Section 9. Eligibility Reviews

A. Follow-up reviews: 8.102.120 NMAC 2 (1) A follow-up review shall be scheduled during a certification period whenever information becomes known to the county office indicating a possible change in a benefit group's circumstances that may affect eligibility or payment amount. (2) Review of a specific condition may be made by home visit, office visit, third party contacts or correspondence as needed. (3) Circumstances which may require follow-up review include, but are not limited to: (a) change in NMW participation work requirements; (b) school attendance of children age six or older; B. Recertification: (1) Cash assistance shall be approved for a fixed certification period at the end of which the assistance shall be terminated. (2) The recertification shall consist of a complete review of all conditions of eligibility; determination of eligibility for an additional period of time and redetermination of the amount of assistance payment. The recertification requires a redetermination of eligibility on those conditions that are subject to change. There shall be a prospective determination beginning the month following the month the certification expires. (3) The caseworker shall ensure that CSSD has been notified of all pertinent information regarding any non-custodial parent who has a child in the benefit group, including but not limited to the current address and work place of the non-custodial parent. (4) Conditions not subject to change: Unchanged information shall not be re-verified unless it is incomplete, inaccurate, inconsistent, or outdated. Outdated is defined as unchanged verification that is more than 60 days old relative to the current month of participation. (5) Work program: The caseworker shall give information to the NMW participants about earned income incentives, assistance through the transitional child care program, medicaid transitional benefits, and work program requirements, opportunities and services. Work program participation shall be reviewed anged verification that is more than 60 days old relative to the current month of participation. (5) Work program: The caseworker shall give information to the NMW participants about earned income incentives, assistance through the transitional child care program, medicaid transitional benefits, and work program requirements, opportunities and services. Work program participation shall be reviewed. (6) Need and payment determination: The caseworker shall obtain current information about family and benefit group: (a) Income: if the source has changed or the amount has changed by more than $50; (b) Resources: if the total of all countable resources for the benefit group exceed the $1500 liquid or $2000 non-liquid resource limit; and (c) any other information which has changed or is questionable. (7) Change reporting: The caseworker shall review with the client the possible changes in circumstances which must be reported if they occur. (8) Providing verification: (a) If electronic verification is not available, the household has primary responsibility for providing documentary evidence to support statements on the application and to resolve any questionable information. (b) ISD shall assist a household in obtaining verification, provided the household is cooperating in the application process. (c) A household or their authorized representative may supply documentary evidence in person, by mail, fax, electronic device or through the YES NM web portal. (d) A household shall not be required to supply verification in person at the ISD office or to schedule an appointment to provide such verification. (e) ISD shall accept any reasonable documentary evidence provided by the household and must be primarily concerned with how adequately the verification proves the statements on the application. (9) Recertification time standards: (a) Timely reapplication: Applications filed before the 15th day of the expiration month will be considered timely o schedule an appointment to provide such verification. (e) ISD shall accept any reasonable documentary evidence provided by the household and must be primarily concerned with how adequately the verification proves the statements on the application. (9) Recertification time standards: (a) Timely reapplication: Applications filed before the 15th day of the expiration month will be considered timely. A household member or authorized representative that attends an interview and provides all necessary verification by the end of the household's current certification period, will have the opportunity to participate by the household's normal issuance cycle in the month following the end of the current certification period, if all eligibility factors have been met. (b) Reapplication after the 15th: If an application for recertification is submitted after the 15th but before the end of a household's certification period and the household is determined eligible for the first month following the end of the certification period, that month is not considered an initial month and benefits are not prorated. 8.102.120 NMAC 3 (c) Late applications: An application that is submitted to ISD after the certification period has expired can be accepted within 30 days after the certification period expires or the case has been closed for any reason. Initial month verification standards will be used for all applications received during this time frame and the benefits for a late recertification will be prorated from the date of approval. C. Certification scheduling: (1) Each case must have eligibility and payment reviewed at least once during the period specified for that category. Cash assistance cases, which also receive SNAP, shall be recertified at the same time the SNAP certification is completed pplications received during this time frame and the benefits for a late recertification will be prorated from the date of approval. C. Certification scheduling: (1) Each case must have eligibility and payment reviewed at least once during the period specified for that category. Cash assistance cases, which also receive SNAP, shall be recertified at the same time the SNAP certification is completed. (2) The certification period shall not exceed the following standards: (a) Regular reporting benefit groups: A benefit group not subject to simplified reporting requirements shall be certified for: (i) five months or less: education works program; (ii) 12 months: state supplement for SSI recipients in residential care; (iii) eight months from date of arrival: refugee resettlement program. (b) Simplified reporting benefit groups: Certification provisions that apply to a NMW benefit group subject to simplified reporting are set forth at Subsection A of 8.102.120.11 NMAC. D. Interview: (1) All recertification interviews shall be in person at the local office or, when circumstances warrant, over the phone or at another place reasonably accessible and agreeable to both the recipient/relative or caretaker and the caseworker. The recipient may bring any individual to the interview. (2) The interview must be with the recipient, unless the recipient’s physical or mental condition makes the interview impossible or inadvisable. See 8.100.130 NMAC for instructions on obtaining information. (3) To help a recipient report changes that may affect the recipient’s eligibility or amount of payment, the caseworker shall make available a change report form upon request, which the client may use to notify the county office of changes in circumstance. E. Scheduling recertification reviews: The certification period end date shall be scheduled for the appropriate interval indicated in Subsection C of 8.102.120.9 NMAC, starting with the initial month of eligibility, or the month following the month in which previous certification expired. F e report form upon request, which the client may use to notify the county office of changes in circumstance. E. Scheduling recertification reviews: The certification period end date shall be scheduled for the appropriate interval indicated in Subsection C of 8.102.120.9 NMAC, starting with the initial month of eligibility, or the month following the month in which previous certification expired. F. Exchange of information with SSA: (1) If information received during any eligibility review indicates that a participant in NMW or GA may be eligible for supplemental security income (SSI) benefits, (this includes children and adults who appear disabled, and needy adults over 65), the caseworker shall promptly refer the participant to the social security administration district office for application. An individual found eligible for SSI must participate in that program. (2) During the review process, ISD will sometimes learn information relevant to the eligibility of a family member who is a SSI recipient. If there is a clear indication that a SSI recipient's countable income exceeds the maximum allowable under the SSI program, the discrepancy shall be reported to the social security administration (SSA) district office. SSA shall also be notified when it appears that the resources of an SSI recipient exceed SSI program standards.