R.C.S.A. § 17b-198-15
Adverse action notice.
Cite as Conn. Agencies Regs. § 17b-198-15
(a) Definitions. For purposes of this section, "adequate notice" means notice concerning a termination,
reduction or suspension of assistance pursuant to SAGA, or concerning a change in
the manner or form of payment of such assistance, that includes a statement of the
department's intended action, the reasons for the intended action, the regulatory
or statutory authority supporting such action, an explanation of the assistance unit's
right to request a fair hearing to contest the action and the circumstances under
which benefits are continued if the assistance unit requests a fair hearing.
(b) Advance notice required. Except as provided in subsection (c) of this section, the department shall provide
an assistance unit with adequate notice of its intent to terminate, reduce or suspend
assistance pursuant to SAGA, or to modify the manner or form of payment of such assistance,
not later than ten days prior to the date it implements any such action. For purposes
of this subsection, the date on which the department mails or otherwise transmits
adequate notice to an assistance unit shall be considered the date such notice was
provided.
(c) Advance notice not required. The department may take any action described in subsection (b) of this section that
is applicable to a particular case without providing the advance notice required pursuant
to said subsection, provided adequate notice is provided not later than the date such
action is taken, whenever:
(1) The department receives information verifying that the assistance unit member died,
moved to another state or has been granted SSI or SSDI benefits or cash assistance
pursuant to any other state or public assistance program;
(2) The department receives a clear, written statement signed by the assistance unit member
indicating that such member (A) no longer wishes to receive assistance pursuant to
SAGA, or (B) is providing information to the department that requires the department
to terminate or reduce the level of assistance being provided to such member, and
that such member understands that such adverse action must result due to such information;
(3) The department receives information verifying that such member has been committed
to an institution that results in his or her ineligibility for continued assistance
pursuant to SAGA;
(4) At the time the department granted assistance, it provided written notice to such
member informing him or her that such assistance would automatically terminate at
the end of a specific period and such period has now ended;
(5) The department determines that an appropriate payee has committed financial mismanagement,
as described in subsection (e) of section 17b-198-12 of the Regulations of Connecticut
State Agencies; or
(6) The assistance unit member's whereabouts are unknown and the post office returns departmental
mail directed to such member, indicating there is no known forwarding address for
such member.
(d) Eligibility pending fair hearing. (1) When advance notice of an adverse action is required pursuant to subsection (b)
of this section and the department receives an assistance unit member's request for
a fair hearing prior to the conclusion of the ten-day adverse action period described
in said subsection, the department shall not terminate, suspend or reduce such member's
assistance prior to the issuance of a decision on such fair hearing, except that:
(A) The department may implement the challenged adverse action prior to such time
if the department provides the assistance unit with notice that it is implementing
such action prior to the fair hearing and: (i) The assistance unit member expressly
waives his or her right to continued receipt of assistance pending such a decision;
or (ii) the department makes a determination at the fair hearing that the sole issue
to be resolved is one of federal or state law or departmental policy, as opposed to
one concerning administrative processing, such as, but not limited to, the computation
of income, assets or benefit amount; and
(B) The department may terminate, suspend or reduce an assistance unit member's assistance
if a separate change, including a mass change, that affects such member's eligibility
or benefit level occurs while such fair hearing is pending and the assistance unit
is issued separate notice pursuant to subsection (b) of this section, but fails to
request a fair hearing during the ten-day adverse action period. For purposes of
this subparagraph, “mass change” means a change that affects all or a portion of assistance
units who share similar circumstances.
(2) When the department erroneously terminates, suspends or reduces an assistance unit
member's benefits prior to the expiration of the ten-day advance notice period prescribed
under subsection (b) of this subsection, the department shall reinstate such member's
benefits pending a fair hearing decision if (i) the department receives a request
for a fair hearing from such member not later than ten days after the date the notice
required under subsection (b) was sent, (ii) the department determines that the sole
issue to be resolved is not one of federal or state law or departmental policy, and
(iii) the provisions of subsection (c) of this section do not apply.
(3) When the department maintains an assistance unit member's level of assistance pending
a fair hearing, and such hearing is subsequently resolved against such member, any
benefits such member received pending such hearing that, based on the results of the
hearing, such member was not eligible to receive, shall be treated as an overpayment
subject to recoupment, as described in section 17b-198-17 of the Regulations of Connecticut
State Agencies. If the department terminates, suspends or reduces an assistance unit
member's benefits pending a fair hearing, and such fair hearing is subsequently resolved
in such member's favor, any benefits that, based on the results of the hearing, such
member was entitled to but did not receive shall be treated as an underpayment and
promptly corrected, as described in said section.
(4) Notwithstanding the provisions of subsection (h) of section 17b-198-3 of the Regulations
of Connecticut State Agencies, the department shall consider a written request for
a fair hearing that is mailed to the department to be received on the date the envelope
containing such request is postmarked.