Section 10. Change Notices

A. Notice of adverse action: Prior to any action to reduce or terminate cash assistance benefits within the certification period, the benefit group shall be provided with a notice of an adverse action, unless the change was reported by the benefit group in writing and was signed by a benefit group member. The adverse action notice shall include at least the following information: (1) proposed action and reason for the action; (2) month in which the change takes effect; (3) adjusted benefit amount; (4) benefit group's right to request a fair hearing, circumstances under which the benefit group can continue benefits at the greater amount, and deadline dates for requesting a hearing; (5) benefit group's liability for any benefits overpaid if the result of the fair hearing is that the 8.106.630 NMAC 3 department took the correct action; (6) general information on whom to contact for additional information, including the right to representation by legal services. B. Adequate notice: If a change was reported by the benefit group in writing, was signed by a benefit group member, and will result in a reduction or termination in benefits, the benefit group shall be provided with advance written notice of the reduction or termination. (1) The benefit group shall be notified that its benefits are being reduced or terminated no later than the date the benefit group receives, or would have received, its benefits. (2) Adequate notice shall be provided when changes reported in writing meet the following conditions: (a) the benefit group provides a written report of the information that results in the reduction or termination and the report is signed by a member of the benefit group; (b) the caseworker can determine the benefit group's reduced benefit amount or ineligibility based solely on the information provided by the benefit group in the written report; and (c) the benefit group retains its right to a fair hearing. C it group provides a written report of the information that results in the reduction or termination and the report is signed by a member of the benefit group; (b) the caseworker can determine the benefit group's reduced benefit amount or ineligibility based solely on the information provided by the benefit group in the written report; and (c) the benefit group retains its right to a fair hearing. C. Fair hearing rights: The benefit group retains its right to have continued benefits if the fair hearing is requested within the adverse action time limit and the benefit group requests the higher benefit amount pending the hearing decision. The caseworker shall continue the benefit group's previous benefit amount if required, within five working days of the benefit group's request. D. Other changes: A notice of adverse action shall not be provided when: (1) there is a mass change in benefits affecting the entire GA program; (2) the caseworker determines, on the basis of reliable information, that the benefit group has moved out of state; (3) the caseworker determines on the basis of reliable information that all members of a benefit group have died; (4) the benefit group has received an increased benefit amount to restore lost benefits, the restoration is complete, and the benefit group has been notified in writing of the date the increased benefit amount will terminate; (5) the benefit group voluntarily requests in writing, or in the presence of the caseworker, that its participation be terminated; or (6) the caseworker determines, on the basis of reliable information, that the benefit group has been approved for a concurrent cash assistance program. [8.106.630.10 NMAC - N, 07/01/2004; A, 12/01/2009] 8.106.630.11 MASS CHANGE NOTICE A. Change in payment amount: A benefit group's cash assistance payment may be increased or decreased after initial certification. (1) Increase in payment amount: The department shall issue adequate notice to GA recipients regarding an increase in payment amount been approved for a concurrent cash assistance program. [8.106.630.10 NMAC - N, 07/01/2004; A, 12/01/2009] 8.106.630.11 MASS CHANGE NOTICE A. Change in payment amount: A benefit group's cash assistance payment may be increased or decreased after initial certification. (1) Increase in payment amount: The department shall issue adequate notice to GA recipients regarding an increase in payment amount. (2) Decrease in payment amount: The department shall issue written notice to GA recipients no later than 60 days prior to the change effective date. The notice shall include the citation to the state statute and regulation and fair hearing rights. B. Application moratorium: Public notice shall be issued 60 days prior to the imposition of a moratorium on applications. Applications received during the moratorium shall be processed in accordance with 8.106.110.16 NMAC. C. Suspension of program: The GA payment for all benefit groups may be denied for a designated time period based on unavailable state funds. During program suspension disposition of applications shall be made pursuant to 8.106.110.16 NMAC. (1) Payment of assistance: There shall be no payment to the GA recipient during the designated suspension period and any right to the payment is lost. Retroactive payments for pending applicants shall be authorized for months prior to a designated suspension period. (2) Notice to recipient and applicant: No later than 60 days prior to the effective change the department shall provide GA recipients appropriate notice regarding suspension or restoration of the grant based on the availability of state funds. The notice shall include the citation to the state statute and regulation and fair hearing rights. D. Public notice: The department shall issue a public notice 60 days prior to the changes made 8.106.630 NMAC 4 based on the availability of state funds in Subsections A - C above. Public notice shall include effective date of change and right to fair hearing consistent with mass change requirements at 8.100.180.15 NMAC lude the citation to the state statute and regulation and fair hearing rights. D. Public notice: The department shall issue a public notice 60 days prior to the changes made 8.106.630 NMAC 4 based on the availability of state funds in Subsections A - C above. Public notice shall include effective date of change and right to fair hearing consistent with mass change requirements at 8.100.180.15 NMAC. [8.106.630.11 NMAC - N, 07/01/2004; 8.106.630.11 NMAC - N, 12/01/2009] 8.106.630.12 LATE REPORTING OF CHANGES A. If the benefit group failed to timely report a change, the caseworker shall verify the change to determine whether the benefit group received benefits to which it was not entitled (an overpayment). B. Failure to report changes: Failure to report any change in a timely manner may result in an underpayment or an overpayment to the benefit group. (1) The caseworker shall establish a claim against the benefit group for any month in which the benefit group was overpaid benefits. (2) If the establishment of an overpayment is made within the certification period, the benefit group is entitled to a notice of adverse action that its benefits will be reduced due to the overpayment. (3) No claim shall be established because of a change in circumstances that a benefit group is not required to report. C. Good cause for failure to report a required change: (1) If a required change is not reported timely, good cause for not reporting on time is considered to exist if the recipient can show, with appropriate documentation, that the recipient was prevented from reporting by a health problem, including illness, or death of an immediate family member during the time period the individual was required to report. (2) The health problem or death of an immediate family member must have been of such severity and duration as to effectively prevent the timely reporting by the head of household or unrelated caretaker entation, that the recipient was prevented from reporting by a health problem, including illness, or death of an immediate family member during the time period the individual was required to report. (2) The health problem or death of an immediate family member must have been of such severity and duration as to effectively prevent the timely reporting by the head of household or unrelated caretaker. The head of household or unrelated caretaker must provide proof of the existence of the health problem and explain exactly how it prevented the recipient from reporting the information to the ISD office. (3) The determination of good cause shall be made by the caseworker, subject to the review and approval of the county director or the county director's designee.