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COMBINED MANUAL

ISSUE DATE 02/2022

INTERIM ASSISTANCE AGREEMENTS

0012.12.03

Clients must sign and date a DHS-1795 and/or DHS-1795A at initial application or whenever changes in their circumstances indicate potential eligibility for other benefits. Clients do not need to sign and date new IAA forms at recertification.

Once IAA forms are signed and dated, they remain valid until 1 of the following occur: ● Social Security Administration (SSA) approves the SSI and/or RSDI application.

● SSA denies an application and client does not appeal the decision within 60 days.

● Client does not apply for other benefits, SSI and/or RSDI within 1 year of signing and dating the form(s).

● Client and agency agree in writing to end IAA authorization(s).

IAA forms signed and dated by an applicant/participant more than 30 days before a Combined Application Form (CAF) or Change Report Form is received are invalid. Enter a case note and file the invalid IAAs. Inform the client that they have 30 days to complete and return new IAA forms. For more information on coding STAT/PBEN see TEMP Manual TE02.12.14 (Interim Assistance Reimbursement Interface).

The agreement allows the state, county, and tribal agencies to seek repayment of benefits issued while an application for other benefits is pending and then approved. Unless prohibited by federal or state law, seek repayment when clients receive retroactive payments from other programs. The amount of the repayment cannot exceed the amount of benefits issued.

People who sign and date the DHS-1795 for SSI agree to let the Social Security Administration (SSA) reimburse the state for GA and/or GRH received during the period of retroactive SSI eligibility. DHS will mail a notice and explanation to clients and will notify counties via MAXIS CASE/NOTE when clients become eligible for SSI and the state has been reimbursed. Refer any remaining questions regarding SSI interim assistance reimbursements to DHS Financial Operations at 651-431-2427 or 1-888-702-9975.

Notify the DHS Benefit Recovery Section (BRS) of clients who sign and date a DHS-1795A for Workers' Compensation. BRS will seek recovery of benefits paid during the period covered by the Workers' Compensation claim.

For benefits that clients may receive directly, request repayment directly from the client. If the client does not voluntarily repay the benefits issued, begin action to recover it. See 0025 (Benefit Adjustments and Recovery).

When the client’s only source of income is RSDI and the client has no other resources, the county must ask the client to voluntarily repay the interim assistance he/she received. If the client refuses to voluntarily repay the interim assistance, the county may initiate a civil action to recover the interim assistance. The DHS-1795A includes a statement informing clients that RSDI payments, both retroactive and current, cannot be garnished, attached, executed upon, or levied upon. The form also explains that, although clients cannot be forced to use their RSDI benefits to repay the interim assistance they received, they can voluntarily use their RSDI benefits to repay their state debt.

Immediately determine MSA eligibility of any client SSA finds eligible for SSI.

GRH: Follow GA, with the following EXCEPTION:

If the client becomes retroactively eligible for SSI, review the case for retroactive GRH eligibility. Consider the following: ● Do not recalculate the client's GRH budget for months that GRH has been reimbursed through the DHS/SSI Interim Assistance Reimbursement (IAR) process or months for which the county received reimbursement directly from the client.

● If GRH was not reimbursed through the DHS/SSI Interim Assistance Reimbursement (IAR) process or voluntarily repaid by the client, the GRH budget must be recalculated for the months in which the client received SSI.