5101:4-5-07 Food assistance: delayed eligibility determinations.

 

5101:4-5-07                 Food stamps: providing notice of eligibility and denial, when to deny an application at the end of thirty days, and actions because of delayed eligibility determinations.

 

 

 

(A)     Every applicant AG found eligible shall be provided with a written notice of eligibility, in accordance with Chapter 5101:6 of the Administrative Code, as soon as a determination is made but no later than thirty days after the date of the initial application. Exceptions to the thirty-day processing standard are discussed in paragraphs (G) to (L) of this rule.

 

(B)   The county agency shall provide AGs that have filed an application by the fifteenth of the last month of their certification period with either a notice of eligibility or a notice of denial, in accordance with Chapter 5101:6 of the Administrative Code, by the end of the current certification period. The county agency shall provide AGs that have received a notice of expiration, at the time of certification and have timely reapplied with either a notice of eligibility or a notice of denial not later than thirty days after the date the AG had an opportunity to obtain its last allotment.

 

(C)  Notice of denial

 

The county agency shall provide every AG found ineligible for food stamp benefits with a written notice of denial in accordance with Chapter 5101:6 of the Administrative Code.

 

(D)    When to deny an application at the end of thirty days: AG fails to appear for scheduled interview

 

If the AG has failed to appear for the first interview scheduled at the time of initial application and has made no attempt to reschedule another interview or has made no subsequent contact with the project area to express interest in pursuing the applicationthe county agency shall send the AG a JFS 04218, "Notice of Missed Interview." If an AG misses its scheduled interview and requests another interview, the county agency shall schedule a second interview. If the AG does not respond to the "Notice OF Missed Interview", the AG is denied and sent a notice of denial on the thirtieth day following the date of application. The application cannot be denied prior to the thirtieth day following the date of application. The AG must file a new application if it wishes to participate in the program.

 

(E)  When to deny an application at the end of thirty days: AG fails to provide verification

 

 

 

 

In cases where an interview was conducted and all the necessary verification was requested on the same day the application was filed, and no subsequent requests for verification have been made, the application shall be denied on the thirtieth day following the date of application if the county agency provided assistance to the AG in obtaining verification when required but the AG failed to provide the requested verification. The AG must then file a new application if it wishes to participate in the program.

(F)   When to deny an application at the end of thirty days: AG given full thirty days

The county agency cannot deny the AG prior to the thirtieth day following the date of application for failure to provide verification. In other words, no time limit can be set for providing verification at initial application. For example, the AG cannot be told that if it does not bring the verification in ten days, it will be denied. The case must be held open for the entire thirty days and the AG given all that time to complete the application process.

(G)    Actions because of delayed eligibility determinations: criteria for denial and initial action

If the county agency cannot make an eligibility determination within the thirty days and cannot deny the AG, the cause of the delay is determined and the actions are taken. The term "fault" is used only to determine entitlement to lost benefits.

(1)   Notices for AG-caused or county agency-caused delays

A notice of either denial or of pending status is provided for applications that are delayed in processing, depending on the cause of the delay.

(2)   Determining cause

The county agency shall first determine the cause of the delay using the following criteria.

(a)   AG-caused delay

A delay shall be considered the fault of the AG if the AG has failed to complete the application process even though the county agency has taken all the action he or she is required to take to assist the AG. The county agency must have taken the actions in paragraph (G)(3) of this rule before a delay can be considered the fault of the AG.

(b)   County agency-caused delay

A delay is the fault of the county agency if it failed to take the actions in paragraph (G)(3) of this rule. Further, the fault is the county agency's if the AG met its obligations in a timely manner but the county agency failed to complete the application process by the thirtieth day.

(3)   Actions

The county agency must take the following actions and the AG not take the counterpart actions for a delay to be caused by the AG.

(a)    For AGs that have failed to complete the application form, the county agency must have offered, or attempted to offer, assistance in its completion.

(b)    If one or more members of the AG have failed to register for work, the county agency must have informed the AG of the need to register for work, determined if  the  AG  member(s)  are  exempt  from   work registration, and  given  the  AG  at  least  ten  days  from  the  date  of notification to register these members.

(c)    In cases where verification is incomplete, the county agency must have provided the AG with a statement of required verification and offered to assist the AG in obtaining required verification and allowed the AG sufficient time prior to the thirtieth day of the application to provide the missing verification. Sufficient time shall be at least ten days from the date of the county agency's initial request for the particular verification that was missing.

(d)     AGs are notified up front on the request for assistance, notice of expiration, and scheduling notice that the AG is responsible for rescheduling a missed interview. If an AG misses its initally scheduled interview, the county agency shall send the AG a JFS 04218, "Notice Of Missed Interview" and notify the AG that it is responsible for rescheduling the missed interview. If the AG contacts the county agency within the thirty day processing period, the county agency must schedule a second interview. For AGs that have failed to appear for an interview, the AG must have attempted to reschedule the initial interview within thirty days of the date the application was filed. However, if the AG has failed to appear for the first interview and a subsequent interview has been requested by the AG but is postponed at the AG's request or cannot otherwise be rescheduled until after the twentieth day but before the thirtieth day following the date the application  was  filed,  the  AG  must  appear  for  the  interview,  bring

verification, and register members for work by that thirtieth day; Otherwiseotherwise, the delay shall be the fault of the AG. If the AG has failed to appear for the first interview, fails to schedule a second interview, and/or the subsequent interview is postponed at the AG's request until after the thirtieth day following the date of application was filed, the delay shall be the fault of the AG. If the AG has missed both scheduled interviews and requests another interview, any delay shall be the fault of the AG.

(4)    If the county agency fails to provide required assistance, fails to give the AG sufficient time, or fails to timely schedule the required interviews, the fault is then the county agency's. County agency-caused delays include but are not limited to these situations.

(H)  If the AG causes the delay: benefits entitlement

If by the thirtieth day, the county agency cannot take further action on the application due to AG fault, the AG shall lose its entitlement to benefits for the month of application. However, the AG shall be given an additional thirty days to take the required action, unless the application was denied under the provisions of paragraphs (G) and (H) of this rule.

(1)   Notifying the AG at the end of thirty days for AG-caused delays

The county agency shall send the AG a notice of denial on the thirtieth day for AG-caused delays.

(2)   Reopening the case

When a notice of denial is sent and the AG takes the required action within sixty days of the date the application was filed, the county agency shall reopen the case without requiring a new application, unless the application was denied under the provisions of paragraphs (G) and (H) of this rule.

(a)   Further county agency action

No further action by the county agency is required after the notice of denial is sent if the AG fails to take the required action within sixty days of the date the application was filed.

(b)   Notice of pending status

If the application is to be held pending because some action by the county is necessary to complete the application process, the county

agency shall provide the AG with a written notice (see "Action Taken on Your Food Stamp Case, ODJFS 7401JFS 07401") which informs the AG that its application has not been completed and is being processed. If some action by the AG is also needed to complete the application process, the notice shall also explain what action the AG must take and that its application will be denied if the AG fails to take the required action within sixty days of the date the application was filed.

(c)   Notice of denial

The county agency shall provide the AG with a notice of denial, in accordance with Chapter 5101:6 of the Administrative Code, when a delay was caused by the AG's failure to take action to complete the application process. See Chapter 5101:6 of the Administrative Code for additional information which must be included on the denial notice.

(3)   Providing benefits

If the AG was at fault for the delay in the first thirty-day period, but is found to be eligible during the second thirty-day period, the county agency shall provide benefits only from the month following the month of application. The AG is not entitled to benefits for the month of application when the delay was the fault of the AG.

(I)  County agency-caused delay in initial thirty days

Whenever a delay in the initial thirty-day period is the fault of the county agency, the county agency shall take immediate corrective action. A notice of pending status must be sent; a notice of denial cannot be sent for county agency-caused delays.

(1)   Pending application

The county agency shall not deny the application if it caused the delay, but shall instead notify the AG by the thirtieth day after the application was filed that its application is being held pending. The county agency shall also notify the AG of any action it must take to complete the application process. If the application is to be held pending because some action by the county is necessary to complete the application process, the county agency shall provide the AG with a written notice which informs the AG that its application has not been completed and is being processed. If some action by the AG is also needed to complete the application process, the notice shall also explain what action the AG must take and that its application will be denied if the AG fails to take the required action within sixty days of the date

the application was filed.

(2)   Action taken

If the AG is found to be eligible during the second thirty-day period, the AG shall be entitled to benefits retroactive to the month of application. If, however, the AG is found to be ineligible, the county agency shall deny the application.

(J)   County agency-caused delays within sixty days: all information received

If the county agency is at fault for not completing the application process by the end of the second thirty-day period and the case file is otherwise complete, the county agency shall continue to process the original application until an eligibility determination is reached.

(1)   Providing benefits

If the AG is determined eligible and the county agency was at fault for the delay in the initial thirty days, the AG shall receive benefits retroactive to the month of application.

(2)    However, if the initial delay was the AG's fault, the AG shall receive benefits retroactive only to the month following the month of application. The county agency may use the original application to determine the AG's eligibility in the months following the sixty-day period, or it may require the AG to file a new application.

(K)  County agency-caused delay: information incomplete

If the county agency is at fault for not completing the application process by the end of the second thirty-day period, but the case file is not complete enough to reach an eligibility determination, the county agency may continue to process the original application, or deny the application. The notice of denial shall be accompanied by notification to the AG to file a new application and of its possible entitlement to benefits lost as a result of county agency delay.

(1)  Providing benefits if case denied

If the county agency was also at fault for the delay in the initial thirty-days, the amount of benefits lost would be calculated from the month of application.

(2)   If, however, the AG was at fault for the initial delay, the amount of benefits lost would be calculated from the month following the month of application.

(L)  Delays beyond sixty days: AG-caused delay in second thirty days

If the AG is at fault for not completing the application process by the end of the second thirty-day period, the county agency shall deny the application and require the AG to file a new application if it wishes to participate.

Effective:                                5/13/2002

R.C. 119.032 review dates:    2/26/2002 and 05/13/2007

CERTIFIED ELECTRONICALLY

Certification

05/03/2002 09:57 AM

Date

Promulgated Under:   111.15

Statutory Authority:   5101.54

Rule Amplifies:           329.04, 329.042, 5101.54 Prior Effective Dates: 6/20/80, 4/1/89, 1/1/95,

2/1/99, 6/1/01 (Emer.),

8/27/01, 3/1/02 (emer.)