements - - - - - - - 2099 Basic Requirements - - - - - - - 2099.05 Acceptable Verification - - - - - - P-2099.05
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _________________________________________________________________________________ Date: 5-1-97 Transmittal: UP-97-8 0300 _________________________________________________________________________________ Assistance Unit Composition 2000 _________________________________________________________________________________
Definitions - - - - - - - - 2500.01 Eligible Child - - - - - - - - - 2505 Determining if There is an Eligible Child in the Home - - P-2505.05 Deprivation of Parental Support or Care - - - - - 2510 General Provisions - - - - - - - 2510.05 Death of the Parent - - - - - - - 2510.10 Absence of the Parent - - - - - - - 2510.15 Determination of the Parent - - - - - - 2510.20 Physical or Mental Incapacity - - - - - 2510.25 Unemployment of the Parent - - - - - - 2510.30 Determination of the Principal Wage Earner - - - - 2510.35 Conditions for Qualifying as an Unemployed Parent - - - 2510.40 Good Cause for Noncompliance with Work Program Requirements - - - - - 2510.45 Determining the Deprivation Factor - - - - - P-2510.05 Making Presumptions About Absence - - - - P-2510.10 Considering Circumstances Which Tend to Support the Presumption that Deprivation Exists - - - - P-2510.15 Considering Circumstances Which Tend to Support the Presumption that Deprivation Does Not Exist - - P-2510.20 Looking at Conditions Which Tend to Refute the Presumption that Deprivation Exists - - - - - P-2510.25 Looking at Conditions Which Tend to Refute the Presumption that Deprivation Does Not Exist - - - - P-2510.30 Exploring the Circumstances of the Parent's Absence- - - P-2510.35 Determining Parental Functioning - - - - - P-2510.40 Resolving Questionable Information - - - - - P-2510.45 Processing a Claim for Physical or Mental Incapacity- - - P-2510.50 Designating the Principal Wage Earner - - - - P-2510.55 Determining Conditions for Qualifying as an Unemployed Parent - - - - - - - P-2510.60 Living with Specified Relative - - - - - - 2515 Degree of Relationship - - - - - - 2515.05 Continuous Care and Supervision - - - - - 2515.10 Jurisdiction or Legal Custody of Child Held by Another - - 2515.15 Absence of Child from the Home - - - - - 2515.20 Absence of the Caretaker Relative from the Home - - - 2515.25 Determination of Caretaker Relative - - - - - 2515.30 Minor Parents - - - - - - - - 2515.35 Determining If Child Resides with Specified Relative- - - P-2515.05 Considering the Absence of the Child From the Home - - P-2515.10 Considering the Absence of the Caretaker Relative from the Home - - - - - P-2515.15 Establishing the Caretaker Relative - - - - - P-2515.20 Determining if the Minor Parent Must Live With an Adult - - P-2515.35 Pregnancy - - - - - - - - - 2520 Pregnancy Requirements - - - - - - 2520.05 Establishing Pregnancy Requirements - -- - - P-2520.05 Age - - - - - - - - - - 2525 Determination of Age - - - - - - - 2525.05 AFDC - Age Requirements - - - - - - 2525.10 State Supplement and Related Medicaid - - - - 2525.15 Determining Age - - - - - - - P-2525.05 Disability - - - - - - - - - 2530 Basis for Disability - - - - - - - 2530.05 SSA Disability Determinations are Conclusive - - - 2530.10 Establishing Eligibility - - - - - - P-2530.05 Accepting SSA Disability Determinations as Conclusive - - P-2530.10 Blindness - - - - - - - - - 2535 Basis for Blindness - - - - - - - 2535.05 SSA Blindness Determinations are Conclusive - - - 2535.10 Establishing Blindness - - - - - - P-2535.05 Accepting SSA Blindness Determinations as Conclusive - - P-2535.10 Medicaid Coverage Groups - - - - - - - 2540 General Principles - - - - - - - 2540.01 HUSKY A - Extended Medical Assistance (F03, F04) - - 2540.09 HUSKY A for Families (F07) - - - - - 2540.24 HUSKY A - Children Receiving Title IV-E Payments (D01) - 2540.40 HUSKY A for Non-Title IV-E Subsidized Adoption Children (D03) - - - - - - 2540.41 HUSKY A for Independent Foster Care Adolescents (D04) - - 2540.42 HUSKY A for Pregnant Women Under 185% of the Poverty Level (P02)- 2540.43 HUSKY A for Categorically Needy Pregnant Women (P01) - 2540.44 HUSKY A for Medically Needy Pregnant Women (P095, P99) - 2540.45 HUSKY A - Pregnant Woman Extension (M01, M02)- - - 2540.48 HUSKY A for Newborn Children (F10, F11) - - - 2540.52 HUSKY A - Categorically Needy Ribicoff Children (F12) - - 2540.56 HUSKY A - Medically Needy Ribicoff Children (F95, F99) - 2540.57 HUSKY A for Children (F25) - - - - - 2540.58 HUSKY A for Long Term Care Facility Residents Eligible Under Special Income Level (T01) - - - - 2540.60 HUSKY A for Individuals Receiving Home and Community Based Services (H01)- - - - - - - 2540.64 HUSKY A for Medically Needy Caretaker Relatives (F95, F99)- - 2540.68 Recipients of AABD - - - - - - - 2540.72 Women with Breast of Cervical Cancer - - - - 2540.74 Severely Impaired (S04) - - - - - - 2540.76 Severely Impaired Non-SSI Recipients - - - - 2540.77 AABD - Eligible Non-Recipients - - - - - 2540.80 Eligible for AABD Except for Non-Medicaid Requirements- - 2540.84 Working Individuals with Disabilities - - - - 2540.85 Long Term Care Facility Residents Eligible Under Special Income Level - MAABD - CN - - - 2540.88 Qualified Disabled Working Individuals - - - - 2540.90 Individuals Receiving Home and Community Based Services MAABD-CN - - - - - 2540.92 Qualified Medicare Beneficiaries - - - - - 2540.94 Specified Low Income Medicare Beneficiaries - - - 2540.95 Medically Needy Aged, Blind and Disabled - - - - 2540.96 Additional Low Income Medicare Beneficiaries Under 135% of Poverty (Q04) - - - - 2540.97 Additional Low Income Medicare Beneficiaries Under 175% of Poverty (Q05) - - - - 2540.98 Establishing Eligibility for Medicaid Coverage Groups - - P-2540.01 Establishing Eligibility for Children Receiving Title IV-E Payments - - - - - - P-2540.40 Establishing Eligibility for Pregnant Women Under 185% the Poverty Level - - - - - P-2540.43 Establishing Eligibility for Categorically Needy Pregnant Women Coverage - - - - - - P-2540.44 Establishing Eligibility for Medically Needy Pregnant Women Coverage - - - - - - P-2540.45 Establishing Eligibility for Pregnant Woman Extension - - P-2540.48 Establishing Eligibility for Newborn Children - - - P-2540.52 Establishing Eligibility for Categorically Needy Ribicoff Children - - - - - - P-2540.56 Establishing Eligibility for Medically Needy Ribicoff Children - - - - - - P-2540.57 Establishing Eligibility for Residents of Long Term Care Facilities - FMA-CN - - - - - - P-2540.60 Establishing Eligibility for Medically Needy Caretaker Relatives - - - - - - - P-2540.68 Establishing Eligibility for Recipients of AABD - - - P-2540.72 Women with Breast and Cervical Cancer - - - - P-2540.74 Establishing Eligibility for the Severely Impaired - - - P-2540.76 Establishing Eligibility for the Severely Impaired Non-SSI Recipients - - - - - - - P-2540.77 Establishing Eligibility for AABD-Eligible Non-Recipients - - P-2540.80 Establishing Eligibility for Individuals Eligible for AABD Except for Non-Medicaid Requirements - - - P-2540.84 Establishing Eligibility for Residents of Long Term Care Facilities - MAABD-CN - - - - - P-2540.88 Establishing Eligibility for Qualified Medicare Beneficiaries - - - - - - - P-2540.94 Establishing Eligibility for Specified Low Income Medicare Beneficiaries - - - - - - - P-2540.95 Establishing Eligibility for the Medically Needy Aged, Blind and Disabled - - - - - P-2540.96 Establishing Eligibility for Additional Low Income Medicare Beneficiaries Under 135% of the Poverty Level - P-2540.97 Establishing Eligibility for Additional Low Income Medicare Beneficiaries Under 175% of the Poverty Level - P-2540.98 FS Categorically Eligible Assistance Units - - - - - 2545 Which Assistance Units are Categorically Eligible - - - 2545.05 Certain Requirements Presumed Met - - - - - 2545.10 Establishing Categorical Eligibility - - - - - P-2545.05 Verification Requirements - - - - - - - 2599 Determination of the Male Parent - - - - - 2599.15 Determining Disability - - - - - - 2599.30 Minor Parent Living Arrangement Requirement - - - 2599.80 Verifying the Determination of the Male Parent - - - P-2599.15 Verifying Disability - - - - - - P-2599.30 Verifying the Minor Parent Living Arrangement Requirement - P-2599.35
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS ________________________________________________________________________________ Date: 4-1-03 Transmittal: UP-06-17 0300 ________________________________________________________________________________ Categorical Eligibility Requirements 2500 ________________________________________________________________________________
Definitions - - - - - - - - 3000.01 Eligibility for AFDC - - - - - - - - 3003 AFDC Policies and Procedures - - - - - 3003.05 Citizenship Status - - - - - - - - 3005 Citizens and Eligible Non-citizens-AFDC - - - - 3005.05 Citizens and Eligible Non-citizens-FS - - - - 3005.06 Eligible Non-citizens-AABD - - - - - - 3005.07 Eligible Non-citizens-MA - - - - - - 3005.08 Additional Requirements for Non-Citizens - - - - 3005.09 Determining Eligibility Requirements - - - - P-3005.05 Residency - All Programs - - - - - - - 3010 Establishing Residency - - - - - - 3010.05 Basic Provisions - - - - - - - 3010.10 Non-Institutionalized Individuals - - - - 3010.15 Institutionalized Individuals - - - - - 3010.20 Disputed Residence - - - - - - - 3010.25 Establishing Residency - - - - - - 3010.30 Temporary Absence - - - - - - - 3010.35 Basic Procedures to Establish Residency - - - - P-3010.05 Residency Procedures for MA - - - - - - P-3010.10 Determining Temporary Absence - - - - - P-3010.15 Institutional Status - AABD, MA, FS - - - - - - 3015 Institutional Requirements - - - - - - 3015.05 Change in Status - - - - - - - 3015.10 Institutional Requirements - - - - - - 3015.15 Determining Institutional Status - AABD and MA - - - P-3015.05 Determining Institutional Status - FS - - - - - P-3015.10 Student Status - - - - - - - - - 3020 Eligible Students - - - - - - - 3020.05 Determining Student Eligibility - - - - - P-3020.05 Transfer of Assets - AABD, MA, FS - - - - - 3025 Effective Dates - - - - - - - 3025.03 Basic Provisions - AABD, MA, FA - - - - - 3025.05 Transfers for the Purpose of Qualifying AABD, MA - - - 3025.10 Transfer Not for the Purpose of Qualifying AABD, MA - - 3025.15 Compensation - AABD, MA - - - - - - 3025.20 Special Circumstances - AABD, MA - - - - 3025.25 Notification and Rebuttal - AABD, MA - - - - 3025.30 Penalty - AABD, MA - - - - - - - 3025.35 Withdrawals - AABD, MA - - - - - - 3025.40 Basic Provisions - FS - - - - - - - 3025.45 Penalty - FS - - - - - - - 3025.50 Defining the "Look Back" Period - - - - - P-3025.07 Exploring Transfers - - - - - - P-3025.10 Choosing the Correct Policy to Use - - - - - P-3025.11 Evaluating Transfers - - - - - - - P-3025.15 Evaluating Transfers Between Spouses - - - - P-3025.18 Determining Fair Market Value - - - - - P-3025.20 Preliminary Decision and Rebuttal - - - - - P-3025.25 Calculating the Penalty Period - - - - - - P-3025.30 Withdrawn Application - - - - - - P-3025.35 Adjustments - - - - - - - P-3025.40 Documenting Transfers - - - - - - P-3025.45 Transfer of Assets - MA (OBRA '93) - - - - - - 3028 Effective Dates - - - - - - 3028.03 Basic Provisions - - - - - - 3028.05 Transfer Not Resulting in a Penalty - - - - - 3028.10 Transfers Involving Trusts - - - - - - 3028.11 Transfer Made Exclusively for Reasons Other Than Qualifying - 3028.15 Transfer Made in Return for Other Valuable Consideration - - 3028.20 Undue Hardship - - - - - - - 3028.25 Compensation - - - - - - - - 3028.30 Notification and Rebuttal - - - - - 3028.35 Withdrawals - - - - - - - 3028.40 Defining the "Look Back" Period - - - - - P-3028.01 Looking for Transfers - - - - - - - P-3028.03 Choosing the Correct policy to Use - - - - - P-3028.04 Identifying Institutionalized Individuals - - - P-3028.06 Considering the Type of Assets Transferred - - - - P-3028.07 Considering Transfers Made to or by Spouses - - - - P-3028.11 Considering Transfers Made to Children - - - - P-3028.12 Considering Transfers Made to Siblings - - - - P-3028.13 Considering Transfers Involving Trusts - - - - P-3028.15 Evaluating Transfers Made for Another Purpose - - - P-3028.16 Evaluating Intent to Receive Fair Value or Other Valuable Consideration - - - - - P-3028.17 Determining Undue Hardship - - - - - - P-3028.18 Determining Fair Market Value - - - - - P-3028.20 Making a Preliminary Decision and Allowing a Rebuttal - - P-3028.25 Calculating and Imposing the Penalty Period - - - - P-3028.30 Processing Withdrawn Applications - - - - - P-3028.35 Documenting Transfers - - - - - - P-3028.40 Transfer of Assets - MA (DRA ’05) - - - - - - - 3029 Effective Dates - - - - - - 3029.03 Basic Provisions - - - - - - 3029.05 Transfer Not Resulting in a Penalty - - - - - 3029.10 Transfers Involving Trusts - - - - - - 3029.11 Treatment of Annuities - - - - - - 3029.12 Purchase of Life Use - - - - - - - 3029.13 Purchase of a Mortgage Note, Loan or Installment Contract - 3029.14 Transfer Made Exclusively for Reasons Other Than Qualifying - 3029.15 Transfer Made in Return for Other Valuable Consideration - - 3029.20 Undue Hardship - - - - - - - 3029.25 Compensation - - - - - - - - 3029.30 Notification and Rebuttal - - - - - 3029.35 Defining the "Look Back" Period - - - - - P-3029.01 Looking for Transfers - - - - - - - P-3029.03 Choosing the Correct policy to Use - - - - - P-3029.04 Identifying Institutionalized Individuals - - - P-3029.06 Considering the Type of Assets Transferred - - - - P-3029.07 Considering Transfers Made to or by Spouses - - - - P-3029.11 Considering Transfers Made to Children - - - - P-3029.12 Considering Transfers Made to Siblings - - - - P-3029.13 Considering Transfers Involving Trusts - - - - P-3029.15 Evaluating Transfers Made for Another Purpose - - - P-3029.16 Evaluating Intent to Receive Fair Value or Other Valuable Consideration - - - - - P-3029.17 Determining Undue Hardship - - - - - - P-3029.18 Determining Fair Market Value - - - - - P-3029.20 Making a Preliminary Decision and Allowing a Rebuttal - - P-3029.25 Calculating and Imposing the Penalty Period - - - - P-3029.30 Documenting Transfers - - - - - - P-3029.40
Concurrent Assistance - AFDC, AABD, MA, FS - - - - 3030 Concurrent Programs - AFDC, AABD, MA, FS - - - 3030.05 Fraudulent Receipt in Two or More States (AFDC) - - - 3030.10 Ensuring Appropriate Assistance - - - - - P-3030.05 Out of State Assistance - - - - - - P-3030.10 Granting Food Stamps Concurrently - - - - - P-3030.15 Striker Status - AFDC, FS - - - - - - 3035 Basic Provisions - AFDC - - - - - - 3035.05 Basic Provisions -FS - - - - - - 3035.10 AFDC Procedures for Active Cases - - - - - P-3035.05 AFDC Procedures for Application - - - - - P-3035.10 Computing Food Stamps for Strikers - - - - - P-3035.15 Voluntary Quit - FS - - - - - - - - 3040 Basic Provisions - - - - - - - 3040.05 Good Cause - - - - - - - 3040.15 Penalty - - - - - - - - - 3040.20 Determining a Voluntary Quit - - - - - - P-3040.05 Felony Status - AFDC, FS - - - - - - - 3050 Convicted Drug Felons - - - - - - 3050.05 Fleeing Felons and Parole and Probation Violators - - - 3050.10 Fleeing Felons - - - - - - - P-3050.10 Verification Requirements - - - - - - - 3099 Citizenship and Non-Citizen Status- - - - - - 3099.03 U. S. Citizens - - - - - - - 3099.04 Citizenship and Non-citizen Status - - - - - P-3099.03 Non-citizen Status- - - - - - - - P-3099.06 SAVE-Primary Verification - - - - - - P-3099.07 SAVE-Secondary Verification - - - - - P-3099.08 PRUCOL Status - - - - - - - P-3099.09 Residency - - - - - - - - 3099.10 Residency - - - - - - - P-3099.10 Institutional Status - - - - - - 3099.15 Institutional Status - - - - - - P-3099.15 Student Status - - - - - - - - 3099.20 Student Status - - - - - - - - P-3099.20 Concurrent Assistance - - - - - - 3099.30 Concurrent Assistance - - - - - - P-3099.30 Striker Status - - - - - - - 3099.35 Striker Status - - - - - - - P-3099.35 Voluntary Quit - - - - - - - 3099.40 Voluntary Quit - - - - - - - P-3099.40
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS ______________________________________________________________________________ Date: 7-1-08 Transmittal: UP-08-13 0300 ______________________________________________________________________________ Technical Eligibility Requirement 3000 ______________________________________________________________________________
Definitions - - - - - - - - 3500.01 Social Security Number - - - - - - - 3505 Basic Provisions - - - - - - - 3505.05 Disclosure of a Social Security Number - - - - 3505.10 Application for a Social Security Number - - - - 3505.15 Penalties - - - - - - - - 3505.20 Employment and Training Requirements - - - - - 3510 Basic Provisions-AFDC - - - - - - 3510.05 Net Loss of Income-AFDC - - - - - - 3510.07 Exemptions-AFDC - - - - - - - 3510.10 Special Age-related Requirements - - - - - 3510.13 Basic Provisions-FS - - - - - - - 3510.15 Exemptions from Registration Requirements-FS - - - 3510.20 Exemptions from Participation Requirements-FS - - - 3510.23 Employment and Training - - - - - - 3510.25 Noncompliance - - - - - - - 3510.30 Good Cause for Noncompliance - - - - - 3510.35 Suitable Employment - - - - - - - 3510.40 Penalties for Noncompliance-AFDC - - - - - 3510.45 Penalties for Noncompliance-FS - - - - - 3510.50 Granting Exemptions - - - - - - - P-3510.25 Applying Penalties - - - - - - - P-3510.30 Determining the Designated Provider-FS - - - - P-3510.35 Work Requirements - - - - - - - - 3512 General Principles - - - - - - - 3512.05 Exemptions - - - - - - - - 3512.10 Time Limits - - - - - - - - 3512.15 Exemptions - - - - - - - - P-3512.10 Time Limits - - - - - - - - P-3512.15 Securing Support - - - - - - - - 3515 Who is Liable for Support - - - - - - 3515.05 Assignment of Rights to Support - - - - - 3515.10 Cooperation in Securing Support - - - - - 3515.15 Establishing Paternity - - - - - - - 3515.20 Good Cause - - - - - - - 3515.25 Initiating Support - - - - - - - P-3515.05 Obtaining Medical Support from Absent Parents - - - P-3515.07 Establishing Paternity - - - - - - P-3515.10 Evaluating Good Cause Claims - - - - - P-3515.15 Granting Time Limit Extensions - - - - - P-3515.20 Assignment - - - - - - - - 3520 What Must be Assigned - - - - - - 3520.05 Penalty for Refusing to Assign - - - - - 3520.10 Executing the Assignment - - - - - P-3520.05 Cooperation - - - - - - - - 3525 Related to Eligibility Processes - - - - - 3525.05 Related to Potential or Inaccessible Income - - - - 3525.10 Related to Pursuing Assets - - - - - 3525.15 Cooperating with Eligibility Processes - - - - P-3525.05 Developing Potential Sources of Income - - - - P-3525.10 Pursuing Assets - - - - - - - P-3525.15 Granting a Security Mortgage - - - - - - - 3530 Granting a Security Mortgage - - - - - - 3530.05 Declaration of Citizenship Status - - - - - - 3535 Requirements for Signature - - - - - - 3535.05 Requirements for Signature - - - - - - P-3535.05 Enrollment in Health Insurance - - - - - - 3545 Basic Provisions - - - - - - - 3545.05 Penalties - - - - - - - - 3545.10 Payment of Medical/Medicaid Premiums – Working Individuals with Disabilities - - - - 3545.15 Applying Penalties - - - - - - - P-3545.05 Digital Imaging Process - - - - - - - 3555 Requirements Related to the Digital Imaging Process - - - 3555.05 Verification - - - - - - - - 3599 Social Security Numbers - - - - - - 3599.05 Work Requirements - - - - - - - 3599.10 Work Requirements - - - - - - - P-3599.10 Securing Support - - - - - - - 3599.15 Securing Support - - - - - - - P-3599.15 Cooperation - - - - - - - - 3599.25 Verifying Cooperation - - - - - - P-3599.25 Enrollment in Health Insurance - - - - - 3599.30 Enrollment in Health Insurance - - - - - P-3599.30
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 3-1-06 Transmittal: UP-06-17 0300 _______________________________________________________________________________ Procedural Eligibility Requirements 3500 ______________________________________________________________________________
Definitions - - - - - - - - 4000.01 Asset Limits - - - - - - - - - 4005 General Principles - - - - - - - 4005.05 Asset Limits for All Programs - - - - - - 4005.10 Reduction of Excess Assets - - - - - - 4005.15 Comparing the Unit's Assets to the Asset Limit- - - - P-4005.05 Determining the Earliest Date of Eligibility - Applications - - P-4005.10 Discontinuing Benefits Because of Excess Assets - - - P-4005.15 Determination of Ownership - - - - - - - 4010 Record Owner Versus Legal Owner - - - - - 4010.05 Assets Held Jointly - - - - - - - 4010.10 Considering Record Owner Versus Legal Owner - - - P-4010.05 Considering Assets Held Jointly - - - - - P-4010.10 Inaccessible Assets - All Programs - - - - - - 4015 General Provisions - - - - - - - 4015.05 General Provisions – Cash and Medical Programs - - - 4015.10 General Provisions - Food Stamps - - - - - 4015.15 Treating Inaccessible Assets - - - - - - P-4015.05 Determining the Net Return Value of a Motor Vehicle - FS - - P-4015.06 Excluded Assets - - - - - - - - 4020 Excluded Assets - AFDC and FMA - - - - - 4020.05 Excluded Assets - AABD and MAABD - - - - 4020.10 Excluded Assets – Working Individuals with Disabilities - - 4020.11 Excluded Assets - Food Stamps - - - - - 4020.15 Excluding Assets - - - - - - - P-4020.05 Excluding Farm Property - - - - - - P-4020.10 Asset Disregards - MAABD - - - - - - - 4022 Community Spouse Disregard - - - - - 4022.05 Long-Term Care Insurance Disregard - - - - - 4022.10 CSD - Initial Eligibility Determination -- - - - P-4022.05 CSD - Redetermination of Eligibility - - - - - P-4022.10 Deemed Assets - - - - - - - - 4025 The Concept of Deeming - - - - - - 4025.05 Disqualified Individuals - AFDC - - - - - 4025.15 Spouses and Children of Women Qualifying on the Basis of Pregnancy - AFDC - - - - 4025.20 Ineligible & Disqualified Individuals - - - - - 4025.22 Disqualified Individuals - FMA - - - - - 4025.25 Deemors of Non-SSI FMA Children - - - - - 4025.30 Deemors of Women Qualifying Under Pregnant Women Coverage Group - FMA - - - 4025.35 Parents and Spouses of Children Who Receive SSI - FMA - - 4025.37 Sponsors of Non-citizens – MA and SNAP - - - - 4025.45 Parents of Blind Children - AABD - - - - - 4025.50 Spouses - AABD - - - - - - - 4025.55 Parents of Blind Children - MAABD - - - - - 4025.60 Non-MCCA Spouses - MAABD - - - - - 4025.65 Sponsors of Non-Citizens - - - - - - 4025.66 MCCA Spouses - MAABD - - - - - - 4025.67 Undue Hardship - MCCA Spouses - - - - - 4025.68 Disqualified Individuals - FS - - - - - - 4025.75 General Principles - - - - - - - P-4025.05 Disqualified Individuals - AFDC - - - - - P-4025.15 Spouses and Children of Women Qualifying on the Basis of Pregnancy - AFDC - - - - - P-4025.20 Disqualified Individuals - FMA - - - - - P-4025.25 Deemors of Non-SSI FMA Children - - - - - P-4025.30
Deemors of Women Qualifying Under Pregnant Woman Coverage Groups - FMA - - - - P-4025.35 Parents and Spouses of Children Who Receive SSI - FMA - - P-4025.37 Sponsors of Non-citizens – MA and SNAP - - - - P-4025.45 Parents of Minors - AABD - - - - - - P-4025.50 Spouses - AABD - - - - - - - P-4025.55 Parents of Minors - MAABD - - - - - - P-4025.60 Spouses - MAABD - - - - - - - P-4025.65 MCCA Spouses - - - - - - - P-4025.67 Undue Hardship - - - - - - - P-4025.68 Disqualified Individuals - FS - - - - - - P-4025.75 Counted Assets - - - - - - -- 4026 Calculated Method - - - - - - - 4026.05 Calculated Method - - - - - - - P-4026.05 Treatment of Specific Types - - - - - - - 4030 Bank Accounts - - - - - - - 4030.05 Burial Funds, Burial Plots and Irrevocable Burial Funds - - 4030.10 Corrective Payments - - - - - - - 4030.15 Earned Income Tax Credits - - - - - - 4030.17 Entrance Fees for Continuing Care Retirement Communities - 4030.18 Home Property - - - - - - - 4030.20 Income Tax Refunds - - - - - - - 4030.25 Life Insurance Policies - - - - - - 4030.30 Life Use - - - - - - - - 4030.35 Loans - - - - - - - - - 4030.40 Lump-sum Payments - - - - - - - 4030.45 Annuities - - - - - - - - 4030.47 Mortgage Notes, Loans and Installment Contracts - - - 4030.50 Motor Vehicles - - - - - - - 4030.55 Nonessential Household Items - - - - - 4030.60 Non-home Property - - - - - - - 4030.65 Pension Plans and Certain Retirement Accounts - - - 4030.66 Rental Security Deposits - - - - - - 4030.70 Stocks and Bonds - - - - - - - 4030.75 Trusts - - - - - - - - - 4030.80 Disaster Assistance - - - - - - - 4030.85 General Principles - - - - - - - P-4030.05 Bank Accounts - - - - - - - P-4030.10 Burial Funds, Burial Plots, and Irrevocable Burial Funds - - P-4030.15 Home Property - - - - - - - P-4030.20 Life Insurance Policies - - - - - - P-4030.25 Life Use - - - - - - - - P-4030.30 Motor Vehicles - - - - - - - P-4030.35 Non-home Property - - - - - - - P-4030.40 Trusts - - - - - - - - - P-4030.45 Annuities - - - - - - - - P-4030.47 Verification - - - - - - - - - 4099 Asset Limits - - - - - - - - 4099.05 Asset Limits - - - - - - - - P-4099.05 Determination of Ownership - - - - - - 4099.10 Determination of Ownership - - - - - - P-4099.10 Inaccessible Assets - - - - - - - 4099.15 Inaccessible Assets - - - - - - - P-4099.15 Excluded Assets - - - - - - - 4099.20 Excluded Assets - - - - - - - P-4099.20 Asset Disregards - - - - - - - 4099.22 Asset Disregards - - - - - - - P-4099.22 Deemed Assets - - - - - - - 4099.25 Deemed Assets - - - - - - - P-4099.25 Treatment of Specific Types - - - - - - 4099.30 Treatment of Specific Types - - - - - - P-4099.30 Undue Hardship - MCCA Spouses - - - - - 4099.35 Undue Hardship - MCCA Spouses - - - - - P-4099.35
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 10-1-09 Transmittal: UP-09-17 0300 _______________________________________________________________________________ Treatment of Assets 4000 _______________________________________________________________________________
Definitions - - - - - - - - 4500.01 Need and Income Standards - - - - - - - 4505 Standards of Assistance - - - - - - 4505.05 Need Standards - - - - - - - 4505.10 Determining Need Standard - - - - - - P-4505.05 Standard of Need (AFDC) - - - - - - - 4510 The Monthly Standard of Need - - - - - 4510.05 Regions - - - - - - - - 4510.10 AFDC Standards of Need - - - - - - 4510.15 Determining Standard of Need - - - - - P-4510.05 Special Needs (AFDC) - - - - - - - 4515 Emergency Housing - AFDC, AABD - - - - 4515.05 Emergency Telephone Installation - - - - - 4515.10 Meals on Wheels - - - - - - - 4515.15 Moving Expenses - - - - - - - 4515.20 Repair or Replacement of Essential Household Items - - - 4515.25 Replacement of Essential Clothing - - - - - 4515.30 Restaurant Meals - - - - - - - 4515.35 Security Deposit - Heating Service - - - - - 4515.40 Security Deposit - Housing - - - - - - 4515.45 Special School Expenses - - - - - - 4515.50 Storage Charges - - - - - - - 4515.55 Determining Eligibility for Emergency Housing - - - P-4515.05 Determining Need for Emergency Telephone Installation - - P-4515.10 Determining Need for Meals on Wheels - - - - P-4515.15 Determining Need for Moving Expenses - - - - P-4515.20 Determining Need for Repair or Replacement of Essential Household Items - - - - - P-4515.25 Determining Replacement of Essential Clothing - - - P-4515.30 Determining Need for Restaurant Meals - - - - P-4515.35 Determining Need for Security Deposit - Heating Service - - P-4515.40 Determining Need for Security Deposit - Housing - - - P-4515.45 Determining Need for Special School Expenses - - - P-4515.50 Determining Need for Storage Charges - - - - P-4515.55 Basic Needs (AABD) - - - - - - - - 4520 General Requirements - - - - - - - 4520.05 Rated Housing Facilities - - - - - - 4520.10 Non-rated Housing - - - - - - - 4520.15 Determining Basic Needs - - - - - - P-4520.05 Determining Basic Needs for Individuals in Both Rated and Non-rated Housing During a Month - - - P-4520.10 Non-Rated Housing - - - - - - - P-4520.15 Determining Basic Needs for Rated Facilities - - - P-4520.20 Special Needs (AABD) - - - - - - - 4525 Emergency Housing - - - - - - - 4525.05 Meals-on-Wheels - - - - - - - 4525.10 Moving Expenses - - - - - - - 4525.15 Purchase of Essential Clothing - - - - - 4525.20 Purchase, Repair or Replacement of Essential Household Items - 4525.25 Refuse Collection Fee - - - - - - - 4525.30 Restaurant and Congregate Meals - - - - - 4525.35 Security Deposit - Heating Service - - - - - 4525.40 Security Deposit - Housing - - - - - - 4525.45 Storage Charges - - - - - - - 4525.50 Telephone Installation - - - - - - 4525.55 Therapeutic Diets - - - - - - - 4525.60 Conversion Need Item (CNI) - - - - - - 4525.65 Determining Eligibility for Emergency Housing - - - P-4525.05 Determining the Number of Days of Eligibility for Emergency Housing - - - - - - P-4525.06 Determining Need for Meals-on-Wheels - - - - P-4525.10 Determining Need for Moving Expenses - - - - P-4525.15 Determining Need for Purchase of Essential Clothing - - P-4525.20 Determining Need for Purchase, Repair or Replacement of Essential Household Items - - - - - P-4525.25 Determining Need for Refuse Collection Fee - - - - P-4525.30 Determining Need for Restaurant and Congregate Meals - - P-4525.35 Determining Need for Security Deposit - Heating Service - - P-4525.40 Determining Need for Security Deposit - Housing - - - P-4525.45 Determining Need for Storage Charges - - - - P-4525.50 Determining Need for Telephone Installation - - - - P-4525.55 Determining Need for Therapeutic Diets - - - - P-4525.60 Medical Assistance Income Standards - - - - - - 4530 Categorically Needy Income Limits (CNIL) - - - - 4530.05 The Special Categorically Needy Income Limit Special (CNIL) - 4530.10 Medically Needy Income Limit (MNIL) - - - - 4530.15 Federal Poverty Level (MA-CN) - - - - - 4530.20 Determining CNIL Standards - - - - - - P-4530.05 Determining the Special CNIL - - - - - P-4530.10 Determining the Medically Needy Income Limit (MNIL) - - P-4530.15 Determining Eligibility for Pregnant Women/Children Under 185% of the Poverty Level (F13, F20) (F25) - - - P-4530.20 Determining Eligibility for Qualified Medicare Beneficiaries - - - - - - P-4530.25 Determining Eligibility for Specified Low Income Medicare Beneficiaries - - - - - - - P-4530.26
Food Stamp Eligibility Standards - - - - - - 4535 The Applied Income Limit - - - - - - 4535.05 The Thrifty Food Plan - - - - - - - 4535.10 The Thrifty Food Plan Amounts- - - - - - P-4535.10 Verification - - - - - - - - 4599 Verification Requirements - - - - - - 4599.05 Acceptable Forms of Verification - - - - - P-4599.05 Essential Household Furniture, Furnishings, Appliances and Clothing - - - - - - - - Appendix 4500
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _________________________________________________________________________________ Date: 7-1-06 Transmittal: UP-06-28 0300 _________________________________________________________________________________ Standards of Assistance 4500 _________________________________________________________________________________
Definitions - - - - - - - - 5000.01PRIVATE Considered Income - General Principles - - - - 5005 General Principles of Considering Income - - - - P-5005.05 Inaccessible Income - - - - - - - 5010 Inaccessible Income - - - - - - P-5010 Excluded Income - - - - - - - - 5015 Types of Excluded Income in AFDC and FMA - - - 5015.05 Types of Excluded Income in AABD and MAABD - - - 5015.10 Types of Excluded Income in FS - - - - - 5015.15 Excluding Income - - - - - - - P-5015 Deemed Income - - - - - - - - 5020 General Principles - - - - - - 5020.05 Coverage Groups and Related Methodologies - - - - 5020.07 Parents, Stepparents & Spouses of Dependent Children (AFDC and FMA) - - - - - - 5020.10 Spouses of Non-Parent Caretaker Relatives (AFDC and FMA) - 5020.20 Disqualified Individuals (AFDC) - - - - - 5020.25 Individuals Disqualified for Fraudulent Misrepresentation - - 5020.27 Deemors of Pregnant Women (AFDC) - - - - 5020.30 Parents and Spouses of Children Who Receive SSI (FMA) - - 5020.32 Deemors of Non-SSI FMA Children (FMA) - - - - 5020.34 Deemors of Pregnant Women (FMA) - - - - - 5020.36 Disqualified Individuals (FMA) - - - - - 5020.38 Sponsors of Non-citizens (MA and SNAP) - - - - 5020.60 Parents of Blind Children (AABD) - - - - - 5020.65 Spouses (AABD) - - - - - - - 5020.70 Spouses and Parents (MAABD) - - - - - 5020.75 Disqualified Persons (SNAP) - - - - - - 5020.85 Deeming Income - General Principles - - - - - P-5020.05 Parents, Guardians, Stepparents; and Spouses of Dependent Children (AFDC and FMA) - - - P-5020.10 Spouses of Non-Parent Caretaker Relatives (AFDC and FMA) - - - - - - P-5020.20 Ineligible Parents of Dependent Children - - - - P-5020.23 Disqualified Individuals (AFDC) - - - - - P-5020.25 Deemors of Pregnant Women (AFDC) - - - - P-5020.30 Step parents, Parents of Minor Parents, Ineligible Parents and Spouses of Dependent Children - - - P-5020.35 Deemors of Pregnant Women (FMA) - - - - - P-5020.36 Disqualified Individuals (FMA) - - - - - P-5020.38 Parents and Spouses of Children Who Receive SSI (FMA) - - P-5020.39 Ineligible Parents of Dependant Children - - - - P-5020.41 Deemors of Non-SSI FMA Children - - - - - P-5020.45 Parents of Blind Children (AABD) - - - - - P-5020.65 Spouses (AABD) - - - - - - - P-5020.70 Spouses and Parents (MAABD) - - - - - P-5020.75 Disqualified Persons (SNAP) - - - - - - P-5020.85 Conversion To Monthly Amounts - - - - - 5025 Income Received Monthly or More Frequently - - - 5025.05 Income Received Less Frequently Than Monthly - - - 5025.10 Self-employment Income - - - - - - 5025.15 Converting Income Received More Often Than Monthly - - P-5025.05 Converting Income Received Less Often Than Monthly - - P-5025.10 Converting Self-Employment Income Received Less Often Than Monthly - - - - - - - P-5025.15 Income Disregards - - - - - - - - 5030 Earned Income Disregards (AFDC, FMA) - - - - 5030.05 Earned Income Disregards (AABD, MAABD) - - - 5030.10 Child Support Disregard - - - - - - 5030.13 Unearned Income Disregards (AABD, MAABD) - - - 5030.15 General Disregard – Working Individuals with Disabilities - - 5030.16 Income Disregards (FS) - - - - - - 5030.20 Disregarding Earned Income (AFDC, FMA) - - - - P-5030.05 Disregarding Earned Income (AABD, MAABD) - - - P-5030.10 Disregarding Unearned Income (AABD, MAABD) - - - P-5030.15 Disregarding Income (FS) - - - - - - P-5030.20 Income Deductions - - - - - - - - 5035 Employment Deductions (AFDC, FMA) - - - - 5035.05 Lump Sum Deductions - (AFDC, FMA) - - - - 5035.07 Self-Support Plan Deductions (AABD, MAABD, QMB, SLMB, FMA) - - - 5035.08 Employment Deductions (AABD, MAABD) - - - - 5035.10 Lump Sum Deductions (AABD, MAABD) - - - - 5035.11 Deductions (FS) - - - - - - - 5035.15 Post Eligibility Deductions for LTCF/CBS Units Without Community Spouses (MAABD) - - - - - - 5035.20 Post Eligibility Deductions for LTCF/CBS Units With Community Spouses (MAABD) - - - - - - 5035.25 Community Spouse Allowance (CSA)(MAABD) - - - 5035.30 Community Family Allowances (CFA)(MAABD) - - - 5035.35 Determining the Deduction for Dependent Care - - - P-5035.05 Determining When Food Stamp Households Who Have Heat Included In Their Rent Are Eligible For the Standard Utility Allowance (SUA) - - - P-5035.07 Minimum Monthly Needs Allowance (MMNA) - - - P-5035.10 Community Spouse Allowance (CSA) - - - - P-5035.15 Excess Medical Expense Deduction - - - - - P-5035.16 Determining the Deduction for Child Support - - - P-5035.17 Standard Utility Allowance - - - - - - P-5035.18 Maximum Shelter Hardship - - - - - - P-5035.19 Community Family Allowance (CFA) - - - - P-5035.20 RESERVED-INCOME DIVERSION - - - - - - 5040 Applied Income - - - - - - - - - 5045 Calculation Method (AFDC, FMA) - - - - - 5045.05 Calculation Method (AABD, MAABD) - - - - 5045.10 Calculation Method (FS) - - - - - - 5045.15 Post-eligibility Treatment of Income (MA) - - - - 5045.20 Post-eligibility Treatment of Income – Premium Payment - - 5045.21 Calculating Applied Income for AFDC/FMA Applicants - - P-5045.05 Calculating Applied Income for AFDC/FMA Recipients - - P-5045.10 Calculating Applied Income for AABD/MAABD Applicants - - P-5045.15 Calculating Applied Income for AABD/MAABD Recipients - - P-5045.20 Calculating Applied Income for LTCF Units Without Community Spouses - - - - - - P-5045.25 Calculating Applied Income for CBS Units Without Community Spouses - - - - - - P-5045.27 Calculating Applied Income for LTCF Units With Community Spouses - - - - - - P-5045.30 Calculating Applied Income for CBS Units with Community Spouses - - - - - - P-5045.32 Calculating Applied Income for FS Applicants and Recipients - - - - - - - P-5045.35 Treatment of Specific Types of Income - - - - - - 5050 Adoption Subsidies - - - - - - 5050.01 Alimony - - - - - - - - 5050.05 Annuity, Pension and Trust Payments - - - - - 5050.09 Assistance from Puerto Rico Nutrition Assistance Program - - 5050.10 Assistance Payments From Other States - - - - 5050.11 Benefits (SSA, SSI, VA) - - - - - - 5050.13 Cash Contributions - - - - - - - 5050.17 Child Support Payments - - - - - - 5050.19 Dividends, Interest, Trusts, and Royalties - - - - 5050.21 Earnings of Dependent Children - - - - - 5050.23 Energy Assistance Grants - - - - - - 5050.29 Essential Service Income - - - - - - 5050.33 Foster Care Payments - - - - - - - 5050.37 General Assistance - - - - - - - 5050.41 Gratuities and Special Allowances - - - - 5050.45 Home Equity Conversion Plans - - - - - 5050.47 Housing Subsidies - - - - - - - 5050.48 Income In-kind - - - - - - - 5050.49 Intermittent Income - - - - - - 5050.53 AFDC Benefits Received by a Job Corps Recipient - - - 5050.55 Job Training Partnership Act (JTPA) - - - - - 5050.57 Loans - - - - - - - - 5050.61 Lump Sum - - - - - - - - 5050.65 Recoupment Withholdings and Benefit Reductions - - - 5050.66 Relocation Assistance Benefits - - - - - - 5050.67 Rental Income - - - - - - - - 5050.69 Roomer and Boarder Income - - - - - - 5050.73 Sick Pay - - - - - - - - 5050.75 Student Income - - - - - - - 5050.77 Uniformed Services Income - - - - - - 5050.85 Vacation/Severance Pay - - - - - - 5050.87 Work Incentive Program (WIN) Income - - - - 5050.89 Workfare Income - - - - - - - 5050.93 Disaster Assistance - - - - - - 5050.94 Work Supplementation and Supported Work Programs - FS - - 5050.95 Adoption Subsidies - - - - - - - P-5050.01 Lump Sums (AFDC) - - - - - - - P-5050.05 Lump Sums (AABD) - - - - - - - P-5050.10 Lump Sums (FMA) - - - - - - - P-5050.15 Lump Sums (MAABD) - - - - - - P-5050.20 Income Received by Dependent Children - - - - P-5050.23 Income From Roomers and Boarders (AFDC, AABD, MA) - - P-5050.25 Income From Roomers and Boarders (FS) - - - - P-5050.30 Foster Care Payments - - - - - - - P-5050.37 Income-in-kind - - - - - - - P-5050.49 Intermittent Income - - - - - - P-5050.53 Student Income - - - - - - - P-5050.77 Verification - - - - - - - - 5099 Income - - - - - - - - - 5099.05 Deductions - - - - - - - 5099.10 Disregards - - - - - - - 5099.15 Loans - - - - - - - - 5099.20 Student Status - - - - - - - - 5099.25 Student Income - - - - - - - 5099.30 PASS Deductions - - - - - - - P-5099.10 Deduction for Legally Obligated Child Support - - P-5099.12 Student Income - - - - - - - P-5099.30
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS ______________________________________________________________________________ Date: 10-1-09 Transmittal: UP-09-17 0300 ______________________________________________________________________________ Treatment of Income 5000 ______________________________________________________________________________
Definitions - - - - - - - - 5500.01 General Principles - - - - - - - - 5503 When Income Eligibility is Determined - - - - - 5505 When Income Eligibility is Determined - - - - P-5505.05 Durational Limits of Eligibility - - - - - - - 5510 Needs and Income Limits - - - - - - - 5515 Needs Group Composition - - - - - - 5515.05 Needs Group's Needs and Income Limits - - - - 5515.10 Calculating the Needs and Income Limits of Needs Group - - P-5515.05 Income Eligibility Tests - - - - - - - 5520 AFDC Tests - - - - - - - - 5520.05 AABD Tests - - - - - - - - 5520.10 MA Tests: Categorically Needy - - - - - 5520.15 MA Tests: Medically Needy - - - - - - 5520.20 MA Tests: Use of Medical Expenses for Spend-down Process- - 5520.25 MA Tests: Community Spend-down Methodology - - - 5520.30 MA Tests: Severely Impaired Non-SSI Recipients - - - 5520.32 MA Tests: Working Individuals with Disabilities - - - 5520.33 MA Tests: Women Diagnosed with Breast or Cervical Cancer - 5520.34 MA Tests: LTCF Spend-down Methodology - - - - 5520.35 FS Tests - - - - - - - - 5520.40 Determining Income Eligibility for AFDC - - - - P-5520.05 Determining Income Eligibility for AABD - - - - P-5520.10 Determining Income Eligibility for Categorically Needy - - P-5520.15 Determining Income Eligibility for Medically Needy - - - P-5520.20 Spending-down Excess Income (Community) - - - P-5520.25 Spending-down Excess Income (LTCF) - - - - P-5520.30 Test for Severely Impaired Non-SSI Recipients - - - P-5520.32 Determining Income Eligibility for FS - - - - P-5520.35
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 5-1-97 Transmittal: UP-06-17 0300 _______________________________________________________________________________ Income Eligibility 5500 _______________________________________________________________________________
Definitions - - - - - - - - 6000.01 Implementation - - - - - - - 6000.05 Comparing Income and Needs - - - - - - 6005 Fill-The-Gap Budgeting - - - - - - P-6005 Retrospective Budgeting System - - - - - - 6010 Units Subject to Retrospective Budgeting - - - - 6010.05 Calculation Methods - - - - - - - 6010.10 Applications and Reinstatements - - - - - 6010.15 Changes in the Assistance Unit Composition - - - - 6010.20 Income Changes - - - - - - - 6010.25 Calculating Benefits Prospectively - - - - - P-6010.05 Calculating Benefits Retrospectively - - - - - P-6010.10 Prospective Budgeting System - - - - - - - 6015 Units Subject to Prospective Budgeting - - - - 6015.03 Calculation Method - - - - - - - 6015.05 Applications and Reinstatements - - - - - 6015.10 Changes in Assistance Unit Composition - - - - 6015.15 Income Changes - - - - - - - 6015.20 Calculating Benefits Prospectively - - - - - P-6015.05 Benefits Adjustments - - - - - - - - 6020 Prorated Benefits - - - - - - - 6020.05 Rounded Benefits - - - - - - - 6020.10 Benefit Amounts - - - - - - - 6020.15 Grant Reduction Recoupments - - - - - 6020.20 Reduction Resulting from a Public Assistance Program Violation - 6020.25 Prorating Benefits - - - - - - - P-6020.05 Rounding Benefits - - - - - - - P-6020.10 Issuing Benefits Amounts - - - - - - P-6020.15
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 5-1-97 Transmittal: UP-06-17 0300 _______________________________________________________________________________ Calculation of Benefits 6000 _______________________________________________________________________________
Definitions - - - - - - - - 6500.01 Form and Method - - - - - - - - 6505 Cash Benefits - - - - - - - - 6505.05 Restricted Payment Method - - - - - - 6505.10 Cases Involving Work Registration or Support Penalties - - 6505.15 Cases Involving Financial Mismanagement - - - 6505.20 Medical Benefits - - - - - - - 6505.25 Food Stamp Benefits - - - - - - - 6505.30 Determining the Payment Method - - - - - P-6505.05 Direct Deposit - - - - - - - - P-6505.07 Issuing Voluntary Vendor Payments - - - - P-6505.10 Issuing Mandatory Vendor Payments - - - - - P-6505.15 Handling Payments in Cases Involving Disqualified Caretaker Relatives - - - - - - P-6505.20 Determining Financial Mismanagement - - - - P-6505.25 Determining the Need for a Protective Payee - - - P-6505.30 Determining Vendor Payment Allocations in Cases Involving Financial Mismanagement - - - - - P-6505.35 Determining the Need for a Guardian or Conservator - - P-6505.40 Payee - - - - - - - - - - 6510 Cash Payments - - - - - - - - 6510.05 Protective Payees in Restricted Payment Cases - - - 6510.10 Medical Benefits - - - - - - - 6510.15 Food Stamp Benefits - - - - - - - 6510.20 Designating the Payee - - - - - - - P-6510.05 Selecting a Protective Payee - - - - - - P-6510.10 Use - - - - - - - - - - 6515 Cash Benefits - - - - - - - - 6515.05 Medical Benefits - - - - - - - 6515.10 Food Stamp Benefits - - - - - - - 6515.15 Inactive EBT Accounts - - - - - P-6515.05 Frequency and Composition - - - - - - - 6520 General Requirements - - - - - - - 6520.05 Scheduled Payments - - - - - - - 6520.10 Supplemental Payments - - - - - - 6520.15 Expiration Dates - - - - - - - 6520.20 Scheduled Mailing Dates - - - - - - P-6520.05 Issuing Supplemental Payments - - - - P-6520.10 Determining Composition of Payments - - - - - P-6520.15 Mailing Address - - - - - - - - 6525 Where Benefits Are Mailed - - - - - - 6525.05 Post Office Box - - - - - - - 6525.10 Determining the Mailing Address - - - - - P-6525.05 Benefit Replacement - - - - - - - - 6530 Basic Provisions - - - - - - - 6530.05 In-Office Visit - - - - - - - - 6530.10 Lost Benefits - - - - - - - - 6530.15 Stolen Benefits - - - - - - - - 6530.20 Destroyed Benefits - - - - - - - 6530.25 Mutilated Benefits - - - - - - - 6530.30 Misuse of Benefits by a Protective Payee - - - - 6530.35 Cash Benefits - - - - - - - - 6530.40 Medical Benefits - - - - - - - 6530.45 Food Stamp Benefits - - - - - - - 6530.50 Action Upon Initial Notification - - - - - P-6530.05 In-Office Visit - - - - - - - - P-6530.10 Establishing Investigation and Replacement Conditions- - - P-6530.15 Alternate Issuance Systems - - - - - - - 6535 Basic Provisions - - - - - - - 6535.05 EBT Clients Who Move to a Non-EBT Area - - - - 6535.07 Choice of Issuance Method - - - - - - 6535.10 Resumption of Regular Mail Delivery - - - - - 6535.15 Application of Policy - - - - - - - P-6535.05 EBT Clients Who Move to Non-EBT Area - - - - P-6535.07 Determining the Method - - - - - - P-6535.10 Notifying Assistance Units - - - - - - P-6535.15 Verifying Identity and Authorization - - - - - P-6535.20 Verification - - - - - - - - - 6599 Restricted Payments - - - - - - - 6599.05 Restricted Payments - - - - - - - P-6599.05 Payee - - - - - - - - - 6599.10 Payee - - - - - - - - - P-6599.10 Post Office Boxes - - - - - - - 6599.15 Post Office Boxes - - - - - - - P-6599.15 Replacement Benefits - - - - - - - 6599.20 Replacement Benefits - - - - - - - P-6599.20 Alternate Issuance Methods - - - - - - 6599.25 Alternate Issuance Methods - - - - - - P-6599.25
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 6-01-03 Transmittal: UP-06-17 0300 _______________________________________________________________________________ Benefit Issuance 6500 _______________________________________________________________________________
Definitions - - - - - - - - 7000.01 Overview of Correction Process - - - - - - 7005 Discovery of a Benefit Error - - - - - - 7005.05 Determination of the Cause of the Error - - - - 7005.10 Computation of the Benefit Error - - - - - 7005.15 Treatment of Intentional Recipient Error - - - - 7005.20 Determination of Correction Procedure - - - - 7005.25 Notification of Assistance Unit - - - - - 7005.30 Correction of the Error - - - - - - 7005.35 Discovering a Benefit Error - - - - - - P-7005.05 Determining the Cause of the Error - - - - - P-7005.10 Computing the Amount of the Benefit Error - - - - P-7005.15 Treating Intentional Recipient Errors - - - - P-7005.20 Determining the Correction Procedure - - - - P-7005.25 Notifying the Assistance Unit - - - - - - P-7005.30 Correcting the Error - - - - - - - P-7005.35 AFDC Underpayments - - -- - - - - 7010 General Principles - - - - - - - 7010.05 Computation of an AFDC Underpayment - - - - 7010.10 Issuing a Corrective Payment - - - - - - P-7010.05 Computing the Amount of an AFDC Underpayment - - - P-7010.10 State Supplement Underpayments - - - - - - 7015 General Provisions - - - - - - - 7015.05 Computation of the State Supplement Underpayment - - 7015.10 Issuing a Corrective Payment - - - - - - P-7015.05 Computing the Amount of a State Supplement Underpayment - - - - - - - P-7015.10 Medicaid Underpayments - - - - - - - 7020 General Provisions - - - - - - - 7020.05 Computation of a Medicaid Underpayment - - - - 7020.10 Issuing a Corrective Payment - - - - - - P-7020.05 Food Stamp Underpayments - - - - - - - 7025 General Principles - - - - - - - 7025.05 When a Corrective Payment is Made - - - - - 7025.10 Computation of the Underpayment - - - - - 7025.15 Underpayments to Disqualified Individuals - - - - 7025.20 Determining Entitlement to a Corrective Payment - - - P-7025.05 Computing the Amount of the Underpayment - - - - P-7025.10 Notifying the Assistance Unit - - - - - - P-7025.15 AFDC Overpayments - - - - - - - - 7030 General Principles - - - - - - - 7030.05 Computation of the Overpayment - - - - - 7030.10 Determination of the Method of Recoupment - - - - 7030.15 Computation of the Recoupment Rate - - - - - 7030.20 Disqualification - - - - - - - 7030.25 Computing the Amount of the Overpayment - - - - P-7030.05 Determining the Recoupment Method - - - - P-7030.10 Computing the Recoupment Rate - - - - - P-7030.15 Establishing Billing Controls - - - - - - P-7030.20 State Supplement Overpayments - - - - - - 7035 General Principles - - - - - - - 7035.05 Computation of the Overpayment - - - - - 7035.10 Determination of the Method of the Recoupment - - - 7035.15 Computation of the Rate of Recoupment - - - - 7035.20 Computing the Amount of the Overpayment - - - - P-7035.05 Determining the Recoupment Method - - - - P-7035.10 Computing the Recoupment Rate - - - - - P-7035.15 Establishing Billing Controls - - - - - - P-7035.20 Medicaid Overpayments - - - - - - - 7040 General Principles - - - - - - - 7040.05 Computation of the Overpayment - - - - - 7040.10 Computing the Amount of the Overpayment - - - - P-7040.05 Determining the Recoupment Method - - - - P-7040.10 Computing the Recoupment Rate - - - - - P-7040.15 Establishing Billing Controls - - - - - - P-7040.20 Food Stamp Overpayments - - - - - - - 7045 General Principles - - - - - - - 7045.05 Limitations to Recoupment - - - - - - 7045.10 Computation of the Overpayment - - - - - 7045.15 Initiation of Recoupment Action - - - - - 7045.20 Determination of the Method of Recoupment - - - - 7045.25 Computation of the Recoupment Rate - - - - - 7045.30 Suspension of Recoupment Action - - - - - 7045.35 Disqualification - - - - - - - 7045.40 Computing the Amount of the Overpayment - - - - P-7045.05 Determining the Recoupment Method - - - - P-7045.10 Computing the Recoupment Rate - - - - - P-7045.15 Establishing Billing Controls - - - - - - P-7045.20 Administrative Disqualification Hearings - (FS,AFDC) - - - 7050 General Principles - - - - - - - 7050.05 Pre-Hearing Interview - - - - - - - 7050.10 Waiver Process - - - - - - - 7050.15 Eligibility During Pending Hearing or Decision - - - 7050.20 The Hearing Process - - - - - - - 7050.25 Disqualification Penalties - - - - - - 7050.30 Appeals - - - - - - - - 7050.35 Preparing the Evidence - - - - - - P-7050.05 Conducting the Pre-Hearing Interview - - - - P-7050.10 Holding the Hearing - - - - - - - P-7050.15 Implementing the Decision - - - - - - P-7050.20
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 5-1-97 Transmittal: UP-97-8 0300 _______________________________________________________________________________ Benefit Error 7000 _______________________________________________________________________________
Definitions - - - - - - - - 7500.01 Recovery By Assignment or Security Mortgage - - - - 7505 Assignments in the Money Payment Programs - - - 7505.05 Assignments in the Medical Assistance Program - - - 7505.10 Security Mortgages - - - - - - - 7505.15 Taking an Assignment of Interest - - - - - P-7505.05 Obtaining a Security Mortgage - - - - - P-7505.10 Recovery From Real Property: Liens - - - - - - 7510 Liens in the AFDC Program - - - - - - 7510.05 Liens in the State Supplement Program - - - - 7510.10 Liens in the Medicaid Program - - - - - 7510.15 Placing a Lien Against Home Property - - - P-7510.05 Taking a Lien in the MA Program - - - - - P-7510.10 Recovery from Acquired Property - - - - - - 7515 Methods of Acquiring Property - - - - - 7515.05 Methods of Recovery - - - - - - - 7515.10 Initiating Recovery Action - - - - - - P-7515.05 Recovery from Third Parties - - - - - - - 7520 Legally Liable Relatives - Income - - - - - 7520.05 Legally Liable Relatives - Assets - - - - - 7520.07 Private Insurance Carriers - - - - - - 7520.10 Referring Information Concerning Legally Liable Relatives - - P-7520.05 Claim Against Community Spouse - Assets - - - - P-7520.07 Claims Against Spouses and Parents of Children who are Institutionalized or Rec. Community-Based Services - - P-7520.10 Recovery from Estates - - - - - - - 7525 Recovery of Financial Assistance from Estates - - 7525.05 Recovery of Medicaid from Estates - - - - - 7525.10 Recovery by Legal Action - - - - - - - 7530 Recovery of Financial Assistance - - - - - 7530.05 Recovery of Medicaid - - - - - - - 7530.10 Referring for Recovery of Assistance by Legal Action- - - P-7530.05
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 5-1-97 Transmittal: UP-97-8 0300 _______________________________________________________________________________ Recovery 7500 _______________________________________________________________________________
Definitions - - - - - - - 8000.01 Refugee Assistance Program - - - - - - - 8010 Refugee Cash Assistance Based on AFDC - - - - 8010.05 Refugee Medical Assistance Based on Family Medicaid - - 8010.10 Assistance Unit Composition - - - - - - 8010.15 Categorical Eligibility Requirements - - - - - 8010.20 Treatment of Income - - - - - - - 8010.25 Treatment of Assets - - - - - - - 8010.30 Technical Eligibility Requirements - - - - - 8010.35 Procedural Eligibility Requirement - - - - - 8010.40 Standards of Assistance - - - - - - 8010.45 Income Eligibility - - - - - - 8010.50 Calculation of Benefits - - - - - - 8010.55 Benefit Issuance - - - - - - 8010.60 Benefit Error - - - - - - - 8010.65 Recovery - - - - - - - - 8010.70 Basic Steps for Determining Eligibility for RCA - - P-8010.05 Basic Steps for Determining Eligibility for RMA - - - P-8010.10 Determining Eligibility for Other PA Programs - - P-8010.15 Providing Adequate Notice - - - - - - P-8010.17 Forming an RCA/RMA Assistance Unit - - - - P-8010.20 Referring Refugee to Case Management Agency - - - P-8010.25 Determining Eligibility for Certain RMA Coverage Groups - - - - - - P-8010.30 Determining Suitability of Recovery Against Sponsors of Soviet Jewish Refugees - - - - - P-8010.32 Cuban and Haitian Entrant Program - - - - - - 8015 Entrant Program Based on Refugee Program - - - - 8015.05 Categorical Eligibility Requirements - - - - - 8015.10 EP Procedures Same as RCA/RMA Procedures - - - P-8015.05 State Medical Assistance for Non-Citizens - - - - - 8016 Program Based on Medicaid - - - - - - 8016.05 Technical Eligibility Requirements - - - - - 8016.10 State Assistance for Illegal Immigrants- - - - - - 8017 Program Based on Medicaid - - - - - - 8017.05 Technical Eligibility Requirements - - - - - 8017.10 Limitations - - - - - - - - 8017.15 Benefits- - - - - - - - - 8017.20 Individual and Family Grant Program - - - - - 8025 Rights and Responsibilities - - - - - 8025.05 The Application Process - - - - - - 8025.10 Reconsideration - - - - - - - 8025.15 Notification to Assistance Unit - - - - - 8025.20 Fair Hearings - - - - - - - - 8025.25 Assistance Unit Composition - - - - - - 8025.30 Categorical Eligibility Requirement - - - - - 8025.35 Treatment of Income and Assets - - - - - 8025.40 Technical Eligibility Requirements - - - - - 8025.45 Procedural Eligibility Requirements - - - - - 8025.50 Standards of Assistance - - - - - - 8025.55 Determining Eligibility and Amount of Assistance - - - 8025.60 Benefit Issuance - - - - - - - 8025.65 Recovery - - - - - - - - 8025.70 Steps in the Application Process - - - - P-8025.05 How to Issue Benefits - - - - - - - P-8025.10 Steps in the Recovery Process - - - - - - P-8025.20 Establishing the Standards of Assistance - - - - P-8025.25 Repatriation Assistance - - - - - - - 8030 Rights and Responsibilities - - - - - 8030.05 The Eligibility Process - - - - - - 8030.10 Special Notification Requirements - - - - 8030.15 Assistance Unit Composition - - - - - - 8030.20 Categorical Eligibility Requirements - - - - - 8030.25 Treatment of Income - - - - - - - 8030.30 Treatment of Assets - - - - - - 8030.35 Technical Eligibility Requirements - - - - - 8030.40 Procedural Eligibility Requirements - - - - - 8030.45 Standards of Assistance - - - - - - 8030.50 Calculation of Benefits - - - - - - 8030.55 Benefit Issuance - - - - - - - 8030.60 Recovery - - - - - - - - 8030.65 Steps in the Application Process - - - - P-8030.05 D.O. Steps in the Case Maintenance Process - - - - P-8030.10 How to Determine Benefits - - - - - - P-8030.15 Issuing Benefits - - - - - - - P-8030.20 Connecticut AIDS Drug Assistance Program (CADAP) - - - 8035 General Principal - - - - - - - 8035.04 Categorical Eligibility Requirements - - - - - 8035.05 Right and Responsibilities - - - - - 8035.10 The Eligibility Process - - - - - - 8035.15 Treatment of Income and Assets - - - - - 8035.20 Technical and Procedural Eligibility Requirements - - - 8035.25 Benefit Issuance - - - - - - - 8035.30 Administering the CADAP Program - - - - - P-8035.05 Connecticut Insurance Assistance Program for AIDS Patients - - 8036 Rights and Responsibilities - - - - - - 8036.05 The Eligibility Process - - - - - - 8036.10 Assistance Unit Composition - - - - - - 8036.15 Categorical Eligibility Requirements - - - - - 8036.20 Technical Eligibility Requirements - - - - - 8036.25 Procedural Eligibility Requirements - - - - - 8036.30 Treatment of Assets - - - - - - - 8036.35 Standard of Assistance - - - - - - 8036.40 Treatment of Income - - - - - - - 8036.45 Income Eligibility - - - - - - - 8036.50 Determining Initial Eligibility While Postponing Verifications - - - - - - P-8036.05 Determining Eligibility - - - - - - P-8036.10 Connecticut Home Care Program for Elders - - - - - 8040 Rights and Responsibilities - - - - - 8040.05 Eligibility Process - - - - - - - 8040.10 Assistance Unit Composition- - - - - - - 8040.15 Categorical Eligibility Requirements - - - - - 8040.20 Technical Eligibility Requirements- - - - - - 8040.25 Procedural Eligibility Requirements - - - - - 8040.30 Treatment of Assets - - - - - - - 8040.35 Income Eligibility - - - - - - - 8040.40 Calculation of Income Applied to the Cost of Care - - - 8040.45 Recovery of Assistance - - - - - - 8040.50 Referrals to the Resource Unit - - - - - P-8040 Calculation of Contribution to the Cost of Care - - P-8040.10 Case Processing- - - - - - - - P-8040.15 Work Supplementation Program - - - - - - 8045 Implementation - - - - - - - 8045.01 General Provisions - - - - - - 8045.05 Rights and Responsibilities - - - - - 8045.10 Eligibility Process - - - - - - 8045.15 Assistance Unit Composition - - - - - - 8045.20 Categorical Eligibility Requirements - - - - - 8045.25 Procedural Eligibility Requirements - - - - - 8045.30 Technical Eligibility Requirements - - - - - 8045.35 Treatment of Income - - - - - - - 8045.40 Treatment of Assets - - - - - - 8045.45 Standards of Assistance - - - - - - 8045.50 Income Eligibility - - - - - - 8045.55 Calculation of Benefits - - - - - - 8045.60 Benefit Issuance - - - - - - - 8045.65 Benefit Error - - - - - - - 8045.70 Recovery - - - - - - - - 8045.75 Rights and Responsibilities - - - - - P-8045.05 Eligibility Process - - - - - - P-8045.10 Assistance Unit Composition - - - - - - P-8045.15 Categorical Eligibility Requirements - - - - - P-8045.20 Procedural Eligibility Requirements - - - - - P-8045.25 Technical Eligibility Requirements - - - - - P-8045.30 Rights and Responsibilities - - - - - - P-8045.35 Treatment of Assets - - - - - - P-8045.40 Standards of Assistance - - - - - - P-8045.45 Income Eligibility - - - - - - P-8045.50 Calculation of Benefits - - - - - - P-8045.55 Connecticut Assistance For Organ Transplant Recipients - - - 8070 General Principle - - - - - - - 8070.04 Rights and Responsibilities - - - - - - 8070.05 Categorical Eligibility Requirements - - - - - 8070.10 Standards of Assistance - - - - - - 8070.15 Technical and Procedural Eligibility Requirements - - - 8070.20 The Eligibility Process- - - - - - - 8070.25 Income and Asset Limits - - - - - - 8070.30 Treatment of Income - - - - - - - 8070.35 Treatment of Assets - - - - - - - 8070.40 Income Eligibility - - - - - - - 8070.45 Determination of Payment - - - - - - 8070.50 Benefit Issuance - - - - - - - 8070.55 Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled- - - - - - - 8075 Rights and Responsibilities - - - - - - 8075.05 The Eligibility Process - - - - - - 8075.10 Assistance Unit Composition - - - - - - 8075.15 Categorical Eligibility Requirements - - - - - 8075.20 Technical Eligibility Requirements - - - - - 8075.25 Treatment of Income and Assets - - - - - 8075.30 Benefit Issuance - - - - - - - 8075.35 Benefit Error - - - - - - - - 8075.40 Recovery - - - - - - - - 8075.45 Administering the ConnPACE Program - - - - P-8075.05 Overpayments and Disqualifications - - - - - P-8075.10 State-Administered General Assistance (SAGA) Introduction - - - - - - - - 8080 Definitions - - - - - - - - 8080.01 Rights and Responsibilities - - - - - - 8080.10 Eligibility Process - - - - - - - 8080.15 Procedures For Eligibility Process - - - - - P-8080.15 Assistance Unit Composition - - - - - - 8080.20 Basic Steps In Creating SCA and SMA Assistance Units - - P-8080.20 Categorical Eligibility Requirements - - - - - 8080.25 Procedures For Categorical Eligibility Requirements - - - P-8080.25 Technical Eligibility Requirements - - - - - 8080.30 Procedures For Technical Eligibility Requirements - - - P-8080.30 Procedural Eligibility Requirements - - - - - 8080.35 Procedures For Procedural Eligibility Requirements - - - P-8080.35 Treatment of Assets - - - - - - - 8080.40 Procedures For Treatment of Assets - - - - - P-8080.40 Standards of Assistance - - - - - - 8080.45 Procedures For Standards of Assistance - - - - P-8080.45 Treatment of Income - - - - - - - 8080.50 Treating Income - - - - - - - P-8080.50 Income Eligibility - - - - - - - 8080.55 Determining Income Eligibility - - - - - P-8080.55 Calculation of Benefits - - - - - - 8080.60 Calculating Benefits - - - - - - - P-8080.60 Benefit Issuance - - - - - - - 8080.65 Procedures For Benefit Issuance - - - - - P-8080.65 Benefit Error - - - - - - - - 8080.70 Treating Benefit Error - - - - - - - P-8080.70 Recovery - - - - - - - - 8080.75 Procedures For Recovery - - - - - - P-8080.75 Special Benefits - - - - - - - 8080.90 Authorizing Special Benefits - - - - - - P-8080.90 Time Limits - - - - - - - - 8080.96 Procedures For Time Limits - - - - - P-8080.96 State-Funded Supplemental Nutrition Assistance Program Introduction and General Principles - - - - - 8090 Eligibility Process- - - - - - - - 8090.05 Non-Financial Eligibility Requirements - - - - 8090.10 Citizenship - - - - - - - - P-8090.10 Residency - - - - - - - - P-8090.15 Financial Eligibility Requirements - - - - - 8090.15 Calculation of Benefits - - - - - - 8090.20 Verification Requirements- - - - - - - 8099 Refugee Verification Requirements - - - - - 8099.10 Verifying Eligibility for Refugee Assistance Program - - P-8099.10 Cuban/Haitian Verification Requirements - - - - 8099.15 Verifying Eligibility for Cuban/Haitian Entrant Program - - - - - - - P-8099.15 Connecticut Energy Assistance Program - - - - 8099.20 Verifying Eligibility for CEAP - - - - - P-8099.20 Individual Family Grant Verification Requirements - - - 8099.25 Verifying Eligibility for IFG Program - - - - - P-8099.25 Repatriation Verification Requirements - - - - 8099.30 Connecticut Aids Drug Assistance Program (CADAP) - - 8099.35 Verifying Eligibility Factors - - - - - P-8099.35 Connecticut Insurance Assistance Program for AIDS Patients - - - - - - - 8099.45 Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled - - - - - 8099.75 Connecticut Insurance Assistance Program for AIDS Patients - - - - - - - P-8099.45
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 0300 ______________________________________________________________________________ Special Programs 8000
Definitions - - - - - - - - 8500.01 Research and Design - - - - - - - - 8505 Experimental Design - - - - - - - 8505.05 Rights and Responsibilities - - - - - - - 8510 Rights of Applicants and Recipients - - - - - 8510.05 Responsibilities of Applicants and Recipients - - - - 8510.10 Department Responsibilities - - - - - - 8510.15 Disclosure of Information - - - - - - 8510.20 Diversion Program - - - - - - - - 8515 Rights and Responsibilities - - - - - - 8515.05 Eligibility Process - - - - - - - 8515.10 Non-Financial Eligibility Requirements - - - - 8515.15 Benefits Available Through Diversion - - - - - 8515.20 Treatment of Income and Assets - - - - - 8515.25 Standard of Assistance - - - - - - - 8515.30 Recovery and Recoupment of Benefits - - - - 8515.35 Eligibility Process - - - - - - - - 8520 Orientation to the Jobs First Program - - - - - 8520.03 Application Process - - - - - - - 8520.05 Redetermination Process - - - - - - 8520.10 Authorized Representative - - - - - - 8520.15 Interim Activity - - - - - - - 8520.20 Cooperation with Quality Control Reviews - - - - 8520.25 Beginning Dates of Eligibility - - - - - - 8520.30 Ending Dates of Eligibility - - - - - - 8520.35 Verification - - - - - - - - 8520.40 Notices Requirements - - - - - - - 8520.45 Completing the Sixty-Month Exit Interview - - - - P-8520.10 Fair Hearings - - - - - - - - - 8525 General Provisions - - - - - - - 8525.05 Limitations to Scope of Hearings - - - - - 8525.07 Continuation of Benefits Pending Fair Hearings - - - 8525.10 Employment Services - - - - - - - 8530 General Service Provisions - - - - - - 8530.05 Exemptions from Participation - - - - - 8530.10 Participation Requirements - - - - - - 8530.15 Suitable Employment - - - - - - - 8530.20 Work Test/Assessment - - - - - - 8530.25 Employability Plan - - - - - - - 8530.30 General Principles for Special Benefits - - - - 8530.35 Transportation Special Benefits - - - - - 8530.40 Participation Allowances - - - - - - 8530.45 Conciliation - - - - - - - - 8530.50 Penalties for Non-Compliance - - - - - - 8530.55 Good Cause for Non-Compliance - - - - - 8530.60 Willful Misconduct - - - - - - - 8530.65 Non-Financial Eligibility Requirements - - - - - 8540 Exemptions from Time Limits - - - - - - 8540.03 Twenty-One Month Time Limit - - - - - 8540.05 Extensions of Benefits Beyond Twenty-One Months - - - 8540.10 Sixty-Month Time Limit - - - - - - 8540.12 Eligible Children, Age Requirements and Pregnant Women - - 8540.15 Convicted Drug Felons, Fleeing Felons, & Probation and Parole Violators- - - - - - - - 8540.20 No Show for Assessment Appointment or Interview - - - 8540.22 Assistance Unit Composition - - - - - - 8540.25 Living with a Caretaker Relative - - - - - 8540.30 Minor Parents - - - - - - - - 8540.35 Citizens and Eligible Non-Citizens - - - - - 8540.40 Residency - - - - - - - - 8540.45 Concurrent Assistance - - - - - - - 8540.50 Striker Status - - - - - - - - 8540.55 Social Security Numbers - - - - - 8540.60 Securing Support - - - - - - - 8540.65 Digital Imaging Process - - - - - - 8540.70 Safety Net Services - - - - - - - - 8545 Provision of Safety Net Services - - - - - 8545.05 Treatment of Assets - - - - - - - - 8550 General Principles - - - - - - - 8550.05 Unavailable Assets - - - - - - - 8550.10 Special Treatment of Assets - - - - - - 8550.15 Deemed Assets - - - - - - - 8550.20 Procedures for Deemed Assets - - - - - - P-8550.20 Treatment of Income - - - - - - - - 8560 General Principles - - - - - - - 8560.05 Special Treatments - - - - - - - 8560.10 Deemed Income - - - - - - - 8560.15 Procedures for Deemed Income of Sponsors - - - - P-8560.15 Standards of Assistance - - - - - - - 8562 Basic Provisions - - - - - - - 8562.05 Regions - - - - - - - - 8562.10 Standard of Need and Payment Standard - - - - 8562.15 Applicability of Family Cap - - - - - - 8562.20 General Provision of Special Needs - - - - - 8562.25 Emergency Housing - - - - - - - 8562.30 Emergency Telephone Installation - - - - - 8562.35 Meals on Wheels - - - - - - - 8562.40 Moving Expenses - - - - - - - 8562.45 Repair or Replacement of Essential Household Items - - - 8562.50 Replacement of Essential Clothing - - - - - 8562.55 Restaurant Meals - - - - - - - 8562.60 Security Deposit - Heating Service - - - - - 8562.65 Security Deposit - Housing - - - - - - 8562.70 Special School Expenses - - - - - - 8562.75 Storage Charges - - - - - - - 8562.80 Income Eligibility and Calculation of Benefits - - - - - 8565 General Provisions - - - - - - - 8565.05 Income Eligibility - - - - - - - 8565.10 Calculation of Benefits - - - - - - 8565.15 Benefit Issuance - - - - - - - - 8570 Form and Method - - - - - - - 8570.05 Restricted Payment Methods - - - - - - 8570.10 Cases Involving Financial Mismanagement - - - - 8570.15 Payees - - - - - - - - - 8570.20 Protective Payees in Restricted Payment Cases - - - 8570.25 Use of Cash Benefits - - - - - - - 8570.30 Frequency and Composition - - - - - - 8570.35 Benefit Replacement - - - - - - - 8570.40 Replacement of Lost Benefits - - - - - - 8570.45 Replacement of Stolen Benefits - - - - - 8570.50 Destroyed or Mutilated Benefits - - - - - - 8570.52 Replacement of Benefits Misused by a Protective Payee - - - 8570.55 Benefit Replacement - Dates of Filing and Processing Standards - - 8570.60 Benefit Error - - - - - - - - - 8580 General Principles - - - - - - - 8580.10 Underpayments - - - - - - - 8580.20 Overpayments - - - - - - - 8580.30 Recoupment - - - - - - - - 8580.40 Treatment of Intentional Recipient Error - - - - 8580.50 Disqualification Periods and Penalties - - - - - 8580.60 Administrative Disqualification Hearings - - - - 8580.70 Recovery of Benefits - - - - - - - - 8585 General Principles - - - - - - - 8585.05 Recovery by Assignment - - - - - - 8585.10 Liens - - - - - - - - - 8585.20 Security Mortgages - - - - - - - 8585.30 Acquired Property - - - - - - - 8585.40 Recovery of Assistance from Estates - - - - - 8585.50 Recovery by Legal Actions - - - - - - 8585.60 Recovery from Third Parties - - - - - - 8585.70 Special Benefits - - - - - - - - 8590 Funeral and Burial Expenses - - - - - - 8590.05 Out-of-State Transportation - - - - - - 8590.10 Property Repairs - - - - - - - 8590.15
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 10-1-09 Transmittal: UP-09-17 0300 _______________________________________________________________________________ Jobs First 8500 _______________________________________________________________________________
Funeral and Burial Expenses - - - - - - - 9005 General Provisions - - - - - - - 9005.05 Paying for Funeral and Burial Expenses - - - - P-9005.05 Out-of-State Transportation - - - - - - - 9010 General Provisions - - - - - - - 9010.05 Preparing the Authorization Packet - - - - - P-9010.05 Providing the Benefit - - - - - - - P-9010.10 Medicare Part A and B Premiums - - - - - - 9015 General Provisions - - - - - - - 9015.05 Providing the Benefit - - - - - - - P-9015.05 Property Repairs - - - - - - - - 9025 General Provisions - - - - - - - 9025.05 Authorizing the Payment - - - - - - P-9025.05 Attorney's Fees in Successful SSI/OASDI Appeals - - - - 9035 General Provisions - - - - - - - 9035.05 Authorizing Payments - - - - - - - P-9035.05 Health and Hospital Insurance Premiums - - - - - 9040 General Provisions - - - - - - - 9040.05 Determining When Payment of Health Insurance Premiums is Cost-Effective - - - - - - - - P-9040.05 Authorizing the Payment for Health Insurance Premiums - - P-9040.07 Job Connection Special Benefits - - - - - - 9045 General Principles - - - - - - - 9045.05 Participation Allowances - FS - - - - - - 9045.10 Fees - - - - - - - - 9045.15 Child Care - AFDC - - - - - - 9045.20 Transportation - AFDC - - - - - - 9045.25 Authorizing Job Connection Special Benefits General Principles - - - - - - P-9045.05 Authorizing Job Connection Special Benefits Specific Rules - - - - - - - P-9045.10 Child Care-AFDC - - - - - - - P-9045.20 Transportation-AFDC - - - - - - - P-9045.25 Verification - - - - - - - - 9099 General Principles - - - - - - - 9099.05 Acceptable Means of Verification - - - - - P-9099.05
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS
_______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 0300 _______________________________________________________________________________ Special Benefits 9000 _______________________________________________________________________________
Job Connection Services - - - - - - - 9505 General Provisions - - - - - - - 9505.01 Definitions - - - - - - - - 9505.04 Job Connection Information - - - - - - 9505.05 Assessment - - - - - - - - 9505.15 Job Connection Plan - - - - - - - 9505.20 Conciliation - - - - - - - - 9505.40 Setting Priorities for Provision of Services - - - - P-9505.05 Orientation and Program Information - - - - - P-9505.10 Conducting the Assessment - - - - - - P-9505.15 Developing the Job Connection Plan - - - - - P-9505.20 Satisfactory Progress and Participation - - - - - P-9505.25 Conciliation - - - - - - - - P-9505.30
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 5-1-97 Transmittal: UP-06-17 0300 _______________________________________________________________________________ Special Services 9500 _______________________________________________________________________________
Child Care Assistance - - - - - - - - 9620 Eligibility Based on Existing Programs- - - - - 9620.05 Child Care Benefits for Active Temporary Family Assistance - - 9620.10 Recipients Transitional Care for Families Discontinued from Temporary - - 9620.15 Family Assistance Calculating Child Care Payments - - - - - P-9620.10 Transitional Child Care Fee Scale - - - - - P-9620.15
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 3-1-98 Transmittal: UP-98-6 0300 _______________________________________________________________________________ Reach For Jobs First 9600 _______________________________________________________________________________
Child Care Enhancements - - - - - - - 9870 Eligibility Based on Existing Programs - - - - - 9870.05 Job Connection (JCCC) and Work Related (WRCC) Child Care - 9870.10 Transitional Child Care - Families Discontinued Prior to 1/1/96 - 9870.15 Transitional Child Care - Families Discontinued After 12/31/95 - 9870.20 Transitional Child Care - - - - - - - P-9870.15
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL TABLE OF CONTENTS _______________________________________________________________________________ Date: 3-1-98 Transmittal: UP-98-6 0300 _______________________________________________________________________________ Welfare Reform Initiatives 9800 _______________________________________________________________________________
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL
GLOSSARY
of
ABBREVIATIONS
AABD State Supplement to the Aged, Blind or Disabled ACE Active Corps of Executives ADH-FS Administrative Disqualification Hearing - Food Stamps AFDC Aid to Families with Dependent Children AG Attorney General AIDS Acquired Immunodeficiency Syndrome ARC Aids-Related Complex ARF Assistance Request Form AU Assistance Unit AZT Azidothymidine CAA Community Action Agency CADAP Connecticut AIDS Drug Assistance Program CAM Coordination, Assessment and Monitoring Agency CBS Community Based Services CCNH Chronic and Convalescent Nursing Homes CEAP Connecticut Energy Assistance Program CFA Community Family Allowance CMS Centers for Medicare and Medicaid Services CNIL Categorically Needy Income Limit COBRA Consolidated Ommibus Reconciliation Act of 1985, P.L. 99-272 CHCPE Connecticut Home Care Program for Elders ConnTRANS Connecticut Assistance for Organ Transplant Recipients ConnPACE Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled CR Caretaker Relatives CSA Community Spouse Allowance CSD Community Spouse Disregard CSPA Community Spouse Protected Amount DCB Direct Cash Benefit DCF Department of Children and Families DEFRA Deficit Reduction Act of 1984, P.L. 98-369 DDS Department of Developmental Services DMV Department of Motor Vehicles DOA Department of Aging DOL Department of Labor DP Diversion Program DPH Department of Public Health DPUC Department of Public Utilities Control EDD Eligibility Determination Document EH Emergency Housing EITC Earned Income Tax Credit EMS Eligibility Management System EP Entrant Program (Cuban and Haitian) EPSDT Early and Periodic Screening, Diagnosis and Treatment ES Jobs First Employment Services FEMA Federal Energy Management Agency FH Fair Hearings FHA Farmers Home Administration FMA Family Medical Assistance FNS Food and Nutrition Service FS Food Stamps – Effective October 1, 2008, the name of the Food Stamp Program changed to Supplemental Nutrition Assistance Program (SNAP) in accordance with the Food, Conservation and Energy Act of 2008. Therefore all references to FS or FSP now refer to the SNAP. GAO General Accounting Office GA General Assistance HMO Health Maintenance Organization HUD Housing and Urban Development ICF Intermediate Care Facility ID Identification IEVS Income Eligibility Verification System IFG Individual and Family Grant Program INS Immigration and Naturalization Service (United States Citizenship and Immigration Services) IPV Intentional Program Violation IRCA Immigration Reform and Control Act IRS Internal Revenue Service JOBS Job Opportunities and Basic Skills JTPA Job Training and Partnership Act LEP Limited-English Proficiency LLR Legally Liable Relative LPN Licensed Practical Nurse LTCF Long Term Care Facility MA Medical Assistance MAABD Medical Assistance for Aged, Blind and Disabled MA-CN Medical Assistance-Categorically Needy MA-MN Medical Assistance-Medically Needy MCCA Medicare Catastrophic Coverage Act of 1988 MID Medical Identification Document MIHPP Maternal and Infant Health Protection Program MMNA Minimum Monthly Needs Allowance MNIL Medical Needy Income Limit MRT Medical Review Team NADA National Automotive Dealers Associates NDSL National Defense Students Loans OASDI Federal Old-Age, Survivors, and Disability Insurance OBRA Omnibus Budget Reconciliation Act of 1981, P.L. 97-35 Omnibus Budget Reconciliation Act of 1986, P.L. 99-509 Omnibus Budget Reconciliation Act of 1987, P.L. 100-203 OJT On Job Training PA Public Assistance P.A. Public Acts (State) PAS Pre-Admission Screening P.L. Public Laws (Federal) PNA Personal Needs Allowance PSE Public Service Employment PWE Principal Wage Earner QMB Qualified Medicare Beneficiaries RA Refugee Assistance RAW Replenishment Agricultural Worker RCA Refugee Cash Assistance RHNS Rest Homes with Nursing Supervision RMA Refugee Medical Assistance RN Registered Nurse RP Repatriation Program RR Railroad Retirement RSDI Retirement, Survivors and Disability Insurance Benefits SAGA State Administered General Assistance SAVE Systematic Alien Verification for Entitlements SAW Special Agricultural Worker SBA Small Business Administration SC SAGA Cash SCORE Service Corps of Retired Executives SCSEP Senior Community Service Employment Program SDX SSI Data Exchange SEOG Supplemental Educational Opportunity Grants SFFS State Funded Food Stamps SM SAGA Medical SN Safety Net Program SMANC State Medical Assistance for Non-Citizens SNAP Supplemental Nutrition Assistance Program (previously called the Food Stamp Program) SNF Skilled Nursing Facility SSA Social Security Administration SSI Supplemental Security Income SSIG State Student Incentive Grant SSN Social Security Number SWICA State Wage Information Collection Agencies TEFRA Tax Equity and Fiscal Responsibility Act of 1982, P.L. 97-248 TFA Temporary Family Assistance TRA Tax Reform Act of 1986, P.L. 99-514 TRE Training Related Expenses UCB Unemployment Compensation Benefits UP Unemployed Parent USCIS United States Citizenship and Immigration Services USDA United States Department of Agriculture UYA University Year for Action VA Veterans Administration VISTA Volunteers in Service to America WIC Food Program For Women, Infants and Children WSP Work Supplementation Program
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL GLOSSARY ______________________________________________________________________________ Date: 05-10-10 Transmittal: UP-10-03 0400 ______________________________________________________________________________
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL
GLOSSARY
of
TERMS
- A -
Adequate Notice (1500)
Adequate notice is a notice of denial, discontinuance, or reduction of assistance which includes a statement of the Department's intended action, the reasons for the intended action, the specific regulations supporting such action, an explanation of the assistance unit's right to request a Fair Hearing to contest the action, and the circumstances under which benefits are continued if the unit requests a Fair Hearing.
Administrative Overpayment (7000)
An administrative overpayment is an overpayment caused by the Department's incorrect action or failure to act within the appropriate time limits.
Adoptive Sibling (2000)
An adoptive sibling is a brother or sister related through adoption.
Allotment (6500)
An allotment is the dollar amount representing the total value of coupons an assistance unit is authorized to receive during a month or other specified period.
Amortization (7500)
Amortization is the process of paying off a loan by installment payments.
Annuity (4000)
An annuity is income which a person receives either annually or at regular intervals on an investment. An annuity is also an asset, that is, the investment which produces the income.
Anticipated Income (5000)
Anticipated income is that income which is expected to exist during a projected period of eligibility.
Applicant (1500)
Applicant means the individual or individuals for whom assistance is requested.
Application (1500)
Application is written indication on a form prescribed by the Department of the desire to obtain assistance.
Application Process (1500)
The application process is all activity related to the exploration, investigation and disposition of an application beginning with the filing of an assistance request and ending with disposition of the application.
Applied Income (5000)
Applied income is that portion of the assistance unit's countable income that remains after all deductions and disregards are subtracted.
Assessment of Spousal Assets (1500) (4000)
An Assessment of Spousal Assets is a determination of the total value of all non-exclued available assets owned by both MCCA spouses which is done upon the request of an institutionalized spouse or a community spouse and is used to calculate the Community Spouse Protected Amount.
Asset (4000)
An asset is cash or any item of value which a person can use or legally convert to cash for support and maintenance.
Asset Limit (4000)
The asset limit is the maximum amount of equity in counted assets which an assistance unit may have and still be eligible for a particular program administered by the Department.
Assignment (3500) (4000) (7500)
An assignment is the act of transferring one's equitable interest in an asset or a claim to another person or to an organization.
The assistance unit consists of one or more individuals who apply for or receive assistance together under one of the Department's programs.
Assistance Unit (2000) (4000)
The assistance unit consists of one or more individuals who apply for or receive assistance together under one of the Department's programs.
Authorization to Participate (ATP) (6500)
An ATP is a FS document which is issued by the Department to an assistance unit that shows the allotment the assistance unit is authorized to received upon presentation of such document to a coupon issuer.
Authorized Representative (1500)
An authorized representative is an adult, over the age of eighteen, who has written authorization to act on the behalf of an assistance unit of which he or she is not currently a member, and who would otherwise not be eligible to act without such authorization.
Available Asset (4000)
An available asset is an asset which someone owns and can readily convert to cash.
Available Income (5000)
Available income is all income from which the assistance unit is considered to benefit, either through actual receipt or by having the income deemed to exist for its benefit.
- B - Basic Needs (4500)
Basic needs are needs which are recognized by the Department as predictable, recurrent, and common to all individuals within a particular assistance program category.
Beginning Date of Assistance (1500)
Beginning Date of Assistance is the earliest date on which an assistance unit or a member of an assistance unit is entitled to the benefits of the program.
Beneficiary (4000)
A beneficiary is a person who is entitled to receive funds, property, or other benefits from an insurance policy, will, trust, or other settlement.
Benefit Expiration Date (6500)
The benefit expiration date is the last day of the period of intended use of a check, medical identification document (MID) or food stamp authorization to participate (ATP).
Boarder (2000)
A boarder is an individual who pays a stipulated sum to others for lodging and meals.
Boarder (8000)
For the purposes of the CEAP, boarders are people to whom food as well as shelter is furnished by the homeowner with whom they live.
Budget Month (6000)
A budget month is the calendar month from which income is used to calculate benefits.
Burial Fund (4000)
A burial fund is a revocable burial contract - that is, a fund held by a licensed funeral director to be used for funeral and burial expenses, but which can be released prior to death by mutual agreement.
Burial Plot (4000)
A burial plot is a grave site, crypt, mausoleum, urn, or any other repository traditionally used for the remains of a deceased person.
- C -
Calendar Quarter (2500)
Calendar quarter is a period of three consecutive calendar months ending March 31, June 30, September 30 or December 31.
Calendar Year (4500)
A period of twelve consecutive months beginning with January 1 and ending December 31.
Calculation of Benefits (6000)
Calculation of benefits is the process in which the amount of program benefits due to an assistance unit is determined by comparing the amount of the unit's applied income to the amount of the unit's total needs or an income limit.
Case Management Agency (8000)
A case management agency is the resettlement agency which has the exclusive responsibility for administering an employment and training program for a refugee.
Case Management Plan (8000)
A case management plan provides an individualized program of training for a refugee preliminary to employment, with the goal of developing economic and social self-sufficiency in the refugee.
Case Record (1000)
A case record is any collection of personal data which is collected, maintained or disseminated by the Department.
Cash Assistance Group (8000)
A cash assistance group is the group of people who receive cash assistance from the Department under a single case number.
Cash Payment (6500)
A cash payment is a monetary benefit issued to or on behalf of an assistance unit in check form.
Cash Surrender Value (4000)
The cash surrender value of a life insurance policy is the amount of equity which the owner has in the policy, and represents the amount the owner can borrow against the policy.
Catastrophic Event (4500)
A catastrophic event is a natural or other disaster over which the individual or family has no control, and which renders the individual's or family's residence uninhabitable, as determined by local or state officials or by the Department.
Categorical Eligibility Requirement (2500)
Categorical eligibility requirement is a program characteristic which in effect sets one program apart from another and which must be met by the individual or group in order to qualify for such program.
Cause of Action (7500)
A cause of action is a claim against an estate, a pending lawsuit, a personal injury action, or a wrongful death action.
Certification of Eligibility (1500)
Certification is the formal authorization to participate in a particular assistance program.
Certification Period (1500)
A certification period is the interval of time within which an assistance unit is eligible to receive benefits from a particular assistance program.
Certified Assistance Unit (6500)
A certified assistance unit is an assistance unit that has been determined eligible to receive benefits from the Department. Certification may be for a current or past period of time.
Commercial Housing (4500)
Commercial Housing is any residential building, other than an apartment building, which contains at least three rental units.
Community Action Agency (CAA) (8000)
A Community Action Agency, operated under the direction of DHR, is the agency which is responsible for processing CEAP applications for households not eligible to receive CEAP through the Department of Income Maintenance.
Community Based Services (8000)
Social services which are prescribed in a plan of care for the purpose of allowing an otherwise institutionalized individual the alternative of remaining in the community.
Community Spouse (1500) (3500) (4000) (5000)
A community spouse is an individual who resides in the community, who does not receive home and community based services under a Medicaid waiver, who is married to an individual who resides in a medical facility or long term care facility or who receives home and community based services (CBS) under a Medicaid waiver.
Community Spouse Disregard (CSD) (1500)
A community spouse disregard is the amount of the institutionalized spouse's available non-excluded assets which is excluded in determining the institutionalized spouse's eligibility for Medicaid.
Community Spouse Protected Amount (CSPA) (1500) (4000)
A community spouse protected amount is the amount of the total available non-excluded assets owned by both MCCA spouses which is protected for the community spouse and is not counted in determining the institutionalized spouse's eligibility for Medicaid.
Compensation (3000)
Compensation is all money, notes, real or personal property, food, shelter, or services received in exchange for something of value.
Continuous Period of Institutionalization (1500) (4000) (5000)
A continuous period of institutionalization is a period of 30 or more consecutive days of residence in a medical institution or long term care facility, or receipt of home and community based services (CBS) under a Medicaid waiver.
Coordination, Assessment and Monitoring (CAM) Agency (8000)
The agency licensed and regulated by the Department of Health Services, which is responsible for the client assessment, development of a plan of care, and coordinating and monitoring the services provided to individuals participating in the PAS program.
Corrective Payment (4000) (6500) (7000)
A corrective payment is assistance which the Department provides to or on behalf of an assistance unit as an adjustment for an underpayment of cash, medical, or Food Stamp benefits, or refunds owed to the assistance unit.
Counted Asset (4000)
A counted asset is an asset which is not excluded and either available or deemed available to the assistance unit.
Counted Income (5000)
Counted income is that income which remains after excluded income is subtracted from the total of available income.
Coupon (6500)
In relation to the FS program, a coupon is a food stamp document which can be used to purchase eligible foods.
Coupon Issuer (6500)
A coupon issuer is any office of the Department or agent that has the responsibility of issuing coupons to individuals that redeem an ATP.
Crisis (8000)
For the purpose of the CEAP Program, a crisis is defined as:
1. being out of deliverable fuel or within one week of being out of a deliverable fuel; or
2. having a shutoff notice for utility service or a past due bill which is more than thirty (30) days old, for services provided after October 31, 1987, and before April 15, 1988.
- D - Date of Application (1500)
The date of application is the date a formal written request for assistance is filed with the Department in accordance with the rules established for the program for which application is made.
Date of Authorization (1500)
The date of authorization is the date the Department makes a case action decision, as opposed to the effective date of the action.
Date of Issuance (1500)
The date of issuance is the actual mailing date of a benefit, notice or other item of correspondence, or the date the item becomes available for in-office pickup.
Decedent Estate (7500)
A decedent estate is the assets and liabilities which a deceased person has at the time of his or her death.
Deductions (5000)
Deductions are those amounts which are subtracted as adjustments to counted income and which represents expenses paid by the assistance unit.
Deemed Asset (4000)
A deemed asset is an asset owned by someone who is not a member of the assistance unit but which is considered available to the unit.
Deemed Income (5000)
Deemed income is that portion of income belonging to someone who is not a member of assistance unit which is considered available to the unit.
Deemor (4000) (5000)
A deemor is a person from whom income or assets are deemed available to the assistance unit.
Deliverable Fuel (8000)
A deliverable fuel is oil, coal, wood, propane gas, or kerosene.
- D -
Department of Mental Health (DMH) Sanctioned Supervised Apartment (4500)
A Department of Mental Health (DMH) sanctioned supervised apartment is a DMH approved residence, owned, leased or co-leased by a private mental health agency which provides on-site services.
Dependent Child (2500)
A dependent child is a child who is deprived of parental support or care by reason of the death, continued absence from the home, physical or mental incapacity or unemployment of a parent.
Deprivation of Parental Support or Care (2500)
Deprivation of parental support or care is the state of being without financial support or day-to-day care and guidance from one parent because that parent died, is continually absent from the home, is incapacitated or is unemployed.
Digital Imaging
Digital Imaging is a biometric identification system that uses scanned graphical information for evaluation and identification purposes.
Disabled Person - Food Stamp Program (5000)
A disabled person, in the context used by the Food Stamp program, means a person who meets any of the following conditions:
1. receives or is certified to receive SSI (Title XVI) benefits or disability or blindness payments under Titles I, II, XIV, or XVI of the Social Security Act; or
2. receives assistance through the AABD program; or
3. receives disability retirement benefits from a governmental agency because of a disability considered permanent under Section 221(i) of the Social Security Act; or
4. is a veteran with a service-connected disability, which under Title 38 of the United States Codes is:
a. rated or paid as a total disability; or
b. considered to necessitate regular aid and attendance; or
c. severe enough to permanently preclude self-support; or
Disabled Person - Food Stamp Program (5000) (continued)
5. is a disabled surviving spouse or child of a veteran and considered to be in need of aid and attendance, permanently housebound, or permanently incapable of self-support; or
6. is a veteran's surviving spouse or child who is considered permanently disabled under Section 221(i) of the Social Security Act and receiving or authorized to receive:
a. compensation for a service connected death; or
b. pension benefits for a non-service connected death; or
7. receives an annuity payment under Section 2(a)(1)(iv) of the Railroad Retirement Act of 1974 and is determined to be eligible for Medicare by the Railroad Retirement Board; or
8. receives annuity payment under Section 2(a)(i)(v) of the Railroad Retirement Act of 1974 and is determined to be disabled based upon the criteria used for SSI; or
9. receives a Federal or State benefit payment under 212 (a) of Public Law 93-66.
Disclosure (1000)
Disclosure is the availability or release of a record about an individual to another party.
Disregards (5000)
Disregards are those amounts which are subtracted as standard adjustments to countable income and which do not represent expenses paid by the assistance unit.
Diverted Income (5000)
Diverted income is that portion of income belonging to a member of the assistance unit which is considered available to meet the needs of someone who is not a member of the assistance unit.
Documentation (1500)
Documentation is the act of recording a fact, circumstance or condition through the use of a supporting reference, annotation or the inclusion of documentary evidence.
- E -
Earned Income (5000)
Earned Income is income which the assistance unit receives in exchange for the performance of duties or through self-employment and may be in the form of wages, salary, benefits, or proceeds from self-employment.
Elderly Person - Food Stamp Program (5000)
An elderly person, in the context used by the Food Stamp program, means a person who is sixty or more years of age.
Electronic Data Processing Cutoff Date (6500)
The electronic data processing (EDP) cutoff date is the last day within any month by which an action can be entered into an automated computer system in order to effect a change in the next issuance cycle.
Eligibility Process (1500)
The eligibility process is all activity related to the application process, interim activity, redetermination and Fair Hearings.
Emancipation (3500)
Emancipation is the act of releasing a minor child from the jurisdiction of his or her parents.
Emergency Housing (4500)
Emergency Housing is housing which serves as a temporary shelter until permanent housing is secured, including, but not limited to, commercial lodging, shelters for the homeless and shelters for victims of domestic violence. Emergency housing shall not include temporary residence with a friend or a relative.
Emergency Medical Condition (3000)
A medical condition is considered an emergency when it is of such severity that the absence of immediate medical attention could result in placing the patient's health in serious jeopardy. This includes labor and delivery, and emergencies related to pregnancy.
Employment Lockout (3000)
Employment lockout is when a place of employment is physically closed by an employer due to a labor dispute, or an employer says there is no work until a labor dispute is terminated, or an employer makes work available under less favorable terms or conditions after the labor contract expires, provided the bargaining agent has notified the employer that employees are willing to work under terms and conditions existing under the expiring contract.
Encumbrance (4000)
Encumbrance is a legal claim against an asset which a person must pay off in order to convert the asset to cash.
Ending Date of Assistance (1500)
Ending date of assistance is the last day on which the assistance unit or a member of an assistance unit is entitled to the benefits of the program.
Entrant (8000)
An entrant is:
1. any individual granted parole status as a Cuban or Haitian entrant or granted any other special status for nationals of Cuba or Haiti, regardless of the status of the individual at the time assistance or services are provided; or
2. any other national of Cuba or Haiti who:
a. was paroled into the United States and has not acquired any other status; and
b. is the subject of exclusion or deportation proceedings under INS regulations; or
c. has an application for asylum pending with INS; or
3. any other national of Cuba or Haiti who with respect to whom a final, nonappealable and legally enforceable order of deportation or exclusion has not been entered.
Equitable Interest (4000)
Equitable interest is the amount of equity which the legal owner has in an asset.
Equity Value (4000)
Equity value is fair market value minus encumbrances.
Essential (4500)
Essential means necessary to the health and well-being of individuals or to the attainment of self-sufficiency as determined by the Department.
Essential Household Item (4000)
An essential household item is furniture, furnishings, and equipment found in or about a house which is used in connection with the operation, maintenance, and occupancy of the home, as well as an item used in the functions and activities of home and family life or for comfort and accommodation.
Excluded Asset (4000)
An excluded asset is an asset which is not counted by the Department in determining the assistance unit's eligibility for assistance.
Excluded Income (5000)
Excluded income is income which is available from certain specified sources and is not counted in determining eligibility and level of benefits.
- F -
Face Value (4000)
The face value of a life insurance policy is the basic amount of insurance purchased on the insured's life, as listed on the policy.
Fair Market Value (3000) (4000)
Fair Market value is the amount at which an asset can be sold on the open market in the geographic area involved at the time of the sale or the amount actually obtained as a result of bona fide efforts to gain the highest possible price.
Family Plan for Self-sufficiency
The family plan for self-sufficiency contains the employment goal for the Job Connection participant, describes the support services to be provided by the Department, describes the activities to be undertaken by the participant to achieve the employment goal, and describes any other needs of the family that might be met by the Job Connection.
Fiduciary Duty (3000)
Fiduciary duty is the duty of a person who stands in a special relationship of trust, confidence, or responsibility in his obligation to others.
Flowage Easement (8000)
Flowage easement means an area where the landowner has given the right to overflow, flood or submerge the land to the goverment or other entity for a public purpose.
Foreseeable Needs (3000)
Foreseeable needs are the needs of a person as they would be anticipated to exist by a reasonable prudent individual for the immediately-forthcoming 24-month period.
Foster Child (2000)
A foster child is one not necessarily related through legal or blood ties for whom parental care and nurturing is provided apart from the child's natural family.
Fuel (4500)
Fuel is electricity, natural gas, petroleum, petroleum products, coal and coal products or wood.
Full-time Employment (5000)
Full-time employment means that the income being counted from a particular calendar month resulted from at least 130 hours of employment.
- G -
Grant for Acquisition or Construction Purposes (8000)
Grant for acquisition or construction purposes is a grant to an individual or family for flood related damage for the purpose of repairing, replacing, or rebuilding the insurable portions of a home, and/or to purchase or repair insurable contents.
Grant Reduction Recoupment (7000)
Grant reduction recoupment is a method of recoupment in which the Department reduces the assistance unit's monthly assistance grant or Food Stamp allotment.
Gross Earned Income (5000)
Gross Earned Income is the total amount of counted earned income before deductions or disregards are subtracted from it. When earnings are from self-employment, the gross amount is the difference between self-employment income and self-employment expenses.
Gross Unearned Income (5000)
Gross unearned income is the total amount of counted unearned income before disregards are subtracted from it.
Group Living Arrangement (3000)
A group living arrangement is a public or private nonprofit residential setting for no more than 16 residents which is certified under section 1616 (e) of the Social Security Act.
- H -
Half-sibling (2000)
A half-sibling is a brother or sister related through only one parent.
Health Screen (8000)
A health screen is a profile of the applicant's health and daily needs, compiled by a health professional, used to assess the need for a long term care placement.
Home Property (4000)
Home property is:
1. real property which someone owns and is using as principal residence; and
2. life use which is the right of a person to occupy and/or enjoy the income proceeds of real property during the person's life time in accordance with the terms of a legal agreement.
Household (2000)
Household is used to designate all of the individuals who are living together in one dwelling unit.
- I -
Immigrant (3000)
An immigrant is an non-citizen or North American Indian born in Canada who is lawfully admitted into the United States for the express purpose of maintaining permanent residence.
Inaccessible Asset (4000)
An inaccessible asset is an asset which someone owns but, for some reason beyond his or her control, cannot readily convert to cash.
Inaccessible Income (5000)
Inaccessible income is money which an assistance unit member is due but neither receives nor benefits from due to circumstances beyond his or her control.
Income-In-Kind (5000)
Income-in-kind is the value of goods, commodities, or services which are provided to the assistance unit or to a third party in behalf of the assistance unit in lieu of cash.
Independent Community Living (4500)
Independent community living is any type of living arrangement which is not a licensed room and board facility or medical or penal institution.
Installment Recoupment (7000)
Installment recoupment is a method of recoupment in which the assistance unit makes monthly installments to the Department in the form of cash or Food Stamps.
Institution (3000)
An institution is an establishment that furnishes food, shelter and some treatment or services to four or more persons unrelated to the proprietor.
Institution for Mentally Retarded (3000)
An institution for mentally retarded is an institution that is primarily for diagnosis, treatment or rehabilitation for the mentally retarded or persons with other developmental disabilities in a protected residential setting.
Institution of Higher Education (3000)
An institution of higher education is an educational institution at post-high school level which is accredited by the Department of Higher Education as either a training and technical institution or as a degree-granting institution.
Institutionalized Spouse (3500) (5000)
An institutionalized spouse is a spouse who resides in a medical facility or long term care facility, or who receives home and community based services (CBS) under a Medicaid waiver, and who is legally married to someone who does not reside in such facilities or who does not receive such services.
Intentional Recipient Error (7000)
An intentional recipient error is an intentionally incorrect oral or written statement made by the assistance unit regarding circumstances affecting eligibility or the amount of benefits. An intentional recipient error is also the intentional failure by the assistance unit to report timely the receipt of income or assets, or other changes in circumstances affecting eligibility or the amount of benefits.
Interim Activity (1500)
Interim activity is any action or activity other than application, redetermination or Fair Hearing.
Intermediate Care Facility (ICF) (3000)
An intermediate care facility (ICF) is a medical institution which provides health-related services not available outside of an institution to individuals who do not require hospital care or a skilled nursing facility.
Intermittent Income (5000)
Intermittent income is income which is received at recurrent intervals longer than one month.
Intervenor (1500)
An intervenor is person who participates in a Fair Hearing on a limited basis in the interest of justice.
Irrevocable Burial Fund (4000)
An irrevocable burial fund is a fund held by a licensed funeral director as a result of a contractual arrangement to be released only upon the death of a recipient, but which can be transferred to another funeral director.
Irrevocable Trust (4000)
An irrevocable trust is a trust which the settlor is unable to dissolve.
Issuance Cycle (6500)
An issuance cycle is the standard interval at which benefits for current ongoing needs are issued to eligible assistance units.
Issuance Date (6500)
The issuance date is the day of a month that a benefit, notice or other item is mailed or made available for pickup in a DIM office.
- J -
Job Connection Agreement
The agreement signed by the Job Connection participant and the Job Connection case manager describing the participant's obligations under the program.
Joint Custody (2500)
Joint custody is the awarding of legal custody of a child by the Court to both parents subsequent to separation or divorce. Joint custody provides for joint decision making by both parents but does not provide for joint physical custody in all cases.
Joint Physical Custody (2500)
Joint physical custody is the awarding of legal custody of a child by the court to both parents subsequent to separation or divorce and provides that the child reside with each parent in such a manner as to assure the child of continuing physical contact with each parent.
Joint Processing (1500)
Joint processing is the simultaneous processing of a PA and FS assistance request that has been filed concurrently.
- K -
- L -
Lawfully Residing (7500)
Lawfully residing is actually residing at a certain address and publicly affirming this address as one's residence to local Post Office, Voters' Registration Office, Immigration Office, or other governmental agencies.
Legal Owner (4000)
The legal owner of an asset is the person who is legally entitled to enjoy the benefit and use of the asset.
Legally-Enforceable Agreement (3000)
A legally-enforceable agreement is a binding and credible arrangement, either oral or written, wherein two or more parties agree to an arrangement in consideration of the receipt of money, property, or services and in which all parties can be reasonably expected to fulfill their parts of the agreement.
Legally Liable Relatives (3500)
Legally liable relatives are those who have an obligation to support a spouse of a minor child as required by law.
Licensed Boarding Facility (4500)
A licensed boarding facility is a community group home, training home, family care home, private boarding home or other residential facility licensed by the State Department of Mental Retardation, Department of Children and Youth Services, Department of Mental Health, Department of Health or other state agency, which at a minimum provides lodging and meals to various groups of elderly, blind or disabled individuals.
Lien (7500)
A lien is a legal claim against property as security for a debt.
Long Term Care Facility (LTCF) (3000) (4000) (7500)
A long term care facility is a skilled nursing facility, intermediate care facility, or other medical institution, where the applicant is required, as a condition of receiving services in such institution under the state medical assistance plan, to spend for costs of medical care all but a minimal amount of any existing income for personal needs.
Lump-sum Recoupment (7000)
Lump-sum recoupment is a method of recoupment in which the assistance unit makes a lump-sum payment to the Department in cash or Food Stamps.
- M -
Maintenance Payments from Title IV-E (2000)
Maintenance payments from Title IV-E are funds administered by DCYS available to individuals for room and board and other services given for qualified foster children or adopted children.
Mass Change (1500)
A mass change is one which affects all or a portion of the caseload which shares similar circumstances.
MCCA Spouses (1500) (4000)
MCCA spouses are spouses who are members of a married couple one of whom becomes an institutionalized spouse on or after September 30, 1989, and the other spouse becomes a community spouse.
Meals on Wheels (4500)
Meals on wheels is a community sponsored program designed to provide nutritious and well-balanced meals to individuals living in the community.
Mental Disease Facility (3000)
A mental disease facility is a hospital, nursing facility or other institution of more than 16 beds, primarily for the diagnosis, treatment or care of persons with mental diseases, not including mental retardation.
Migrant Farm Worker (6000)
A migrant farm worker is a worker whose primary livelihood is derived from farm labor.
Migrant or Seasonal Farm Worker Assistance Unit (1500)
A migrant or seasonal farm worker assistance unit is an assistance unit whose primary livelihood is derived from farm labor.
Minor (3500)
A minor is an individual who is under the age of 18.
Month of Loss of Income (6000)
The month of loss of income is the month in which the last payment of non-public assistance income from a particular source is received by the assistance unit.
Mortgage (7500)
A mortgage is a temporary and conditional pledge of property to a creditor as security against a debt.
Motor Vehicle (4000)
A motor vehicle is a passenger car or other vehicle which a person owns for the purpose of providing transportation of individuals or goods.
Mutilated Benefits (6500)
A mutilated benefit is a check, medical identification document (MID), authorization to participate (ATP) or coupons that has been improperly manufactured or damaged in an event other than a disaster to such an extent that is cannot be used.
- N -
Naturalization (3000)
Naturalization is the granting of full United States citizenship and the rights and responsibilities thereof.
Needs (4500)
Needs are essential items recognized by the Department to be required for the daily living, health and well-being of individuals for which the Department has determined a specific monetary value.
Needs Budget (4500)
The needs budget is the itemized summary of basic and special need standards of the State Supplement Programs.
Needs Group (4000) (4500) (5500)
Needs group is the group of persons comprising the assistance unit and certain other persons whose basic needs are added to the total needs of the assistance unit members when determining the income eligibility of the assistance unit.
Net Earned Income (5000)
Net earned income is that portion of the gross earned income which remains after deductions are subtracted from the gross earned income amount.
Net Unearned Income (5000)
Net unearned income is the amount of gross unearned income which remains after disregards are subtracted from the total gross unearned income.
New Horizons (4500)
New Horizons is a nonprofit, nonsectarian corporation which provides independent community living arrangements and related services to severely physically disabled adults. Basic housing is provided in the form of independent apartment units with separate metering of heating fuel and utility costs, and is designed to accommodate family groups.
Non-Citizen (3000)
An non-citizen is a person born outside of the United States who is a subject or citizen of a foreign country and is not a citizen of the United States.
Non-Essential Household Item (4000)
A nonessential household item is a household item which a person or family has acquired as an investment to be sold for a profit at a later date.
Non-Home Property (4000)
Non-home property is real property which a person owns but is not using as principal residence.
Notice (1500)
A notice is a written statement which the Department mails to the assistance unit to inform the unit that the Department has taken or intends to take a specific action in the unit's case.
- O -
Overpayment (7000)
An overpayment is the amount of financial or medical assistance paid to or on behalf of the assistance unit, or the amount of the Food Stamp allotment issued to an assistance unit, in excess of the amount to which the unit is properly entitled.
- P -
Parent (2500)
Parent is a mother or father, natural or adoptive.
Part-time Employment (5000)
Part-time employment means fewer than 130 hours were spent in the performance of the duties for which the total earned income received in a calendar month is paid.
Party to a Hearing Requested by Another (1500)
A party to a hearing requested by another is a person who is allowed to participate in a hearing requested by another person on an issue of mutual interest.
Payment Month (6000)
Payment month is the calendar month for which eligibility is determined and for which benefits are issued.
Permanent Housing (4500)
Permanent housing is housing which is intended to be a residence for the foreseeable future.
Personal Data (1000)
Personal data is any information about an assistance unit's education, finances, medical or emotional condition or history, employment or business history, family or personal relationships, reputation or character which because of name, identifying number, mark or description can be readily associated with a particular unit.
Personal Effects (4000)
Personal effects are clothing, jewelry, or items used for personal care or individual education.
Personal Property (4000)
Personal property is an asset in the form of temporary or movable property as opposed to real property.
Plan of Care (8000)
A plan of care is a written individualized plan of community services, prepared by a CAM agency, which specifies the type and frequency of all services required to maintain the individual in the community, the service providers, and the cost of services regardless of whether or not there is an actual charge for the service.
Port of Entry (8000)
The port of entry is the place in which the individual first arrives in Connecticut.
Post-Eligibility Treatment of Income (6000)
Post-eligibility treatment of income is the method used to calculate the extent of liability for medical expenses for residents of long term care facilities or for those receiving home and community-based services.
Prerelease Applicant
A prerelease applicant is an individual who is currently ineligible for Food Stamps due to institutional status, but who has applied jointly for Food Stamps and SSI in anticipation of being released from the institution.
Primary Heat Source (4500) (8000)
A primary heat source is the type of fuel which supplies the main method of heating a residence.
Primary Language (1000)
Primary language is the language normally used by an individual to conduct day-to-day affairs and includes the language spoken at home or the language used to conduct essential functions outside the home such as shopping, working and worshipping.
Primary Verification (1500)
Primary verification is an inquiry to verify non-citizen status using direct access into the INS data base in accordance with the Immigration Reform and Control Act of 1986.
Principal (7500)
Principal is the amount of money owed as a debt, upon which interest is calculated.
Principal Wage Earner (2500)
Principal wage earner is whichever parent, in a two parent family, earned the greater amount of income in the 24-month period the last month of which immediately precedes the month in which application is made.
Principal Wage Earner (FS) (3000)
A principal wage earner is whichever individual in a Food Stamp assistance unit earned the most money during the period of time used in respect to voluntary quit provisions.
Private Fuel Supplier (4500)
A private fuel supplier is a privately operated business or corporation engaged in the retail sale and delivery of fuel.
Prospective Calculation Method (6000)
Prospective calculation method is a method of calculating financial benefits in which the budget month and the payment month are the same calendar month.
Prospective Determination of Eligibility (5500)
Prospective determination of eligibility means that income eligibility is determined for a particular month by comparing the income to the needs that exist in that same month for which eligibility is being determined.
Protective Payee (6500)
A protective payee is an individual designated by the Department to receive and discharge cash benefits on behalf of an assistance unit in which he or she is neither a member nor a guardian or caretaker relative. Protective Payment (6500)
A protective payment is a type of restricted payment that is issued on behalf of an assistance unit to a protective payee who is interested in or concerned with the welfare of the assistance unit.
Public Assistance (1500)
Public Assistance (PA) means any of the following programs: Aid to Families with Dependent Children (AFDC), Aid to the Aged, Blind or Disabled (AABD), and Medical Assistance (MA).
Public Housing (4500)
Public Housing is an apartment building or complex which is not privately developed, where the apartment unit rather than the tenant is subsidized by a state, federal, or municipal housing program.
Public Institution (3000)
A public institution is an institution that is the responsibility of a governmental unit or over which a governmental unit exercises administrative control.
Public Service Company (4500)
A public service company is a public utility company which is not a private fuel supplier or municipal corporation, and is enjoined by state law from refusing to provide utility service to a residential customer based on the inability of the customer to pay a security deposit.
Putative Father (3500)
A putative father is a man named as the father by the mother of a child for whom paternity has not been legally established.
- Q -
- R -
Rated Housing Facility (4500)
A rated housing facility is a licensed boarding facility, New Horizons or other living arrangement for which the Department has regulatory authority to establish rate standards for the housing cost charged to assistance units that are residents of the housing unit.
Record Owner (4000)
The record owner of an asset is the person who has apparent ownership interest as shown on a title, registration, or other documentation.
Recoupment (7000)
Recoupment is a process by which the Department recovers an overpayment from the assistance unit.
Recovery (7500)
Recovery is the process by which the Department collects certain income or assets of an individual who either received benefits from the Department, or who was legally liable for the support of a person when that person was receiving benefits from the Department.
Redetermination Process (1500)
The redetermination process is all activity related to the reevaluation of a recipient's eligibility, and the recertification of a food stamp assistance unit.
Real Property (4000)
Real property is an asset in the form of real estate - that is, land and buildings.
Refugee (8000)
A refugee is any person designated as a refugee by the Immigration and Naturalization Services (INS), who because of presecution or a well-founded fear of persecution is unable or unwilling to return to his or her country of nationality. Repatriation (8000)
Repatriation is the process by which United States citizens or their dependents are returned to the United States from a foreign country.
Request for a Fair Hearing (1500)
A request for a Fair Hearing is a clear statement by the assistance unit or the unit's authorized representative which indicates that the unit disagrees with a Departmental action or non-action, and wishes to have its case reviewed by an independent authority.
Resettlement Agency (8000)
A resettlement agency is a public or private nonprofit agency which has developed a comprehensive program to assist refugees with social, educational and employment services.
Restricted Payment (6500)
A restricted payment is a third party payment issued on behalf of an assistance unit to a vendor or to a protective payee.
Retrospective Budgeting System (6000)
Retrospective Budgeting System is a system of calculating financial benefits in which both the prospective and retrospective calculation methods are used.
Retrospective Calculation Method (6000)
Retrospective calculation method is a method of calculating benefits in which the payment month follows the budget month.
Revocable Trust (4000)
A revocable trust is a trust which the settlor reserves the right to dissolve when he or she desires.
Roomer (2000)
A roomer is an individual who is provided lodging, but not meals, by a household.
Roomer (8000)
For purposes of the CEAP, a roomer is an individual who lives with a home-owning assistance unit and pays rent with heat-but not meals-included to that unit.
- S -
Scheduled Payment (6500)
A scheduled payment is a cash, medical or food stamp assistance payment that is issued on a recurring basis at monthly or semi-monthly intervals, and which contains benefits for current on-going needs.
Second Trimester of Pregnancy
The second trimester of pregnancy is a period of time beginning with the first day of the sixth calendar month prior to the expected month of delivery and ending the day preceding the first day of the third trimester.
Secondary Heat Source (8000)
A secondary heat source is the fuel or utility used by a device designed primarily for heating, which is used to supplement the primary heat source.
1.Devices designed primarily for heating include, but are not limited to, electric space heaters, kerosene heaters, wood stoves, coal stoves, gas and gas stoves and quartz heaters.
2.Devices designed primarily for heating do not include the electric motor for oil furnances, the pilot for gas furnaces, thermostats and cooking ovens.
Secondary School (8000)
A secondary school is:
1. grades seven through twelve in a public or private school which has been approved by the state board of education, and/or accredited by a national or regional accrediting agency so recognized by the United States Department of Education; or
2. regular instruction at home, in a grade equivalent to any of the customary grades seven through twelve, by a teacher or parent whose qualification have been approved by the state board of education where incapacity of the child to attend a secondary school has been established on the basis of a physician's report; or
3. customary grades seven through twelve or their equivalent in a special school in Connecticut provided for the blind, deaf, or handicapped; or
4. customary grades seven through twelve or their equivalent in a special school or institution recommended by responsible individuals or agencies because the child is emotionally disturbed to such an extent that his progress in the customary school setting is seriously retarded.
Secondary Verification
Secondary verification is a written request to verify non-citizen status with INS, in addition to or in lieu of primary verification, in accordance with the Immigration Reform and Control Act of 1986.
Section 8 Subsidy (4500)
A Section 8 Subsidy is a federally assisted housing program established by the US Housing Act of 1937, which subsidizes the rent payments of individuals, or the operating costs of apartment buildings or complexes.
Secured Note (3000)
A secured note is a written acknowledgment of a debt for which repayment is guaranteed through the assignment of collateral.
Security Mortgage (7500)
A security mortgage is a mortgage in which property is used as security against a debt which has not yet been incurred.
Self-employment Expenses (5000)
Self-employment expenses are non-personal business expenses directly related to producing goods or services and incurred in the budget month.
Self-employment Income (5000)
Self-employment income means the total amount of income derived from a self-employment enterprise before self-employment expenses are deducted.
Self-initiated Activity
A self-initiated activity is one that the assistance unit member is engaged in at the time he or she becomes a participant in the Job Connection Program.
Settlor (4000)
The settlor is the person who establishes a trust.
Short Term Placement (8000)
A short term placement means a maximum stay of ninety (90) days for rehabilitative and/or recuperative care, in a long term care facility, which is expected to result in the individual's return to the community.
Skilled Nursing Facility (3000)
A skilled nursing facility is an institution which provides daily inpatient medical services ordered by and provided under the direction of a physician and 24 hour nursing services.
Special Needs (4500)
Special needs are needs other than basic needs which are recognized by the Department as essential to the health and well-being of a particular assistance unit. Special needs may be recurrent or nonrecurrent.
Spend-Down (1500)
Spend-down is the process by which income exceeds an MA assistance unit's Medically Needy Income Limit (MNIL) is offset by incurred medical expenses.
Sponsor (5000)
A sponsor is an individual who executed an affidavit of support or similar agreement on behalf of an non-citizen, other than the non-citizen's parent or spouse, as a condition of the non-citizen's entry into the United States.
Spousal Share (1500) (4000)
A spousal share is one-half of the total value of assets which result from the assessment of spousal assets.
SSI Assistance Unit (1500)
A SSI assistance unit is an assistance unit which is composed entirely of individuals who are either applicant or recipients of SSI.
Standard of Assistance (4500)
A standard of assistance is a rate established by the Department for a particular item of need or consolidated group of need items.
Status (2500)
1619(a)
1619(a) Status is a term used by the Social Security Administration to describe an individual who is determined eligible for SSI on the basis of a disability, and retains SSI eligibility despite performing substantial gainful activity.
1619(b)
1619(b) Status is a term used by the Social Security Administration to describe an individual who is under age 65, is determined eligible for SSI on the basis of blindness or disability, and subsequently becomes ineligible for SSI because of income.
Strike (3000)
A strike includes any concerted stoppage of work by employees (including a stoppage by reason of the expiration of a collective-bargaining agreement) and any concerted slowdown or other concerted interruption of operations by employees.
Substantial Gainful Activity (2500)
Substantial gainful activity means significant and productive physical or mental duties performed for pay or profit regularly and on a predictable basis.
Supplemental Payment (6500)
A supplemental payment is a cash, medical or food stamp assistance payment which is issued apart from an assistance unit's regularly scheduled assistance payment on an as needed basis.
- T -
Term Insurance (4000)
Term insurance is a form of life insurance having no cash surrender value and furnishing coverage for only a specified period of time.
Third Trimester of Pregnancy (2500)
The third trimester of pregnancy is a period of time beginning with the first day of the third calendar month prior to the expected month of delivery and ending upon the date of actual delivery.
Thrifty Food Plan (4500)
The Thrifty Food Plan is the table of maximum coupon benefits of the Food Stamp program. It represents the minimum expenditure for food that is required to meet the basic monthly nutritional needs of assistance units of equal size.
Timely Notice (1500)
Timely notice is notice of discontinuance or reduction of assistance which the Department mails to the assistance unit at least 10 days before the Department's intended action becomes effective.
Transferee (3000)
A transferee is an individual to whom ownership of an asset is conveyed by another individual.
Transfer of an Asset (3000)
A transfer of an asset is the conveyance of beneficial ownership from one person to another, or disposal of an asset in some other way so as to end its beneficial ownership by the transferor.
Transferor (3000)
A transferor is an individual of any age who conveys the ownership of an asset to another individual.
Trust (4000)
A trust is an oral or written agreement in which someone (the trustee) holds the legal title to an asset for the benefit of another person (the beneficiary).
Tuberculosis Facility (3000)
A tuberculosis facility is an institution primarily for the diagnosis, treatment or care of persons with tuberculosis.
- U -
Uncompensated Value (3000)
Uncompensated value is the difference between the fair market value of an asset and the compensation received.
Underpayment (7000)
An underpayment is a financial or medical assistance payment or Food Stamp issuance to which the assistance unit is entitled, but which the Department did not make to or on behalf of the unit.
Undue Influence (3000)
Undue influence is causing another party through misrepresentation, deceit, fraud, or any other improper means to do something that would otherwise not be done.
Unearned Income (5000)
Unearned income is income which does not constitute compensation for work or services performed or business conducted and includes returns from capital investments when the individual is not actively involved in the production of the income.
Utility (8000)
A utility is electric or gas service provided by a utility company under the jurisdiction of the Department of Public Utility Control, or by any municipal utility.
- V -
Vendor (6500)
A vendor is an individual, corporation or other organization that provides goods, services or other items in exchange for compensation.
Vendor Payment (6500)
A vendor payment is a type of restricted payment issued on behalf of an assistance unit to a third party vendor.
Verification (1500)
Verification is the act of confirming a fact, circumstance or condition through direct evidence or other reliable documentation or collateral contact.
- W -
Windfall (5000)
A windfall is a type of lump sum which is not earned, does not occur on a regular basis, and does not represent accumulated monthly income received in a lump sum.
X - Y - Z
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL GLOSSARY OF TERMS
_________________________________________________________________________________ Date: 1-1-96 Transmittal: 96-2 0500 _________________________________________________________________________________
INDEX
- A - ABSENCE OF THE PARENT, 2510.10
ACCOUNTS Bank, 4030.05, P-4030.10
ADH ADMINISTRATIVE DISQUALIFICATION HEARINGS, 7050 General Principles, 7050.05 Pre-hearing Interview, 7050.10, P-7050.10 Waiver Process, 7050.15 Eligibility During Pending Hearing on Decision, 7050.20 Hearing Process, 7050.25, P-7050.15 Disqualification Penalties, 7050.30 Appeals, 7050.35 Preparing the Evidence, 7050.35, P-7050.05 Implementing the Decision, P-7050.20
ADOPTION SUBSIDIES, 5050.01
AGE Verification, 1599.15, P-1599.15 Determination of, 2525.05, P-2525.05, 2525 AFDC Requirements, 2525.10 State Supplement/Related Medicaid, 2525.15
ALIEN STATUS, Verification of, 3099.05, P-3099.05
ALIMONY, 5050.05
ALLOWANCES, SPECIAL, 5050.45
ANNUITIES, 4030.50, 5050.09
APPEALS OF FAIR HEARING DECISIONS - See "Fair Hearing, Appeals of Decision"
APPLICANTS/RECIPIENTS, Right of - See "Rights of Applicants/Recipients"
APPLICATION PROCESS, 1005.05, 1505 Filing an, 1505.10, P-1505.10 Individuals Qualified to File, 1505.15 Completing the Form, 1505.20
ASSET LIMITS General Principles, 4005.05 All Programs, 4005.10 Verification of, 4099.05, P-4099.05
ASSETS Calculation Method, 4026.05 Counted, 4026 Definitions, 4000.01 Reduction of Excess, 4005.15 Held Jointly, 4010.10, P-4010.10 Inaccessible - General Provisions, 4015.05, P-4015.05 Deemed - Sponsors of Aliens - AABD, 4025.45, P-4025.45 Deemed - Parents of Minors, 4025.50, P-4025.50 Deemed - Spouses - AABD, 4025.55, P-4025.55 Deemed - Parents of Minors - MAABD, 4025.60, P-4025.60 Deemed - Spouses - MAABD, 4025.65, P-4025.65 Deemed - Sponsors of Aliens - FS, 4025.70, P-4025.70 Deemed - Disqualified Individuals - FS 4025.75, P-4025.75 Deemed - General Principles, P-4025.05 Treatment of Specific Types, 4030, P-4030.05 Inaccessible - Verification of, 4099.15, P-4099.15 Excluded - Verification of, 4099.20, P-4099.20 Excluded, 4020 Excluded - AFDC/FMA, 4020.05 Excluded - AABD/MAABD, 4020.10 Excluded - FS, 4020.15 Excluded - P-4020.05 Deemed, 4025 Deemed - The concept of Deeming, 4015.05 Deemed - Sponsors of Aliens - AFDC, 4025.10, P-4025.10 Deemed - Disqualified Individuals - AFDC, 4025.15, P4025.15 Deemed -Spouses and Children of Women Qualifying on the Basis of Pregnancy - AFDC, 4025.20, P-4025.20 Deemed - Disqualified Individuals - FMA, 4025.25, P-4025.25 Deemed - Parents and Siblings of Children Qualifying Under Ribicoff Coverage Groups, 4025.30, P-4025.30 Deemed - Spouses and Children of Women Qualifying Under Pregnant Women Coverage Groups - FMA, 4025.35, P-4020.35 Deemed - Parents Qualifying Under MAABD Coverage Groups- FMA 4025.40, P-4025.40 Deemed - MCCA Spouses - MAABD, 4025.67 Deemed - Non-MCCA Spouses - MAABD, 4025.65 Disregards - MAABD, 4022.05 Deemed - Verification of, 4099.25, P-4099.25 Treatment of Specific Types - Verification, 4099.30 Transfer of - See " Transfer of Assets"
ASSIGNMENT What Must be Assigned, 3520.05 Money Payment Program, 7505.05, P-7505.05
ASSISTANCE UNIT Informing the, 1015.10, P-1015.05 Head of 1505.25 Additions to 1560.20, P-1560.10 Circumstances, Verification, 1599.20, P-1599.20 Composition, 2000 Definition, 2000.01 Who Must be Included, 2005.10 Who May be Included, 2005.15 Who is Excluded, 2005.20 of One, 2005.25 Basic Steps in Creating - AFDC, P-2005.05 Stepparent Household, P-2005.10 Special Steps Individuals away From Home, P-2005.15 Adding Mandatory Inclusion, P-2005.25 Living in the Same Household, P-2005.30 Family Medical Requirements, 2010,2010.05 FMA, Unit of Two or More, 2010.15 FMA, Special Guidelines For Certain Medicaid Groups, 2010.20 FMA, Determining, P-2010.05 FMA, Dividing the Assistance Unit into Sub-units, P-2010.20 AABD and Related MA, 2015 AABD/MAABD, Basic Requirements, 2015.05, P-2015.05 FS, Requirements, 2020 FS, General Requirements, 2020.05 FS, Who May Be a Separate Unit, 2020.15, P-2020.10 FS, Optional Members of, 2020.20 FS, In Institutions, 2020.25, P-2020.15 FS, Who is Excluded, 2020.30 FS, Determining the Basic Unit, P-2020.15 Composition, Verification Requirements, 2099.05, P-2099.05 FS Categorically Eligible 2545 FMA, Unit of One, 2010.10 Requirements - AFDC, 2005 General Provisions, 2005.05
ASSISTANCE Concurrent Programs, 3030.05 Ensuring Appropriate, P-3030.05 Payments from Other States, 5050.11 General, 5050.41
ATTORNEY FEES Successful SSI Appeals, 9035
AUTHORIZED REPRESENTATIVE, 1525 General Requirements, 1525.05, P-1525.05 Who Can Be One, 1525.10 Responsibilities, 1525.15 Disqualification, 1525.20 Agency Requirements, 1525.25 Signature on Documents, 1525.30 Application Procedures, P-1525.10
- B -
BASIC NEEDS - See " Needs, Basic" For All Programs
BENEFIT ISSUANCE Use of Cash Benefits, 6515.05 Use of Medical Benefits, 6515.10 Use of Food Stamp Benefits, 6515.15 Frequency/Composition, 6520 General Requirements, 6520.05 Scheduled Payments, 6520.10, P-6520.10 Supplemental Payments, 6520.15, P-6520.10 Expiration Dates, 6520.20 Determining Composition of Payments, P-6520.15 Verification, 6599 Verification re: Restricted Payments, 6599.05, P-6599.05 Verification re: Payee, 6599.10, P-6599.10 Verification re: Post Office Boxes, 6599.15, P-6599.15 Verifiction re: Replacement Benefits, 6599.20, P-6599.20 Verification re: Alternate Issuance Methods, 6599.25 Definition, 6500, 6500.01 Form/Method, 6505 Cash Benefits, 6505.05 Restricted Payment Method, 6505.10, P-6505.05 Cases Involving Work Registration Penalties, 6505.15, P-6505.20 Cases Involving Support Penalties, 6505.15, P-6505.20 Cases Involving Financial Mismanagement, 6505.20, P-6505.25, P-6505.30 P-6505.35, P-6505.40
BENEFIT REPLACEMENT Basic Provisions, 6530.05 In office Visit, 6530.10, P-6530.10 Lost Benefits, 6530.15 Stolen Benefits, 6530.20 Destroyed Benefits, 6530.25 Mutilated Benefits, 6530.30 Misuse of Benefits by a Protective Payee, 6530.35 Cash Benefits, 6530.40 Food Stamp Benefits, 6530.50 Action upon Initial Notification, P-6530.05 Medical Benefits, 6530.45
BENEFIT ERROR Definitions, 7000.01 Overview of Correction Process, 7005 Discovery of, 7005.05, P-7005.05 Determination of the Cause, 7005.10, P-7005.10 Computation of, 7005.15, P-7005.15 Treatment of Intentional Recipient, 7005.20, P-7005.20 Determination of Correction Procedure, 7005.25, P-7005.25 Notification of Assistance Unit, 7005.30, P-7005.30 Correction of, 7005.35, P-7005.35
BENEFITS - SSA, SSI, VA, 5050.13 Calculation of, 6000 Calculaton of - Definitions, 6000.01 Comparing Income/Needs, 6005
BLINDNESS, 2535 Basis for, 2535.05 SSA Determinations are Conclusive, 2535.10, P-2535.10 Establishing, P-2535.05
BONDS, 4030.75
BURIAL FUNDS, 4030.10, P-4030.15 Irrevocable Funds, 4030.10, P-4030.15 General Provisions, 9005.05, P-9005.05
- C -
CALCULATION OF BENEFITS - See "Benefits, Calculation Of"
CARE AND SUPERVISION Continuous, 2515.10
CARETAKER RELATIVE Absence from the Home, 2515.25, P-2515.15 Determination of, 2515.30, P-2515.30
CASE RECORDS Maintaining, 1015.15
CASH CONTRIBUTIONS, 5050.17
CERTIFICATION, 1530 General Requirements, 1530.05 Food Stamp Periods, 1530.10 Notification of, 1530.15
CHANGE Report Form, 1555.20 Effective Date of, 1555.35, P-1555.20 Reporting, 1555.05 What Must be Reported, 1555.15 Processing, 1555.30
CHILD Eligible, 2505, P-2505 Jurisdiction or Legal Custody of Held by Another, 2515.15 Absence of from the Home, 2515.20, P-2515.10
CITIZENSHIP Verification of, 3099.05, P-3099.05
CLOTHING Purchase of Essential - AABD, 4525.20, P-4525.20 Replacement of Essential - AFDC, 4515.30, P-4515.30
COMPLAINTS Handling Discrimination, P-1005.10
CONCURRENT ASSISTANCE Verification of, 3099.30, P-3099.30
CONTRACTS Installment, 4030.50
COOPERATION Related to Eligibility Process, 3525.05 Related to Potential/Inaccessible Income, 3525.10, P-3525.10 Related to Pursuing Assets, 3525.15, P-3525.15 Verification of, 3599.15, P-3599.15
COVERAGE GROUPS, MEDICAID, 2540 General Principles, 2540.01, P-2540.01 Recipients of AFDC, 2540.04, P-2540.04 Work Transition Extension, 2540.12, P-2540.12 HMO Extension, 2540.20, P-2540.20 AFDC-Eligible Non-Recipients, 2540.24, P-2540.24 Special Child Care Deduction 2540.28, P-2540.28 Participants in Supplementation, 2540.32, P-2540.32 Eligible for AFDC Except for Non-Medicaid Requirements, 2540.36, P-2540.36 Children Receiving Title IV-E Payments, 2540.40, P-2540.40 Pregnant Women Under 185% of the Poverty Level, 2540.43, P-2540.43 Categorically Needy Pregnant Women, 2540.44, P-2540.44 Medically Needy Pregnant Women, 2540.45, P-2540.45 Pregnant Woman Extension, 2540.48, P-2540.48 Newborn Children 2540.52, P-2540.52 Children Under 185% of the Poverty Level, 2540.54, P-2540.54 Categorically Needy Ribicoff Children, 2540.56, P-2540.56 Medically Needy Ribicoff Children, 2540.57, P-2540.57 Long Term Care Facility Residents Eligible Under Special Income Levels-FMA-CN, 2540.60, P-2540.60 Individuals Receiving Home and Community Based Services, 2540.64 Medically Needy Caretaker, 2540.68 Recipients of AABD, 2540.72,P-2540.72 Severely Impaired, 2540.76, P-2540.76 AABD-Eligible Non-Recipients, 2540.80, P-2540.80 Eligible for AABD Except Non-Medicaid Requirements, 2540.84, P-2540.84 Long Term Care Facility Residents Eligible Under Special Income Level MAABD-CN, 2540.88, P-2540.88 Individuals Receiving Home and Community Based Services, 2540.92 Medically Needy Aged, Blind, and Disabled, 2540.96, P-2540.96 Medicaid, 2540
CUBAN HAITIAN ENTRANT PROGRAM Categorical Eligibility Requirements, 8015.10 EP Procedures Same RCA/RMA Procedures, 8015.05 Verification of, 8099.15, P-8099.15
- D -
DATES OF ASSISTANCE Beginning, 1560, P-1560.05 Financial Assistance Beginning, 1560.05 Medical Beginning, 1560.10 Ending, 1565 Basic Provisions of Ending, 1565.05,
DEATH OF THE PARENT, 2510.10
DECLARATION OF CITIZENSHIP OR ALIEN STATUS, 3535, P-3535
DEDUCTION Verification, 5099.10 DEEMED INCOME - See " Income, Deemed "
DENIED CASES Reevaluating, 1510.10
DEPOSIT, SECURITY, Heating Service - AFDC, 4515.40, P-4515.40 Housing - AFDC, 4515.45, P-4515.45 Heating Service - AABD, 4525.40, P-4525.40 Housing - AABD, 4525.45, P-4525.45
DEPRIVATION Parental Support/Care, 2510 Determining the Factor, P-2510.05 Considering Circumstances which Tend to Support the Presumption it Exists, P-2510.15 Looking at Conditions Which Tend to Refute the Presumption it Exists, P-2510.25 Looking at Conditions Which Tend to Refute the Presumption it does not Exist, P-2510.30 Considering Circumstances Which Tend to Support the Presumption it does not Exist, P-2510.20 DIETS Therapeutic - AABD, 4525.60, P-4525.60
DISABILITY Verification, 1599.15, P-1599.15, 2530 Basis for, 2530.05 SSA Determinations are Conclusive, 2530.10, P-2530.10 Estabilishing Eligibility, P-2530.05
DIVIDENDS, 5050.21
DSP DEPENDENT STUDENT PROGRAM, 8005 Assistance Unit Composition, 8005.10 Categorical Eligibility Requirements, 8005.15 Technical/Procedural Eligibility Requirements, 8005.20 Treatment of Assets, 8005.25 Standards of Assistance, 8005.30 Income Eligibility, 8005.35 Calculation of Benefits, 8005.40 Benefit Insurance, 8005.45 Medical Coverage, 8005.50 Verification of, 8099.05 Based on AFDC, 8005.10
- E -
EARNED INCOME TAX CREDITS, 5050.25
EARNINGS Dependent Children, 5050.23, P-5050.23
ELIGIBILITY PROCESS Definitions, 1500.01 Determining in a Timely Manner, 1015.05 Determination, 1505.40 Redetermining, P-1545.25 Requirements, Categorical, 2500 Requirements - Procedural, Definitions, 3500.01 Standards, Applied Income Limits - FS, 4535.05 Standards, Thrifty Food Plan - FS, 4535.10
EMERGENCY HOUSING - See " Housing Emergency "
EMPLOYMENT AND TRAINING REQUIREMENTS Good Cause for Non-Compliance With, P-2510.65, 2510.40 Basic Provisions-AFDC, 3510.05 Net Loss of Income-AFDC, 3510.07 Exemptions-AFDC, 3510.15 Special Age-Related Requirements-AFDC, 3510.13 Basic Provisions-FS, 3510.15 Exemption from Registration Requirements-FS, 3510.20 Exemption from Participation Requirements-FS, 3510.23 Employment/Training, 3510.25 Non-Conpliance, 3510.30 Good cause for Non-Compliance-FS, 3510.35 Suitable Employment, 3510.40 Penalties for Non-Compliance-AFDC, 3510.45 Penalties for Non-Compliance-FS, 3510.50 Completing Employment and Training Registration Form and Referral-FS, P-3510.05 Completing Employment and Training Registration Form and Referral-AFDC, P-3510.10 Completing Employment and Training Registration Form for Joint AFDC/FS Applications, P-3510.15 Granting Exemptions, P-3510.25 Determining Net Loss of Income-AFDC, P-3510.27 Applying Penalties, P-3510.30 Determining the Designated Provider-FS, P-3510.35
EMPLOYMENT OF THE PARENT, 2510.25
ENERGY Verification of, 8099.20
ESSENTIAL SERVICE INCOME, 5050.33
ESTABLISHING BILLING CONTROLS, P-7035.20
EXCESS RENT, 4515.60, P-4515.60
EXCLUDED - See " Income, Excluded "
EXPEDITED SERVICE, 1515 Identifying Eligible Assistance Units, 1515.05 Processing Requirements, 1515.10, P-1515.10 Procedure for, 1515.15 Certification and Entitlement to Benefits, 1515.20 Limitations, 1515.25 Procedures at the Time of Application, P-1515.05
- F -
FAIR TREATMENT, Right to, 1005.10, P-1005.05
FAIR HEARINGS, 1570 Definitions, 1570.01 General Provisions, 1570.05 Resolution of Dispute prior to, 1570.15 Eligibility Pending, 1570.20 Procedures, 1570.25, P-1570.10, P-1570.15 Appeals of Decision, 1570.30
FOSTER CARE GRANTS, 5050.37
FUNERAL - See " Burial "
- G -
GOOD CAUSE, 3515.25, P-3515.15
GRATUITIES, 5050.45
- H -
HEARING Right to a, 1005.15
HOME EQUITY CONVERSION PLANS, 5050.47
HOUSEHOLD Nonessential Items, 4030.60 Repair or Replacement of Essential Items - AFDC, 4515.25, P-4515.25 Purchase, Replacement or Repair of Essential Items- AABD, 4525.25 P-4525.25 Three Generations, 2005.35, P-2005.30
HOUSING Emergency - AFDC, 4515.05, P-4515.05 Rated Facilities - AABD, 4520.10 Non-rated - AABD, 4520.15 Emergency - AABD, 4525.05, P-4525.05 Emergency - AFDC, 4515.05, P-4515.05
- I -
IDENTIFICATION CARDS, 1505.50
IEVS-METHOD OF VERIFICATION, 1540.15
IFG INDIVIDUAL AND FAMILY GRANT PROGRAM, 8025 Rights and Responsibilities, 8025.05 Application Process, 8025.10, P-8025.05 Reconsideration, 8025.15 Notification to Assistance Unit, 8025.20 Fair Hearings, 8025.25 Assistance Unit Composition, 8025.30 Categorical Eligibility Requirement, 8025.35 Treatment of Income and Assets, 8025.40 Technical Eligibility Requirements, 8025.45 Procedural Eligibility Requirements, 8025.50 Standards of Assistance, 8025.55 Determination of Eligibility and Amount of Assistance, 8025.60 Recovery, 8025.70, P-8025.20 How to Determine Eligibility and Amount of Assistance, 8025.10 Verification of, 8099.25, P-8099.25 Benefit Issuance, 8025.65, P-8025.15
INACCESSIBLE INCOME - See "Income Inaccessible"
INCAPACITY Physical, 2510.20 Mental, 2510.20 Processing a Claim for Physical, P-2510.50 Processing a Claim for Mental, P-2510.50
INCOME STANDARDS Medical Assistance, 4530
INCOME LIMITS Categorically Needy - MA, 4530.05, P-4530.05 Special Categorically Needy - MA, 4530.10, P-4530.10 Medically Needy - MA, 4530.15, P-4530.15
INCOME Definitions, 5000.01 Considered - General Principles, 5005, P-5005 Treatment of Inaccessible, 5010, P-5010 Treatment of Excluded, 5015 Types of Excluded - AFDC, FMA, 5015.05 Types of Excluded - AABD, MAABD, 5015.10 Types of Excluded - FS, 5015.15
INCOME (con't)
Deemed - Coverage Groups and Related Methodologies-FMA, 5020.07 Parents, Guardians, Stepparents & Spouses of Dependent Children - AFDC/FMA, 5020.10, P-5020.10 Sponsors of Aliens - AFDC/FMA, 5020.15, P-5020.15 Spouses of Non-Parent, Caretaker Relative - AFDC/FMA, 5020.20, P-5020.20 Ineligible Parent of Dependent Child - AFDC, 5020.23, P-5020.23 Disqualified Individuals - AFDC/FMA, 5020.25, P-5020.25 Deemors of Pregnant Women - AFDC/FMA, 5020.30, P-5020.30 Coverage Groups and Related Methodology - FMA, 5020.33 Spouses, Parents, Siblings and Half-Siblings of Ribicoff Children; MAABD Parents of FMA Children-FMA, 5020.34, P-5020.45 Stepparents, Parents of Minor Caretaker Relatives, Spouses of Dependent Children - FMA, 5020.35, P-5020.35 Spouses of Non-parent Caretaker Relatives - FMA, 5020.37, P-5020.37 Parents of Children Receiving SSI - FMA, 5020.39, P-5020.39 Ineligible Parent of Dependent Children - FMA, 5020.41, P-5020.41 Spouses/Children of Pregnant Women - FMA, 5020.43, P-5020.43 Disqualified Persons - FMA, 5020.47, P-5020.47 Sponsors of Aliens - AABD, 5020.60, P-5020.60 Parents of Blind Children - AABD, 5020.65, P-5020.65 Spouses - AABD, 5020.70, P-5020.70 Spouses/Parents, 5020.75, P-5020.75 Disqualified Persons - FS, 5020.85, P-5020.85 Sponsors of Aliens - FS, 5020.90, P-5020.90 Conversion to Monthly Amounts, 5025 Received Monthly or More Frequently, 5025.05, P-5025.05 Received Less Frequently than Monthly, 5025.10, P-5025.05 Self-Employment, 5025.15, P-5025.15 Disregards, 5030 Disregards - Earned - AFDC/FMA, 5030.05, P-5030.05 Disregards -Earned - AABD/MAABD, 5030.10, P-5030.10 Disregards - Unearned - AABD/MAABD, 5030.15, P-5030.15 Disregards - FS, 5030.20, P-5030.20 Deductions, 5035 Employment Deductions - AFDC/FMA, 5035.05 Employment Deductions - AABD/MAABD, 5035.10 Deductions - FS, 5035.15 PostEligibility Treatment for LTCF/CBS Units Without Community Spouses - MAABD, 5035.20 With Community Spouses - MAABD, 5035.25 Applied, 5045 Applied-Calculation Method - AFDC/FMA, 5045.05, P-5045.10 Applied-Calculation Method - AABC, MAABD, 5045.15, P-5045.20
INCOME (con't) Applied-Calculation Method - FS, 5045.15, P-5045.30 Applied-Post-Eligibility Treatment of Income - MA, 5045.20 Applied-LTCF/Residents - MA, P-5045.25 Applied - CBS - MA, P-5045.27 Treatment of Specific Types, 5050 In-Kind, 5050.49 Intermittent, 5050.53, P-5050.53 Rental, 5050.69 Roomers/Boarders, 5050.73, P-5050.25, P-5050.30 Student, 5050.77, P-5050.77 Uniformed Services, 5050.85 WIN, 5050.89 Workfare, 5050.93 Verification, 5099.05
INCOME ELIGIBILITY Definitions, 5500.01 General Principles, 5503 When Determined, 5505, P-5505.05 Durational Limits, 5510 Needs Limits, 5515 Tests, 5520 AFDC Tests, 5520.05, P-5520.05 AABD Tests, 5520.10, P-5520.10 MA Tests: Categorically Needy, 5520.15, P-5520.15 MA Tests: Use of Medical Expenses for Spend-Down Process, P-5520.25 MA Tests: Community Spend-Down Methodology, 5520.20 MA Tests: LTCF Spend-Down Methodology, 5520.35, P-5520.30 FS Test, 5520.40, P-5520.35 Verification, 5599 Standards - Medical Assistance, 4530
INDIVIDUALS, Qualifications of - See "Qualifications of Individuals"
INFORMATION Keeping Confidential, 1015.20 Disclosure of, 1020, P-1020.10 Types to be Safeguarded, 1020.05 Releasing, 1020.10 Recording, P-1555.05
INSTITUTIONAL Verification of Status, 3099.15, P-3099.15
INSURANCE Authorizing Payment For, P-9040.05 Health/Hospital Premiums, 9040 General Provisions, 9040.05
INTEREST, 5050.21
INTERIM ACTIVITY, 1555
INTERVIEW Completing the, P-1505.30 Application, 1505.30, P-1505.25 Redetermination, 1545.20, P-1545.15 Interviews, Application, 1505.30, P-1505.25
ISSUANCE SYSTEMS Basic Provisions, 6535.05 Choice of Issuance Method, 6535.10 Resumption of General Mail Delivery, 6535.10 Application of Policy, P-6535.05 Determining the Method, P-6535.10 Notifying Assistance Units, 6535.15 Verifying Identity/Authorization, P-6535.20
- J -
JOB CONNECTION Special Benefits, 9045 Conciliation, 9535
JTPA INCOME, 5050.57
- K -
- L -
LIENS In AFDC Program, 7510.05 In AABD Program, 7510.10 In MA Program, 7510.15, P-7510.10
LIFE USE, 4030.35, P-4030.35
LOANS, 4030.40, 5050.61 Verification, 5099.20
LUMP SUM, 5050.65, P-5050.05, P-5050.10, P-5050.15, P-5050.20
- M -
MAILING ADDRESS Where Benefits are Mailed, 6525.05 Post Office Box, 6525.10 Determining the, P-6525.05
MEALS-ON-WHEELS - AFDC, 4515.15, P-4515.15, 4525.10, P-4525.10
MEALS Restaurant - AFDC, 4515.35, P-4515.35, 4525.35, P-4525.35
MEDICARE Part A and B Premiums, 9015 General Provisions, 9015.05 Providing the Benefit, P-9015.05
MONTHLY REPORTING, 1550 Units Required to Report, 1550.05
MORTGAGE - See "Notes, Mortgage"
MOTOR VEHICLES - See "Vehicles, Motor"
MOVING EXPENSES AFDC, 4515.20, P-4515.20 AABD, 4525.15, P-4525.15
- N -
NEEDS Basic - AFDC, 4510 The Monthly Basic Standard - AFDC, 4510.05, P-4510.05 Regions - AFDC, 4510.10 Standards of Assistance - AFDC, 4510.15 Special - AFDC, 4515 Basic - AABD, 4520 Basic - General Requirements - AABD, 4520.05, P4520.05 Determining Basic for Individuals in Both Rated and Non-rated Housing During a Month - AABD, P-4520.10 Determining Basic for Individuals in Non-licensed Room and Board Arrangements - AABD, P-4520.15 Determining Basic for Rated Facilities - AABD, P-4520.20 Special - AABD, 4525 Group - Composition, 5515.05 Group - Needs/Income Limits, 5515.10, P-5515.05 Basic - AFDC, 4510 Group - Needs/Income Limits, 5515.10, P-5515.05
NON-COOPERATION Penalty for, 2005.30
NOTES Mortgage, 4030.50
NOTICES Redetermination, 1545.15, P-1545.10
NOTIFICATION, 1555.25
- O -
OVERPAYMENT AFDC - Computing the amount of, P-7030.05 AABD - General Principles 7030.05 AABD - Computation of 7030.10,P-7030.05 MA - General Principles 7040.05 MA - Computation of 7040.10, P-7040.05 FS - General Principles 7045.05 FS - Computation of 7045.15, P-7045.05
OWNERSHIP Determination of, 4010 Record Owner v. Legal Owner, 4010.05, P-4010.05 Determination - Verification of, 4099.10, P-4099.10
- P - PARENT Determination of, 2510.15
PARENTAL FUNCTIONING Determining, P-2510.40
PATERNITY Establishing, 3515.20, P-3515.10
PAYEE Medical Benefits, 6510.15 Food Stamp Benefits, 6510.20 Designating the, P-6510.05 Cash Payments, 6510.05 Protective In Restricted Payment Cases, 6510.10, P-6510.10
PAYMENTS Lump-Sum, 4030.45 Corrective, 4030.15
PENSION PAYMENTS, 5050.09
POLICIES Life Insurance, 4030.30, P-4030.25
PREGNANCY, 2520, 2520.05, P-2520.05
PRINCIPAL WAGE EARNER Determination of, 2510.30 Designating, P-2510.55
PROCESSING REQUIREMENTS Categorical Eligibility, 1510
PROCESSING STANDARDS, Application - See Application Processing Standard
PROPERTY Home, 4030.20, P-4030.20 Non-home, 4030.65, P-4030.40 Repairs, 9025 Authorizing Payment for Repairs, P-9025.05
- Q -
QUALIFICATIONS OF INDIVIDUALS, 1599.05, P-1500.05
QUALIFIED MEDICARE BENEFICIARIES, 2540.94, P-2540.94, P-4530.20
- R -
RECOUPMENT Withholdings, 5050.66 AFDC - Determination of the Method, 7030.15, P-7030.10 AFDC - Computation of the Rate, 7030.20, P-7030.15 AFDC - Establishing Billing Controls, P-7030.20 AABD - Determination of the Method, 7035.15, P-7030.10 AABD - Computation of the Rate, 7035.20, P-7035.15 MA - Determining the Method, P-7040.10 MA - Computing the Rate, P-7040.15 MA - Establishing Billing Controls, P-7040.20 Limitations to, 7045.10 FS - Initation of Action, 7045.20 FS - Determination of the Method, 7045.25, P-7045.10 FS - Computation of the Rate, 7045.30, P-7045.15
RECOVERY Definitions, 7500.01 By Assignment, 7505 By Security Mortgage, 7505 From Real Property: Liens, 7510, 7515 Methods of Acquiring Property, 7515.05 Methods of, 7515.10, P7515.10 From Third Parties, 7520 Legally Liable Relatives, 7520.05, P-7520.05 Private Insurance Carriers, 7520.10 From Estates, 7525.05 Of Medicaid from Estates, 7525.10 By Legal Action, 7530 Of Financial Assistance by Legal Action, 7530.05 Of Medicaid by Legal Action, 7530.10 From Estates, 7525.05 Of Medicaid from Estates, 7525.10
REDETERMINATION General Requirements, 1545.05 Periods, 1545.10, P-1545.05 Form, 1545.25, P-1545.29 Timeliness Requirements, 1545.35 Processing Standards, 1545.40, P-1545.30, P-1545.35 Special Processing Requirements, 1545.45 Process, 1545
REFUGEE ASSISTANCE PROGRAM, 8010 Based on AFDC, 8010.05, P-8010.05 Based on Family Medicaid, 8010.10, P-8010.10 Unit Composition, 8010.15, P-8010.20 Categorical Eligibility Requirements, 8010.20 Treatment of Income, 8010.25
REFUGEE ASSISTANCE PROGRAM (con't) Treatment of Assets, 8010.30 Technical Eligibility Requirements, 8010.35 Procedural Eligibility Requirements, 8010.40 Standards of Assistance, 8010.45 Income Eligibility, 8010.50 Calculation of Benefits, 8010.55 Refugee Benefit Issuance, 8010.60 Benefit Error, 8010.65 Recovery, 8010.70 Determining Eligibility for Other PA Programs, P-8010.15 Referring to Case Management Agencies, P-8010.25 Determining Eligibility of Certain RMA Coverage Groups, P-8010.30 Verification of, 8099.10, P-8099.10 Refugee Categorical Eligibility Requirements, 8010.20
REFUNDS Income Tax, 4030.25
REFUSE Collection Fee - AABD, 4525.30, P-4525.30
RELATIONSHIP Degree of, 2515.05
RELATIVE Living with Specified, 2515, 2540.68, P-2540.68
RELOCATION ASSISTANCE BENEFITS, 5050.67
RENTAL Security Deposits, 4030.70
REPATRIATION Rights and Responsibilities, 8030.05 Eligibility Process, 8030.10, P-8030.05 Special Notification Requirements, 8030.15 Assistance Unit Composition, 8030.20 Categorical Eligibility Requirements, 8030.25 Treatment of Income, 8030.30 Treatment of Assets, 8030.35 Technical Eligibility Requirements, 8030.40 Procedural Eligibility Requirements, 8030.45 Standards of Assistance, 8030.50 Calculation of Benefits, 8030.55, P-8030.15 Benefit Issuance, 8030.60, P-8030.20 Recovery, 8030.65 D.O. Steps in the Case Maintenance Process, P-8030.10 Verification of, 8099.30
RESIDENCY Verification of, 3099.10, P-3099.10
RESPONSIBILITIES Of Applicants/Recipients, 1010 Departmental, 1015, 1505.05, 1000.01
RESTAURANT MEALS - See " Meals, Restaurant "
RIGHTS Of Applicants/Recipients, 1010
ROYALTIES, 5050.21
- S -
SAVE Method of Verification, 1540.15 Primary Verification, P-3099.07 Secondary Verification, P-3099.08
SCHOOL Special Expenses - AFDC, 4515.50, P-4515.50
SECURITY MORTGAGE Granting a, 3530.05
SECURITY DEPOSIT - See " Deposit, Security"
SECURITY MORTGAGE, 7505.15
SEVERANCE PAY, 5050.87
SICK PAY, 5050.75
SOCIAL SECURITY NUMBER, 3505 Basic Provisions, 3505.05 Disclosure of, 3505.10 Application for, 3505.15 Penalties for not Applying, 3505.20 Confirming Number, P-3505.05 Referring to SSA for an Application, P-3505.10 Verification of, 3599.05, P-3599.05
SPECIAL BENEFITS Verification of, 9099.05, P-9099.05, 9000
SPECIAL PROGRAMS Definitions, 8000.01
SPECIAL NEEDS - See "Needs, Special" For All Programs
STANDARD OF ASSISTANCE, 4500 Definitions, 4500.01 Need/Income, 4505 Assistance, 4505.05 Need, 4505.10, P-4505.05 Verification of, 4599 Verification Requirements, 4599.05, P-4599.05
STOCKS, 4030.75
STORAGE
Charges - AFDC, 4515.55, P-4515.55 AABD, 4525.50, P-4525.50
STRIKER STATUS - AFDC, FS, 3035 Basic Provisions - AFDC, 3035.05 Basic Provisions - FS, 3035.10 AFDC Procedures - Application, P-3035.10 Computing Food Stamps for, P-3035.15 Verification of, 3099.35, P-3099.35 Status - AFDC, FS, 3035 AFDC Procedures - Application, P-3035.10 Computing Food Stamps for, P-3035.15 Verification of, 3099.35, P-3099.35
STUDENT STATUS, 3020 Eligible, 3099.20, P-3099.20 Verification of Status, 5099.25 SUPERVISION Continuous, 2515.05
SUPPORT Who is Liable for, 3515.05 Assignment of Rights to, 3515.10 Cooperation in Securing, 3515.15 Initiating, P-3515.05 Granting Time Limit Extensions, P-3515.20 Who is Liable for, 3515.05 Assignment of Rights to, 3515.10 Cooperation in Securing, 3515.15 Initiating, P-3515.05 Verificaton of Securing, 3599.15, P-3599.15 Payment, 5050.81
- T -
TELEPHONE Emergency Installation - AFDC, 4515.10, P-4515.10 Installment - AABD, 4525.55, P-4525.55
THERAPEUTIC DIETS - See " Diets, Therapeutic"
TIMELY ACTION Taking, P-1555.10
TRANSFER Assets - All Programs, 3025 Effective Dates-All Programs, 3025.03 Basic Provisions - AABD, AFDC, MA, 3025.05 For Purpose of Qualifying - AABD, AFDC, MA, 3025.10 Not for the Purpose of Qualifying - AABD, AFDC, MA, 3025.15 Compensation - AABD, AFDC, MA, 3025.20 Special Circumstances - AABD, AFDC, MA, 3025.25 Notification/Rebuttal - AABD, AFDC, MA, 3025.30, P-3025.25 Penalty, 3025.35, P-3025.30 Withdrawls, - AABD, AFDC, MA, 3025.40, P-3025.35 Basic Provisions - FS, 3025.45 Penalty-FS, 3025.50 Documenting, P-3025.05 Exploring Transfers, P-3025.10 Evaluating Transfers, P-3025.15 Evaluating Transfers Between Spouses, P-3025.18 Determining Fair Market Value, P-3025.20 Adjustments, P-3025.40 Assets-MA, 3026 Effective Dates-MA, 3026.03 Basic Provisions-MA, 3026.05 Transfers Not Resulting in a Penalty-MA, 3026.10 Transfers Made Exclusively for Reasons other Than Qualifying-MA, 3026.15 Transfers Made in Return for Other Valuable Consideration-MA, 3026.20 Under Hardship-MA, 3026.25 Compensation-MA, 3026.30 Notification and Rebuttal-MA, 3026.35 Withdrawls-MA, 3026.40 Verification of, 3099.25
TRANSPORTATION Out of State, 9010 General Provision, 9010.05 Preparing the Authorization Packet, P-9010.05 Providing the Benefit, P-9010.10
TRUSTS, 4030.80, P-4030.45, 5050.21
- U -
UNDERPAYMENT AFDC - General Principles, 7010.05 AFDC - Computation of, 7010.10, P-7010.10 AFDC - Issuing a Corrective payment, P-7010.05 AABD - General Principles, 7015.05 AABD - Computation of, 7015.10, P-7015.10
UNEMPLOYED PARENT Conditions for Qualifying as, 2510.35 Determining Conditions for Qualifying as, P-2510.60
UTILITY Excess Costs, 9020 General Provision, 9020.05 Completing the Authorization Request, P-9020.05
- V -
VACATION PAY, 5050.87
VEHICLES, MOTOR, 4030.55, P-4030.35
VERIFICATION General Principles of, 1540 Requirements/Penalties, 1540.05 Unit/Agency Responsibilities, 1540.10 Methods of, 1540.15, P-1540.15
VOLUNTARY QUIT Principal Wage Earner - FS, 3040.10 FS, 3040 Basic Provisions - FS, 3040.05 Good Cause - FS, 3040.15 Penalty - FS, 3040.20 Determining a Voluntary Quit - FS, P-3040.05 Verification of, 3099.40, P-3099.40
- W -
WORK SUPPLEMENTATION PROGRAM Special Programs, 8045
X-Y-Z
ZERO BENEFIT Cases with, 1535 Processing Requirements, 1535.05, P-1535.05 Changes to Issuance Status, 1535.10 Notification, 1535.15
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL
INDEX ______________________________________________________________________________ Date: 1-1-89 Transmittal: UP-88-55 0600 ______________________________________________________________________________
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL
INDEX ______________________________________________________________________________ Date: 1-1-89 Transmittal: UP-88-55 0600 ______________________________________________________________________________
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL AFDC PROGRAM REFERENCES ________________________________________________________________________________ Date: 10-1-01 Transmittal: UP-01-16 0800 _______________________________________________________________________________
Effective October 1, 2001 the Aid for Dependent Children (AFDC) program no longer exists. All references to AFDC in the UPM now only refer to certain provisions of Medicaid and State Administered General Assistance (SAGA).
CONNECTICUT DEPARTMENT Of SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-1-04 Transmittal: UP-04-18 1000 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL PROGRAMS ______________________________________________________________________________ Subject:
______________________________________________________________________________
1000 The assistance unit has the right to apply for assistance from the Department. The unit has other rights, such as the right to be treated without discrimination by the Department. Subject to the conditions outlined in Section 1570, the unit also has the right to a Fair Hearing if it is dissatisfied with a decision or delay in a decision regarding their eligibility or level of benefits for certain programs administered by the Department. Also, the assistance unit has the right to file a complaint, if they feel they have been subject to discrimination by the Department.
An assistance unit also has certain responsibilities, such as supplying information the Department needs to determine the unit's eligibility, reporting changes in circumstances, and meeting certain procedural requirements.
The Department has certain responsibilities, also, in its relationship with the assistance unit. The Department is responsible for determining the unit's eligibility objectively and in a timely manner. It must base its decision on state and federal law.
In this section the rights and responsibilities of applicants and recipients are described in detail, as are the Department's responsibilities. In addition, there is a separate chapter describing the Department's policies and procedures regarding the safeguarding of information.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1000.01 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Programs: ALL PROGRAMS ______________________________________________________________________________ Subject: Definitions ______________________________________________________________________________
1000.01 Case Record
A case record is any collection of personal data which is collected, maintained or disseminated by the Department.
Correctional Facility
A correctional facility is an institution for prisoners, including those who have been arrested or detained pending disposition of charges or are held under court order as material witnesses or juveniles.
Disability
For the purposes of this section, disability means a physical or mental impairment that substantially limits one or more major life activities of such individual, a record of such an impairment or being regarded as having such an impairment.
Disclosure
Disclosure is the availability or release of a record about an individual to another party.
Major Life Activities
Major Life Activities means functions such as, but not limited to, caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working.
Mental Disease Facility
A mental disease facility is a hospital, nursing facility or other institution of more than 16 beds, primarily for the diagnosis, treatment or care of persons with mental diseases, not including mental retardation.
Personal Data
Personal data is any information about an assistance unit's education, finances, medical or emotional condition or history, employment or business history, family or personal relationships, reputation or character which because of name, identifying number, mark or description can be readily associated with a particular unit.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1000.01 page 2 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Programs: ALL PROGRAMS ______________________________________________________________________________ Subject: Definitions ______________________________________________________________________________
1000.01 Primary Language
Primary language is the language normally used by an individual to conduct day-to-day affairs. Primary language includes the language spoken at home, or the language used to conduct essential functions outside the home such as shopping, working, and also includes worshiping, and American Sign Language.
Reasonable Accommodation
The term reasonable accommodation means reasonable modifications to the Department’s policies, practices, or procedures that are necessary to allow an individual with a disability to participate meaningfully in the services, benefits, activities, and programs administered by the Department including, but not limited to, alterations in the eligibility and redetermination process that are necessary as a result of the individual’s disability to allow him or her to establish and maintain eligibility notwithstanding his or her disability. A reasonable modification does not include a waiver of any essential factor of eligibility or modification of the Department’s policies, practices, or procedures that would either fundamentally alter the nature of the program or cause undue fiscal or administrative burden on the Department.
Record of Such an Impairment
Record of such an impairment means that the individual has a history of having a mental or physical impairment that substantially limits one or more major life activities.
Regarded as Having an Impairment
Regarded as having an impairment means that the individual is regarded by, or treated by, a worker or the Department as having a mental or physical impairment that substantially limits one or more major life activities, whether or not the individual actually has such an impairment.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 05-10-10 Transmittal: UP-10-03 1005 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________________
Subject: ______________________________________________________________________________
1005 An applicant or recipient of Public Assistance or Supplemental Nutrition Assistance Program (SNAP) has certain rights which are guaranteed by the United States Constitution, the Social Security Act, the Food and Nutrition Act of 2008, Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, and Title II of the Americans with Disabilities Act of 1990 (ADA). As the agency which administers the Public Assistance and SNAP programs in the state, the Department of Social Services is responsible to provide such services in a manner that conforms to the requirements of the foregoing laws.
This chapter describes the rights to which all applicants and recipients of assistance are entitled under state and federal law.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-1-04 Transmittal: UP-04-18 1005.05 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________________ Subject: Right to Participate in Application Process ______________________________________________________________________________
1005.05 A. Right to File an Application
The assistance unit has the right to apply for assistance under any of the programs administered by the Department.
B. Right to Withdraw an Application
The assistance unit has the right to voluntarily withdraw its application for assistance at any time before the Department determines the unit's eligibility.
C. Right to Request Discontinuance
The assistance unit has the right to voluntarily have its assistance discontinued at any time if the unit no longer wishes to receive benefits.
D. Right to Reapply
The assistance unit has the right to reapply at any time after it has been discontinued or has withdrawn its application for assistance.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-4-09 Transmittal: UP-09-20 1005.10 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________________ Subject: Right to Fair Treatment ______________________________________________________________________________
1005.10 A. General Principle
The assistance unit has the right to be treated fairly by the Department regardless of the unit's race, color, religious creed, sex, marital status, age, national origin, ancestry, criminal record, political beliefs, sexual orientation, mental retardation, mental disability, learning disability or physical disability, including, but not limited, to blindness.
The Department shall notify the assistance unit of its right to non-discrimination, of the availability of accommodations for individuals with a disability and the complaint procedure on its application and redetermination of eligibility forms and on each notice of action affecting eligibility for, or the amount of, benefits. The Department shall also provide oral notice at face-to-face intake and redetermination interviews.
B Right to Reasonable Accommodation for Assistance Units
An individual with a disability has a right to receive a reasonable accommodation from the Department when a reasonable accommodation is necessary to allow the individual to have an equally effective and meaningful opportunity to participate in, and benefit from, programs administered by the Department, if the individual has a disability, or is regarded by the worker or the Department as having a disability, and a modification in the Department’s policies, practices or procedures is required in order to allow the individual to participate. Accommodations may be appropriate at any point of interaction between the individual and the Department. Any accommodation must be reasonable and not cause a fundamental alteration in the program or cause undue administrative or fiscal burden on the Department. Reasonable accommodations do not include waivers of essential factors of eligibility.
When an accommodation is required, the accommodation that is provided is determined by the Department through an interactive process on a case by case basis that involves both the client and the Department. The Department takes into account both the wishes of the client and the availability of any less burdensome, alternative accommodations that would allow the client to participate in activities, program or services.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-4-09 Transmittal: UP-09-20 1005.10 page 2 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________________ Subject: Right to Fair Treatment ______________________________________________________________________________
B. Right to a Reasonable Accommodation for Assistance Units (continued)
The following are not considered a reasonable accommodation as they constitute a fundamental alteration to the Department’s programs:
Waiving the requirement that an applicant for benefits based on disability provide medical documentation to substantiate that he or she meets a program’s disability criteria.
Waiving the requirement that verification of income or assets be provided in order to qualify for programs that require such verification.
If the Department determines that an individual who is applying for assistance has a disability that requires that the Department provide an accommodation of assistance in obtaining the required medical verifications, the Department shall offer to provide such assistance as a reasonable accommodation that includes, but is not limited to, writing to the medical provider to obtain existing documentation of the disability, provided:
the client cannot obtain the required verification himself or herself as a result of his or her disability; and
there is no authorized representative or other person identified by the client willing and able to act on behalf of the client.
The Department shall inform the assistance unit in writing or orally that reasonable accommodations are available if a member of the assistance unit has a disability and an accommodation is required in order to allow the individual an equally effective and meaningful opportunity to participate in activities, services or programs provided by the Department
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-4-09 Transmittal: UP-09-20 1005.10 page 3 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________________ Subject: Right to Fair Treatment ______________________________________________________________________________
1005.10 B. Right to a Reasonable Accommodation for Assistance Units (continued)
In addition to providing notice of availability of accommodations at the time of application, redetermination and notice of action, the Department shall inform assistance units of the availability of reasonable accommodations whenever it becomes apparent to the worker or the Department that an individual with a disability may need a reasonable accommodation in order to allow the individual an equally effective and meaningful opportunity to participate in activities, services or programs provided by the Department.
The Department shall review whether an accommodation is required in every case where an individual requests an accommodation, including when a client requests an accommodation after being informed of the availability of accommodations because it became apparent to the Department that the client may need an accommodation in order to participate meaningfully in Department programs, activities or services.
If there is no record of the individual’s disability and the individual is not regarded as having a disability, then the individual has the burden of demonstrating the existence of a disability.
An individual with a disability must demonstrate that an accommodation is needed in order to enable the client to participate meaningfully in the Department’s programs, activities or services.
Individuals or their representative have the option to request an accommodation, either in writing or orally, from their eligibility worker or from the agency’s ADA coordinator.
Upon receipt of a request for an accommodation:
the Department’s eligibility worker or ADA coordinator shall inform the client of any information that the eligibility worker or ADA coordinator needs in order to make a determination on the request for an accommodation, and specify a date for the documentation to be provided and;
the Department’s eligibility worker shall offer assistance in obtaining existing documentation that is necessary to determine eligibility for an accommodation, if it appears likely to the worker that the client cannot obtain such documentation without assistance as a result of his or her disability and there is no authorized representative or other person identified by the client willing and able to act on behalf of the client.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-4-09 Transmittal: UP-09-20 1005.10 page 4 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________________ Subject: Right to Fair Treatment ______________________________________________________________________________
1005.10 B. Right to a Reasonable Accommodation for Assistance Units (continued)
The existence of a disability is not sufficient to demonstrate the need for an accommodation when:
the resulting functional limitations do not substantially interfere with the client’s ability to participate in the activities, services and programs administered by the Department without an accommodation; or
an authorized representative identified by the assistance unit is available, willing, and able to perform the required tasks on behalf of the individual.
The need for an accommodation and the availability of an accommodation is determined by the eligibility worker. Approval of the eligibility worker’s immediate supervisor or regional manager is secured when the accommodation requires agency resources beyond the eligibility worker’s control, but within the control of the regional office. Accommodations that involve significantly greater administrative or fiscal burden may only be granted after consultation with the Department’s ADA coordinator. The following are examples of accommodations that are presumed to be reasonable and may be offered by the eligibility worker:
maintaining a list of visually or cognitively impaired persons requesting to be called prior to the mailing of notices;
waiving office interviews or conducting interviews via the telephone;
extending deadlines for providing documentation related to factors of eligibility; requesting the assistance of a specialized worker to help complete necessary forms, gather necessary documentation. Assist with making medical appointments, or assist with collecting medical documentation in order to establish disability where disability is a factor of eligibility;
providing forms or materials in Braille, tape or large print; and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-4-09 Transmittal: UP-09-20 1005.10 page 5 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS _____________________________________________________________________________ Subject: Right to Fair Treatment ______________________________________________________________________________
1005.10 B. 13. Right to a Reasonable Accommodation for Assistance Units (continued)
requesting the assignment of a social worker to conduct a home visit to explain notices or explain or help complete forms and review and receive documentation.
Home visits are necessary if a face-to-face interview is required as part of the eligibility process and cannot be waived, the assistance unit cannot come to the Regional Office or sub-office because of a disability and there is no authorized representative available to attend the interview.
The eligibility worker shall document each request for an accommodation in the client’s case file, and shall indicate the result thereof in the file (including when the accommodation is granted or denied by the ADA coordinator). If the accommodation is granted, the worker shall record the nature of the accommodation in the assistance unit’s case record in a manner that Department staff will easily recognize and utilize when contacting the assistance unit. The worker shall also record the reason for denial in the client’s file, if the request for accommodation is not granted.
When an accommodation is requested, whether it is granted or not, the eligibility worker shall inform the individual that he or she may request that the ADA coordinator review the determination of the eligibility worker.
Before taking any action on a case, the worker shall review whether a need for accommodation is recorded and whether the Department provided the necessary resources required to accommodate the individual.
All requests for accommodation directed to the Department’s ADA coordinator shall be acted upon in accordance with the Department’s ADA Policy Statement for Applicants/Recipients. The ADA coordinator shall:
acknowledge all requests for accommodation in writing within ten (10) working days of receipt of the request by the ADA coordinator; and
approve or deny all requests not later than twenty working days after the date of receipt, unless additional medical or technical information or evaluation is necessary.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-4-09 Transmittal: UP-09-20 1005.10 page 6 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS _____________________________________________________________________________ Subject: Right to Fair Treatment ______________________________________________________________________________
1005.10 B. Right to a Reasonable Accommodation for Assistance Units (continued)
An individual may request that the Department’s Deputy Commissioner for Administration review the determination of the Department’s ADA coordinator. All requests for review by the Deputy Commissioner for Administration shall be:
in writing; and
b. received by the Department’s Deputy Commissioner for Administration not later than fifteen days after the date of issuance of the ADA coordinator’s decision.
The determination by the Deputy Commissioner for Administration constitutes the Department’s final administrative determination and is only subject to whatever external review may be available to the applicant or recipient by operation of law.
C. Spanish Speaking, Other Non-English Speaking, or Limited-English Proficiency (LEP) Assistance Units
If the head of an assistance unit or unit's representative is Spanish speaking, non-English speaking or has limited-English proficiency and requests that the eligibility process be conducted in his or her primary language, the Department explains to the assistance unit that the unit has the right to an interpreter provided by the Department instead of using a family member, friend or client advocate as an interpreter.
The Department shall conduct the initial and periodic eligibility interviews and interim interviews in the language normally used by the assistance unit or assistance unit's representative, as follows:
The Department shall use a bilingual eligibility worker or any other interpreter provided by the Department;
the Department shall obtain an interpreter; or
the Department may use a family member or friend age 16 or older as an interpreter, if the assistance unit expressly requests such an arrangement.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-4-09 Transmittal: UP-09-20 1005.10 page 7 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ________________________________________________________________________
Subject: Right to Fair Treatment ______________________________________________________________________________ 1005.10 C. Spanish Speaking, Other Non-English Speaking, or Limited-English Proficiency (LEP) Assistance Units (continued)
For Spanish speaking assistance units, the Department shall use applications, redeterminations and interim activity forms and notices written in Spanish during the eligibility process or at time of interim contact.
The Department shall require that the interpreter sign all forms which the head of the assistance unit or the assistance unit's representative signs to acknowledge that he or she has informed the unit in the unit's primary language.
Upon request, the Department shall provide an interpreter for any Spanish speaking, non-English speaking or limited-English proficiency assistance unit when such services are necessary for communicating with the unit.
An assistance unit speaking Spanish has the right to receive application forms and notices in Spanish.
The services of the interpreter are used at the time of each contact with the assistance unit during the eligibility determination process and during any interim case actions.
The Department uses any employee of the Department or an interpreter from outside the Department to the extent that such services are available.
The Department uses family members, friends or client advocates of Spanish speaking, non-English speaking or limited-English proficiency (LEP) assistance units as interpreters only when assistance unit expressly requests such an arrangement.
Department reserves the right to provide its own interpreter to assist with communication, if the Department determines that the interpreter provided by the assistance unit is not accurately transmitting information between the Department and the assistance unit.
Children under age 16 are not permitted to act as interpreters for the assistance unit.
The Department does not require a Spanish speaking, non-English speaking, or limited-English proficiency (LEP) assistance unit to pay for the services of any interpreter used by the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-1-04 Transmittal: UP-04-18 P-1005.10 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________ _____ Subject: Right to Fair Treatment ______________________________________________________________________________
P-1005.10 Assistance Units with Members who have a Disability
Affix form W-117 "Accommodations Required” green tag to the ready reference file to identify recipients with a disability for whom an accommodation is to be provided. Write the type of accommodation to be provided on the tag.
Record any impairments requiring an accommodation on the EMS Address (ADDR) screen. Include remarks indicating the specific nature of the accommodation.
Spanish Speaking, Other Non-English Speaking, or Limited-English Proficiency (LEP) Assistance Units
Affix form W-117 “Accommodations Required” green tag to identify that this is a Spanish speaking, non-English speaking, or LEP communication case and note the unit's primary language.
Record the assistance unit's primary language in EMS.
Additional conditions for Assistance Units with Hearing Impaired Members
Inform the unit that the Department will provide interpretive services for the interview process and for any additional communications upon request. If the unit expressly asks, allow the unit to bring someone age of 16 or older to the initial and periodic eligibility interviews to help ensure that the unit understands the questions asked at the interviews. In all cases an individual with a hearing impairment is to be given the same opportunities as other non-English speaking units.
Inform the unit that the Department's Central Office Information Unit has a TDD machine for those persons who have similar machines in their home and wish to use this method of accommodation for information purposes.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-4- 09 Transmittal: UP-09-20 P-1005.10 page 2 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________ _____ Subject: Right to Fair Treatment ______________________________________________________________________________
P-1005.10 Additional conditions for Assistance Units with Visually Impaired Members
Send a memo to the Director of Public and Government Relations, Central Office, listing the name and telephone number of any individual who is blind or visually-impaired and requests to be called prior to the Department mailing a mass notice.
Call the assistance unit whenever an EMS alert #119 is generated, if the client requests a call as an accommodation whenever an EMS notice is issued.
Assistance Units with Authorized Representatives SHAPE \* MERGEFORMAT An authorized representative must: SHAPE \* MERGEFORMAT be available, willing and able to perform the required task on behalf of the assistance unit and; SHAPE \* MERGEFORMAT adhere to appropriate fiduciary responsibilities as determined by the Department and;
communicate clearly and effectively with the assistance unit.
If the authorized representative fails to meet any of the requirements as listed above under Assistance Units with Authorized Representatives then;
the Department shall notify the assistance unit and;
in the absence of the assistance unit appointing a replacement authorized representative, the Department shall determine the need for an accommodation (cross reference 1005.10 B2 and 1005.10 B13).
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-1-04 Transmittal: UP-04-18 1005.15 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants PROGRAMS ______________________________________________________________________________ Subject: Right to File a Discrimination Complaint and Right to a Hearing ______________________________________________________________________________
1005.15 A. Discrimination Complaint
The Department shall inform the assistance unit or their representative that they have the right to file a discrimination complaint if the assistance unit feels its civil rights have been violated by the Department with any of the following offices, as appropriate (cross reference: P-1005.10):
State of Connecticut Commissioner of the Department of Social Services Attn: Affirmative Action Division
State of Connecticut Commission on Human Rights and Opportunities
U.S. Department of Health & Human Services Office of Civil Rights
U.S. Department of Agriculture Office of Civil Rights
The Department shall advise the assistance unit or their representative that the complaint should contain the following information:
the name, address, and telephone number or other means of contacting the person alleging discrimination;
the location and name of the person or organization, if other than the Department, which is accused of discriminatory practices;
the nature of the incident or action or the aspect of program administration that led the person to allege discrimination;
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-06 Transmittal: UP-06-04 1005.15 page 2 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________________ Subject: Right to File a Discrimination Complaint and Right to a Hearing ______________________________________________________________________________
1005.15 A. 2. Discrimination Complaint (continued)
the reason for the alleged discrimination, e.g. race, color, religious creed, sex, age, national origin, ancestry, criminal record, political beliefs, sexual orientation, mental retardation, mental disability, physical disability or learning disability;
the names, titles if appropriate, and address of persons who may have knowledge of the alleged discriminatory act; and
the date or dates on which the alleged discriminatory action occurred.
The Department shall document the complaint with the information listed in 1005.15(A)(2), if the assistance unit makes an oral complaint but is reluctant or unable to file a written one,
4. Upon receipt of a written complaint made to the department or after documenting an oral complaint taken for DSS, the worker shall forward the complaint to the Affirmative Action Division Director, Central Office.
The Affirmative Action Division Director shall:
review the complaint for determination of probable cause;
investigate the complaint;
resolve the complaint, if possible; and
submit a report on each discrimination complaint to the US Department of Agriculture, if the complaint is filed by a Food Stamp recipient
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-1-04 Transmittal: UP-04-18 1005.15 page 3 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POILCY ______________________________________________________________________________ Chapter: Program: ALL Rights of Applicants and Recipients PROGRAMS ______________________________________________________________________________ Subject: Right to File a Discrimination Complaint and Right to a Hearing _______________________________________________________________________________
1005.15 B. Right to a Hearing
Subject to the conditions described in Section 1570 (and section 8525 for TFA and 8080.15 for SAGA), the assistance unit has the right to a Fair Hearing if the Department fails to determine eligibility in a timely manner, or if the unit disagrees with a Department decision affecting eligibility for, or the amount of, benefits.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1010 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Responsibilities of Applicants and Recipients AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1010 The assistance unit, by the act of applying for or receiving benefits, assumes certain responsibilities in its relationship with the Department.
This chapter describes those responsibilities which an assistance unit assumes when it applies for or receives benefits from the Department.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-87 Transmittal: UP-90-15 1010.05 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Responsibilities of Applicants and Recipients AABD _______________________________________________________________ FS Subject: MA Responsibilities in Relationship with the Department ______________________________________________________________________________
1010.05 A. Supplying Information
1. The assistance unit must supply the Department, in an accurate and timely manner as defined by the Department, all pertinent information and verification which the Department requires to determine eligibility and calculate the amount of benefits (cross reference: 1555).
2. The assistance unit must permit the Department to verify information independently whenever the unit is unable to provide the necessary information, whenever verification is required by law, or whenever the Department determines that verification is necessary (Cross reference: 1540).
B. Reporting Changes
1. The assistance unit must report to the Department, in an accurate and timely manner as defined by the Department, any changes which may affect the unit's eligibility or amount of benefits (cross reference 1555).
2. An assistance unit which is required to submit monthly reports to the Department must submit its monthly reports to the Department by the date specified by the Department (Cross reference: 1550).
C. Satisfying Procedural Requirements
The assistance unit must satisfy certain procedural requirements as described in Section 3500, including:
1. disclosing or obtaining a Social Security number;
2. complying with work requirements when necessary;
3. taking certain actions to secure support, when appropriate;
4. completing an assignment, when appropriate;
5. signing a security mortgage, when appropriate;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 3-1-91 Transmittal: UP-91-8 1010.05 page 2 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Responsibilities of Applicants and Recipients AABD _______________________________________________________________ FS Subject: MA Responsibilities in Relationship with the Department ______________________________________________________________________________
1010.05 C. Satisfying Procedural Requirements (continued)
6. cooperating with the Department as necessary. Cooperation includes:
a. taking steps as required by the Department to complete the eligibility determination, periodic redetermination of eligibility, interim changes in eligibility or benefit level and Quality Control reviews;
b. seeking any potential income or assets for which the unit may be eligible.
D. Reporting Requirement - Pending Eviction
1. Assistance units receiving benefits under the AFDC or AABD program must report within 10 days, the receipt of a notice to quit, issued pursuant to Chapter 832 of the General Statutes.
2. There is no penalty imposed on the assistance unit for failure to report receipt of a notice to quit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1015 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1015 The Department has certain responsibilities in its relationship with an assistance unit. This chapter specifies what these responsibilities are.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1015.05 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Determining Eligibility in a Timely Manner ______________________________________________________________________________
1015.05 A. Providing an Opportunity to File an Application
1. The Department must afford the assistance unit an opportunity to file an application the same day it contacts the appropriate Department District Office during regular working hours. The Department must also mail the assistance unit an application form the same day the unit contacts the Department either by mail or by phone to request assistance (Cross reference: 1505).
2. In the MA program, the Department must allow an individual who would be eligible under more than one category to have his or her eligibility determined for the category the individual selects.
B. Processing Applications in a Timely Manner
The Department must determine the assistance unit's eligibility within the time limits specified in Section 1500.
C. Providing Information to the Assistance Unit
The Department must tell the assistance unit what the unit has to do to establish eligibility when the Department does not have sufficient information to make an eligibility determination.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-1015.05 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Informing the Assistance Unit ______________________________________________________________________________
P-1015.05 General Information
1. Give the assistance unit or anyone inquiring about assistance informational brochures explaining Departmental programs.
2. At the time of every application and redetermination give the assistance unit Form 1236 explaining the rights and responsibilities of applicants and recipients. Require the unit to sign and date the form. Keep a copy for the case record.
Policy Manual
1. Allow any interested party the opportunity to read the policy manual during normal working hours.
2. Mail any interested party the appropriate section of the policy manual if the party so requests.
Case Decisions
1. Send the assistance unit a notice explaining the eligibility decision at the time initial eligibility is determined, and whenever eligibility is redetermined.
2. Send the assistance unit proper notice, as described in Section 1570, whenever taking adverse action on the unit's case.
Case Record
If the assistance unit requests to see its case record, inform the unit of the Department's disclosure policy, and follow the procedures described in P-1020.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1015.10 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Informing the Assistance Unit ______________________________________________________________________________
1015.10 A. General Information
The Department must inform the assistance unit regarding the eligibility requirements of the programs administered by the Department, and regarding the unit's rights and responsibilities.
B. Policy Manual
The Department must allow the assistance unit or the unit's representative to examine the Department's policy manual during regular working hours and to reproduce without charge or at a reasonable cost certain manual materials.
C. Case Decisions
The Department must send the assistance unit a notice regarding the Department's determination of the unit's initial eligibility, and, subject to conditions described in Section 1570, adequate notice before taking action to change the unit's eligibility status or the amount of benefits.
D. Case Record
Subject to the restrictions described in Section 1020, the Department must allow the assistance unit or its representative, upon request to:
1. examine the unit's case record during regular working hours; and
2. obtain a free copy of the portions of the unit's case record which are relevant to a scheduled Fair Hearing.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-1015.10 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Informing the Assistance Unit ______________________________________________________________________________
P-1015.10 1. Document the case record with only that information relevant and necessary to accomplish the lawful purposes of the Department (e.g. determining eligibility and level of benefits).
2. Periodically update the case record based on redeterminations, monthly reports, or interim changes as necessary.
3. If after examining its case record, the assistance unit alleges that its case record contains information which is inaccurate, incomplete, or irrelevant, inform the unit that it may file a written request to have the Department correct the record.
4. If the assistance unit files such a written request, refer the case to the Program Supervisor, who evaluates the request.
5. Within 30 days of the date the request is received, inform the assistance unit whether the Department agrees with the unit's allegation and is correcting the case record.
6. If the Program Supervisor so advises, delete, add, or revise the information in question. Inform the assistance unit.
7. If the Program Supervisor so advises, inform the assistance unit that the record is not being changed as requested, and that the unit may add a written statement to the case record to reflect the unit's opinion regarding the information in question.
8. If the assistance unit submits such a written statement, place it in the case record, where it becomes part of such record.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1015.15 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Maintaining Case Records ______________________________________________________________________________
1015.15 A. Maintenance of Records
For every assistance unit, the Department maintains a case record which is complete, accurate, and containing only that material which is necessary in the Department's administration of its assistance programs.
B. Accuracy of Information
1. If the assistance unit feels that information contained in its case record is inaccurate, incomplete, or irrelevant, the Department must allow the unit to file a written request asking that a correction be made.
2. If the assistance unit files such a written request with the Department, the Department gives the unit, within 30 days, a written notice stating that the Department:
a. is making the requested correction; or
b. is not making the requested correction. If the Department does not grant the assistance unit's request to correct case record information, the Department notifies the unit regarding:
(1) the Department's reason for not making the requested correction; and
(2) the unit's right to add its own statement to the case record.
3. The assistance unit has the right to a Fair Hearing if the Department uses the contested information in a way which adversely affects the unit's eligibility for benefits.
C. Adding Personal Statement to Case Record
1. If the Department denies the assistance unit's request to correct information contained in the unit's case record, the Department allows the unit to add to its record a statement explaining what the unit believes to be an accurate, complete and relevant version of the information in question.
2. The unit's statement becomes a permanent part of the case record, and is subject to the rules regarding disclosure as outlined in Section 1020.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1015.20 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Keeping Information Confidential ______________________________________________________________________________
1015.20 A. General Principle
The Department must keep the facts concerning the assistance unit's eligibility for benefits confidential. Disclosure of such information is limited to purposes directly related to the administration of the program (Cross reference: Section 1020).
B. Referred to DCF
The Department notifies the Department of Children and Families if there is evidence indicating that any child under the age of 18 is being physically or mentally abused by a parent or other person responsible for the child's care.
C. Food Stamps
The Department is required to provide any Federal, State, or local law enforcement officer the address, social security number and the photograph (if available) of any household member of a Food Stamp assistance unit subject to the limitations as described in 1020.10 A.6.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-95 Transmittal: UP-94-37 1015.25 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Voter Registration ______________________________________________________________________________
1015.25 General Principles
A. The Department must allow all applicants and recipients of public assistance who meet the qualifications as noted under B, the opportunity to register to vote at the time of application, predetermination of eligibility or at the time a change of address is reported.
B. To register to vote, applicants and recipients must be:
1. 18 years of age; and
2. United States citizens; and
3. residents of a Connecticut city or town.
C. The Department must assist the applicant or recipient in completing the registration form in the same way that assistance would be given to complete a departmental form.
D. Failure or refusal to register to vote does not affect eligibility for benefits.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-07 Transmittal: UP-07-09 P-1015.25 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Voter Registration ______________________________________________________________________________
P-1015.25 At Application or Redetermination - Face to Face Interview
Ask the applicant or recipient if he or she wishes to register to vote.
If yes, have the applicant or recipient check “yes” and sign the declination. If the applicant or recipient refuses to sign the declination, notate the declination accordingly and sign at the bottom. Remove the tear off section of the declination and give it to the applicant or recipient. Provide the client with a registration application form (ED-671 or W-614). Document your actions in the EMS narrative. File the declination as directed in 2. below.
If no because the applicant or recipient is already registered, have the client check “already registered” and sign the declination. If the applicant or recipient refuses to sign the declination, notate the declination accordingly and sign at the bottom. Remove the tear off section of the declination and give it to the applicant or recipient. Document your actions in the EMS narrative. File the declination as directed in 2. below.
If no for any other reason, have the applicant or recipient check "no" and sign the declination. If the applicant or recipient refuses to sign the declination, notate the declination accordingly and sign at the bottom. Remove the tear off section of the declination and give it to the applicant or recipient. Document your actions in the EMS narrative. File the declination as directed in 2. below.
Keep copies of all declinations in a central file in the office for auditing purposes.
For those wishing to register, offer assistance in completing the ED-671 or W-614. If the applicant or recipient is unable to write, ask if he or she would like you to complete the form.
If the applicant or recipient chooses to take the ED-671or W-614 with him or her, note that on the declination.
Advise the applicant or recipient that he or she can mail the registration application directly to the registrar of voters in the town in which he or she lives, or return it to the D.S.S. office.
After the applicant completes the ED-671 or W-614, write the date of receipt in the left hand box at the bottom of the form and forward it to the person in the office responsible for mailing these to the registrars. Do not use date stamps that identify the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-07 Transmittal: UP-07-09 P-1015.25 page 2 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Voter Registration ______________________________________________________________________________
P-1015.25 7. The person responsible for mailing applications to the registrars will complete and mail a W-619 receipt to each applicant submitting voter registration application forms to the department.
At Application or Redetermination - Mail-In
When mailing materials, that do not include a declination page, include a form ED-671 or W-614 and the special declination for mail-ins ED-682M.
Note in the case narrative that these were sent to the applicant or recipient.
If the declination is not completed, make a note of it on the declination, sign it and file it as described in item 2. in the face-to-face interview section above.
If either a declination or a registration application (W-614 or ED-671) is returned, follow the same procedures used at face-to-face interviews.
At Notification of Address Change
Ask the recipient if he or she is registered to vote. Follow the appropriate procedures (either face-to-face or mail-in) for application or redetermination to secure a declination. If applicant or recipient is registered to vote, go on to step 2.
Give or send the client an ED-671 or W-614 to complete in order to change his or her address with the registrar of voters.
Offer assistance in completing the ED-671 or W-614. If the applicant or recipient is unable to write, ask if he or she would like you to complete it.
Note in the case narrative that an ED-671 or W-614 was given or sent to the client.
Advise the recipient that he or she can mail the ED-671 or W-614 directly to the registrar of voters in the town in which he or she lives, or return it to the D.S.S. office.
After the applicant completes the ED-671 or W-614, write the date of receipt in the left hand box at the bottom of the form and forward it to the person in the office responsible for mailing these to the registrars.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-07 Transmittal: UP-07-09 P-1015.25 page 3 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Departmental Responsibilities AABD _______________________________________________________________ MA Subject: FS Voter Registration ______________________________________________________________________________
The person responsible for mailing applications to the registrars will complete and mail a W-619 receipt to each applicant or recipient submitting voter registration application forms to the department.
Completed Registration Application Forms (ED-671 or W-614)
Forward the completed ED-671 or W-614 to the appropriate registrar of voters as soon as possible, but not more than ten days after receipt.
If the ED-671 or W-614 is received within five days of the close of voter registration for an upcoming election (closing is the 14th day before the election), forward them to the registrars no later than five days after receipt.
Mail the ED-671 or W-614 in an unmarked envelope using the registrar's address as the return address. If more than one application for registration is being forwarded to the same registrar of voters, send them in one envelope.
Do not use any envelopes or stamps that could identify the agency to the registrar.
The person responsible for mailing applications to the registrars will complete and mail a W-619 receipt to each applicant submitting voter registration application forms to the Department.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1020 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1020 The assistance unit is required to disclose personal and financial information to the Department in order to establish and maintain eligibility under any program which the Department administers. The Department is required by federal and state law to restrict the use or disclosure of information it has pertaining to the assistance unit to purposes directly connected with the administration of the particular program.
In this chapter the Department's policy regarding the assistance unit's right to confidentiality is explained in detail. Among the items covered include:
° Types of information to be safeguarded;
° Releasing information;
° Publicizing safeguarding requirements;
° Distributing informational material to the assistance unit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1020.05 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: FS Types of Information to Be Safeguarded ______________________________________________________________________________
1020.05 A. Information Regarding the Assistance Unit
The following are examples of information to be safeguarded from the public. This list is not all-inclusive:
1. the fact that an individual is an applicant or recipient;
2. name and address of the assistance unit;
3. amount or type of benefits or services provided to or on behalf of the assistance unit;
4. social or economic situation or circumstances of the assistance unit;
5. Departmental evaluation of personal information regarding the assistance unit;
6. medical data, including diagnosis and past history of disease or disability.
B. Lists of Applicants or Recipients
In addition to safeguarding information regarding individual assistance units, the Department does not publish lists containing the names of groups of assistance units.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-1020.05 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: FS Explaining the Department's Disclosure Policy ______________________________________________________________________________
P-1020.05 When Information is Released
When the assistance unit signs the application form, make sure that it understands that:
1. the Department discloses information pertinent to the assistance unit if disclosure is necessary to accomplish any purpose directly connected with the administration of the Department's program; and
2. the unit's signature serves as the unit's permission for the Department to do so.
Standards of Confidentiality for those Who Receive Information
When sending a tracer to a third party, or when disclosing information regarding an assistance unit to a third party, make sure that the tracer or item of information contains the Department's policy regarding safeguarding of information, as described in policy.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1020.10 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: [FS] Releasing Information SNAP ______________________________________________________________________________
1020.10 A. When Information is Released
The Department releases information concerning the assistance unit only for purposes directly connected with:
1. the administration of the Department's programs. Such purposes include:
a. establishing eligibility for assistance under the program;
b. determining the amount of assistance; or
c. providing services for the assistance unit under the program;
2. an investigation, prosecution [,] or civil or criminal proceeding related to the administration of the Department's program. The following activities are considered related to the administration of the program:
a. collecting overpayments or other recoveries;
b. investigating fraud cases;
c. locating legally liable relatives when required by law; or
d. collecting support payments when required by law;
3. the administration of any other federal or federally assisted program which provides assistance in cash, or in kind, or services directly to individuals on the basis of need;
4. certification of receipt of AFDC to an employer for the purposes of claiming tax credit under Public Law 94-12, the Tax Reduction Act of 1975;
5. an audit or similar activity conducted in connection with the administration of the program by any governmental entity authorized by law to conduct such audit or activity; or
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 6/1/10 Transmittal: UP-10-04 1020.10 page 2 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: [FS] Releasing Information SNAP ______________________________________________________________________________
1020.10 A. When Information is Released (continued)
6. The Department is required to provide any Federal, State, or local law enforcement officer with the address, social security number and the photograph (if available) of any household member of a [Food Stamp] SNAP assistance unit under certain conditions. These conditions are:
a. The [Food Stamp] SNAP assistance unit member:
1) must be fleeing to avoid prosecution, custody [,] or confinement for a crime or attempt to commit a crime that is a felony; [or]
2) must be in violation of probation or parole imposed under Federal or State law; or
3) must have information that is necessary for the officer to conduct an official inquiry related to[numbers a. 1 or a. 2.] subsection A.6.a.1 or A.6.a.2 of this section.
b. The law enforcement officer must have as his or her official duty the location or apprehension of the member and be exercising his request for information pursuant to that official duty.
B. Release to Governmental Agencies
The Department does not disclose any information identifying the assistance unit by name or address to any federal, state or local committee or legislative body other than for purposes described in [paragraph A.] subsection A of this section.
C. Standards of Confidentiality for Those Who Receive Information
The Department releases information concerning the assistance unit only to persons or agency representatives who protect the assistance unit's confidentiality using the same standards of confidentiality as the Department.
D. Department Explains Confidentiality Policy
The Department informs the person or agency representative to whom information is disclosed of the Department's policy concerning confidentiality, including that the information released must be kept confidential to the same extent as the Department does.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-96-17 1020.10 page 3 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: [FS] Releasing Information SNAP ______________________________________________________________________________
1020.10 E. Consent from Assistance Unit
1. The Department obtains permission from the assistance unit, whenever possible, before disclosing information to an outside source. In an emergency situation, if the Department does not have time to obtain the unit's consent, the Department notifies the unit immediately after disclosing the information.
2. Situations in which consent from the assistance unit is not necessary include, but are not limited to:
a. investigations of alleged fraud; and
b. verifications obtained under the [Income Verification Eligibility System] Income Eligibility Verification System (IEVS). F. Court Cases
If a court issues a subpoena for a case record or for a Department representative to testify concerning the assistance unit, the Department informs the court of state and federal law and Departmental policy restricting the disclosure of information. If the court still insists on disclosure, the Department complies.
G. Examination of Case Record by the Assistance Unit
1. The Department allows the assistance unit or its authorized or legal representative an adequate time to examine the unit's case record prior to and during a scheduled Fair Hearing.
2. Subject to the restrictions described below, the Department discloses information contained in the assistance unit's case record to the unit or unit's authorized or legal representative at any time during normal work hours if the unit requests disclosure in writing. If the person making the request is not a member of the assistance unit, the person must have written permission from the unit to obtain disclosure.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 6/1/10 Transmittal: UP-10-04 1020.10 page 4 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: [FS] Releasing Information SNAP ______________________________________________________________________________
1020.10 G. Examination of Case Record by the Assistance Unit (continued)
3. The Department does not disclose confidential information in the assistance unit's case record to the unit if the information contains:
a. the names of individuals who have disclosed information about the assistance unit without the unit's knowledge; [or]
b. [the nature or status of a pending criminal prosecution;]information compiled in reasonable expectation of, or for use in, a civil or criminal proceeding; or
c. medical, psychiatric[,] or psychological data concerning the unit and the Department determines that disclosure would be detrimental to the unit.
4. If the Department decides not to disclose information contained in the assistance unit's case record to the unit, the Department informs the unit of its right to appeal this decision to the Superior Court within 30 days of the decision. SHAPE \* MERGEFORMAT 5. If the Department initially decides not to disclose medical, psychiatric[,] or psychological data concerning the assistance unit to the unit because of a determination that disclosure would be detrimental to the unit, the Department revises this decision under the following conditions:
a. the unit requests in writing that a qualified medical doctor review the data to determine whether disclosure is appropriate; and
b. the unit's personal doctor recommends disclosure of the [.] information contained in its case record if the unit feels the information is incorrect (Cross reference: 1015).
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-1020.10 ______________________________________________________________________________ Section: Type: Rights and Responsibilities PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: FS Disclosing Information to the Assistance Unit ______________________________________________________________________________
P-1020.10 1. If the assistance unit asks to see its case record during normal working hours, inform the unit that the request must be in writing.
2. Ask if there is something in particular the unit wishes to see.
3. Refer the case to the Program Supervisor, who decides whether to disclose the information.
4. If the Program Supervisor allows disclosure, set up a date and time for the assistance unit to read the case record. Reserve a quiet area in the office where the unit can examine the record.
5. Remove any material which is subject to the safeguarding provisions of Section 1020, and oversee the unit as it examines the record.
6. If the assistance unit is requesting to examine its record in preparation for a Fair Hearing, make copies of any pertinent material which the unit requests and allow the unit to keep the copies.
7. If the Program Supervisor does not allow disclosure, inform the assistance unit that it can challenge the denial by appealing to the Superior Court within 30 days.
8. Allow the assistance unit's representative to examine the unit's case record only with written authorization from the unit, and with the consent of the Program Supervisor.
9. Verify the identity of the representative before allowing him or her to examine the record.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-97 Transmittal: UP-98-3 1020.12 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: Disclosure of Information AFDC _______________________________________________________________ Subject: Release of Information to Law Enforcement Officers ______________________________________________________________________________
1020.12 The Department discloses to federal, state, or local law enforcement officers the address of a recipient if the conditions described below are met:
A. Conditions for the Release of Information Regarding Felons
1. The recipient has been convicted of one of the following crimes or has attempted to commit one of the following crimes, as defined by the place where the charges originated:
a. a felony; or
b. a high misdemeanor as defined by and being pursued under the laws of the State of New Jersey; or
c. a violation of a condition of probation or parole imposed for a felony under state or federal law; and
2. The recipient is fleeing to avoid prosecution or custody or confinement after conviction; and
3. The law enforcement officer provides the Department with the recipient's name and indicates to the Department that the recipient meets the conditions listed above in 1. a, and b, and that the location or apprehension of the recipient is within his or her official duties.
B. Conditions for the Release of Information Regarding Others
1. The law enforcement officer provides the Department with the recipient's name; and
2. The law enforcement officer indicates that the recipient has information that is necessary for him or her to conduct his or her official duties; and
3. The location or apprehension of the recipient is within the law enforcement officer's official duties.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-97 Transmittal: UP-98-3 1020.13 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: Disclosure of Information AFDC _______________________________________________________________ Subject: Release of Information to the Department of Children and Families (DCF) ______________________________________________________________________________
1020.13 A. The Department of Social Services releases to the Department of Children and Families necessary information concerning a child or the immediate family of a child receiving assistance under the following conditions:
1. if the child's health, safety, or welfare is in imminent danger as determined by DCF; and
2. release is only to the Commissioner of DCF or his official designee.
B. In addition to the provisions of A, above, and notwithstanding a request for information, the Department of Social Services notifies the Commissioner of the Department of Children and Families or his or her official designee if the Department of Social Services has reason to believe that any child under the age of eighteen (18) is being subjected to physical or mental abuse or neglect while in the care of a parent or other person responsible for the child's care.
C. The Department of Children and Families may use the information released to them by the Department of Social Services only for the purposes and to the extent necessary to carry out the prescribed functions of that department.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 1020.15 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: FS Publicizing Safeguarding Requirements ______________________________________________________________________________
1020.15 A. Publication of Right to Confidentiality
The Department publicizes its policy concerning the assistance unit's right to confidentiality, including the penalty for illegal disclosure.
B. Distribution of Department's Confidentiality Policy
The Department provides copies of the policy described in paragraph A to assistance units and to agencies and individuals to whom the Department discloses information.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-1-91 Transmittal: UP-91-51 1020.20 ______________________________________________________________________________ Section: Type: Rights and Responsibilities POLICY ______________________________________________________________________________ Chapter: Program: AFDC Disclosure of Information AABD _______________________________________________________________ MA Subject: FS Distributing Information to the Assistance Unit ______________________________________________________________________________
1020.20 A. Limitations to Distribution
The Department distributes material to assistance units or to medical providers only if such material:
1. relates directly to the administration of the particular program;
2. has no political implications;
3. contains the names only of individuals directly connected with the administration of the program;
4. identifies these individuals only in their official capacity with the Department; and
5. relates directly to the health and welfare of the assistance unit, such as announcements of free medical examinations, availability of surplus food, or consumer protection information.
B. Items Not Distributed
The Department does not distribute materials such as "holiday" greetings, general public announcements, voting information, or non-citizen registration announcements.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1500 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1500 The Eligibility Process is a comprehensive manual section which encompasses a variety of subjects that relate to processing case action and is divided into the following chapters:
1505 The Application Process 1507 Assessment of Spousal Assets 1510 Categorical Eligibility Processing Requirements 1515 Expedited Service 1520 Reserved 1525 Authorized Representatives 1530 Certification 1535 Cases with Zero Benefit Level 1540 General Principles of Verification 1545 The Redetermination Process 1550 Monthly Reporting 1555 Interim Activity 1560 Beginning Dates of Assistance 1565 Ending Dates of Assistance 1570 Fair Hearings 1599 Verification
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1500.01 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
1500.01 Adequate Notice
Adequate notice is a notice of denial, discontinuance, or reduction of assistance which includes a statement of the Department's intended action, the reasons for the intended action, the specific regulations supporting such action, an explanation of the assistance unit's right to request a Fair Hearing to contest the action, and the circumstances under which benefits are continued if the unit requests a Fair Hearing.
Allotment
An allotment is a dollar amount representing the total value of Food Stamp benefits an assistance unit is authorized to receive during a month or other specified period.
Applicant
Applicant means the individual or individuals for whom assistance is requested.
Application
Application is written indication on a form prescribed by the Department of the desire to obtain assistance.
Application Process
The application process is all activity related to the exploration, investigation and disposition of an application beginning with the filing of an assistance request and ending with disposition of the application.
Assessment of Spousal Assets
An Assessment of Spousal Assets is a determination of the total value of all non-excluded available assets owned by both MCCA spouses which is done upon the request of an institutionalized spouse or a community spouse or upon the filing of an application for medical assistance and is used to calculate the Community Spouse Protected Amount.
Authorized Representative
An authorized representative is an adult, over the age of eighteen, who has written authorization to act on the behalf of an assistance unit of which he or she is not currently a member, and who would otherwise not be eligible to act without such authorization.
PRIVATE tc \l 1 ""PRIVATE CONNECTICUT DEPARTMENT OF SOCIAL SERVICEStc \l 1 "CONNECTICUT DEPARTMENT OF SOCIAL SERVICES" UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-38 1500.01 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
1500.01 Beginning Date of Assistance
Beginning Date of Assistance is the earliest date on which an assistance unit or a member of an assistance unit is entitled to the benefits of the program.
Certification of Eligibility
Certification is the formal authorization to participate in a particular assistance program.
Certification Period
A certification period is the interval of time within which an assistance unit is eligible to receive benefits from a particular assistance program.
Community Spouse
A community spouse is an individual who resides in the community, who does not receive home and community based services under a Medicaid waiver, who is married to an individual who resides in a medical facility or long term care facility or who receives home and community based services (CBS) under a Medicaid waiver.
Community Spouse Disregard (CSD)
A community spouse disregard is the amount of the institutionalized spouse's available non-excluded assets which is excluded in determining the institutionalized spouse's eligibility for Medicaid.
Community Spouse Protected Amount (CSPA)
A community spouse protected amount is the amount of the total available non-excluded assets owned by both MCCA spouses which is protected for the community spouse and is not counted in determining the institutionalized spouse's eligibility for Medicaid.
Continuous Period of Institutionalization
A continuous period of institutionalization is a period of 30 or more consecutive days of residence in a medical institution or long term care facility, or receipt of home and community based services (CBS) under a Medicaid waiver.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-06 Transmittal: UP 06-07 1500.01 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
1500.01 Date of Application
The date of application is the date a formal written request for assistance is filed with the Department in accordance with the rules established for the program for which application is made.
Date of Authorization
The date of authorization is the date the Department makes a case action decision, as opposed to the effective date of the action.
Date of Issuance
The date of issuance is the actual mailing date of a benefit, notice or other item of correspondence, or the date the item becomes available for in-office pickup.
Documentation
Documentation is the act of recording a fact, circumstance or condition through the use of a supporting reference, annotation or the inclusion of documentary evidence.
Eligibility Process
The eligibility process is all activity related to the application process, interim activity, redetermination and Fair Hearings.
Ending Date of Assistance
Ending date of assistance is the last day on which the assistance unit or a member of an assistance unit is entitled to the benefits of the program.
Exceptional Circumstances
Exceptional circumstances are conditions that are unusual or extreme for a community spouse, and which either directly threaten the community spouse's ability to remain in the community, or pose some other type of unusual or extreme hardship for the community spouse, such as caring for a disabled child, sibling or other immediate relative.
Fraud Early Detection (FRED) System
The Fraud Early Detection System is used to identify, investigate and determine if an application under AABD, Medicaid or Food Stamps is fraudulent before granting assistance.
PRIVATE tc \l 1 ""PRIVATE CONNECTICUT DEPARTMENT OF SOCIAL SERVICEStc \l 1 "CONNECTICUT DEPARTMENT OF SOCIAL SERVICES" UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-01-04 1500.01 page 4 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________ 1500.01 Interim Activity
Interim activity is any action or activity other than application, redetermination or Fair Hearings.
Intervenor
An intervenor is person who participates in a Fair Hearing on a limited basis in the interest of justice.
Institutionalized Spouse
An institutionalized spouse is a spouse who resides in a medical facility or long term care facility, or who receives home and community based services (CBS) under a Medicaid waiver, and who is legally married to someone who does not reside in such facilities or who does not receive such services.
Joint Processing
Joint processing is the simultaneous processing of a PA and FS assistance request that has been filed concurrently.
Mass Change
A mass change is one which affects all or a portion of the caseload which shares similar circumstances.
MCCA Spouses
MCCA spouses are spouses who are members of a married couple one of whom becomes an institutionalized spouse on or after September 30, 1989, and the other spouse becomes a community spouse.
Migrant or Seasonal Farm Worker Assistance Unit
A migrant or seasonal farm worker assistance unit is an assistance unit whose primary livelihood is derived from farm labor.
Notice
A notice is a written statement which the Department mails to the assistance unit to inform the unit that the Department has taken or intends to take a specific action in the unit's case.
PRIVATE tc \l 1 ""PRIVATE CONNECTICUT DEPARTMENT OF SOCIAL SERVICEStc \l 1 "CONNECTICUT DEPARTMENT OF SOCIAL SERVICES" UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-1-91 Transmittal: UP-01-04 1500.01 page 5 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
1500.01 Party to a Hearing Requested by Another
A party to a hearing requested by another is a person who is allowed to participate in a hearing requested by another person on an issue of mutual interest.
Prerelease Applicant
A prerelease applicant is an individual who is currently ineligible for Food Stamps due to institutional status, but who has applied jointly for Food Stamps and SSI in anticipation of being released from the institution.
Primary Verification
Primary verification is an inquiry to verify non-citizen status using direct access into the INS data base in accordance with the Immigration Reform and Control Act of 1986.
Public Assistance
Public Assistance (PA) means any of the following programs: Aid to Families with Dependent Children (AFDC), Aid to the Aged, Blind or Disabled (AABD), and Medical Assistance (MA).
Redetermination Process
The redetermination process is all activity related to the reevaluation of a recipient's eligibility, and the recertification of a food stamp assistance unit.
Request for a Fair Hearing
A request for a Fair Hearing is a clear statement by the assistance unit or the unit's authorized representative which indicates that the unit disagrees with a Departmental action or non-action, and wishes to have its case reviewed by an independent authority.
Secondary Verification
Secondary verification is a written request to verify non-citizen status with INS, in addition to or in lieu of primary verification, in accordance with the Immigration Reform and Control Act of 1986.
PRIVATE tc \l 1 ""PRIVATE CONNECTICUT DEPARTMENT OF SOCIAL SERVICEStc \l 1 "CONNECTICUT DEPARTMENT OF SOCIAL SERVICES" UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1500.01 page 6 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
1500.01 Significant Financial Duress
Significant financial duress is a severe expense or set of expenses to be paid by the community spouse as a direct result of exceptional circumstances, and are those for which the community spouse could not reasonably be expected to pay from his or her monthly income or assets.
Spend-Down
Spend-down is the process by which income which exceeds an MA assistance unit's Medically Needy Income Limit (MNIL) is offset by incurred medical expenses.
Spousal Share
A spousal share is one-half of the total value of assets which result from the assessment of spousal assets.
SSI Assistance Unit
An SSI assistance unit is an assistance unit which is composed entirely of individuals who are either applicants or recipients of SSI.
Timely Notice
Timely notice is notice of discontinuance or reduction of assistance which the Department mails to the assistance unit at least 10 days before the Department's intended action becomes effective.
Verification
Verification is the act of confirming a fact, circumstance or condition through direct evidence or other reliable documentation or collateral contact.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Application Process AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1505 The application process outlines the general methods and requirements used in obtaining assistance and in determining an assistance units initial eligibility. The application process is essentially the same for all programs. It is designed to provide aid in a prompt and efficient manner to those who request assistance.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505.05 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ FS Subject: MA Agency Responsibilities ______________________________________________________________________________
1505.05 A. Opportunity to Request Assistance
1. Any individual regardless of age, sex or other consideration is entitled to request assistance from the Department.
2. A request for assistance may be for the individual making the application, or for others for whom the individual is acting responsibly.
3. Individuals requesting assistance on the behalf of others must be qualified to do so in order for assistance to be granted.
B. Contacts with the District Office
1. Individuals are encouraged to contact the district office which serves their region of residence in order to avoid delays in the eligibility process.
2. Applicants who contact a district office are allowed to obtain or submit an assistance request to that office.
3. If an individual requests application materials, the district office receiving the request gives or mails the materials to the individual on the day of the request.
C. Certification Materials
1. Certification materials are made readily available to all potentially eligible individuals and those groups and organizations involved in outreach efforts.
2. Certification materials include:
a. application forms; and
b. change report forms.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505.05 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ FS Subject: MA Agency Responsibilities ______________________________________________________________________________
1505.05 D. IEVS Process Notification
The Department is required to notify applicants that social security numbers are used in conjunction with income verification as part of the Income Eligibility Verification System (IEVS).
The Department also provides IEVS notification to relevant non-recipients whose income or assets are considered in determining eligibility.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1505.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ________________________________________________________________ MA Subject: FS Primary Steps in the Application Process ______________________________________________________________________________
P-1505.05 1. In general, take the following steps in processing an application:
° obtain a signed ARF and complete the initial screening;
° evaluate the ARF for entitlement to expedited service;
° schedule and complete the required application interview;
° make appropriate referrals, including referral to the Job Connection, Support or Health Track;
° complete the eligibility investigation;
° acquire verification;
° document all case actions and findings;
° determine eligibility and benefit level;
° certify or deny assistance;
° provide for the periodic review of eligible cases.
2. Explain the following to each applicant:
° the type of assistance available;
° programs for which the applicant may qualify;
° how to obtain assistance;
° general rights and responsibilities;
° the applicant's responsibilities in obtaining verification;
° the deadline for providing verification and how to get an extension;
° the Department's responsibilities in obtaining verification;
° requirements of the IEVS process;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1505.05 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Primary Steps in the Application Process ______________________________________________________________________________
P-1505.05 2. (continued)
° the Department's responsibility for processing the application within the standard of promptness, and what factors may cause a delay;
° the Emergency Case Client Representative System;
° how to contact the Department to check the status of the application.
3. Provide sufficient information to allow the applicant to make informed choices about the programs for which he or she is applying before taking the application.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1505.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Filing an Application ______________________________________________________________________________
1505.10 A. Application Form
1. All applicants are required to complete an application form, except as noted below in 1505.10 A.3.
The Department may utilize a single uniform application for multiple programs, or separate applications for individual programs.
For all programs except Food Stamps, a new application form is not required if the applicant applies not later than thirty days after being released from a correctional or mental disease facility, was a recipient of cash or medical assistance and lost eligibility, directly or indirectly, because of his or her institutionalization within the twenty-four month period preceding the date of his or her release.
B. Requesting Assistance
1. Individuals who desire to obtain aid must file a formal request for assistance.
2. The formal request must be made in writing on the application form.
3. At a minimum, the following information must be presented:
a. the full name and address of the applicant; and
b. the signature of the applicant, caretaker relative or other individual who is requesting assistance on behalf of the applicant.
4. The application may be submitted in person or by mail.
5. Telephone contacts or other requests for aid which are not written, do not contain the required information, or are not made on the prescribed application form are considered inquiries and do not constitute an application.
6. Individuals who appear in person to request assistance must be given an opportunity to file an application for any desired program on the day they personally appear.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505.10 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Filing an Application ______________________________________________________________________________
1505.10 C. Where to File an Assistance Request
1. Offices of the Department
a. The Department has designated district offices which serve as certification sites for specific geographical regions of the state.
b. Each district office is responsible for applications made by individuals that reside in the geographic region served by such office.
c. A district office may out-post workers, or have designated outreach stations which serve as extensions of the Department.
d. A breakdown of the district regions by cities and towns is made readily available to the general public.
e. An assistance request may be filed at any Department office or extension.
f. Actions other than filing the assistance request must be completed at the district office of appropriate jurisdiction.
2. Social Security Offices (FS only)
In addition to filing with the Department, assistance units in which all members are applicants or recipients of SSI may apply for the FS program at an in-state office of the Social Security Administration, provided that the assistance unit:
a. has not applied for food stamps within the previous thirty days; and
b. does not have a FS application pending with the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1505.10 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Filing an Application ______________________________________________________________________________ 1505.10 D. Date of Application
1. For AFDC, AABD and MA applications, except for the Medicaid coverage groups noted below in 1510.10 D.2, the date of application is considered to be the date that a signed application form is received by any office of the Department.
2. For the Healthy Start coverage groups, the date of application is the date that a signed application is received at an outreach site or the date it is received by any office of the Department, whichever is sooner. The following are the Healthy Start coverage groups:
a. Pregnant Women Under 250% of the Poverty Level;
b. Pregnant Women Extension;
c. Children Under 185% of the Poverty Level;
d. Children Under 133% of the Poverty Level; and
e. Children Under the Poverty Level
3. For Food Stamp applications, except as noted below in 1510.10 D.4, the date of application is considered to be the date that a signed application form is received by:
a. the appropriate District Office designated to serve the applicant's geographic region of residence; or
b. an office of the Social Security Administration.
4. For prerelease applicants, the application date is the date of release from the institution.
5. The applicant must indicate the programs for which he or she is applying:
a. at the time of the application interview; or
b. when contacted by the Department for that purpose.
6. The date of application is protected retroactively to the original filing date as long as the applicant informs the Department of the programs for which he or she is applying by the appropriate date noted above in 1510.10 D.5.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1505.10 page 4 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Filing an Application ______________________________________________________________________________
1505.10 D. Date of Application (continued)
7. A separate application is required if the applicant requests aid from an additional program category subsequent to the date noted above in 1510.10 D.5.
8. The application date for the new assistance program is the filing date of the second application form.
E. Self-generated MA Applications
1. Individuals who apply for AABD are automatically considered to have requested assistance from the MA program.
2. A determination of eligibility for assistance under other Medicaid coverage groups is done without requiring a separate application when:
a. AABD is denied or discontinued; or
Medicaid is denied or discontinued in regard to a particular coverage group; or
c. an applicant or recipient of SAGA medical assistance is determined to meet the disability requirement for the Medicaid program.
F. Self-generated State Supplement Applications
1. SSI recipients who apply for or receive Medicaid as residents of long term care facilities are automatically considered to have requested assistance from the State Supplement program.
2. A determination of eligibility for assistance under the State Supplement program is done without requiring a separate application when an applicant or recipient of SAGA cash assistance is determined to meet the disability requirement for the State Supplement program.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 P-1505.10 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Initiating the Application ______________________________________________________________________________
P-1505.10 A. Initial Contacts
1. Determine if the individual has any previous record with the Department.
2. Consult records which are readily available. Consider circumstances such as:
° is there an active case or one that may be converted from a suspended to an issuance status;
° has the applicant's eligibility been terminated less than 6 calendar months;
° has a previous application been denied within the past fifteen days;
° has an applicant for Food Stamps only been denied within the past thirty days?
3. Do not require a new interview or completion of a new EDD under the following circumstances:
° a previous application for any program was denied within the past 15 days due to missing verification, and that verification has now been submitted; or
° a previous application for Food Stamps only was denied within the past 30 days due to missing verification, and that verification has now been submitted, and the new application is for Food Stamps only; or
° the applicant requests cash or medical assistance no later than thirty days after being released from a correctional or mental disease facility, was a recipient of cash or medical assistance and lost eligibility directly or indirectly because of his or her institutionalization within the twenty-four month period preceding the date of his or her release.
Loss of eligibility indirectly related to institutionalization includes situations where the applicant lost eligibility due to whereabouts unknown, failure to complete a redetermination or failure to cooperate with any procedural requirement if it can be reasonably established that the failure was due to his or her institutionalization. Please see P-1505.10 D below for special processing instructions.
4. Complete the ARF portion of the application form and the initial screening.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-04 Transmittal: UP-09-06 P-1505.10 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Initiating the Application ______________________________________________________________________________
P-1505.10 A. Initial Contacts (continued)
5. Obtain the applicant's signature on the ARF in order to establish a formal application. If the interview is conducted on the same day and the EDD is signed, it will not be necessary to obtain the applicant's signature on the ARF portion of the application.
6. Review the application for expedited service entitlement. Try to complete the application interview at this time if the applicant is entitled to expedited processing.
7. Consider actions taken prior to the signing of the ARF as actions related to an inquiry. If, for example, the applicant withdraws the assistance request prior to signing the ARF, do not complete a denial notice.
8. Provide the applicant with any materials necessary to complete the application, including the following when appropriate:
° EDD;
° verification check list;
° work registration material;
° verification forms;
° informational materials;
° return envelope.
9. Provide form (W-1660) "Application Processing Time Limit" to the client and explain the system.
10. Explain to applicant either in person, by mail, or over the phone, the next step in the application process. Include instructions on filling out an application form, verification requirements, time frame for taking action, and the time and place of any necessary interviews.
11. When a unit reapplies after having been discontinued for no more than six calendar months as the result of situations involving such things as the receipt of a lump sum or the reduction of excess assets:
° have the applicant sign a completed ARF:
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 9-1-06 Transmittal: UP-09-06 P-1505.10 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Initiating the Application ______________________________________________________________________________
P-1505.10 A. Initial Contacts (continued)
° obtain the closed record;
° interview the applicant and update the information on EMS or the existing EDD if that information is reasonably current;
° for programs not requiring an interview, update the information on EMS if that information is reasonably current;
° require that a new EDD be completed, or have the applicant sign an EMS generated EDD, if information received seems questionable or appears to have changed significantly;
° request all necessary verification;
° make all appropriate referrals;
° refer all cash and Medicaid applicants under the age of twenty-one and pregnant woman applicants, to the HealthTrack unit.
12. Establish the case file after the initial screening is completed.
B. Special Instructions for Mail-In or Hand Delivered Applications
1. If an ARF is submitted through the mail, review it along with anything else that was submitted.
2. Follow all procedures for Initial Contacts, as listed above.
Consider the application date the date the application is received. The application must be date stamped the day it is received and screened in EMS by the end of the next business day.
4. Attempt to contact the applicant by telephone.
5. If the applicant is contacted:
° review the information on the ARF, or conduct a screening if the ARF was not complete;
° review the verification requirements with the applicant;
° arrange for completion of the interview if one is required. CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 P-1505.10 page 4 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Initiating the Application ______________________________________________________________________________
P-1505.10 B. Special Instructions for Mail-In or Hand Delivered Applications (continued)
6. Return any other forms or materials that require signature or further completion, if necessary.
C. Special Instructions for Faxed Applications
1. Follow the procedures for mail-in and hand delivered applications.
2. Consider the application date the date the fax is received.
Notify the applicant or the representative that the original, signed application form must be submitted before the case can be granted.
D. Special Processing Instructions for Individuals Recently Released from a Correctional or Mental Disease Facility
When an applicant requests cash or medical assistance within thirty days of being released from an institution and was previously a recipient of cash or medical assistance and lost eligibility, either directly or indirectly, because of his or her institutionalization within the twenty-four month period preceding the date of his or her release:
1. reinstate previous cash or medical case; and
2. initiate and complete an expedited redetermination in EMS if the previous redetermination period has expired or will expire no later than three months from the current benefit month by using the information already in EMS and rekeying all appropriate verification codes; and
before confirming completed redetermination, shorten the redetermination period to three months by adding three months to the current benefit month.
E. Self-Generated State Supplement and Medicaid Applications for SAGA Clients
1. When a SAGA client is awarded Social Security or Supplemental Security Income (SSI) benefits:
Determine whether the client requested “Money Assistance” on his or her original application;
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 P-1505.10 page 5 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Initiating the Application ______________________________________________________________________________
P-1505.10 E. Self-Generated State Supplement and Medicaid Applications for SAGA Clients (continued)
b. If the client requested “Money Assistance”, determine State Supplement eligibility for any month in which he or she is eligible for Social Security or SSI benefits as follows:
1. Budget Social Security retro benefits as income for the months that they were intended, even if the benefits were SSI benefits paid to DSS as a reimbursement for SAGA cash benefits;
2. Budget any unreimbursed SAGA cash benefits as unearned income;
3. Calculate the client’s applied income and compare it to his or her needs;
4. Screen and grant a State Supplement AU for any month in which the client’s applied income is less than his or her needs. Remember to budget Social Security disability and SSI benefits as unearned income types “SD” and “SI” respectively on the UINC screen. Unreimbursed SAGA cash income should be coded as unearned income type “OA”.
5. If the client is ineligible for State Supplement, screen and grant an S03 Medicaid AU. Treat retroactive Social Security benefits as a lump sum in the month of receipt and determine ongoing Medicaid eligibility accordingly.
c. If the client did not request “Money Assistance” on his or her original application, evaluate for both retrospective and prospective Medicaid eligibility.
When a SAGA client is determined disabled by Colonial Cooperative Care:
a. Screen an S03 Medicaid AU using the original application date or the onset of disability date (whichever is later) as the application date. CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 P-1505.10 page 6 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Initiating the Application ______________________________________________________________________________
P-1505.10 E. Self-Generated State Supplement and Medicaid Applications for SAGA Clients (continued)
b. Process all application months, completing the disability fields on the DEM2 screen. Enter an AU Status Reason Code of “586” on the STAT screen of the SAGA medical AU for any month that will be closed due to the Medicaid grant.
c. Finalize the application, awarding Medicaid and closing SAGA medical. It is important to grant S03 for all months in which the client has been found disabled in order to collect Federal matching funds on his or her medical expenditures.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505.15 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Individuals Qualified to Make an Application ______________________________________________________________________________
1505.15 A. Provisions
1. Applicants may apply for and be granted assistance on their own behalf or, under certain conditions, be represented by other qualified individuals who act responsibly for them.
` 2. The Department recognizes the right of an applicant to be represented by a responsible individual, but maintains the authority to determine whether or not the person is acting responsibly on behalf of the assistance unit prior to granting assistance.
3. Applicants may be assisted, if so desired, by individuals of their choice in various aspects of the eligibility process. They may be accompanied by such individuals in contact with the Department, and when so accompanied may also be represented by them.
4. A responsible individual applying for assistance on the behalf of others must:
a. be familiar with household circumstances to the extent that questions concerning need and eligibility can be answered with reasonable accuracy;
b. have a basic understanding of the assistance program(s) for which application is being made;
c. understand the responsibilities which they assume;
d. be able to communicate with members of the assistance unit in order to obtain information and to explain rights and responsibilities;
e. have an interest in the well-being of the entire assistance unit.
B. Applicants (All Programs)
Any individual who is applying solely on his or her own behalf may request assistance and complete the application process regardless of age, sex or other consideration, unless the person has been declared incompetent.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-88 Transmittal: UP-87-21 1505.15 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Individuals Qualified to Make an Application ______________________________________________________________________________
1505.15 C. Individuals Representing Others
1. AFDC, AABD, MA
a. The following individuals are qualified to request cash or medical assistance, be interviewed and, complete the application process on the behalf of others who they represent:
(1) the caretaker relative of a child applicant;
(2) the spouse, provided that the spouse is not estranged;
(3) a conservator, guardian or other court appointed fiduciary.
b. If none of the above individuals are available, the following persons may file the application on the assistance unit's behalf:
(1) another responsible assistance unit member; or
(2) an authorized representative. (cross reference: 1525)
c. In cases involving an incompetent or incapacitated person, a responsible adult may request assistance and complete the entire application on behalf of the applicant without any prior authorization if:
(1) none of the individuals in 1.a. are available; and
(2) the responsible adult is acting on behalf of an applicant; or
(3) a physician attests to the applicant's inability to make the application because of incompetence or incapacity.
d. A responsible person may complete the entire MA application on behalf of a deceased person without any prior authorization, if none of the individuals in 1a. above are available.
e. An individual or agency responsible for the care of a child may apply for MA on behalf of that child.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505.15 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Individuals Qualified to Make an Application ______________________________________________________________________________
1505.15 C. Individuals Representing Others (continued)
2. FS
a. The following individuals are qualified to request FS assistance, be interviewed, and complete the application on the behalf of others who they represent:
(1) the head of the assistance unit;
(2) a spouse or other responsible member of the assistance unit;
(3) an authorized representative or court appointed fiduciary. (cross reference: 1525)
b. Prior to granting assistance, the application form must be signed by an adult member of the assistance unit, unless:
(1) the application is completed by an authorized representative; or
(2) the assistance unit does not contain an adult member.
c. The head of the assistance unit must sign the application form if the assistance unit does not contain an adult member and applies on its own behalf.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-1-06 Transmittal: UP-06-23 P-1505.15 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ____________________________________________________________ MA Subject: FS Contacting the Wrong District Office ______________________________________________________________________________
P-1505.15 1. If the wrong District Office is contacted:
° inform the applicant of the right to file an ARF;
° explain that in order to obtain assistance the rest of the application process must be completed with the appropriate district;
° explain that the FS date of application is not established until the application is received by the appropriate district;
° inform the assistance unit of other probable processing delays, including expedited service processing.
2. Allow the ARF to be filed if the applicant insists on submitting it to the wrong district.
3. Forward the date stamped application to the correct office on the same day it is received.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1505.20 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Completing the Application Form ______________________________________________________________________________
1505.20 A. Applicant Requirements
1. Individuals who have applied for aid are required to complete the pertinent sections of the application form.
2. The application form:
a. provides a detailed account of the assistance unit circumstances which are necessary for determining eligibility; and
b. must be completed to the satisfaction of the Department prior to granting assistance.
3. Applicants who fail to complete the application form within reasonable time standards established by the Department are denied assistance.
B. Submitting the Eligibility Determination Document
1. The application form may be submitted through the mail or in person to the appropriate district office.
2. Medicaid applications for the Healthy Start coverage groups may be submitted to a Healthy Start outreach site or to the appropriate district office. (Cross Reference: 1505.10)
3. Documents received by the wrong district office are forwarded to the appropriate district within one working day of the date of receipt.
4. Applicants or recipients of SSI making application for the FS program at an SSA office may submit the Food Stamp application form to such office.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1505.20 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Telephone and Mail Inquiries ______________________________________________________________________________
P-1505.20 Telephone Inquiries
1. If a telephone inquiry is made:
° inform the caller of pertinent application requirements;
° explain how the date of application is established and the need to file an ARF;
° tell the caller how and where to obtain application materials;
° encourage the caller to apply as soon as possible.
2. Generally, attempt to complete the initial ARF screening unless the caller indicates that he or she will apply in person.
3. If the screening is conducted, set up an appointment for an application interview if one is required for AFDC or FS applicants and it is feasible to do so.
4. Review the policy for waiver of the office interview if one is requested. Take steps to set up a telephone interview or home visit if the in-office visit is waived.
5. Mail a complete application (ARF and EDD) along with instructions, the appointment schedule and other pertinent materials to the applicant.
Mail Inquiries
1. If a mail inquiry is received, attempt to contact the applicant by telephone.
2. If a telephone contact is made, follow the procedures beginning with step 1. above.
3. If phone contact is not established mail the application materials to the applicant, including the EDD.
4. Maintain a copy of the ARF if a telephone screening is completed.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-22-06 Transmittal: UP-07-14 P-1505.22 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process FS _______________________________________________________________ Subject: Head of the Assistance Unit ______________________________________________________________________________
P-1505.22 Changes in the Head of the Assistance Unit
1. Have the new head of household sign the application form.
2. Determine if there are benefits left in the account. If no, go to step #5. If yes, go to step #3.
3. Determine if the new head of household has the previous head of household's EBT card.
° If yes and he/she knows the PIN advise him/her to use the remaining benefits. Then go to step #5.
° If yes and he/she does not know the PIN, have him/her select a new PIN and advise him/her to use the remaining benefits. Then go to step #5.
° If no, go to step # 4.
4. Issue a new card for the previous head of household and send it to the new head of household. This will automatically deactivate the previous head of household's card. Have the new head of household select a new PIN for the new card to allow the assistance unit to access to funds remaining in the existing EBT account.
5. After the new head of household has used all of the benefits in the existing account, change the case name, issue a second new EBT card to the new head of household and have him or her select a new PIN for that second card. (Cross Reference: P-6535.07).
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-92 Transmittal: UP-93-29 1505.25 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: The Application Process FS _______________________________________________________________ Subject: Head of the Assistance Unit ______________________________________________________________________________
1505.25 A. General Statement
1. In general, the assistance unit may select any responsible individual as head of the Food Stamps assistance unit, except in the situations described below in B.
2. Whenever possible, the head of the assistance unit will be the adult responsible for the care or supervision of the majority of the assistance unit members.
3. The head of the assistance unit must be an eligible member of the assistance unit, except when he or she:
a. is the only adult able to serve as head of the assistance unit; and
b. is excluded from participation in the FS program because of non-citizen status, or a disqualification penalty (Cross Reference: 2020); and
c. would otherwise be included in the assistance unit if not for the exclusion.
4. Additional requirements are not imposed based on the head of the assistance unit classification, such as requiring the head of the assistance unit rather than another responsible member to appear at the district office for an interview.
B. Assistance Units That Have Violated Employment and Training Requirements or Voluntary Quit Requirements
1. The assistance unit may select as its head the adult parent of a child of any age or an adult who has parental control over a minor child in the assistance unit.
a. All adults in the assistance unit must agree on the individual selected.
b. The adult parent or adult with parental control does not have to be the principal wage earner.
2. The Department designates the head of the assistance unit when:
a. the assistance unit fails to select its own head;
all adults in the assistance unit cannot agree on a designee. CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 1505.25 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: The Application Process FS _______________________________________________________________ Subject: Head of the Assistance Unit ______________________________________________________________________________
1505.25 C. When the Head of the Assistance Unit Is Selected
1. An assistance unit may select its head only:
a. at certification; or
b. when the composition of the assistance unit changes.
2. The Department cannot delay certification or deny benefits solely because the assistance unit fails to select its head.
D. Notification
The Department must notify all assistance units to inform them:
1. that they may have the option to select their head; and
2. which assistance units are eligible to select the head; and
3. how changes in the designation of head of the assistance unit must be reported.
E. Fraud Disqualification
If the adult is excluded because of a fraud disqualification, the individual may represent the assistance unit only if no other adult is immediately available to act as an authorized representative for the purpose of applying or purchasing foods with the EBT debit card.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1505.25 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process _______________________________________________________________ Subject: Application Interviews ______________________________________________________________________________
P-1505.25 Scheduling
1. Require AFDC and FS applicants to attend an office interview unless they are otherwise entitled to a waiver.
2. Make every attempt to complete the interview the same day entitlement to expedited service is determined.
3. As a general rule, if the interview is to be held at a later date, schedule the appointment within ten days of the date of application.
4. Always allow enough time in your schedule to accommodate clients who are tardy or for disruptions in your schedule.
5. Consider the following when scheduling an interview:
° combined interview requirements for FS applicants who are also requesting cash assistance;
° postal delivery time if the appointment notice is mailed;
° normal and expedited service promptness standards;
° 10 day requirements for the return of verification or accomplishing other required client actions.
6. Notify the applicant of the date and time of the scheduled appointment.
7. Make a reasonable attempt to interview applicants if they appear late or at a time that was not scheduled in advance.
Waiving the Interview
1. If a waiver of the office interview is requested:
° determine the reason for the request;
° determine if another qualified person is available to attend the interview.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-95 Transmittal: UP-95-7 P-1505.25 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: The Application Process AFDC _______________________________________________________________ FS Subject: Application Interviews ______________________________________________________________________________
P-1505.25 Waiving the Interview (continued)
2. Explore the feasibility of postponing the interview.
3. Allow the waiver if there is reasonable evidence to support the request.
4. Arrange for a home visit or telephone interview if the in-office interview requirement is waived.
5. Document the reason for granting or denying the request for a waiver of the office interview in the case record or in the EMS narrative.
Scheduling a Second Appointment
1. Schedule a second appointment if the applicant fails to keep the first one and requests a second.
2. Allow enough time for obtaining verification and completing processing when scheduling a new appointment.
3. Notify the applicant of the date and time of the appointment.
4. Document the file and maintain your system controls.
Conducting Unscheduled Interviews
1. If the applicant appears at a time other than the scheduled appointment time try to complete the interview whenever possible.
2. Do not unnecessarily reschedule the interview for people who appear late, but appear on the day of the scheduled appointment if within reason you are able to adjust your work schedule to accommodate the individual.
3. Prior to deciding to schedule a new appointment, consider such factors as:
° if there is sufficient time left in the standard processing period, or if rescheduling would potentially cause the standard to be exceeded;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1505.25 page3 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: The Application Process AFDC _______________________________________________________________ FS Subject: Application Interviews ______________________________________________________________________________
P-1505.25 Conducting Unscheduled Interviews (continued)
3. ° if other scheduled appointments would be affected;
° hardship caused to the client;
° your work schedule.
4. Always allow enough time in between appointments when you schedule to accommodate interruptions or people who are not on time.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505.30 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ FS Subject: MA Application Interviews ______________________________________________________________________________
1505.30 A. Provisions
1. In certain programs, the applicant may be required to appear at an appropriate certification site for a face to face interview, unless the applicant is entitled to a waiver of the requirement.
2. The office interview is conducted as a condition of eligibility in the following programs:
a. AFDC; and
b. FS.
3. Office interviews are not required for AABD or MA applicants. The application process may be completed entirely through mail correspondence and telephone contact.
4. The Department may request any applicant to appear for an application interview. However, assistance is not denied to AABD or MA applicants solely on the basis of their failure to appear for a scheduled office interview.
B. Appropriate Certification Sites
1. AFDC and FS applicants must appear at the appropriate district office, or subdivision of that office which serves their region of residence.
2. The Department is not required to conduct an application interview with an applicant who appears at the wrong district office.
C. Purpose of the Interview
1. The purpose of the application interview is:
a. to review the application form and any other relevant information or documents for accuracy and completeness; and
b. to explain applicant rights and responsibilities; and
c. to ascertain pertinent information relating to the current circumstances of the assistance unit; and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1505.30 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process _______________________________________________________________ FS Subject: Application Interviews ______________________________________________________________________________
1505.30 C. 1. Purpose of the Interview (continued)
d. to explore any other issues related to need or eligibility which are unclear or unresolved; and
e. to make appropriate referrals.
2. Where application interviews are not required, the Department resolves the above issues through telephone contact, mail correspondence, home visits, or when necessary, by attempting to conduct an office interview.
D. Combined Interview
1. The Department may not require an applicant to appear for a separate food stamp interview if:
a. all members of the assistance unit are concurrently applying for AFDC or AABD; and
b. an in‑office interview is to be conducted for the PA cash assistance program.
2. A combined interview is scheduled if all members of the assistance unit concurrently apply for cash and food stamp assistance.
3. A combined interview is conducted unless the applicant and the agency agree to separate interviews.
4. The screening of an applicant to the extent necessary to determine whether an FS applicant is entitled to expedited service does not constitute an application interview. An application interview has been conducted if all the steps in C. above are completed.
E. Scheduling Interviews
1. The Department is not required to conduct the application interview on the same day the assistance request is filed.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 1505.30 Page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process FS _______________________________________________________________ Subject: Application Interviews ______________________________________________________________________________
1505.30 E. 2. Scheduling Interviews (continued)
2. Reasons for conducting the interview on the same day include, but are not limited to the following:
a. a second appearance at the certification site may cause unnecessary hardship or a FS expedited service delay;
b. the applicant has most of the information required to complete the interview on hand;
c. personnel are readily available to conduct the interview.
3. If the interview is not conducted at the time the assistance request is filed, it is scheduled within a reasonable period which will allow:
a. the application process to be completed within the established time limit; and
b. the applicant at least ten days to complete any required actions subsequent to the interview.
4. Factors that are considered in scheduling the interview include, but are not limited to the following:
a. time constraints imposed by joint interview requirements in cash assistance and FS cases;
b. potential delays caused by mail correspondence;
c. timely action and notification requirements;
d. processing capabilities;
e. time limitations for providing assistance to applicants.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 7-1-93 Transmittal: UP-93-19 1505.30 Page 4 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process FS _______________________________________________________________ Subject: Application Interviews ______________________________________________________________________________
1505.30 F. SSI Assistance Units (FS)
1. SSI assistance units that have been interviewed by SSA are not required to see an eligibility worker from the Department or otherwise be subjected to an additional interview.
2. The Department may not further contact the assistance unit in order to obtain information unless:
a. the application is incomplete or improperly completed; or
b. required verification is missing; or
c. information provided to the Department is questionable.
G. Waiver of the Office Interview
1. The in‑office interview requirement may be waived at the request of the applicant if:
a. the assistance unit member or other qualified person is unable to attend the interview for one of the following reasons:
(1) the individual(s) is 65 years of age or older; or
(2) the individual(s) is mentally or physically handicapped; or
(3) the individual(s) has good cause not to appear; and
b. for FS assistance units, an authorized representative cannot be appointed; and
c. postponement of the interview until such time that the applicant is able to appear at the district office would cause the Department to exceed the timeliness standard for processing the application.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 09/01/04 Transmittal: UP-04-20 1505.30 Page 5 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process FS _______________________________________________________________ Subject: Application Interviews ______________________________________________________________________________
1505.30 G. Waiver of the Office Interview (continued)
2. Good cause may include, but is not limited to the following hardships:
a. illness;
b. severe weather;
c. death in the immediate family;
d. other circumstances beyond the control of the applicant;
e. a conflict between the Department's hours and the applicant's working or training hours; or
f. transportation difficulties.
3. For the FS program, the Department conducts a telephone interview or a home visit once every twelve months if the office interview is waived.
H. Failure to Appear
1. Rescheduling Appointments
a. The Department does not schedule a second interview if an applicant fails to appear for the application interview and fails to contact the Department to reschedule.
b. The Department does not deny the application for at least thirty days from the date of application in cases where the applicant fails to appear for the application interview.
2. Failure to Appear Because of Hardship
a. If a hardship such as an accident or family illness causes the applicant to miss the interview appointment, the Department reschedules the interview upon the applicant's request.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 7-1-87 Transmittal: UP-91-2 1505.30 Page 6 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process FS _______________________________________________________________ Subject: Application Interviews ______________________________________________________________________________
1505.30 H. 2. Failure to Appear Because of Hardship (continued)
b. Any resulting delay in processing is considered the fault of the applicant.
I. Unscheduled Interviews
1. The Department is not required to interview applicants on the same day they appear at the office if:
a. the applicant comes into the office at a time other than the scheduled appointment time; and
b. a new appointment can be scheduled at least ten days in advance of the last day of the standard processing period.
2. A reasonable attempt is made to complete the interview the same day. However, if adequate time remains in the standard processing period a new appointment may be scheduled.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-1-93 Transmittal: UP-93-38 P-1505.30 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Completing the Interview ______________________________________________________________________________
P-1505.30 1. Conduct the interview. Use the EDD or EMS screens as a guideline and review all factors related to:
° Technical eligibility;
° Categorical eligibility;
° procedural eligibility requirements;
° Financial eligibility.
2. Complete all appropriate sections of the EDD or EMS screens.
3. Assist the applicant in deciding which programs he or she wishes to apply for:
° advise the applicant of the type of assistance available;
° discuss any program options.
4. Document your findings. Use the EDD margins or EMS Remarks Screen to make notes or records of the interview.
5. Provide the applicant with any forms or materials necessary to establish eligibility or meet procedural eligibility requirements.
6. Make referrals to preventive services, HealthTrack, or other areas where appropriate.
7. For all cash and Medicaid assistance units with children under the age of twenty-one, discuss the importance of regular age appropriate well-child care, including immunizations and blood lead testing. Encouarage these assistance units to take advantage of the following services which HealthTrack staff can provide:
° helping to schedule regular medical, dental, vision and hearing appointments
° helping to find a doctor, dentist or other medical provider convenient for the family
° arranging medical transportation, if necessary
° help with eliminating barriers (i.e. child care) which prevents families from receiving medical care
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-93 Transmittal: UP-93-38 P-1505.30 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ____________________________________________________________ MA Subject: FS Completing the Interview ______________________________________________________________________________
P-1505.30 7. (continued)
° providing health education information, including the benefits of preventive health care, the importance of age appropriate immunizations and the periodicity schedule for well-child care.
° explaining the benefits and availability of the WIC program and other community services of interest
° providing information on the availability of local immunization clinics, which provide vaccines free of charge.
° reminding the client when a child is due for an appointment
8. Review the application information with the applicant.
9. Discuss with the applicant all of the eligibility factors which need to be verified. Come to an agreement with the applicant on what documents the applicant will submit, based on what is the best documentation, which the applicant can readily obtain. Refer to Chapter 1540 for guidelines on verification.
10. Provide a notice of documents that must be submitted to verify eligibility factors (W-1348). Include the deadline for submitting these documents and explanation of the consequences of not providing these documents. Also provide a list of alternative documents which can be used.
11. Ask the heads of households of all cash or Medicaid assistance units with children under the age of twenty-one, to document whether the children have a primary care provider and are receiving regular physical exams. Refer all of these clients to the HeathTrack Unit.
12. Explain that the Department may provide assistance if it will be difficult for the applicant to obtain any required verifications by the deadline.
13. Refer to the General Principles of Verification (chapter 1540) for detailed information on handling verification and evaluating evidence.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-1-92 Transmittal: UP-93-38 P-1505.30 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Completing the Interview ______________________________________________________________________________
P-1505.30 (continued)
14. Explore any other issues, which need to be discussed.
15. Obtain signature on all pertinent forms, including the Agency/Client Agreement sections of the verification checklist. The Agency/Client section of the verification checklist does not have to be signed unless the client was interviewed in person. If an interpreter was used, require the interpreter's signature on the EDD and on other appropriate documents. Do not have the applicant sign documents that he or she does not understand.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 6-1-94 Transmittal: UP-94-11 1505.35 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ______________________________________________________________ MA Subject: FS Application Processing Standards ______________________________________________________________________________
1505.35 A. Prompt Action
1. Prompt action is taken to determine eligibility on each application filed with the Department.
2. Reasonable processing standards are established to assure prompt action on applications.
B. Notification
The Department notifies applicants of:
1. any actions taken on applications; and
2. when applications are not acted upon within the established time limits.
C. Standard of Promptness for Processing Applications
1. The following promptness standards are established as maximum time periods for processing applications:
a. thirty calendar days for eligible FS applicants that do not qualify for expedited service;
b. thirty calendar days for FS applicants who are found to be ineligible for FS benefits. However, the Department is allowed an additional seven days to issue the denial notice to ineligible applicants;
c. forty-five calendar days for:
(1) AFDC applicants; and
(2) AABD or MA applicants applying on the basis of age or blindness;
d. ninety calendar days for AABD or MA applicants applying on the basis of disability.
2. The first day of the processing period begins on the day following the date of application.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 1505.35 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Application Processing Standards ______________________________________________________________________________
1505.35 C. Standard of Promptness for Processing Applications (continued)
3. The standard of promptness has been met if by the last day of the processing standard the Department has:
a. issued a notice of denial to the applicant, except that for FS cases, the Department has an additional seven days to issue the notice of denial; or
b. issued benefits to the assistance unit either in check form or by deposit into a financial institution by the thirtieth day following the date of application.
4. FS assistance units have been given an opportunity to participate if by the thirtieth day following the date of application they have received FS benefits through an Electronic Benefits Transfer (EBT).
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 8-1-93 Transmittal: UP-97-1 1505.35 page 3 ______________________________________________________________________________ Section: Type: Special Programs POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Application Processing Standards ______________________________________________________________________________
1505.35 D. Use of the Standard of Promptness
1. The Department determines eligibility within the standard of promptness without exception for the FS program.
2. The Department determines eligibility within the standard of promptness for the AFDC, AABD, and MA programs except when verification needed to establish eligibility is delayed and one of the following is true:
a. the client has good cause for not submitting verification by the deadline; or
b. the client has been granted a 10 day extension to submit verification which has not elapsed; or
c. the Department has assumed responsibility for obtaining verification and has had less than 10 days; or
d. the Department has assumed responsibility for obtaining verification and is waiting for material from a third party.
3. Processing standards are not used as a waiting period for granting assistance. Applications are processed with reasonable promptness as soon as the Department is able to make an eligibility determination.
4. Processing standards are not used as the basis for denying assistance. Denial results from the failure to meet or establish eligibility within the applicable time limit.
5. Processing standards apply separately to the specific program for which application is made. Therefore, an application for several programs may be awarded or denied at different times for each program.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 P-1505.35 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Processing Standards ______________________________________________________________________________
P-1505.35 1. Maintain controls and monitor the status of each pending application.
2. Determine eligibility within the established time limits, except in unusual circumstances where a delay is necessary.
3. Give priority to emergencies. Process these cases first, and refer the applicant to other agencies if they can provide assistance faster. Emergencies include situations in which the following conditions either exist or are soon likely to exist:
° immediate medical treatment is required and no medical assistance is available; or
° there is no money and there is a threat of serious harm as a result; or
° there is no deliverable fuel to heat a home and that fact presents an immediate threat.
4. Give next priority to those cases which are either overdue or are approaching overdue status.
5. Whenever an emergency case is overdue or is going to become overdue, refer the case to the client representative system for expedited attention, unless an eligibility determination can be made immediately.
6. EMS will default to "E" for all new, reopened, or reinstated cash assistance units that have an instrument type of "X" on MISC. If the case that is being reopened or reinstated had an instrument type code of "C" or "D", EMS will default to that instrument type code for that assistance unit.
Ask the State Supplement applicant who is not in a boarding facility if he/she wants to receive benefits by EBT, EFT, or check. The Department prefers not to issue benefits via EBT to State Supplement recipients who live in boarding facilities. Therefore ask these recipients if they want to receive benefits in check form or via direct deposit.
° For EBT, enter "E" in the "INSTR TYPE" field on MISC
° For check, enter "C" in the "INSTR TYPE" field on MISC.
° For direct deposit, have the client get the necessary form from the reception area in the regional office or go to his/her bank to get the necessary form, complete the form and send it to the Financial Management Unit in C. O. CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 2-1-97 Transmittal: UP-97-3 P-1505.35 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Processing Standards ______________________________________________________________________________
P-1505.35 7. For cases whose benefits are not to be issued through EBT or EFT, adjust the processing schedule to make allowances for:
° weekends;
° mail delivery days;
° redemption requirements in the FS Program;
° other administrative delays.
8. Notify the assistance unit if action is taken or if the eligibility determination will not be completed on time.
9. Document any case actions or notifications in the case file.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-06 Transmittal: UP-06-07 1505.40 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ____________________________________________________________ FS Subject: MA Eligibility Determinations ______________________________________________________________________________
1505.40 A. Processing Applications
1. Prior to making an eligibility determination the Department conducts a thorough investigation of all circumstances relating to eligibility and the amount of benefits.
2. A Fraud Early Detection (FRED) investigation is done on AABD, Medicaid and Food Stamps applications that meet an error prone profile. Conditions that would cause a case to meet this profile include, but are not limited to:
a. a previous fraud overpayment;
b. children under the age of six;
c. the household is suspected of living above its means;
d. the case was denied or closed within three months;
e. application is inconsistent with prior case history;
f. questionable absent parent information;
g. no income for two consecutive months;
h. questionable verification;
i. living in Connecticut for less than three months;
j. household composition appears different than reported;
k. assets appear to be greater than reported.
PRIVATE CONNECTICUT DEPARTMENT OF SOCIAL SERVICEStc \l 1 "CONNECTICUT DEPARTMENT OF SOCIAL SERVICES" UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-00 Transmittal: UP-00-2 1505.40 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ____________________________________________________________ FS Subject: MA Eligibility Determinations ______________________________________________________________________________
1505.40 A. Processing Applications (cont.)
3. The eligibility determination for an assistance program is not delayed pending a determination of eligibility for the same applicant in a different program category, unless participation in the MA or FS program as categorically needy is dependent upon eligibility for cash assistance.
4. The Department may complete the eligibility determination at any time during the application process when:
a. the applicant withdraws the application; or
b. all requirements for determining eligibility on a FS expedited service application are met; or
c. the application process is complete and all required verification has been obtained; or
d. adequate information exists to determine ineligibility because one or more eligibility requirements are not satisfied; or
e. the applicant refuses to cooperate in completing an eligibility requirement rendering the entire assistance unit ineligible.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-15-90 Transmittal: UP-00-2 1505.40 Page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ____________________________________________________________ FS Subject: MA Eligibility Determinations ______________________________________________________________________________
1505.40 B. Incomplete Applications
1. Applicant Failure (All Programs)
The following provisions apply if the applicant failed to complete the application without good cause:
a. If eligibility has been established to the extent that assistance can be granted to all or a part of the assistance unit, the case is processed between:
(1) the day after the expiration of the applicants deadline for completing the required action; and
(2) the last day of the agency promptness standard for processing the application;
b. If assistance cannot be granted:
(1) AFDC, AABD and MA cases are denied between the thirtieth day and the last day of the appropriate promptness standard for processing the application;
(2) FS applications are denied on the thirtieth day following the date of application.
c. The applicant's failure to provide required verification by the processing date causes:
(1) one or more members of the assistance unit to be ineligible if the unverified circumstance is a condition of eligibility; or
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-1-91 Transmittal: UP-00-2 1505.40 Page 4 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ____________________________________________________________ FS Subject: MA Eligibility Determinations ______________________________________________________________________________
1505.40 B. 1. c. Applicant Failure (All Programs) (continued)
(2) the circumstance to be disregarded in the eligibility determination if consideration of the circumstance is contingent upon the applicant providing verification;
d. Verification received after the date that an incomplete application is processed:
(1) is used only with respect to future case actions; and
(2) is not used to retroactively determine a corrective payment.
2. Administrative Delays (All Programs)
a. The Department cannot postpone the eligibility determination beyond the standard thirty, forty-five or ninety day processing period if due to an administrative delay the only information needed is verification of non-citizen status.
b. If the eligibility determination is delayed, the Department continues to process the application until a decision can be made.
c. Delaying the FS eligibility determination beyond the thirtieth day causes the processing period to be extended by an additional thirty days.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-15-90 Transmittal: UP-00-2 1505.40 Page 5 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ____________________________________________________________ FS Subject: MA Eligibility Determinations ______________________________________________________________________________
1505.40 B. 3. Applicant Failure Subsequent to Administrative Delays
The following provisions apply if subsequent to an administrative delay the applicant becomes responsible for not completing the application process:
a. for AFDC, AABD and MA applications, the Department:
(1) determines eligibility without further delay; or
(2) continues to pend the application if good cause can be established or if a 10 day extension is granted.
b. for FS applications, the Department:
(1) determines eligibility without further delay if eligibility can be established; or
(2) denies assistance on the last day of the second thirty day period if eligibility cannot be established.
4. Delays Due to Good Cause (AFDC, AABD, MA Only)
a. The eligibility determination is delayed beyond the AFDC, AABD or MA processing standard if because of unusual circumstances beyond the applicant's control, the application process is incomplete and one of the following conditions exists:
(1) eligibility cannot be determined; or
(2) determining eligibility without the necessary information would cause the application to be denied.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-1-03 Transmittal: UP-03-34 1505.40 page 6 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ FS Subject: MA Eligibility Determinations ______________________________________________________________________________
1505.40 B. 4. b. Delays Due to Good Cause (AFDC, AABD ,MA only) (continued)
If the eligibility determination is delayed, the Department continues to process the application until:
(1) the application is complete; or
(2) good cause no longer exists.
5. Delays Due to Insufficient Verification (AFDC, AABD, MA Only)
a. Regardless of the standard of promptness, no eligibility determination is made when there is insufficient verification to determine eligibility when the following has occurred:
(1) the Department has requested verification; and
(2) at least one item of verification has been submitted by the assistance unit within a time period designated by the Department, but more is needed.
b. Additional 10 day extensions for submitting verification shall be granted, as long as after each subsequent request for verification at least one item of verification is submitted by the assistance unit within each extension period.
C. Determining Cause of Delay (FS Only)
1. The applicant is considered responsible for incomplete applications if the Department has taken the following actions:
a. offered assistance in completing application materials or procuring difficult to obtain verification; or
b. scheduled a second interview for applicants who failed to appear for the first scheduled interview but who contacted the Department to reschedule; or
c. with the exception of (3) below, has allowed at least ten days from the date it notifies the applicant of a required action for the applicant to complete the action, including requests to provide verification.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-93 Transmittal: UP-01-04 1505.40 page 7 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS The Application Process ______________________________________________________________ Subject: Eligibility Determinations ______________________________________________________________________________
1505.40 C. Determining Cause of Delay (FS Only) (continued)
2. The Department is responsible for incomplete applications if in the appropriate situation it has not:
offered assistance in completing application materials or obtaining verification where appropriate; or
b. scheduled a second interview; or
c. allowed the applicant 10 days to complete a required action.
The Department is considered responsible for delays in processing applications if it has agreed to accept responsibility for obtaining verification on behalf of the assistance unit, and the delay is due to a delay in getting that verification, provided that the assistance unit continues to cooperate in the verification process.
Applicants are not allowed 10 days to complete the application process, but instead must complete the process by the last day of the application processing standard if:
a. they failed to appear for both the initial and rescheduled office interview, but complete the interview prior to the last day of the standard processing period; and
b. the date the interview is conducted is after the twentieth day of the processing period; and
c. except for administrative delays, there is less than 10 days between the date the verification is requested and the standard of promptness.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1505.40 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Determining Eligibility ______________________________________________________________________________
P-1505.40 1. Investigate all factors relating to eligibility or benefit level prior to granting or denying assistance.
2. Allow ten days for the applicant to provide verification or complete other required actions.
3. Follow these guidelines in order to avoid unnecessary processing delays and undue client hardship:
° at the time the interview is conducted, identify all the actions that the applicant must take to establish eligibility, including verification and procedural requirements;
° make certain that the applicant understands his or her responsibilities;
° assist the applicant as necessary, as long as he or she cooperates;
° follow procedures specified in P-1540 in verifying eligibility factors;
° prioritize the caseload and regularly review the priorities, considering such factors as processing deadlines, applicant hardship, and estimated time frames for obtaining all required documentation;
° utilize internal sources of information (such as DMV and labor access), and other resources as much as possible in order to avoid excessive requests for verification or processing delays.
4. Review documents as they are received. Take action within 7 calendar days from the date of receipt.
5. When some verification is received but it is not sufficient to completely determine eligibility, allow the applicant a 10 day extension to submit more verification.
6. Also allow a 10 day extension if the applicant has good cause for failing to submit required verification on time.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1505.40 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Determining Eligibility ______________________________________________________________________________
P-1505.40 7. Except for Food Stamps, continue the above steps 4, 5, and 6 indefinitely, until:
a. eligibility is established; or
b. the applicant fails to submit any additional verification, by the deadline, without good cause.
8. For Food Stamps, continue steps 4, 5, and 6 unless granting an extension will cause the case to exceed the FS standard of promptness.
9. Consider making a follow-up contact to check on the applicant's progress and offer assistance if any of the following conditions exist:
° the applicant has expressed difficulty in obtaining verification and has indicated that the information may be provided late; or
° the applicant is having difficulty complying because of age or disability; or
° the missing information is reasonably available through some other means.
10. Take the following actions when contacting the applicant:
° inform the applicant of the verification which is outstanding and of the availability of assistance if the applicant is having difficultly obtaining the verification;
° discuss other forms of verification which might be easier for the applicant to obtain;
° allow the applicant an additional 10 days to provide the missing information;
° if no verification is received, determine if there is good cause to grant a ten day extension;
° document the case record, being sure to show the date of any action taken, and the deadlines for response from the applicant.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 8-1-90 Transmittal: UP-90-26 P-1505.40 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Determining Eligibility ______________________________________________________________________________
P-1505.40 11. Provide notification and document the case file if it is determined that the applicant is required to take additional actions that were not requested at the time of the interview in order to complete the application.
12. When there is enough information and verification to establish eligibility, process the application and grant assistance.
13. If application was made for more than one program, process each program application independently if this will ensure faster delivery of benefits. Do not wait to process the program applications simultaneously unless FS eligibility is dependent upon the status of the companion cash assistance application.
14. Process the application and deny assistance under the following circumstances:
° when enough information has been obtained to determine the assistance unit ineligible; or
° when the applicant has not submitted any of the required verification, within 30 days of the application date, and does not have good cause for the delay; or
° when the applicant has not provided any verification by the end of the 10 day period or of a 10 day extension to submit verification and another extension has not been granted, and the applicant does not have good cause for the delay; or
° when the applicant has failed to submit additional verification during a 10 day extension which was granted for that purpose, without good cause.
15. For FS applications held pending beyond thirty days because of administrative delays, wait until the sixtieth day following the date of application to deny assistance if the applicant becomes at fault for not completing the application in the second thirty day period. (Cross reference: 1505.40).
16. Issue the appropriate notice to the assistance unit.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-22-06 Transmittal: UP-07-14 P-1505.40 page 4 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Determining Eligibility ______________________________________________________________________________
P-1505.40 17. Advise clients that benefits issued through EFT will be available by the third business day after the case is granted.
18. Advise clients who have benefits issued through EBT that:
° their benefits will be in the EBT account by the third business day after the case is granted
° their EBT cards will be mailed the day after they are issued in EMS and should be received within 2 mailing days after the card is issued
° clients must call the EBT customer service phone number to select a PIN
° benefits cannot be accessed until the client has his/her EBT card and selects his/her PIN
19. Document your actions in EMS or the paper file.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ________________________________________________________________________ Date: 3-1-00 Transmittal: UP-00-2 P-1505.42 ________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ________________________________________________________________________ Chapter: Program: AFDC The Application Process MA _______________________________________________________________ FS Subject: Fraud Early Detection System (FRED) ________________________________________________________________________
P-1505.42 Intake
1. If there is questionable or inconsistent information that cannot be resolved without further investigation, complete the first page of the W-109CF2, “FRED Referral/Response Form”.
2. Remember to refer all cases that were previously referred to FRED and denied, regardless of the reason for denial. This information should be available on the EMS narrative.
3. Make sure to have the W-109CF2 signed by your supervisor.
4. When the investigation is complete and you have received page two of the W-109CF2, complete the W-959, “Intake Disposition Response to FRED Investigation”. Submit the completed W-959 to your supervisor for signature and route to the FRED Unit.
FRED Investigator
1. Before going into the field, the following should be done:
Get the field investigation approved by the FRED supervisor.
Read the W109CF2 to determine what verification the Intake Unit is requesting.
Check all previous assistance units.
Read all case narratives.
Using the name inquiry, look up any legally liable relatives (LLR) to determine if they were ever on assistance. Check for date of birth and social security number.
Check DMV for the LLR’s address.
Check labor files for LLR and applicant.
Check the Shelter Screen for the landlord’s name, address and telephone number.
Check the fire marshal’s list.
PRIVATE CONNECTICUT DEPARTMENT OF SOCIAL SERVICEStc \l 1 "CONNECTICUT DEPARTMENT OF SOCIAL SERVICES" UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 3-1-00 Transmittal: UP-00-2 P-1505.42 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process MA _______________________________________________________________ FS Subject: Fraud Early Detection System (FRED) ______________________________________________________________________________
P-1505.42 FRED Investigator (cont.)
Check the assessor’s list for the landlord’s name, address, and telephone number.
Try calling the landlord or sending a letter.
If the applicant has just moved from another state, call the previous state.
If the applicant has school aged children call the board of education or school to verify enrollment and attendance. If no school is listed check with the Board of Education to determine what school the child should be attending and contact that school.
2. At the time of the home visit bring the ten day letter with you. If the client is not at home, complete the ten day letter, make a copy and leave the original at the client’s home. Make a copy of the letter when back at the office and send it to the Intake supervisor.
3. Set a tickler for the ten days and remind the Intake worker to deny the case if the client has not contacted him or her. If the client contacts you, remember to advise the Intake worker.
4. When the investigation is complete, make a narrative entry in EMS and make a copy to attach to the W-109CF2.
5. Complete the response page on the W-109CF2. Check off the disposition and conclusions. Explain investigation results in detail.
6. Submit the W-109CF2 to the FRED Supervisor for signature.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-05 Transmittal: UP-05-15 1505.45 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ FS Subject: MA Reopening Denied Applications ______________________________________________________________________________
1505.45 A. FS Requirements
1. Provisions
a. FS applicants who failed to complete the application and were denied on the thirtieth day following the date of the application, are given an additional thirty days to take the required action before requiring them to file a new application.
b. The denied case is reopened if within the second thirty-day period the applicant takes the required action to complete the application process.
c. The provision for reopening a denied application applies only to those FS applicants who were denied assistance on the last day of the thirty day processing period because the Department could not take any further action on the application due to the fault of the applicant.
2. Applications
a. The Department may not require the applicant to file a new application if the case is reopened within the second thirty day period.
b. A new application is required only if:
(1) the case is not reopened in the second thirty day period; or
(2) a reopened case is denied a second time.
3. Loss of Benefits
a. The applicant's failure to complete the application process within the first thirty day period results in a loss of entitlement to benefits for the original month of application.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-06 Transmittal: UP-06-08 1505.45 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ FS Subject: MA Reopening Denied Applications ______________________________________________________________________________
1505.45 A. 3. Loss of Benefits (continued)
b. A reopened case that is found eligible in the second thirty day period is entitled to benefits beginning the date the FS applicant provides the necessary information or takes the necessary action to complete the application process.
4. Processing the Application
a. The Department processes the reopened application by the end of the second thirty day period.
b. The applicant must complete the application process by the sixtieth day following the original date of application or the application is denied.
c. A complete investigation of all material relevant to eligibility and benefit level is conducted. The applicant may be contacted, but is not required to appear for a second office interview if one has already been held.
d. The rules established in this chapter for determining eligibility apply equally to reopened applications, including;
(1) The provision to pend the reopened application until the thirtieth day of second processing period if it is incomplete; and
(2) The provision to continue processing the application for administrative delays beyond the sixtieth day following the original date of application.
B. AABD, MA Requirements
1. The Department reopens the denied application of AABD or MA applicant who:
a. was denied assistance for failing to meet the disability criteria; and
b. successfully appeals the SSI decision.
2. The case is reopened retroactive to the original date of application when the Department is notified that SSI has been awarded due to a successful appeal.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1505.45 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD ______________________________________________________________ MA Subject: FS Reopening Denied Applications ______________________________________________________________________________
P-1505.45 Food Stamps
1. If a denied FS application is reopened within sixty days from the original date of application:
° review the incomplete actions which lead to the denial of the original application;
° review all material on the original application for accuracy.
2. If necessary, contact the client in order to review the application material, but do not require a second office interview if one has already been conducted.
3. Process the application and grant or deny assistance.
4. Apply the appropriate "loss of benefits" penalty if assistance is granted. (cross reference: 1560)
5. Document your actions and issue the appropriate notification to the assistance unit.
AABD, MA
1. Reopen the denied application retroactive to the original filing date.
2. Review the application material for accuracy.
3. Contact the applicant if it is necessary to obtain additional information.
4. Process the application and determine eligibility for both the current and retroactive period.
5. Document your actions and issue the appropriate notification to the assistance unit.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 1505.50 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: The Application Process FS _______________________________________________________________ Subject: Identification Cards ______________________________________________________________________________
1505.50 A. Provisions
1. The Department issues specially marked non-photo identification (ID) cards to FS assistance units who are eligible to use their FS for delivered meals, at restaurants or at communal dining facilities.
2. All assistance units eligible for and interested in delivered meal services are issued ID cards marked with the letter "M".
3. All assistance units eligible for and interested in using communal dining facilities are issued ID cards marked with the letters "CD".
4. All assistance units eligible for and interested in using their food stamps at participating restaurants are issued ID cards marked with the letter "R".
5. The ID card is issued in the name of the individual designated as head of the assistance unit.
6. Individuals listed on the ID card must sign the card prior to its use.
B. Issuance of ID Cards
1. ID cards are issued at the time the individual becomes eligible and expresses a desire to use their FS as specified in 1505.50 A.
2. Replacement of ID cards is limited to instances of:
a. loss; or
b. mutilation or destruction; or
c. changes in the head of the assistance unit.
3. Whenever possible, the Department attempts to recover the ID card that is being replaced.
C. Use
The ID card must be presented to the meal delivery service, the restaurant or the communal dining facility.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 P-1505.50 ______________________________________________________________________________ Section: Type: Eligibility Processing PROCEDURES ______________________________________________________________________________ Chapter: Program: FS The Application Process _______________________________________________________________ Subject: Issuing Identification Cards ______________________________________________________________________________
P-1505.50 1. Issue a W-1304 (non-photo ID card) only if the client is eligible to use FS for delivered meals, at restaurants or at communal dining facilities. (Cross Reference: 1505.55)
2. If a W-1304 is needed, have the head of the assistance unit sign the Food Stamp I.D. card
3. If the in-office interview is waived, complete all of the information on the ID, mark it as described in policy and mail it to the client. Include the name of the head of the assistance unit and the AU number.
4. Do not mail a blank ID card.
5. Follow the same procedure for replacement of ID cards.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 1505.55 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ FS Subject: Department Issued Debit Cards ______________________________________________________________________________
1505.55 A. Provisions
1. Debit cards are issued to all Food Stamp assistance units, all AFDC assistance units except those having their benefits directly deposited into their personal bank accounts, and to those AABD assistance units choosing to receive benefits through the EBT system.
2. The debit card is issued to the head of the assistance unit, protective payee or authorized representative.
B. Issuance of EBT Debit Cards
1. Debit cards are issued at the time the household is eligible to receive benefits.
2. Replacement of debit cards is limited to instances of:
a. loss; or
b. theft; or
c. mutilation or destruction; or
d. demagnetization of magnetic stripe; or
e. changes in the head of the assistance unit; or
f. changes in the authorized representative; or
g. changes in the protective payee.
3. EBT debit cards must be replaced within three business days following the day the Department is notified by the household that a new debit card is needed.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-22-06 Transmittal: UP-07-14 1505.55 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ FS Subject: Department Issued Debit Cards ______________________________________________________________________________
1505.55 C. Issuance of Personal Identification Numbers (PINs)
PINs are selected via telephone to a specified customer service telephone number, which is issued with the EBT cards along with instructions to call the specified number.
D. Use
The Department-issued debit card is used to:
1. purchase eligible food items; and
2. access cash assistance benefits; and
3. pay public housing rent, utility payments or other payments where POS terminals are available to process these types of transactions.
E. Fees
The Assistance Unit is responsible for any fees charged by any banking institution in conjunction with the use of the EBT debit card.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 P-1505.55 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Replacement of EBT Debit Cards ______________________________________________________________________________
P-1505.55 1. Go to KMEN and select "K" to bring you to the "CAID" screen.
° "Mail PIN", "CL NO", "FST NME", and "LST NME" will be prefilled.
° Data will also be listed for any AREP's on record and for children active on an AFDC case.
° Select the client for whom the replacement card is being issued by typing a "Y" next to the person's data, type in the appropriate reason code, and hit "enter".
2. Tell the individual that he or she must go to the regional office to pick up the EBT card and to select a PIN.
3. If the person cannot go to the regional office make arrangements to mail the EBT card when it arrives in the regional office.
4. If the person cannot go to the regional office to select a PIN because he or she is elderly or disabled and is homebound, change the prefilled "N" to "Y" in the "MAIL PIN" field on "CAID".
5. To determine if the PIN should be mailed, follow the guidelines used to determine if the office interview is waived for redetermination, pick up of replacement benefits, etc. (Cross Reference: 1505.30, 6505)
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-38 1507 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: MAABD Assessment of Spousal Assets ______________________________________________________________ Subject:
______________________________________________________________________________
1507 The chapter on assessment of spousal assets discusses the special processing requirements associated with the evaluation of assets of an institutionalized spouse and community spouse.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-15-06 Transmittal: UP-06-14 1507.05 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Assessment of Spousal Assets MAABD _______________________________________________________________ Subject: Assessment Process - MCCA Spouses ______________________________________________________________________________
1507.05 A. Assessment Process
1. The Department provides an assessment of assets:
a. at the request of an institutionalized spouse or a community spouse:
(1) when one of the spouses begins his or her initial continuous period of institutionalization; and
(2) whether or not there is an application for Medicaid; or
b. at the time of application for Medicaid whether or not a request is made.
2. The beginning date of a continuous period of institutionalization is:
a. for those in medical institutions or long term care facilities, the initial date of admission;
b. for those applying for home and community based services (CBS) under a Medicaid waiver, the date that the Department determines the applicant to be in medical need of the services.
3. The assessment is completed using the assets which existed as of the date of the beginning the initial continuous period of institutionalization which started on or after September 30, 1989.
4. The assessment consists of:
a. a computation of the total value of all non-excluded available assets owned by either or both spouses; and
b. a computation of the spousal share of those assets.
5. The results of the assessment are retained by the Department and used to determine the eligibility at the time of application for assistance as an institutionalized spouse.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-7-09 Transmittal: UP-09-04 1507.05 Page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Assessment of Spousal Assets MAABD _______________________________________________________________ Subject: Assessment Process - MCCA Spouses ______________________________________________________________________________
1507.05 A. 6. Initial eligibility is determined using an assessment of spousal assets except when:
undue hardship exists (Cross Reference 4025.68); or
b. the institutionalized spouse has assigned his or her support rights from the community spouse to the department (Cross Reference: 4025.69); or
the institutionalized spouse cannot execute the assignment because of a physical or mental impairment. (Cross Reference: 4025.69).
B. Requesting the Assessment
1. MCCA spouses shall file a completed written request for the assessment on a form prescribed by the Department.
2. Telephone contacts or other requests for the assessment not made on the prescribed form are considered inquiries and do not constitute a request.
3. The request may be submitted in person or by mail.
4. The assessment form shall be signed by the community spouse or the institutionalized spouse or another individual who is qualified to request the assessment on behalf of either MCCA spouse.
5. The Department determines the individuals who are qualified to request the assessment on the same basis as it determines the individuals who are qualified to make an application for assistance (Cross Reference 1505.15).
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-15-06 Transmittal: UP-06-14 1507.05 Page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Assessment of Spousal Assets MAABD _______________________________________________________________ Subject: Assessment Process - MCCA Spouses ______________________________________________________________________________
1507.05 C. Notification
1. The Department provides a notification of the results of the assessment to each spouse.
2. The notification contains the following information:
a. the result of the assessment; and
b. the documents used for the assessment; and
c. the amount of the spousal share; and
d. the maximum amount of assets which may be retained by the spouses at the time of the results of the assessment which would not adversely affect eligibility; and
e. the Department's determination of the assistance unit's current eligibility status in regard to assets; and
the right of each spouse to request a Fair Hearing (Cross Reference 1570).
D. Fee
1. The Department charges a fee of $50.00 if the request for the assessment is made at any time other than:
a. during the application process; or
b. while the assistance unit is currently eligible for Medicaid.
2. Payment of the fee is a pre-requisite for the Department's performance of the assessment.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-92-20 P-1507.05 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Assessment of Spousal Assets - MCCA Spouses MAABD ___________________________________________________________________________ Subject: When to Complete an Assessment
P-1507.05 1. Do not complete an assessment if the institutionalized spouse is a recipient of Medicaid when he or she becomes institutionalized.
2. Determine if a continuous period of instituionalization exists by looking for a period of 30 or more consecutive days during which the institutionalized spouse was subject to any one or any combination of the following:
° was a resident in a medical facility;
° was a resident in a LTCF;
° was determined to be in medical need of CBS services under a Medicaid Waiver.
3. Determine if the institutionalized spouse began his or her continuous period of institutionalization on or after September 30, 1989.
4. If the institutionalized spouse started his or her continuous period of institutionalization before September 30, 1989, stop here. The spouses are not MCCA spouses.
5. If the institutionalized spouse started a continuous period of institutionalization on or after September 30, 1989, instruct the MCCA spouses to complete the assessment in respect to the assets they owned at the time the period of institutionalization began.
6. If you did not get information or verification of assets do not complete an assessment.
7. If no assessment was completed prior to the date of application, complete an assessment at the time of application.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-92-20 P-1507.10 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Assessment of Spousal Assets - MCCA Spouses MAABD _______________________________________________________________ Subject: Assessment Process ______________________________________________________________________________
P-1507.10 1. Ask the spouse who is requesting the assessment to complete and return the "Request for Assessment of Spousal Assets" form.
2. Ask for verification of all assets being evaluated.
3. If the assessment is not being made during a concurrent application process, advise the requesting spouse of the necessity of sending a payment of $50.00 at the time the request form is returned.
4. Complete the evaluation of the assessment within 45 days of the receipt of all the required documentation.
5. Evaluate each asset owned by either or both spouses according to the policy in section 4000 - Treatment of Assets. Be sure to use the rules for MCCA spouses.
6. If the asset is excluded, document the assessment form regarding the reason for the exclusion. Do not count the value toward the counted assets of the spouse.
7. If the asset is inaccessible, document the assessment record regarding the reason for inaccessibility. Do not count the asset or require either spouse to pursue the inaccessible asset for the purpose of the assessment.
8. If the asset is not excluded and is accessible, determine the equity value of the asset by subtracting any encumbrances against the value from the asset's fair market value.
9. If an asset is held jointly with someone other than a spouse, follow the policy in section 4010 - "Determination of Ownership" to determine the spouse's equity value in the asset.
10. If the asset is accessible, count the equity value of the asset toward the counted assets of the spouse.
11. Follow the process in steps 5-10, for each asset owned by either or both spouses.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-92-20 P-1507.10 Page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Assessment of Spousal Assets - MCCA Spouses MAABD _______________________________________________________________ Subject: Assessment Process ______________________________________________________________________________
P-1507.10 12. Compute the total value of all counted assets owned by the institutionalized spouse by adding the equity value of all non-excluded accessible assets.
13. Compute the total value of all counted assets owned by the community spouse by adding the equity value of all non-excluded accessible assets.
14. Add the amounts computed in steps 12 and 13.
15. Divide the amount calculated in step 14 by 2 to determine the spousal share for each spouse.
16. Prepare a notification of results and send a copy to both MCCA spouses.
17. Retain the assessment form and copies of the notification of results in the case record.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1510 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Categorical Eligibility Requirements _______________________________________________________________ Subject:
______________________________________________________________________________
1510 The chapter on categorical eligibility discusses special processing requirements associated with FS assistance units that are or appear to be categorically eligible for the FS program.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-01 Transmittal: UP-03-31 1510.05 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Categorical Eligibility Requirement _______________________________________________________________ Subject: Special Processing Requirements ______________________________________________________________________________
1510.05 A. Evaluating Categorical Eligibility
1. Assistance units that are or appear to be categorically eligible for the FS program are identified by the Department at the time of application. (cross reference: 2500)
2. An evaluation of an assistance unit's categorical eligibility is performed prior to denying or discontinuing FS eligibility.
B. Application of Eligibility Process Requirements
Except where otherwise stated, assistance units that are or appear to be categorically eligible are subject to the same eligibility process requirements as all other assistance units that are not categorically eligible.
C. Eligibility Determinations
1. With the exception of expedited service cases, the FS eligibility determination is temporarily delayed on applications with a pending AFDC or AABD application which:
a. appear to be categorically eligible; and
b. would otherwise be found ineligible for the FS program if eligibility is not determined on a categorical basis.
2. Cases that are entitled to expedited processing are determined within the expedited service processing standards.
3. In no event may processing be delayed beyond the thirty day FS application processing standard.
4. If processing is delayed and the case is not found categorically eligible, assistance is denied on the thirtieth day following the date of application.
D. Notification
A jointly processed assistance unit that is denied FS assistance is told on the notice of denial to inform the Department if it becomes eligible for TFA, including diversion assistance, AABD, GA, SAGA, refugee assistance or SSI.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1510.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: FS Categorical Eligibility Requirements _______________________________________________________________ Subject: Handling of Applications ______________________________________________________________________________
P-1510.05 1. Evaluate categorical eligibility prior to denying or discontinuing FS assistance.
2. For application, delay your decision if the case may become categorically eligible. However, do not exceed the thirty day processing requirement.
3. If the case is found to be categorically eligible and all other eligibility factors are satisfied:
° provide assistance at the minimum benefit level; or
° convert the case to suspended status.
4. Issue appropriate notification if assistance is discontinued or denied.
5. Reevaluate the case if you become aware of, or requested to review categorical eligibility.
6. Take appropriate action if the case is later found to be categorically eligible, including action to correct an underpayment.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-01 Transmittal: UP-03-31 1510.10 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Categorical Eligibility Requirement _______________________________________________________________ Subject: Special Processing Requirements ______________________________________________________________________________
1510.10 A. Provisions
1. Jointly processed FS assistance units are entitled to a reevaluation of their FS eligibility if:
a. FS assistance was denied; and
b. the assistance unit is later found eligible for TFA, including diversion assistance, AABD, GA, SAGA, refugee assistance or SSI benefits; and
c. the unit is otherwise categorically eligible.
2. Eligibility is reevaluated on the basis of:
a. the original FS application; and
b. any pertinent changes that have occurred since the application was filed.
3. The reevaluation is done at the request of the assistance unit or when the Department otherwise becomes aware of the unit's TFA, including diversion assistance, AABD, GA, SAGA, refugee assistance or SSI eligibility.
B. Processing Requirements
1. The assistance unit is not required to appear for another interview.
2. Information is updated through mail or telephone contact.
3. If any significant changes have occurred, the assistance unit is required to:
a. initial the changes on the original application, and
b. resign and redate the application.
4. Eligible assistance units are entitled to a corrective payment for any benefits lost as a result of the initial denial.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1515 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject:
______________________________________________________________________________
1515 Applicants for the FS program that meet a specific set of financial criteria are entitled to have their food stamp applications processed on an expedited basis. This chapter discusses the expedited processing requirements of the FS program.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _______________________________________________________________________________ Date: 4-1-02 Transmittal: UP-02-14 1515.05 _______________________________________________________________________________ Section: Type: Eligibility Process POLICY _______________________________________________________________________________ Chapter: Program: FS Expedited Services _______________________________________________________________ Subject: Identifying Eligible Assistance Units _______________________________________________________________________________
1515.05 A. Entitlement to Expedited Services
The Department determines FS eligibility on an expedited basis in cases meeting any of the following criteria:
The assistance unit's rent or mortgage costs, plus utility costs or the standard utility allowance, exceed its total monthly gross income plus liquid assets.
2. The assistance unit's total monthly gross income is less than $150, and its total liquid assets do not exceed $100.
3. The assistance unit is a destitute migrant or seasonal farm worker assistance unit whose total assets do not exceed $100.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _______________________________________________________________________________ Date: 9-21-96 Transmittal: UP-96-17 1515.05 page 2 _______________________________________________________________________________ Section: Type: Eligibility Process POLICY _______________________________________________________________________________ Chapter: Program: FS Expedited Services _______________________________________________________________ Subject: Identifying Eligible Assistance Units _______________________________________________________________________________
1515.05 B. Destitute Assistance Units
1. Migrant or Seasonal Farm Workers
a. For the purpose of determining entitlement to expedited service, the classification of an assistance unit as destitute applies only to migrant or seasonal farm worker assistance units.
b. FS assistance units that are not migrant or seasonal farm worker assistance units are never classified as destitute for expedited service purpose.
c. Migrant or seasonal farm worker assistance units which are destitute are entitled to expedited service and to the special income calculation methods applicable to destitute assistance unit. (cross reference: 5015)
d. The determination of whether an assistance unit is destitute is made:
(1) at application when the assistance request is filed; and
(2) at redetermination.
e. Migrant or seasonal farm worker assistance units which are determined destitute at redetermination are entitled to the special method of calculating income in the first month of the new certification period. (cross reference: 5015)
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-88 Transmittal: UP-88-28 1515.05 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Services _______________________________________________________________ Subject: Identifying Eligible Assistance Units ______________________________________________________________________________
1515.05 C. Destitute Assistance Units (continued)
2. What Constitutes Destitution
a. Income From a Terminated Source
(1) Assistance units are considered to be destitute if:
(a) their only income for the month of application is from a terminated source; and
(b) such income is received prior to the date of application.
(2) Income is considered as coming from a terminated source if:
(a) income which is normally received on a monthly or more frequent basis will not be received again for the balance of the month of application or the following month; or
(b) income which is normally received less often than monthly will not be received in the month in which the next payment would normally be received.
b. Income From a New Source
(1) Assistance units are considered to be destitute if:
(a) their only income for the month of application is from a new source; and
(b) they receive no more than $25 from the new income source prior to the tenth calendar day after the date of application.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-88 Transmittal: UP-88-28 1515.05 page 4 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Services _______________________________________________________________ Subject: Identifying Eligible Assistance Units ______________________________________________________________________________
1515.05 C. 2. b. Income From a New Source (continued)
(2) Income which is normally received on a monthly or more frequent basis is considered as coming from a new source if within thirty days prior to the date of application:
(a) no income is received from that source; or
(b) income of $25 dollars or less is received from that source.
(3) The receipt of wage advance for travel costs of a new employee are not counted in the determination of whether subsequent payments from the employer are from a new source or whether the assistance unit is destitute.
c. Income From Both a Terminated and New Source
(1) Assistance units who receive both income from a terminated source prior to the date of application, and income from a new source after the date of application, are considered destitute if:
(a) they receive no income from a terminated source for the balance of the month of application; and
(b) they receive no more than $25 from a new source prior to the tenth calendar day after the date of application.
(2) A migrant farm worker's source of income is considered to be the grower for whom the migrant is working and not the crew chief. A migrant who travels with the same crew chief but moves from one grower to another is considered to have moved from a terminated income source to a new source.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1515.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject:
______________________________________________________________________________
P-1515.05 1. Determine if the applicant is entitled to expedite service:
° at application when the ARF is filed; and
° at redetermination when calculating income for destitute assistance units. (cross reference: 5015).
2. Confirm that the case had been certified under normal processing standards, or that verification requirements that had been postponed at the last expedited certification have been provided.
3. Make every attempt to completer the application interview on the day the application is filed.
4. If the application is not made in person, contact the applicant by phone or mail an interview notice by the next business day.
5. Conduct a telephone interview if the office interview requirement is waived. Arrange a home visit only in unusual circumstances or when telephone contact is not possible.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 1515.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject: Processing Requirements ______________________________________________________________________________
1515.10 A. Standard of Promptness
1. For assistance units that qualify for expedited service, eligibility is determined no later than the seventh calendar day following the expedited service filing date.
2. The expedited service filing date is the day the signed application is received by the Regional Office having administrative responsibility for the applicant's geographic region of residence, except with prerelease applicants.
3. The expedited service filing date for prerelease applicants is the date of release from the institution.
4. If the assistance unit is eligible, benefits must be deposited into their EBT account by the seventh calendar day following the expedited service filing date.
5. Assistance units that file an application at an office of the SSA or at a Regional Office which does not serve their geographic region must be informed of the potential delay caused by submitting the request to the wrong office.
6. If the Department fails or is unable to identify entitlement to expedited service on the filing date, but subsequently discovers such entitlement, the seven day processing requirement is applied beginning with the day after the discovery date.
7. The standard of promptness has been met if by the seventh calendar day following the expedited service filing date one of the following actions has occurred:
a. A notice has been issued if the assistance unit is found ineligible, or because of proration requirements, is not entitled to receive benefits for the month of application; (cross reference: 6020)
b. The assistance unit's benefits have been deposited into the unit's EBT account.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1515.10 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject: Processing Requirements ______________________________________________________________________________
1515.10 B. Allowances for Mailing Time in Expedited Service Cases
1. Allowances are made for delays in the expedited service processing standards if:
a. application is made by mail rather than in person; and
b. the Department must schedule the application interview or obtain signature on the eligibility screening document through mail correspondence; and
c. all reasonable efforts are made to contact the applicant by telephone and to determine eligibility within the special processing standard.
2. If a telephone interview is conducted with an applicant who is entitled to a waiver of the office interview, the mailing time required to obtain signature on the application form is discounted in the calculation of the processing time.
3. If the Department must mail a notice to the applicant in order to schedule an in-office interview or a home visit, the time period between the mailing date of the notice and the scheduled appointment or home visit is counted in the calculation of the processing time. However, the Department is not held responsible for any resulting delay, provided that a reasonable effort is made to complete the application process with the promptness standard.
4. The Department has made reasonable effort to contact the applicant and process the application within the expedited service processing standards if:
a. the applicant is contacted by phone or mailed an interview or home visit notice within one business day of the date that entitlement to expedited service is discovered; and
b. the home visit or interview is conducted at the earliest possible date.
5. The Department is not responsible if the processing standard is exceeded due to the applicant's failure to respond to correspondence in a prompt manner.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 P-1515.10 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject: Processing Requirements ______________________________________________________________________________
P-1515.10 1. Follow the same process used in determining initial eligibility on a non-expedited application, except:
° observe the seven day processing standard;
° you may postpone verification of anything other than verification of identity;
° you may postpone work registration for anyone other than the unit member who is applying and who is not otherwise exempt.
2. Inform the assistance unit that:
° postponed actions must be completed prior to the next regular or expedited certification; and
° benefits may be withheld pending the receipt of in-state verification or work registration.
3. Complete the EDD and inform the applicant of any required actions.
4. Make the EBT card available by the seventh day.
5. Arrange for the client to come into the office to select the PIN by the seventh day.
6. If the case is not certified on an ongoing basis, issue a redetermination notice and EDD at the same time the expedited benefit is provided.
7. Provide appropriate notices.
8. Document the case file.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1515.15 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject: Procedures for Expediting Service ______________________________________________________________________________
1515.15 A. Application Interview
1. Interview Requirement
a. The application interview must be conducted prior to granting aid, unless the applicant is entitled to a waiver.
b. In order to expedite service the Department makes all reasonable attempts to complete the interview requirement within the expedited service processing standard.
c. If the assistance unit is entitled to a waiver of the office interview, the Department makes all reasonable attempts to conduct a home visit or telephone interview within the expedited service processing standard.
2. Applications Filed in Person
Whenever possible, individuals making application in person who are identified as eligible for expedited service are interviewed on the same day the assistance request if filed.
3. Mail Applications
a. Individuals making application by mail who are identified as eligible for expedited service, are contacted by telephone or mailed an interview notice within one working day of the day entitlement to expedited service is discovered.
b. The Department attempts to schedule the interview in time to allow the application to be processed within the expedited processing standard.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-1-91 Transmittal: UP-91-51 1515.15 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject: Procedures for Expediting Service ______________________________________________________________________________
1515.15 B. Postponed Verification
1. In order to expedite the processing of the application, the Department may postpone any mandatory verification factor with the exception of:
a. the identity of the individual making the application; and
b. the identity of the head of the assistance unit.
2. Verification requirements may be postponed only for the month of application, except that migrant farm worker assistance units are entitled to a postponement of out-of-state verification for the month of application and the following month.
3. All reasonable efforts are made to obtain verification prior to granting assistance.
4. Processing may not be delayed solely because of the lack of verification of any factor other than identity.
C. Declaration of Citizenship or Non-citizen Status
Household members who have not signed a declaration attesting to their citizenship or non-citizen status must be provided benefits if otherwise eligible.
D. Work Registration
1. Work registration must be completed for the person making the application unless:
a. the individual is exempt from the work registration requirement; or
b. the individual is acting as an authorized representative and is not considered a part of the applicant assistance unit.
The mandatory registration of all other assistance unit members may be postponed for the month of application.
E. Completing Postponed Requirements
Verification or work registration requirements that are postponed must be completed prior to the assistance unit's next expedited or regular certification.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1515.20 ______________________________________________________________________________ Section: Type: Eligibility Processs POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject: Certification and Entitlement to Benefits ______________________________________________________________________________
1515.20 A. Completed Applications
1. Assistance units determined eligible without benefit of postponed work registration or verification requirements are certified in accordance with the regular certification procedures for non-expedited cases.
2. Assistance units certified under regular procedures are entitled to receive benefits on an on going basis.
B. Postponed Verification or Work Registration Requirements
1. Eligible assistance units from whom work registration or mandatory verification requirements are postponed are certified:
a. for the month of application if application is made prior to the sixteenth day of the calendar month; or
b. for the month of application and the following month if application is made after the fifteenth day of the calendar month.
2. A redetermination must be completed if the assistance unit is to be certified on an ongoing basis without an interruption in benefits.
3. The following rules regarding benefit entitlement apply to assistance units that are certified for two months and have had verification or work registration requirements postponed:
a. Assistance units, other than migrant farmer assistance units, are entitled to benefits for the month of application only.
b. Migrant farmer assistance units are entitled to benefits:
(1) for the month of application only if a work registration or instate verification requirement is postponed;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1515.20 page 2 ______________________________________________________________________________ Section: Type: Eligibility Processs POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject: Certification and Entitlement to Benefits ______________________________________________________________________________
1515.20 B. 3. b. Postponed Verification or Work Registration Requirement (continued)
(2) for the month of application and the following month if out-of-state verification is postponed but all instate requirements are completed.
4. The second month's benefits for assistance units certified for two months are issued within five working days of the date the postponed requirement is completed.
C. Notification
Assistance units certified for two months for whom a work registration or verification requirement is postponed must be notified of the following:
1. that the benefits for the second month will not be issued until the postponed requirement has been completed; and
2. if verification results in a change in eligibility or benefit level that action is taken without notice of adverse action.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1515.25 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Expedited Service _______________________________________________________________ Subject: Limitations ______________________________________________________________________________
1515.25 There is no limit to the number of times that an applicant may be entitled to expedited service, provided that:
A. prior to each expedited certification the assistance unit completes the verification requirements postponed from the last expedited certification; or
B. the applicant was certified under normal processing standards since the last expedited certification.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-10 Transmittal: UP-11-01 1521 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Pregnant Women MA _______________________________________________________________ Subject:
______________________________________________________________________________
1521 Presumptive eligibility for pregnant women is a method of determining temporary Medicaid eligibility for pregnant women. The determination is made by providers authorized under federal and state law and approved by the Department to make presumptive eligibility determinations. These organizations are called “qualified providers.” Presumptive eligibility determinations made by “qualified providers” are temporary and end when a final determination of eligibility is made by the Department, or on an earlier date as specified in section 1521.10 A.2.
This chapter describes the conditions and methods used in the determination of presumptive eligibility for pregnant women.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-10 Transmittal: UP-11-01 1521.05 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: MA Presumptive Eligibility for Pregnant Women _______________________________________________________________ Subject: Identifying Eligible Assistance Units ______________________________________________________________________________
1521.05 A. Cases Entitled to Presumptive Eligibility for Pregnant Women
The Department determines HUSKY eligibility on a presumptive basis for those who qualify for the coverage group of Pregnant Women Under 250% of the Federal Poverty Level (P02). (Cross Reference: 2540.43)
Eligibility Determinations
1. The presumptive eligibility determination for pregnant women is made by the qualified provider. In making presumptive eligibility determinations, qualified providers act as agents of the Department and are governed by all Department policies and procedures including, but not limited to, the areas of confidentiality, equal treatment and nondiscrimination.
The qualified provider secures a completed application form from the applicant.
The qualified provider makes its presumptive eligibility determination that the applicant meets the categorical, technical and income eligibility criteria based on the information reported on the application form.
The qualified provider is not required to verify factors of eligibility, but shall forward to the Department a copy of the completed application and any readily available verification documents.
The qualified provider’s presumptive eligibility determination remains in effect until the ending date of presumptive eligibility specified in subsection A.2. of section 1521.10.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-10 Transmittal: UP-11-01 1521.07 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Pregnant Women MA _______________________________________________________________ Subject: Qualified Providers ______________________________________________________________________________
1521.07 A. Qualified Provider Categories
A qualified provider means any provider that meets the following requirements:
eligible to receive payments under an approved State plan; and
provides services of the type provided by: (a) outpatient hospitals (see §1905(a)(2)(A) of the Social Security Act); (b) rural health clinics (see §1905(a)(2)(B) of the Social Security Act); or (c) clinics furnished by, or under, the direction of a physician, without regard to whether the clinic itself is administered by a physician (see §1905(a)(9) of the Social Security Act); and
has been designated by the Department, in writing, as a qualified provider on the basis of the Department’s determination that the provider is capable of making determinations of presumptive eligibility; and
(a) receives funds under one of the following:
the Migrant Health Centers, Community Health Centers, or Public Health Service primary care research and demonstration projects (see §329, 330 and 340 of the Public Health Service Act); or the Maternal and Child Health Services Block Grant Program (see Title V of the Social Security Act); or the Urban Indian Health Program (see Title V of the Indian Health Care Improvement Act); or
(b) participates in a program established under:
the Special Supplemental Food Program for Women, Infants and Children (see §17 of the Child Nutrition Act of 1966); or the Commodity Supplemental Food Program (see §4(a) of the Agriculture and Consumer Protection Act of 1973); or the Indian Health Service or a health program or facility operated by a tribe or tribal organization under the Indian Self-Determination Act; or
participates in a State perinatal program.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-10 Transmittal: UP-11-01 1521.07 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Pregnant Women MA _______________________________________________________________ Subject: Qualified Providers ______________________________________________________________________________
1521.07 B. Standards for Designating a Qualified Provider
The Department decides which specific qualified providers are authorized to make presumptive eligibility determinations for pregnant women. The Department is not required to authorize all providers that fall within the foregoing categories to make presumptive eligibility determinations.
The Department may limit which providers it invites to participate as a qualified provider based on the Department’s capacity to train and monitor qualified providers in the performance of their presumptive eligibility responsibilities.
The Department retains the right to determine, at any time, in its discretion, whether a qualified provider will be allowed to continue making presumptive eligibility determinations.
A qualified provider shall agree to:
accurately determine presumptive eligibility; process applications in a timely manner; and not participate in unfair, discriminatory or unequal treatment of applicants or recipients.
The Department may revoke, suspend or deny a qualified provider’s authorization to make presumptive eligibility determinations at any time for any reason deemed sufficient by the Department including, but not limited to, its failure to meet the requirements of subsection B.4. of this section.
Procedures for Designating a Qualified Provider
The Department shall contact providers that are permitted to determine presumptive eligibility as set forth in subsection A. of this section to inquire about their interest in participating as a qualified provider;
The Department shall explain the requirements for being designated a qualified provider;
The qualified provider must agree to the terms and conditions as set forth in a Statement of Agreement between the qualified provider and the Department and execute the required Statement of Agreement;
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-10 Transmittal: UP-11-01 1521.07 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Pregnant Women MA _______________________________________________________________ Subject: Qualified Providers ______________________________________________________________________________
1521.07 C. Procedures for Designating Qualified Providers (continued)
4. The Department can revoke the authority of a provider to make presumptive eligibility determinations at any time, in its discretion.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-10 Transmittal: UP-11-01 1521.10 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: MA Presumptive Eligibility for Pregnant Women _______________________________________________________________ Subject: Processing Requirements ______________________________________________________________________________ 1521.10 A. Period of Eligibility
1. Beginning Date of Eligibility The beginning date of presumptive eligibility is the date that the qualified provider determines, on the basis of preliminary information, that the family income of the woman does not exceed the applicable income level of eligibility under the Medicaid State Plan for presumptive eligibility for pregnant women. (Cross Reference: 1521.05 B)
Ending Date of Eligibility Eligibility for presumptive eligibility for pregnant women ends with the earlier of: a. the day on which a determination is made with respect to the eligibility of the woman for medical assistance under the State plan; b. if a presumptively eligible pregnant woman does not file a completed application for Medicaid, through the Qualified Provider, with the Department by the last day of the month following the month in which she is determined presumptively eligible, her presumptive eligibility ends on the last day of the month following the month the presumptive eligibility determination is made; or c. the last day of the month in which the pregnancy ends.
B. Subsequent Periods of Presumptive Eligibility
The Department shall limit the number of times a pregnant women may receive presumptive eligibility to a single period for any given pregnancy.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 1523 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject:
______________________________________________________________________________
1523 Presumptive eligibility for children is a method of determining temporary Medicaid eligibility for children under the age of nineteen (19). The determination is made by organizations authorized under Federal and State law and approved by the Department to make presumptive eligibility determinations. These organizations are called “Qualified Entities.”
This chapter describes the conditions and methods used in the determination of presumptive eligibility for children.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 1523.01 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Qualified Entities ______________________________________________________________________________
1523.01 A. Qualified Entity Categories
A qualified entity is an organization that is permitted under federal and State law to determine presumptive eligibility. The types of entities that may be permitted to serve as qualified entities include the following:
those eligible to receive payments for medical services provided to children under the State administered Title XIX program;
those authorized to determine eligibility of a child to participate in a Head Start program under the Head Start Act (42U.S.C. 9821 et seq.);
those authorized to determine eligibility of a child to receive child care services for which financial assistance is provided under the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858 et seq.);
those authorized to determine eligibility of an infant or child to receive assistance under the special supplemental nutrition program for women, infants, and children (WIC) under section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786);
elementary and secondary schools;
homeless shelters that provide food and shelter under a grant under the Stuart B. McKinney Homeless Assistance Act;
child support workers; Medicaid, SCHIP and TANF workers;
certain public housing authorities that determine eligibility for any assistance or benefits provided under any program of public or assisted housing that receives Federal funds including the program under section 8 or any other section of the United States Housing Act of 1937 (42 U.S C. 1437); and
any other entity approved by the Secretary of the Department of Health and Human Services at the request of the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 1523.01 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Qualified Entities ______________________________________________________________________________
1523.01 B. Standards for Designating a Qualified Entity
1. The Department decides which specific qualified entities are authorized to make presumptive eligibility determinations for children. The Department is not required to authorize all entities that fall within the foregoing categories to make presumptive eligibility determinations.
The Department may limit which organizations, entities and persons it invites to participate as a qualified entity based on the Department’s capacity to train and monitor qualified entities in the performance of their presumptive eligibility responsibilities.
The Department retains the right to determine, at any time, in its discretion, whether a qualified entity will be allowed to continue making presumptive eligibility determinations.
A qualified entity shall agree to:
. a. accurately determine presumptive eligibility;
b. process applications in a timely manner; and
c. not participate in unfair, discriminatory, or unequal treatment of applicants or recipients.
The Department may revoke, suspend, or deny a qualified entity’s authorization to make presumptive eligibility determinations at any time for any reason deemed sufficient by the Department including, but not limited to, its failure to meet the requirements of 4 above.
C. Procedures for Designating a Qualified Entity
The Department will contact organizations, entities and persons that are permitted to determine presumptive eligibility as set forth in A. above to inquire about their interest in participating as a qualified entity;
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 1523.01 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Qualified Entities ______________________________________________________________________________
1523.01 C. Procedures for Designating a Qualified Entity (continued)
The Department will explain the requirements for being designated a qualified entity;
3. The qualified entity must agree to the terms and conditions as set forth in a Memorandum of Agreement between the qualified entity and the Department and execute the required Memorandum Agreement;
4. The Department can revoke the authority of an organization, entity or person to make presumptive eligibility determinations at any time, in its discretion.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 1523.05 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Identifying Eligible Assistance Units ______________________________________________________________________________
1523.05 A. Cases Entitled to Presumptive Eligibility for Children
Presumptive eligibility for children is determined using the same eligibility requirements as those used for Children Under 185% of the Federal Poverty Level (F13, (F20), (F25) except as found in this chapter. (Cross References: 2540.54, 2540.55, 2540.58)
Eligibility Determinations
1. The eligibility determination for presumptive eligibility for children is made by the qualified entity.
In making presumptive eligibility determinations, qualified entities act as agents of the Department and are governed by all Department policies and procedures including, but not limited to, the areas of confidentiality, equal treatment, and nondiscrimination.
The qualified entity secures a completed application form from the applicant.
The qualified entity makes its presumptive eligibility determination that the applicant meets the categorical, technical and income eligibility criteria based on the information reported on the application form.
The qualified entity is not required to verify factors of eligibility, but assists the applicant in submitting any readily available verification documents to the department.
The qualified entity’s presumptive eligibility determination remains in effect until the ending date of eligibility specified at 1523.10 B.2.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 1523.10 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Processing Requirements ______________________________________________________________________________
1523.10 A. Standard of Promptness
Once all required information is supplied, assistance is authorized by the qualified entity no later than the close of business of the next working day.
Period of Eligibility
Beginning Date of Eligibility
The beginning date of eligibility is the date that the qualified entity determines presumptive eligibility for Medicaid.
Ending Date of Eligibility
If the Department determines that the assistance unit is eligible, the ending date for Presumptive Eligibility is the date the Department makes the determination of ongoing Medicaid eligibility. If the Department determines that the assistance unit is ineligible, the ending date for Presumptive Eligibility is the last day of the month that the Department makes the determination of ineligibility for Medicaid. In the event the qualified entity does not submit a completed application form to the department or the submitted application form does not meet the minimal requirements for an application (cross reference 1505.10), the ending date of eligibility is the last day of the month following the month the presumptive eligibility determination is made.
Subsequent Periods of Presumptive Eligibility
The Department shall limit the number of times an individual may receive presumptive eligibility to twice in a calendar year.
Verification Requirements
The qualified entity considers all factors of eligibility to be verified by the self-declared statements made by the applicant or recipient on the application form that is completed and signed by the applicant or recipient.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 1523.10 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Processing Requirements ______________________________________________________________________________
1523.10 D. Additional Requirements for the Qualified Entity
Within five (5) days of making the determination of presumptive eligibility for children, the qualified entity shall do the following:
notify the Department that they have granted presumptive eligibility and refer a complete application form and any available verification to the Department for processing; and
2. inform the parent or custodian of the child that in referring the granted presumptive eligibility application to the Department the family has initiated an application for ongoing Medicaid benefits and that follow-up by the family will be necessary to remain Medicaid eligible.
E. Fair Hearing Rights
Applicants for and recipients of presumptive eligibility for children are not entitled to appeal any case action or inaction of presumptive eligibility through a fair hearing or any other administrative appeal.
Notice Requirements
Applicants for and recipients of presumptive eligibility for children are not entitled to advance notice of a presumptive eligibility discontinuance or continued benefits based on the filing of a fair hearing request.
Managed Care
Recipients of presumptive eligibility for children are not enrolled in managed care. Instead, medical services are provided via fee-for-service.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 P-1523.10 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Determining Eligibility for Presumptive Eligibility for Children ______________________________________________________________________________
P-1523.10 Qualified Entity Responsibilities
1. A Qualified Entity (QE) will accept applications and grant Presumptive Eligibility (PE) whenever they have contact with a child under the age of nineteen whose family income is under 185% of the Federal Poverty Level and who is in need of medical care.
The QE will either utilize the Automated Eligibility Verification System (AEVS) or contact the DSS Regional Processing Unit (RPU) to determine if the child to be granted PE is currently enrolled in the HUSKY A program.
The QE will secure a fully completed and signed W-1HUS – “HUSKY Application and Renewal Form” from the parent or caretaker relative of the child. The child may also apply if living independently or if she or he is familiar enough with the family’s circumstances to accurately complete the application.
The QE will submit any available verification of HUSKY eligibility requirements (proof of income, residency, alien status) along with the fully completed and signed W-1HUS at the time of application to the DSS RPU.
If at the time of the presumptive eligibility determination there are missing verifications the QE is responsible for giving the applicant a checklist on the form prescribed by the Department requesting that the missing information be provided to the Department within ten (10) days along with a postage paid return envelope to the appropriate DSS RPU (envelope to be provided by the Department).
The QE will review and consider all factors of eligibility utilized by DSS as verified by the statements made by the applicant or recipient on the application form along with any available verification.
The QE will grant presumptive eligibility to the child no later than the close of business of the next working day if eligibility requirements are met.
The QE will refer the applicant to ACS for possible eligibility in the HUSKY B program if eligibility requirements have not been met because the family’s income exceeds the HUSKY A income guideline limit.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 P-1523.10 Page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Determining Eligibility for Presumptive Eligibility for Children ______________________________________________________________________________
P-1523.10 Qualified Entity Responsibilities (continued)
9. The QE will provide the child (and/or the guardian) with a completed form W-538 Medicaid Presumptive Eligibility Certification and Guarantee of Payment so that medical services can be obtained upon granting PE.
10. The QE will transmit via fax, to the appropriate DSS RPU, copies of the W- 538, the completed and signed W-1HUS form, any available verifications and the verification checklist used for the determination of presumptive eligibility.
The QE will serve as agents of DSS and agree to abide all DSS policies and procedures, including but not limited to, the areas of confidentiality, equal treatment, and nondiscrimination.
The QE will maintain the W-538 in a secure location and maintain a log of the issuance of the W-538.
The QE will designate liaisons to the Department.
Department of Social Services Responsibilities
The Department of Social Services (DSS) shall, as the state agency responsible for the administration of the HUSKY A program and the designation of organizations as QE’s:
Ensure that the DSS RPU’s, upon their receipt of the QE transmission described in 10. above immediately grant presumptive eligibility for the HUSKY A program on the DSS Eligibility Management System (EMS) so that the child can immediately access medical services.
Issue a DSS Medicaid CONNECT card for the eligible child.
Notify the QE of the presumptive eligibility grant.
Process the W-1HUS “HUSKY Application and Renewal Form” for a final determination of HUSKY A eligibility utilizing the regular application process.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-05 Transmittal: UP-06-03 P-1523.10 Page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Presumptive Eligibility for Children FMA _______________________________________________________________ Subject: Determining Eligibility for Presumptive Eligibility for Children ______________________________________________________________________________
P-1523.10 Department of Social Services Responsibilities (continued)
Refer the W-1HUS “HUSKY Application and Renewal Form” to ACS for a determination of HUSKY B eligibility, if the family’s income is determined to be greater than the HUSKY A income guideline limit.
Designate liaisons to the QE for each of the DSS RPU’s.
Notify the QE of any changes thereto and shall allow the QE a reasonable period of time, not to exceed five (5) business days, to comply with such changes.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1525 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD _______________________________________________________________ FS Subject: MA
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1525 Under certain conditions an assistance unit may designate an authorized representative to act on the unit's behalf in dealings with the Department. In the Public Assistance programs, authorized representatives serve limited functions during the application process. However, in the FS program their role is extended into many aspects of the eligibility process.
This chapter discusses the provisions for the use of authorized representatives and the duties which they may perform.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 1525.05 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD ________________________________________________________________ FS Subject: MA General Requirements ______________________________________________________________________________
1525.05 A. An assistance unit may be represented in various aspects of the eligibility process by a responsible individual who has been given prior authorization to act as the assistance unit's representative.
B. An authorized representative is qualified to perform specific functions which vary and are limited by the requirements of each specific program category.
C. An authorized representative must be designated in writing by one of the following individuals:
1. in the AFDC program, by the caretaker relative of the dependent child;
2. in the AABD and MA programs, by the applicant, or if the applicant is a child, incompetent or incapacitated, by the parent, custodian, or court appointed fiduciary;
3. in the Food Stamp program, by the head of the assistance unit, spouse or other responsible member of the assistance unit.
D. An assistance unit is permitted to have one authorized representative at a given time, except in the Food Stamp program where separate representatives may be designated to perform the individual functions of making application and purchasing food with an EBT debit card.
E. There is no limit to the number of assistance units that an authorized representative may represent.
F. In the FS program, confirmation of the authorized representative status is obtained periodically at redetermination or whenever questionable.
G. The appointment of an authorized representative does not relieve the assistance unit of any responsibilities. Both the assistance unit and the representative may be held responsible for assistance improperly obtained through action by the authorized representative.
H. An assistance unit may withdraw its authorization at any time through a written statement.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 P-1525.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD _______________________________________________________________ FS Subject: MA General Requirements ______________________________________________________________________________
P-1525.05 1. Always review the following information when dealing with an authorized representative:
° age and identity;
° employment status;
° whether or not the individual has been given authorization.
2. Inform the cash assistance units that only one authorized representative is allowed at a time.
3. Require FS assistance units to designate the capacity in which they wish the representative to serve, i.e. making application or purchasing foods.
4. Inform the assistance unit that only one person can be designated to serve in any category at one time.
5. Inform the assistance unit that the person designated as the shopper will receive his/her own EBT card which will allow access to the assistance unit's EBT food benefit account.
6. Designate this person as the authorized shopper on EMS by coding him/her as "S1".
7. Designate the person authorized to do the application as F1, F2, or F3.
8. Inform the assistance unit that it is responsible for actions performed by the authorized representative on its behalf.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-97 Transmittal: 97-1 1525.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD _______________________________________________________________ MA Subject: FS Who Can Be An Authorized Representative ______________________________________________________________________________
1525.10 A. All Programs
1. In order to be an authorized representative a person must be a responsible individual who is:
a. eighteen years of age or older; and
b. sufficiently familiar with circumstances of the assistance unit.
2. Employees of the Department involved in the eligibility process or issuance of benefits may not act as authorized representatives without the specific written approval of an agency administrative official.
B. FS
Retailers that are authorized to accept food stamp benefits may not act as authorized representatives without specific written approval of an agency administrative official.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1525.10 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD ____________________________________________________________________ FS Subject: MA Application Procedures ______________________________________________________________________________
P-1525.10 1. Allow the representative to file the assistance request after confirming the individual's qualifications.
2. If the representative does not present written authorization from the assistance unit, allow the application to be filed, but hold the ARF as a pending inquiry until you are able to confirm the legitimacy of the request.
3. For AFDC, AABD or MA application, generally do not complete an interview, but instead obtain as much information as required to directly involve the applicant and continue processing. If the applicant is incompetent or incapacitated, gather as much information as possible from the representative.
4. You may complete the entire process with the authorized representative if application is made for FS. Take into consideration the expedited service and combined interview requirements prior to scheduling or completing the interview.
5. Have the authorized representative sign any documents prepared by them.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES PRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 04-01-03 Transmittal: UP-03-03 1525.15 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD ______________________________________________________________ FS Subject: MA Responsibilities ______________________________________________________________________________
1525.15 A. Role of the Authorized Representative
1. AFDC, AABD, MA
a. In the AFDC, AABD and MA programs, the authorized representative's primary role is to allow the applicant to file an application without delay in an emergency when no other person is able to do so.
b. The authorized representative may:
(1) file the application; and
(2) represent the assistance unit at an interview if one is conducted at the time the assistance request is filed.
2. FS
a. The role of the authorized representative in the Food Stamp program may involve the following duties:
(1) filing the application and preparing other application and work registration materials;
(2) representing the assistance unit at interviews and other contacts with the Department, including interim contacts and redeterminations;
(3) using an EBT debit card to purchase eligible food items; and
(4) signing agency documents on behalf of the assistance unit.
b. Eligible food items may be purchased as long as the representative is in possession of an EBT debit card issued in the name of the authorized representative.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-22-06 Transmittal: UP-07-14 1525.15 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Authorized Representatives ______________________________________________________________ Subject: Responsibilities ______________________________________________________________________________
1525.15 B. Emergency Authorized Representative (FS)
1. In an emergency, if neither the person in whose name the EBT card has been issued nor the authorized representative is able to do the shopping, an emergency authorized representative may be designated to do the shopping.
For the purposes of this section, the emergency authorized representative shall be:
a. a responsible assistance unit member of any age designated orally or in writing by the head of the assistance unit and whose name appears on the specially issued debit card; or
b. a responsible adult designated in writing by the head of the assistance unit and whose name appears on the specially issued debit card.
3. An emergency EBT card is issued for and mailed to that authorized representative.
C. Institutions as Authorized Representatives
1. All Programs
a. Residents of institutions may apply for assistance and be certified on their own behalf, or through the use of an authorized representative who may be an individual of the applicant's choice or an employee designated by the institution for this purpose. In the Food Stamp program, for residents of drug and alcohol treatment centers, the authorized representative must be an employee designated by the institution.
b. In order for the institution to represent an applicant, the individual must be a current resident of the institution.
c. In cases of incompetence or incapacity, the institution may act responsibly on behalf of the resident without prior authorization. (Cross Reference 1505)
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-01-97 Transmittal: UP-03-03 1525.15 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Authorized Representatives ______________________________________________________________ Subject: Responsibilities ______________________________________________________________________________
1525.15 C. 2. Specific Food Stamp Provisions
a. Residents of drug or alcoholic treatment centers shall apply and be certified for program participation through the use of an authorized representative who shall be an employee of the institution designated by the institution for this purpose.
Blind or disabled residents of group living arrangements are permitted the option of applying on their own behalf or through the use of an authorized representative of the applicant's choice.
c. Institutions that act in the capacity of authorized representative on behalf of a resident, are responsible for reporting relevant changes in circumstances which affect eligibility or benefit level.
d. The above provision does not relieve the assistance unit of the responsibility of reporting relevant changes which are not known to the institution.
e. Institutions acting in the capacity of authorized representative are liable for any overpayments, losses or misuse of food stamp benefits incurred on behalf of the residents.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 P-1525.15 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD _______________________________________________________________ FS Subject: MA Disqualification of the FS Head of Household ______________________________________________________________________________
P-1525.15 1. When the head of household is disqualified from participating in the FS Program due to an intentional program violation:
° inform the assistance unit of the requirements relating to the disqualified member's future representation of the unit;
° determine if the unit contains another adult who can replace the disqualified member.
2. Allow the disqualified member to participate in the decision.
3. If another adult member is designated the new unit head:
° have the new head of household sign the application form
° change the case name (Cross Reference: P-6535.07)
° issue a new EBT card in the name of the new head of household (Cross Reference: P-6535.07)
4. If the unit contains no other adult who can function as the unit head, ask the disqualified member if an authorized representative can be appointed.
5. If the disqualified member indicates that a representative is not available or willing to act in that capacity allow the disqualified member to continue to represent the assistance unit.
6. If a representative is available:
° advise the unit that the representative is expected to appear for interviews and represent the unit during other in-office contacts with the Department;
° take steps to issue a new EBT card in the name of the authorized representative.
7. If the assistance unit later informs the Department that the representative is no longer available or willing to act in such a capacity, allow the disqualified member to resume the duties of representing the assistant unit and deactivate the authorized representative's EBT card.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-97 Transmittal: UP-98-12 1525.20 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Authorized Representatives _______________________________________________________________ Subject: Disqualification ______________________________________________________________________________
1525.20 A. Non-institutional Cases
1. An individual is disqualified from participation in the eligibility process as an authorized representative if the Department obtains evidence that the individual:
a. has knowingly misrepresented the circumstances of the assistance unit and provided false information to the Department; or
b. has made improper use of an EBT debit card.
2. The period of disqualification shall be for twelve months beginning with the month following the month of discovery of the misrepresentation or the misuse of an EBT debit card.
B. Institutions
1. If an institution has its status as authorized representative suspended by the Food and Nutrition Service (FNS), the Department disqualifies the institution from participating in the eligibility process upon notification from FNS.
2. The period of disqualification shall be for the period imposed by FNS.
3. The Department informs FNS of any violation committed by an authorized institution acting on behalf of a resident as an authorized representative.
C. Individuals Disqualified for an Intentional Program Violation
1. Individuals disqualified from the FS program because of an intentional program violation may not serve as authorized representatives for any assistance unit other than the one from which they are excluded for the longer of the following periods:
a. the period of overpayment disqualification; or
b. twelve months beginning with the first month of the overpayment disqualification period.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 04-1-03 Transmittal: UP-03-03 1525.20 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Authorized Representatives _______________________________________________________________ Subject: Disqualification ______________________________________________________________________________
1525.20 C. Individuals Disqualified for an Intentional Program Violation (continued)
2. Individuals disqualified from the FS program because of an intentional program violation may not serve as authorized representative for the assistance unit from which they are excluded during the fraud disqualification period, except when:
a. the individual is the only adult able to act as head of the assistance unit; and
b. no other adult is able to serve as the authorized representative for the assistance unit.
3. The Department determines separately whether the disqualified individual is permitted to:
a. make application; and
b. obtain and use an EBT debit card as the authorized representative.
4. The individual's authorization is limited during the fraud disqualification period to those duties which no other adult representative is able to perform.
D. Notification
The Department notifies the affected assistance unit and the authorized representative at least thirty days prior to the date the authorized representative is disqualified.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1525.25 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD _______________________________________________________________ FS Subject: MA Agency Requirements ______________________________________________________________________________
1525.25 A. Identification
The Department does not take action based on information provided by an authorized representative until the authorized representative provides verification of his or her identity.
B. Review of Certification Materials
Whenever possible, the Department requires the head of the assistance unit, caretaker relative, custodian or court appointed fiduciary to review the actions of the authorized representative.
C. Home Visits and Collateral Contacts
The Department conducts home visits, makes collateral contacts or uses other means at its disposal to confirm actions of an authorized representative if the appropriateness of the action is questionable or requires further exploration.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-97 Transmittal: UP-97-14 1525.30 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Authorized Representatives AABD _______________________________________________________________ FS Subject: MA Signature on Documents ______________________________________________________________________________
1525.30 A. AFDC, AABD
1. Appointment of an authorized representative in the cash assistance programs does not relieve the applicant, or where appropriate his caretaker relative, custodian or court appointed fiduciary, from the responsibility of signing any and all documents used or related to the determination of eligibility for assistance which require a signature.
2. The authorized representatives are required to sign documents prepared by them or in their presence on behalf of the applicant. However, the application is not complete until the signature of the applicant, caretaker relative, custodian or court appointed fiduciary is obtained.
B. MA
In the Medicaid program, any and all documents related to determining eligibility and requiring a signature must be signed under penalty of perjury, by one of the following:
1. the applicant or recipient; or
2. the applicant or recipient's authorized representative; or
3. a person acting responsibly on behalf of an applicant or recipient who is incompetent or incapacitated.
C. FS
1. In the FS program the authorized representative is permitted to sign any and all documents related to determining eligibility and requiring a signature on behalf of the assistance unit provided that the individual is acting with proper authority.
2. The Department may request the signature of the head of the assistance unit or spouse on appropriate documents, but does not require this signature as a condition of eligibility, or delay assistance beyond normal processing standards while obtaining the signature.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1530 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Certification AABD _______________________________________________________________ FS Subject:
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1530 The eligibility of an assistance unit is certified by the Department for a particular period of time. The certification period may be of a specific length, or continuous over an indefinite period depending on the program category. This chapter discusses certification periods and their application to the eligibility process.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1530.05 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Certification AABD _______________________________________________________________ FS Subject: MA General Requirements ______________________________________________________________________________
1530.05 A. AFDC, AABD, MA
1. AFDC, AABD and MA assistance units are certified for an indefinite period of time beginning with the initial month of eligibility.
2. The assistance unit's certification continues until such time that the unit is found ineligible through a periodic review or other eligibility evaluation.
B. Certification of FS Assistance Units
1. Assistance units that are determined eligible for the FS program are assigned certification periods of definite length at the time of application and redetermination.
2. Eligibility for the FS program automatically terminates at the end of the certification period unless:
a. the assistance unit is recertified through the redetermination process; or
b. the certification period is extended by the Department.
3. Under no circumstances is eligibility continued upon expiration of the certification period unless the assistance unit is recertified.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-21-96 Transmittal: UP-96-17 P-1530.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Certification Periods FS _______________________________________________________________ Subject: General Requirements ______________________________________________________________________________ P-1530.05 1. Review the case circumstances and determine the length of the certification period:
° whenever assistance is granted;
° whenever a redetermination is conducted.
2. Consider such factors as:
° mandatory extensions of shorter certification periods;
° combined PA/FS redetermination schedules;
° two to three months certification for households that cannot reasonably predict future circumstances or are highly error prone;
° up to three months for households with reasonably predictable circumstances;
° up to six months for households if there is little likelihood of change in income or household;
° the twelve month maximum length for all other households, such as assistance units whose primary source of income is annualized self-employment or assistance units comprised entirely of unemployable persons, except those in which all adult members are elderly or disabled;
° the twenty-four month maximum length for all households in which all adult members are elderly or disabled.
3. In cases of multiple program involvement, adjust the certification period so that it coincides with the redetermination schedule of the companion PA case whenever possible.
4. If it is advisable to review FS eligibility more frequently than cash or medical assistance eligibility, try to establish a certification period with a common basis to the PA redetermination schedule.
For example, if a household AFDC redetermination is scheduled at 6 month intervals and FS is to be reviewed more frequently, establish a three month certification period so every other redetermination will coincide between the two programs.
5. Issue notification.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-21-96 Transmittal: UP-96-17 1530.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Certification FS _______________________________________________________________ Subject: Food Stamp Certification Periods ______________________________________________________________________________
1530.10 A. Beginning and Ending Dates
1. Certification periods conform to calendar months.
2. The certification period:
a. begins with the initial month of eligibility, regardless of when the determination is made; and
b. runs continuously without interruption; and
c. ends on the last calendar day of the final month of the assigned certification period.
B. Length of the Certification Period
1. Assistance units are assigned the longest certification period possible based on the predictability of the household circumstances.
2. Certification periods may be up to 24 months if all adult household members are elderly or disabled. However, contact must be made with each certified household every 12 months.
3. Except for households described in B.2. an assigned certification period may not exceed twelve months. A new eligibility determination must be made every twelve months, at a minimum.
4. The Department may vary the certification period on a case to case basis or establish general standards which vary according to such factors as:
(1) the likelihood of a change in the household's circumstances;
(2) case history;
(3) administrative needs;
(4) error prone profiles.
5. Waiver of the office interview requirement does not affect the length of the certification period.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-21-96 Transmittal: UP-96-17 1530.10 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Certification FS _______________________________________________________________ Subject: Food Stamp Certification Periods ______________________________________________________________________________
1530.10 C. One Month Extension Requirement
1. Certification periods of three months or less are extended by one month if the eligibility determination is completed after the fifteenth day of the month of application, unless:
a. the household circumstances do not warrant the extension; or
b. the case is an expedited service case with postponed verification.
2. Certification periods of three months or less are automatically extended by one month if:
a. the eligibility determination is completed in the month following the month of application; and
b. the assistance unit is entitled to retroactive benefits for a prior month; and
c. household circumstances warrant the extension.
D. Cash Assistance Applicants/Recipients
1. FS assistance units in which all members are applicants or recipients of AFDC, or AABD are, to the extent possible, assigned certification periods which coincide with the PA redetermination schedule.
2. The certification period is not coordinated with the PA redetermination schedule if assistance unit circumstances do not warrant such coordination.
E. Changes In the Certification Period
1. The Department may change the length of an already assigned certification period if:
a. changes in assistance unit circumstances warrant the change; and
b. the change is made in sufficient time to provide a notice of expiration in a timely manner if the certification period is shortened (Cross Reference: 1545).
2. In no event does a change in the certification period cause the assistance unit to be certified for more than twelve months without completing a new eligibility determination.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1530.15 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Certification AABD _______________________________________________________________ FS Subject: MA Notification ______________________________________________________________________________
1530.15 A. Assistance units are provided with a written notice of eligibility at the time assistance is granted, and upon completion of a redetermination.
B. The notice of eligibility contains, at a minimum, the following information where appropriate to the particular assistance unit and assistance program:
1. dates of assistance;
2. explanation of benefits, including the amount of retroactive and on-going benefits;
3. variations in benefit level based on anticipated changes at the time of certification;
4. length of the FS certification period;
5. notice of right to a fair hearing;
6. availability of legal services;
7. agency telephone number and whenever possible the name of the person to contact;
8. for FS assistance units the need to reapply at the end of the certification period;
9. the next scheduled month of redetermination;
10. other information as determined necessary by the Department.
C. Assistance units certified on an expedited basis with postponed verification are informed of the need to provide the verification and to reapply.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1535 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Cases With a Zero Benefit Level AABD _______________________________________________________________ FS Subject:
______________________________________________________________________________
1535 Due to the method of computing benefits (Cross Reference: 6000), an assistance unit may not be eligible to receive a benefit even when all other eligibility criteria are met. This chapter discusses special processing requirements that are established in such cases.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1535.05 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Cases With a Zero Benefit Level AABD _______________________________________________________________ FS Subject: Processing Requirements ______________________________________________________________________________
1535.05 A. All Programs
1. The Department takes one of the following actions if due to the method of computing benefits an otherwise eligible assistance unit is determined to have a non-prorated benefit level of zero (Cross Reference: 6000):
a. certifies the assistance unit but suspends participation; or
b. denies or discontinues assistance on the basis that income exceeds the need level.
2. Zero benefit assistance units that are certified as eligible are subject to the same requirements that are established for cases which are entitled to a benefit.
3. Certification is not affected if the zero benefit level results from proration of the monthly benefit in an initial month of eligibility.
B. Specific Treatment
1. AFDC
a. AFDC assistance units that are not entitled to a monthly benefit, but are otherwise eligible, are suspended from participation.
b. The Department certifies eligibility but does not provide benefits as long as the assistance unit's benefit level remains below the minimum required to issue benefits. (cross reference: 6000)
2. AABD
AABD assistance units with a zero benefit level are discontinued or denied assistance.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1535.05 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: Cases With a Zero Benefit Level FS _______________________________________________________________ Subject: Processing Requirements ______________________________________________________________________________
1535.05 C. FS Cases
1. One and Two Person Assistance Units
FS assistance units containing one or two members that have a computed benefit level of zero are eligible for a minimum benefit and are subject to normal certification procedures if they are otherwise eligible.
2. Assistance Units with Three or More Members
a. Categorically Eligible Cases
Assistance units containing three or more members that have a zero benefit level, but are otherwise categorically eligible are:
(1) certified according to regular certification procedures; and
(2) suspended from participation.
b. Cases Not Categorically Eligible
Assistance units containing three or more members that have a zero benefit level and are not categorically eligible are discontinued or denied assistance.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1535.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Cases With a Zero Benefit Level AABD _______________________________________________________________ FS Subject: Processing Requirements ______________________________________________________________________________
P-1535.05 1. If the assistance unit is not entitled to benefits but is otherwise eligible for the program, determine if it is appropriate to:
° deny or discontinue assistance; or
° certify and suspend participation
2. For FS assistance units, first determine if the unit is categorically eligible.
3. Deny or discontinue assistance for AABD units, and FS units that are not categorically eligible.
4. Certify and suspend participation for AFDC all cases and FS cases that are categorically eligible.
5. Adhere to the ten day conversion requirements if a suspended case subsequently becomes eligible for benefits.
6. Remember to prorate FS benefits in the conversion month.
7. Issue appropriate notice to the unit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1535.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Cases With a Zero Benefit Level FS _______________________________________________________________ Subject: Changes to Issuance Status ______________________________________________________________________________
1535.10 A. Conversion
1. The Department converts assistance units from a suspended to an issuance status without requiring an additional office interview.
2. Benefits are issued within:
a. ten days of the date the change is reported if verification is not required; or
b. ten days of the date the assistance unit provides required verification; or
3. Assistance units are eligible for conversion to issuance status at any time that a reported change makes the unit eligible for benefits.
B. Entitlement to Benefits
1. AFDC assistance units and FS monthly reporting assistance units that are converted to issuance status are entitled to benefits for the entire month of conversion.
2. Benefits for all FS non-monthly reporting assistance units are prorated for the month of conversion beginning with the date of the reported change.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1535.15 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Cases With a Zero Benefit Level FS _______________________________________________________________ Subject: Notification ______________________________________________________________________________
1535.15 Assistance units that are suspended from participation are notified of the following:
A. notification that the case is certified but participation is suspended;
B. notification of reporting requirements;
C. notification that changes in circumstances may affect the suspended status;
D. notification of rights and responsibilities.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1540 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ FS Subject: MA
______________________________________________________________________________
1540 Information which is provided to the Department for the purpose of determining eligibility or calculating benefits may require verification.
This chapter describes the methods used for verification, who bears the responsibility for verification, and when information must be verified.
The specific verification requirements pertaining to each eligibility factor can be found in the last chapter of the section which addresses the eligibility factor.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 7/1/06 Transmittal: UP-10-09 1540.05 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: SNAP Requirements and Penalties ______________________________________________________________________________
1540.05 A. Standard of Proof
A statement made by an applicant or a recipient is considered by the Department to be verified when the available evidence indicates that it is more likely to be true than not.
Verification of Citizenship and Identity-Special Rule for MA Except for those individuals listed in section 1599.05 F. 8. and section 3099.04 N., claims of U.S. citizenship from individuals applying for or receiving MA, as well as statements from these individuals about their identities, shall be verified by only certain documents or databases as described in 42 USC 1396b(x) and 42 USC 1396a(ee) or by regulations subsequently promulgated by the Secretary of Health and Human Services. For purposes of this requirement, individuals who claim U.S. citizenship includes those individuals with a status as a national of the United States as defined by section 101(a)(22) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(22)) including both citizens of the United States and non-citizen nationals of the United States. Except for the documents listed in section 3099.04 B., the same document cannot be used to verify both U.S. citizenship and identity. All documents shall be either originals or copies certified by the issuing agency.
C. When Verification is Required
1. The Department requires verification of information:
a. when specifically required by federal or State law or regulations; and
b. when the Department considers it necessary to corroborate an assistance unit's statements pertaining to an essential factor of eligibility.
2. The Department does not require applicants or recipients to provide documentary evidence to verify the nonexistence of any factor, including the following:
a. lack of income; or
b. lack of bank accounts or other assets; or
c. absence of one parent from the home.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 7-1-08 Transmittal: UP-08-13 1540.05 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Requirements and Penalties ______________________________________________________________________________
1540.05 D. Consequences for Failure to Provide Verification
The penalty for failure to provide required verification depends upon the nature of the factor or circumstance for which verification is required:
1. If the eligibility of the assistance unit depends directly upon a factor or circumstance for which verification is required, failure to provide verification results in ineligibility for the assistance unit. Factors on which unit eligibility depends directly include, but are not limited to:
income amounts;
asset amounts.
2. If the eligibility of an individual assistance unit member depends directly upon a factor or circumstance for which verification is required, failure to provide verification results in ineligibility for that individual member. Factors on which individual assistance unit member eligibility depends directly include, but are not limited to, the following:
a. citizenship;
b. cooperation with the Employment Services program;
c. non-citizen status.
3. If the eligibility of the assistance unit does not depend directly on a factor or circumstance for which verification is required, but the benefit level could be affected by it, failure to provide verification results in non-consideration of the factor or circumstance. Factors like this include, but are not limited to:
a. income deduction amounts;
b. self-support plan deduction amounts;
c. special need items;
d. medical costs used in spend-down cases.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 7-1-08 Transmittal: UP-08-13 1540.05 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Requirements and Penalties ______________________________________________________________________________
1540.05 D. Consequences for Failure to Provide Verification (continued)
4. Ineligibility of the assistance unit may result indirectly from failure to provide verification of a factor or circumstance described in section 1540.05 D.3. if the non-consideration of the factor or circumstance leads to ineligibility for the unit. Situations like this include, but are not limited to:
a. non-consideration of an unverified income deduction causes the applied income to exceed the need standard;
b. non-consideration of an unverified special need item lowers the total amount of needs to below the applied income level;
c. non-consideration of unverified medical expenses causes excess income not to be offset in a spend-down process.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1540.05 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Determining When Verification is Required ______________________________________________________________________________
P-1540.05 1. Determine which statements require verification. Remember that rules on what to verify are found in verification chapters located at the end of a section.
2. Do not require verification of statements under the following conditions:
° when neither eligibility nor benefit level are affected; or
° when the information has already been verified, as indicated on EMS or in the case record, unless there is reason to believe circumstances may have changed.
3. Do not require documentary verification of a client's statement of the nonexistence of some factor except in the investigation of a possible transfer of assets.
4. Do not use the procedure in 3, above, to prevent verification of the date a client last worked or last was paid.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 1540.10 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ FS Subject: MA Unit and Agency Responsibilities ______________________________________________________________________________
1540.10 The verification of information pertinent to an eligibility determination or a calculation of benefits is provided by the assistance unit or obtained through the direct efforts of the Department.
A. The assistance unit bears the primary responsibility for providing evidence to corroborate its declarations.
B. The assistance unit may submit any evidence which it feels will support the information provided by the unit.
C. The Department obtains verification on behalf of the assistance unit when the following conditions exist:
1. the Department has the internal capability of obtaining the verification needed through such means as case files, microfiche records, or direct access to other official records; or
2. the Department has the capability to obtain the verification needed, and the assistance unit has done the following:
a. made a reasonable effort to obtain the verification on its own; and
b. been unable to obtain the verification needed; and
c. requested the Department's help in obtaining the verification; and
d. continued to cooperate in obtaining the verification.
3. when the evidence necessary can only be obtained by payment of a fee, and the Department is able to obtain the evidence.
D. The Department considers all evidence submitted by the assistance unit or received from other sources.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1540.10 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Methods of Verification ______________________________________________________________________________
P-1540.10 1. Work with the client to determine whether the client or the Department will obtain verification for each factor which needs to be verified, and the best method for obtaining the verification.
2. For each factor which needs to be verified, explore the client's ability to obtain necessary verification, considering the following:
° Documents the client already has in his or her possession;
° Documents which the client can readily obtain;
° Documents which are less readily available, but which can be obtained without extreme efforts;
° readily available alternate forms of verification;
° Possible barriers to obtaining verification, including language, illiteracy, lack of transportation, or the inability to pay a required fee;
° any unusual or extenuating circumstances.
3. Consider the Department responsible for obtaining verification in the following circumstances:
° When the factor has already been satisfactorily verified as indicated in active or closed case files;
° when verification is readily available through contact with General Assistance offices, Connecticut Labor Department, Department of Motor Vehicles, Social Security Administration or other agencies;
° when the client cannot obtain the verification without paying a fee and the Department has a means of obtaining verification without paying a fee, by such means as bank tracers.
4. Use the Application Verification List (W-1348) and other forms, as appropriate, to document the decision on what methods of verification will be used.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-1-91 Transmittal: UP-91-51 P-1540.10 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Methods of Verification ______________________________________________________________________________
P-1540.10 (continued)
5. Assist the client in obtaining verification when appropriate using methods such as the following:
° advising the client of alternate forms of verification;
° advising the client on how to go about obtaining verification;
° Writing letters on behalf of any client who has difficulty with written expression, if requested to do so;
° referring the client to other agencies, which may be able to assist by offering guidance or by paying a fee on the client's behalf.
6. If the client tries to obtain verification but has difficulty, reevaluate the situation and reconsider the options to find the best approach. Document changes in the verification process by revising the W-1348 or by clearly noting the changed requirements and deadlines in the case record.
7. In addition to other forms of verification, use IEVS to obtain verification about income and SAVE to obtain verification about citizenship and non-citizen status.
8. Provide a dated receipt whenever verification is left with the receptionist and whenever a receipt is requested by the assistance unit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1540.15 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Methods of Verification ______________________________________________________________________________
1540.15 A. Choice of Method
The information provided by the assistance unit is verified through a cooperative effort between the Department and the members of the unit:
1. The Department determines the adequacy and appropriateness of the method selected.
2. The method of verification which is chosen depends upon the nature of the information being verified and the feasibility of other available methods.
B. Documentary Evidence
1. Documents are the primary sources of verification whenever such evidence can be acquired.
2. The Department accepts any document which it feels clearly establishes the veracity of the unit's declarations without restricting the evidence to any one particular type of document.
C. Collateral Contacts
1. In the absence of available documentary evidence, the Department verifies information through contacts with persons who are not members of the assistance unit.
2. Verification through collateral contacts consists of obtaining oral or written affirmations of the unit's statements from persons who are capable of providing first-hand testimony.
3. The persons who serve as the sources of verification are selected by:
a. the Department; or
b. the assistance unit subject to the Department's approval of the persons as acceptable sources of verification.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1540.15 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Methods of Verification ______________________________________________________________________________
1540.15 D. Home Visits
Home visits are made to facilitate verification when:
1. the Department regards it as necessary to determine eligibility or calculate benefits; and
2. the unit agrees to being interviewed at home.
E. IEVS
In addition to other methods of verification, the Department also uses the Federally-mandated Income Eligibility Verification System (IEVS) to obtain and utilize information on income.
1. IEVS is used in regard to the income of the following persons:
a. applicants for and recipients of assistance under all programs;
b. former members of FS units who received benefits for at least one month within the quarter;
c. other persons who:
(1) are not applying for or receiving assistance; and
(2) have income or assets that are counted in determining the unit's eligibility or in calculating the unit's benefits; and
(3) have their Social Security number on file with the Department or voluntarily furnish it at the request of the Department.
2. All information obtained through IEVS is verified whenever the information is not being obtained from its primary source.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-1-88 Transmittal: UP-90-26 1540.15 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Methods of Verification ______________________________________________________________________________
1540.15 E. IEVS (continued)
3. All verified IEVS information is used for the following purposes:
a. to determine eligibility;
b. to calculate benefits;
c. to detect overpayment and to calculate the amount;
d. to investigate violations of program regulations and to support resulting prosecutions.
4. IEVS obtains and utilizes information from the following sources:
a. Social Security Administration;
b. Department of Labor;
c. Internal Revenue Service;
d. State Wage Information Collection Agencies (SWICA).
5. Members of the assistance unit and deemors who are subject to the IEVS process are provided with written notification of IEVS:
a. at the time of application for assistance;
b. when eligibility is redetermined;
c. when an adult member is being added to the needs group.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 12-1-91 Transmittal: UP-91-51 1540.15 page 4 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Methods of Verification ______________________________________________________________________________
1540.15 F. SAVE
The Department uses the Federally-mandated Systematic Alien Verification for Entitlement (SAVE) to obtain information from the Immigration and Naturalization Service regarding the status of all individuals who are not citizens, except those ineligible non-citizens applying for emergency medical treatment.
1. The status of individuals who are subject to SAVE is verified:
a. at the time of application; or
b. when eligibility is being redetermined; or
c. when a temporary status is expiring; or
d. when a request is made to add a new member to the assistance unit.
2. Non-citizens with permanent status will be subject to the SAVE process only one time.
3. In addition to the initial process non-citizens with temporary or conditional status will be subject to SAVE:
a. when their temporary status expires; and
b. until permanent status is granted by INS.
4. Information from SAVE is obtained through two processes:
a. Primary verification - a direct access to INS files;
b. Secondary verification - a manual procedure in addition to or in lieu of primary verification.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 1540.15 page 5 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Methods of Verification ______________________________________________________________________________
1540.15 G. Affidavits
1. Affidavits are accepted for review by the Department:
a. in addition to any documentary evidence or verification through collateral contacts or home visits; or
b. when documentary proof is required, and the assistance unit cannot provide it after good faith efforts; or
c. when submitted as proof of the nonexistence of an eligibility factor.
2. When an affidavit is reviewed by the Department, it is evaluated along with all other evidence relative to the eligibility factor.
3. The Department uses all the available evidence, including the affidavit, to determine whether it is more likely than not that the eligibility factor has been established.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1540.15 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Evaluating the Evidence ______________________________________________________________________________
P-1540.15 Evaluating the Evidence
1. Consider all evidence submitted by the client or received from other sources.
2. Evaluate each piece of evidence to decide how credible it is.
3. Consider the following factors in evaluating documentary evidence:
° is the evidence an official document of an agency or an organization?
° does the person or organization supplying the document have direct knowledge of the relevant facts?
° does the document show current information?
° is the person who supplied the document a disinterested third party, who will not directly benefit by the client's eligibility?
° is the person who supplied the document an objective source of information, who would have no reason to want the client to be eligible?
° is the document consistent with other information from the same source?
° if the information on the document is questionable or unclear, is the supplier accessible for follow-up questioning?
4. Consider official documents to be more credible than unofficial documents.
5. Consider documentary evidence to be more credible than oral statements.
6. Consider affidavits more credible than informal oral or written statements.
7. Consider statements from disinterested people to be more credible than statements from people who might directly benefit from the client's eligibility, such as family members, friends, landlords.
8. Consider statements from objective sources to be more credible than statements from people who have a personal relationship with the client.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1540.15 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Application Process AABD _______________________________________________________________ MA Subject: FS Evaluating the Evidence ______________________________________________________________________________
P-1540.15 9. After evaluating each piece of evidence for credibility, evaluate the total of all the evidence which is relevant to the particular factor of eligibility.
10. Consider that the client's statement has been verified if evaluation of the evidence leads to the conclusion that the statement is more likely to be true than not.
11. If there is evidence available to support the client's statement which is considered substantially credible and no evidence is available to the contrary, consider the factor verified.
12. If the only evidence available is not considered credible, do not consider the factor verified. If this is the case, require more verification before eligibility can be established.
13. If some of the available evidence support the client's statements and some refutes the same statements, consider the credibility of evidence on each side to determine whether the statement is more likely to be true than not.
14. If the statement is more likely to be true than not, the statement is considered verified, even if some evidence refutes the statement.
15. If the statement is less likely to be true than not, consider the statement not to be verified, even if some evidence supports the statement.
16. If the statement seems equally likely to be true and not true, consider the statement not to be verified.
17. Only consider quantity of evidence of a factor if the evidence being considered is equally credible.
18. Remember that a single piece of highly credible evidence such as an official document from an objective source, can carry more weight than numerous less credible pieces of evidence, such as oral statements from friends and family members.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1540.20 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Verification through IEVS ______________________________________________________________________________
P-1540.20 1. Provide an explanatory notification of the IEVS process to all affected persons:
° at the time of application;
° when eligibility is redetermined;
° when adding a member to the needs groups.
2. Solicit and record all the Social Security numbers of all members of the needs group, and any other persons who are subject to the IEVS process.
3. Use all the Social Security numbers furnished without verifying them beforehand.
4. Request information about Unemployment Compensation Benefits from the Department of Labor:
° at the time of application;
° for each of the three months subsequent to the month of application;
° in each month UCB are received;
° only at the time of application for institutionalized recipients.
5. Request information about wages from the Department of Labor:
° at the time of application;
° quarterly for all recipients;
° quarterly for former FS assistance unit members if they received FS benefits at least one month in the quarter;
° at the time of application and annually thereafter for institutionalized individuals.
6. Request information about RSDI benefits, net self-employment income, wages and retirement income from the Social Security Administration through the BENDEX system:
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1540.20 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Verification through IEVS ______________________________________________________________________________
P-1540.20 6. (continued)
° at the time of application;
° whenever the income of an assistance unit member or a deemor changes.
7. Request information about unearned income from the Internal Revenue Service at the time of application and annually thereafter.
8. Request information on income as necessary through the State Wage Information Collection Agencies (SWICA) and agencies which administer UCB programs.
9. Do not delay the disposition of the case pending receipt of IEVS information unless it constitutes the sole source of adequate verification and current eligibility cannot be determined without it.
10. Take action on all information obtained through IEVS:
° at the time of initially granting assistance if the information has already been received;
° within 30 calendar days of receipt of the information when the unit is a recipient of assistance unless, required verification cannot be obtained because of a third party.
11. Verify all data received when the agency supplying the data is not the primary source of the benefits in question.
12. Compare the data obtained through IEVS to information which the Department has already obtained from other sources and resolve any discrepancies which may exist.
13. Continue to process IEVS data even when a recipient fails to take part in the redetermination of eligibility or when discontinuance is pending.
14. When a recipient fails to comply with the 10-day limit for submitting requested verification, send a notice of proposed adverse action as compliance with the mandated 30-day limit for processing IEVS data unless the delay is caused by a third party.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1540.20 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Verification through IEVS AABD _______________________________________________________________ MA Subject: FS Using the Methods of Verification ______________________________________________________________________________
P-1540.20 15. When data is obtained from IRS computer files:
° do not transcribe the information into the Department's case file or in any other manner which would compromise the individual's right to confidential treatment of the data;
° incorporate any verification obtained into the Department's records;
° destroy any data erroneously received about any person who is not part of the assistance unit or who is a deemor.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 11-15-90 Transmittal: UP-90-26 P-1540.25 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC General Principles of Verification AABD _______________________________________________________________ MA Subject: FS Determining the Appropriate Action ______________________________________________________________________________
P-1540.25 1. Determine the appropriate penalty if the assistance unit fails to provide any verification, or to provide acceptable verification within the established deadlines, unless an extension has been granted.
2. If the assistance unit's eligibility depends upon the unverified factor, deny or discontinue assistance for one of the following reasons, whichever is appropriate:
° for failure to verify eligibility if the assistance unit did not provide any verification of a required factor; or
° for failure to establish eligibility if verification was provided for a required factor, but such verification was determine to be insufficient.
3. If the unverified factor or circumstance does not directly cause ineligibility but may potentially affect the benefit level, do not give consideration to it when determining eligibility and calculating the benefit.
4. If not considering a factor results in ineligibility for the assistance unit, deny or discontinue assistance.
5. If not considering a factor does not result in ineligibility, but results in a lower benefit amount, authorize the appropriate benefit amount.
6. If not considering a factor results in fewer assistance unit members being eligible, authorize assistance for the eligible members.
7. Do not deny assistance or withhold benefits to the assistance unit for failure to verify a factor if the Department has accepted the responsibility of obtaining verification.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1545 The eligibility of an assistance unit is periodically redetermined by the Department. During the redetermination, all factors relating to eligibility and benefit level are subject to review. This chapter discusses the requirements of the redetermination process, its purpose, and how the Department conducts a redetermination of eligibility.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.05 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS General Requirements ______________________________________________________________________________
1545.05 A. Provisions
1. Eligibility is redetermined:
a. regularly on a scheduled basis; and
b. as required on an unscheduled basis because of known, questionable or anticipated changes in assistance unit circumstances.
2. A redetermination constitutes:
a. a complete review of AFDC, AABD or MA certification;
b. a reapplication for the FS program.
3. In general, eligibility is redetermined through the same methods by which eligibility is initially determined at the time of application.
B. Purpose
1. The purpose of the redetermination is to review and, for FS assistance units, to recertify all circumstances relating to:
a. need;
b. eligibility;
c. benefit level.
2. A review of recipient-agency responsibilities is also conducted.
3. Circumstances subject to change, or which are unclear or questionable are investigated and verified.
4. Assistance is discontinued if eligibility is not reestablished.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.05 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS General Requirements ______________________________________________________________________________
1545.05 C. Prompt Action
1. The redetermination process is designed to allow continuous participation without interruption in eligibility or in the issuance of benefits.
2. In order to assure continuous participation the Department takes prompt action on all redeterminations.
3. Prompt action is taken to effect any interim actions necessitated by changes in circumstances that are discovered during the redetermination process.
4. Interim actions are processed in accordance with the interim change rules. (Cross Reference: 1555)
D. Notification
Assistance units are timely notified of all actions taken by the Department, including:
1. notification that a redetermination is to be conducted;
2. notification of adverse action where appropriate; (Cross Reference: 1570)
3. notification of the result of the redetermination;
4. notice of recertification for FS assistance units.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-90 Transmittal: UP-90-11 P-1545.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ FS Subject: MA Determining the Length of the Redetermination Period ______________________________________________________________________________
P-1545.05 1. Establish the length of the standard redetermination period for each assistance unit:
° when assistance is granted; and
° subsequent to each scheduled redetermination.
2. Use the following table as a general guide in determining the standard length of the redetermination period:
Assistance Unit Type Standard Redetermination Period
Monthly Reporting 12 months MA Non-Spend-Down 12 months AABD (Earned Income) 6 months AABD (Unearned Income) 12 months Stable FS Elderly Disabled 12 months MA Spend-Down 6 months On-going AFDC 6 months Stable FS 6 months Newly Awarded AFDC (Non MR Cases) 3 months Unstable FS 3 months Very Unstable FS 1-2 months FS Expedited/Verification Postponed 1-2 months
3. Vary the length of the redetermination period on a case-by-case basis according to error prone profiles, case history or other individual characteristics.
4. For initial AFDC reviews, schedule the redetermination 3 months following the month assistance is granted.
5. For FS assistance units, follow the certification rules established in chapter 1530 of this section, including the rules for extending the certification period for units certified to one or two months.
6. Whenever possible, try to synchronize the redetermination schedules of assistance units receiving assistance from multiple programs.
7. Issue notice of the review schedule to the unit when assistance is granted and at subsequent redeterminations.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Redetermination Periods ______________________________________________________________________________
1545.10 A. Defining the Redetermination Period
1. General Provisions
a. Redetermination periods correspond to calendar months, and for FS assistance units are equivalent to certification periods.
b. The redetermination period is defined in the same manner for all programs except for the first month of the period at initial application for MA assistance units.
c. The assistance unit becomes due for redetermination in the final month of the redetermination period.
d. The final month of the redetermination period is considered to be the redetermination month, even if the review is conducted in the prior month.
2. First Month in the Redetermination Period
a. Initial Application
(1) The first month of the redetermination period is the first month, beginning with or after the month of application, that:
(a) an assistance unit, other than an MA spend-down assistance unit is eligible for benefits;
(b) an MA spend-down assistance unit meets all eligibility requirements, except that applied income exceeds the MNIL.
b. Subsequent to Initial Application (All Programs)
The month following the redetermination month is the first month of the new redetermination period for an active case.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-90 Transmittal: UP-90-11 1545.10 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Redetermination Periods ______________________________________________________________________________
1545.10 B. Maximum Intervals
1. The following standards are established as maximum intervals for conducting regularly scheduled redeterminations:
a. for AFDC non-monthly reporting cases and AFDC cases that do not have low error-prone profiles, at least as often as every six months;
b. for AFDC monthly reporting cases and AFDC cases with low error-prone profiles, at least as often as every twelve months;
c. for AABD cases with earnings, at least as often as every six months;
d. for AABD without earnings and MA assistance units, at least as often as every twelve months;
e. for FS assistance units, at least as often as every twelve months.
2. Unscheduled redeterminations may be conducted whenever circumstances warrant the review, provided that the assistance unit is given adequate notice.
C. General Guidelines
1. Assistance units are generally assigned the longest review period possible.
2. The redetermination cycle may be varied for specific cases or target groups on the basis of such factors as error-prone profiles or individual case history.
D. Specific Program Requirements
1. MA Spend-down Cases
a. Medically needy spend-down cases must be redetermined at least as often as every six months.
b. The six month redetermination cycle corresponds to the six month excess income spend-down period. (Cross reference: 5500)
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 12-5-08 Transmittal: UP-09-06 1545.10 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Redetermination Periods ______________________________________________________________________________
1545.10 D. Specific Program Requirements (continued)
2. MA and AABD cases are redetermined no later than three months after the grant date when:
a. the individual applies no later than thirty days after being released from a correctional or mental disease facility; and
b. was granted cash or medical assistance without a new application (Cross-reference 1505.10 A.3); and
c. the previous redetermination period has expired or will expire not later than three months following the month assistance is granted.
3. FS Assistance Units
a. The redetermination cycle for FS assistance units corresponds to the length of the certification period.
b. The assistance unit's eligibility must be redetermined by the end of the last month of the certification period if eligibility is to continue without interruption.
E. Redetermination Cycles Which Coincide
1. MA Assistance Units Receiving Cash Assistance
The medical eligibility of cash assistance recipients is redetermined on the same periodic schedule as the corresponding cash program.
2. FS Assistance Units Receiving Public Assistance
a. FS assistance units are redetermined on the same periodic schedule as the corresponding PA program if:
(1) at least one member of the FS assistance unit is a PA recipient; and
(2) circumstances warrant redetermination cycles of equal length.
b. Redetermination periods of different length may be assigned if circumstances do not warrant a combined FS and PA redetermination.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-93 Transmittal: UP-93-5 P-1545.10 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Issuing the Redetermination Notice ______________________________________________________________________________
P-1545.10 1. Issue notice of the redetermination at the appropriate time.
2. Include an interview appointment schedule, if necessary.
3. If the notice is automated, review the preliminary system schedule and make any necessary adjustments by the EDP cut-off date.
4. For manually issued notices:
° arrange an appointment schedule for your redetermination caseload;
° issue the redetermination notice along with an EDD to the assistance unit.
5. Take necessary steps to contact, schedule home visits or provide special materials to handicapped individuals who are entitled to the use of auxiliary aids. (Cross Reference: 1000)
6. Whenever possible issue a joint redetermination notice, or attempt to coordinate the interview schedule if:
° some or all of the assistance unit members receive assistance from multiple programs; and
° the redetermination month for different programs coincides.
7. For NMR AFDC and related FS cases, make sure that the "Next Redet" indicator on the MISC screen shows the same appropriate code (either "M" for mail-in or "O" for office) with respect to both the AFDC and the FS unit.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-01 Transmittal: UP-03-05 1545.11 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: The Redetermination Process FMA _______________________________________________________________ Subject: Redetermination Periods - TFA Related Assistance Units ______________________________________________________________________________
1545.11 A. Except as stated below, TFA related Medicaid assistance units which also receive TFA benefits are redetermined on the same periodic schedule that pertains to the TFA assistant unit. (cross reference: 8520.10)
B. TFA related Medicaid assistance units which also receive TFA benefits are not subject to the six (6) month counter review. (cross reference: 8520.10)
C. TFA related Medicaid assistance units which also receive TFA benefits are subject to the six (6) month calendar review, the twelve (12) month redetermination and the exit interview. (cross reference: 8520.10)
D. TFA Extended Medical Assistance is reviewed after twelve months of eligibility as described at 2540.09.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.15 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Redetermination Notices ______________________________________________________________________________
1545.15 A. Notification Requirements
1. The Department is required to provide assistance units with timely notification of the scheduled redetermination.
2. FS assistance unit must also be provided with timely notification if a redetermination is to be conducted at an earlier date as the result of a change in the certification period. (Cross Reference :1530).
B. Issuance Requirements
1. AFDC, AABD, MA Cases
a. Prior to implementation of the EMS system, notice of the redetermination must be issued to AFDC, AABD, or MA assistance units within the following limits;
(1) no earlier than forty-five days prior to the first day of the redetermination month; and
(2) no later than the last day of the month preceding the redetermination month.
b. Upon implementation of the EMS system, notice of the redetermination must be issued no earlier than the first day, or later than the last day of the month preceding the redetermination month.
2. FS Cases
FS assistance units must be provided with timely notification of the scheduled redetermination in accordance with the following time standards:
a. The notice is issued at the time of certification to assistance units that are:
(1) certified for one month; or
(2) certified for two months in the second month of the certification period; or
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.15 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Redetermination Notices ______________________________________________________________________________
1545.15 B. 2. a. FS Cases (continued)
(3) certified for two months prior to the sixteenth day of first month of the certification period;
b. The notice is issued at the time the AFDC or AABD notice is issued to assistance units that:
(1) are comprised entirely of AFDC or AABD recipients; and
(2) have a redetermination schedule that coincides with that of the cash assistance program;
c. The notice is issued to assistance units that do not fall into categories a. or b. above no earlier than the first day, or later than the last day of the month preceding the redetermination month.
C. Joint Notices
The Department may issue separate redetermination notice if a joint review is to be conducted for recipients of cash assistance and food stamps.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-93 Transmittal: UP-93-38 P-1545.15 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process FS _______________________________________________________________ Subject: Interviewing and Interview Waivers ______________________________________________________________________________
P-1545.15 Interviewing
1. Conduct the interview in the same manner as at the time of application.
2. Complete all applicable sections of the EDD and obtain the signature of the client. If an interpreter is used also have the interpreter sign the redetermination forms.
3. Review all factors affecting eligibility and benefit level.
4. Ask the unit to provide any required verification.
5. Offer assistance if it will be difficult for the unit to provide verification by the deadline for submitting the verification.
6. Advise the unit of any additional assistance that may be available.
7. Make appropriate referrals, including work registration or HealthTrack.
8. For all cash and Medicaid assistance units with children under the age of twenty-one, discuss the importance of regular age appropriate well-child care; including immunizations and blood level testing. Encourage these assistance units to take advantage of the following services which the HealthTrack staff can provide:
° helping to schedule regular medical, dental, vision and hearing appointments
° helping to find a doctor, dentist or other medical provider convenient for the family
° arranging medical transportation, if necessary
° help with eliminating barriers (i.e. child care) which prevents families from receiving medical care
° providing health education information, including the benefits of preventive health care, the importance of age appropriate immunizations and the periodicity schedule for well-child care.
° explaining the benefits and availability of the WIC program and other community services of interest
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-95 Transmittal: UP-95-7 P-1545.15 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process FS _______________________________________________________________ Subject: Interviewing and Interview Waivers ______________________________________________________________________________
P-1545.15 8. (continued)
° providing information on the availability of local immunization clinics, which provide vaccines free of charge.
° reminding the client when a child is due for his or her next appointment
providing health education information, including WIC and other valuable services
9. If an interview is not specifically required, make a telephone contact and review the EDD whenever possible.
10. Explore any other issues that require further investigation or clarification.
Interview Waivers
1. If a waiver of the office interview requirement is requested, review the conditions and determine if the waiver should be allowed.
2. If the waiver is granted, decide if a home visit or telephone interview should be conducted.
3. Generally consider a telephone interview to be sufficient, except when a home visit is necessary.
° meet the annual face-to-face redetermination requirements.
° accommodate limitations of handicapped individuals;
° assure the accuracy of the eligibility or benefit level determination.
4. Document the reason for granting or denying the request for a waiver of the office interview in the case record or in the EMS narrative.
Unscheduled Appearances
1. Generally, follow application process procedures if an assistance unit appears for the interview at a time other than the scheduled appointment time. (cross reference: P-1505)
2. Try to provide enough open time in your appointment schedule to allow for delays and interruptions.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-91 Transmittal: UP-95-7 P-1545.15 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process FS _______________________________________________________________ Subject: Interviewing and Interview Waivers ______________________________________________________________________________
P-1545.15 (continued)
3. Make a reasonable attempt to accommodate people who do not appear on schedule.
4. If a new appointment date must be set, try to complete the interview no later than the fifteenth day of the redetermination month. As a general rule, schedule the appointment after the fifteenth only at the client's request.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 05-10-10 Transmittal: UP-10-03 1545.20 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: SNAP Redetermination Interviews ______________________________________________________________________________
1545.20 A. Provisions
1. Except for the following rules, the redetermination interview requirements are the same as the requirements established for the application process. (cross reference: 1505)
2. In-office interviews are required for AFDC assistance units at least once every twelve months, but not for SNAP, AABD and MA assistance units.
B. Face-to-Face Redetermination Requirements
1. AFDC assistance units must be redetermined face-to-face at least once every twelve months through an office interview or home visit.
2. Non-Monthly Reporting AFDC assistance units, either with or without related SNAP benefits, which are redetermined every six months may be redetermined by mail at alternate redeterminations.
3. The requirement covers periods of continuous activity beginning with the initial date of eligibility of the particular assistance unit.
C. Combined Interview Requirement
1. The rule requiring combined application interviews also applies at the time of redetermination to SNAP assistance units that:
a. are composed entirely of AFDC recipients; and
b. have the AFDC redetermination scheduled in the same month as the SNAP redetermination.
2. Since office interviews are not required for AABD assistance units, the combined interview requirement does not specifically apply. However, the Department attempts to complete a combined interview for AABD assistance units that:
a. appear for an in-office SNAP redetermination interview;
b. have also received notice of their AABD redetermination; and
c. desire assistance in completing the AABD redetermination.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 05-10-10 Transmittal: UP-10-03 1545.20 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process SNAP _______________________________________________________________ Subject: Redetermination Interviews ______________________________________________________________________________ 1545.20 D. Scheduling Interviews
1. Assistance units are notified of scheduled interview appointments at the time the notice of redetermination is issued.
2. Initial appointments are scheduled:
a. no earlier than five business days after the mailing date of the redetermination notice; and
b. no later than the fifteenth day of the redetermination month.
3. The assistance unit is responsible for requesting a new appointment if the original appointment is missed or cannot be kept.
E. Waiver of the Office Interview
1. The rules for waiving the office interview for the SNAP are the same at redetermination as at the time of application. (Cross Reference 1505.30)
2. If an AFDC assistance unit has good cause not to attend the office interview, the Department:
a. reschedules the interview for as late as the twentieth day of the month following the redetermination month; or
b. conducts a home visit or telephone interview as required in this chapter; and
c. continues cash assistance payments beyond the redetermination month unless the assistance unit refuses to cooperate or is otherwise found ineligible.
3. For AFDC, a home visit rather than telephone interview is conducted if the face to face redetermination requirement:
a. has not been met within the past twelve months; and
b. will not be met by the next scheduled redetermination if the current office interview is waived.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-88 Transmittal: UP-93-05 1545.20 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: SNAP Redetermination Interviews ______________________________________________________________________________
1545.20 F. Unscheduled Appointments
1. The Department is not required to interview assistance units on the same day they appear at the office if:
a. the assistance unit comes into the office at a time other than the scheduled appointment time; and
b. a new appointment can be scheduled by the fifteenth day of the redetermination month.
2. A reasonable attempt is made to complete the interview on the same day. However, if adequate time remains in the redetermination month a new appointment may be scheduled.
3. Assistance units that have not yet filed their redetermination document must be allowed to submit the document prior to leaving the office if the interview is postponed.
G. Rescheduled Appointments
1. The Department reschedules appointments at the request of the assistance unit.
2. Unless otherwise requested by the assistance unit, the new appointment is rescheduled by the fifteenth day of the redetermination month in order to:
a. allow ten days for the assistance unit to provide required verification or complete other required actions; and
b. provide the Department with sufficient time to process the redetermination.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1545.20 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermine Process AABD _______________________________________________________________ MA Subject: FS Completing the Redetermination Form ______________________________________________________________________________
P-1545.20 1. Review and assist the client with completing the EDD during the redetermination interview.
2. If a face-to-face interview is not required, attempt to contact the unit by telephone in order to review the EDD and acquire all necessary information.
3. Treat the EDD in the same manner as a new application, except that circumstances which have been previously confirmed, and are unchanged, need not be verified unless otherwise questionable.
4. Obtain signatures from the appropriate individuals. For FS assistance units require signature of the authorized representative or an adult member of the assistance unit.
5. Document your findings.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.25 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ FS Subject: Redetermination Form ______________________________________________________________________________
1545.25 A. Assistance units are required to complete a redetermination form at each redetermination.
B. The redetermination form may be:
1. the same form used at the time of application; or
2. a form designed specifically for the redetermination process.
C. The Department provides each assistance unit with a redetermination form at the same time unit is issued its notice of redetermination.
D. Assistance units that do not complete the redetermination form within the time limits specified in this chapter may be subject to discontinuance or an interruption in benefits.
E. The redetermination form must be signed by someone qualified to complete the redetermination on behalf of the assistance unit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1545.25 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Redetermining Eligibility ______________________________________________________________________________
P-1545.25 1. Investigate all factors relating to eligibility or benefit level prior to completing the redetermination.
2. Allow sufficient time for the assistance unit to complete any required actions.
3. Provide notice and document the case file if the assistance unit is requested to take additional actions that were not required at the time of the interview.
4. If there is multiple program involvement, process each case separately according to the individual program standards.
5. Evaluate categorical eligibility for the MA or FS programs where appropriate.
6. Use discretion in determining when to evaluate incomplete cases. For example, you may consider allowing more than ten days to provide verification, instead of taking action on the eleventh day after the verification was requested.
7. Take into consideration such factors as:
° the amount of time left in the standard processing period;
° the possibility of internal mail delivery delays;
° if the client has expressed difficulty in obtaining verification and that the information may be provided late;
° is the client having difficulty complying because of age or disability.
8. Observe the timeliness requirements established for:
° filing the EDD;
° completing the interview;
° providing verification.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1545.25 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Redetermining Eligibility ______________________________________________________________________________
P-1545.25 9. Take whatever action is necessary to continue or discontinue eligibility, or where appropriate, to delay processing for good cause factors or administrative delays.
10. Issue appropriate notice to the assistance unit.
11. Document your actions in the case file.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.30 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Qualified Individuals ______________________________________________________________________________
1545.30 A. Except for the following modifications, the rules regarding individuals qualified to complete the redetermination are the same as those established for making application. (Cross Reference: 1505).
B. The AFDC,AABD or MA redetermination must be completed by the appropriate individual listed below.
1. the AABD or MA recipient;
2. the caretaker relative;
3. the spouse;
4. a court appointed fiduciary, or a responsible adult acting on behalf of a person who is incompetent or incapacitated.
C. An authorized representative or other person not listed in B. above is not considered qualified to complete the AFDC,AABD, or MA redetermination on behalf of the assistance unit.
D. The FS redetermination must be completed by:
1. the designated head of the assistance unit; or
2. the designated authorized representative; or
3. a responsible member of the assistance unit.
E. For FS assistance units, the redetermination form must be signed by the head of the unit, an adult assistance unit member, or by the authorized representative.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1545.30 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: The Redetermination Process FS _______________________________________________________________ Subject: Processing Incomplete FS Cases ______________________________________________________________________________
P-1545.30 1. Process the incomplete case after the appropriate client time limit for taking action has expired, i.e., the fifteenth day of the redetermination month or 10 days, whichever is later.
2. Do not act prior to the fifteenth day, unless:
° an interim change is necessary;
° the unit withdraws from the program;
° the unit refuses to cooperate.
3. Except at your own discretion, do not issue additional notices to the FS unit prior to taking action:
° unless an interim change is planned.
4. Wait as long as possible to discontinue cases that are potentially categorically eligible if the cash assistance redetermination is incomplete.
5. Issue the appropriate certification or discontinue notice after the case is processed.
6. Do not continue eligibility if the certification period expires and the case has not been found eligible.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.35 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Timeliness Required ______________________________________________________________________________
1545.35 A. Uninterrupted Benefits (FS)
1. Assistance units are provided benefits without interruption by the first normal issuance date following the redetermination month if they timely complete the required actions of the redetermination process.
2. The following actions must be timely completed in order to receive uninterrupted benefits:
a. The redetermination form must be filed and completed; and
b. The office interview must be completed, unless exempt from the requirement; and
c. Required verification of factors that are conditions of eligibility must be provided.
B. Timely Filing of the Redetermination Form (All Programs)
1. An assistance unit must submit the redetermination form by the following date in order to be considered timely filed.
a. FS non-monthly reporting assistance units that are certified for one or two months and issued the redetermination notice at the time of certification must file by the fifteenth day after the date the redetermination notice is issued;
b. All other PA and FS non-monthly reporting assistance units must file by the fifteenth day of the redetermination month;
c. Monthly reporting assistance units must file by the day of the redetermination month that the monthly report form is normally due.
2. The assistance unit is considered to have timely filed if by the filing deadline the redetermination form is:
a. delivered in person or by mail to the appropriate district office, or for SSI assistance units being redetermined for food stamps, to an SSA office; and
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.35 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Timeliness Required ______________________________________________________________________________
1545.35 B. 2. Timely Filing of the Redetermination Form (All Programs)(continued)
b. complete to the extent that a legible name and address appear on the form; and
c. signed by the applicant or other qualified individual.
C. Interviews (AFDC, FS)
An assistance unit has timely completed the interview requirement if it appears for any interview by the later of the following dates:
1. the date scheduled by the Department; or
2. the deadline for filing the redetermination form.
D. Verification (All Programs)
Required verification has been timely submitted if it is provided to the appropriate district office by the later of the following dates:
1. the deadline for filing the redetermination form; or
2. ten days following the date the verification is initially requested by the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-95 Transmittal: UP-95-5 P-1545.35 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: Processing Incomplete AFDC, AABD or MA Cases ______________________________________________________________________________
P-1545.35 Missed AFDC Interviews
Take the following actions when an AFDC assistance unit fails to complete the redetermination interview:
1. Issue an adverse action notice the day after the scheduled appointment date.
2. Inform the unit that assistance will be discontinued on the last day of the redetermination month if the interview is not completed by the fifteenth day of the redetermination month.
3. If the unit has notified you of good cause, schedule a second appointment at your discretion.
4. Do not take steps to hold benefits at this time.
5. If the unit has not completed the interview or had one scheduled by the fifteenth day of the redetermination month EMS will:
° issue a second adverse notice on the sixteenth affirming the proposed discontinuance action; and
° not issue the scheduled benefit payment for the month following the redetermination month; and
° discontinue medical assistance.
6. If the unit completes the interview in the month following the redetermination month:
° treat the case as a late redetermination if good cause is established;
° treat the case as an initial application if good cause is not established.
7. Process cases treated as late redetermination within 5 days of the date the redetermination requirements are completed.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-95 Transmittal: UP-95-5 P-1545.35 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: Processing Incomplete AFDC, AABD or MA Cases ______________________________________________________________________________
P-1545.35 Missed AFDC Interviews (continued)
8. For assistance units appearing by the tenth day of the month, consider good cause to exist as long as:
° the unit completes the interview; and
° has not expressly refused to comply with the redetermination requirements.
9. For assistance units appearing between the tenth day and the last day of the month following the redetermination month, consider good cause to exist only if the unit demonstrates that a specific set of circumstances outside of its control delayed compliance.
10. Complete the redetermination if good cause is established.
11. If the unit is eligible:
° release any held benefits; or
° reinstate assistance retroactive to the first day of the month if the case was discontinued and the held benefits voided.
12. If good cause is not established require a reapplication through the normal intake process.
All Other Incomplete Cases
1. In cases of missing verification, contact the unit at your discretion. There is no notice requirement, provided that:
° the unit had been properly informed when the EDD was reviewed of any required verification; or
° no interim action is required.
2. Issue an adverse action notice on the fifteenth day of the redetermination month if benefits are to be reduced or terminated because of the incomplete redetermination.
3. Process the case after the fifteenth day if verification was not mandatory and no reduction in benefits will occur.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-95 Transmittal: UP-95-5 P-1545.35 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: Processing Incomplete AFDC, AABD or MA Cases ______________________________________________________________________________
P-1545.35 All Other Incomplete Cases (continued)
4. Take action to reduce or discontinue assistance if the adverse action period expires, unless:
° the unit complies;
° a fair hearing is requested and benefits are continued pending the hearing;
° good cause is established.
5. If the unit takes any of the above actions, continue to process the case to completion within five days of the date the redetermination requirements are completed.
6. If the unit complies in the month following the redetermination month, but does not establish good cause:
° treat a discontinued case as a new application from the date the EDD was filed;
° treat verification provided by an eligible assistance unit as an interim change.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.40 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Processing Redeterminations ______________________________________________________________________________
1545.40 A. Processing Requirements
1. Agency Action
a. Eligibility is redetermined by the end of the current redetermination period in all cases where sufficient information exists to reach a decision.
b. Continued eligibility is either approved or denied, and the assistance unit notified of the Department's determination.
c. Eligible assistance units are entitled to receive benefits by the normal issuance date in the first month of the new redetermination period, provided that they meet all other program or monthly reporting requirements.
2. Discontinuance
Unless otherwise stated, assistance is discontinued on the last day of the redetermination month if eligibility is not reestablished through the redetermination process.
3. Immediate Action
a. Immediate action is taken in the following situation:
(1) when a change is discovered that can be affected as in interim action prior to the end of the redetermination period; and
(2) when an assistance unit refuses to cooperate with an eligibility requirement.
b. The rules concerning advance notice requirements in the FS program apply to adverse changes that are treated as interim actions prior to the end of the certification period.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1545.40 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Processing Redeterminations ______________________________________________________________________________
1545.40 A. 4. Medical Assistance Eligibility (continued)
When cash assistance is to be discontinued for an ineligible AFDC or AABD assistance unit, the Department:
a. explores eligibility for medical assistance; and
b. takes immediate action to continue medical coverage to eligible assistance units.
B. Continuing Eligibility on Incomplete Cases
1. AFDC, AABD, MA
a. If eligibility has not been reestablished by the end of the redetermination period, the Department continues to provide assistance under the following conditions if it appears that the assistance unit will remain eligible:
(1) when the agency is responsible for not completing the redetermination; or
(2) when the assistance unit fails to act timely but completes the redetermination form and any required interview by the last day of the redetermination month; or
(3) when the assistance unit demonstrates good cause for failing to complete the redetermination process.
b. If eligibility is continued, the assistance unit must complete the redetermination process by the end of the month following the redetermination month, unless circumstances beyond the units control continue to delay the process.
c. Eligibility may be continued, and the redetermination held pending, as long as:
(1) circumstances beyond the control of the assistance unit delay completion of the redetermination process; and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 1545.40 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Processing Redeterminations ______________________________________________________________________________
1545.40 B. 1. c. Continuing Eligibility on Incomplete cases (continued)
(2) the assistance unit appears to be eligible for assistance.
d. Good cause may include, but is not limited to the following hardships.
(1) illness;
(2) severe weather;
(3) death in the immediate family;
(4) other circumstances beyond the control of the assistance unit.
2. FS
a. Eligibility for the FS program is discontinued at the end of the redetermination period in all situations where the redetermination is incomplete and the assistance unit has not been recertified.
b. Discontinuance is automatic, regardless of the reason for the imcomplete redetermination.
c. Good cause is not a consideration in the FS program.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1545.45 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC The Redetermination Process AABD _______________________________________________________________ MA Subject: FS Special Processing Requirements ______________________________________________________________________________
1545.45 A. Specific Requirements (AFDC, AABD, MA)
The following provisions apply to AFDC, AABD or MA assistance units whose eligibility was discontinued at the end of the redetermination period because they failed to complete the redetermination process.
1. Untimely Filing
a. Redetermination forms filed in the month following the redetermination month are treated as initial applications if good cause is not established for the untimely filing.
b. If good cause is established:
(1) the case is processed as a late redetermination; and
(2) eligibility is redetermined within five working days of the date the assistance unit completes all required actions.
2. Untimely Interviews or Submission of Verification
Assistance units that file a redetermination form by the end of the redetermination month, but fail to complete the interview or submit required verification until the following month, are:
a. processed as an initial application within forty-five days of the filing date if good cause is not established;
b. processed within five business days of the date the assistance unit completes all redetermination requirements if good cause is established.
B. Specific FS Requirements
1. Administrative Delays
a. The Department cannot cause an interruption of benefits if due to an administrative delay the only information missing from the redetermination is verification of non-citizen status.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1545.45 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS The Redetermination Process _______________________________________________________________ Subject: Special Processing Requirements ______________________________________________________________________________
1545.45 B. 1. Administrative Delays (continued)
b. The Department takes immediate action to provide eligible assistance units with an opportunity to participate if due to an administrative delay benefits are interrupted.
c. If an interruption in benefits is due to the minimum waiting period for providing required verification, the Department provides an opportunity to participate within five business days of the date of receipt of the verification, if the verification is received timely.
2. Untimely Filing
a. Redetermination forms that are untimely filed are treated as initial applications and are subject to the processing requirements established for the application process. (Cross reference: 1505)
b. If the assistance unit files untimely, but prior to the end of the redetermination month, a reasonable attempt is made to complete a redetermination before the certification period expires.
c. If the certification period expires, the application is processed within thirty calendar days of the filing date.
3. Untimely Interviews or Submitted Verification
a. Assistance units that timely file a redetermination form, but complete the interview or submit required verification in an untimely manner, are provided an opportunity to participate within thirty calendar days of the date the redetermination form was filed, if benefits were interrupted.
b. If benefits were not interrupted, the redetermination is processed in time to provide benefits by the normal issuance date in the first month of the new certification period.
c. An opportunity to participate is provided within five business days of the date of receipt of required verification if the Department is unable to comply with the thirty day standard because of the waiting period for providing required verification.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-88 Transmittal: UP-88-44 1550 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Monthly Reporting AABD _______________________________________________________________ FS Subject:
______________________________________________________________________________
1550 Certain designated AFDC, AABD, and FS assistance units are required to report their circumstances to the Department each month. This chapter describes the units who are required to be monthly reporters, how they must meet the requirements, and how the Department processes the reports.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-88 Transmittal: UP-88-44 1550.01 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Monthly Reporting AABD _______________________________________________________________ MA Subject: FS Implementation ______________________________________________________________________________
1550.01 The material contained in this chapter pertains to a one-month monthly reporting system and is effective upon implementation of EMS in each district.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-90 Transmittal: UP-90-11 1550.05 ______________________________________________________________________________ Section: Type: The Eligibility Processw POLICY ______________________________________________________________________________ Chapter: Program: Monthly Reporting AFDC _______________________________________________________________ Subject: Units Required to Report Monthly ______________________________________________________________________________
1550.05 Units required to submit monthly reports are designated on the basis of the ability of the monthly reporting process to enhance the accuracy of the determination of eligibility and amount of assistance.
A. AFDC
AFDC units required to submit monthly reports are those which:
1. have earned income; or
2. received a final earned income payment, other than a one time earned income payment such as EITC, lump sum vacation or severance pay, within the past two calendar months; or
3. receive, or are expecting to receive benefits from Unemployment Compensation or Worker's Compensation; or
4. have income deemed to them from deemors who:
a. have earned income; or
b. have received a final earned income payment, other than a one time earned income payment such as EITC, lump sum vacation or severance pay, within the past two calendar months.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-90 Transmittal: UP-90-11 1550.05 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Processw POLOCY ______________________________________________________________________________ Chapter: Program: Monthly Reporting AFDC _______________________________________________________________ Subject: Units Required to Report Monthly ______________________________________________________________________________
1550.05 B. FS
1. Food Stamp units which are required to report monthly, subject to the restrictions below, are those which:
a. have members who are part of an AFDC unit which reports monthly; or
b. have earned income unless the only earnings on the case are from AABD recipients; or
c. receive a final income payment, other than a one time earned income payment such as an EITC, lump sum vacation or severance payment, within the past two calendar months unless the only final income payments are from AABD recipients; or
d. receive or are expecting to receive benefits from Unemployment Compensation of Worker's Compensation unless the only ones receiving or expected to receive such benefits are AABD recipients; or
e. have income deemed to them from deemors, who are not AABD recipients, who:
(1) have earned income; or
(2) have received a final earned income payment, other than a one time earned income payment such as an EITC, lump sum vacation or severance payment, within two calendar months.
2. Food Stamp assistance units are not required to report monthly if they:
a. consist of migrant workers; or
b. consist entirely of adult members who are elderly or disabled and who have no earned income; or
c. consist entirely of members who are all homeless individuals.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-89 Transmittal: UP-89-20 P-1550.05 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Monthly Reporting AABD _______________________________________________________________ Subject: Units Required to Report Monthly ______________________________________________________________________________
P-1550.05 1. At the time of application for assistance, determine if any member of the assistance unit meets the criteria for being required to report monthly.
2. If the unit is to be required to report monthly:
° describe the requirement to report monthly;
° provide the unit with a copy of the pamphlet describing the Monthly Reporting System;
° enter the appropriate data into EMS.
3. Do not require submission of a MRF during the period when the case is pending.
4. Until EMS is operative, make sure that a MRF is issued by CLEM or manually, whichever is appropriate, for the month in which a W-52 is completed to grant assistance.
5. If a unit was not included in the Monthly Reporting system at the time of application, determine if a unit should be reporting monthly whenever changes are found in the unit's circumstances.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-89 Transmittal: UP-89-20 1550.10 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Monthly Reporting AABD _______________________________________________________________ Subject: Reporting Requirements ______________________________________________________________________________
1550.10 A. Basic Reporting Requirements
The month in which assistance is granted is the first budget month for which a Monthly Report Form is required. In each month in which the assistance unit is subject to the requirements of the Monthly Reporting system, the unit must submit a reporting form to the Department which:
1. contains all of the requested information; and
2. includes all required information; and
3. is received by the Department on a timely basis. (Cross Reference: 1555)
B. Completeness
The Department considers the Monthly Reporting form to be complete when:
1. all questions requiring completion are answered; and
2. "yes" answers are adequately explained; and
3. income verification is provided; and
4. it is signed by a responsible member of the assistance unit or, in the case of a Food Stamp unit, an authorized representative.
C. Timeliness
1. The Department considers the Monthly Reporting form to have been received on a timely basis when a completed report is received by the Department on or before the due date.
2. The Department uses the date stamped on the reporting form indicating receipt to determine if the timeliness requirement has been met.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 3-1-90 Transmittal: UP-90-2 P-1550.10 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Monthly Reporting AABD _______________________________________________________________ Subject: Reporting Requirements - Completeness ______________________________________________________________________________
P-1550.10 1. When a monthly report form is received from an assistance unit, review all sections for completeness.
2. Only require completion of those questions necessary to determine eligibility. Do not delay processing of case or consider monthly report form incomplete if missing answers are irrelevant for purposes of determining eligibility.
3. Determine if all questions requiring completion are answered appropriately.
4. Be sure all responses requiring explanation have been adequately completed.
5. Check to see if all necessary verification has been included with the report form.
6. Be sure the form has been dated and signed by a member of the assistance unit or authorized representative.
7. Enter the appropriate data into EMS:
° update all information in EMS according to what's provided on the report form;
° indicate incompleteness, if such is the case.
8. Modify the amount of benefits to be issued in the payment month based on changes reported.
9. Determine if the eligibility of the unit is affected by any changes reported or anticipated and take appropriate actions.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-88 Transmittal: UP-88-44 1550.15 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Monthly Reporting AABD _______________________________________________________________ Subject: Processing Monthly Reports ______________________________________________________________________________
1550.15 A. Incomplete Reporting Forms
The Department notifies units which submit incomplete reporting forms that:
1. they have submitted an incomplete form; and
2. they must provide additional designated information; and
the Department must receive the completed form by a designated date to avoid a termination of benefits.
B. Late Reporting Forms
1. The Department notifies units which do not return report forms in a timely manner that:
a. the reporting form is late; and
b. benefits will be terminated if a form is not received by the end of the reporting month; and
c. if the form is returned without good cause for being late, gross earned income will be used in determining eligibility and calculating benefits for AFDC.
2. The Department considers good cause circumstances to include, but not necessarily be limited to, the following:
a. hospitalization or documented serious illness of the recipient or a member of the recipient's immediate family;
b. incarceration;
c. death of an immediate family member;
d. agency error;
e. lost or stolen mail which is duly reported to the postal authority;
f. loss resulting from a catastrophic event such as fire, flood, or natural disaster.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-88 Transmittal: UP-88-44 1550.15 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Monthly Reporting AABD _______________________________________________________________ Subject: Processing Monthly Reports ______________________________________________________________________________
1550.15 B. Late Reporting Forms (continued)
3. When an assistance unit establishes good cause for a late reporting form, the Department:
a. determines eligibility and calculates benefits for AFDC using the appropriate disregards and deductions;
b. reinstates any discontinued benefits, if the unit remains eligible.
4. No eligibility exists in the payment month when no monthly reporting form is received by the end of the month in which it is due.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-88 Transmittal: UP-88-44 P-1550.15 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Monthly Reporting AABD _______________________________________________________________ Subject: Reporting Requirements - Timeliness ______________________________________________________________________________
P-1550.15 1. When a monthly report form is received from an assistance unit:
° check the due date on the front page of the form;
° check the date of receipt stamped on the form.
2. Consider the report form to have been received in a timely manner if the date of receipt stamped on the form is the due date or an earlier date.
3. Consider the report form to have been received late if the date of receipt is later than the due date.
4. When the form has been submitted late by an AFDC unit, use gross income to determine AFDC eligibility and to calculate AFDC benefits unless good cause is established.
5. Use all appropriate deductions and disregards in determining eligibility and calculating benefits for the AABD and FS programs regardless of whether the form is returned late or not.
6. Reinstate any discontinued benefits if the unit remains eligible.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1555 Interim activity relates to changes that occur between the time of application and redetermination, or between Fair Hearings, which may affect the eligibility or benefit level of assistance units. The chapter discusses the reporting of changes and actions that are taken in response to interim changes.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date:5-1-94 Transmittal: UP-94-5 1555.05 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD ____________________________________________________________ FS Subject: MA Reporting Changes ______________________________________________________________________________
1555.05 A. Timely Reporting
1. Assistance units, with the exception of FS monthly reporting assistance units, are required to report changes to the Department within ten calendar days of the date of the change.
2. A Food Stamp assistance unit is required to report the following changes using a monthly reporting form:
a. program changes;
b. a change of $25 in the total medical expenses incurred during the month;
c. a change of $25 that was not anticipated in the estimate of medical expenses provided for the certification period.
3. The ten day reporting requirement applies equally to changes occurring:
a. after the application interview but prior to certification; and
b. subsequent to certification.
4. AFDC and AABD assistance units must also meet other requirements for considering basic and special needs. (Cross Reference: 4500)
B. Timely Verification
1. Assistance units, with the exception of FS assistance units, are required to provide verifications within ten calendar days of the date of the Department's request.
2. A Food Stamp assistance unit, who qualifies for an excess medical deduction, has the option of verifying the expense monthly or only verifying an increase in total medical expenses of $25 that was not anticipated for the certification period.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-95 Transmittal: UP-95-28 1555.05 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD ____________________________________________________________ FS Subject: MA Reporting Changes ______________________________________________________________________________
1555.05 B. 3. A Food Stamp assistance unit who qualifies for the child support deduction is required to report changes greater than $50 in the amount of legally obligated child support actually paid when the changes were not anticipated in the certification period.
4. Monthly reporting assistance units must comply with the monthly reporting requirements.
5. The Department offers assistance if it would be difficult for the unit to provide verification in a timely manner.
C. Failure to Take Timely Action
Failure to report or verify changes in a timely manner may cause:
1. ineligibility if eligibility is contingent upon verification of the circumstance;
2. non-consideration of the circumstance in determining eligibility or benefit level either for a current or retroactive period.
D. How Changes are Reported
1. Changes in circumstances may be reported in person, in writing or by telephone.
2. For AFDC or MA assistance units requesting the addition to the unit of a non-mandatory member, the request must be made in writing.
E. Combined Reporting Requirement
1. Assistance units receiving aid from the Department in more than one program area are not required to report changes separately for each program.
2. If the assistance units case maintenance responsibilities are assigned to different case workers, the unit is considered to have properly reported if the change is timely reported to any one of the case workers.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-94 Transmittal: UP-95-28 1555.05 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD ____________________________________________________________ FS Subject: MA Reporting Changes ______________________________________________________________________________
1555.05 F. Reporting Date
An assistance unit is considered to have reported a change on the day that any office of the Department receives notification of the change.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1555.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Recording Information ______________________________________________________________________________
P-1555.05 1. Document changes that are reported or discovered by you which may affect eligibility, benefits or the accuracy of the Department's records.
2. Include in the documentation such information as:
° the date and nature of the report;
° how or through what means the information was discovered;
° individual or case identification;
° an address or phone number for follow-up contact.
3. If a change is reported or discovered by the wrong office, unit or unit worker:
° forward any written change information to the appropriate area within 1 business day of the date of receipt.
° assist persons contacting the Department directly with reaching the appropriate office, unit or unit worker.
4. Document the change yourself if you are not reasonably sure that the information has been recorded, or if you are unsuccessful in directing the person to the appropriate area.
Failure to record change information may lead to client hardship, a benefit error, or to a false accusation of intentional program violation.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Good Cause ______________________________________________________________________________
1555.10 A. Basic Provisions
1. Under certain conditions, good cause may be established if an assistance unit fails to timely report or verify changes in circumstances and the delay is found to be reasonable.
2. If good cause is established, the unit may be given additional time to complete required actions without loss of entitlement to benefits for a current or retroactive period.
3. In good cause situations, the Department may delay taking action, but reserves the right to take corrective action to prevent possible benefit errors.
B. AFDC, AABD, MA Requirements
1. PA assistance units may establish good cause for:
a. failing to report timely; or
b. failing to provide required verification timely.
2. Good cause may include, but is not limited to:
a. illness;
b. severe weather;
c. death in the immediate family;
d. other circumstances beyond the unit's control.
C. FS
1. FS assistance units are considered to have good cause for failing to provide required verification in a timely manner if:
a. the verification is difficult to obtain; and
b. the unit requests assistance in obtaining the verification prior to the last day of the timeliness deadline; and
c. the Department agrees to provide assistance.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555.10 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Good Cause ______________________________________________________________________________
1555.10 C. FS (continued)
2. There are no provisions for establishing good cause if a FS assistance unit fails to timely report a change in circumstances.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1555.10 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Taking Timely Action ______________________________________________________________________________
P-1555.10 Complete any required actions within a reasonable period of time from the date you become aware of the change in circumstances.
Try to take actions affecting eligibility or benefits in time to prevent a benefit error from occurring or continuing.
Take into consideration any limitations imposed on you by rules pertaining to the date that a change in circumstance may be considered in the determination of eligibility or benefit level.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555.15 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS What Must Be Reported ______________________________________________________________________________
1555.15 A. In general, assistance units are required to report timely all changes which may affect eligibility or benefit level.
B. Changes affecting eligibility or benefit level include, but are not limited to the following:
1. changes in the source of income;
2. changes in the amount of income or resources, regardless of whether or not the income is countable;
3. changes in the status of excluded income or resources which may become countable;
4. the acquisition of licensed motor vehicles;
5. changes in household or assistance unit composition;
6. changes in address and resulting shelter cost changes;
7. changes in the amount of deductible expenses;
8. changes relating to any other categorical, technical or procedural eligibility requirement;
9. changes in the status of an authorized representative;
10. changes in basic or special needs.
C. Assistance units are not required to report changes in the amount of assistance which is provided by the Department.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1555.15 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Processing Changes ______________________________________________________________________________
P-1555.15 1. Obtain any information that you require to accurately assess and determine the effect of the change on case circumstances.
2. Evaluate the areas of potential involvement. For example, consider how the change impacts on:
° the assistance unit;
° other related assistance units;
° other programs if the assistance unit receives aid from multiple programs.
3. Whenever possible, make an assessment of whether or not the change was reported timely. This information is important in determining if a benefit error has occurred and the period of time that you will need to request verification for.
4. Notify the assistance unit of any actions it is required to perform and document your request. Also inform the unit of any time limits for compliance.
5. Once you have obtained sufficient information, take the appropriate steps to determine the effect on eligibility or benefit level.
6. Where appropriate, allow an assistance that has not taken timely action to establish good cause.
7. Consider all pertinent eligibility factors and financial information. Perform any required financial computations.
8. Perform a medically needy eligibility determination if the assistance unit is to lose its categorical eligiblity for the MA program.
9. Take steps to effect the appropriate changes in case circumstances.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1555.15 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Processing Changes ______________________________________________________________________________
P-1555.15 10. If an adverse action notice is required, issue one to the unit.
11. Review the data and determine if an overpayment has occurred or if the assistance unit is due a corrective payment.
12. Take the appropriate action if a benefit error has occurred.
13. Document your findings and actions in the case file.
14. Issue appropriate notice to the assistance unit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555.20 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Change Report Form ______________________________________________________________________________
1555.20 A. EMS Dependency
1. Prior to implementation of the EMS system, change report forms are utilized only in the FS program.
2. Subsequent to EMS implementation, the change report form is used uniformly for all assistance programs.
B. Providing Forms to Recipients
1. Assistance units are provided with change report forms in order to facilitate the reporting of interim changes.
2. Change report forms are issued at the following times:
a. at the time of application when assistance is granted; and
b. at the time of redetermination if eligibility is continued; and
c. subsequent to the receipt of a change report form from an assistance unit.
3. Self-addressed envelopes with prepaid postage are issued along with change report forms.
C. Contents of the Form
1. At a minimum, the change report form includes the following:
a. space to indicate the nature of the change and whether the changed circumstances are expected to continue beyond the report month; and
b. assistance unit reporting requirements; and
c. a reminder that FS assistance units are entitled to claim actual utility expenses; and
d. penalties associated with the failure to report changes.
2. The change report form may also include any other relevant information as deemed necessary by the Department.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1555.20 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Determining the Effective Date ______________________________________________________________________________
P-1555.20 1. Review the policy that relates to when a change in circumstance is taken into consideration in the determination of eligibility or benefit level.
2. Use the appropriate prospective or retrospective budgeting method to determine the date a change should begin to affect the case circumstances.
3. Consider any good cause factors that have been established by the assistance unit.
4. Take action to effect the necessary change in the on-going award at the earliest possible date.
5. Take action to establish an overpayment or to issue a corrective payment if timely action was not taken by the assistance unit or by the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-97 Transmittal: UP-97-1 1555.25 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Notification ______________________________________________________________________________
1555.25 A. Assistance units incurring a change in circumstances are notified of actions taken by the Department which affect eligibility or benefit level.
B. Assistance units are provided with notice of adverse action when a change in assistance unit circumstances results in ineligibility or reduced benefits, except when such notice is not required. (Cross Reference: 1570)
C. The Department notifies assistance units of programmatic changes which result in mass modification of all or a portion of the general caseload. (Cross Reference: 1570)
D. The Department notifies assistance units prior to expunging inactive EBT accounts.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555.30 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Processing Changes ______________________________________________________________________________
1555.30 A. Agency Action
1. The Department acts promptly to determine the effect on eligibility or benefit level whenever changes become known to the Department.
2. Prior to taking corrective action the Department:
a. determines the accuracy of the information upon which it is acting; and
b. may require verification of any reported information which is questionable.
B. Agency Timeliness Requirements
1. Mass Changes
Programmatic changes that require a mass modification of all or a portion of the case load are acted upon within the time constraints imposed by state or federal law.
2. Individual Case Changes
a. The Department takes corrective action within a reasonable period of time from the date it becomes aware of the change.
b. Whenever possible, the Department attempts to effect necessary actions within thirty calendar days after receiving notification of the change in circumstances.
c. If an adverse action notice is required, such notice is issued within ten calendar days after acquiring sufficient information to support the proposed action.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555.35 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Effective Date of Change ______________________________________________________________________________
1555.35 A. General Provisions
1. Changes in circumstances are taken into consideration in determining eligibility or benefit level in accordance with rules of this subject and the appropriate prospective or retrospective budgeting method. (cross reference: 6000)
2. Specific requirements for the inclusion or deletion of assistance unit members are established in the chapter of this section dealing with beginning and ending dates. (cross reference: 1560-1565)
B. Changes Resulting in Decreased Benefits
1. AFDC, AABD, MA Adverse Changes
Changes that cause a decrease in benefits or ineligibility are taken into consideration in the month the change occurred, regardless of when the change is reported.
2. FS Adverse Changes
a. Changes that cause ineligibility or a decrease in benefits are taken into consideration:
(1) no earlier than the month following the month of the change; and
(2) no later than the month following the month in which the notice of adverse action would expire if the change had been timely reported.
b. The change may be taken into consideration in the same month that the adverse action notice expires as long as the notice expires:
(1) after the month in which the change occurred; and
(2) before the regularly scheduled issuance date of the unit's monthly benefits.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555.35 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Effective Date of Change ______________________________________________________________________________
1555.35 C. Changes Resulting in Increased Benefits
1. AFDC, AABD, MA Changes
a. Changes resulting in increased benefits are considered in the month the change occurs, provided that:
(1) the change is reported and verified in a timely manner; or
(2) good cause is established if the change was not timely reported or verified.
b. Changes either reported or verified in an untimely manner are considered beginning with the following months if good cause is not established:
(1) the reporting month if verification is provided timely; or
(2) the month of verification if the verification is not provided in a timely manner.
c. Changes in basic or special needs reported later than the month following the month that the need is incurred are not considered in the total need determination.
2. FS Changes
a. Changes resulting in increased FS benefits are considered in the month following the month of the change, provided that:
(1) the change is reported and verified in a timely manner.
(2) good cause is established if the change is not timely verified.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1555.35 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Interim Activity AABD _______________________________________________________________ MA Subject: FS Effective Date of Change ______________________________________________________________________________
1555.35 C. 2. FS Changes (continued)
b. Changes that are either reported or verified in an untimely manner are considered beginning with:
(1) the month following the month the change is reported if verification is provided timely; or
(2) the month following the month of verification if the verification is not provided in a timely manner and good cause is not established.
3. Retroactive Consideration
Assistance units are not entitled to a retroactive consideration of changed circumstances if they fail without good cause, to report or provide verification timely.
D. FS Assistance Units Receiving Cash Assistance
1. Increases in FS benefits caused by a reduction in the amount of AFDC or AABD cash assistance are not made effective prior to the expiration of the PA notice of adverse action.
2. If the PA action is appealed, no action is taken to increase the FS benefits.
3. If the PA action is not appealed, the effective date is determined in the same manner as in paragraph B.2. above, except that the effective date of increase is calculated from the date the notice of adverse action expires.
4. The Department issues a FS Recertification notice informing the assistance unit that it must reapply if:
a. the Department does not have sufficient information to determine the affect of the PA change on FS eligibility; and
b. the unit does not appeal the PA action.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1560 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Beginning Dates of Assistance AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1560 This chapter contains the policy for determining the beginning date of assistance after eligibility has been established, both for initial benefits and when there is an addition to an active assistance unit. This policy provides the basis for setting the effective date of benefits.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-98 Transmittal: UP-98-31 1560.05 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Beginning Dates of Assistance AABD _______________________________________________________________ Subject: Financial Assistance Beginning Dates ______________________________________________________________________________
1560.05 A. With the exception of residents of long term care facilities who are applying for AABD benefits, the beginning date of assistance in the AFDC and AABD programs is the date the Department receives a signed application, or the date all eligibility factors are met, whichever is later, as follows:
1. The date the application is received is used as the beginning date of assistance when:
a. financial eligibility exists for the month of application; and
b. all categorical and technical eligibility requirements are met as of that date; and
c. procedural requirements are complied with as required during the application process.
2. The date all eligibility factors are met is used as the beginning date of assistance when:
a. the assistance unit has excess assets at the time of application, but the amount is reduced to within eligibility standard levels during the application process in accordance with policy; or
b. a categorical or technical eligibility requirement is met at a later date during the application process.
3. The first day of the month following application is used as the beginning date of assistance when:
a. income eligibility does not exist in the month of application; and
b. income eligibility does exist in the month following application; and
c. all other eligibility requirements are met.
B. The beginning date of financial assistance for residents of long term care facilities requesting AABD benefits is the first of the month in which all of the following conditions are met:
1. the individual is eligible for Medicaid; and has been found eligible to receive SSI benefits; and meets all other eligibility factors.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-21-96 Transmittal: UP-96-17 P-1560.05 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Beginning Dates of Assistance AABD _______________________________________________________________ FS Subject: MA Determining the Beginning Date of Assistance ______________________________________________________________________________
P-1560.05 All Programs
1. Complete the eligibility process and establish that all eligibility requirements are met for the assistance unit.
2. Decide whether eligibility factors were met as of the date of the application or whether eligibility was not established until a later date.
3. Consider the date of application to be the date all eligibility factors are met, if verification submitted after the application date proves that all factors were clear on the application date.
4. Follow the rules in policy for setting the specific date based on steps 1, 2, and 3.
Medicaid
1. Determine eligibility for each of the 3 months prior to application separately.
2. Consider eligibility factors only for a retroactive month in which there were medical services which are payable under Medicaid.
3. In spend-down cases, see 5520 Income Eligibility Procedures to determine the earliest date of eligibility.
Food Stamps
1. Determine if the assistance unit is a migrant/seasonal farmworker assistance unit that participated in the Food Stamp program within 30 days prior to application.
2. If yes, go to steps 3 and 4. If no, go to steps 5 and 6.
3. If the application is processed within 30 days, use the first day of the month of application as the beginning date of assistance.
4. If the application is processed beyond 30 days:
° If due to agency delay, use the first day of the month of application as the beginning date of assistance.
° If due to assistance unit delay, use the first day of the month in which eligibility is established.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 6-2-91 Transmittal: UP-96-17 P-1560.05 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Beginning Dates of Assistance AABD _______________________________________________________________ FS Subject: MA Determining the Beginning Date of Assistance ______________________________________________________________________________
P-1560.05 Food Stamps
5. If the application is processed within 30 days, use the date of application as the beginning date of assistance.
6. If the application is processed beyond 30 days:
° If due to agency delay, use the date of application as the beginning date of assistance.
° If due to assistance unit delay, use the first day of the month in which eligibility is established.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-89 Transmittal: UP-89-9 1560.10 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: MA Beginning Dates of Assistance _______________________________________________________________ Subject: Medicaid Beginning Dates of Assistance ______________________________________________________________________________
1560.10 The beginning date of assistance for Medicaid may be one of the following:
A. the first day of the first, second or third month immediately preceding the month in which the Department receives a signed application when all non-procedural eligibility requirements are met and covered medical services are received at any time during that particular month; or
B. the first day of the month of application when all non-procedural eligibility requirements are met during that month; or
C. the actual date in a spenddown period when all non-procedural eligibility requirements are met. For the determination of income eligibility in spend-down, refer to Income Eligibility Section 5520; or
D. the first of the calendar month following the month in which an individual is determined eligible when granted assistance as a Qualified Medicare Beneficiary (Cross Reference: 2540.94). The month of eligibility determination is considered to be the month that the Department receives all information and verification necessary to reach a decision regarding eligibility.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-1-93 Transmittal: UP-93-38 P-1560.10 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Beginning Dates of Assistance AABD _______________________________________________________________ MA Subject: FS Adding a Member to the Assistance Unit ______________________________________________________________________________
P-1560.10 AFDC, FMA
1. Determine if the new member is a mandatory member of the assistance unit (see 2005.10).
2. Find out when the new member arrived in the household.
3. Decide whether or not the arrival was reported within 10 days. If not, decide if there was good cause (see 1555.10).
4. Accept a completed W416 as notification for both programs of the addition of a newborn to an active assistance unit in which the newborn is a mandatory member.
5. Refer parents of all newborns and other children under the age of twenty-one to Health Track. Discuss the importance of regular age appropriate well-child care, including immunizations and blood lead testing. Encourage these parents to take advantage of the following services which HealthTrack can provide:
° helping to schedule regular medical, dental, vision and hearing appointments
° helping to find a doctor, dentist or other medical provider convenient for them and their family
° arranging medical transportation, if necessary
° help with eliminating barriers (i.e. child care) which prevents families from receiving medical care
° providing health education information, including the benefits of preventive health care, the importance of age appropriate immunizations and the periodicity schedule for well-child care.
° explaining the benefits and availability of the WIC program and other community services of interest
° providing information on the availability of local immunization clinics, which provide vaccines free of charge.
° reminding the client when a child is due for his or her next appointment
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-93-38 P-1560.10 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Beginning Dates of Assistance FMA _______________________________________________________________ FS Subject: Adding a Member to the Assistance Unit ______________________________________________________________________________
P-1560.10 (continued)
6. Use the date the form was signed to determine whether the notice was within 10 days.
7. If the notice was not signed within 10 days of the child's birth, determine whether good cause exists (see 1555.10).
8. Confirm that either an individual whose presence is reported or one whose presence is not reported meets categorical, financial and technical requirements on the beginning date of assistance;
9. Presume that an individual who reported timely will be cooperative with procedural requirements;
10. Do not add an individual who did not report timely, however, until cooperation with procedural requirements is demonstrated by such things as keeping appointments with WIN, Support or Resources, and producing a Social Security number.
FS
1. Determine eligibility of the assistance unit including the additional member.
2. Set the beginning date of assistance based on whether assistance increases or decreases as a result of the eligibility determination.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 04-01-06 Transmittal: UP-06-08 1560.15 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Beginning Dates of Assistance _______________________________________________________________ Subject: Food Stamp Beginning Dates ______________________________________________________________________________
1560.15 A. Full Cooperation
1. For assistance units which fully cooperate in providing eligibility information, the beginning date of Food Stamp assistance is the date the Department receives a signed application, or the first day of a subsequent month in which all eligibility factors are met, if eligibility does not exist in the month of application, except for prerelease applicants.
2. For prerelease applicants who fully cooperate in providing information, the beginning date of Food Stamp assistance is the date of release from the institution, or the first day of a subsequent month in which all eligibility factors are met, if eligibility does not exist in the month of application.
B. Lack of Cooperation
For an assistance unit which causes a delay in processing due to a lack of cooperation in providing eligibility information the beginning date of Food Stamp assistance is:
1. the date the Department receives a signed application when all information required for a decision to grant is submitted within 30 days following the date of application; or
2. the date the FS applicant provides the necessary information or takes the necessary action to complete the application process, when all eligibility information is submitted in the second thirty day period.
C. Migrant and Seasonal Farmworkers Who Reapply Within 30 Days of Termination of Benefits
For migrant or seasonal farmworker assistance units which participated in the Food Stamp program within 30 days prior to application, the beginning date of Food Stamp assistance is the first day of the month in which the Department receives a signed application, or the first day of a subsequent month in which all eligibility factors are met, if eligibility does not exist in the month of application.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-21-96 Transmittal: UP-96-17 1560.15 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: FS Beginning Dates of Assistance _______________________________________________________________ Subject: Food Stamp Beginning Dates ______________________________________________________________________________
1560.15 D. Assistance Units Other Than Migrant and Seasonal Farmworkers That Apply Within One Month of Discontinuance
For Food Stamp assistance units that participated in the program within one month prior to application, the beginning date of Food Stamp assistance is the date the Department receives a signed application, or the first day of a subsequent month in which all eligibility factors are met, if eligibility does not exist in the month of application.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1560.20 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Beginning Dates of Assistance FMA _______________________________________________________________ Subject: Additions to the Assistance Unit ______________________________________________________________________________
1560.20 A. Mandatory Inclusions in the Assistance Unit
1. Presence of Member Reported
For a new member whose addition to the household is reported within 10 days of the individual's arrival, the beginning date of assistance for mandatory inclusion in the unit is:
a. the date of the report, if:
(1) all categorical, financial and technical requirements are met on that date; and
(2) all procedural eligibility requirements are complied with by the dates set by the Department; or
b. whichever of the following dates occurs later:
(1) the date on which all categorical, financial and technical requirements are met if eligibility does not exist on the date of the report; or
(2) the date on which procedural eligibility requirements are complied with if this date occurs after the time limit set by the Department.
2. Presence of Member Not Reported
For a new member whose presence is not reported within 10 days of arrival in the household, the beginning date of assistance for the new member is the date that all eligibility requirements are met, including procedural.
B. Non-Mandatory Additions to the Assistance Unit
For a new member who is a non-mandatory addition to the assistance unit, the beginning date of assistance is one of the following dates, whichever occurs later:
1. the date a written request for the individual is received; or
2. the date all categorical, financial and technical requirements are met and all procedural eligibility requirements are complied with as required by the Department.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1560.20 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: MA Beginning Dates of Assistance FS _______________________________________________________________ Subject: Additions to the Assistance Unit ______________________________________________________________________________
1560.20 C. Medicaid - Newborns
For a newborn child who qualifies automatically by living with its mother who receives Medicaid, the beginning date of FMA is the child's date of birth.
D. Food Stamps
After eligibility is determined the beginning date of assistance for adding a member to the assistance unit depends on whether benefits increase or decrease.
1. If the addition increases benefits, the beginning date of assistance is the first of the month following the month the change is reported.
2. If the addition decreases benefits, the beginning date of assistance is:
a. the first of the month following the month the change occurs when the advance notice of action ten-day period expires before the last day of the cycle in the month of change; or,
b. the first of the second month following the month the change occurs when the advance notice of action ten-day period expires after the last day of the cycle in the month of change.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1565 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Ending Date of Assistance AABD _______________________________________________________________ MA Subject: FS
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1565 The policy on Ending Dates of Assistance provides the basis for the discontinuance date. In addition, overpayments and entitlement to lost benefits are determined using this policy.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1565.05 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Ending Dates of Assistance AABD _______________________________________________________________ MA Subject: FS Basic Provisions ______________________________________________________________________________ 1565.05 A. AFDC, AABD, MA
When eligibility has been determined to no longer exist, the last day for which the assistance unit is entitled to the benefits of the program is:
1. the last day of the month preceding the month in which ineligibility is caused by:
a. excess income or excess assets - AFDC, AABD, MA; b. striking - AFDC only; or
2. the last day of the month in which a nonfinancial eligibility factor causes ineligibility, provided that eligibility had existed on the first of the month. This includes death of a recipient. B. FS
1. When Food Stamp eligibility no longer exists, the ending date of entitlement to benefits is:
a. the last day of the last month of the certification period, when ineligibility is determined based on a recertification; or
b. the end of the month in which ineligibiltiy is established when no advance notice is required.
2. When a change occurs which causes ineligibility, the ending date of entitlement to benefits is:
a. for a change which is correctly reported:
(1) the last day of the month of the change if the advance notice period expires before the last day of the cycle of that month; or
the last day of the month following the month of the change if the advance notice period expires after the last day of the cycle of the month of change.
b. for a change which is not correctly reported, the endof the first month action could have been taken if the change had been correctly reported.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-1565.05 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Ending Dates of Assistance AABD _______________________________________________________________ MA Subject: FS Determining the Ending Date of Assistance ______________________________________________________________________________
P-1565.05 AFDC, AABD, MA
1. Determine the ending date of assistance on the basis of the reason for ineligibility.
2. Note that the ending date is always the end of a month.
3. Use these rules in computing overpayments (see 7000 Benefit Error).
4. Remember that excess income and asset cases which require a retroactive ending date will generate overpayments.
5. Do not confuse "ending date of assistance" which refers to eligibility for benefits with "discontinuance date" which is the date action is taken.
FS
Use policy regarding certification periods, time standards, notification and continuation of benefits from this Section and 7000 Benefit Error in conjunction with this policy.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1570 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS
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1570 The Department provides an appeal in the form of a Fair Hearing.
In this chapter, the Department's Fair Hearing policies and procedures are described in detail, as well as those related to the issuance of proper notification of adverse actions. Among the subjects contained in this chapter are:
° General Provisions
° Notice of Action
° Resolution of Dispute Prior to Fair Hearing
° Eligibility Pending Fair Hearing
° Hearing Procedures
° Appeals
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1570.05 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS General Provisions ______________________________________________________________________________ 1570.05 A. Purpose
The purpose of the Fair Hearing process is to allow the requester of the Fair Hearing to present his or her case to an impartial hearing officer if the requester claims that the Department has either acted erroneously or has failed to take a necessary action within a reasonable period of time.
B. Right to a Fair Hearing
Subject to the conditions described in this chapter, the requester has the right to a Fair Hearing if:
1. the Department denies the assistance unit's application for benefits; or
2. the Department does not take action on the assistance unit's application within the time limits specified in Section 1500; or
3. the requester feels that the Department has either failed to take a required action or has taken an erroneous action. Such actions include:
suspending, reducing, discontinuing, or terminating benefits; or
b. imposing conditions upon eligibility; or
c. issuing benefits in a manner other than directly to the assistance unit; or
d. taking any other action affecting the receipt of benefits, such as computing the amount of benefits.
C. Denial or Dismissal of Request for a Fair Hearing
The Department denies or dismisses a request for a Fair Hearing if:
the request for the Fair Hearing is not made within the time limits described in this section; or
2. the requester or his or her representative withdraws the request in writing; or
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1570.05 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS General Provisions ______________________________________________________________________________
1570.05 C. Denial or Dismissal of Request for a Fair Hearing (continued)
3. the requestor or his or her representative fails to appear at the scheduled hearing without good cause; or
4. the sole issue is one of state or federal law requiring automatic benefit adjustment for a class of recipients. In such cases, the requester has a right to a hearing only if the issue is that the Department has misapplied the law or that the Department has made an error in computation.
D. Who Can Request a Fair Hearing
1. Any member of the assistance unit, as well as the unit's authorized representative, or conservator of a unit member, has the right to request a Fair Hearing.
2. In the Medicaid program, the following persons have the right to request a Fair Hearing on behalf of a deceased unit member:
a. spouse;
b. child or parent;
c. executor, administrator or conservator;
d. any other person who, during the deceased's lifetime, assumed personal financial liability for the deceased's medical debts which would be covered under Medicaid.
3. Others who may be aggrieved by a Department action, and have a right to a Fair Hearing, are those persons from whom the Department is attempting to recover income or assets, as described in Section 7500.
4. In the Medicaid program, a community spouse, as well as the community spouse's authorized representative, or conservator of a community spouse, has the right to request a Fair Hearing regarding:
a. the assessment of spousal assets (Cross Reference 1507.05); and
b. the determination of the Community Spouse Disregard (CSD) (Cross Reference 4022.05); and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.05 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS General Provisions ______________________________________________________________________________
1570.05 D. 4. Who Can Request a Fair Hearing (continued)
c. the determination of deemed assets (cross reference 4025.65); and
d. the determination of the Community Spouse Allowance (CSA) (Cross reference 5035.30); and
e. the determination of the Community Family Allowance (CFA) (cross reference 5035.35).
E. Party to a Hearing Requested by Another
1. The Fair Hearing official may grant status as a party to a hearing requested by another. To be granted this status, a person must meet the following conditions:
a. he or she is directly affected by the action taken by the Department;
b. he or she is a person who can request a hearing on his or her own behalf, as listed in D, above;
c. he or she submits a written request to the Department at least five days prior to the scheduled hearing;
d. he or she has sent a copy of the request to the person who originally requested the hearing and to any other person who is a party to the hearing;
e. the request states facts that demonstrate that the requestor's legal rights, duties or privileges are directly affected by the Department's action.
2. The Fair Hearing official may waive the five day deadline for requesting party status if there is good cause.
F. Intervenor
1. The Fair Hearing official may grant status as an intervenor. To be granted this status, a person must meet the following conditions:
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.05 page 4 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS General Provisions ______________________________________________________________________________
1570.05 F. 1. Intervenor (continued)
a. he or she must submit a written request to the Department at least five days prior to the scheduled hearing;
b. he or she must send a copy of the request to the person who requested the hearing and to all other persons who are parties to the hearing;
c. he or she must state facts that demonstrate that his or her participation in the hearing is in the interest of justice and will not impair the orderly conduct of the hearing;
d. he or she must designate the issues in which he or she has an interest.
2. The Fair Hearing official may waive the five day deadline for requesting intervenor status if there is good cause.
G. Informing the Assistance Unit
1. The Department issues and publicizes all Fair Hearing policies and procedures appearing in this section.
2. At the time of application and at the time of any action affecting the assistance unit's benefits, the Department informs the requester, in writing, of the following:
a. the requester's right to a Fair Hearing; and
b. the method by which the requester obtains a Fair Hearing; and
c. that the requester may be self-representative, may use legal counsel, a relative, friend, or other spokesperson; and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.05 page 5 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS General Provisions ______________________________________________________________________________
1570.05 G. 2. Informing the Assistance Unit (continued)
d. the address of the local Legal Aid office, if there is free legal representation available.
H. Time Limits for Requesting a Fair Hearing
1. The request for a Fair Hearing must be made within a specified period of time from the date that the Department mails a notice of action.
a. For all programs except Food Stamps, this period is 60 days.
b. For the Food Stamp program, this period is 90 days.
2. Subject to the conditions described in this chapter, the requester has 10 days from the date the Department mails a notice of action to request a Fair Hearing in order to prevent termination or reduction of benefits before the Fair Hearing decision is rendered.
3. If the dispute involves a delay in action on an application, the assistance unit has the right to request a Fair Hearing as of the date the action becomes overdue, as described in this section.
4. If the dispute involves a delay or refusal to make a change, the requester has the right to request a Fair Hearing as of the date the change should have been made, as described in this section.
5. The requester's right to a Fair Hearing on the issue of delays extends for a period not to exceed 12 months from the date of application or date of requested change.
6. In the Food Stamp program, the assistance unit may request a Fair Hearing to dispute its current level of benefits at any time within a certification period.
I. Request for a Hearing
1. The request for a Fair Hearing must be in writing for all programs except the Food Stamp program. In the Food Stamp program, the request for a Fair Hearing may be written or oral.
2. The Department does not limit or interfere with the requester's freedom to submit a request for a Fair Hearing.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.05 page 6 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS General Provisions ______________________________________________________________________________
1570.05 I Request for a Hearing (continued)
3. The Department helps the requester in submitting a Fair Hearing request if the requester is having difficulty in doing so. If the requester is Spanish-speaking, the Department explains the hearing procedures to him or her in Spanish.
J. Impartiality of Fair Hearing Official
The official conducting the Fair Hearing is an employee of the Department who is authorized by the Commissioner and:
1. has no personal stake or involvement in the case; and
2. was not directly involved in the initial determination of the action which is being contested; and
3. was not the immediate supervisor of the eligibility worker who took the action.
K. Group Hearings
1. The Department conducts a group hearing in response to a series of individual requests under the following conditions:
a. the sole issue involved is one of federal or state law or of Departmental policy; and
b. the request is made for a group hearing; or
c. the Department feels that a group hearing is appropriate and the requesters agree.
2. The policies and procedures concerning Fair Hearings, as outlined in this chapter, are the same for group hearings.
3. Each requester involved in a group hearing has the right to present his or her own case or be represented by his or her representative.
L. Resolution of the Fair Hearing Issue - Time Limits
1. The Department takes prompt, definitive, and final action in resolving the dispute. Final action includes the following:
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.05 page 7 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS General Provisions ______________________________________________________________________________
1570.05 L. 1. Resolution of the Fair Hearing Issue-Time limits (continued)
a. issuance of the Fair Hearing decision; and
b. notifying the requester of the decision; and
c. making any changes in the assistance unit's case as mandated by the Fair Hearing decision; and
d. notifying the requester of the changes.
2. The Department issues the Fair Hearing decision within a specified period of time. This period starts with the date the Department receives the request for a Fair Hearing.
a. for all programs except Food Stamps, the time period is 90 days;
b. for the Food Stamp program, the time period is 60 days.
3. When a request for an extension is made by the person who requested the Fair Hearing, the time limit for resolving the dispute is extended if the Fair Hearing is postponed. The extension period equals the number of days the Fair Hearing is postponed.
M. Issues Affecting More Than One Program
1. If the Fair Hearing issue affects the assistance unit's eligibility for both financial and medical assistance, a single decision serves to resolve the eligibility question for both programs.
2. If the Fair Hearing issue affects Food Stamp eligibility and eligibility under another program, one decision resolves the Food Stamp eligibility question and a separate decision resolves the eligibility question for the other program.
3. If the Fair Hearing issue involves eligibility for both Food Stamps and another program, the Department follows the guidelines concerning Fair Hearing time limits governing the other program, as described in this chapter.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 P-1570.05 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Notifying the Assistance Unit ______________________________________________________________________________
P-1570.05 1. At the time of application and at redeterminations, inform the assistance unit that it has the right to a Fair Hearing if it is dissatisfied with a Departmental action, a delay in processing an application or in making a change, or a failure to take a required action.
2. When required by policy, send a notice at least 10 days prior to discontinuing, terminating, suspending, or reducing benefits, and prior to changing the form of payment.
3. When the assistance unit consists of an institutionalized spouse, inform both the institutionalized spouse and the community spouse that either spouse has the right to a Fair Hearing if he or she is dissatisfied with a Departmental action concerning:
° the assessment of spousal assets (cross reference 1507.05);
° the determination of the Community Spouse Disregard (CSD) (Cross Reference 4022.05);
° the determination of deemed assets (Cross Reference 4025.65);
° the determination of the Community Spouse Allowance (CSA) (Cross Reference 5035.30);
° the determination of the Community Family Allowance (CFA) (Cross Reference 5035.35).
4. State on the notice:
° the reason for the Department's intended action;
° in the case of discontinuance due to receipt of a lump sum, the beginning and ending dates of the period of ineligibility;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 P-1570.05 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Notifying the Assistance Unit ______________________________________________________________________________
P-1570.05 4. State on the notice: (continued)
° in situations where ineligibility is expected to last for no more than three calendar months, the earliest date on which the unit is expected to be eligible again and the necessity of applying at that time;
° in cases where an assessment of assets in completed and there is no concurrent application for assistance, inform the MCCA spouses that they have the right to a Fair Hearing upon application for Medicaid;
° the policy citation (section, chapter, subject) supporting this action;
° the unit's right to a Fair Hearing to contest the action;
° the method of requesting a Fair Hearing;
° the time limit for requesting a Fair Hearing;
° that the requester may be self-represented, may have legal representation, or have anyone he or she wishes to act as a representative;
° the address of the local Legal Aid Office, if there is free legal help available;
° that benefits will be continued if the request for a Fair Hearing is made within 10 days from the date the notice is mailed;
° that the unit will be subject to recoupment action if its benefits are continued and the Fair Hearing decision upholds the Department.
5. When denying an application, send the assistance unit a notice which provides all the information described in step 4. Except for the last two items concerning continuation of benefits and recoupment, which are not appropriate.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.10 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ SNAP Subject: MA Notice of Action ______________________________________________________________________________
1570.10 A. Notice Requirements
Except in situations described below, the Department mails or gives adequate notice at least ten days prior to the date of the intended action if the Department intends to:
discontinue, terminate, suspend or reduce benefits; or
change the manner or form of payment for programs.
B. Exceptions to Timely Notice Requirements
1. AFDC, AABD, MA, SNAP
The Department mails an adequate notice no later than the date of the action if the action is based on any of the following circumstances:
a. the Department has factual information that all members of the assistance unit have died; or
b. the Department receives a clear, written statement signed by the assistance unit stating that:
(1) the unit no longer wishes to receive benefits; or
(2) the unit is giving the Department information which requires that the Department terminate or reduce benefits, and that the unit understands that this must be the result of supplying that information; or
c. the assistance unit is required to submit monthly reports and the unit either:
(1) furnishes information which requires that the Department reduce or discontinue benefits; or
(2) fails to complete a timely monthly report without good cause; or
d. the affected individual has been admitted to or committed to an institution, and the individual is not eligible for assistance while living there; or
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.10 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD ____________________________________________________________ SNAP Subject: MA Notice of Action ______________________________________________________________________________
1570.10 B. 1. Exceptions to Timely Notice Requirements (continued)
e. the assistance unit's whereabouts are unknown and the post office returns departmental mail directed to the unit indicating no forwarding address; or
f. the Department verifies that the assistance unit has been granted benefits under the same program in another state.
2. AFDC
In the AFDC program, the Department sends an adequate notice no later than the date of the action, under the following situations, as well as under those described in paragraph 1:
a. the Department has factual information that an assistance unit member has died, or that the AFDC payee has died and there is no relative available to serve as new payee; or
b. the assistance unit member has been placed in a long term care facility and no longer qualifies for assistance; or
c. an AFDC child is removed from the home as a result of a judicial determination, or voluntarily placed in foster care by his or her caretaker relative or legal guardian; or
d. the Department grants the assistance unit a special allowance for a specific period of time and informs the unit in writing at the time of grant that the allowance automatically terminates when the specific period ends; or
e. the Department determines that the AFDC payee has mismanaged the unit's finances and that the Department should issue a restricted method of payment (Cross Reference 6505).
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.10 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD ____________________________________________________________ SNAP Subject: MA Notice of Action ______________________________________________________________________________
1570.10 B. Exceptions to Timely Notice Requirements (continued)
3. AABD
In the AABD program, the Department sends an adequate notice no later than the date of the action, under the following situations, as well as under those described in paragraph 1:
a. the Department grants the assistance unit a special allowance for a specific period of time and informs the unit in writing at the time of grant that the allowance automatically terminates when the specific period ends; or
b. the Department determines that the AABD payee has mismanaged the unit's finances and that the Department should issue a restricted method of payment (Cross Reference 6505).
4. MA
In the Medicaid program, the Department sends adequate notice no later than the date of the action, under the following situations, as well as under those described in paragraph 1:
a. the Department has factual information that a member of the assistance unit has died; or
b. the unit member's physician prescribes a change in the unit member's level of care; or
c. the Department authorizes the assistance unit to receive assistance for a specific period of time and informs the unit in writing at the time of authorization that assistance automatically terminates when the specific period ends.
5. SNAP
a. In the Supplemental Nutrition Assistance Program, the Department does not mail individual notices to assistance units when the Department initiates a mass change affecting a class of recipients. The Department does publicize the mass change, however, by mailing a general notice to the affected class.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.10 page 4 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD Fair Hearings SNAP MA _______________________________________________________________________________ Subject: Notice of Action ______________________________________________________________________________ 1570.10 B. Exceptions to Timely Notice Requirements (continued)
b. In the Supplemental Nutrition Assistance Stamp program, the Department does not send individual notices to assistance units regarding a reduction or termination of benefits if:
(1) the assistance unit has been receiving an increased allotment as a corrective payment, and the Department notifies the unit in writing, at the time of the increase, that such increase will terminate after a specific period of time; or
(2) the assistance unit's allotment varies from month to month within the certification period to reflect changes anticipated at the time of certification, and the Department so notifies the assistance unit at the time of certification; or
(3) the assistance unit applies for Public Assistance as well as SNAP benefits and has been receiving SNAP benefits pending approval of the Public Assistance grant, and the Department notifies the unit at the time of certification that SNAP benefits will be reduced upon approval of the Public Assistance grant; or
(4) an overpaid assistance unit fails to make repayment and the Department recoups the overpayment by benefit reduction (Cross Reference: Section 7000); or
(5) the assistance unit consists of someone who is a resident of a drug or alcoholic treatment center or group living arrangement if the facility either loses its certification or has its status as an authorized representative suspended because of disqualification by the Food and Nutrition Service (Cross Reference: Section 1505); or
(6) the assistance unit's benefits are being reduced or terminated as a result of an intentional program violation.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 P-1570.10 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: MA Procedures Prior to the Hearing - All Issues Except Emergency Housing SNAP ______________________________________________________________________________ P-1570.10 1. If you receive a written request for a Fair Hearing, stamp the date of receipt and forward the hearing request (including the envelope) to the Office of Legal Counsel, Regulations and Administrative Hearings (OLCRAH) in Central Office. You may fax the request or send it by intra or interoffice mail. Keep a copy of the request for the case record. If the requester did not include a name or address or client identification number, note that information on a separate piece of paper and provide that with the documents you send to OLCRAH.
2. If you receive an oral request for a Fair Hearing:
For all programs except SNAP, inform the requester that he or she must file the request in writing to the OLCRAH in Central Office. Requests may be mailed or faxed to:
Department of Social Services Office of Legal Counsel, Regulations and Administrative Hearings 25 Sigourney Street Hartford, CT 06106
FAX 860-424-5729
For issues involving SNAP, inform the assistance unit that he or she may request a hearing by calling the Office of Legal Counsel, Regulations and Administrative Hearings at 1-800-462-0134 or 860-424-5760; he or she may also mail or fax his or her request to the above address or fax number.
3. If the requester asks, assist the requester in submitting the Fair Hearing request to OLCRAH.
4. When you learn that a Fair Hearing has been requested, determine the issue being contested.
5. If the request for a Fair Hearing is received by OLCRAH or the regional office within 10 days from the mailing of a notice of adverse action, as described in policy at HYPERLINK "http://dssweb/dscgi/ds.py/Get/File-1099/1570_20.doc" 1570.20, continue benefits at their present level and do not take the adverse action prior to the Fair Hearing decision unless directed by the Hearing Officer. For Medicaid, if the recipient requests a hearing before the date of the action, the agency may not terminate or reduce benefits. The exception to this rule is for programs where the client was notified ahead of time that there was an expiration date to the benefits, i.e. spenddown cases (S99/F99/G99), and the extended medical benefits program (F03). For the TFA program, refer to Section HYPERLINK "http://dssweb/dscgi/ds.py/Get/File-2415/8525_10.doc" 8525.10B.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 P-1570.10 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: MA Procedures Prior to the Hearing - All Issues Except Emergency Housing SNAP ______________________________________________________________________________
P-1570.10 6. Review the case record with your supervisor to determine whether the Department has acted correctly and in a timely manner.
7. If the Department has erred, contact the requester and resolve the dispute in favor of the requester, if appropriate. If the requester agrees that the issue is resolved, ask him or her to send OLCRAH a written withdrawal. Let OLCRAH know that the requester has indicated that the matter has been resolved.
8. Ask the requester if he or she wishes to withdraw his or her request for a Fair Hearing if the issue is resolved in favor of the requester. Inform the requester that the withdrawal must be in writing. Assist with the withdrawal if so requested. If the requester tells you that he or she will not attend the hearing or will withdraw the hearing, let the Hearing Officer know as soon as possible.
9. If you receive a written withdrawal of a Fair Hearing request, make a copy for the case record and fax the withdrawal to the Fair Hearing Unit. If you are unable to fax the withdrawal, please call the Hearing Officer as soon as possible. If you receive an oral withdrawal of a hearing, please call the Hearing Officer as soon as possible.
10. If the request for a Fair Hearing is not withdrawn, prepare a written case summary for the Hearing Officer. The summary should include:
A brief statement of the case situation; All relevant facts pertaining to the issue being contested; The policy citation upon which the Department's decision is based; Your name and telephone number; and Copies of relevant exhibits, e.g. documents, notices from the department, EMS screens.
11. Submit the summary to your supervisor and have it reviewed by the Operations Manager for approval.
12. The requester, his or her legal representative and the Hearing Officer should receive a copy of the hearing summary and exhibits so that it is received at least five working days prior to the scheduled hearing date.
13. Allow the assistance unit and its legal representative to examine the case record at a reasonable time prior to the Fair Hearing date, if so requested, as described in Section 1020.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 P-1570.10 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: MA Procedures Prior to the Hearing - All Issues Except Emergency Housing SNAP ______________________________________________________________________________
P-1570.10 14. For Spanish-speaking assistance units, arrange to have a Spanish interpreter available to attend the hearing.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-05 Transmittal: UP-04-28 P-1570.12 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: Preparing for Emergency Housing Hearings ______________________________________________________________________________
P-1570.12 1. If you receive a written request for a Fair Hearing on an emergency housing issue, notify the Office of Legal Counsel, Regulations and Administrative Hearings (OLCRAH) the same day.
2. Send (fax to 860-424-5729) the request to OLCRAH in Central office.
3. If OLCRAH receives a request for an emergency housing hearing, you will be notified of the date and time at the same time as the assistance unit.
4. Review the decision being contested and resolve the issue with the requester if possible.
5. If the issue is not resolved, prepare a summary of all pertinent facts and include all supporting documents.
6. Submit the summary to your supervisor and have it reviewed by the Operations Manager.
7. Prepare copies of the summary and all attachments for the Hearing Officer, the assistance unit, and any representative.
8. Send the requester, his or her legal representative and the Hearing Officer a copy of the hearing summary and exhibits prior to the scheduled hearing.
9. Allow the assistance unit and its legal representative to examine the case record prior to the hearing if they request it.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.15 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Resolution of Dispute Prior to Fair Hearing ______________________________________________________________________________
1570.15 A. Effect on Fair Hearing Process
If the Department resolves the requester's dispute prior to the holding of a Fair Hearing, the Department still holds the Fair Hearing unless the request is withdrawn in writing.
B. Department Conference-Food Stamps Expedited Service
1. The Department offers a conference to an assistance unit wishing to contest a denial of expedited service in the Food Stamp program, as described in this Chapter.
2. The Department schedules the conference within two working days from the date the assistance unit contests the denial, unless the unit states that it does not want a conference or that it wants the conference scheduled at a later date.
3. The Department informs the assistance unit that the conference is optional and does not delay or replace the Fair Hearing process.
4. The Department's eligibility supervisor attends the conference, along with the assistance unit or its authorized representative.
5. If the conference leads to a resolution of the assistance unit's dispute, the Department still holds the Fair Hearing unless the unit withdraws the Fair Hearing request in writing.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-05 Transmittal: UP-04-28 P-1570.15 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: MA Procedures During the Hearing FS ______________________________________________________________________________
P-1570.15 1. See if the requester has appeared at the office at the scheduled hearing time (for in-office hearings) and bring him or her to the hearing room. Please be prompt. Hearings are scheduled back-to-back, every 30 minutes for most programs. If the requester has not received a copy of the hearing summary by this time, be sure that he or she has an opportunity to read it before the scheduled hearing time. If the requester speaks Spanish only, arrange for an interpreter prior to the hearing.
2. Represent the Department as a witness and present the Department's case as set forth in the case summary as directed by the Hearing Officer.
3. Answer any questions asked by the Hearing Officer and by the requester pertaining to the issue being contested.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.20 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: SNAP Eligibility Pending Fair Hearing ______________________________________________________________________________
1570.20 A. Maintaining Benefits Pending Hearing Decision
Except in situations described below, the Department does not terminate or reduce the assistance unit's benefits until the Fair Hearing decision is reached if the unit requests a Fair Hearing within the 10‑day notice period, as described in this chapter.
Unless the assistance unit specifically waives its right to a continuation of benefits, the Department assumes that the unit's request for a Fair Hearing within the 10‑day period includes a request that the unit's benefits remain the same pending the Fair Hearing decision.
B. Exceptions to Maintenance of Benefits
The Department reduces or terminates the assistance units benefits prior to the Fair Hearing decision even if the unit requests a Fair Hearing within the 10 day notice period if it determines at the Fair Hearing that the sole issue is one of federal or state law or departmental policy, and not one of incorrect grant computation.
In respect to benefits issued under the Emergency Housing policy (Cross Reference: 4515 and 4525), the benefits are not continued beyond a specific date if the Department notified the assistance unit in writing at the time of grant that:
the benefits are being authorized for a specific period of time; and
the benefits will automatically terminate when the specific period ends.
In the AFDC program and the Supplemental Nutrition Assistance Program, the Department reduces or terminates the assistance unit's benefits prior to the Fair Hearing decision, in addition to the situation described in paragraph 1, if:
a change affecting the assistance unit's grant occurs while the Fair Hearing decision is pending and the unit fails to request a Fair Hearing based on this notice; or
a mass change affecting the unit’s eligibility or grant occurs while the Fair Hearing decision is pending.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.20 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: SNAP Eligibility Pending Fair Hearing ______________________________________________________________________________
1570.20 B. Exceptions to Maintenance of Benefits (continued)
In the Supplemental Nutrition Assistance Program, the Department reduces or terminates the assistance unit's benefits prior to the Fair Hearing decision, in addition to the situations described in paragraphs 1 and 3, if the unit's certification period expires. In this case, the unit must reapply for benefits.
C. Notification of Assistance Unit
The Department promptly notifies the assistance unit in writing if benefits are reduced or terminated pending the Fair Hearing decision, as described in paragraph B.
D. Reinstatement of Benefits
1. Under the conditions described below, the Department reinstates the assistance unit's benefits if such benefits have been reduced or terminated pending a Fair Hearing decision.
a. In the AFDC and Medicaid programs, the Department reinstates the assistance unit's benefits if:
(1) the Department takes an action without sending timely notice; and
(2) the assistance unit requests a Fair Hearing within 10 days of the mailing date of the notice; and
(3) the Department determines that federal or state law or departmental policy is not the sole issue involved in the Fair Hearing.
b. In the Supplemental Nutrition Assistance Program, the Department reinstates the assistance unit's benefits if:
the unit establishes to the satisfaction of the Department that it had good cause for not requesting a Fair Hearing within the 10 day notice period. Good cause includes, but is not limited to the following:
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.20 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: SNAP Eligibility Pending Fair Hearing ______________________________________________________________________________
1570.20 D. Reinstatement of Benefits (continued)
an onset of serious illness or injury; or
a catastrophic event such as fire, flood or eviction; or
(c) non‑receipt of the notice; or
(2) the issue involves a reduction or termination of benefits caused by a mass change, and the assistance unit claims either that the Department made a computation error or that the Department misapplied federal law or regulation.
2. If the Department reinstates the assistance unit's benefits pending the Fair Hearing decision, the unit continues to receive such benefits until the decision is rendered, except under conditions described in paragraph B.
E. Corrective Action
1. If the Department does not reduce or terminate the assistance unit's benefits pending the Fair Hearing decision, and the decision upholds the Department, the Department recoups the overpayment which the unit received during this period.
2. If the Department reduces or terminates the assistance unit's benefits pending the Fair Hearing decision, and the decision favors the unit, the Department makes a prompt corrective payment to the unit to correct the underpayment which occurred during this period.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 P-1570.20 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings TFA _______________________________________________________________ AABD Subject: MA Procedures Subsequent to the Hearing SNAP ______________________________________________________________________________
P-1570.20 1. If the assistance unit's circumstances change after a Fair Hearing has been held, take whatever action is necessary, as described in this section. There is no need for a referral to the Office of Legal Counsel, Regulations and Administrative Hearings (OLCRAH), as the change in circumstances is a separate issue from the one contested at the hearing.
2. If the Fair Hearing decision requires action by the Department, take such action by the date indicated in the hearing decision. Notify the assistance unit, requester and his or her authorized representative and the Office of Legal Counsel, Regulations and Administrative Hearings when completing the action. Provide a copy of the specific document requested for compliance to OLCRAH no later than the date specified in the hearing decision.
3. If the Fair Hearing decision upholds the Department, begin recoupment, if appropriate, as described in Section 7500.
4. If the requester asks for, and is granted, a reconsideration of the hearing decision, and the Hearing Officer subsequently orders the Department to take a specific action, take such action by the date specified by the Hearing Officer. Provide a copy of the document requested for compliance to OLCRAH no later than the date specified in the decision.
5. If the requester appeals a Fair Hearing decision to the Superior Court, and the Court subsequently orders the Department to take a specific action, take such action by the date specified by the Court.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.25 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 A. Notification of the Requester
1. The Department notifies the requester in writing regarding the time and place of the Fair Hearing, as follows:
a. for all issues except emergency housing at least 10 days in advance;
b. for emergency housing issues at least one business day prior to the hearing.
2. The Department's notice:
a. advises the requester or the requester's representative of the name, address, and telephone number of the person to notify if the requester is unable to attend the Fair Hearing; and
b. states that the Department will dismiss the Fair Hearing request if neither the requester nor his or her representative appears at the Fair Hearing without good cause; and
c. describes Departmental Fair Hearing procedures and any other information which would assist the requester in presenting his or her case; and
d. explains that the assistance unit or its representative has the right to examine the case record prior to the Fair Hearing.
B. Scheduling and Location of Fair Hearing
1. The Department schedules the Fair Hearing to be held:
a. during normal working hours; and
b. for all issues except emergency housing - within 30 days from the date the request is received; and
c. for emergency housing issues - within 4 business days from the date the request is received; and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.25 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 B. Scheduling and Location of Fair Hearing (continued)
d. at a reasonable location accessible to the requester. If the requester is disabled, the hearing is held at his or her home if he or she so requests.
2. The requester has the right to request and receive a postponement of the scheduled Fair Hearing.
a. In the Food Stamp program, the postponement cannot exceed 30 days.
b. In the money payment and Medicaid programs, the postponement can be for any reasonable time period if the Department determines there is good cause for the delay. Good cause includes, but is not limited to:
(1) serious illness or injury of the requester; or
(2) inability by the requester, despite a good faith effort, to secure medical records or other information necessary in presenting its case.
c. The time limit for action on the decision is extended for as many days as the Fair Hearing is postponed.
C. Administrative Duties of Fair Hearing Official
1. The Department designates an employee of the Department who meets the qualifications described in this chapter to conduct the Fair Hearing.
2. The Fair Hearing official:
a. makes decisions regarding the scheduling of the hearing;
b. administers oaths or affirmations;
c. determines the issue of the hearing;
d. considers all relevant issues;
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1570.25 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 C. 2. Administrative Duties of Fair Hearing Official (continued)
e. determines who may be a party to a hearing requested by another;
f. determines who may be an intervenor;
g. limits intervenor's participation in a hearing to issues in which he or she has stated an interest in a written request;
h. requests, receives, and makes part of the Fair Hearing record all evidence necessary to decide the issues being raised;
i. regulates the conduct and course of the Fair Hearing consistent with due process to insure an orderly Fair Hearing;
j. maintains a Fair Hearing record;
k. renders a Fair Hearing decision in the name of the Department, in accordance with the criteria in this chapter, to resolve the dispute.
D. Non-Administrative Duties of Fair Hearing Official
1. The Fair Hearing official orders, when relevant and useful, an independent medical assessment or professional evaluation from a source mutually satisfactory to the assistance unit and the Department.
a. this occurs if the dispute involves a medical issue such as that concerning a diagnosis, and examining physicians report, or a medical review board decision;
b. the Department pays for this independent assessment.
2. The Fair Hearing official adjusts the modifies the results of the assessment of spousal assets when:
a. either MCCA spouse requests a hearing regarding the assessment; and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1570.25 page 4 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________ 1570.25 D. Non-administrative Duties of Fair Hearing Official (continued)
b. the Fair Hearing official determines the results of the assessment were incorrectly determined (Cross Reference 1507).
3. The official increases the community spouse's MMNA previously determined by the Department if either MCCA spouse establishes that the community spouse has exceptional circumstances resulting in significant financial duress, and the MMNA previously calculated by the Department is not sufficient to meet the community spouse's monthly needs as determined by the hearing official.
a. Exceptional circumstances are those that are severe and unusual and that:
(1) prevent the community spouse from taking care of his or her activities of daily living; or
(2) directly threaten the community spouse's ability to remain in the community; or
(3) involve the community spouse's providing constant and essential care for his or her disabled child, sibling or other immediate relative (other than institutionalized spouse).
b. Significant financial duress is an expense or set of expenses that:
(1) directly arises from the exceptional circumstances described in subparagraph a above; and
(2) is not already factored into the MMNA; and
(3) cannot reasonably be expected to be met by the community spouse's own income and assets.
c. Expenses that are factored into the MMNA, and thus do not generally qualify as causing significant financial duress, include, but are not limited to:
(1) shelter costs such as rent or mortgage payments;
(2) utility costs;
(3) condominium fees; CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-03 Transmittal: UP-03-28 1570.25 page 5 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 D. 3. c. Non-administrative Duties of Fair Hearing Official (continued)
(4) real estate and personal property taxes;
(5) real estate, life and medical insurance;
(6) expenses for the upkeep of a home such as lawn maintenance, snow removal, replacement of a roof, furnace or appliance;
(7) medical expenses reflecting the normal frailties of old age.
d. In order to increase the MMNA, the Fair Hearing official must find that the community spouse's significant financial duress is a direct result of the exceptional circumstances that affect him or her.
4. The Fair Hearing official increases the Community Spouse Protected Amount (CSPA) if either MCCA spouse establishes that the CSPA previously determined by the Department is not enough to raise the community spouse's income to the MMNA (Cross References 4022.05 and 4025.67).
a. For applications filed prior to 10-1-03, in computing the amount of the community spouse's income, the Fair Hearing official first allows for a diversion of the institutionalized spouse's income in the following situations:
(1) the community spouse is not expected to outlive the institutionalized spouse (including situations in which the community spouse actually dies while the institutionalized spouse's Medicaid application is pending); or
(2) the CSPA previously determined by the Department is less than the spousal share, as determined by the Department; or
(3) either spouse has transferred assets within the look-back period and the transfer led to a penalty period; or
(4) the community spouse has written the institutionalized spouse out of his or her will, or left the spouse with only the statutory amount required under State law.
For applications filed on or after 10-1-03, in computing the amount of the community spouse's income, the Fair Hearing official first allows for CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-03 Transmittal: UP-03-28 1570.25 page 6 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 D. 4. b. Non-administrative Duties of Fair Hearing Official (continued)
a diversion of the institutionalized spouse's income in all cases.
c. In determining the amount of assets needed to raise the community spouse's income to the MMNA, the Fair Hearing official computes the amount of assets that would generate the required income, assuming the asset is producing income at the higher of the following rates: the current average rate of return generated by a 12 month certificate of deposit as determined by the Department as of the date of the Fair Hearing; or the rate that is actually being generated by the asset.
E. Attendance at Fair Hearing
1. The following persons attend the Fair Hearing:
a. Fair Hearing official; and
b. representative from the Department; and
c. representative of the local Job Connection office, when appropriate, if the dispute involves a work registration requirement, exemption determination, or finding of failure to appear for an appraisal interview; and
d. assistance unit member and/or conservator if the requester is incapable of representing himself or herself; and
e. authorized representatives, if the unit so chooses. At a Food Stamp hearing, the requester may choose to have the authorized representatives attend the hearing in his or her place; and
f. legal counsel for requester, if there is such counsel; and
g. friends or relatives of the requester if the requester so chooses; and
h. parties to the hearing; and
i. intervenors; and
j. any other individuals being given an opportunity to present relevant oral or written statements, at the discretion of the Fair Hearing official. CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-03 Transmittal: UP-03-28 1570.25 page 7 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 E. Attendance at Fair Hearing (continued)
2. The Department limits the number of persons attending the Fair Hearing if the Fair Hearing location has limited space, or under other circumstances which the Hearing official determines to justify limiting attendance.
F. Matters Considered at the Fair Hearing
The Department considers the following issues:
1. an action by the Department or failure by the Department to act, within the appropriate time limits described in this section, on the application for benefits, including:
a. undue delay in reaching a decision on eligibility or in providing benefits; and
b. refusal to consider a request for or undue delay in making an adjustment in the amount of benefits; and
c. discontinuance, termination, or reduction of benefits.
2. decisions by the Department regarding:
a. eligibility for benefits in both initial and subsequent determinations; and
b. amount of benefits or change in amount of benefits; and
c. the manner or form in which benefits are issued, including protective payments (cross reference: Section 6505); and
d. the assessment of spousal assets (Cross Reference 1507.05).
G. Rights of the Requester at the Fair Hearing
1. The requester or his or her representative has the right to:
a. examine, at a reasonable time before the Fair Hearing and during the Fair Hearing, the case record and all documents and records to be used by the Department at the Fair Hearing. This right is subject to the Department's policies regarding Disclosure of Information, as described in Section 1015; and CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-03 Transmittal: UP-03-28 1570.25 page 8 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 G. 1. Rights of the Requester at the Fair Hearing (continued)
b. present its case or have it presented by legal counsel or another person; and
c. bring witnesses; and
d. establish all pertinent facts and circumstances; and
e. present an argument without undue interference; and
f. question or refute testimony or evidence, including the opportunity to confront and cross-examine adverse witnesses.
2. A party to a hearing requested by another has the same rights as the requester at a Fair Hearing.
H. Intervenor's Participation at the Fair Hearing
1. The intervenor's participation is limited to issues in which he or she has stated a particular interest on the written request to be an intervenor.
2. On these issues, the intervenor may participate as follows:
a. inspect and copy records, papers, documents, and physical evidence;
b. introduce evidence;
c. present arguments;
d. cross examine witnesses.
3. The Fair Hearing official may further restrict the participation of an intervenor to promote the orderly conduct of the hearing proceedings.
I. The Fair Hearing Record
1. The Fair Hearing record consists only of:
a. transcript or recording of testimony and exhibits, or an official report containing the substance of what happened at the Fair Hearing; and
all papers and requests filed in the proceeding; and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-03 Transmittal: UP-03-28 1570.25 page 9 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 I. 1. The Fair Hearing Record (continued)
c. the decision made by the Fair Hearing official.
2. The Department maintains the Fair Hearing record as well as the assistance unit's case record.
3. The Department makes the Fair Hearing record available to the person who requests the Fair Hearing or his or her representative at any reasonable time for copying and inspection. This right is subject to the Department's policies regarding Disclosure of Information, as described in Section 1015.
J. The Fair Hearing Decision
1. The time limit for issuing a decision after a Fair Hearing depends on the issue.
a. For emergency housing issues, a Fair Hearing decision is rendered no later than 3 business days after the hearing.
b. For Food Stamp issues, a Fair Hearing decision must be rendered in time to enable final administrative action to be taken on the contested issue within 60 days of the date of the request for the hearing.
c. For all other issues, a Fair Hearing decision must be rendered no later than 60 days after the hearing.
2. The Fair Hearing decision is based exclusively on evidence introduced at the Fair Hearing, as contained in the Fair Hearing record.
3. The decision itself is a written document which becomes part of the Fair Hearing record.
4. The decision:
a. summarizes the facts; and
b. identifies the evidence and regulations supporting the decision.
5. The decision is binding upon the Department.
6. Unless the requester appeals to the court of jurisdiction, as described in this chapter, the decision serves as a final resolution of the issue being contested. CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-89 Transmittal: UP-01-04 1570.25 page 10 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 J. The Fair Hearing Decision (continued)
7. Both the requester and the Department are notified in writing of the Fair Hearing decision. The notice contains:
a. the decision; and
b. the reasons for the decision; and
c. a statement of requester's right to appeal to the court of jurisdiction, and that such appeal may result in a reversal of the decision; and
d. a description of how the unit's benefits will be affected by the decision.
8. All Fair Hearing decisions are indexed by name and subject.
9. The Fair Hearing record, including the decision, is available for public inspection and copying, subject to the Department's policies regarding Disclosure of Information, as described in Section 1015.
K. Reconsideration
1. Up to fifteen days from the date of receipt of a Fair Hearing decision, the requester may request reconsideration of the decision.
2. Reconsideration may be requested for the following reasons:
a. an error was made in the interpretation or application of a law, or in the facts of the case;
b. new evidence has been discovered which affects the merits of the case and which for a good reason was not presented at the hearing;
c. there is other good cause for reconsideration.
3. Within twenty-five days of receipt of a request for reconsideration, the Department decides whether to reconsider.
4. If the Department decides reconsideration is not warranted, no further action is required.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 2-1-97 Transmittal: UP-01-04 1570.25 page 11 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Hearing Procedures ______________________________________________________________________________
1570.25 K. Reconsideration (continued)
5. Regardless of a request for reconsideration, the Department may decide, within forty days, to reconsider a hearing decision.
6. If the Department decides that reconsideration is warranted, it proceeds in a reasonable time to conduct additional proceedings, as may be necessary, to render a decision to modify, affirm, or reverse the hearing decision.
L. Implementation of Fair Hearing Decision
1. The Department makes the appropriate changes in the assistance unit's case as mandated by the Fair Hearing decision within the time limits specified in this chapter.
2. If the decision favors the requester or if the Department resolves the dispute in favor of the requester prior to the Fair Hearing, the Department promptly makes a corrective payment to the unit, if necessary.
a. The payment is retroactive to the date the Department made the incorrect action or inaction.
b. In the Food Stamp program, if the decision results in an increase in the assistance unit's benefits, the increase is reflected in the unit's food stamp allotment within 10 days of the date the Department receives the Fair Hearing decision.
3. If the decision upholds the Department, the Department takes action to recover any benefits which the assistance unit improperly received.
a. The beginning date of the overpayment is retroactive to the date that the assistance unit first received benefits to which it was not entitled.
b. In the Food Stamp program, if the decision results in a decrease in benefits, the decrease is reflected in the next scheduled issuance after the date the Department receives the Fair Hearing decision.
(Cross Reference: Benefit Error, Section 7000)
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 P-1570.25 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Fair Hearings MAABD _______________________________________________________________ Subject: Calculation of CSPA ______________________________________________________________________________
P-1570.25 1. Determine the reason for the Fair Hearing request.
2. If the Fair Hearing is being requested because the requester considers the computed CSPA to be insufficient to maintain adequate income, stop here and go to P-1570.30 - Adjustment of CSPA.
3. If the Fair Hearing is being requested because the requester considers the computation of the CSPA to be incorrect, go to step 4.
4. Obtain a Fair Hearing summary with:
° a copy of the request for the assessment.
° a copy of any documentation used for the assessment.
5. Determine the assets which were owned by both the community spouse and the institutionalized spouse at the beginning of the continuous period of institutionalization.
6. Evaluate each asset owned by either or both spouses according to the policy in section 4000 - "Treatment of Assets." Do not require either spouse to pursue inaccessible assets.
7. Compute the total value of all counted assets owned by the institutionalized spouse by adding the equity value of all his or her non-excluded accessible assets.
8. Compute the total value of all counted assets owned by the community spouse by adding the equity value of all his or her non-excluded accessible assets.
9. Add the amounts computed in steps 7 and 8.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 P-1570.25 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Fair Hearings MAABD _______________________________________________________________ Subject: Calculation of CSPA ______________________________________________________________________________
P-1570.25 10. Divide the amount calculated in step 9 by 2 to determine The spousal share for each spouse.
11. Determine the amount of the CSPA by using the policy at 4022.05.
12. Render a decision based upon the result of step 11.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 P-1570.26 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: MAABD Fair Hearings _______________________________________________________________ Subject: Adjustment of MMNA -- Exceptional Expenses/Significant Financial Duress ______________________________________________________________________________
P-1570.26 1. Use these procedures if the Fair Hearing involves the issue of adjusting the CSPA or the CSA because of the claim that the community spouse has exceptional circumstances resulting in significant financial duress.
2. Consider first the issue of exceptional circumstances.
° What are these circumstances?
° Are they unusual and extreme?
° Do they prevent the community spouse from taking care of his or her activities of daily living (bathing, dressing, transferring, toileting, feeding, preparing meals, administering medication, ambulating, controlling bladder and bowel)?
° Do they directly threaten the community spouse's ability to remain in the community, or do they involve the community spouse's providing constant and essential care for a disabled child, sibling or other immediate relative (other than the institutionalized spouse)?
3. Do not consider expenses in themselves to be exceptional circumstances. Rather, look for conditions or sets of conditions affecting the community spouse, as described in step 2.
4. Do not consider a situation relating to household upkeep (replacement of a roof or appliance, lawn maintenance, snow removal, etc.) to be an exceptional circumstance unless caused by a natural disaster or other extreme situation.
5. Do not consider the normal frailties of old age, or the need for increased costs relating to medical insurance to be an exceptional circumstance.
6. Do consider an exceptional circumstance a severe medical condition that:
° completely confines the community spouse to bed; or
° prevents him or her from taking care of activities of daily living; or
° requires constant care by others.PRIVATE tc \l 1 ""
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 P-1570.26 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: MAABD Fair Hearings _______________________________________________________________ Subject: Adjustment of MMNA -- Exceptional Expenses/Significant Financial Duress ______________________________________________________________________________
P-1570.26 7. Do consider an exceptional circumstance the community spouse's providing constant and essential care to his or her disabled child, sibling or other immediate relative (other than institutionalized spouse).
8. Using the above steps as guidelines, determine whether there are exceptional circumstances.
9. If you find that there is no exceptional circumstance, stop here. Do not adjust the MMNA. If you find that there is an exceptional circumstance, go on to step 10.
10. If you found that there is an exceptional circumstance in step 9, ask the following questions:
° What are the community spouse's expenses directly arising from the exceptional circumstance?
° Are these expenses severe and unusual, and beyond what is covered in the MMNA?
° Can the community spouse reasonably meet these expenses from his or her own income and assets?
° Must the community spouse meet these expenses either to continue to remain in the community, or to continue to care for his or her disabled child, sibling or other immediate relative (other than institutionalized spouse)?
° Is there any other way to meet these expenses, such as insurance or other third party coverage?
11. If the expense or set of expenses is not related to the exceptional circumstance, stop here. Do not increase the MMNA.
12. Do not consider expenses related to costs already factored into the MMNA as examples of significant financial duress. Such costs include, but are not limited to:
° rent or mortgage payments
° utility costs
° condominium fees
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 P-1570.26 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: MAABD Fair Hearings _______________________________________________________________ Subject: Adjustment of MMNA -- Exceptional Expenses/Significant Financial Duress ______________________________________________________________________________
P-1570.26 ° real estate and personal property taxes
° real estate, life and medical insurance.
13. Do not consider expenses for the upkeep of a home (lawn maintenance, snow removal, replacement of roof, furnace, appliance, etc.) as examples of significant financial duress unless:
° they are the direct result of the exceptional circumstance determined in step 9; and
° they are severe and unusual, and cannot be reasonably expected to paid from the community spouse's income or assets.
14. Do not consider expenses for medical costs including prescriptions as examples of significant financial duress unless:
° they are severe and unusual; and
° they are the direct result of the exceptional circumstance determined in step 9; and
° they cannot be reasonably expected to paid from the community spouse's income or assets.
15. If you find that there is significant financial duress as a result of the exceptional circumstance, evaluate the related expenses as presented by the requester. Allow those that are reasonable and necessary.
16. Recompute the MMNA as follows:
° Follow steps 1 through 7 at P-5035.10;
° Add the expenses from step 15 above to the figure calculated at P-5035.10, step 6 or 7, whichever is appropriate.
17. Adjust the MMNA by using the figure from step 16. You are not bound by the limits defined in P-5035.10.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 1570.30 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Appeals ______________________________________________________________________________
1570.30 A. Right to Appeal
The requester has the right to appeal a Fair Hearing decision to the court of jurisdiction.
B. Time Limit for Appeal
The requester must file his or her appeal within 45 days of the date the Fair Hearing official mails the notice of a decision to the requester, unless there is good cause to request an extension.
C. Extensions
1. The requester may request an extension of the time limit for filing an appeal for good cause provided the request:
a. is submitted in writing to the Department; and
b. is mailed no later than 90 days after the date on the Fair Hearing decision.
2. Good cause circumstances include, but are not limited to:
a. the requester's serious illness or incapacity which materially affects the conduct of personal affairs; or
b. death or serious illness in the requester's immediate family which precludes perfecting an appeal; or
c. incorrect or misleading information given to the requester by the agency regarding the time period; or
d. other unforeseen and unavoidable circumstances of an exceptional nature.
3. The Department's decision whether or not to grant an extension is final, not subject to review or appeal.
4. A decision to grant an extension is sent to the requester in writing.
5. The date the decision is mailed serves as the date from which the time limit to file an appeal is counted.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 1570.30 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: FS Appeals ______________________________________________________________________________
1570.30 D. Appeals Procedures
The requester must follow all appeal procedures described in state law, including the requirement to serve a copy of its petition to appeal upon the Commissioner's Office within 45 days from the date the Hearing official mails the notice of decision.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES
UNIFORM POLICY MANUAL
______________________________________________________________________________
Date: 01-1-19 Transmittal: UP-03-28 P-1570.30
______________________________________________________________________________
Section: Type:
The Eligibility Process PROCEDURES
______________________________________________________________________________
Chapter: Program: MAABD
Fair Hearings
_______________________________________________________________
Subject:
Adjustment of CSPA
______________________________________________________________________________
P-1570.30 1. Determine the reason for the Fair Hearing request.
2. If the Fair Hearing is being requested because the requester considers the computation of the CSPA to be incorrect, go to P-1570.25 - "Calculation of CSPA."
3. If the Fair Hearing is being requested because the requester feels that the community spouse's income from all sources including income from the CSPA is insufficient to meet the MMNA, go to step 4.
4. Obtain a Fair Hearing Summary with:
a copy of the request for the assessment
a copy of the notification of the result of the assessment
a copy of any documentation used for the assessment
verification of the community spouse's monthly needs
verification of the community spouse's gross monthly income.
5. Calculate the MMNA for the community spouse following the procedures in P-5035.10 - "MMNA."
6. If it is claimed that the community spouse (CS) has exceptional circumstances resulting in significant financial duress, evaluate the claim and adjust the MMNA, if appropriate, by following the procedures in P- 1570.26.
7. Determine whether the CS’ own income, including income generated from his or her present CSPA, plus income that may be diverted from the institutionalized spouse, is sufficient to meet the CS' MMNA (using the MMNA from step 5 or 6, as appropriate).
If the income from step 7 is sufficient to meet the CS’ MMNA, stop here. Do not adjust the CSPA.
UNIFORM POLICY MANUAL
______________________________________________________________________________
Date: 01-01-19 Transmittal: UP-09-01 P-1570.30 page 2
______________________________________________________________________________
Section: Type:
The Eligibility Process PROCEDURES
______________________________________________________________________________
Chapter: Program: MAABD
Fair Hearings
_______________________________________________________________
Subject:
Adjustment of CSPA
P-1570.30 9. If the income from step 7 is not sufficient, compare the income currently
being generated by the CS’ assets (the CSPA amount) to what would be generated if the assets were producing income at a rate equal to the current average rate of return generated by a 12 month CD. To determine the return generated by a 12 month CD, average the three highest yields on 12 month CDs for banks with a physical presence in Connecticut. This figure can be obtained by referring to a reliable internet website, such as depositaccounts.com. If depositaccounts.com no longer exists or no longer provides information about banks with a physical presence in Connecticut, you may use a different website to obtain information about the rate of return on a 12 month CD for banks with a physical presence in Connecticut. Document the source of your information in the case notes. For spouses who live in another state, the yield determination should be based on the average of the three highest yields in banks with a physical presence in the state where the spouse resides. Again, if you cannot obtain this information using depositaccounts.com, you may use a different website and document the source of your information in the case notes.
Compute the income generated based on the higher of the two figures
described in step 9 above.
If the CS’ assets, producing income at the appropriate rate described above, when added to the CS’ other income, would be sufficient to meet the CS’ MMNA, stop here. Do not adjust the CSPA.
If the income would not be sufficient, continue to step 10.
10. If you determine that the CSPA should be increased, compute the amount of assets, based on the current average rate of return on a 12 month CD, needed to generate sufficient income to raise the community spouse's income to the MMNA. This the adjusted CSPA.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-46 P-1570.35 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Fair Hearings MAABD _______________________________________________________________ Subject: Calculation of CSA ______________________________________________________________________________
P-1570.35 1. Determine the reason for the Fair Hearing request.
2. If the Fair Hearing is being requested because the requester considers the computed the CSA to be inadequate stop here and go to P-1570.20-Adjustment of CSA.
3. If the Fair Hearing is being requested because the requester considers the computation of the CSA to be incorrect go to step 4.
4. Obtain a Fair Hearing summery with verification of:
° the community spouse's monthly shelter costs
° the community spouse's gross monthly income
° the institutionalized spouse's monthly applied income
5. Calculate the MMNA for the community spouse following the procedures in P-5035.10 - "MMNA."
6. Calculate the CSA for the community spouse following the procedures in P-5035.15 - "CSA."
7. Issue a decision based on the amount calculated in step 6.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 P-1570.40 ______________________________________________________________________________ Section: Type: The Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: Fair Hearings MAABD _______________________________________________________________ Subject: Adjustment of CSA ______________________________________________________________________________
P-1570.40 1. Determine the reason for the Fair Hearing request.
2. If the Fair Hearing is being requested because the requester considers the computation of the CSA to be incorrect, stop here and go to P-1570.35 - "Calculation of CSA."
3. If the Fair Hearing is being requested because the requester considers the computed CSA to be inadequate, go to step 4.
4. Obtain a Fair Hearing Summary with verification of:
° the community spouse's monthly shelter costs
° the community spouse's gross monthly income
° the institutionalized spouse's monthly applied income.
5. Calculate the MMNA for the community spouse by following the procedures in P-5035.10 - "MMNA."
6. If it is claimed that the community spouse has exceptional circumstances resulting in significant financial duress, evaluate the claim and adjust the MMNA, if appropriate, by following the procedures in P-1570.26.
7. Calculate the CSA for the community spouse by following the procedures in P-5035.15.
8. Issue a decision based on the amount calculated in step 7.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1599 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
1599 This chapter discusses the verification requirements that are associated with the manual section on Eligibility Process. The subjects detail the primary issues, factors and issues that are subject to verification by the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-06 Transmittal: UP-10-13 1599.05 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA SNAP Subject: Qualifications of Individuals ______________________________________________________________________________
1599.05 A. Except for MA, individuals may be required to provide verification of their identity if they are not known to the Department or if their identity is otherwise questionable.
B. MA
1. Except for those listed in 1599.05 F. 8 who are otherwise exempt, all individuals applying for or receiving MA who claim to be U.S. citizens shall verify their identity. Such verification shall be required only one time, unless later evidence raises a question about the person’s identity or the Department’s prior record is no longer available to the Department.
2. Individuals are required to provide information to the Department that allows the Department to verify their U.S. citizenship through a match with Social Security Administration (SSA) records, as requested by the Department for this purpose. Verification of U.S. citizenship through this SSA match also verifies an individual’s identity for purposes of eligibility for MA.
3. Individuals are not required to provide verification of identity in order to be and remain eligible for MA when:
a. the Department is in the process of making a reasonable effort to verify U.S. citizenship with the SSA; or
b. the Department has successfully matched the individual’s citizenship information with the SSA information; or
c. the Department has commenced the individual’s reasonable opportunity period (ROP) because the SSA match has failed and the ROP has not ended.
C. The following information concerning individuals who represent applicants or recipients is verified by the Department whenever questionable:
1. relationship or legal capacity;
2. authorized representative status;
3. absence of other qualified persons when a responsible adult applies on behalf of a deceased, incompetent or incapacitated individual;
4. actions taken by the representative; or
5. employment of a SNAP authorized representative.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-06 Transmittal: UP-10-09 1599.05 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA SNAP Subject: Qualifications of Individuals ______________________________________________________________________________
1599.05 D. Failure to provide required verification may result in the following actions where appropriate to the particular circumstance in question:
1. the Department may deny an application or discontinue assistance;
2. the Department may refrain from taking action until further clarification is obtained; or
3. the Department may require that a qualified individual or the assistance unit take action.
E. If verification is required at the time of application, the representative shall be allowed to file the application even though his or her qualifications may be in question.
F. Special Identity Verification Rules for MA
Except for those individuals listed in section 1599.05 F. 8. who are exempt from this requirement, or individuals listed in section 1599.05 B.2 and B.3., to be eligible for MA, individuals claiming U.S. citizenship who are applying for or receiving MA shall verify their identity by having a successful SSA match or by submitting to the Department one of the following documents:
a. a valid or expired U.S. passport originally issued with or without limitation;
b. a Certificate of Naturalization (DHS Forms N-550 or N-570);
a Certificate of U.S. Citizenship (DHS Forms N-560 or N-561);
d. a document received on or after 7/1/06, issued by a federally recognized Indian tribe, evidencing membership or enrollment in, or affiliation with, such tribe unless tribal lands cross an international border whose membership includes individuals who are not U.S. citizens;
e. documentation received on or after 7/1/06, as approved by the Secretary of the U.S. Department of Health and Human Services, from a federally recognized Indian tribal member whose tribal location is located within a state that has an international border and whose tribal membership includes individuals who are not U.S. citizens;
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-06 Transmittal: UP-10-09 1599.05 page 3 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA SNAP Subject: Qualifications of Individuals ______________________________________________________________________________
1599.05 F. 1. Special Identity Verification Rules for MA (continued)
f. a driver’s license issued by a state or U. S. territory either with the individual’s name and photograph, or the individual’s name and other identifying information such as age, sex, race, height, weight, or eye color;
g. a school identification card with a photograph of the individual;
h. a U.S. military card or draft record;
i. a state, federal, U.S. territory or local government issued identity card if that identity card has the same identifying information as found on a Connecticut driver’s license;
j. a military dependent’s identification card;
k. a Certificate of Degree of Indian Blood, or other American Indian/Alaska Native Tribal document with either the individual’s name and photograph, or the individual’s name and other personal identifying information such as age, weight, height, race, sex and eye color;
l. a U.S. Coast Guard merchant mariner card;
m. at the Department’s option, a cross match with a federal or state governmental, public assistance, law enforcement or corrections agency’s data system to establish identity if the agency establishes and certifies the true identity of individuals. Such agencies may include, but not be limited to, the food stamp agency, the child support agency, corrections, juvenile detention, motor vehicle or child protective services;
n. for children under 16 years of age, school records (which may include nursery or daycare records and report cards), clinic, doctor, or hospital records. If the individual submits a school record, the Department shall verify the document’s authenticity with the originating organization. For children under16 years of age, if none of these documents are available, an affidavit may be used to verify identity if it is signed under penalty of perjury by a parent, guardian or caretaker relative stating the date and place of birth of the child. Such affidavits do not have to be notarized.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-06 Transmittal: UP-10-09 1599.05 page 4 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA SNAP Subject: Qualifications of Individuals ______________________________________________________________________________
1599.05 F. 1. Special Identity Verification Rules for MA (continued)
o. for children 16 or 17 years of age, an affidavit signed under penalty of perjury by a parent, guardian or caretaker relative stating the date and place of the birth of the child may be used to verify identity if a school identification card or driver’s license is not available. Such affidavits do not have to be notarized.
p. Corroborating Documents.
If attempts to verify identity for adults using documents listed in this subsection have not been successful and no other acceptable documents to verify identity are available, three or more available documents that together reasonably corroborate the identity of an individual shall be used provided such documents have not been used to establish the individual’s citizenship and a Secondary or Third Level Document has been used to verify citizenship (cross reference UPM section 3099.04). Such corroborating documents shall, at a minimum, contain the individual’s name plus any additional information that verifies the individual’s identity. All documents shall contain consistent identifying information. Corroborating documents include the following:
(1) employer identification cards;
(2) high school and college diplomas from accredited institutions including general education and high school equivalency diplomas;
marriage certificates;
(4) divorce decrees;
(5) property deeds and titles;
government documents;
(7) employer documents;
(8) medical records; and
(9) school records;
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-06 Transmittal: UP-10-09 1599.05 page 5 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA SNAP Subject: Qualifications of Individuals ______________________________________________________________________________
1599.05 F. 1. Special Identity Verification Rules for MA (continued)
q. for disabled adults residing in any licensed facility where adults with disabilities reside, including, but not limited to, nursing facilities, chronic disease hospitals and residential care homes, an affidavit completed and signed by the director or administrator of the facility (under penalty of perjury) that states the date and place of birth of the facility resident. All other means of verifying identity shall first be pursued prior to completion and acceptance of this affidavit. This affidavit is not required to be notarized. Any adult residing in such a facility will be considered a disabled adult for purposes of this subsection.
2. For children under the age of 18, if an affidavit is used to verify U.S. citizenship (cross reference UPM section 3099.04), an affidavit shall not be used to verify identity.
3. The verification of identity for an applicant or recipient shall be required only once by the Department unless later evidence raises a question of the person’s identity or the Department’s prior record has been destroyed pursuant to record retention guidelines.
All documents used to verify identity shall be either originals or copies certified by the issuing agency.
5. Individuals may submit evidence of identity without appearing in person. Documents may be submitted in person, by mail or by another individual selected by the applicant or recipient.
6. Individuals have one 90-day reasonable opportunity period (ROP) in their lifetimes, during which they are eligible for MA, to verify their identity either through a successful SSA match or by providing documents as set forth in this subsection. This ROP may not be extended for any reason. The 90 days of the ROP do not have to run consecutively. This ROP begins after the Department has made its own reasonable effort to verify citizenship through the SSA match process and the individual receives notification that this process has failed to verify his or her identity. If, by the end of the ROP, the SSA match process continues to fail and the individual does not provide the required documentation to establish identity, MA shall be discontinued for that individual within 30 days after the end of the ROP.
7. Entities authorized by the Department as outstation locations pursuant to 42 CFR 435.904 may also view and validate identity documentation on behalf of the Department.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-06 Transmittal: UP-10-09 1599.05 page 6 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA SNAP Subject: Qualifications of Individuals ______________________________________________________________________________
1599.05 F. Special Identity Verification Rules for MA (continued)
8. The following individuals are exempt from the verification requirements set forth in this section:
a. those entitled to, or enrolled in, Medicare;
b. those eligible in the HUSKY A for Newborn Children coverage group (cross reference UPM section 2540.52);
c. those eligible under the Presumptive Eligibility for Children process (cross reference UPM section 1523);
d. those presumptively eligible in the Women with Breast or Cervical Cancer Medicaid coverage group (cross reference UPM section 2540.74);
e. SSI recipients;
f. recipients of SSDI or Social Security benefits if receipt is based on their own disability;
g. foster care children receiving services funded by Titles IV-B or IV-E of the Social Security Act;
h. children receiving adoption assistance under Title IV-E of the Social Security Act;
i. those eligible under the Presumptive Eligibility for Pregnant Women process; or
j. a child who, at the time of his or her current application for Medicaid, is under 12 months old and who is documented to have been born in the United States to a mother eligible for and receiving Medicaid at the time of the child’s birth.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-06 Transmittal: UP-10-09 P-1599.05 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ FS Subject: MA Qualifications of Individuals ______________________________________________________________________________
P-1599.05 1. Ask the individual to present or obtain verification if you question the capacity in which the person is acting or his or her identity.
2. For those applying for or receiving MA who claim to be U.S. citizens and who are not otherwise exempt as stated in section 1599.05 F. 8., verify identity once at time of application or if active, at time of redetermination. Verify identity more than once if later evidence raises a question of the person’s identity or if the Department’s prior record has been destroyed under record retention guidelines.
3. Except for those claiming to be U.S. citizens who are applying for MA and not otherwise exempt, acceptable means of verification of identity include such forms as:
° driver's license;
° photo I.D. cards;
° letters of reference;
° birth or marriage records;
records of the individual's signature.
4. For those claiming to be U.S. citizens who are applying for MA and are not otherwise exempt, follow the rules in the OSD desk guide entitled “Citizenship and Identity Documentation for Medicaid ” to verify identity.
5. Verification of relationship or legal capacity includes, but is not limited to:
° birth records;
° marriage certificates;
° documentation of legal court appointment.
6. Obtain verification of authorized representative status from the requester.
Obtain verification from collateral sources if necessary whenever a responsible adult applies on behalf of a deceased, incompetent or incapacitated individual.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-08 Transmittal: UP-08-13 P-1599.05 page 2 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ FS Subject: MA Qualifications of Individuals ______________________________________________________________________________
P-1599.05 8. Acceptable means of verification of employment includes, but is not limited to:
° wage stubs;
° employee I.D. badges;
Department of Labor records.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 1599.10 ______________________________________________________________________________ Section: Type: Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA Subject: FS Good Cause Circumstances ______________________________________________________________________________
1599.10 A. The Department requires verification of good cause claims by the assistance unit which has failed to comply with the time limits in the eligibility process if:
1. the circumstances are questionable; and
2. taking good cause into consideration would affect eligibility or benefit level for a current or retroactive period of time, or otherwise alter the Department's actions.
B. A claim of good cause for requesting an extension of the time limit for filing an appeal of a Fair Hearing must be accompanied by evidence substantiating the claim.
C. Failure to provide required verification of good cause circumstances results in non-consideration of the claim.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-87 Transmittal: UP-87-13 P-1599.10 ______________________________________________________________________________ Section: Type: Eligibility Process PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Verification AABD _______________________________________________________________ MA Subject: FS Good Cause Circumstances ______________________________________________________________________________
P-1599.10 1. In general, accept the statement of the assistance unit as long as the explanation is reasonable.
2. Require documentation of good cause for every request for an extension of the time limit for a Fair Hearing appeal.
3. Where appropriate, consider the following:
° whether the unit contacted the Department before the deadline for taking action expired;
° whether the unit attempted to complete the necessary action within a reasonable period of time from when the good cause circumstances ended;
° whether the unit has a history of not taking timely action or intentional program violation;
° was proper notice issued by the Department.
4. As a general rule, consider the following conditions as evidence of good cause:
° delays caused by a third party;
° AFDC units appearing by the tenth day following the redetermination month for a missed interview with a reasonable explanation of good cause.
5. Acceptable means of verification of illness includes, but is not necessarily limited to:
° a statement by a physician;
° hospital records.
6. Obtain written documentation or acknowledgement from reliable collateral sources whenever verification is necessary.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2000 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
2000 This section describes which individuals or groups of individuals in each designated program are members of an assistance unit. Certain individuals who live together in the same household must be members of the same assistance unit. Others may qualify individually as an assistance unit.
Requirements regarding assistance unit composition vary considerably from program to program. Each program is therefore discussed separately in this section. For all programs, however, an individual must meet all of the program eligibility requirements in order to be included in an assistance unit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2000.01 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
2000.01 Adoptive Sibling
An adoptive sibling is a brother or sister related through adoption.
Assistance Unit
The assistance unit consists of one or more individuals who apply for or receive assistance together under one of the Department's programs.
Boarder
A boarder is an individual who pays a stipulated sum to others for lodging and meals.
Foster Child
A foster child is one not necessarily related through legal or blood ties for whom parental care and nurturing is provided apart from the child's natural family.
Half-sibling
A half-sibling is a brother or sister related through only one parent.
Household
Household is used to designate all of the individuals who are living together in one dwelling unit.
Maintenance Payments from Title IV-E
Maintenance payments from Title IV-E are funds administered by DCYS available to individuals for room and board and other services given for qualified foster children or adopted children.
Roomer
A roomer is an individual who is provided lodging, but not meals, by a household.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-91 Transmittal: UP-91-1 2005 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC AFDC Assistance Unit Requirements ______________________________________________________________________________ Subject:
______________________________________________________________________________
2005 This chapter describes which individuals are included in the AFDC assistance unit of the dependent child for whom application is made.
Under separate subjects are:
° which individuals must be included in the assistance unit;
° which individuals have the option to either be in the unit or to apply separately; and
° which individuals are specifically excluded from the AFDC assistance unit.
A three-generation household is also explained under a separate heading in this chapter.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-22-93 Transmittal: UP-93-42 2005.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC Assistance Unit Requirements AFDC _______________________________________________________________ Subject: General Provisions ______________________________________________________________________________
2005.05 A. The primary member of the AFDC assistance unit is the dependent child for whom assistance is requested or received. The brothers, sisters and parents of that child who live with the child must be included in the child's assistance unit unless they are otherwise excluded. This is true even if assistance has not been requested for them. It is also true even if one of the children has income specifically designated for his or her needs, unless that income is SSI or AABD.
B. There may be other dependent children in the household who are not siblings who meet the eligibility requirements of the program. These individuals have the option of being members of the same assistance unit or a separate assistance unit.
C. The one exception to the above rule involves a child who receives SSI. Such a child may be the basis of an AFDC assistance unit even though this child is not eligible to be a recipient. The siblings of an SSI child are not mandatory assistance unit members.
D. More than one assistance unit may share living quarters.
1. Unrelated assistance units in the same household are not combined into one assistance unit except at their request.
2. When a woman with dependent children marries a man with dependent children, all of whom request or receive AFDC:
a. two separate assistance units may exist as long as there is no child in common who is eligible for AFDC;
b. one assistance unit exists if they have a child in common who is eligible for AFDC, based on their relationship to the common child.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-91 Transmittal: UP-91-44 2005.05 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC Assistance Unit Requirements AFDC _______________________________________________________________ Subject: General Provisions ______________________________________________________________________________
2005.05 E. A dependent child who receives assistance as a mandatory inclusion in a parent's assistance unit may not receive assistance as the caretaker relative of a separate assistance unit while living in the parent's home.
F. A dependent child who lives with a non‑parent caretaker relative may receive assistance as the caretaker relative of a separate unit or remain with her child in the non‑parent caretaker's unit if he or she has no siblings in the home who are eligible as dependent children.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _______________________________________________________________________________ Date: 1-1-91 Transmittal: UP-91-1 P-2005.05 _______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC AFDC Procedures _______________________________________________________________ Subject: Basic Steps in Creating the AFDC Assistance Unit ______________________________________________________________________________
P-2005.05 1. Start with the dependent child or children for whom assistance is requested. Consider all of the child's brothers and sisters.
2. If there is more than one child in the home, one of whom receives SSI, see "Special Steps For SSI Children," at P-2005.17. If not, go on.
3. Include sisters and brothers who have only one parent in common and adopted sisters and brothers, as well as siblings who share both parents.
4. Determine and add to the unit those siblings who:
° live in the household; and
° qualify for AFDC by meeting categorical, technical and procedural eligibility requirements.
5. Consider the parents of each eligible child and add to the unit those who:
° live in the household; and
° qualify for AFDC by meeting categorical, technical and procedural eligibility requirements.
6. Include both parents regardless of marital status when the basis of deprivation is incapacity or unemployment.
7. Include individuals who have applied for SSI while the application for SSI is pending.
8. Remove mandatory exclusions.
9. Count the income and assets of an individual who is removed solely due to disqualification from the program.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 1-1-91 Transmittal: UP-91-1 P-2005.05 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC AFDC Procedures _______________________________________________________________ Subject: Basic Steps Creating the AFDC Assistance Unit ______________________________________________________________________________
P-2005.05 10. Consider any other individuals in the household for whom AFDC is requested. Explain to the caretaker relative the difference between including such individuals in the unit, and creating a separate unit for them.
11. Add the other individuals only if the caretaker relative requests their addition.
12. If a separate unit is created for the other individuals, follow steps 1 through 9 for that unit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-92 Transmittal: UP-92-13 2005.10 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Assistance Unit Requirements AFDC _______________________________________________________________ Subject: Who Must Be Included ______________________________________________________________________________
2005.10 A. The assistance unit must include certain individuals who are in the home, if they meet the eligibility requirements for the program. The following individuals must be included in the assistance unit:
1. the dependent child for whom assistance is requested;
2. all brothers and sisters of the dependent child who themselves qualify as dependent children, and half siblings;
3. the natural or adoptive parent of the dependent child;
4. adoptive siblings who:
a. receive adoption assistance payments when excluding the child would reduce the benefits of the assistance unit; or
b. adoptive siblings who do not receive such payments.
5. the second parent of the dependent child who is eligible based on one parent's incapacity or unemployment.
B. The individuals in A. above are considered as if they were in the home under certain circumstances. They must be included in the assistance unit as long as they continue to meet the AFDC eligibility requirement of living with a specified relative. Included are the following:
1. a child or parent in a general hospital who lived in the home prior to the hospital admission;
2. a child who attends a special school away from home, such as for the deaf, blind, physically handicapped or emotionally disturbed if:
a. the caretaker relative retains primary responsibility for the child; and
b. the caretaker relative maintains a home for the child; and
c. the child returns to the home for vacations and holidays;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2005.10 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Assistance Unit Requirements AFDC _______________________________________________________________ Subject: Who Must Be Included ______________________________________________________________________________
2005.10 B. (continued)
3. a child who returns home for a visit of at least 30 consecutive days from an institution which has primary responsibility for the care of the child. These institutions include, but are not limited to, state hospitals, training schools for the mentally retarded, juvenile correctional institutions and foster homes. The child is considered a member of the assistance unit for the entire length of the visit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: Transmittal: UP-88-7 P-2005.10 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Procedures AFDC _______________________________________________________________ Subject: Stepparent Household ______________________________________________________________________________
P-2005.10 1. Follow the basic steps for creating the AFDC assistance unit in P-2005.05.
2. Include in the assistance unit the stepparent who:
° lives in the household; and
° meets the categorical, technical and procedural requirements; and
° has a child in common with the other parent in the home.
3. Include the stepparent's children when the stepparent meets the criteria in #2 above.
4. Include the stepparent and the stepparent's children when the caretaker relative requests their addition if:
° they live in the household; and
° they meet the eligibility requirements; and
° there is no child in common.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2005.15 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Assistance Unit Requirements AFDC _______________________________________________________________ Subject: Who May Be Included ______________________________________________________________________________
2005.15 The assistance unit may include certain individuals if they meet the eligibility requirements for the program. The following individuals have the option of being included in the assistance unit of the dependent child:
A. the non-parent needy caretaker relative, who may choose between AFDC and another public assistance program, if qualifications for both are met;
B. dependent children other than mandatory inclusions who are of acceptable relationship to the caretaker relative, if the caretaker relative chooses to have them included rather than receive assistance for them as a separate assistance unit;
C. the stepparent and step siblings of an eligible dependent child when the stepparent has no child in common with the parent of the eligible dependent child.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-2005.15 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Procedures AFDC _______________________________________________________________ Subject: Special Steps for Individuals Away from Home ______________________________________________________________________________
P-2005.15 1. When an adult household member is away from home, find out:
° the estimated length of absence; and
° whether the return to this household is planned.
2. When a caretaker relative is away from home, find out also:
° whether the home will be maintained.
3. When a child is away from home, find out:
° the estimated length of absence;
° plans for periodic visits home, such as holidays and visits.
4. Add to the assistance unit those individuals who meet the categorical requirement of "living with" a specified relative (refer to policy) and who:
° qualify in all other respects for AFDC; and
° are mandatory inclusions in the assistance unit.
5. Refer to DHR any situations requiring agency assistance with the care and supervision of children.
6. For a child living in an institution which has primary care of the child, find out how long a visit home will be.
7. If the visit will be for fewer than 30 days, do not add the child to the assistance unit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-2005.15 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Procedures AFDC _______________________________________________________________ Subject: Special Steps for Individuals Away from Home ______________________________________________________________________________
P-2005.15 8. If the visit will be for 30 days or longer:
° add the child effective with the first day of the visit;
° remove the child effective the end of the last month of the visit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-91 Transmittal: UP-91-1 P-2005.17 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC AFDC Procedures _______________________________________________________________ Subject: Special Steps for SSI Children ______________________________________________________________________________
P-2005.17 1. In situations in which an SSI child resides with other siblings, review with the caretaker relative the options available for creating the AFDC assistance unit.
2. Compute what the AFDC payment would be for the assistance unit consisting of all eligible adults and children.
3. Compute what the AFDC payment would be for the assistance unit consisting of eligible adults only, with the children excluded.
4. Share the results of the computations made above with the caretaker relative.
5. Explain to the caretaker relative the options with respect to establishing an assistance unit of one, with the other children excluded, or in cases in which there are two eligible parents, establishing an assistance unit of two with the other children excluded.
6. If the caretaker relative chooses to include the other children in the assistance unit, go back to step 3 under, "Basic Steps in Creating the AFDC Unit." at P-2005.05.
7. Make the above determination at time of intake, redetermination, and whenever an SSI child returns to the home.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-92 Transmittal: UP-92-13 P-2005.18 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Procedures AFDC _______________________________________________________________ Subject: Special Steps for Children Receiving Adoption Assistance Payments ______________________________________________________________________________
P-2005.18 When an assistance unit receives an adoption assistance payment on behalf of an adopted child, the following special steps are used:
1. Exclude any portions of the payment which are intended:
° to meet needs not provided for in the AFDC assistance benefit amount;
° to supplement AFDC assistance benefits which are insufficient to meet the special needs of the child.
2. Compute what the AFDC payment would be for the assistance unit consisting of all eligible adults and children by:
° including the child for whom the adoption assistance is paid; and
° including the counted amount of the payment as income.
3. Compute what the AFDC payment would be for the assistance unit consisting of all eligible adults and children except the child receiving adoption assistance payments.
4. If the AFDC payment computed in step 2 is less than the AFDC payment computed in step 3, exclude the child from the assistance unit. If not, include the child in the same assistance unit as the other eligible members.
5. Make the above determination at time of intake, redetermination, and whenever a child receiving adoption assistance payments returns to the home.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-92 Transmittal: UP-92-13 2005.20 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Assistance Unit AFDC _______________________________________________________________ Subject: Who Is Excluded ______________________________________________________________________________
2005.20 Certain individuals are excluded from participating in the AFDC program as members of the assistance unit. These exclusions take precedence over the mandatory inclusion requirement. The following individuals are excluded from the assistance unit:
A. an individual who does not meet the categorical, procedural or technical eligibility requirements for the program;
B. a recipient of Supplemental Security Income (SSI). The exclusion applies as of the month the individual starts to receive SSI checks;
C. a State Supplement recipient;
D. a parent, other than the caretaker relative, who is under sentence of the court serving the sentence doing unpaid work or community service and living at home;
E. a child for whom federal, state or local foster care maintenance payments are made;
F. a child whose minor parent is a recipient of federal, state or local foster care maintenance payments;
G. a child for whom adoption assistance payments are made when the exclusion does not reduce the benefits of the assistance unit in which the child would otherwise be considered a member;
H. a dependent child who returns home for a visit of fewer than 30 consecutive days from an institution which has primary responsibility for the care of the child. These institutions include, but are not limited to, state hospitals, training schools for the mentally retarded, juvenile correctional institutions and foster homes;
I. an individual who was a member of an assistance unit when it received a lump sum which made the unit ineligible for a specified period of time. The individual members of such a unit are excluded from any assistance unit for the prescribed period of ineligibility;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-92 Transmittal: UP-92-29 2005.20 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC Assistance Unit Requirements AFDC _______________________________________________________________ Subject: Who Is Excluded ______________________________________________________________________________
2005.20 J. an individual disqualified from the program for any reason, including but not limited to:
1. failure to cooperate with IV-D support requirements;
2. failure to cooperate with work requirements;
3. transferring an asset for the purpose of qualifying for assistance. The individual is excluded from any assistance unit for the prescribed period of ineligibility;
4. failing to comply with or violating any procedural eligibility requirement;
5. delaying or failing to report the presence in the home of a mandatory assistance unit member. This individual is excluded from the assistance unit from the date the individual would have been added until the effective date he or she is made part of the unit;
6. committing an intentional recipient error in the AFDC program. (Cross-Reference: 7050.30)
K. [Reserved]
L. a sponsored non-citizen whose income or assets exceed the program limits.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _______________________________________________________________________________ Date: 9-1-90 Transmittal: UP-90-23 P-2005.20 _______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES _______________________________________________________________________________ Chapter: Program: AFDC AFDC Procedures _______________________________________________________________ Subject: Creating the Assistance Unit in a Three Generation Household ______________________________________________________________________________
P-2005.20 Determining Who Is Caretaker Relative
1. Determine whether the minor parent meets the age and deprivation factors as a dependent child. In making this determination consider:
° the age of the minor parent;
° if the minor parent qualifies under any deprivation factor for a dependent child.
2. If the minor parent is a dependent child and he or she has any siblings living in the home who receive AFDC as dependent children, consider the grandparent to be the caretaker relative.
3. If the minor parent is not a dependent child or is a dependent child who has no siblings in the home receiving AFDC as dependent children, consider any of the following to be indications that the minor parent is the caretaker relative:
° the grandparent no longer provides care or supervision of the minor parent;
° the minor parent has had an independent living arrangement involving care of the child;
° the minor parent has had unusual responsibilities in the home due to a parent's disability or drug or alcohol abuse.
Minor Parent Is Caretaker Relative
If you determine that the minor parent is the caretaker relative:
1. add the siblings of the grandchild, following the basic steps in P‑2005.05;
2. add the minor parent as an adult.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _______________________________________________________________________________ Date: 9-1-90 Transmittal: UP-90-23 P-2005.20 page 2 _______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC AFDC Procedures _______________________________________________________________ Subject: Creating the Assistance Unit in a Three Generation Household ______________________________________________________________________________
P‑2005.20 Grandparent Is Caretaker Relative
If you determine that the grandparent is functioning as the caretaker relative:
1. add the sibling of the grandchild, following the basic steps in P‑2005.05;
2. add as a dependent child the minor parent who meets the categorical eligibility requirements of a dependent child;
3. add as an adult the minor parent who does not meet the categorical eligibility requirements of a dependent child.
4. add the grandchild's other parent, if in the home, following the basic steps in P‑2005.05;
5. if the minor parent is added as a dependent child:
° follow the basic steps in P‑2005.05;
° add the minor parent's siblings;
° add the minor parent's parents (the grandparents);
6. if the minor parent is added as an adult, do not add the minor parent's siblings unless assistance is also requested for at least one of them;
7. if assistance is requested for one sibling add all of them;
8. if the minor parent is added as an adult, add the grandparent caretaker relative only:
° if needy and requesting assistance; or
° if one of the minor parent's siblings is added;
9. do not add the caretaker relative/grandparent's spouse unless:
° the spouse or the caretaker grandparent is incapacitated or unemployed; and
° one of the minor parent's siblings was added or the minor parent is a dependent child; and
° the spouse is the siblings parent.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2005.25 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Assistance Unit Requirements AFDC _______________________________________________________________ Subject: The Assistance Unit of One ______________________________________________________________________________
2005.25 Some individuals, who meet all of the other eligibility requirements, are assistance units of one. They include the following:
A. the caretaker relative when the only dependent child receives Supplemental Security Income (SSI);
B. a dependent child who meets both of the following conditions:
1. the caretaker relative with whom the child lives is either:
a. an ineligible non-parent; or
b. an excluded parent; and
2. none of the following are in the home:
a. an eligible brother or sister;
b. a non-sibling who is included in the assistance unit;
C. a pregnant female with no other children receiving assistance, who is not receiving assistance as a dependent child in her parent's home.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-2005.25 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Procedures AFDC _______________________________________________________________ Subject: Adding Mandatory Inclusions ______________________________________________________________________________
P-2005.25 1. When a family member who is required to be a member of the assistance unit comes into the home:
° redetermine eligibility retroactive to the date the individual became a mandatory inclusion;
° discontinue assistance if inclusion of the additional member results in ineligibility of the unit;
° refer any overpayment for collection;
° pay any underpayment from the date all procedural eligibility requirements, such as enumeration and work requirements, are met.
2. If the new member does not cooperate with procedural eligibility requirements:
° redetermine eligibility of the unit using total income and assets; and
° exclude the budgeted needs of the new member.
3. If the new member does not cooperate in providing income and asset information, discontinue the case.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2005.30 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC Assistance Unit Requirements _______________________________________________________________ Subject: Penalty for Noncooperation ______________________________________________________________________________
2005.30 The nature of the penalty for noncooperation with assistance unit requirements depends on the type of noncooperation and whether the individual concerned is a mandatory or non-mandatory member of the assistance unit.
A. If information is not provided about every mandatory assistance unit member sufficient to enable the Department to accurately compute income and asset eligibility, the entire assistance unit is ineligible.
B. When sufficient information about the income and assets of a non-mandatory member of the assistance unit is not provided, only that specific individual is ineligible.
C. When a categorical, technical or procedural requirement is not met, only the specific individual who is a mandatory or non-mandatory member is ineligible for benefits.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-2005.30 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Procedures AFDC _______________________________________________________________ Subject: Living in the Same Household ______________________________________________________________________________
P-2005.30 1. When an individual who is mandatory in the assistance unit claims to be living in the same building separately from the household applying for or receiving assistance, investigate the circumstances.
2. Accept as evidence of a separate household:
° a landlord's receipts for rent for two rental units; or
° two separate post office street addresses; or
° a lease showing two units; or
° separate utility bills for each unit.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-22-93 Transmittal: UP-93-42 2005.35 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC AFDC Assistance Unit Requirements __________________________________________________________ Subject: Three Generation Household ______________________________________________________________________________
2005.35 A. General Principles
In a three generation household there may be one or two separate assistance units depending on which members are requesting assistance and which members of the middle generation qualify as dependent children by meeting the age and deprivation requirements due to death, absence, incapacity, or unemployment (Cross Reference 2525.10 and 2510).
B. Determining Assistance Unit Members
In determining which members of a three generation household are mandatory inclusions in the AFDC assistance unit, the following apply:
1. The primary member of the assistance unit is the dependent child or children for whom assistance is requested or received.
2. All of the mandatory inclusions and exclusions requirements apply to households consisting of three generations (Cross Reference 2005.10 and 2005.20).
3. Individuals must meet all of the other categorical, technical and procedural eligibility factors in order to be included in the assistance unit.
4. A household cannot contain two assistance units if any individual is a mandatory inclusion in both assistance units.
C. Treatment of the Grandparent
When the middle generation parent applies for assistance for his or her child, the following rules apply:
1. The grandparent is excluded from the assistance unit when:
a. neither the middle generation parent nor his or her siblings are dependent children; and
b. the grandparent is not the caretaker relative of his or her grandchild; and
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 11-22-93 Transmittal: UP-93-42 2005.35 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC AFDC Assistance Unit Requirements __________________________________________________________ Subject: Three Generation Household ______________________________________________________________________________
2005.35 C. Treatment of the Grandparent (continued)
c. the grandparent is not requesting or receiving assistance for the middle generation parent or for children who are:
(1) siblings of the middle generation parent; and
(2) qualify as dependent children.
2. The grandparent is included in the assistance unit as an optional inclusion when:
a. the middle generation parent is included as an adult; and
b. the grandparent is determined to be a needy caretaker relative of the middle generation parent's child.
3. The grandparent is included in the assistance unit as a mandatory inclusion when:
a. the middle generation parent is a dependent child; and
b. the grandparent requests or receives assistance for the middle generation parent or for children who are:
(1) siblings of the middle generation parent; and
(2) qualify as dependent children.
4. The grandparent, along with all other family members for whom AFDC is requested or received, is included in a unit separate from the middle generation parent and his or her child when:
a. the middle generation parent is not a dependent child; and
b. the grandparent is not the caretaker relative of the middle generation parent's child.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 8-1-89 Transmittal: UP-89-26 2010 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: FMA Family Medical Assistance Unit Requirements Subject: ______________________________________________________________________________
2010 The assistance unit requirements for the Family Medical Assistance program are based on various criteria. Some of the requirements are the same as those for the AFDC assistance unit. There are some differences, however.
This chapter describes under separate headings:
° determining the unit;
° the assistance unit of one;
° the assistance unit of two or more;
° special guidelines for certain Medicaid groups.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 02-13-01 Transmittal: UP-01-04 2010.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: FMA Family Medical Assistance Unit Requirements ____________________________________________________________ Subject: General Principles ______________________________________________________________________________
2010.05 A. Individuals for whom assistance is not requested are not mandatory inclusions in the assistance units.
B. Except as described below, AFDC assistance unit composition rules apply to all eligible individuals for whom FMA is requested (cross‑reference: 2005).
1. Certain FMA assistance units are divided into sub‑units in order to avoid inappropriate deeming, as described in this chapter (cross‑reference: 2010.20).
2. Individuals may request assistance in the coverage group of their choice, including, but not limited to:
a. aged, blind or disabled individuals who have the option of being included in the FMA unit or choosing an aged, blind or disabled coverage group; (cross‑reference: 5020.34)
b. pregnant women who have the option of being included in the FMA unit or choosing a pregnant woman coverage group;
c. newborns and infants under the age of one who may be included in the FMA unit with other siblings or may apply for and receive FMA under the newborn or 185% of poverty coverage groups;
d. children aged one through five years inclusive who may be included in the FMA unit with other siblings or may apply for and receive FMA under the 185% of poverty coverage group for children between one and six;
e. children who may be included in the FMA unit with other siblings or may apply for and receive FMA under the 185% of federal poverty level coverage group for children whose birthdays are after September 30, 1983, who have attained the age of six, and who have not reached the age of nineteen.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 6-1-89 Transmittal: UP-89-49 P-2010.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: FMA Family Medical Assistance Units ____________________________________________________________ Subject: Determining the FMA Unit ______________________________________________________________________________
P-2010.05 1. Note that no one is required to apply for or receive FMA who does not want it.
2. Explain to the applicant or recipient the option of requesting or not requesting FMA assistance for each family member.
3. Include all eligible parents and siblings who are requesting FMA assistance and are living together in the same assistance unit, except for those individuals who apply for or receive MA under another coverage group.
4. Allow any aged, blind or disabled individual to apply for MAABD. Check the rules on deeming to see if you must count the individual's income and assets.
5. Include in the unit those who do not meet the age requirement for AFDC but do meet the age requirement for FMA.
6. Remember that children receiving SSI, although excluded for AFDC, are eligible for FMA as units of one.
7. If the unit is ineligible due to deemed income from an individual outside the assistance unit who is neither a parent nor a spouse of at least one unit member, divide the original unit into sub-units (see P-2010.10).
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 6-1-92 Transmittal: UP-92-16 2010.10 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: FMA Family Medical Assistance Unit Requirements ___________________________________________________________________ Subject: The Assistance Unit of One
2010.10 A. Some individuals, who meet all of the other eligibility requirements, are FMA assistance units of one. They include the following:
1. a child who is the only individual in a household for whom assistance is requested;
2. a child whose residence is an institution which has primary responsibility for care of the child;
3. the caretaker relative when the only dependent child receives Supplemental Security Income (SSI);
4. the dependent child with no eligible brothers or sisters in the home living with:
a. an ineligible non-parent caretaker relative; or
b. an excluded caretaker relative;
5. a dependent child who is a recipient of SSI based on disability;
6. a dependent child who receives federal, state, or local foster care payments;
7. a dependent child who receives adoption assistance when the child is not included in the AFDC assistance unit;
8. a non-parent caretaker relative (NPCR) who is not eligible as part of the AFDC assistance unit due to excess income. (Cross References: 2540.68, 5020.20)
B. Other individuals have the option of being assistance units of one or receiving assistance as members of larger eligible related units in the household. They include the following:
1. a dependent child who is not a sibling, such as a niece, nephew or grandchild of an AFDC caretaker relative;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-92-16 2010.10 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: FMA Family Medical Assistance Unit Requirements ____________________________________________________________ Subject: The Assistance Unit of One ______________________________________________________________________________
2010.10 B. (continued)
2. a pregnant female who:
a. has no children of her own receiving assistance ; and
b. does not qualify as a dependent child; and
c. lives with other related eligible dependent children.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 6-1-89 Transmittal: UP-89-49 P-2010.10 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Family Medical Assistance Unit FMA _______________________________________________________________ Subject: Dividing the Assistance Unit into Sub-units ______________________________________________________________________________
P-2010.10 1. Calculate deemed income using the appropriate AFDC/FMA methodology.
2. If the assistance unit is income eligible, grant or continue assistance.
3. If deemed income causes a spenddown, check to see if there are any members of the assistance unit who are not the spouse or child of the deemor. If not, stop here.
4. If there are any members of the assistance unit who are neither a spouse nor a child of the deemor, split the original assistance unit into sub-units.
5. Create an assistance sub-unit of all members who are related to the deemor as a spouse or child.
6. Create the other sub-unit to comprise all of the remaining members of the original unit.
7. Remember, all members of the original assistance unit are members of the needs group for each sub-unit and all their income, except that income deemed to them, must be counted. (cross-reference: 5020, 5515)
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-91 Transmittal: UP-91-30 2010.15 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: FMA Family Medical Assistance Unit ____________________________________________________________ Subject: The Assistance Unit of Two or More ______________________________________________________________________________
2010.15 A. Some individuals who apply for or receive FMA shall be combined with others into one assistance unit, except as described in 2010.20. This applies to two or more eligible individuals living together, provided:
1. assistance is requested for each individual; and
2. they are related as follows:
a. brothers and sisters under age twenty‑one (21), including half‑siblings and adoptive siblings and their parent or parents;
b. spouses, when both of them are under age twenty‑one (21); and
3. they do not apply for or receive MA separately in another coverage group.
B. Those individuals who qualify for MA in another coverage group and have the option of being included in the FMA unit or choosing another coverage group include, but are not limited to:
1. aged, blind or disabled individuals;
2. pregnant women;
3. infants and newborns;
4. children between the ages of one and six;
5. children whose birthdays are after September 30, 1983, who have reached the age of six, and who have not reached the age of nineteen.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-94 Transmittal: UP-94-22 2010.20 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: FMA Family Medical Assistance Unit Requirements ___________________________________________________________ Subject: Special Guidelines for Certain Medicaid Groups ______________________________________________________________________________
2010.20 A. When a member of an assistance unit under certain Medicaid coverage groups is ineligible due to income deemed from a person outside the assistance unit who is neither a parent nor a spouse of the unit member, the assistance unit is separated into sub‑units. These coverage groups include the following:
1. Eligible for AFDC except for Non‑Medicaid Requirements;
2. Medically Needy Ribicoff Children;
3. Medically Needy Caretaker Relatives;
4. Children Under 185% of the Poverty Level (under age one);
5. Children Under 185% of the Poverty Level (between ages one and six);
6. Children Under 185% of the Federal Poverty Level (age six or older born after 9/30/83).
B. The original assistance unit is separated into sub‑units so that no member of the sub‑unit has income deemed to him or her from any person outside the assistance unit who is neither a spouse nor a parent.
C. Assistance units which are subdivided if inappropriate deeming causes ineligibility include, but are not limited to, those units containing:
1. children who reside with their parent and stepparent;
2. children who reside with their minor parent and grandparent;
3. non-citizens with sponsors who reside with other individuals who are not sponsored non-citizens.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2015 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AABD AABD and MAABD Assistance Unit MAABD _______________________________________________________________ Subject:
______________________________________________________________________________
2015 This chapter describes the assistance unit requirements for the State Supplement program for the Aged, Blind and Disabled. Provisions for the related Medical Assistance programs are also included.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2015.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AABD AABD and MAABD Assistance Unit MAABD _______________________________________________________________ Subject: Basic Requirements ______________________________________________________________________________
2015.05 A. The assistance unit in AABD and MAABD consists of only one member. In these programs, each individual is a separate assistance unit.
B. An eligible spouse in the home applies for and receives assistance as a separate assistance unit.
C. Any other member of the household who meets the eligibility requirements for the program is also a separate assistance unit of one.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-2015.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: AABD AABD and MAABD Assistance Unit MAABD _______________________________________________________________ Subject: Determining AABD and MAABD Requirements ______________________________________________________________________________
P-2015.05 1. Include in the assistance unit only the one individual who requests assistance.
2. Refer to Treatment of Income 5500 and Treatment of Asset 4000 for the method of deeming income and counting assets of a spouse in determining eligibility.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2020 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Food Stamp Assistance Unit Requirements FS _______________________________________________________________ Subject:
______________________________________________________________________________
2020 This chapter describes how the composition of a Food Stamp assistance unit is determined. Included as separate subjects are:
° which household members must be included in the same assistance unit;
° who may apply as a separate unit;
° who has the option of being a member of the assistance unit;
° assistance units in institutions;
° who is excluded.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2020.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Food Stamp Assistance Unit Requirements FS _______________________________________________________________ Subject: General Requirements ______________________________________________________________________________
2020.05 A. A group of individuals living together, buying food, preparing meals for home consumption and eating together are, as a general rule, a Food Stamp assistance unit.
B. Individuals do not need to be related to each other in order to be in the same Food Stamp assistance unit.
C. Certain closely related family members must be included in the same assistance unit unless they meet the special conditions applicable only to certain elderly or disabled individuals.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 8-1-95 Transmittal: UP-95-21 P-2020.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Food Stamp Procedures FS _______________________________________________________________ Subject: Determining the Basic Food Stamp Unit ______________________________________________________________________________
P-2020.05 1. Start with the individuals for whom Food Stamps are requested.
2. Question if there are others living in the household.
3. Consider all of the individuals who live in the same household as potential members of one assistance unit.
4. Disregard any individuals who are specifically excluded according to policy.
5. Consider anyone age 60 or over according to the procedures at P-2020.10.
6. Ask how other individuals in the household who are not listed on the application buy and prepare meals.
7. Disregard individuals who buy and prepare meals separately when they can be a separate unit according to policy.
Add to the unit all individuals who must be included according to policy.
9. Add to the unit all individuals who buy and prepare meals together.
10. Add to the unit those who present themselves as spouses, but are not married. This includes those sometimes referred to as common-law spouses, and unmarried parents of children.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-2005 Transmittal: UP-05-12 2020.10 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Food Stamp Assistance Unit Requirements FS _______________________________________________________________ Subject: Who Must Be Included ______________________________________________________________________________
2020.10 The assistance unit must include certain individuals who are in the home, if they are not specifically excluded or ineligible to participate in the Food Stamp program.
A. Those who are related as follows must be included in the assistance unit, except when the child or adult is a foster child or foster adult:
1. a child under age 18 under the parental control of a member of the assistance unit;
2. a spouse of a member of the assistance unit including any who presents himself or herself as a spouse;
3. children ages 18 through 21 living with their parents.
B. All others who buy food and prepare meals together for home consumption must be included in the assistance unit except those adults who are under the foster care of a unit member.
C. A boarder who pays less than the equivalent of the Thrifty Food Plan for meals for the boarder group must be included in the assistance unit. The Thrifty Food Plan amounts are determined by the USDA and are revised annually.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date:10-1-11 Transmittal: UP-11-09 P-2020.10 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Supplemental Nutrition Assistance Program Procedures SNAP _______________________________________________________________ Subject: Determining Separate Units ______________________________________________________________________________
P-2020.10 1. Grant assistance as a separate unit to an individual who has the separate assistance unit option according to policy when the individual states he or she buys and prepares meals separately from any other individuals who live with him or her.
2. To determine separate status of an individual age 60 or over who does not buy and prepare food separately from other individuals who live with them:
° accept SSI or OASDI disability findings;
° judge from observation and discussion the permanent inability of the individual to buy and prepare food.
3. When an individual meets the requirements for separate status in #2, treat the individual's spouse as follows:
° include the spouse in the separate unit;
° disregard the spouse's ability to buy and prepare meals;
apply the spouse's income only in a determination of the eligibility of the separate unit, not in the 165% test.
The following table reflects the gross monthly income limits based on 165% of the SNAP Applied Income Limit for determining separate household status for elderly people who do not buy and prepare food separately from those they with whom they live because they are incapable of doing so due to disability:
The following table reflects the gross monthly income limits based on 165% of the SNAP Applied Income Limit:
Household Size 165% SNAP Applied Income Limit
1 $1,498 2 $2,023 3 $2,548 4 $3,074 5 $3,599 6 $4,124 7 $4,649 8 $5,175 Each additional member $526
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-2005 Transmittal: UP-05-12 2020.15 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Food Stamp Assistance Unit Requirements FS _______________________________________________________________ Subject: Who May Be a Separate Unit ______________________________________________________________________________
2020.15 Certain types of individuals may choose to be included in the same assistance unit with others, or may choose to be considered a separate assistance unit. The following types of individuals have the separate assistance unit option:
A. Individuals residing with others who are not their spouses, children, parents or siblings, and who buy food and prepare meals separately.
B. Adult children living with their parents if they purchase and prepare food separately.
C. Adult siblings who live together if they prepare and purchase food separately.
D. An individual who is elderly and disabled, and spouse if any, who does not buy and prepare food separately from others in the household, provided either spouse meets “all” of the following conditions:
1. 60 years of age or older in the month of application; and
2. Incapable of preparing meals and buying food because of a disability considered permanent under Social Security Administration or Supplemental Security Income or a non-disease related severe permanent disability; and
3. Living with others, the total of whose gross income does not exceed 165% of the Food Stamp Applied Income Limit (FSAIL). The FSAIL is 100% of the federal poverty level and is revised annually by USDA effective October 1 of every year. The income of the individual and the individual's spouse is not counted in this test.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 P-2020.15 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: Food Stamp Procedures FS _______________________________________________________________ Subject: Assistance Units in Institutions ______________________________________________________________________________
P-2020.15 1. When an individual in an institution applies, make sure the institution has met the certification requirements of FNS.
2. Request the assistance of Eligibility Services in Central Office if certification information is not available in the district office.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 5-1-89 Transmittal: UP-89-15 2020.20 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Food Stamp Assistance Unit Requirements FS _______________________________________________________________ Subject: Optional Members of the Assistance Unit ______________________________________________________________________________
2020.20 Certain individuals living in a household are included in the assistance unit under specific conditions. In this category are the following:
A. boarders paying the equivalent of the Thrifty Food Plan when the other eligible members of the assistance unit request their inclusion;
B. disabled or blind individuals receiving SSI or Social Security Disability payments who live in group living arrangements, when the group determines they should participate together as one unit. This determination is based on the individuals' physical and mental ability to handle their own affairs. These homes must be certified by FNS and have no more than 16 residents;
C. a foster child of any age or a foster adult when the other eligible members of the assistance unit request his or her inclusion.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 4-1-06 Transmittal: UP-06-16 2020.25 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Food Stamp Assistance Unit Requirements FS _______________________________________________________________ Subject: Assistance Units in Institutions ______________________________________________________________________________
2020.25 Residents of the following institutions (Cross Reference: 3015.15) are eligible to apply for or receive Food Stamps as individual assistance units apart from others in the institution:
A. federally subsidized housing for the elderly, built under either section 202 of the Housing Act of 1959 or Section 236 of the National Housing Act;
B. drug or alcohol treatment centers which:
1. are authorized by FNS as retailers; or
2. are eligible for funding under part B of Title XIX of the Public Health Act;
C. group living arrangements that have no more than sixteen residents and are certified by FNS provided the individual who is applying for Food Stamps:
1. is physically and mentally capable of handling his or her own affairs; and
2. is not included in an assistance unit with other residents in that group, and
3. meets one of the following criteria:
a. is disabled or blind and is receiving SSI or Social Security; or
b. is a veteran who has a disability rated as total under title 38, United States Code or who is considered in need of regular aid and attendance or permanently housebound under such title; or
c. is a surviving spouse of a veteran and is considered in need of regular aid and attendance or is permanently housebound under title 38, United States Code, or is entitled to compensation for a service-connected death, or to pension benefits for a non-service-connected death under title 38, United States Code, and who has a disability considered permanent under section 221(i) of the Social Security Act; or
d. is an offspring of a veteran and is considered permanently incapable of self-support under section 414 of title 38, United States Code, or is entitled to compensation for a service-connected death or to pension benefits for a non-service-connected death under title 38, United States Code, and has a disability considered permanent under section 221(i) of the Social Security Act; or
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-06 Transmittal: UP-06-16 2020.25 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Food Stamp Assistance Unit Requirements FS _______________________________________________________________ Subject: Assistance Units in Institutions ______________________________________________________________________________
2020.25 C. (continued)
e. is receiving an annuity under section 2(a)(1)(iv) or 2(a)(1)(v) of the Railroad Retirement Act of 1974, if the individual's service as an employee under the Railroad Retirement Act of 1974, after December 31, 1936, had been included in the term "employment" as defined in the Social Security Act and has made application for disability benefits; or
f. is a blind or disabled foster adult for whom federal, state or local foster care payments are made.
D. shelters for battered women which:
1. are certified by the Department as nonprofit organizations; and
2. serve meals or provide food; and
3. reserve space exclusively for battered women and their children;
E. shelters for the homeless.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-94 Transmittal: UP-94-5 2020.30 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: Food Stamp Assistance Unit Requirements FS _______________________________________________________________ Subject: Who is Excluded from the Assistance Unit ______________________________________________________________________________
2020.30 Certain individuals who are in the home are excluded from participating in the Food Stamp Program as members of the assistance unit. The following are excluded:
A. a roomer, who may, however, qualify as a separate assistance unit;
B. boarders who pay the equivalent of the Thrifty Food Plan to a household that does not request that they be included. Except for children and adults who receive federal, state, or local foster care payments, the following individuals are not considered boarders:
1. parents living with their children;
2. children living with their parents;
3. siblings;
4. spouses;
5. children under age 18 under parental control of a member of the household;
C. residents of institutions which provide at least 50% of three meals per day, except those listed in 2020.25;
D. residents of commercial boarding homes;
E. live-in attendants, who reside with a household to provide medical, housekeeping, child care or other similar personal services;
F. an individual disqualified from the program for either of the following reasons:
1. failure to meet the enumeration requirements; or
2. an intentional program violation;
G. ineligible students;
H. ineligible non-citizens;
I. other individuals who do not meet the eligibility requirements for the program.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2099 ______________________________________________________________________________ Section: Type: Assistance unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification Requirements AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
2099 This chapter contains the policy and procedures for verification pertaining to assistance unit composition. The policy discusses what factors must be verified; the procedures specify what type of verification is acceptable.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-87 Transmittal: UP-87-1 2099.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition POLICY ______________________________________________________________________________ Chapter: Program: AFDC Verification Requirements AABD _______________________________________________________________ MA Subject: FS Basic Requirements ______________________________________________________________________________
2099.05 A. AFDC, AABD, MA
All of the factors involved in determining the assistance unit for AFDC, AABD and MA are verified by meeting other eligibility criteria for these programs.
B. FS Verification Requirements
1. Verification is required when individuals request Food Stamps as a separate assistance unit from others in the household.
a. Factors which must be verified if they are the basis for separate unit status are:
(1) age, when questionable;
(2) pension benefits;
(3) disability benefits;
(4) disability.
b. The gross income of others in the household must be verified when separate assistance unit status is requested in accordance with 2020.10 C.
2. Boarders must verify the amount of board they pay.
3. Before determining the eligibility of a resident of an institution, the Department must verify that the institution in which the individual lives qualifies for Food Stamp recipients.
4. A resident in a qualified group living arrangement must verify the receipt of SSI or SSA for the disabled or blind.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-92 Transmittal: UP-92-14 P-2099.05 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Verification Requirements AABD _______________________________________________________________ MA Subject: FS Acceptable Verification ______________________________________________________________________________
P-2099.05 Age
Accept as verification of age:
° any document showing date of birth or age, such as a drivers license or birth certificate;
° receipt of any assistance program for which one must be at lease 60 years old;
° record of age in the SDX, Bendex, or CLEM systems.
Disability
1. Accept as verification of disability for separate unit status:
° Social Security notices for OASDI and SSI:
° record of benefit entitlement based on disability in the SDX or Bendex;
° receipt of State Supplement or Medicaid on the basis of disability;
° Railroad Retirement documents when accompanied by documentation of Medicare;
° Veterans benefits notices when they contain statements that they establish the FS criteria.
2. Accept as verification of disability for eligibility as institutionalized person:
° Statements from the Veterans' Administration that illustrate that the criteria described in policy for Food Stamps have been met;
° Statements from the Social Security Administration that illustrate that the criteria described in policy for Food Stamps have been met.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 9-1-95 Transmittal: UP-95-21 P-2099.05 page 2 ______________________________________________________________________________ Section: Type: Assistance Unit Composition PROCEDURES ______________________________________________________________________________ Chapter: Program: AFDC Verification Requirements AABD _______________________________________________________________ MA Subject: FS Acceptable Verification ______________________________________________________________________________
P-2099.05 Income
Accept as verification of income:
° wage stubs;
° written statement from employer;
° telephone contact with employer.
Boarder Income
Accept as verification of boarder income:
° a written statement from the boarder attesting to the amount paid;
° a receipt for the amount paid.
Separate Assistance Unit Status
Accept as verification that an individual who lives with others and has the option to be a separate assistance unit buys and prepares meals separately:
° the individual's verbal statement; or
° a written statement signed by the individual.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2500 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS
______________________________________________________________________________
2500 In order to qualify for the AFDC, State Supplement and Medicaid programs, the assistance unit must meet certain categorical eligibility requirements.
This section is organized according to type of categorical eligibility requirement. Each requirement is a separate chapter. Program differences with respect to the categorical requirement are described within that chapter. The chapter relative to Medicaid Coverage Groups addresses the mandatory and optional groups of individuals to whom Medicaid is provided. The provisions of Food Stamp categorical eligibility are also described in this section.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-98 Transmittal: UP-98-17 2500.01 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
2500.01 Applied Income
Applied income is that portion of the assistance unit's countable income that remains after all deductions and disregards are subtracted.
Calendar Quarter
Calendar quarter is a period of three consecutive calendar months ending March 31, June 30, September 30 or December 31.
Categorical Eligibility Requirement
Categorical eligibility requirement is a program characteristic which effectively sets one program apart from another and which must be met by the individual or group in order to qualify for such program.
Continuous Eligibility (CE)
Continuous Eligibility (CE) refers to a fixed period of twelve (12) consecutive months during which individuals under 19 years of age remain eligible for Medicaid in spite of a change in certain circumstances that would have caused the person to lose Medicaid eligibility.
Dependent Child
A dependent child is a child who is deprived of parental support or care by reason of the death, continued absence from the home, physical or mental incapacity or unemployment of a parent.
Deprivation of Parental Support or Care
Deprivation of parental support or care is the state of being without financial support or day-to-day care and guidance from one parent because that parent died, is continually absent from the home, is incapacitated or is unemployed.
Guaranteed Eligibility (GE)
Guaranteed Eligibility (GE) refers to a fixed period of six (6) consecutive months, starting with the effective date of initial enrollment into Managed Care, during which an individual remains eligible for Managed Care services in spite of a change in certain circumstances that would have caused the person to lose eligibility for Managed Care services.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-98 Transmittal: UP-98-17 2500.01 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
2500.01 Joint Custody
Joint custody is the awarding of legal custody of a child by the Court to both parents subsequent to separation or divorce. Joint custody provides for joint decision making by both parents but does not provide for joint physical custody in all cases.
Joint Physical Custody
Joint physical custody is the awarding of legal custody of a child by the court to both parents subsequent to separation or divorce and provides that the child reside with each parent in such a manner as to assure the child of continuing physical contact with each parent.
Parent
Parent is a mother or father, natural or adoptive.
Principal Wage Earner
Principal wage earner is whichever parent, in a two parent family, earned the greater amount of income in the 24-month period the last month of which immediately precedes the month in which application is made.
1619(a) Status
1619(a) Status is a term used by the Social Security Administration to describe an individual who is determined eligible for SSI on the basis of a disability, and retains SSI eligibility despite performing substantial gainful activity.
1619(b) Status
1619(b) Status is a term used by the Social Security Administration to describe an individual who is under age 65, is determined eligible for SSI on the basis of blindness or disability, and subsequently becomes ineligible for SSI because of income.
Substantial Gainful Activity
Substantial gainful activity means significant and productive physical or mental duties performed for pay or profit regularly and on a predictable basis.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-98 Transmittal: UP-98-17 2500.01 page 3 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC AABD _______________________________________________________________ MA Subject: FS Definitions ______________________________________________________________________________
2500.01 Third Trimester of Pregnancy
The third trimester of pregnancy is a period of time beginning with the first day of the third calendar month prior to the expected month of delivery and ending upon the date of actual delivery.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89-40 2505 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Eligible Child AFDC _______________________________________________________________ Subject:
______________________________________________________________________________
2505 A. An eligible child is one who meets all the categorical, technical and procedural requirements of the AFDC program.
B. The AFDC assistance unit must have an eligible child. If the assistance unit does not have an eligible child, there is no eligibility for the child or the caretaker relative.
C. The following children who would otherwise qualify for AFDC are considered to be eligible children for the purposes of this categorical eligibility requirement:
1. a child receiving SSI benefits;
2. a child ineligible solely for failure to comply with employment and training requirements.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-89 Transmittal: UP-89040 P-2505.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Eligible Child AFDC _______________________________________________________________ Subject: Determining if There Is An Eligible Child in the Home ______________________________________________________________________________
P-2505.05 1. Check to see if at least one child in the home meets all of the categorical, technical and procedural requirements, or who receives SSI.
2. Remember, if the only child in the home is ineligible solely because he or she does not meet employment and training requirements, the caretaker relative remains eligible.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject:
______________________________________________________________________________
2510 This chapter describes in separate subjects the following deprivation factors:
° Death of a Parent;
° Absence of a Parent;
° Physical or Mental Incapacity of a Parent;
° Unemployment of a Parent.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: General Provisions ______________________________________________________________________________
2510.05 A. In order to qualify for AFDC, a child must meet the categorical eligibility requirement of deprivation of parental support or care.
B. For the purposes of meeting this requirement, a child may be deprived of support or care by:
1. the death of a parent or parents; or
2. the absence of a parent; or
3. the physical or mental incapacity of a parent; or
4. the unemployment of a parent.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprication of Support or Care AFDC _______________________________________________________________ Subject: Determining the Deprivation Factor ______________________________________________________________________________
P-2510.05 1. Based on the circumstances of the assistance unit, determine which factor or factors of deprivation might apply to the assistance unit.
2. Determine the deprivation factor for each child separately.
3. If more than one factor of deprivation might apply to the assistance unit, consider both factors concurrently, such as in cases in which the factors of incapacity and unemployment might both be present.
4. Follow the procedures which apply to the particular factor of deprivation you are trying to establish.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510.10 ______________________________________________________________________________ Section: Type: Categorical eligibility Requirements POLICY Chapter: Program: Deprivation of Parental Support or Care AFDC Subject: Death of the Parent
2510.10 A. Deprivation of parental support or care exists when one or both parents of the child is deceased.
B. If it is determined that deprivation exists due to the death of a parent, deprivation is considered to exist from the date of death.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.10 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Making Presumptions About Absence ______________________________________________________________________________
P-2510.10 1. When a parent is absent from the home, consider the circumstances of such absence to see if a presumption can be made as to whether deprivation due to absence of the parent does or does not exist.
2. Decide, from the information gathered, whether the circumstances of the absence makes it likely or unlikely that the parent is functioning in the parental role.
3. After making your presumption regarding deprivation due to absence, you receive evidence which appears to contradict your presumption, refer to the procedures for resolving questionable information.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510.15 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Absence of the Parent ______________________________________________________________________________
2510.15 A. Deprivation due to the absence of the parent from the home exists when:
1. the parent is not living with the child; and
2. the absence significantly interrupts or terminates the parent's day-to-day functioning as a provider of financial support or physical care and guidance of the child; and
3. the duration of the absence makes it impossible to count on the parent to plan for the present support or care of the child; or
4. the parent is living with the child, but has been convicted of an offense and is serving a court-imposed sentence which permits the parent to live at home while serving the sentence by:
a. performing unpaid public work during the day; or
b. performing unpaid community service.
B. Deprivation due to the absence of the parent from the home does not exist when:
1. both parents are living with the child; or
2. the parent is living separately from the child but the parent's absence from the home does not significantly interrupt the performance of the parent as a provider of day-to-day maintenance, physical care and guidance of the child; or
3. the parent is absent solely due to active duty with the uniform service of the United States.
C. If deprivation is determined to exist, it is considered to exist from the date the parent's absence began.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 P-2510.15 ______________________________________________________________________________ Section: Type: Categoricla Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Considering Circumstances Which Tend to Support the Presumption that Deprivation Exists ______________________________________________________________________________
P-2510.15 1. Think about the following circumstances as tending to support the presumption that deprivation due to absence exists:
° the parents of the needy child are divorced or legally separated and the caretaker relative has sole custody of the child;
° at least one parent deserts, abandons or otherwise voluntarily leaves the family and neglects or refuses to provide support and care to the child;
° the absent parent is incarcerated or confined in:
° a penal or correctional institution;
° a state institution for mental illness;
° a hospital for chronic diseases including tuberculosis;
° a long term care facility.
2. Decide, based on the information provided, if the circumstances tend to back the supposition that deprivation due to absence of the parent exists.
3. If the actual conditions do not uphold the presumption, take a look at the procedures for refuting the above.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-91 Transmittal: UP-91-20 2510.20 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Deprivation of Parental Support or Care _______________________________________________________________ Subject: Determination of the Parent ______________________________________________________________________________
2510.20 A. Determination of the Male Parent
The Department considers a male to be the father of a child if:
1. legal marriage existed between him and the natural mother of the child at the time of the child's birth and this fact is not contested by the natural mother; or
2. he has legally adopted the child; or
3. he has been adjudged to be the father by the court; or
4. he has signed a statement recognizing that he is the natural father of the child. This statement need not be notarized or witnessed; or
5. he is listed as the father on the child's Connecticut birth certificate; or
6. there is a preponderance of evidence that he is the father. (Cross Reference: 2599)
B. Determination of Female Parent
The Department considers the female to be the mother of the child if:
1. she has legally adopted the child; or
2. her name is on the child's birth certificate.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.20 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Considering Circumstances Which Tend to Support the Presumption that Deprivation does not Exist ______________________________________________________________________________
P-2510.20 1. Consider the following circumstances as tending to support the presumption that deprivation due to absence does not exist:
° the parents of the needy child are divorced or legally separated but have been awarded joint custody with or without joint physical custody by the court.
° the dwelling unit of the absent parent is contiguous to the dwelling unit of the child.
2. Decide, with the information given, if the conditions tend to back the supposition that deprivation due to absence does not exist.
3. If the actual conditions do not support the presumption, take a look at the procedures for refuting the above.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510.25 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Deprivation of Parental Support or Care _______________________________________________________________ Subject: Physical or Mental Incapacity ______________________________________________________________________________
2510.25 A. Deprivation exists when one parent has a physical or mental defect, illness or impairment which results in incapacity, as determined by the Department.
B. In order for the individual to be determined physically or mentally incapacitated by the Department, the physical or mental illness or impairment must:
1. be of such debilitating nature so as to reduce substantially or eliminate the parent's ability to support or care for the child, including:
a. ability to engage in employment; or
b. performing essential tasks related to the physical care or guidance and supervision of the child; and
2. be expected to last for a minimum period of 30 consecutive days.
C. In determining the parent's ability to engage in employment or to perform the duties of the parental role, consideration must be given to the following:
1. the duties of the particular job in terms of knowledge, skill and physical activity required; and
2. the individual's capacity to perform the duties of the job on a predictable basis with reasonable regularity; and
3. the accessibility of the job in terms of the individual's ability to travel without undue strain and adverse physical effect; and
4. the ability to care for and supervise the child in an adequate and predictable manner; and
5. the ability to perform household management tasks in an adequate and predictable manner; and
6. the limited employment opportunities of handicapped individuals.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510.25 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Deprivation of Parental Support or Care _______________________________________________________________ Subject: Physical or Mental Incapacity ______________________________________________________________________________
2510.25 D. In determining the individual's ability to function in the role of breadwinner of caretaker, the parent's previous role prior to incapacity is not a consideration since reduced ability to function in either role establishes incapacity.
E. Receipt of SSI or OASDI benefits based on disability or blindness establishes incapacity. Receipt of SSI or OASDI benefits based on age does not establish incapacity.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.25 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURE ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Look at Conditions Which Tend to Refute the Presumption that Deprivation Exists ______________________________________________________________________________
P-2510.25 1. You may find that the actual circumstances of the assistance unit tend to refute the presumption that deprivation exists. Think about the following examples as tending to refute the presumption that deprivation due to absence of the parent exists:
° the parents of the child are divorced or legally separated with sole custody awarded to the caretaker relative, but the visitation of the parent without custody is so extensive that actual participation in the physical care and guidance of the child occurs on a day-to-day basis.
° the absent parent who has otherwise voluntarily left the home has done so for some purpose other than to abandon the family and is exercising responsibility for the continuous care and guidance of the child during such absence.
2. After considering the circumstances presented, decide if the actual circumstances tend to refute the presumption.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510.30 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Unemployment of the Parent ______________________________________________________________________________
2510.30 Deprivation exists when the principal wage earner in a two parent family is determined to be unemployed in accordance with Departmental standards.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 P-2510.30 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Looking at Conditions Which Tend to Refute the Presumption that Deprivation Does Not Exist ______________________________________________________________________________
P-2510.30 1. You may find that the actual circumstances of the assistance unit tend to refute the presumption that deprivation does not exist. Consider the following examples as tending to refute the presumption that deprivation due to absence of the parent does not exist.
° The parents of the child are divorced or legally separated with an award of joint custody, but the parents are not following the court order and the absent parent is clearly not functioning in the parental role.
° The parents of the child are legally separated, but the joint custody arrangement provides for periods of time at least six months long between visitations of the absent parent with the child.
° The dwelling unit of the absent parent is contiguous to that of the child but the absent parent is clearly not functioning in the parental role, or the absent parent resides at this location for reasons other than a temporary purpose and there are no plans for the absent parent to return to the home or provide for the child's support and care.
2. After considering the circumstances presented, decide if the actual circumstances tend to refute the presumption.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510.35 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Determination of the Principal Wage Earner ______________________________________________________________________________
2510.35 A. The parent who is designated the principal wage earner by virtue of higher earnings, or as designated by the Department, is considered the unemployed parent.
B. The parent who is the principal wage earner is established in the following manner:
1. The earnings of each parent are considered regardless of when their relationship began; and
2. The Department arbitrarily designates which parent is the principal wage earner when:
a. primary evidence of earnings for the 24 month period cannot be obtained; or
b. both parents earned an identical amount of income in the 24 month period; or
c. both parents earned no income in the 24 month period.
C. The principal wage earner so specified remains the principal wage earner for each consecutive month for which the family receives assistance.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.35 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Exploring the Circumstances of the Parent's Absence ______________________________________________________________________________
P-2510.35 1. If the absence of the parent is the reason for deprivation, explore the circumstances of the absence. Start by finding out:
° the current marital status of the child's parents;
° the date the absence began;
° the length of continuous absence.
2. In determining the reason for the parent's absence, consider the following factors:
° whether the absence is temporary for some purpose other than to abandon the family such as in cases in which one parent is absent because of seasonal employment out-of-state;
° whether the absence is involuntary, such as in cases of incarceration or confinement;
° whether the absence is due solely to active duty with the uniformed services of the United States.
3. Determine the current whereabouts of the absent parent, if possible.
4. Review any pertinent court orders relative to child custody provisions.
5. With the information gathered so far, assess the expected ability of the absent parent to fulfill the parental role by providing support or care to the child on a predictable and continuous basis.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2510.40 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Conditions for Qualifying as an Unemployed Parent ______________________________________________________________________________
2510.40 The principal wage earner must meet certain specific conditions to qualify as an unemployed parent.
A. Unemployment of Principal Wage Earner for Specified Period
In order to qualify as an unemployed parent, the principal wage earner must be unemployed for thirty (30) days prior to the effective date of eligibility for AFDC.
B. Unemployment Status of Principal Wage Earner
The principal wage earner is considered to be unemployed if the individuals is:
1. not working; or
2. working fewer than 100 hours per month.
C. Meeting the 100 Hour Requirement
The principal wage earner meets the requirement of working fewer than 100 hours per month even if work exceeds 100 hours in a particular month, if:
1. the parent worked fewer than 100 hours for the prior two months; and
2. the parent is expected to work fewer than 100 hours in the next month.
D. Conditions Which Do Not Disqualify the Principal Wage Earner as an Unemployed Parent
The principal wage earner is not disqualified as an unemployed parent even if the individual is:
1. unemployed as a result of participation in a labor dispute other than a strike; or
2. disqualified for unemployment compensation benefits.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-94 Transmittal: UP-94-09 2510.40 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Conditions for Qualifying as an Unemployed Parent ______________________________________________________________________________
2510.40 E. Job-Related Requirements
1. In order to qualify as an unemployed parent, the principal wage earner must meet at least one of the following work requirements:
a. For six (6) or more calendar quarters within any thirteen (13) calendar quarter period ending within one year prior to the month of application for AFDC, the parent must have:
(1) received earned income of not less than fifty ($50) dollars per quarter; or
(2) participated in the Department's work program; or
(3) earned OASDI quarters of coverage as defined by the Social Security Act. Quarters of coverage are determined by dividing annual earnings by an amount designated by the Social Security Administration (Cross-Reference: P-2510.60); or
b. Within one year prior to the month of application the parent:
(1) must have been receiving unemployment compensation; or
(2) would have been eligible to receive unemployment compensation upon making application for such benefits; or
(3) would have been eligible to receive unemployment compensation upon making application if:
(a) the work performed was not covered by unemployment compensation; and
(b) had it been covered, along with any covered work performed, the work would have made the parent eligible for unemployment compensation.
2. The principal wage earner can receive credit toward the work requirement for up to a maximum of four of the six appropriate quarters when during those quarters he or she:
a. attended an elementary school, secondary school, or vocational or technical training course full-time to prepare him or her for gainful employment; or
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-94 Transmittal: UP-94-09 2510.40 page 3 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Conditions for Qualifying as an Unemployed Parent ______________________________________________________________________________
2510.40 E. 2. Job-Related Requirements (continued)
b. participated in an education or training program established under JTPA.
F. Job Offer Requirements
To be eligible as an unemployed parent, the individual must not have refused a bona fide offer of employment or training for employment within thirty (30) days prior to the effective date of eligibility without good cause.
G. Unemployment Compensation Requirements
To be eligible as an unemployed parent the individual must apply for and accept unemployment compensation benefits if entitled to such benefits.
H. Work Program Requirements
To qualify as an unemployed parent, the principal wage earner must cooperate with the Department in meeting the pre-employment training and work requirements of the Department's work program, unless specifically exempt (cross-reference 3510.05 and 3510.10). Cooperation includes, but is not limited to:
1. providing additional information as needed by the Department or an employment service agency designated by the Department;
2. participating in job search when appropriate; and
3. being available for work; and
4. cooperating with the Department in efforts to secure employment and provide education, job training and support services;
5. reporting for an interview with an employer to whom referred for potential suitable employment; and
6. accepting a bona fide offer of suitable employment as described herein.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.40 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Determining Parental Functioning ______________________________________________________________________________
P-2510.40 1. When making the determination of whether or not the absent parent is fulfilling the responsibilities of the parental role, consider whether the absence significantly interrupts or terminates the parents day-to-day functioning in the parental role.
2. Start by finding out whether the duration of the absence is making it impossible to count on the parent to plan for the present care or support of the child.
3. Find out how often and to what extent the absent parent is:
° meeting the child's physical needs;
° providing for the child's daily living expenses;
° guiding the child as well as making major decisions for the child in such areas as:
° diet;
° personal hygiene;
° peer contacts and leisure activities;
° religious affiliation.
4. From the information obtained, decide if the absent parent is providing care or support to the child on a continuous and predictable basis as provided for in policy.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL
Date: 1-1-88 Transmittal: UP-88-7 2510.45 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Deprivation of Parental Support or Care ____________________________________________________________ Subject: Good Cause for Non-Compliance With Work Program Requirements ______________________________________________________________________________
2510.45 A. Claim of Good Cause
If the unemployed parent fails to comply with a requirement of the Department's work program subsequent to registration, the parent is permitted the opportunity to claim good cause and to explain the reasons for non-compliance.
B. Determination of Good Cause
1. Job Offers
a. In cases of job offers made through public employment or Manpower agencies, the determination as to whether the offer is authentic or whether there was good cause to not accept it is to be made by that office or agency.
b. In cases of job offers made through any other means, including private agencies, employers or organizations, the determination as to whether the offer is authentic or whether there was good cause not to accept it is to be made by the Department.
2. Training
In cases of job-related training including job search requirement through the Department's work program, the Department determines if there was good cause for failure to participate in such training.
C. Circumstances for Good Cause
The Department considers good cause to exist if the following conditions are established:
1. circumstances beyond the individual's control, such as, but not limited to:
a. illness;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL
Date: 10-1-89 Transmittal: UP-89-40 2510.45 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Deprivation of Parental Support or Care ____________________________________________________________ Subject: Good Cause for Non-Compliance With Work Program Requirements ______________________________________________________________________________
2510.45 C. 1. Circumstances for Good Cause (continued)
b. illness of another household member;
c. if necessary child care is not available and payment cannot be guaranteed by the Department;
d. an emergency;
e. the unavailability of transportation;
2. conditions of employment, such as, but not limited to:
a. discrimination on the basis of age, sex or color;
b. working without being paid on schedule;
c. net loss of income as a result of accepting employment (cross-reference: 3510.07);
d. unsuitable employment.
D. Suitable Employment
The suitability of employment depends on some conditions related to the individual and some related to the particular job. A job is considered unsuitable when:
1. it is not within the documented physical and mental capability of the individual;
2. it interferes with the individual's religious beliefs of observances;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL
Date: 1-1-88 Transmittal: UP-88-7 2510.45 page 3 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Deprivation of Parental Support or Care ____________________________________________________________ Subject: Good Cause for Non-Compliance With Work Program Requirements ______________________________________________________________________________
2510.45 D. Suitable Employment (continued)
3. the distance to the job is unreasonable in that:
a. it is neither within walking distance nor is there available public transportation; or
b. commuting time is more than two hours per day, not including trips to provide child care;
4. the wage is less than the higher of:
a. the Federal minimum wage; or
b. the State minimum wage; or
5. the employer or potential employer is discriminatory;
6. the job is the site of a strike or a lockout;
7. a condition of employment is either joining or not joining a legitimate labor organization;
8. the job poses an unreasonable risk to health or safety;
9. the job does not have a regular pay schedule;
10. employment offered within the first 30 days of registration is not in the individual's major field of experience.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.45 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURE ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Resolving Questionable Information ______________________________________________________________________________
P-2510.45 1. If questionable information is revealed in the determination of absence of the parent, make a decision by evaluating all the available facts.
2. Reevaluate the absence factor if the information on the application:
° is inconsistent with statements made by the applicant;
° contradicts other data on the same application form or the preceding application form.
° is inconsistent with information received from collateral contacts or other sources.
3. Review the case record to determine:
° whether the case history reveals any documented instances of inaccurate statements or intentional withholding of information, especially as it relates to the absent parent.
° if the case history indicates a series of separations and reconciliations occurring within a relatively short period of time.
4. After investigating all available information, confront the assistance unit with the discrepancies:
° allow the assistance unit a reasonable opportunity to resolve the discrepancies by rebuttal of any collateral verifications;
° give the assistance unit a reasonable opportunity to provide evidence to support the rebuttal;
° consider any extenuating circumstances which explain the reasons for any previous inconsistencies.
5. After evaluating the circumstances you decide that deprivation due to absence of the parent does not exist, follow adverse action procedures for denying or discontinuing AFDC.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 P-2510.50 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Processing a Claim for Physical or Mental Incapacity ______________________________________________________________________________
P-2510.50 1. When physical or mental incapacity is the reason for deprivation, find out if the incapacitated parent is in receipt of SSI or SSA benefits on the basis of blindness or disability.
2. If incapacity is established as above, grant AFDC to the assistance unit, if otherwise eligible.
3. Set a tickler for redetermination of eligibility.
4. If incapacity is not established by receipt of SSI/SSA as provided for in policy, go on.
5. Obtain the information necessary for a determination of incapacity by the Department's Medical Review Team (MRT). To accomplish this, use the procedures which follow.
6. Give the assistance unit the following forms:
° "Instructions for Form WR-3A";
° "Medical Examination Report", Form W-R3;
° "Social Information and Disability Report", Form W-176.
° "Notice-Examination Report for Medical Eligibility Determination - Registration For WIN Program", Form W-513.
7. Explain to the assistance unit the use of Form W-R3 and encourage the unit to tell the examining physician the importance of returning the form in a timely fashion.
8. Advise the unit of the purpose of Form W-176 and emphasize the need for:
° returning the forms to the Department within the specified time standards;
° filling in all the blank areas on the form;
° giving special attention to the completeness of the "Education" and "Work History" sections of the W-176.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.50 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Processing a Claim for Physical or Mental Incapacity ______________________________________________________________________________
P-2510.50 9. Inform the unit that you will provide assistance upon request if a problem arises with obtaining information or completing the W-176 form.
10. Obtain the signature of the incapacitated parent on Form W-149, "Request for Medical Records Information."
11. Send the W-149 to the designated medical facility if appropriate.
12. Set appropriate ticklers for the return of the W-R3, W-176 and W-149 forms.
13. Upon return of the appropriate forms, complete the following actions:
° complete and attach Form W-542, "Route Slip to MRT," to the medical information;
° arrange all medical information in chronological order, most recent first;
° submit the entire medical packet to MRT, Central Office.
14. If Form W-146, "Record of Action by Medical Review Team" returns from MRT marked, "Eligible," and all other factors of eligibility have been met, take the following actions:
° grant assistance to the assistance unit;
° set a tickler for the redetermination of the incapacity status, using the date specified on the W-146 form.
15. If Form W-146 returns from MRT marked, "Ineligible," take the following actions:
° determine if the assistance unit or any member of the assistance unit qualifies for MA.
° deny AFDC assistance to the family.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.50 page 3 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Processing a Claim for Physical or Mental Incapacity ______________________________________________________________________________
P-2510.50 16. If Form W-146 returns from MRT marked "Undetermined," check for the specific supplementary medical data requested by MRT and take the following actions:
° advise the unit of the additional medical data needed and the type of medical specialist indicated;
° refer the unit back to the examining physician for a referral to the appropriate specialist, if necessary;
° give the unit the specialist referral letter provided by MRT;
° set a tickler for the return of the medical information.
17. If the incapacitated parent requests assistance in finding the appropriate specialist:
° help the parent make an appointment using the resources available;
° contact health services for the name of a specialist if all other resources have been exhausted.
18. Upon return of the specialist's report, follow the procedures in step #13.
19. If Form W-146 returns from MRT marked, "Eligible", follow the procedures in step #14.
20. If Form W-146 returns from MRT marked "Ineligible", follow the procedures in step #15.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2510.55 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Designating the Principal Wage Earner ______________________________________________________________________________
P-2510.55 1. If unemployment is the reason for deprivation, first establish which parent will be considered the principal wage earner.
2. If only one parent had earned income in the 24-month period, designate this parent as the principal wage earner.
3. If both parents had earned income:
° consider total income earned by each parent in the 24-month period;
° determine which parent earned the greater amount of income in the 24-month period.
4. Designate as the principal wage earner whichever parent earned the greater amount of earned income in the period specified.
5. If the principal wage earner cannot be determined by comparing the wages of each parent as specified in policy, select the principal wage earner giving consideration to:
° the parent most likely to be the primary wage earner;
° the preference according to the family.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-94 Transmittal: UP-94-09 P-2510.60 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Determining Conditions for Qualifying as an Unemployed Parent ______________________________________________________________________________
P-2510.60 Determining Current Employment Status
1. Review the employment status of the principal wage earner.
2. Start by determining if the principal wage earner is unemployed.
3. If the principal wage earner is unemployed, establish the following:
° the date the individual last worked;
° the reason the individual is unemployed.
4. If the reason for unemployment is a strike and the principal wage earner is still on strike, stop here (Refer to the procedures for strikers, P-3035).
5. If the principal wage earner is working more than 100 hours per month, determine if the 100 hour requirement is met by giving consideration to:
° the number of hours the parent worked in the prior 2 months;
° the number of hours the parent is expected to work in the next month.
6. If you determine that the principal wage earner is employed 100 hours per month or more, stop here. The deprivation requirement is not met by reason of unemployment.
7. If you determine that the principal wage earner is unemployed or employed fewer than 100 hours per month, go on.
Determining Job-Related Requirements
1. Review the parent's work/education and training history to determine if the individual meets at least one of the job related requirements.
2. Find out if the principal wage earner is receiving unemployment compensation or was receiving unemployment compensation within the time period specified in policy.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-94 Transmittal: UP-94-09 P-2510.60 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Determining Conditions for Qualifying as an Unemployed Parent ______________________________________________________________________________
P-2510.60 Determining Job-Related Requirements (continued)
3. If the principal wage earner has sufficient work history, go on to "Determining Job Offer Refusal."
4. If the principal wage earner does not have a sufficient work history based on the unemployment compensation requirements, go on to step #5 to check if the parent meets the $50 per quarter test.
5. When determining if the parent meets the $50 per quarter test:
° define the limits of the 13 calendar quarter periods as noted in step 6;
° obtain the applicable quarters of work information.
6. To establish the 13 calendar quarter periods:
° determine the month of application;
° go back to the quarter immediately preceding the quarter the application month falls in;
° from this quarter count back 15 calendar quarters.
7. Remember, there are always four 13 calendar quarter periods in which to establish eligibility.
8. If the parent meets the $50 per quarter test, go on to "Determining Job Offer Refusal."
9. If the parent does not have sufficient calendar quarters in which he or she earned at least $50, determine if he or she participated in the Department's work program, or met the education and training criteria described in policy. Remember that you can credit the parent with only up to four calendar quarters based on the education and training criteria.
If the parent has a total of at least 6 quarters in the designated period in which he or she either earned $50, participated in the Department's work program or met the education and training requirements, go on to "Determining Job Offer Refusal."
11. If the parent does not have 6 quarters of the $50 earnings, participation in the work program or the education and training requirements, determine if he or she earned any quarters under the OASDI criteria.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 5-1-94 Transmittal: UP-94-09 P-2510.60 page 3 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Determining Conditions for Qualifying as an Unemployed Parent ______________________________________________________________________________
P-2510.60 Determining Job-Related Requirements (continued)
12. When determining if the parent meets the OASDI criteria:
° obtain earnings information for the calendar years covered;
° divide the total earned income for each year by the amount designated by the Social Security Administration for the respective year:
Quarter of Coverage Amounts
1986...$440 1989...$500 1992...$570 1987... 460 1990... 520 1993... 590 1988... 470 1991... 540 1994... 620
° give the parent credit for the number of quarters resulting from the division, up to 4 quarters per year.
13. If the parent has at least 6 quarters in any of the 13 quarter periods determined in step 6 in which he or she has earned at least $50, participated in the work program, earned quarters based on the OASDI criteria, or met education and training requirements, go on to "Determining Job Offer Refusal."
14. If the parent does not have at least 6 quarters as described above, stop here. The deprivation requirement is not met by reason of unemployment.
Determining Job Offer Refusal
1. Find out if the principal wage earner has refused a bona fide offer of employment or training. If such refusal was made consider:
° how long ago the refusal took place;
° if good cause is claimed.
2. If the parent has refused a job offer within the time period specified in policy, but good cause is established, go on to the procedures for referring the parent for Unemployment Compensation benefits.
3. If the parent has refused a job offer within the time period specified but good cause is not established, stop here. The deprivation requirement is not met by reason of unemployment.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-91-47 P-2510.60 page 4 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Deprivation of Parental Support or Care AFDC _______________________________________________________________ Subject: Determining Conditions for Qualifying as an Unemployed Parent ______________________________________________________________________________
P-2510.60 Referring For Unemployment Compensation
1. Unless the parent is receiving or was receiving unemployment compensation within the time period specified in policy, tell the parent that application must be made for such benefits.
2. If the parent complies with the above requirement, the deprivation requirement is met by reason of unemployment. Go on to "Referring to Work Program."
3. Remember, assistance is not delayed pending receipt of unemployment compensation benefits.
4. If the parent fails or refuses to make such application, or refuses to accept benefits if determined eligible to receive them, stop here. The deprivation requirement is not met by reason of unemployment.
Referring to Work Program
1. Explain to the assistance unit the pre-employment training and work requirements of the Department's work program.
2. Complete Form W-1406 for the parent for participation in the work program.
3. Route the W-1406 to the case manager when assistance is granted.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2515 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Living with Specified Relative ______________________________________________________________ Subject:
______________________________________________________________________________
2515 In this chapter the requirements regarding living with a specified relative are described in detail. Among the issues covered include:
° The degree of relationship a child must have to a relative in order to qualify for AFDC;
° The conditions under which a child is considered to be meeting the "living with specified relative" requirements;
° The circumstances under which the "living with specified relative" requirements continue to be met even when the child or caretaker relative is temporarily absent from the home.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-97 Transmittal: UP-98-3 2515.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY _______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Degree of Relationship ______________________________________________________________________________
2515.05 A. Degree of Relationship
1. In order to qualify, a child must be living with a caretaker relative who is a blood relative, adoptive relative, or a spouse or former spouse of a blood relative.
2. The spouse of a blood relative is considered to be an acceptable degree of relationship even after the marriage is terminated by death or divorce.
3. Blood relatives are considered to be an acceptable degree of relationship even when the child is subsequently adopted.
B. The Department considers a male to be the father of the child if:
1. legal marriage existed between the male and the natural mother of the child at the time of the child's birth and this fact is not contested by the natural mother; or
2. he has legally adopted the child; or
3. he has been adjudged to be the father by the court; or
4. he is listed as the father on the child's Connecticut birth certificate; or
5. he has signed a statement recognizing that he is the natural father of the child. This statement need not be notarized or witnessed; or
6. there is a preponderance of evidence that he is the father. (Cross Reference: 2599)
C. The Department considers a female to be the mother of the child if:
1. she has legally adopted the child; or
2. her name is on the child's birth certificate.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2515.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Determining if Child Resides with Specified Relative ______________________________________________________________________________
P-2515.05 1. Check if the relationship established between the child and the caretaker relative meets the degree of relationship specified in policy.
2. If either the child or caretaker relative are temporarily absent from the home at any one time, determine if:
° the caretaker relative is providing continuous care and supervision of the child;
° the duration of the absence is approaching the 90 consecutive day limitation.
3. If jurisdiction of the child is held by another make sure it meets the limitations set by policy.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2515.10 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Living with Specified Relative _______________________________________________________________ Subject: Continuous Care and Supervision ______________________________________________________________________________
2515.10 A. The child is considered to be meeting the requirement of living with the caretaker relative, providing these conditions are met:
1. the caretaker relative is exercising responsibility for the continuous care and supervision of the child, even though the child or caretaker relative may be temporarily absent from the home; and
2. if the child or caretaker relative is absent from the customary family setting, such absence does not exceed 90 consecutive days.
B. The child is not considered to be meeting the requirement of living with the caretaker relative if the absence does exceed ninety (90) consecutive days, regardless of whether or not the caretaker relative is exercising responsibility for the continuous care and supervision of the child.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2515.10 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Considering the Absence of the Child from the Home ______________________________________________________________________________
P-2515.10 Absence from the Home
1. When determining if the child meets the "living with specified relative" requirements when absent from the home, consider:
° when the child left home;
° the reason for the absence;
° where the child is staying;
° the estimated length of absence;
° the extent to which the caretaker relative is providing care and supervision to the child;
° what plans have been made for the child's periodic visits home.
2. If the child is staying in an institution or other group setting, determine who has primary responsibility for the continuing care of the child during the absence from the home.
3. If the child is in a general hospital, find out:
° the nature of the child's illness;
° the prognosis in terms of the anticipated length of absence.
4. Given the particular set of circumstances, decide if the child continues to meet the "living with specified relative" requirements. If not, follow the procedures for removing the child from the assistance unit, or in cases of 2 member assistance units, discontinuing the case.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2515.10 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Considering the Absence of the Child from the Home ______________________________________________________________________________
P-2515.10 Temporary Return to the Home
1. In determining if the child meets the "living with specified relative" requirements when home on a temporary basis from an institution having primary responsibility for the care of the child, find out the anticipated length of the visit.
2. If the child is visiting for a period of 30 consecutive days or more:
° add the child effective with the first day of the visit;
° remove the child effective the last day of the month in which the child leaves the home.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2515.15 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Jurisdiction or Legal Custody of Child Held by Another ______________________________________________________________________________
2515.15 The child is considered to be living with the caretaker relative in situations in which:
A. the child continues to reside with the caretaker relative but is under the jurisdiction of the court such as in cases in which probation services or protective supervision is being received; or
B. the child continues to reside with the caretaker relative but legal custody is held by another agency.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2515.15 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Considering the Absence of the Caretaker Relative from the Home ______________________________________________________________________________
P-2515.15 1. In determining if the child continues to meet the "living with specified relative" requirements when the caretaker relative is absent from the home, consider:
° the estimated length of absence.
2. When the caretaker relative is hospitalized or in a long term care facility, determine:
° the anticipated length of stay;
° the caretaker relative's capacity for exercising the responsibility for care and supervision of the child in light of the illness or disability;
° to what extent the caretaker is actually assuming the responsibility of continuous care and supervision of the child directly, or indirectly through a responsible person;
° whether the child is temporarily living with another specified relative because the caretaker relative is currently incapable of fulfilling the duties of the parental role.
3. Decide, with the information available, if the child is considered to be living with a relative within a specified degree of relationship. If not, follow procedures for discontinuing AFDC.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2515.15 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Considering the Absence of the Caretaker Relative from the Home ______________________________________________________________________________
P-2515.15 4. If the caretaker relative is residing in a shelter other than the usual family setting due to a catastrophe, determine:
° the anticipated length of stay;
° whether the caretaker relative continues to assume the responsibility of care and supervision of the child directly, or indirectly through a responsible person;
° whether the child is temporarily residing with another specified relative because the circumstances of the catastrophe precludes the caretaker relative from assuming the duties of the parental role.
5. Decide, with the information available, if the child is considered to be living a relative within a specified degree of relationship. If not, take steps to discontinue AFDC assistance.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2515.20 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Absence of Child from the Home ______________________________________________________________________________
2515.20 A. Child Considered to be Living With The Caretaker Relative
1. Temporary Absence From the Home
The child is considered to be living with the caretaker relative in situations in which the child is absent from the home because of:
a. attendance at a specialized educational program on a "live-in" basis for part of each week such as those programs provided by the American School for the Deaf, the Oak Hill School for the Blind, or the regional center for the mentally retarded; or
b. hospitalization in a general hospital for a period of less than 90 consecutive days.
2. Temporary Return to the Home for 30 Days or More
a. The child is considered to be living with the caretaker relative in cases in which the child returns to the home from an institution which has primary responsibility for the care of the child for a visit of thirty (30) consecutive days or more.
b. The child is considered to be living with the caretaker relative only for the duration of the visit.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2515.20 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Absence of Child from the Home ______________________________________________________________________________
2515.20 B. Child Considered Not to be Living With the Caretaker Relative
1. Extended Absence From the Home
The child is considered not to be living with the caretaker relative in situations in which the child's absence from the home is due to placement in the following settings, because the institution or foster parent has assumed responsibility for the child's care and supervision:
a. a public institution such as a State hospital for the mentally ill or a training school for the mentally retarded; or
b. a chronic disease hospital; or
c. a juvenile correctional institution such as Long Lane School or Meriden School for Boys; or
d. a foster home, when the foster parent is not within an acceptable degree of relationship.
2. Temporary Return to the Home for Less Than 30 Days
The child is considered not to be living with the caretaker relative in situations in which the child returns home for a visit of less than thirty (30) consecutive days from an institution which has primary responsibility for the care of the child.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2515.20 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Establishing the Caretaker Relative ______________________________________________________________________________
P-2515.20 1. In cases in which more than one specified relative resides in the home, make the caretaker relative the one who is assuming responsibility for the day-to-day care and supervision of the child.
2. See procedures at P-2005 for additional considerations.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2515.25 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Absence of the Caretaker Relative from the Home ______________________________________________________________________________
2515.25 A. Child Considered to be Living With The Caretaker Relative
The child is considered to be living with the caretaker relative in situations in which the caretaker relative is absent from the home because:
1. the caretaker relative is hospitalized and such confinement does not exceed ninety (90) consecutive days and during the period of confinement:
a. the caretaker relative continues to exercise responsibility for the care of the child directly, or indirectly through a responsible person; or
b. the child is temporarily residing with another individual who is within the acceptable degree of relationship and who is assuming the duties of care and supervision of the child; or
2. the caretaker relative is residing, for a period of ninety (90) consecutive days or less, in a shelter other than the usual family setting due to its loss from fire or flood and the needy child is living elsewhere, but:
a. the caretaker relative continues to fulfill the responsibility of care and supervision of the child directly or indirectly through a responsible person; or
b. the child is temporarily staying with another individual who is of acceptable degree of relationship and who is assuming the duties associated with the parental role.
B. Child Considered Not to be Living With The Caretaker Relative
The child is considered not to be living with the caretaker relative in situations in which the caretaker relative's absence is due to:
1. incarceration in a penal or correctional institution; or
2. confinement in a public institution; or
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2515.25 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Absence of the Caretaker Relative from the Home ______________________________________________________________________________
2515.25 B. Child Considered Not to be Living With The Caretaker Relative (continued)
3. confinement in a hospital for chronic diseases including tuberculosis; or
4. confinement in a long term care facility or hospital when:
a. the length of stay is in excess of 90 days; or
b. the caretaker relative is too sick or is otherwise incapable of exercising the responsibility for care and supervision of the child; and
c. there is no relative of an acceptable degree of relationship able or willing to assume the responsibility of caring for the child.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2515.30 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Determination of Caretaker Relative ______________________________________________________________________________
2515.30 Regardless of which individual applies for assistance, when more than one individual resides in the home each of whom is within a specified degree of relationship to the child, the caretaker relative is that relative who is responsible for the day-to-day care and supervision of the child.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-92 Transmittal: UP-92-32 2515.35 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living With Specified Relative AFDC _______________________________________________________________ Subject: Minor Parents ______________________________________________________________________________
2515.35 A. General Requirement
To be eligible for AFDC, a minor parent must live in the home of a parent or in another appropriate living arrangement, as described in this subject.
B. Minor Parent
For the purposes of this subject, the term minor parent means those who:
1. are less than 18 years old; and
2. have never been married; and
3. have a dependent child or are pregnant.
C. Basic Provisions
1. This requirement applies to the following individuals:
a. a minor parent and his or her dependent child who live together in the same household; and
b. a minor pregnant woman who is otherwise eligible to receive AFDC separately from her parents and siblings, except for this requirement.
2. For the purpose of this provision, appropriate living arrangements are limited to the following:
a. the home of a natural or adoptive parent;
b. the home of a stepparent;
c. the home of a legal guardian;
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-92 Transmittal: UP-92-32 2515.35 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living With Specified Relative AFDC _______________________________________________________________ Subject: Minor Parents ______________________________________________________________________________
2515.35 C. 2. Basic Provisions (continued)
d. the home of a relative of the minor parent, or of the dependent child, who
(1) is eighteen years of age or older; and
(2) is within a specified degree of relationship as described elsewhere in this section (Cross Reference: 2515);
e. an adult-supervised supportive living arrangement.
3. An adult-supervised supportive living arrangement is a private family setting or other living arrangement, not including public institutions, that:
a. is approved by the Department; and
b. is maintained as a family setting as evidenced by
(1) the assumption of responsibility for the care and control of the minor parent; or
(2) the provision of supportive services, such as counseling, guidance or supervision.
4. Adult-supervised supportive living arrangements include, but are not limited to:
a. foster homes;
b. maternity homes;
c. private families.
5. The relative or legal guardian's residence must be maintained as a home for the minor parent and dependent child, as follows:
a. he or she is willing and able to assume responsibility for the care and control of the minor parent; and
b. he or she is willing and able to exercise control and supervision of the minor parent.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-92 Transmittal: UP-92-32 2515.35 page 3 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living With Specified Relative AFDC _______________________________________________________________ Subject: Minor Parents ______________________________________________________________________________
2515.35 D. Exemptions From the General Requirement
A minor parent is exempt from the requirement described in A. when any of the following conditions applies:
1. there is no living parent or legal guardian; or
2. the whereabouts of the parent or legal guardian are not known; or
3. the parent or legal guardian will not allow the minor parent and/or the dependent child to live in his or her home; or
4. the minor parent has lived apart from the parent or legal guardian for at least one year prior to:
a. the birth of the minor parent's dependent child; or
b. the date the minor parent applies for AFDC; or
c. October 1, 1992; or
5. the minor parent has been emancipated by court involvement; or
6. the supervising adult will not assume responsibility for the care and control of the minor parent; or
7. the supervising adult cannot exercise control and supervision over the minor parent; or
8. the supervising adult would violate the terms of a lease if the minor parent moved into his or her residence; or
9. the physical or emotional health or safety of the minor parent or dependent child would be jeopardized if they resided in the same residence with the parent or legal guardian; or
10. the minor parent is participating in a vocational or educational program that is not located within a reasonable distance from the home of the parent or legal guardian (Cross Reference: 3510); or
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-92 Transmittal: UP-92-32 2515.35 page 4 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Living With Specified Relative AFDC _______________________________________________________________ Subject: Minor Parents ______________________________________________________________________________
2515.35 D. Exemptions From the General Requirement (continued)
11. the minor parent is working and the job is not located within a reasonable distance from the home of the parent or legal guardian (Cross Reference: 3510); or
12. the parent or legal guardian lives in another state or country and the Department determines it is not practical for the minor parent to return to that state or country.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-92 Transmittal: UP-93-4 P-2515.35 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Determining if the Minor Parent Must Live With an Adult ______________________________________________________________________________
P-2515.35 1. Explore the minor parent's current living arrangement. Consider such things as:
° Does the minor parent live with anyone?
° If yes, what is the relationship between that person and the minor parent?
° If the minor parent does not live with anyone, try to find out why.
° Would the minor parent be able to return to his or her parent's home?
° Is there an adult relative with whom the minor parent could live?
° How long has the minor parent lived on his or her own?
° Does he or she rent a room, apartment, live in a shelter, etc.?
° Does the minor parent go to school or work?
2. Evaluate the answers to the questions described in #1 in light of the policy.
3. Consider that the minor parent has met the requirement if he or she lives with:
° a parent
° a legal guardian
° an adult relative, including paternal relatives of the dependent child. Remember, paternity has to be acknowledged or adjudicated in order for the paternal relationships to be established.
4. Consider the situations listed below as exemptions that can be determined by obtaining verification and do not require DHR's involvement.
° the minor parent has lived on his or her own for at least one year
° the minor parent's parents or legal guardian are deceased
° the minor parent does not know the whereabouts of the parents or legal guardian
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-92 Transmittal: UP-92-32 P-2515.35 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Determining if the Minor Parent Must Live With an Adult ______________________________________________________________________________
P-2515.35 4. (continued)
° the minor has been emancipated by a court
° the minor parent is participating in a vocational or educational program or has employment that is not located within a reasonable distance from the home of the parent or legal guardian
° the parent or legal guardian lives in another state or country
5. Even if the minor parent meets one of the exemptions in #3, refer to DHR to evaluate whether the minor parent is able to cope sufficiently in his or her current arrangement or if that ability would be enhanced by living with another suitable adult. Make referrals at any time, but only if the client agrees to be referred.
6. If the minor parent does not meet one of the exemptions listed in #3 and the Eligibility Worker cannot determine whether or not the minor parent is otherwise exempt, and the minor parent does not live in an appropriate living arrangement, make a referral to DHR. Do not complete a determination of eligibility for AFDC without DHR's response. Examples of situations requiring referrals are:
° the minor parent lives with an unrelated adult
° the minor parent says he or she wants to live on his or her own
° the minor parent and the parent or legal guardian do not get along
° the parent will not assume responsibility for the minor
° the parent cannot control the minor parent
° the minor parent states that returning to the parent or legal guardian's home would jeopardize the physical or mental safety of the minor parent or the dependent child.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 10-1-92 Transmittal: UP-93-4 P-2515.35 page 3 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Living with Specified Relative AFDC _______________________________________________________________ Subject: Determining if the Minor Parent Must Live With an Adult ______________________________________________________________________________
P-2515.35 7. Consider the following as examples of evidence that indicate that the physical or mental health or safety of the minor parent or of the dependent child would be jeopardized:
° there is a substantiated report of abuse or neglect
° a neglect petition has been filed
° the minor parent has made a statement that has been corroborated by an adult, or substantiated through agency investigation
° the minor parent's return results in the family living arrangement becoming overcrowded, violating the terms of a lease, or violating local health or safety standards
8. If the minor parent is clearly not exempt from the requirement, and refuses to return to his or her parent's home, or to another suitable living arrangement, consider that the minor parent has not met this eligibility requirement.
9. If the minor parent does not wish to be involved with DHR, evaluate the living arrangement according to policy and determine if the minor parent is meeting the requirement, or is exempt from the requirement.
10. Use form W-171, "Referral to DHR for Assessment," to refer a case to DHR. Complete side one of the form.
11. If eligibility cannot be established without DHR's recommendation, indicate on the form that this is a Priority #1.
12. If AFDC has been granted, and the referral is only to help the minor parent connect with DHR, send the referral form and indicate that this is a Priority #2.
13. If AFDC has been denied, but the minor parent wants to be involved with DHR, send the referral form and indicate that this is a Priority #2.
14. DHR will complete side two of the form when they have completed their investigation, and return it to DIM.
15. Consider this recommendation along with all other available information when making a decision with respect to this eligibility requirement.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 1-1-88 Transmittal: UP-88-7 2520 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Pregnancy AFDC _______________________________________________________________ Subject:
______________________________________________________________________________
2520 This chapter addresses the categorical requirement of pregnancy in the AFDC program.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-97 Transmittal: UP-97-19 2520.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Pregnancy AFDC _______________________________________________________________ Subject: Pregnancy Requirements ______________________________________________________________________________
2520.05 A. In order to qualify for AFDC, a woman with no other children receiving AFDC must:
1. be pregnant; and
2. meet the eligibility factors for AFDC which would be required if her child were already born and were living with her, including, but not limited to, deprivation of parental support or care (Cross Reference: 2510).
B. Deprivation as it relates to a pregnant woman exists as follows:
1. One Parent Household
In one parent households, deprivation exists when:
a. one of the parents is deceased or continually absent from the home; or
b. the alleged father resides in the home. The alleged father is not considered the legal parent until the child is born, and:
(1) he has acknowledged paternity; or
(2) he has been adjudged the father; or
(3) he has signed a statement recognizing that he is the natural father of the child; or
(4) he is listed as the father on the child's Connecticut birth certificate.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2520.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Pregnancy AFDC _______________________________________________________________ Subject: Establishing Pregnancy Requirements ______________________________________________________________________________
P-2520.05 1. Make sure the pregnant woman meets the AFDC eligibility factors which would be required if her child were already born and living with her.
2. When determining if the pregnant woman meets the categorical requirement of deprivation, remember:
° if incapacity or unemployment of a parent is the reason for deprivation, make sure that the parents are married;
° deprivation due to absence of the parent still exists even if the alleged father resides in the home as paternity is not established prior to the child's birth.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2525 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AFDC Age AABD _______________________________________________________________ Subject:
______________________________________________________________________________
2525 This chapter addresses the categorical eligibility requirement of age.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 2525.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Age AFDC _______________________________________________________________ Subject: Determination of Age ______________________________________________________________________________
2525.05 A. The determination of whether an individual meets the age requirements of the individual program is made in accordance with the "popular usage method" under which a specific age is attained on the anniversary of the individual's birth.
B. In situations in which the year can be established but the month of an individual's birth is not available, July 1 is used as the point from which age is computed.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-87 Transmittal: UP-87-2 P-2525.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: AABD Age MAABD _______________________________________________________________ Subject: Determining Age ______________________________________________________________________________
P-2525.05 1. To establish the age of an individual, use the "popular usage method" as specified in policy.
2. If only the year of the individual's birth is established, use July 1st as the point from which age is computed.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-97 Transmittal: UP-97-19 2525.10 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Age AFDC _______________________________________________________________ Subject: AFDC - Age Requirements ______________________________________________________________________________
2525.10 The child meets the categorical eligibility requirements of age if the child meets the following conditions:
A. has not attained 18 years of age; or
B. has not attained 19 years of age and is a full-time student in a secondary school or in the equivalent level of vocational or technical training.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 7-1-98 Transmittal: UP-98-31 2525.15 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: AABD Age MAABD _______________________________________________________________ Subject: State Supplement and Related Medicaid ______________________________________________________________________________
2525.15 A. To meet the age requirement for State Supplement and related Medicaid based on disability, the individual must be eighteen (18) years of age through sixty-five (65) years of age.
B. To meet the age requirement for State Supplement and related Medicaid based on old age, the individual must be sixty-five (65) years of age or older.
C. There is no age requirement for an individual qualifying for State Supplement benefits as a resident of a long term care facility.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICES PRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-93 Transmittal: UP-93-2 2530 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Disability AABD _______________________________________________________________ MAABD Subject:
______________________________________________________________________________
2530 Certain individuals applying for AABD or Medical Assistance must be disabled to qualify for assistance. The Social Security Administration (SSA) generally is responsible for determining if an individual is disabled. Under certain conditions, the Department makes a determination separate from SSA.
The Department uses the same criteria as SSA to determine disability. In most cases, a decision by SSA takes precedence over a decision which has been made by the Department's Medical Review Team (MRT). This chapter discusses the controlling nature of the SSA decision and the circumstances under which the Department makes a determination apart from SSA.
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-00 Transmittal: UP-00-22 2530.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Disability AABD _______________________________________________________________ MAABD Subject: Basis for Disability ______________________________________________________________________________
2530.05 A. To qualify for the State Supplement or related Medical Assistance programs on the basis of disability, the individual must be disabled as determined by SSA or the Department. The individual must be found to have an impairment which:
1. is medically determinable; and
2. is severe in nature; and
3. can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve (12) months; and
4. except as provided in paragraph C below, prevents the performance of previous work or any other substantial gainful activity which exists in the national economy.
B. Except as provided in paragraph C below, the medical criteria the Department uses for determining disability are the same as those used for evaluating disability under SSI in accordance with 20 CFR Chapter III Appendices 1 and 2.
C. Under the Medicaid coverage group "Working Individuals with Disabilities," the individual must have a medically determinable impairment. However, the individual's ability to perform substantial gainful activity has no effect on the disability determination (Cross Reference: 2540.85).
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-93 Transmittal: UP-93-2 P-2530.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Disability AABD _______________________________________________________________ MAABD Subject: Establishing Eligibility ______________________________________________________________________________
P-2530.05 1. Consider the individual disabled if the individual is considered disabled by SSA.
2. Take action to determine disability in the following situations:
° if the applicant has not applied to SSA or if the application is still pending;
° if the applicant was denied by SSA for a reason other than disability, (e.g. excess income for SSI purposes).
3. If SSA has previously denied disability, make a separate determination whenever the applicant alleges a condition which is different from or in addition to the one SSA evaluated.
4. Refer the applicant to SSA if within 12 months of the latest SSA denial the applicant alleges that the same condition has changed or deteriorated.
Make a separate determination only if SSA refuses to reconsider the new allegations, or denies the application without making a new disability determination, e.g. the application is denied for excess assets.
5. Take action to determine disability if more than 12 months after the latest SSA denial the applicant alleges the same condition has changed or deteriorated and SSA has not made a new determination based on the allegations.
6. If a separate determination is required, obtain the information necessary for the Department's Medical Review Team (MRT) to determine disability.
7. Give the assistance unit the following forms:
° "Instructions for Forms WR-3A";
° "Medical Examination Report," Form W-R3;
° "Notice-Examination Request for Medical Eligibility Determination," Form W-513;
° "Social Information Disability Report," Form W-176.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-93 Transmittal: UP-93-2 P-2530.05 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Disability AABD _______________________________________________________________ MAABD Subject: Establishing Eligibility ______________________________________________________________________________
P-2530.05 8. Explain Form W-R3 and encourage the unit to advise the examining physician of the importance of promptly returning the form.
9. Explain Form W-176 and emphasize the need to do the following:
° return the form within the specified time standard;
° fill in all the blank areas;
° complete the "Education" and "Work History" sections.
10. Inform the applicant that you will provide assistance upon request if help is needed in obtaining information or completing the W-176 form.
11. Obtain the signature of the assistance unit on Form W-149, "Request for Medical Records Information," and send it to the designated medical facility if it is appropriate.
12. Set alerts for the return of the W-R3, W-176 and W-149 forms.
13. Take the following actions upon return of the forms;
° complete and attach Form W-542, "Route Slip to MRT," to the Medical information;
° arrange all medical information in chronological order, most recent first;
° submit the entire medical packet to MRT, Central Office.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-93 Transmittal: UP-93-2 2530.10 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Disability AABD _______________________________________________________________ MAABD Subject: SSA Disability Determination are Conclusive ______________________________________________________________________________
2530.10 A. Disability Determinations Made by SSA
1. An individual who is considered disabled by SSA is considered disabled by the Department.
2. A final determination by SSA that an individual is not disabled takes precedence over a determination by the Department, except in the situations described in paragraph C, below.
3. An SSA decision denying disability is binding for 12 months from the date the decision becomes final.
4. The SSA determination is considered final when there is no further right to administrative appeal through the SSA appeals process. Administrative levels in the SSA appeals process include all of the following:
a. reconsideration of the initial decision;
b. hearing before an administrative law judge;
c. Appeals Council review
5. The right to administrative appeal ends when a decision is rendered by the SSA Appeals Council or when the 60 day time limit for appealing a lower level decision expires without an appeal being filed.
6. If assistance is granted based on an MRT disability determination and SSA subsequently determines the individual is not disabled, benefits are terminated unless eligibility exists on some other basis or the recipient timely appeals the SSA decision. (cross reference 2530.10 D.)
7. Prompt action to terminate benefits is taken once the Department is notified of the initial SSA decision to deny disability, or when a denial is upheld at an appeals level.
8. The Department may delay action to terminate benefits if the recipient indicates that an administrative appeal will be filed with SSA; however, benefits are terminated if the recipient does not promptly file the appeal.
9. Action to terminate benefits must begin no later than the date the deadline for filing an administrative appeal expires.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-93 Transmittal: UP-93-2 2530.10 page 2 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Disability AABD _______________________________________________________________ MAABD Subject: SSA Disability Determination are Conclusive ______________________________________________________________________________
2530.10 B. Disability Determinations Made by the Department
1. The Department does not make a separate determination of disability if SSA already has determined that the individual is disabled.
2. The Department makes a determination of disability under the following conditions:
a. when the applicant has not previously applied to SSA as a disabled person;
b. when the applicant has applied to SSA on the basis of disability and the application is pending or a final decision has not been rendered;
c. when the applicant is denied by SSA for a reason other than disability;
d. in the circumstances described in paragraph C, below.
3. A determination is made within the 90 day standard of promptness requirements for processing disability applications if SSA has not rendered a decision.
C. Exemptions to Precedence of SSA Disability Determinations
The Department makes a separate determination of disability in each of the following situations, even though SSA has previously determined that the individuals was not disabled. The prior decision by SSA is not considered binding under these conditions.
1. The Department makes a separate determination any time an applicant alleges a disabling condition which is different from, or in addition to the conditions considered by SSA in making its last determination.
2. The Department makes a separate determination if within 12 months of the most recent SSA decision the following conditions exist:
a. the applicant alleges that he or she is disabled as the result of a change or deterioration of the same condition; and
b. the applicant has applied to SSA and SSA has refused to reconsider the new allegations or has denied SSI for a reason other than disability.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-93 Transmittal: UP-93-2 2530.10 page 3 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Disability AABD _______________________________________________________________ MAABD Subject: SSA Disability Determination are Conclusive ______________________________________________________________________________
2530.10 C. Exemptions to Precedence of SSA Disability Determinations (continued)
3. The Department makes a separate determination if more than 12 months after SSA denies disability the following conditions exist:
a. the applicant alleges that he or she is disabled as the result of a change or deterioration of the same condition; and
b. SSA has not made a determination with respect to the new allegations.
4. The Department refers individuals who allege new information or evidence affecting previous SSA determinations to SSA for reconsideration or reopening of the disability determination, except in the circumstances specified above.
D. Eligibility Status During SSA Administrative Appeal Process
1. An individual receiving assistance at the time SSA denies disability is entitled to continued benefits under the following conditions:
a. the individual timely appeals the SSA decision; and
b. the appeal is filed at an administrative level.
2. Individuals who timely appeal an SSA decision are not required to file a separate appeal with the Department to receive continued benefits.
3. The Department may terminate assistance before the deadline for filing an administrative appeal to SSA expires; however, benefits must be reinstated if an administrative appeal is filed before the deadline.
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 2-1-93 Transmittal: UP-93-2 P-2530.10 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Disability AABD _______________________________________________________________ MAABD Subject: Accepting SSA Disability Determinations as Conclusive ______________________________________________________________________________
P-2530.10 1. Consider the individual to be disabled under the following conditions:
° SSA has determined the individual is disabled;
° MRT has determined the individual is disabled, and there is no binding decision by SSA to the contrary;
° an appeal of an SSA decision to deny disability has been filed and assistance already has been granted based on disability.
2. Consider the individual not to be disabled under any other circumstances.
3. Take the following steps if the individual was granted assistance based on disability and SSA subsequently finds the individual is not disabled:
° Determine if the individual is eligible on some basis other than disability. Unless a delay is warranted, take immediate steps to discontinue benefits if the individual is not eligible on some basis other than disability.
° Delay the action for a reasonable period if an SSA administrative appeal is likely. However, proceed with the discontinue if an appeal is not filed promptly.
The SSA decision becomes final once the deadline for filing the appeal expires; usually 60 days from the date SSA notifies the individual of the decision. Action to discontinue benefits must be initiated by this date.
° If the SSA decision is appealed, continue benefits until the next administrative decision is rendered. Repeat this process if the decision is appealed to the next higher level in the administrative appeals process. The Appeals Council is the highest administrative level.
4. If assistance is discontinued, add the following text to the bottom of the discontinuance notice:
"Social Security has determined you are not disabled. You can appeal to Social Security if you disagree with the decision. If you appeal, please call your worker. We may be able to give you benefits if you do this right away."
CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 10-1-00 Transmittal: UP-00-22 2535.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements POLICY ______________________________________________________________________________ Chapter: Program: Blindness AABD _______________________________________________________________ MAABD Subject: Basis for Blindness ______________________________________________________________________________
2535.05 A. In order to be eligible for the State Supplement or related Medicaid on the basis of blindness, the individual must be blind as determined by the Department. The individual must be found to have:
1. total loss of sight in both eyes; or
2. visual acuity of 20/200 (6/60 metric) or less in the better eye, after correction to the best acuity obtainable with ophthalmic lenses; or
3. visual fields restricted to 20 degrees or less in the widest diameter, without regard to the amount of visual acuity; or
4. a visual impairment as described in paragraph C below.
B. Except as provided in paragraph C below, the medical criteria the Department uses for determining blindness are the same as those for evaluating blindness under SSI.
C. Under the Medicaid coverage group "Working Individuals with Disabilities," the individual must have a medically determinable impairment. However, the individual's ability to perform substantial gainful activity has no effect on the disability determination (Cross Reference: 2540.85).
CONNECTICUT DEPARTMENT OF INCOME MAINTENANCEPRIVATE UNIFORM POLICY MANUAL ______________________________________________________________________________ Date: 4-1-88 Transmittal: UP-88-21 P-2535.05 ______________________________________________________________________________ Section: Type: Categorical Eligibility Requirements PROCEDURES ______________________________________________________________________________ Chapter: Program: Blindness AABD _______________________________________________________________ Subject: Establishing Blindness ______________________________________________________________________________
P-2535.05 1. If disability is not established by receipt of SSI/SSA based on blindness as provided for in policy, obtain the information necessary for a determination of blindness by the Department's Medical Review Team (MRT). To accomplish this, use the procedures which follow.
2. Give the assistance unit the following forms:
° "Instructions for Form WR-3A";
° "Medical Examination Report", Form WR-3;
° "Social Information and Disability Report", Form W-176.
3. Explain to the assistance unit the use of Form WR-3 and encourage the unit to tell the examining physician the importance of returning the form in a timely fashion.
4. Advise the unit of the purpose of Form W-176 and emphasize the need for:
° returning the form to the Department within the specified time standards;
° filling in all the blank areas on the form;
° giving special attention to the completeness of the "Education" and "Work History" sections of the W-176.
5. Inform the unit that you will provide assistance upon request if a problem arises with obtaining information or completing the forms.
6. Set ticklers for the return of the forms.
7. When the forms are returned:
° arrange all of the medical information in chronological order, most recent first;
° complete and attach W-542 "Route slip to MRT,"
° submit the medical packet to MRT, Central Office.
This section is unusually large; deeper subsections were cut off. Open a subsection via its designator link — for example (0100) — to read its full text.