UPM P-1545.35 - Processing Incomplete AFDC, AABD or MA Cases

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.