218-RICR-20-00-2
218-RICR-20-00-2. Rhode Island Works Program Rules and Regulations (version Amendment, 10/01/2009 to 04/29/2010)
1432 REDETERMINATIONS AND CHANGES
1432.05 PURPOSE OF REDETERMINATION
REV: 10/2009
In addition to the change reporting requirements outlined in Section
1408.30 for all recipients, a redetermination of eligibility is
completed whenever a significant change is expected to occur that may
affect a family's eligibility and at least once every twelve (12)
months to ensure that eligibility for assistance continues and that the
payment is correct.
For families that are recipients of RI Works cash assistance but NOT of
Food Stamps, a redetermination of eligibility is completed whenever a
significant change is expected to occur that may affect the family's
eligibility and at least once every twelve (12) months.
1432.10 PROCESS OF REDETERMINATION
EFF: 10/2008
INRHODES stores the next redetermination date for each active case.
One month before the month in which the case is due to be reviewed, a
redetermination report is distributed to the field.
The agency representative sends out the Redetermination (REDT) packet
which consists of the following:
- Redetermination Appointment Letter - C-4,
- Statement of Need - DHS-2, and
- Other informational material, as appropriate.
1432.15 REDETERMINATION APPOINTMENT
EFF: 10/2008
The agency representative responds to any request from the recipient
for assistance in completing the DHS-2 for the redetermination of
eligibility. This help may be given by telephone or may be completed
during the scheduled office or home visit, whichever is most
appropriate. The DHS-2 should be completed by the recipient except for
the signature which must be witnessed by the eligibility technician at
the redetermination interview. The Redetermination Appointment Letter
indicates the time and location of the appointment along with the name
of the agency representative. The letter refers the recipient to page 3
of the DHS-2 for a list of documents that should be brought to the
appointment.
A face-to-face interview is required with each client filing the
application in order to review it with him/her and to determine
continuing eligibility for assistance. The same process for reviewing
the DHS-2 and determining initial eligibility (see Section 802) is
followed when reviewing the subsequent DHS-2(s).
The Information on the Family Violence Option sheet (Form WVR-1a)
should be reviewed with the recipient so that s/he is re-informed that
s/he may be excused from certain RI Works requirements under the Family
Violence Option if meeting these requirements puts the applicant or
her/his children at risk of domestic violence.
Information on the DHS-2 which was previously documented and not
subject to change, such as birth certificates, marriage and divorce
documents, should not be redocumented unless there is a discrepancy
noted between the new DHS-2 being reviewed and the DHS-2(s) previously
filed. Bankbooks, wage stubs, rent receipts, and all other information
subject to change must be verified again through documents at each
redetermination, and the source of verification entered in the shaded
area of the DHS-2 next to the item.
1432.15.05 Redetermination Appointment Not Kept
EFF: 10/2008
If the recipient does not keep the redetermination appointment or call
to reschedule, s/he is notified that the payment will be discontinued.
A notice of discontinuance is issued through INRHODES stating that:
- that the assistance payment is being discontinued
because of failure to keep the redetermination
interview appointment;
- that the filing of the DHS-2 is necessary in order to
determine continued eligibility; and
- the effective date of discontinuance.
A copy of the notice is stored in CASE/Notc in INRHODES. The action is
noted in the CLOG.
1432.17
INTERIM REPORTING
EFF: 10/2009
All RIW households are subject to Interim Reporting requirements.
Household composition and financial circumstances at the time of
application will be the basis of the RIW benefit amount for the first
half of the certification period unless the household reports a change
during the certification period before the Interim Report period. The
household composition and financial circumstances reported on the
Interim Report will be the basis of the RIW benefit amount for the
remainder of the certification period unless the household reports
additional changes following the filing of the Interim Report.
Household Responsibilities
In the fifth month of certification, households subject to Interim
Reporting will receive an Interim Report form in the mail. Households
must complete the form in its entirety and mail the form along with the
required verifications back to the agency by the fifth day of the sixth
month of certification.
Any responsible household member or authorized representative may
complete the Interim Report. At the household's request, the agency
can provide assistance to the household in completing the report. A
household that submits an Interim Report by the fifth day of the sixth
month of the certification period is considered to have made timely
report. Failure to return the Interim Report form will result in
closure of RIW benefits.
NOTE: An application (DHS-2) can be accepted in lieu of an Interim
Report form if it is received in the month the Interim Report is due,
or the following month. If an application in lieu of an Interim Report
is used to reinstate benefits, an interview is not required, and all
verification rules applicable to Interim Report processing instead of
application processing apply. Benefits are also not prorated.
Agency Responsibilities
Upon receipt of an Interim Report, the worker shall review the report;
determine if any additional information is needed; contact the
household as needed to obtain further information or verification
(giving the household at least 10 days to provide information); and
determine eligibility and benefits for the remainder of the
certification period.
If a household fails to return the Interim Report form by the fifth day
of the sixth month of the certification period, the agency must send
the household another Interim Report form. The household will have ten
(10) days from the date of mailing to return the second Interim Report
form, along with all of the necessary verifications, or the case will
auto-close by the end of the sixth month of the household's
certification period.
The agency must assess the returned Interim Report form for
completeness (including the necessary verifications). If the Interim
Report is incomplete or lacks required verifications of reported
changes, the agency must send a request for documentation (RDOC) for
any missing verifications, or return the original Interim Report form
back to the household if it is not complete. The household will have
ten days to supply the missing information, verification, or to
complete the form.
An Interim Report form is incomplete if:
* The head of household, responsible household member or authorized
representative has not signed the form;
* The household fails to submit verification of changes in
earned income, changes in unearned income, or residency; or
* The household fails to provide information needed to
determine eligibility or benefit level.
Note: If a household marks "no change" on the Interim Report form, the
report should not be considered incomplete.
Similarly, if a household fails to provide verification of a deductible
expense, there is no need to request verification because the household
is not required to receive a deduction.
If a household fails to return the Interim Report form or the required
verifications within the appropriate timeframe, the case will auto-
close by the end of the sixth month of the household's certification
period.
Reinstatement of Benefits
If an eligible household files a complete Interim Report after the case
has been closed, but before the end of the report month (month in which
the report is due), the agency shall reopen the case without requiring
the household to file an application and shall approve benefits no
later than 10 days after the household normally receives benefits.
If a household files a complete Interim Report after the end of the
report month but before the end of the month following the month in
which it was due, the agency shall reinstate assistance and, if
otherwise eligible, approve benefits within 30 days from the date the
Interim Report is received. Benefits for the month shall not be
prorated and the household shall not be required to file a new
application.
1432.17.10 Interim Report Verification Requirements
EFF: 10/2009
In order to determine eligibility for the second half of the
household's certification period, the household must supply
verification of certain eligibility factors. The household must
provide the following information:
1. Proof of earned income. Verification is needed of all earned
income if the amount or source has changed. At a minimum,
the household must provide verification of earned income
from the month the Interim Report is prepared (Month 5).
2. Proof of changes in unearned income when it goes up or goes
down fifty dollars ($50) or more a month.
3. Changes in household composition: all individuals living in
the household including new household members and newborns
if applicable, their dates of birth and social security
numbers
4. Current address and telephone number
5. If the household has moved, information regarding the new
address and resulting changes in shelter and utility
expenses
6. Any change in legal obligation to pay child support
If verification of changes in earned or unearned income is not
provided, benefits shall be terminated. If the household fails to
provide sufficient information or verification regarding shelter,
dependent care, medical or child support expenses, benefits shall not
be terminated, rather benefits will be determined without including the
deduction. If this occurs, the household must be notified that a
deduction or deductions were not allowed since verification was not
provided, and that benefits will be redetermined if the verification is
subsequently provided.
1432.20 COMPLETION OF REDETERMINATION
EFF: 10/2008
The eligibility technician updates appropriate information into the
recipient's case in INRHODES. S/he approves any subsequent versions of
eligibility and updates the Redetermination Complete Date in the REDT
panel to establish the next redetermination due date. INRHODES issues
an adequate and timely notice to the recipient, as appropriate. Any
changes in circumstances or anticipated changes are noted in the case
log (CLOG).
If a potential resource is expected in the future, the eligibility
technician sets up a TIKL through the INRHODES SPEC function as a
reminder of the anticipated change so that proper activity about the
resource can be initiated and completed on time.
1432.25 CHANGES IN CIRCUMSTANCES
EFF: 10/2008
In the initial contact with the agency, and generally in any subsequent
contacts, the recipient is made aware of her/his responsibility to
report within ten (10) days any changes in income, resources, family
composition, or other factors affecting eligibility or the amount of
benefits, with the exception of the temporary absence of a minor child,
which must be reported within five (5) days, as outlined in Section
1408.30. Financial need is subject to change whenever there is a
change in the family composition, income, or resources. Other changes
can affect eligibility, some of which the agency may be aware in
advance and others which are unexpected and the agency can learn about
only when the recipient or another source makes the information known.
When it is known, or presumed, that income, resources, family size, or
other circumstances will change at a specific time, the agency
representative must review the situation promptly and take appropriate
action in a timely manner.
Information on the change in circumstances and the payment change are
annotated in the Case Chronology (CLOG).
1432.25.05 Addition of Member to Assistance Unit
EFF: 10/2008
A new household member joining a household may qualify for assistance
from the RI Works program. The date the agency is notified of the
addition of the family member constitutes the official application date
for that member.
A Statement of Need (DHS-2) need not be completed for a new member
being added to the unit, but the CLOG must be updated to reflect the
request for assistance for the member and the date it was made. The
eligibility technician adds or revises the new member's MEMB panel and
any appropriate secondary panels and approves any retroactive and
current versions of eligibility.
1432.25.10 Discontinuance
EFF: 10/2008
A RI Works program cash payment must be discontinued whenever it is
determined that need no longer exists. A notice of discontinuance is
issued through INRHODES at least ten (10) days prior to the effective
date of discontinuance.
1432.25.15 Eligibility for Medical Assistance Only
EFF: 10/2008
When a recipient of a RI Works program cash assistance payment is no
longer eligible on the basis of financial need, the eligibility worker,
as part of the closing process, determines eligibility for Medical
Assistance (MA) on the basis of information in the case record. (If
information to determine MA eligibility is insufficient, the notice of
discontinuance must specify what is needed.)
If the family became ineligible for cash assistance as a result of
excess earned income, the family/assistance unit shall continue to be
covered by medical assistance, if otherwise eligible, through the RIte
Care or RIte Share program, in six month periods, for a period of no
longer than eighteen (18) months or until the employer-paid family
health care coverage begins, whichever occurs first.