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(i) an application is withdrawn by the applicant; or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