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When a request for a special allowance for supportive services is made, the CAO will:
Enter the date an oral request (including those made in person or by phone) for a special allowance was made or the date a written request was received in the case record narrative;
55 Pa. Code § 165.43
Set a control to ensure that the request is acted on within the required time-frame;
Promptly inform the individual of the verification needed to determine eligibility for the SPAL and assist the individual, including making collateral contacts, to obtain necessary verification;
Issue a written decision approving or denying the request, on an Eligible/Not Eligible Notice, no later than 15 calendar days following the request. For specific requirements related to issuing special allowances see Section 135.65 .Time-Frames For Approving Or Denying A Request For Special Allowance For Supportive Services.
When verification of these factors indicates a change in eligibility, the CAO will reduce, terminate, or increase the special allowance as appropriate, upon issuance of a Confirming Notice to the participant.
A notice approving the request must contain:
The amount of the payment.
The time frame covered by the payment.
An explanation of how the payment was determined, including the specific regulation used by the CAO to determine the amount.
The remaining SPAL balance.
The type of SPAL being issued.
A notice denying the request must contain:
Type of SPAL being denied
A statement of the reason for denial.
The facts on which the denial was based.
The specific regulation on which the denial was based.
A brief explanation of the regulation.
The individual has the right to appeal a decision by the CAO concerning a request for a special allowance for supportive services. See Supplemental Handbook Chapter 870, Appeal and Fair Hearing .
The following documentation must be made in the case record narrative when a SPAL is issued:
The type of allowance requested.
The reason code used.
The activity supported by the special allowance and if a current ETP plan reflects that activity.
The number of hours the individual is expected to participate and/or the number of hours that are required.
The amount of the special allowance and the calculations used to determine the amount, including the source of any collateral contact or third-party verification.
The remaining SPAL balance.
The dates the SPAL is intended to cover.
The following documentation must be made in the case record narrative when a SPAL is denied:
Type of SPAL being denied.
A statement of the reason for denial.
The facts on which the denial was based.
The specific regulation on which the denial was based.
Case comments are part of the case record narrative and must reflect case specific actions taken and the supporting details that led to taking the action.