Food Assistance Program Rule Rewrite Summary

Transcription

1 Food Assistance Program Rule Rewrite Summary Overview The Food Assistance rules have not had a comprehensive update for over twenty years. There are currently over 400 rules, and most revisions have occurred to only a limited portion of the rules. This has led to the rules not flowing in an order that is user friendly for county workers and other stakeholders. Sometimes the appropriate rule was difficult to find; rules were duplicative of each other; and in a few instances, rules conflicted with one another or did not support current practice. Additionally, in efforts to meet federal timely processing standards, the Program provided a lot of clarification and guidance to county departments through Agency Letters rather than clarifying rules through the rule-making process. As a result of the Program s history, a complete rewrite of the Food Assistance (FA) rules is necessary to ensure the rules are correct, up-to-date, support current practice and are more user-friendly. Steps in the Rule Revision Efforts 1. The first step in the rule reduction efforts initiated by Executive Order D was to repeal any outdated rule. Effective May 1, 2012, the Food Assistance Program repealed 26 outdated rules. 2. The Program s next (and current) step is to rewrite the Food Assistance rules in its entirety. The anticipated effective date of the new rules is August 1, However, due to the large volume of rules being reorganized and revised, the effective date may be pushed back to September 1, Final confirmation of the effective date will be communicated to all county departments. The 4 goals of the rewrite phase are to: 1. Reorganize the rules into a more user-friendly order 2. Remove duplicative and outdated language and terminology 3. Correct incorrect rules 4. Clarify most commonly used and misunderstood rules As part of the rewrite phase, major policy changes are not being pursued, and for most of the rules, no changes to the policy or intent have been made. Page 1 of 16

2 3. Future phases of rule revision will focus on providing more detailed clarification for rules on claims, fair hearings, intentional Program violations and fraud. Electronic Benefit Transfer (EBT) specific rules will also be removed from the FA manual and placed in the EBT rule manual at 12 CCR Fiscal Impacts Estimated Savings: It is estimated that there will be some costs savings with improved efficiencies for county and state workers by having rules that are easier to understand and more user friendly; however, we cannot project costs or time saved with these changes. Estimated Costs: This phase of the revisions will have minimal fiscal impact for the State. As a result of the renumbering of the Food Assistance rules, updates to the rule citations found in client correspondence will be necessary. It is not expected that additional costs will be necessary to complete this since changes to client correspondence have already been scheduled to occur in June/July As part of this scheduled change, we will update the rule citations found on notices. As a result of changing policy to accept a client s declaration of shelter costs as acceptable verification, modifications to CBMS will be necessary to update the verification sources. The implementation of the policy is not contingent upon changes to CBMS; however, it is likely we will be able to make modifications to CBMS by December Stakeholder Feedback 6 full-day work sessions were conducted over the course of 13 months. o 4 sessions were conducted with eligibility staff; and o 2 sessions were conducted with county investigators. The proposed changes have also been sent to other stakeholders outside the county departments. Page 2 of 16

3 Summary of Changes 1. Reordered rules into a more user-friendly order, starting with basic Program functions and then progressing through the application processing requirements, managing ongoing cases and ending with county and state administrative requirements. This also includes: a. Streamlining and removing duplicative language; and b. Developing a new numbering system to align with other public assistance programs Current Order of Rules Proposed New Order of Rules (over 400 rules) (less than 300 rules) 4000 Food Stamp Program Food Assistance Manual 4100 Food Assistance Applicant Household Food Assistance Program Definitions 4200 Eligibility Standards Applications and Recertifications 4300 Households with Special Non-Financial Eligibility Circumstances Criteria 4400 Administrative Procedures and Financial Eligibility Criteria Issuance Tables 4500 (NONE) Verification and Documentation 4600 Food Assistance Issuance and Ongoing Case Management Accountability 4700 Inventory Verification Food Assistance Benefit Issuance 4800 CO EBT System Claims, Appeal Process, and Fraud 4900 (NONE) Administrative Procedures 2. Created a definition section 3. Updated outdated terminology 4. Clarified most commonly used and misunderstood rules Page 3 of 16

4 7 Major Areas of Clarification a. Expedite Service Processing and verification requirements b. Redeterminations Processing time frames and requirements c. Interviews Scheduling appointments; how to handle missed interviews; documentation requirements; waiving a face-to-face interview for a phone interview; household s responsibilities d. Simplified Reporting Clarified household responsibility to report changes during the certification period; how to act on changes that occur during the middle of the certification period, including information considered verified upon receipt e. Non-citizenship rules Overhaul of rules to make the requirements more easy to understand f. County administrative requirements Clarified certain county administrative requirements pertaining to state and federal Management Evaluation Reviews, Program Access Reviews, and Recipient Integrity Reviews g. Certification periods Clarified the length of a household s certification period Current rule sections New rule sections B ; B B B B B B B Throughout rule manual Incorporated throughout and and throughout Technical Cleanup Many of the revisions completed consist of a technical cleanup, updating outdated terminology and standardizing language. Page 4 of 16

5 Terminology Updates Outdated Language Updated Language 1. Food stamp Food assistance 2. Coupon Electronic Benefit Transfer (EBT) or another appropriate term 3. Alien Non-citizen 4. USDA, Food and Consumer Service USDA, Food and Nutrition Service (FNS) (FCS) 5. Recipient Participant 6. Case file Case record (pertained to only the physical or (now inclusive of the case file and electronic case file) documentation contained within the 7. CAFFS (old automation system no longer in use) automated system) Automated system 8. County office/food assistance office Local office 9. Immigration and Naturalization Service (INS) and Immigration and Customs Enforcement (ICE) United States Citizenship and Immigration Services (USCIS) 10. Disabled person Person with a disability 11. Elderly person Person that is elderly 12. Local level hearing Local level dispute resolution conference 13. IPV hearing Administrative Disqualification Hearing (ADH) Other Technical Cleanup 14. Clarified calendar days or business days when a regulation outlines timeframes in days. 15. Removed references to Agency Letters 16. Form numbers have been removed and form names have been updated 17. All eligibility standards have been included in rule. This includes gross and net income standards and other deductions used when determining a household s allotment. All standards are subject to change each October 1 st as required by federal regulation. Changes to gross and net income standards and deductions were previously communicated to county departments through an Agency Letter, which practice is no longer consistent with guidance received from the Office of Legislative Legal Services. Page 5 of 16

6 Meaningful Policy Changes The Food Assistance Program is proposing 89 meaningful policy clarifications and changes, which are classified into 4 categories: 1. Policy corrections and new federal policy options and waivers pursued (3 updates) 2. Administrative requirements reviewed in state and federal audits (16 updates) (Management Evaluation reviews, Program Access Reviews and Recipient Integrity Reviews) 3. New policy clarifications (17 updates) (Not previously communicated state-wide) 4. Policy clarifications supporting current interpretations and practice (55 updates) (Previously communicated state-wide) These changes can be accomplished without CBMS changes and without intensive policy research. Some changes create efficiencies for the county eligibility worker; some clarify vague rules; others clarify rules to support consistency in the application of the rule; and some add clarifying language to formalize current policy and practice into rule. Much of the clarification added is based on federal clarification and many of the clarifications have been previously communicated to county departments through Agency Letters. Federal Policy Options and Waivers Pursued and Policy Corrections New Rule Description of Meaningful Changes Invoking a federal waiver for determining student eligibility for full-time students who are working. Currently, one of the criteria that a student can meet to become eligible for participation in the Program is that the student can work 20 hours a week; however, the monthly hours worked cannot be averaged. The federal waiver allows the student s work hours to be averaged, so long as the student works 80 hours per month. This waiver will allow students who were previously not eligible to be eligible Invoking a federal policy option that allows a household s declaration of its shelter costs (rent, mortgage, HOA, property taxes) to be an acceptable verification source, unless questionable, when determining a household s shelter deduction. Currently, client declaration is not acceptable, which requires the county department and/or the household to take extra steps to obtain and submit documentation verifying shelter costs. This rule change will decrease the amount of verification the household has to provide and create efficiencies in making eligibility determinations. Page 6 of 16

7 , B, 3-4 Correcting, based on federal clarification, our application of policies regarding how changes are acted upon for households that contain an elderly person or a person with a disability that has to meet the 200% FPL rather than the 130% FPL. Households that have to meet the 200% FPL but are certified with income under 130% FPL are required to report when their income increases above 130% FPL, and the county is required to adjust the household s allotment based on the increase in income. Currently, for these households, we are not acting on changes that put the household above 130% FPL, and we are not adjusting the household s allotment as required. Clarifications and Updates regarding Administrative Requirements Reviewed in State and Federal Audits (Management Evaluation reviews, Program Access Reviews and Recipient Integrity Reviews) New Rule Description of Meaningful Changes Added that any pattern of deficiency identified through complaint records can be included in a county Performance Improvement Plan Added, Local offices shall not conduct any pre-eligibility screening process prior to securing the date of application. This is to ensure all households are treated equally and receive proper noticing regarding decisions made on their eligibility. This mirrors language found in the Colorado Works rules Clarified that offices shall record racial/ethnic data obtained from applicants in the automated system for federal reporting purposes. This has previously been communicated to county departments through Agency Letter FA P , B Clarified that the case record must clearly indicate the reason for denial or termination and the verification used to make the decision , B Clarified the requirements for case documentation for fair hearings and administrative disqualification hearings , C Clarified that to obtain an EBT card, a household shall not be required to provide identity verification beyond what was utilized to establish identity when determining eligibility for food assistance Added requirements about checking the national disqualification database at the time of application and when adding a new household member in order to verify if anyone has an active IPV from another state and not eligible to receive benefits. This is added based on recent changes to federal regulations Clarified the requirements around compromising a claim, including that county departments cannot institute a policy of never compromising claims. Fraud/IPV claims are not eligible for compromise. Much of this clarification was provided through Agency Letter FA P , F, 2 Added that the local office shall forward a copy of decisions from local level dispute resolution conferences to the State Food Assistance Program. This was Page 7 of 16

8 previously clarified through Agency Letter FA P , D Added, Counties shall receive approval from the State Food Assistance Programs Division prior to using any county-developed forms in the administration of the Program. This is to ensure all households receive notices that contain correct information Strengthened the rule regarding accessibility to the local office for persons who are elderly and/or disabled Strengthened the rule regarding Program staff being trained and familiar with interpreter services to make arrangement for non-english speaking clients. This is to ensure equitable treatment and accommodations among all clients Revised the county s responsibilities for conducting supervisory case file reviews. The county no longer has to conduct six reviews per worker per month. Rather, the county must be able to demonstrate to the satisfaction of the State Food Assistance Program that the frequency and scope of the reviews are adequate enough to ensure that integrity of both the program and participants. Additionally, the county must demonstrate a consistent process for tracking error trends, correcting case records timely, and providing eligibility technician s opportunities to improve their program knowledge Clarified the state and county s responsibility to respond to state QA case reviews and to correct any identified errors Added, Both state and local offices shall ensure that all staff responsible for the administration, issuance, review, and eligibility determination of the FA Program are knowledgeable about civil rights procedures and able to assist program participants with the filing of civil rights complaints. These procedures must be reviewed with staff annually. New Policy Clarifications (not previously communicated state-wide) New Rule Description of Meaningful Changes Updated what constitutes a household s opportunity to participate to include having access to an active EBT card and receiving a PIN. This is to clarify that benefits must be issued timely and accessible for spending. This is based on updates made to federal regulations , C Added that an individual can be exempt from providing a Social Security Number based on a sincere religious objection. This was previously communicated through Agency Letter FA I and is based on federal clarification , C, 2 Clarified how household composition should be determined for spouses who are legally separated. Spouses who are legally separated can be separate Page 8 of 16

9 households, unless they purchase and prepares meals together or have a child in common living in the home. This is based on federal clarification , C, 3 1.) Clarified in accordance with federal guidance that partners in a same sex must be considered spouses if the marriage is recognized by the state in which the marriage was celebrated. If the state does not recognize same-sex marriages, then the individuals are not considered spouses, and therefore can have their own food assistance case if they purchase and prepare their meals separately. 2.) If in a same sex-relationship the spouses are not considered married, and there is a child living in the home but only one of the parents is the biological parent to the child, then the non-biological parent does not have to be considered part of the household if the non-biological parent is not the natural parent or adoptive parent to the child and purchases and prepares meals separately form the rest of the household , E, 3 Clarified that students in an institution of higher education are considered as being a resident of an institution and not eligible for food assistance if the student has a meal plan that provides the student 50% or more of his/her meals. This was previously communicated through Agency Letter FA I and is based on federal clarification , F Added, Any money an inmate receives upon release from prison, including earnings from work performed while incarcerated and accumulated over the length of the incarceration is considered a non-recurring lump sum payment and exempt from consideration as income. This is based on federal clarification , G Added, Monies received from a reverse annuity mortgage (RAM) loan program should be treated as a loan and excluded from income. These loans meet the accepted definition of a loan since there is a verifiable agreement to repay with interest. This is based on federal clarification , E, 1 Clarified, based on federal guidance, what is considered a continuing charge for shelter when determining what shelter costs are allowable as a shelter deduction. a) Monthly payments to repay amounts of a reverse mortgage are considered a continuing charge and therefore an allowable shelter costs; b) Payments on loans secured by a lien placed on the property, such as a second mortgage or home equity loan, shall be an allowable shelter costs; c) Payments on unsecured or personal loans are not an allowable shelter costs; d) Expenses incurred to keep a pet which are billed separately from the household s rent are not allowable as shelter deductions , E, 6 1.) Added, The cost of telephone service that is associated with a specific Page 9 of 16

10 device, which includes land-line service or cellular service, including disposable cell phones, and voice over internet protocol (VOIP) is an allowable telephone costs. 2.) Also clarified that households are not allowed to deduct the cost of pay phones and of phone cards that are not associated with a specific device. This is based on federal clarification. 3.) In rule , clarified based on federal guidance that households that received a LEAP payment within the previous 12 month period is eligible for the HCUA, regardless of whether or not the individual is still residing at the address for which s/he received the LEAP payment Added, Legally obligated child support paid by a household member under the age of 18 shall be an allowable deduction, even if the income of the child is considered exempt Therefore, the child support deduction is being applied to other household member s income. This is based on federal clarification , A, 6 Added that the cost of caring for service animals may be deducted as a medical expense only when the animal has received special training to provide a service to the client. This is based on federal clarification , A, 7 Clarified what rate to use when calculating the cost of transportation when allowing a medical deduction. Either the IRS medical or business rate can be used. Based on stakeholder feedback, the IRS medical rate has been chosen. Federal clarification gives states the option to choose , B, 2, b When an individual is both an ineligible non-citizen and an ineligible student, clarified whether or not the individuals income should be considered when determining eligibility. Ineligible students are considered non-household members and therefore their income and resources are exempt. Ineligible non-citizens are considered disqualified household members and therefore their income and resources are considered. Federal guidance states that such individual s income shall be prorated under the ineligible non-citizens provisions rather than excluded due to being an ineligible student , A Clarified that offices must mail EBT cards to ensure households have an opportunity to participate by the 30 th day for regular households and by the 7 th day for expedite households. This is based on federal regulations Updated definition of trafficking based on federal regulation changes. A household can now be pursued for fraud for the intent to commit an act of trafficking. This is based on recent changes made to federal regulations , C When pursuing an intentional Program violation (IPV), Federal regulations require that there is a review conducted after the investigation and prior to pursuing the IPV and notifying the household. Current state rule requires that an eligibility supervisor must review all cases being pursued for IPV. This has been modified to allow the review to be conducted by any staff member who was not involved in the investigation of the household and who has a thorough Page 10 of 16

11 understanding of food assistance policy in order to ensure policy is correctly applied and that the evidence meets the clear and convincing criteria necessary for an IPV determination Clarified record retention rules, including case records relating to IPVs shall be retained indefinitely until the disqualified individual has died or reached its 80 th birthday. This is based on recent updates to federal regulations. Clarifications Supporting Current Interpretations and Practices (these clarifications have been previously communicated state-wide) New Rule Description of Meaningful Changes Removed requirement that the state is the entity that investigates complaints of alleged discrimination since the United States Department of Agriculture, Food and Nutrition Service (FNS) is responsible for the investigation Created a definition section Clarified that once an eligibility determination is made by the county, including manual determinations made outside of the automated system, the local office cannot withdraw an application. This is to ensure all households are treated equally and receive proper noticing regarding decisions made on their eligibility Clarified the filing date for applications submitted after business hours. Added, When an application is submitted.outside of business hours, the application filing date shall be recorded as the next business day Clarified the application filing date when a county has multiple offices. Current rule states processing time begins when it is received in the correct office within a county. This has been modified to state, An application shall be considered filed and processing standards begin the day it is received by any food assistance office in the correct county. This change has been made throughout Clarified that when an ineligible non-citizen applies on behalf of unemancipated minors, he/she may do so without being considered as having applied for him/herself. However, any income of the ineligible non-citizen is still considered when determining the household s eligibility and benefit allotment Clarified interview processes regarding: 1.) When to schedule interviews 2.) The documentation requirements of interviews 3.) What actions to take when a household misses their interview 4.) Conducting phone or face-to-face interviews Page 11 of 16

12 A lot of the added clarification comes from several Agency Letters Clarified that households entitled to expedite service shall complete an interview prior to any determination of eligibility. If a household fails to complete the required interview within 7 calendar days from the date of application, the household is no longer entitled to have access to benefits by the 7 th calendar day from the date of application Added that the Department of Motor Vehicles (DMV) is an acceptable source of identity verification Clarified processing timeframes when households miss their first scheduled interview and are not able to attend their rescheduled interview until after the 20 th day following the date of application Added new language outlining that certification periods are 3-months, 6- months, or 24-months and prescribed which households are eligible for which length. This is an overhaul of current rule Clarified that when a household misses their interview at redetermination, the local office can mail the household a notice of missed interview that same day and a notice of denial can be sent at the same time Added what constitutes an untimely receipt of a redetermination, and outlined the circumstances under which a household loses its right to uninterrupted benefits ) Added more information about the periodic reporting requirements that apply to households who are certified for 24 months and required to complete a periodic report form at the 12 th month. 2.) Clarified that if the periodic report form is not submitted to the local office by the last day of the 12 th month, the case shall be terminated effective the first day of the 13 th month. If a household submits a periodic report form in the 13 th month and provides all required verification, then benefits can be reinstated without proration , A Added language to clarify the intent of household composition rules that require that parents and children (under age 22) to be included in the same food assistance household if they are living together , D Clarified intent of rule regarding individuals not eligible due to violating a condition of probation/parole. Changed individuals who have violated to individuals who are currently violating , A-B Completed an overhaul of non-citizen rules to make the requirements easier to understand and follow. The rewriting of the rules was taken primarily from the USDA, FNS Non-citizen Guidance handbook. New requirements have not been added; however, additional clarifications received from FNS have been incorporated and includes clarification regarding the following: a) Non-citizen nationals enjoy the same potential eligibility for food assistance as citizens Page 12 of 16

13 b) Specified the types of verification that victims of trafficking and battered non-citizens receive to verify their alien status c) Iraqi and Afghan Special Immigrants are eligible to the same extent as refugees are. This was previously communicated to county departments through Agency Letter FA I. d) Clarified how to review a non-citizen s qualifying work quarters e) Specified additional groups of non-citizens who are not eligible f) For sponsors, clarified that prior to December 19, 1997, affidavits of support were not legally binding; therefore, the sponsor cannot be legally compelled to support the non-citizen , B Clarified how to act on verification of income that is received for a case after the case was approved using anticipated income , A Added clarifying information about allowable exclusions from state work study income and that the balance of any state work study income after allowable exclusions is treated as earned income, and the 20% earned income deduction is allowed. This is based on federal clarification , B Clarified when income from the VISTA program is countable and when it is not countable. This is based on federal clarification , F Added clarification about how to determine and calculate income for owners of Limited Liability Corporations (LLCs) and S-Corporations. For food assistance purposes, owners of LLCs and S-Corporations are considered employees of the corporation and therefore cannot be considered self-employed. This guidance was previously communicated through Agency Letter FA I , A Added clarification regarding self-employed individuals by adding, The selfemployed individual need not own 100% of the company to be considered self-employed. This was previously communicated through Agency Letter FA I and is based on federal clarification Clarified that when determining expedite eligibility, the appropriate utility allowance shall be applied when establishing the household s shelter costs , B, 4 Clarified that medical marijuana is not an allowable medical expense. This is based on federal clarification , B, 5 Clarified that vitamins and supplements are not an allowable medical expense unless prescribed by a physician. This is based on federal clarification , B, 4 Clarified when medical expenses from past billing periods are allowable. This is based on federal clarification , A Clarified the verification requirements for expedite service. Added, Only verification of the identity of the applicant is required client declaration of social security number and residency shall be accepted client declaration of other household circumstances shall be accepted, and verification of client declared information shall be postponed , A Added that when conducting a collateral contact the name of the individual Page 13 of 16

14 contacted, the individual s contact information, and the information provided by the contact shall be documented in the case record , B Added, When talking with collateral contacts, the local office shall avoid disclosing that the household has applied for food assistance , F Clarified that Unemployment Benefit information received from IEVS does not follow the 45-day timeframe that applies to responding to other IEVS information. This was clarified in Agency Letter FA P. The processing of UIB information received through IEVS follows the timeframe for acting on other changes , H, 2 Clarified the following about information received from data matches: a) Social Security income information can be verified through SDX and BENDEX; b) Wage data received from the Department of Labor and Employment (DOLE) shall not be considered as verified and shall be subject to independent verification; and c) Unemployment information reported through IEVS shall be verified through DOLE or by the household , B Clarified that a household shall not be convicted of fraud for not reporting a change in information it is not required to report , D Clarified that claims may be established as a result of information considered verified upon receipt , E Added several clarifications to verified upon receipt rules. a) Clarified when various sources of information is considered reported and verified b) Added that death information received from the Burial Assistance program is considered verified upon receipt , B Added what information is not considered verified upon receipt. 10 sources of information have been included in this list. Information from these sources cannot affect a simplified reporting household s allotment during the certification period Clarified that if an individual s county residency cannot be verified but the individual s Colorado residency is not questionable, the individual shall be certified if otherwise eligible and not participating in another FA household , C Added clarification about verifying self-employment income , F, 2 Clarified how to handle cases of no reported income and for following up with a household on how it is meeting its needs. Added that follow-up of such information should only be explored through an interview. A household s case cannot be denied for failing to provide information about how it is meeting its needs and that the interview process should be followed in such instances , F Clarified that a simplified reporting household s case should not be terminated in the middle of the certification period for failing to verify a change it was not Page 14 of 16

15 required to report , B, 5 Clarified how to act on changes that occur after the interview but before the case is processed. These changes are handled in accordance with simplified reporting rules , B, 6 Clarified how to act on changes that occur after a household submits a RRR or periodic report form but before the case is processed in instances when an interview is not completed because one is not required , G Clarified that county departments shall document in the case record changes that occur during the middle of the certification period but are not acted upon because of simplified reporting rules Clarified the noticing requirements when mass changes occur Clarified that advance notice of adverse action is not required when processing a redetermination or periodic report , C Clarified what households are considered a non-simplified reporting household Reworded rules on restorations to make the requirements easier to understand Modernized rules pertaining to replacement of coupons to apply to the replacement of EBT cards Updated the word coupon with EBT card. This is completed throughout , C, , E, Clarified how to calculate a claim for food assistance if the household receives both TANF and food assistance and misreports information to TANF. The food assistance claim shall be calculated based on the actual amount of TANF the household received. This is based on federal clarification. Added that the Treasury Offset Program (TOP) is authorized to apply a processing fee each time a successful offset for collection occurs. The delinquent food assistance debtor is responsible for the fee each time it is applied. A TOP offset taken in error and later refunded will have the processing fee refunded, except for partially refunded offsets. This was previously communicated through past Agency Letters, with the most recent being FA I Added that collection activity on a claim can be suspended if a court decision postpones collection activity for a period of time Clarified the criteria for when collection activity can be terminated , A, 4 Clarified when continued benefits cannot be provided to a household who is appealing an action on their case. Added that household s appealing a decision based on changes in their case as a result of processing a redetermination or periodic report are not eligible for continued benefits , D, Clarified that while a final agency decision is pending regarding a household s Page 15 of 16

16 4 benefit, the household s benefit allotment shall be adjusted to take into account reported changes, information considered verified upon receipt, and mass changes. Page 16 of 16