Part 351 - INVESTIGATION AND ELIGIBILITY

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Statutory Authority: 
Social Services Law, Sections 17(b), 20(3)(d), 34(3)(f), 131, 131-t, 134-a, 139-a(3), 153, 158, 355(3)

Section 351.1 - Investigation.

Section 351.1 Investigation. (a) Definition. Investigation is a continuous process which is concerned with all aspects of eligibility for public assistance or care from the period of initial application to case closing. Investigation means the collection, verification, recording and evaluation of factual information on the basis of which a determination is made of eligibility and degree of need, or of ineligibility, for any form of public assistance or care.

(b) Responsibility for furnishing information. (1) The social services official shall:

(i) provide applicants and recipients, and others who may inquire, with clear and detailed information concerning programs of public assistance, eligibility requirements therefor, methods of investigation and benefits available under such programs; and

(ii) inform each applicant and recipient, at the time of application and subsequently, of such person's initial and continuing responsibilities to furnish the information described in paragraph (2) of this subdivision.

(2) Each applicant and recipient must, as a condition of eligibility:

(i) provide accurate, complete and current information on his or her needs and resources as well as the whereabouts and circumstances of responsible relatives;

(ii) furnish evidence to provide verification of those factors which affect eligibility and the amount of entitlement, including:

(a) identity;

(b) residence;

(c) family composition;

(d) rent payment or cost of shelter;

(e) income from any source;

(f) savings or other resources; and

(g) lawful residence in the United States, if the recipient is an alien;

(iii) apply for and utilize any benefits or resources that will reduce or eliminate the need for public assistance or care; and

(iv) make a timely report to the district of any changes in his or her needs and resources. A report will be considered timely if made within 10 days of the changes except as provided in section 352.30(d)(4) of this Title. A report to a social services district concerning changes in income will be considered timely if made within the time frames specified in section 351.24(d) of this Part.

(c) Responsibility for prompt determination of eligibility. Upon receipt of an application for assistance, the social services official shall conduct an investigation and secure, record and evaluate the findings thereof in order to:

(1) promptly determine eligibility or ineligibility for public assistance;

(2) determine the type of public assistance or care, including food stamps required, and authorize such assistance;

(d) Constitutional and statutory rights of applicants and recipients. Any investigation or reinvestigation of eligibility shall be conducted in a manner that will not result in practices that violate an applicant's or recipient's constitutional rights. An applicant or recipient shall be permitted to appear with an attorney or other representative at any interview or conference with a representative of a social services district, whenever such interview or conference relates to questions of eligibility for public assistance and care, or the amount to which the person interviewed is or was entitled.

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Section 351.2 - Aspects of investigation and eligibility.

351.2 Aspects of investigation and eligibility. (a) Identity. The applicant or recipient must furnish verification of his or her identity, as a condition of eligibility, at the time of application or recertification for public assistance or care. Any member of a household eighteen years of age or older and the head of a household who is receiving or applying for safety net assistance or emergency safety net assistance, public institutional care for adults, family assistance or emergency assistance to needy families with children, is, when requested to do so by the social services district, required to establish his or her identity by means of finger images to be used in the automated finger imaging system authorized in Part 384 of this Title. No household can receive safety net assistance, emergency safety net assistance, public institutional care for adults, family assistance or emergency assistance to needy families with children if any member of the household, eighteen years of age or older, or the head of the household, refuses to allow his or her finger images to be obtained for use in the automated finger imaging system. Any such household's application must be denied or, if the household is participating in the program, benefits must be discontinued. Persons applying for or receiving benefits under the food stamp program or food stamp assistance program must also allow their finger images to be obtained in accordance with section 387.9 and 388.8 of this Title.

(b) Residence and cost of shelter. Place of residence and rent payment or other shelter costs of the applicant or recipient shall be verified.

(c) Family composition. For each member of the household for whom an application for assistance is made the following information must be furnished: name; date and place of birth; relationship to other members of the household; veteran status; activity status; marital status if 16 years of age or over; if any person is pregnant, the anticipated date of delivery; and if the applicant is employed, the expenses incident to such employment. For each members of the household not applying for assistance, the name and relationship to those applying for assistance shall be furnished. In addition, each member of the household for whom an application for assistance is made or any other individual whose needs are considered in determining the amount of assistance must apply for and must furnish a social security number as a condition of the household's eligibility for public assistance.

(d) Need. Consideration shall be given to individual and family requirements for all items of need and any changes in such requirement for need in accordance with department regulations.

(e) Resources. Resources include individual or family financial assets, income from employment, eligibility for or receipt of benefits, and the services and social resources available through family relationships and community programs. Resources shall be explored, verified and evaluated, as to their immediate and/or potential availability to remove or reduce the need for public assistance. All resources shall be evaluated according to their equity value. Equity value means fair market value less encumbrances (legal debts).

(1) Financial resources. Each financial asset or resource immediately or potentially available to the applicant or recipient shall be identified and shall be explored to determine its nature, equity value, form and availability. Each such resource shall be evaluated and a decision reached in regard to its utilization. Such resources include, but are not limited to: employability, earnings, work-related benefits, pensions, health insurance, small business, real and personal property, securities, cash on hand, bank accounts, insurance, trust funds, estate settlements, servicemen's benefits, income in kind, contributions from relatives and friends, support orders, and any other benefits or interest in real or personal property. To obtain information on RSDI payments, each local social services department shall, in accordance with the instructions of the State Department of Social Services, submit input to the beneficiary data exchange (BENDEX) system.

(2) Relatives. (i) There shall be reviewed with the applicant the whereabouts of any legally responsible relatives. Unless proof of death of each legally responsible relative is shown, there shall be referred to the local child support enforcement unit, on a form prescribed therefor, as much information as can be obtained on each such legally responsible relative. A referral in writing shall also be made to the local law enforcement official. The referral to the local child support enforcement unit shall be within two working days of furnishing aid.

(ii) When the applicant for or the recipient of public assistance or care is an unmarried mother and surrender of the child to the social services official for the purpose of adoption is under consideration, or the child has been surrendered to the social services official for the purpose of adoption, referral to the local child support enforcement unit may be deferred for a period of 90 days after the birth of the child.

(iii) When the applicant for or recipient of public assistance is pregnant with, or is the parent of, and residing with, an out-of-wedlock child and surrender of the child to the social services official for purpose of adoption is not under consideration, referral in writing must be made to the local child support enforcement unit within two days of furnishing assistance.

(iv) When an applicant for or recipient of public assistance willfully fails or refuses to cooperate by furnishing information or aid to the local child support enforcement unit in establishing a support obligation, enforcing a support order or establishing paternity, the social services official shall not provide or continue to provide assistance or care for such applicant or recipient for so long as such cooperation is withheld. Such person's needs shall be excluded from consideration and the needs of the remaining family members shall be met in accordance with department regulations in the form of protective payments.

(f) Categorical eligibility factors. The special eligibility requirements of aid to the aged, blind and disabled (AABD), aid to dependent children (ADC), and emergency assistance to needy families with children

(EAF) shall be considered whenever there is a possibility that eligibility for one of these categories exists. When eligibility or presumptive eligibility is evident, full utilization of these categories shall be made. Where veteran assistance (VA) is administered, eligibility for this type of assistance shall be considered, if eligibility for a Federal category does not exist. Adult institutional care shall be considered when care in such a facility is required and eligibility for a federally aided category does not exist.

(g) Residence. Information obtained shall be sufficient to establish that:

(1) the applicant or recipient is residing or found within the social services district on the date of application, except in cases of temporary absence or continuing responsibility under subdivision (5) of section 62 of the Social Services Law;

(2) where applicable, another social services district is responsible for reimbursing the costs of institutional care; and

(3) where indicated, the State is responsible for reimbursing the full costs of assistance or care.

(h) An applicant or recipient who is an alien shall furnish evidence to verify that he is lawfully residing in the United States.

(i) Requirements for alcoholism and substance abuse screening, assessment and rehabilitation services.

(l) Screening and assessment.

(i) Investigation of eligibility for public assistance must include a screening for alcohol and/or substance abuse of all heads of households and of all adult household members, using a standardized screening instrument developed by the Office of Alcoholism and Substance Abuse Services in consultation with the office. Such screening will be performed at the time of application and periodically thereafter, unless the recipient is actively participating in alcoholism and/or substance abuse treatment in accordance with the provisions of this subdivision, but no more frequently than every six months, unless the district has reason to believe that an applicant or recipient is abusing or dependent on alcohol and/or drugs.

(ii) When the screening process indicates that there is reason to believe that an applicant or recipient is abusing or dependent on alcohol or drugs, or there is other evidence that an applicant or recipient is abusing or dependent on alcohol or drugs, the local district must require the applicant or recipient to undergo a formal alcohol or substance abuse assessment, which may include drug testing, to be performed by an alcohol and/or substance abuse professional credentialed by the Office of Alcoholism and Substance Abuse Services. The assessment may be performed directly by the district or pursuant to contract with the district.

(iii) If the formal assessment determines that the applicant or recipient is unable to work by reason of his or her need for treatment for alcohol or substance abuse, the social services official must refer the individual to an appropriate alcoholism and/or substance abuse treatment program.

(iv) To be considered an appropriate treatment program, the treatment program must:

(a) be licensed or certified by the Office of Alcoholism and Substance Abuse Services or operated by the United States Department of Veterans Affairs and be determined by the social services official to meet the rehabilitation needs of the individual, in accordance with standards developed by the Office of Alcoholism and Substance Abuse Services;

(b) develop a treatment plan for the individual which includes an expected date of availability for work related activities and provide a copy of such plan to the local district responsible for payment, in a manner consistent with 41 CFR Part 2;

(c) provide at a minimum of every three months, a treatment progress report for each recipient of public assistance to the local district responsible for payment of public assistance benefits; and

(d) request approval by the local district responsible for payment of public assistance benefits prior to changing an individual's level of treatment care.

(v) If the local district is responsible for payment of treatment, the district can require in-district treatment, provided an appropriate treatment program is available. When residential treatment is appropriate for a single custodial parent, the social services official must make diligent efforts to refer the parent to a program that would allow the family to remain intact for the duration of the treatment.

(vi) A person who fails to participate in the screening or in the assessment is ineligible for public assistance. Other members of a household which includes a person who has failed to participate in the screening or assessment must, if otherwise eligible, receive public assistance only through non-cash safety net assistance.

(vii) If a person required to participate in treatment pursuant to this subdivision fails to consent to disclosure of necessary treatment information by the treatment program to the social services district, or subsequently revokes such consent, such person will be ineligible for public assistance. Other members of the household which includes such person will, if otherwise eligible, receive public assistance only through non-cash safety net assistance.

(2) Rehabilitation services.

(i) A person referred to, or participating in, a treatment program pursuant to paragraph (1) of this subdivision, and the household in which he or she resides will receive non-cash safety net assistance while the person is participating in such treatment program, if the household is otherwise eligible for public assistance. If a person referred to treatment cannot participate in that treatment because treatment is not presently available, that person and the household in which he or she resides will receive non-cash safety net assistance if the household is otherwise eligible for public assistance.

(ii) Local districts are required to monitor treatment progress at a minimum of every three months.

(iii) If an applicant for or recipient of public assistance is required to participate in an appropriate rehabilitation program and fails to participate in such program without good cause or leaves such program prior to completion of the program without good cause, or if an applicant or recipient has been suspended from the receipt of social security disability benefits or supplemental security income benefits by reason of noncompliance with requirements of the Federal social security administration for treatment for substance abuse or alcohol abuse, the person must be disqualified from receiving public assistance for the time periods set forth below. Failure to participate in such program is defined as failure to comply with the established treatment plan including scheduled treatment sessions. The applicant or recipient is required to document compliance with the treatment plan. The question of whether the applicant or recipient has completed the program will be determined solely by using the guidelines and rules of the rehabilitation program.

(a) For the first failure to participate in or complete the program or to comply with the requirements of the Federal social security administration, until the failure ceases or for 45 days, whichever period of time is longer.

(b) For the second such failure, until the failure ceases or for 120 days, whichever period of time is longer.

(c) For the third and subsequent failures, the person is disqualified until the failure ceases or for 180 days, whichever period is longer.

The household in which the person resides will continue to receive non-cash safety net assistance, if otherwise eligible.

(iv) The applicant or recipient must be considered to have good cause for failing to participate or failing to complete a rehabilitation program when:

(a) the local district, the facility and the applicant or recipient agree that the applicant or recipient is in need of a different program than the one to which he or she was referred or which he or she is attending and the applicant or recipient has enrolled in a rehabilitation program which the local district has determined appropriate; or

(b) a verified unforeseen circumstance occurs that is beyond the applicant's or recipient's control such as illness or a death in the family.

(v) Persons disqualified from receiving public assistance pursuant to subparagraph (iii) of this paragraph who would otherwise be eligible for public assistance and who return to required treatment prior to the end of the disqualification period and are receiving care in an Office of Alcoholism and Substance Abuse certified congregate care Level II facility, as defined in section 352.8 of this Title or United States Veterans Hospital residential treatment program, are eligible for non-cash safety net assistance.

(vi) If a recipient required to participate in an appropriate treatment program receives a personal needs allowance, such allowance must be made as a restricted payment to the treatment program and must be a conditional payment. If such recipient leaves the treatment program prior to completion of the program, any accumulated personal needs allowance must be considered an overpayment and returned to the local district which provided the personal needs allowance.

(3) For purposes of this subdivision, an adult is any individual in the household who is 18 years of age or over who is applying for or in receipt of public assistance, except an individual 18 years of age who is a full time student regularly attending a secondary school, or in the equivalent level of vocational or technical training.

(j) An applicant for ADC who is determined to be employable and who is assigned to job search activities, must, as a condition of eligibility of the filing unit, actively seek employment and provide verification of doing so. Compliance with this requirement shall be determined by the standards for job search set forth in section 385.7 of this Title.

(k) Ineligible individuals. In addition to any other individual who is ineligible for public assistance, the following individuals are also ineligible for such assistance:

(1) any individual under the age of 18 who is not married and has a minor child 12 weeks of age or more in his or her care and who has not successfully completed a high school education or its equivalent if such individual does not participate in educational activities directed toward the attainment of a high school diploma or its equivalent or an alternative educational or training program directly related to employment and approved by the social services district. Local districts must not determine any person ineligible under this paragraph during any period of time in which enrollment in required educational activities is not available. Nothing prohibits a social services district from requiring any person to work toward attaining a secondary school diploma or its equivalent unless such individual has been determined by a medical, psychiatric or other appropriate professional to lack the requisite capacity to complete successfully such a course of study;

(2) any individual during the ten-year period that begins on the date the individual is convicted in federal or state court of having made a fraudulent statement or representation with respect to his or her place of residence in order to receive public assistance, medical assistance or food stamps simultaneously from two or more states, or supplemental security income in two or more states. This paragraph does not apply with respect to the conviction of an individual in any month beginning after the president of the United States grants a pardon with respect to the conduct which was the subject of the conviction. Such individual is also ineligible to receive benefits under the food stamp program as set forth in section 387.1 of this Title;

(3)(i) any individual who is fleeing to avoid prosection or custody or conviction under the laws of the place from which the individual flees for a crime or attempt to commit a crime which is a felony under the laws of the place from which the individual flees, or which, in the case of the state of New Jersey, is a high misdemeanor under the laws of such state; or

(ii) any individual who is violating a condition of probation or parole imposed under federal or state law. Local districts must consider a person to be violating a condition of probation or parole only if:

(a) the person is currently an absconder from probation or parole supervision and a warrant alleging such a violation is outstanding; or

(b) the person has been found by judicial determination to have violated probation or by administrative adjudication by the division of parole to have violated parole. Such person must be considered to be violating a condition of probation or parole under this paragraph only until he or she is restored to probation or parole supervision or released from custody, or until the expiration of the person's maximum period of imprisonment or supervision, whichever occurs first.

A person considered to be violating a condition of probation or parole under this paragraph includes a person who is violating a condition of probation or parole imposed under federal law. For purposes of this paragraph, probation or parole includes conditional release, wherever applicable; or

(4) Any individual who is a minor child who has been or is expected to be absent from the home of his or her parent or other caretaker relative for a consecutive period of 45 days or more without good cause. In addition, no assistance may be given to any parent or other caretaker relative who fails to notify the social services district of the absence of the minor child within five days after it becomes clear to the parent or relative that the child will be absent for a consecutive period of 45 days or more. Good cause includes absence for placement in foster care if the goal set forth in the child service plan under sections 428.6 and 428.7 of this Title is the return of the child to a member of the household, visits to friends or relatives, attendance at school, attendance at camp or hospitalization; if it is in the best interests of the child to return home and return is expected within a reasonable time. A parent or caretaker relative who fails to comply with the provisions of this paragraph is ineligible for public assistance for a period of 30 days for each whole or partial calendar month during which the child was absent from the home before the social services district was notified of the absence.

* (l) Requirements for domestic violence screening, assessment, and referral for services, public assistance program waivers.

(1) Definitions.

(i) For purposes of this subdivision, victim of domestic violence means an individual who has been subjected to:

(a) physical acts that resulted in, or could result in, physical injury to the individual;

(b) sexual abuse;

(c) sexual activity involving a dependent child;

(d) being forced as the caretaker relative of a dependent child to engage in nonconsensual sexual acts or activities;

(e) threats of, or attempts at, physical or sexual abuse;

(f) mental abuse; or

(g) neglect or the deprivation of medical care; and

(h) such act or acts have or are alleged to have been committed by a family or household member.

(ii) For the purposes of subparagraph(i) of this subdivision, family or household members mean the following persons:

(a) persons related by blood or marriage;

(b) persons legally married to one another;

(c) persons formerly married to one another regardless of whether they still reside in the same household;

(d) persons who have a child in common regardless of whether such persons are married or have lived together at any time;

(e) unrelated persons who are continually or at regular intervals living in the same household or who have in the past continually or at regular intervals lived in the same household;

(f) unrelated persons who have had intimate or continuous social contact with one another and who have access to one another's household; or

(g) any other persons referenced in section 459-a(2) of the Social Services Law.

(2) Domestic violence liaison.

(i) Responsibilities. Domestic violence liaisons are responsible for the following tasks:

(a) assessing the credibility of the applicant/recipient's assertion of domestic violence based upon information and corroborating evidence;

(b) assessing the safety of the victim and the victim's dependents and their need for services and support;

(c) informing a victim of domestic violence referred to the liaison about domestic violence and the options for protection, services and other supports;

(d) informing a victim of domestic violence referred to the liaison about the rights and responsibilities with respect to obtaining waivers of public assistance program requirements;

(e) gathering facts regarding the extent to which domestic violence is a barrier to the victim of such violence meeting public assistance program requirements including employment requirements and the need for obtaining waivers of such requirements;

(f) determining the need for waivers where compliance with public assistance program requirements would place the victim and/or the victim's children at greater risk of harm or make it more difficult to escape from the abuse, and making recommendations for granting waivers or granting waivers of public assistance program requirements;

(g) periodically reassessing the individual's domestic violence circumstances and modifying, terminating or extending the public assistance program waiver(s);

(h) maintaining a list of, at a minimum, available domestic violence services and maintaining a relationship with the providers of the services including, but not limited to domestic violence service providers, key court personnel and the local domestic violence coalition, where applicable;

(i) coordinating activities with other case managers and examiners within the social services district; and

(j) facilitating emergency safety planning for victims of domestic violence in a crisis situation, as necessary.

(ii) Qualifications. Social services districts must give a strong preference to relevant advocacy or counseling experience in determining whether someone should be designated a domestic violence liaison. Domestic violence liaisons must meet the following minimum job qualifications:

(a) be a caseworker, or

(1) possess a bachelor's degree, or

(2) have one year of domestic violence advocacy or domestic violence counseling experience with an approved domestic violence program, or

(3) have two years of relevant advocacy or domestic violence counseling experience; and

(b) complete a course of training for domestic violence liaisons sponsored by the Office of Temporary and Disability Assistance (Office); and

(c) possess good communication, listening and assessment skills and the ability to work positively in a team setting.

(iii) If a social services district chooses to contract for the domestic violence liaison position(s), it must comply with the following requirements:

(a) the agency employing the liaison(s) must be an approved residential program for victims of domestic violence pursuant to Part 452, 453, 454, or 455 of this Title and/or a non-residential program for victims of domestic violence pursuant to Part 462 of this Title;

(b) if it is not feasible for the assessment function to be carried out at the offices of the social services district, the district must make provision for ensuring that individuals can go to the alternative location, that their safety will be ensured and that their confidentiality will be maintained. The district must make this information available to the Office when requested;

(c) the liaison must maintain regular contact with appropriate social services district staff, including providing the district with data pertaining to public assistance program waivers; and

(d) the agency employing the liaison and the district must provide each other with necessary training so that the agency and district can optimally fulfill their obligations under this subdivision.

(3) Universal notification. Social services districts must notify all public assistance applicants and recipients of the procedures for protecting themselves from domestic violence and the availability of domestic violence services. Such notification will be done by using the universal notification handout, developed by the Office in consultation with the Office for the Prevention of Domestic Violence and statewide domestic violence advocacy groups.

(4) Screening and referral to liaisons.

(i) Social services districts must inquire of all public assistance applicants and recipients regarding the existence of any domestic violence committed against the applicant or recipient. Such inquiry will be done by using the universal screening form developed by the Office in consultation with the Office for the Prevention of Domestic Violence and statewide domestic violence advocacy groups.

(ii) Social services districts must advise clients that responding to questions concerning the existence of domestic violence is voluntary and that any response will remain confidential; provided, however, that information regarding suspected maltreatment or abuse of children will be reported to the Statewide Central Register of Child Abuse and Maltreatment.

(iii) Social services districts must make the screening form available for voluntary client completion, in writing, at the application and recertification interview. However, the district must accommodate clients who wish to provide this screening information verbally when completion is not possible due to literacy problems. The district must also accommodate clients who wish to provide this screening information at another time when completion is not initially possible due to risk of danger to themselves, for example due to the presence of the batterer at the time of the initial screening. The district must provide the screening form to any individual who at any time is identified as a victim of domestic violence, or otherwise requests such screening.

(iv) When an individual indicates the presence of domestic violence by providing an affirmative response on the screening form, the district must refer that individual to a domestic violence liaison as soon as practicable and prior to any other assessment.

(5) Assessment of credibility.

(i) The domestic violence liaison must, as soon as practicable, assess the credibility of a positively screened individual's assertion of domestic violence based upon all relevant information including, but not limited to: an order of protection; court, medical, criminal, child protective services, social services, psychological, or law enforcement records; presence in a domestic violence shelter; a signed statement by a domestic violence counselor or other counselor or other corroborating evidence.

(ii) Such assessment must be based upon the relevant information and corroborating evidence, but must in the absence of other sufficient evidence include, at a minimum, a sworn statement by the individual alleging the abuse.

(6) Services referral and waiver assessment. If the domestic violence liaison determines that the allegation of domestic violence is credible, the domestic violence liaison must, as soon as practicable:

(i) inform the individual of services related to domestic violence, which are available to the individual on a voluntary basis;

(ii) conduct an assessment to determine if and to what extent domestic violence is a barrier to compliance with public assistance program requirements or to employment;

(iii) assess the need for temporary waivers of such program requirements;

(iv) recommend or grant any necessary waivers in coordination with social services district staff who are charged with the implementation of such waivers and/or the administration of public assistance program requirements; and

(v) inform social services district staff responsible for the administration of public assistance requirements of the final determination or recommendation with respect to waivers.

(7) Waivers.

(i) Waivers are a temporary suspension of public assistance program requirements including, but not limited to, residency rules, child support and paternity cooperation requirements, alcohol and substance abuse screening and referral requirements, employment and training requirements, and learnfare. Any such waivers must be consistent with federal law.

(ii) The granting of a waiver does not affect the amount of the grant or the budgeting of income for the applicant or recipient.

(iii) Waivers will be granted in cases where compliance with public assistance program requirements would make it more difficult for the individual or the individual's children to escape from domestic violence or subject them to further risk of domestic violence. Such waivers must be for an initial period of not less than four months. All such waivers will be subject to on-going review of the individual's circumstances by the domestic violence liaison and may be extended, modified or terminated based on such review at any time, including the time covered by the initial four month waiver period.

(iv) In considering the extension of waivers, the domestic violence liaison must consider the totality of the individual's case circumstances. However, unwillingness on the part of the individual to engage in any options, steps or activities that might assist the individual in terms of safety or self-sufficiency may affect the individual's credibility.

(v) Waivers may be granted permitting the receipt of Family Assistance benefits by individuals who have already received benefits for sixty months and who would not be required to participate in work or training activities, pursuant to the regulations of the Department of Labor, because of an independently verified physical or mental impairment resulting from domestic violence that is anticipated to last for three months or longer, or if the individual is unable to work because of the need to care for a dependent child who is disabled as a result of domestic violence.

(vi) An individual may decline a waiver or terminate an existing waiver at any time without penalty.
(8) Alien eligibility and deeming.

(i) Under Immigration and Naturalization Services (INS) rules, certain battered aliens not otherwise considered qualified aliens for public assistance eligibility purposes can petition INS and be granted qualified alien status thereby entitling them to receive benefits. Aliens so qualified will be issued a "Notice of Prima Facie Case" by INS.

(ii) Social services districts must exempt such battered aliens from alien deeming requirements in accordance with section 352.33 (c) of this Title. *NB Effective until 98/08/06

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Section 351.3 - Required approval of facility.

351.3 Required approval of facility. Insofar as practicable, assistance and care for a needy person shall be provided in his own home, or in an approved facility suitable to the needs of the person in accordance with department regulations relating thereto.

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Section 351.4 - Front end detection system (FEDS) referrals.

351.4 Front end detection system (FEDS) referrals. The appropriate social services eligibility worker must refer applicants for assistance to the social services district's FEDS investigative unit in accordance with criteria set forth in the district's approved FEDS plan submitted to the Department in accordance with Part 348 of this Title. Any referrals to the FEDS investigative unit must not delay the eligibility determination process beyond the time frames established by the Social Services Law or this Title.

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Section 351.5 - Sources of information.

351.5 Sources of information. (a) Primary sources. The applicant, recipient, members of his/her household and public records must be relied upon as primary sources of information. Information received from applicants, recipients, and members of the household must be verified. The applicant or recipient is required, wherever possible, to provide such verification by documentation. If the applicant or recipient has previously verified necessary information which is not subject to change and the social services district possesses documentation of such verification in its files, the applicant or recipient is not required to resubmit verification of such information; provided, however, that such documentation may be required in connection with any State quality control review of social services district programs. When an applicant or recipient establishes that he/she has made reasonable efforts to obtain information or verification from a third party (other than a third party who is required to be in the filing unit, or whose income is used in determining eligibility or an individual living in the household) and the third party fails or refuses to provide the information or verification or seeks to impose a charge or fee for providing the information to the applicant or recipient, the social services official must pay such fee or must assist the applicant or recipient in obtaining the information or verification from the third party or by other means as may be necessary.

(b) Secondary and collateral sources and collateral investigation. Secondary or collateral sources of information are relatives outside the immediate family group, and other persons, agencies or resources. Collateral investigation means the collection of additional information through contacts with secondary sources such as relatives, employers, banks, insurance companies, school personnel, social agencies, and other appropriate individuals and organizations.

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Section 351.6 - Verification.

351.6 Verification. Verification of data, which are pertinent to the determination of initial and continuing eligibility or the amount of the assistance grant, is an essential element of this investigation.

(a) Documents, personal observation, personal and collateral interviews and contacts, reports, correspondence and conferences are means of verification.

(b) When information is sought from collateral sources other than public records because the applicant or recipient cannot provide verification, there shall be a clear interpretation to the applicant, recipient or legally responsible relatives of what information is desired, why it is needed and how it will be used.

(c) Verification of information with respect to legally responsible relatives from collateral sources shall be made only with the knowledge and consent of such relatives, after first giving them the opportunity to provide verification of their income, resources and expenses by other means.

(1) In the event that a legally responsible relative residing outside the applicant's or recipient's household fails or refuses to cooperate in providing necessary information about his financial circumstances, such refusal shall not be a ground for denying or discontinuing assistance. Such refusal shall be referred to the law enforcement officer in accordance with department regulations.

(2) In the event that a legally responsible relative residing in the applicant's or recipient's household fails or refuses to cooperate in providing necessary information about his financial circumstances, such refusal shall be a ground for denying or discontinuing assistance to the persons for whom he is legally responsible.

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Section 351.7 - Supervisory review and approval.

351.7 Supervisory review and approval. The findings of the investigation together with the recommendations for case action shall be reviewed and approved by the supervisor. Supervisory approval shall be indicated by a dated signature in the case record. Supervisory approval shall be based upon review of all available information pertaining to eligibility and the amount of entitlement. It shall include approval of decisions to deny public assistance as well as decisions to change a grant or to refer an applicant or recipient for services.

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Section 351.8 - Decision on initial eligibility and payment of assistance

351.8 Decision on initial eligibility and payment of assistance grants. (a) Decision on initial eligibility is the conclusion or determination reached at any point in the application process. Such decision, as approved on supervisory review, shall constitute the decision of the social services official. The decision shall be one of the following:

(1) Accepted for assistance. This means that eligibility has been fully established through investigation or that emergency need and presumptive eligibility has been established and authorization for assistance has been made and approved by the social services official.

(2) Not accepted for assistance. Applications are denied and not accepted for assistance when:

(i) In the course of the application interview the information given by the applicant establishes, without the need for further investigation, that he is ineligible.

(ii) Ineligibility is determined in the course of or upon completion of the investigation, or if the applicant refuses to comply with any requirement essential to the determination of eligibility.

(3) Terminations without decision. No decision is required when:

(i) an application is withdrawn by the applicant; or

(ii) the social services official documents that the applicant has died, cannot be located, or has left the district prior to the completion of the investigation.

(b) The decision to accept or deny the application must be made within 30 days from the date of application for Aid to Dependent Children (ADC) and within 45 days from the date of application for Home Relief (HR), except where the applicant requests additional time or where difficulties in verification lead to an unusual delay, or for other reasons beyond the social services official's control. The applicant must be notified in writing of the decision in accordance with department regulations. The reason for the delay in deciding whether to accept or deny an application for ADC or HR must be recorded in the case record and communicated to the applicant. The applicant must be notified of the availability of assistance to meet emergency circumstances or to prevent eviction.

(c) (1) When eligibility has been established, the application shall be accepted for assistance pending the development of potential resources, i.e., support from relatives, adjustment of insurance, or eligibility for benefits. It shall be the responsibility of the social services official to fully explore and develop all such resources.

(2) The amount of the initial grant of regularly recurring financial assistance for ADC must be computed starting with the date of establishment of eligibility or the 30th day after the date of application, whichever is earlier. The amount of the initial grant of regularly recurring financial assistance for HR must be computed starting with the 45th day after the date of application. In determining the amount of the initial grant, the monthly budget deficit must be prorated to reflect the number of days in the month in which there was initial coverage. Paid rent must be treated as income for purposes of determining the monthly budget deficit under this paragraph, except when such rent is paid using income already being budgeted. This paragraph will not be construed as limiting the obligation of the agency to make payments pursuant to subsequent paragraphs of this subdivision.

(3) For ADC cases, the first payment must be authorized no later than 30 days from the date of application. State reimbursement will not be made for payments made to HR recipients for periods prior to 45 days from the date of application unless such payments are required to meet emergency circumstances or to prevent eviction. Emergency circumstances include situations in which the applicant or the applicant's household has no food and is not eligible for food stamps; has no shelter; has no fuel for heating during the cold weather period; has a utility disconnect notice and utilities have been scheduled to be disconnected within 72 hours of receipt of such notice, or utilities have been disconnected; or lacks items necessary to meet the health and safety needs of the applicant or the applicant's household, and there are no resources, including family and community resources, available to meet the emergency circumstances. Notwithstanding any other provisions of this Title, social services districts are not required to provide HR to any person otherwise eligible if State reimbursement is not available in accordance with the provisions of the Social Services Law.

(4) When eligibility has not been established but immediate need is determined to exist, an emergency or predetermination grant of assistance shall be made in accordance with department regulations.

(5) (i) A child who is born to a recipient of public assistance is eligible for such assistance from the date of his/her birth, provided verification of the birth is received by the appropriate social services official:

(a) within six months of the birth of the child; or

(b) by the recipient's first scheduled recertification interview after the birth of the child; whichever is later.

(ii) The failure to present verification of a child's birth to a social services official in accordance with the provisions of subparagraph (i) of this paragraph will result in such child becoming eligible for public assistance beginning on the date that verification of the birth is provided to such official.

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Section 351.9 - Concurrent benefits prohibited.

351.9 Concurrent benefits prohibited. (a) Definitions. For purposes of this section:

(1) Benefits means public assistance grants or any other grants or benefits provided in accordance with the Social Services Law or in accordance with other provisions of this Title. Such benefits include home relief, aid to dependent children or other public assistance cash grants which are provided to cover basic needs.

(2) Concurrent benefits means benefits paid from a public assistance program more than once or from more than one public assistance program, or any other programs or activities for which the department is responsible, which are provided during the same time period to meet the same needs of the same individual. Medical assistance, energy assistance, food stamp assistance or other assistance provided to individuals who have been determined to be eligible for a public assistance cash grant will not be considered concurrent benefits. Aid to dependent children may be considered concurrent benefits when provided to meet the needs of home relief recipients; medical assistance based upon eligibility for home relief may be considered concurrent benefits when provided to meet the needs of recipients of federally funded aid to dependent children.

(3) Individual includes a public assistance recipient or a recipient of benefits from any other programs or activities for which the department is responsible, any legally responsible relative of such recipient and any other adult payee for such recipient.

(b) No individual may receive concurrent benefits unless a social services official, in accordance with the policies or directions of the department, specifically has determined that such duplication of benefits is necessary and appropriate due to specific case circumstances which are stated in the case record.

(c) If a social services official learns that an individual is applying improperly for or receiving benefits when such individual is also receiving, or has been approved to receive, concurrent benefits in that social services district, or in another social services district, state, territory or commonwealth, then the social services official must deny the benefits for which the individual, legally responsible relative or payee is applying, or must discontinue any concurrent benefits being provided for such individual.

(d) A determination that an individual is receiving or applying for concurrent benefits must be based on information which establishes with reasonable certainty that the same individual is receiving or applying for assistance to meet the same needs in the same or separate subdivisions of that social services district, or in another social services district, state, territory or commonwealth. Information used to identify an individual with reasonable certainty includes, but is not limited to:

(1) finger images;

(2) photographic images;

(3) official identification documents; and

(4) governmental or public records containing verifiable biological or demographic information unique to particular individuals.

(e) A social services official discovering or investigating the application for or receipt of concurrent benefits must notify any other social services entity which has authorized payment for benefits which are concurrent and inform such social services entity of the existence of the concurrent cases and of the action that the referring social services official has taken or plans to take. A social services official that has been notified that concurrent benefits are being claimed or paid, must, after an investigation, take any necessary action to assure that only appropriate social services benefits are being provided to any individual identified as receiving concurrent benefits.

(f) Subject to the provisions of sections 358-3.3(g), 358-3.6(a) (2)

(vi) and 358-3.6(c) (2) (iii) of this Title, individuals whose benefits are being discontinued are entitled to aid continuing as defined in section 358-2.5 of this Title for only one open case in the State during the time period in which concurrent benefits are denied or terminated. Social services officials must make determinations to discontinue or deny benefits to individuals applying for or receiving concurrent benefits by issuing, to the extent permitted by Part 358 of this Title, only adequate notices that do not afford to such individuals any right to receive aid continuing as defined in section 358-2.5 of this Title for more than one open case at one time in the State.

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Section 351.10 - Identification and referral of adolescents to case management

351.10 Identification and referral of adolescents to case management activities. A pregnant or parenting adolescent who is receiving public assistance or is a payee of such benefits on behalf of his or her child(ren) must be identified and referred to the appropriate unit or agency for case management activities as described in Part 361 of this Title.

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Section 351.12 - Learnfare.

351.12 Learnfare. (a) Subject to the implementation schedule set forth in section 131-y of the Social Services Law, social services districts are required to establish a learnfare program. The purpose of the learnfare program is to prevent children from dropping out of school and to improve the attendance of children in school.

(b) Social services districts must provide every applicant for and recipient of public assistance whose household includes a child enrolled in school in grades one through six with written notification that their child will be subject to the learnfare program. The notice must be provided at the time of application for public assistance and at the beginning of the school year. The notice must inform the applicant or recipient of the attendance requirements of the learnfare program, the consequences of a child's failure to meet such requirements and the rights of the child and parent or guardian in the learnfare program. That portion of the notice that sets forth the consequences of a child's failure to meet the requirements of the learnfare program must be printed in bold face type.

(c) In order to implement the learnfare program, social services districts participating in the program are required, in cooperation with school districts, to develop a plan setting forth arrangements with schools for obtaining attendance reports, providing school-based counseling services and encouraging parental intervention and cooperation with the school to encourage attendance. The plans must include protection for the confidentiality of the identities of students subject to the provisions of this section, consistent with the provisions of section 136 of the Social Services Law, and must provide for the designation of one school administrator to administer the learnfare program in each school. The plans must be submitted to the Office of Temporary and Disability Assistance and approved by appropriate staff of the office prior to implementation of the learnfare program in a social services district. Any amendments that a district proposes to make to its plan must be approved by the office before the amended plan is implemented. All plans submitted to the office pursuant to this section must be submitted in time to meet the implementation schedule set forth in section 13l-y of the Social Services Law.

(d) (1) A child enrolled in grades one through six who is receiving public assistance must attend school. If a child subject to the provisions of this section accumulates at least three unexcused absences in any academic quarter, without good cause, the child must be referred to counseling services in the school. The social services district, or the school district if so provided for in the plan, must initiate a conference with the child's parent or other head of household to notify him or her that the child is being referred to counseling and the reason for the referral. If the social services district determines that such services are either not available or not appropriate, the services may be provided directly by the social services district or by other government agencies or not-for-profit or other available community providers.

(2) Any counseling provided pursuant to paragraph (1) of this subdivision must include, but is not limited to, an appropriate discussion of the expectations of the school regarding attendance requirements, the consequences of the child's unexcused absences from school, and a review of the child's home and school environment to determine whether that environment may have caused the child's unexcused absences. After the counseling is completed, the social services district or the school district must prepare an intervention plan that will address the needs of the child to ensure that there are no more unexcused absences.

(e) If a child subject to the provisions of this section has accumulated five or more unexcused absences from school during an academic quarter without good cause, the social services district must withhold $60 from the child's household's public assistance grant for three consecutive months. The amount withheld from the household's grant must be returned to the household if, in the following academic quarter, the child has no unexcused absences. If the grant reduction was the result of absences in the last academic quarter of the school year, the plan described in subdivision (c) of this section may provide options for a child to use in order to receive restoration of amounts withheld including, but not limited to, attendance in summer school. The payment of any withheld amounts must be disregarded in determining eligibility for and the amount of benefits in the month such benefits are restored and the following month.

(f) A child has good cause for an unexcused absence from school when unsafe or unsanitary conditions at the school present a threat to the child's physical or emotional health, safety or welfare or other circumstances exist that justify absenteeism pursuant to the rules of the local school district or, if a statewide standard for the determination of such absences has been promulgated pursuant to the Education Law, such statewide standard will govern. If a child is suspended from school, the suspension will be treated as an excused absence for the purpose of this section.

(g) As a condition of eligibility for public assistance, the parent or guardian of a child in grades one through six must consent to the release of any school attendance records necessary for the conduct of the learnfare program. Such parent or guardian also must cooperate in providing the social services district with the child's report card or other information necessary to establish the child's school attendance record.

(h) Prior to imposing any fiscal sanction pursuant to this section, a social services district must provide the household with timely notice of its intention to impose such a sanction and inform the household of its right to request a hearing pursuant to Part 358 of this Title.

(i) For purposes of this section, the learnfare administrator is required to determine whether a child's absence from school is authorized or unauthorized.

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Section 351.20 - Determination of continuing eligibility.

CONTINUING ELIGIBILITY

351.20 Determination of continuing eligibility. (a) Continuing eligibility for public assistance shall be established by investigation and documentation at specified intervals and the process shall be known as recertification, which shall include a reevaluation and reconsideration of all variable factors of need and other factors of eligibility.

(b) In connection with periodic redetermination of eligibility, the social services district shall:

(1) require that the recipient complete the State-prescribed form and submit appropriate supporting data;

(2) determine the need for additional information from the recipient and/or collateral sources;

(3) interview the recipient in a face-to-face interview, in order to verify factors of eligibility, including those related to:

(i) identity of recipient;

(ii) domicile of recipient;

(iii) family composition;

(iv) rent payment or cost of housing;

(v) income from any source;

(vi) savings or other resources;

(vii) lawful residence in the United States, if the recipient is an alien;

(4) make appropriate collateral investigation, as required, where the recipient is unable to secure documentation of the above factors and any additional factors of eligibility as required to establish continued eligibility;

(5) evaluate all the factual information gathered as to its completeness, relevancy and consistency;

(6) identify the factors of eligibility subject to change which call for prompt review of continuing eligibility; and

(7) advise the recipient of his continuing responsibility to keep the agency informed of changes in his circumstances.

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Section 351.21 - Required contacts and investigation.

351.21 Required contacts and investigation. (a) Contacts with recipients and collateral sources shall include face-to-face contacts, correspondence, reports on resources, eligibility mailouts and other documentation. Contacts with or concerning recipients shall be made as frequently as individual need, change in circumstances or the proper administration of assistance or care may require.

(b) All variable factors of need and eligibility shall be reconsidered, reevaluated and verified at least once in every:

(1) three months, in cases of Aid to Dependent Children when eligibility is based on the unemployment of a parent; and

(2) six months, in cases of Aid to Dependent Children when eligibility is not based on the unemployment of a parent and in cases of Home Relief.

(c) The social services district shall use the State-prescribed form in the recertification process and shall require:

(1) a face-to-face interview with the recipient for each recertification; and

(2) a face-to-face interview by the end of the third calendar month following the month of acceptance for all new and reopened ADC and HR cases.

(d) The recipient shall appear at the face-to-face interviews, and shall present appropriate documentation as required to substantiate both categorical and financial eligibility. If because of age, handicap or other verifiable limiting condition, the recipient is unable to appear for a face-to-face interview or requires the use of an interpreter for the deaf, the district shall make appropriate arrangement to accommodate the client. The client shall notify the district of special needs or requirements as soon as the notice to appear is received and give the reason for such special needs or requirements.

(e) In addition to personal interviews and correspondence with the recipient, there shall be contact, as the circumstances of the individual case may require, with appropriate persons and agencies to secure verification of data which is essential to establish eligibility for public assistance and which the recipient is unable to secure.

(f) Contacts with recipients and with collateral sources of information shall be directed toward consideration of all variable factors of eligibility.

(1) Financial need. Identity of the recipient and his individual circumstances shall be reviewed and verified as indicated in relation to changes in the household, in living arrangements, in income and in allowance schedules, in order to determine those items of need that should be added, deleted or changed in amount.

(2) Financial resources. Current availability and use of financial resources shall be reconsidered and verified in relation to fluctuations in value or income, or the initiation or termination of rights to benefits.

(3) Employment, employability and training for employment. The employment, potential employability, availability for employment, or need for training or retraining shall be reviewed and established for each person 16 years of age or over.

(4) Relatives. Changes in circumstances, which affect the ability or willingness of relatives to financially assist the recipient, shall be reviewed. If a legally responsible relative is failing to support according to ability and/or court order, referral for appropriate legal action shall be made.

(5) Special categorical requirements. There shall be review of factors of categorical eligibility which are subject to change, such as further impairment, recovery or improvement in the condition of an incapacitated parent, return of an absent parent, termination of eligibility of children because of age or leaving school, and obtaining employment. In review of a Home Relief case, entitlement to assistance under a federally aided category shall be considered.

(6) Health. Changes in health conditions shall be considered with respect to continuing eligibility and required services.

(7) Services. There shall be a review of the need for services and appropriate referral made therefor.

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Section 351.22 - Action to be taken upon failure to appear at face-to-face

351.22 Action to be taken upon failure to appear at face-to-face interviews, or upon determination of ineligibility or of change in degree of need. (a) In all programs of public assistance, there shall be face-to-face recertification interviews, and contacts as needed in excess of the minimum required by department regulations shall be made in cases where there is indication of change in need or resources.

(b) Failure to appear at the face-to-face interviews. If a recipient fails to appear without good cause, the social services official shall send a 10-day notice of proposed discontinuance of assistance on a form required by the department.

(1) If the recipient does not respond within this 10-day period, the case shall be closed as of the end of the 10-day period. Any request for assistance made after a case is closed shall be considered a new application.

(2) If the recipient appears for a face to-face interview during the 10-day notice period, an interview shall be arranged. If it is determined that he is eligible for continued assistance, the 10-day notice of proposed discontinuance shall be nullified.

(c) Eligibility mailout process. (1) Social services districts which use eligibility mailout questionnaires must develop plans outlining the eligibility mailout process which is to be used, consistent with the provisions of paragraph (2) of this subdivision. Such plans must be submitted to and approved by this department before a social services district's mailout process can be implemented. Concurrently with the submission of the plan, or anytime thereafter, a social services district may request, and the department may approve, a waiver of the provisions set forth in subparagraphs (i) and (ii) of paragraph (2) of this subdivision. The department may rescind the approval of any eligibility mailout plan or suspend such process when circumstances make such action appropriate.

(2) (i) If a recipient fails to respond to an eligibility mailout questionnaire within the time period described in the questionnaire, the social services official must send another eligibility mailout questionnaire with a 10-day notice of proposed discontinuance of assistance on the State prescribed form.

(ii) If the recipient does not respond to the eligibility mailout questionnaire within the 10-day period, the case must be closed at the end of the 10-day period. Any request for assistance made after a case is closed must be considered a new application.

(iii) If the recipient responds to the eligibility mailout questionnaire during the 10-day notice period, the 10-day notice of proposed discontinuance must be nullified.

(d) Failure to cooperate with a quality control review. When a head of household refuses without good cause to cooperate in a quality control review conducted in accordance with Part 326 of this Title, the entire household is ineligible for public assistance until the head of household cooperates with the review. Good cause includes circumstances beyond the head of household's control, such as, but not limited to, illness of the head of household, illness of another household member requiring the presence of the head of the household, or a household emergency.

(e) When a social services district receives indication of ineligibility or of change in degree of need, action shall be taken to review these situations as they occur. An investigation shall be initiated promptly and completed within 30 days.

(f) When a social services district verifies ineligibility or a change which results in a decrease in need, it shall immediately initiate action to reduce the grant for the appropriate payment month and to notify the recipient of the proposed change in his assistance grant in accordance with department regulations. When the verified data indicates an increase in need, action shall be taken immediately to increase the grants for the next payment period possible under the existing payment procedure. An appropriate entry shall be made in the case record of any such change in grant, and the basis for it. Such reduction or increase in grant involves a reauthorization for a continuing grant in a different amount, while a discontinued grant may involve the following action:

(1) Case closed. This is a final terminal action, signifying that the case is no longer eligible for financial assistance in that public assistance program. Such action is also taken when the case is transferred or reclassified to another category of public assistance.

(2) The case must be closed when the recipient fails to pick up public assistance benefits from an electronic payment file transfer outlet for two consecutive months.

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Section 351.23 - Notification of change in grant.

351.23 Notification of change in grant. (a) The recipient must be notified of any change in grant in accordance with this Title.

(b) The recipient must be notified of the right to a fair hearing in accordance with Part 358 of this Title whenever there is a proposed reduction in, or discontinuance of, or increase in, the grant.

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Section 351.24 - Mandatory reporting.

351.24 Mandatory reporting. (a) The following definitions are used in this Part:

(1) Quarterly reporting refers to a procedure for obtaining information concerning the incomes and circumstances of certain public assistance recipients through semi-annual recertifications and semi-annual mailed reports. Quarterly reporting is a modified system of monthly reporting in which written reports are made at semi-annual intervals and public assistance grants are calculated prospectively.

(2) Authorization period means the six-month period for which public assistance benefits are authorized pursuant to sections 350.2(a) (2) and 350.2(a) (4) of this Title following a recertification pursuant to section 351.21(b) (2) of this Title. Each authorization period is divided into two payment quarters.

(3) Quarterly report means a form upon which a recipient reports income for the most recent four weeks in a three-month period and household circumstances for that three-month period.

(4) Report quarter means the three-month period covered by a quarterly report.

(5) Process month means the month in which information contained in a quarterly report or obtained during a recertification is reviewed. With respect to information obtained from a quarterly report, the process month is the third month of an authorization period. With respect to information obtained at recertification, the process month is the last month of the authorization period.

(6) Payment quarter means the three-month period after the process month.

(b) A public assistance household must submit a quarterly report form to the social services district in the first process month following recertification when:

(1) any member of the public assistance case has earned income; or

(2) another member of the household, whose income must be applied in determining the amount of the benefit, has earned income.

(c) The quarterly report form must contain the following information:

(1) report quarter income, household composition and other circumstances relevant in determining the amount of assistance; and

(2) any changes in income, resources, or other relevant circumstances affecting eligibility for or the amount of benefits which the household expects to occur in the current or future months.

(d) The quarterly reporting process does not relieve recipients of their responsibility to report changes in income, resources or family composition in a timely manner. Recipients must report the receipt of new or increased income no later than 10 days after the receipt of the income. A report of such income made more than 10 days after receipt is not timely, but a report made more than 10 days prior to the end of the month is timely with respect to the next month and any succeeding month.

(e) (1) Quarterly report forms must be provided to recipients in sufficient time for recipients to return completed reports to the social services districts by the tenth day of the process month.

(2) A quarterly report is considered complete when the recipient has:

(i) answered all questions;

(ii) provided verification of all reported income; and

(iii) signed and dated the report on or after, but not before, the last day of the report quarter.

(f) Failure to submit a completed report. If a recipient fails, without good cause, to return a completed quarterly report by the tenth day of the process month, the social services district must send a timely and adequate notice of discontinuance with a copy of any quarterly report which was returned as incomplete or with a second quarterly report form if no report was returned.

(g) If the recipient responds to the discontinuance notice and submits a completed report before the effective date of the discontinuance, the social services district must accept the completed quarterly report and void the notice of discontinuance.

(h) (Repealed)

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Section 351.25 - Proration of benefits at time of case closing or reduction of

351.25 Proration of benefits at time of case closing or reduction of benefits. When a case is closed or benefits are reduced, the public assistance grant must be prorated so that only those benefits to which the recipient is entitled, if any, are provided beyond the date of discontinuance or reduction. Any benefits that have been provided for a period in which the recipient was no longer eligible for benefits or was eligible for lesser benefits must be recovered in accordance with section 352.31(d) of this Title.

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Section 351.26 - Good Cause.

Section 351.26. Good Cause. (a) An applicant for a recipient of public assistance is exempt from complying with any requirement concerning eligibility for public assistance if the applicant or recipient establishes that good cause exists for failing to comply with the requirement. Except where otherwise specifically set forth in any provision of this Title, good cause for failure to comply with an eligibility requirement exists when:

(i) the applicant or recipient has a physical or mental condition which prevents compliance;

(ii) the applicant's or recipient's failure to comply is directly attributable to social services district error; or

(iii) other extenuating circumstances, beyond the control of the applicant or recipient, exist which prevent the applicant or recipient from being reasonably expected to comply with an eligibility requirement.

(b) The applicant or recipient is responsible for notifying the social services district of the reasons for failing to comply with an eligiblity requirement and for furnishing evidence to support any claim of good cause. The social services district must review the information and evidence provided and make a determination of whether the information and evidence supports a finding of good cause.

 

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Section 351.27 Reserved

Reserved

Section 351.28 - Home visits.

351.28 Home visits. (a) A visit to the home of an applicant for or recipient of Aid to Dependent Children (ADC) or Home Relief (HR) may be conducted by an official of the social services district as part of an investigation into eligibility or continuing eligibility for such assistance. The visit may be conducted with advance notice that a visit may take place, or without advance notice in the circumstances described in subdivision (b) of this section. A home visit must ordinarily be conducted only during the normal business hours of the social services district or during daylight hours, unless the circumstances of the applicant or recipient make such time impractical. The social services official conducting such visit must properly identify himself or herself.

(b) A visit to the home of an applicant for or a recipient of ADC or HR by an official of the social services district may be conducted without advance notice to the applicant or recipient when the district has information that is inconsistent with or fails to support pertinent information reported by the applicant or recipient during the eligibility or redetermination of eligibility process, when the applicant or recipient fails to provide information pertinent to the eligibility or redetermination of eligibility process that he or she would reasonably be expected to provide or when it appears that information provided by the applicant or recipient during the eligibility or redetermination of eligibility process is false. Examples of such circumstances include, but are not limited to: where the landlord does not verify the household composition or provides information which is inconsistent with the information in the application; where the household's stated expenses exceed the stated income or the current grant without a reasonable explanation; where there is no information concerning a parent who is alleged to be absent from the home or the information is inconsistent with the information in the application; where the application is inconsistent with prior case information in the district's possession; or where the application contains inconsistent information that would affect eligibility for ADC or HR.

(c) Consent by the applicant or recipient to a visit must not be considered to be permission to search the premises. The official may question the applicant or recipient about people or objects in plain view on the premises.

(d) Failure by the applicant to cooperate during an unscheduled visit or to permit such visit is not a basis for a discontinuance or denial of assistance. An official conducting an unscheduled visit must not indicate or lead the applicant or recipient to believe that failure to cooperate or to permit the visit will be a basis for denying or discontinuing benefits.

 

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