Page 198
I. A County Board of Social Services may review, approve, disapprove, or amend an award of assistance made by the County Department of Social Services. The State Department of Social Services may review applications for public aid, disapprovals, or modifications of awards made by the county departments and may make decisions as to the granting and the amount of payment. J. Determination of Eligibility and Continued Eligibility. (1) No more than forty-five days (sixty days for Medical Assistance Only -Disability) shall elapse between the date of application and the date that either the first assistance grant, or the notice of denial of assistance, is mailed to the individual or family, unless: (a) The applicant or the agency, after repeated attempts, has failed to secure the necessary facts regarding eligibility and further processing time is necessary; (b) An applicant or physician has failed to provide needed information or an administrative or other emergency which could not be prevented causes a delay; (c) The applicant requests that an imminent negative action be delayed until additional information concerning eligibility can be secured. (2) Continued eligibility for financial or medical assistance shall be redetermined or reviewed in each of the following instances, whichever occurs earliest. (a) Immediately after the agency receives a report that a change has occurred in the recipient’s circumstances which may affect eligibility or the amount of the assistance grant; (b) When required on the basis of information the agency has obtained previously about anticipated changes in the recipient’s situation; (c) Every six months in Aid to Families with Dependent Children -Foster Care, Regular Foster Care, and Mandatory State Supplementation, and every twelve months for Aid to Families with Dependent Children, Medical Assistance Only and Optional Supplementation. (3) A home visit prior to certification shall be made on each AFDC application and review. A home visit shall be made before certification for General Disability Assistance, General Assistance-Ineligible Spouse and Optional Supplementation, but a home visit is not required for subsequent redetermina- tions in these assistance categories. Home visits are not required on Medical Assistance Only applications and reviews. Applicants and recipients shall be given oral or written notice of the intended date and purpose of any home visit. (4) The applicant or recipient shall provide necessary information and documentation of his eligibility for assistance, unless he is unable to do so because of age, physical or mental disability, language barriers, or other pertinent reason. (a) If the individual is physically or mentally incapable of providing complete or accurate information, the agency may take the initiative to secure such information. (b) An individual other than the applicant or recipient may be used as a collateral source of information as long as he: (i) Has definite knowledge of facts which relate to the applicant’s or recipient’s eligibility; and (ii) Is willing to have his identity revealed to the applicant or recipient, upon request, should the information provided result in an adverse action. (c) If an applicant refuses to provide information necessary to establish eligibility, which is within his capacity to provide, assistance shall be denied or terminated because eligibility cannot be established. (5) The agency shall give prompt written notification to an applicant or recipient of any decision concerning an application for financial or medical assistance. (a) If assistance is authorized the notice shall include the amount of the financial assistance grant, if applicable. (b) If assistance is denied the notice shall contain: (i) A written explanation of the reason for denial, (ii) The citation of the specific manual section or circular letter supporting the reason for denial; and