UPM 1545.40 - Processing Redeterminations

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.