218-RICR-20-00-3
218-RICR-20-00-3. General Public Assistance Program (version Amendment, 03/30/2020 to 09/01/2021)
3.1 Introduction
A.
COVID-19 Virus and the National State of Emergency
1. Prior
to the implementation of any new procedure under this regulation, the
Director of the Department of Human Services shall seek federal
waivers or approval, when required, from the Federal agencies that
provide funding and oversight for the programs the Department of
Human Services administers. The Director shall also consider any
guidance by these Federal agencies, when available, when implementing
new procedures.
2. Upon
withdrawal of the R.I. State of Emergency, as it relates to COVID-19,
these new procedures shall lapse after three business days from the
withdrawal of the State of Emergency for Rhode Island.
B. R.I.
Gen. Laws Chapter 40-6, entitled "Public Assistance Act,"
establishes the legal basis for a General Public Assistance Program.
1. The
General Public Assistance (GPA) Program is available for adults age
18-64 years of age who have very limited income and resources and
have an illness or medical condition that keeps them from working.
2. GPA
shall not be provided to any individual who has been determined
eligible for SSI or to any individual who is eligible or who would,
but for income and resources, be eligible for Rhode Island Works
(RIW) program cash assistance.
3. GPA
eligibility shall not exist for certain persons who are in the care
of, confined by, or in the custody of another State Agency such as
the Department of Corrections, the Department of Children, Youth and
Families or the Department of Behavioral Healthcare, Developmental
Disabilities & Hospitals (BHDDH).
B. Types
of GPA Assistance
1. Interim
cash assistance for the disabled is provided to individuals
determined to have applied for and have been approved for Medicaid
and to have applied for and pursuing a claim for SSI.
2. Supplemental
payments for funeral and burial costs may be provided through vendor
payments as determined by Departmental regulations.
3.2 Recording
3.2.1 ORGANIZATION
OF CASE RECORD
A. The
GPA case record is organized by subject matter. The general order of
the record for hard copy material received is as follows:
1. essential
documents such as birth, baptismal, marriage, or death certificates,
divorce decrees, Social Security cards, I-94s, I- 151s, G-845-AB,
etc. are duplicated and retained inside the back cover for the life
of the record.
2.
apart from vital statistics information, essential forms and other
materials are ordered from the front of the record, following the
narrative, as follows:
a. DHS-2
Application for Assistance forms, package as above and retained for
the life of the record.
b. MA-63's,
AP-70's and other documents pertaining to medical history and
employability, packaged as above;
c. Documents
pertaining to income and resources such as the AP-175, AP-175a,
AP-175b and TPQY cards and replies.
d.
Miscellaneous items packaged as above; and
e. Correspondence
packaged as above.
3. Denied
applications for GPA are retained for a period of three (3) years and
client case files and associated documentation are retained for a
period of ten (10) years in accordance with the Department of Human
Services record retention schedule.
3.3 Topical Outline for Recording
the Narrative
A. The
Topical Outline is used by the worker to record the assessment of a
client's problem(s) and, in cooperation with the client, to prepare a
service plan directed toward specific goals.
B. Only
information pertinent to the client's particular problem(s) is
gathered and recorded.
C. Subsequent
changes in circumstances and/or assessment, and/or a modification of
the service plan, may not require use of the complete outline.
D. Repetition
is to be avoided. Reference can be made to the date of an earlier
recording.
3.3.1 Client
Identification/Presenting Problem
A. For
all cases, the client is identified by date of birth, marital status,
family members, next of kin, and living arrangement.
B. This
section also relates why the client is contacting the agency at this
time and why the client is in need of GPA.
C. It
identifies monetary need, medical need, and other problems presented
by the client.
3.3.2 Assessment
A. An
assessment is defined as the worker's understanding of the nature of
the problem, its origin and the contributing factors.
B. The
assessment is an ongoing process which changes as service is being
provided. Its purpose is to make service effective.
C. A
health problem is detailed in respect to its nature, the expected
duration of its effect upon the client's functioning, the identity of
the treatment facility, and the treatment modality (therapy,
counseling, periodic monitoring, plans for surgery, medication,
etc.). Reference is made to the MA-63. Of importance are the planned
frequency of visits to the facility and whether the client is
following through with the treatment. During the COVID-19 crisis,
treatment may be amended from in-person facility visits to telephonic
visits.
D. Additional
information necessary to establish eligibility and to formulate an
assessment is recorded, as pertinent to the individual case.
E. With
respect to employment or underemployment problems, an assessment is
made to include the feasibility of alternative employment, training
and/or counseling for problems contributing to the client's low
income status or lack of a job. A referral to employment counseling
is sometimes indicated. However, due to the COVID-19 virus and the
Rhode Island State of Emergency, the Department of Human Services
will temporarily suspend all employment and training activities as a
compliance requirement in determining eligibility and will utilize
discretion to allow for alternative measures of fulfilling this
requirement.
3.3.3 Planning
with Client
A. Planning
for service is a cooperative effort between client and worker which
involves the client at every step in the process, focusing upon the
presenting of problem(s) with which the client wants help and
applying the worker's assessment of the situation.
B. The
plan should indicate that the worker has given the client information
as to the services to be provided and by whom: the worker and/or
another agency.
1. It
is important that the client's attitude about and understanding of
the plan be recorded.
2. The
client's commitment to follow the treatment plan as prescribed on the
MA-63 is obtained.
C. Short-term
and long-term goals, and the agreed upon objectives to be
accomplished to reach such goals, are established by client and
worker and recorded.
1. The
roles of the client and the worker are identified.
2. Tasks
to achieve the agreed upon objectives are assigned to both client and
worker.
3. A
reasonable time frame is established for completion of each task.
4. Contacts
between client and worker are planned for in order to carry out the
objectives and review the planning.
D. The
service plan is shared in its entirety with the client.
3.3.4 File
Instructions
A. Case
reminder maintenance is done via the state’s electronic
eligibility system.
B. Reminder
instructions would be used to indicate the month in which any
specific activity for the worker is to take place and to indicate
when it is completed.
C. Such
activities include the updating of the MA-63, the recertification due
date, and closings.
3.4 Recording of Continuing
Eligibility Factors
A. Recertification
interviews are recorded, identifying any changes in the client's
circumstances, such as any changes in the client's health or medical
condition, as noted on an updated MA-63.
B. All
other pertinent interim changes should be a part of the case record.
3.5 Recording of the Continuity of
Service
A. The
ongoing activities between the worker and the client are recorded.
These may be summarized, or recorded contact by contact, according to
date, if important, and should reflect:
1. the
progress, or lack of progress, toward the achievement of the service
plan;
2. any
changes in the direction of the goals; and/or
3. the
client's ability to participate in the plan.
B. In
summarizing several contacts or activities, the worker should record
the most pertinent service activities and the problem(s)
precipitating such activities in chronological order. Such
recordings assist the worker in evaluating the total situation and
the service plan.
C. In
those situations where it is essential to record each contact, the
contact is dated and the important elements are recorded.
3.6 Closed Records
A. When
a case is closed on GPA, a GPA-56 is sent to the client with a dated
copy filed in the case record.
B. This
closing notice will indicate the effective date of the closing, the
reason for the closing, and notify the client of his/her rights to
appeal. See General Provisions, § 10-00-1.3
of this Title for
information about the appeal and hearing process for GPA recipients.
3.7 The Application Process
A. The
application process for General Public Assistance starts when a
person or his/her representative contacts the agency to request
assistance, and ends with either the decision by the agency to
approve or to deny assistance, or the decision by the applicant to
withdraw his/her request for assistance.
1. The
purpose of the application process is to:
a.
Ensure the right of a person to apply without delay for assistance.
However, decreases in staff during the COVID-19 pandemic may delay
the processing of timely applications.
b. Provide
an opportunity for the person to state his/her needs and to learn
what the agency can do to help him/her.
c. Provides
the initial opportunity for the person to know what his/her
responsibilities are in his/her relationship with the agency.
2. An
applicant may be assisted by an individual(s) of his/her choice and,
when accompanied by such individual(s), may be represented by
him/her.
3. The
agency requires a face-to-face interview be held during the
application process. During the COVID-19 pandemic, this requirement
is temporarily waived and applications will be reviewed with the
applicant during a phone interview as needed until after three
business days from the withdrawal of the State of Emergency for Rhode
Island.
4. The
application process is one of the agency's major opportunities to
provide service to people by learning from the person about his/her
difficulty, by informing the person about the agency, and by offering
the full scope of the agency's service, as appropriate.
3.8 The Request for Assistance
A. During
the COVID-19 crisis, the request for assistance can be made by phone,
electronically, or by mail. The Department has temporarily restricted
face-to-face access at all State Offices.
B. A
request for assistance may be received in the district office in
person, by phone, electronically or by mail. The GPA caseworker
gives, or mails to the applicant, the application packet.
C. This
packet, which provides information about the agency and conditions
under which assistance is provided and the applicant's rights and
responsibilities contains the:
1. DHS-2
Application for Assistance (including Affordable Care Coverage)
2. MA-63
Medical Diagnostic Study (for individuals)
3. AP-70
GPA Disability Supplement (for individuals)
D. The
signed DHS-2 may be returned via the US Postal Service, returned to
the field office drop box, or by uploading the signed application to
the individual’s Customer Portal Account of the State’s
integrated electronic eligibility
system.
3.8.1 Preparation
for Intake
A. The
GPA caseworker plans for an intake appointment with the applicant. If
an emergency intake is needed immediately, the GPA caseworker plans
for the intake according to the district office system for handling
emergencies.
B. The
applicant is asked to complete the DHS-2, with the exception of the
signatures, prior to the interview.
C. If
the applicant is seeking health coverage, he/she is asked to complete
the UHIP LF-1, Application for Health Care Coverage or is directed to
apply online at www.healthsourceri.com .
1.
A determination for Medicaid affordable care coverage (MACC) must be
completed under MAGI rules prior to a determination of eligibility
under a disability.
D. The
applicant is advised of the documentation of information required in
the determination of eligibility. The applicant is also made aware
that in completing the application(s), s/he may be helped by a
relative or friend, or the GPA caseworker.
E. The
applicant is informed that the application period starts on the date
the completed application is received and date stamped in the
Department of Human Services district office.
1. The
stamped date, on the application is the official filing date from
which financial assistance begins if eligibility is later found to
exist and to have existed when the application was filed.
2. The
applicant is accordingly advised that it may be in his/her best
interest to complete and return the application as soon as possible.
F. No
one will be denied an application or an interview because they have
not yet secured medical verification of their health status.
G. Refer
to 210-RICR-30-00-1.5,
1.6, and 1.7 for eligibility for Medicaid
Affordable Care Coverage Groups and 210-RICR-30-00-3.1
for the Medicaid Application process.
3.8.2 Participation
in SNAP
A. An
applicant wishing to participate in the Supplemental Nutrition
Assistance Program (SNAP) must be encouraged to file the DHS-2 at the
time of the request for assistance in order to establish the earliest
filing date and be screened for expedited service.
1. If
the information provided on the DHS-2 indicates that such applicant
may be eligible for expedited service, the DHS-2 Application for
Assistance must be completed.
2. If
eligibility exists, expedited service must be made available
according to the processing standards in the SNAP Rules and
Regulations, § 1.3.9 of this Subchapter.
3.9 Application Forms
A. The
DHS-2 Application for Assistance is the basic document used in the
application process through which eligibility, or ineligibility, for
GPA interim assistance and burial assistance is determined.
B. The
UHIP LF-1, Application for Health Care Coverage is the basic document
used in the application process through which eligibility for
Medicaid affordable care coverage (MACC) is determined.
C. These
documents, along with appropriate supplementary forms, constitute the
application for GPA financial assistance and Medicaid affordable care
coverage (MACC).
D. For
persons applying for SNAP benefits as an AP household, the DHS-2
serves as the SNAP application.
E. The
DHS-2 must be completed and signed, under penalty of perjury, by the
applicant and his/her spouse, if living together, or by an authorized
representative in cases of extreme incapacity or emergencies.
F. The
DHS-2 must be completed and signed for all reopened cases when the
case has been closed for more than one month. After the interview,
the signature on the DHS-2 must be witnessed by the GPA caseworker.
During the COVID-19 crisis, the Department will temporarily accept
applications signed by the applicant without being witnessed by staff
prior to submitting to the department for review.
3.10 Intake Interview/Determining
Eligibility
A. The
Intake Interview is scheduled by appointment or plan. Due to the
Rhode Island State of Emergency concerning the COVID-19 virus, the
Department of Human Services has temporarily suspended all
face-to-face interviews for benefit applications. Applicants for GPA
that require an interview will receive a phone call from a department
staff person to schedule and conduct the interview by phone.
B. The
DHS-2 is reviewed with the applicant and the eligibility and need
factors (as described in §§ 3.16, 3.18 and 3.19 of this
Part) are verified through the appropriate documents supplied by the
applicant. A list of the necessary documents is included on the
DHS-2, Application for Assistance.
1. If
the necessary documentation is not supplied by the applicant at the
initial intake, the worker must list the specific types of
documentation needed to complete the application and how and when
these items are to be submitted.
2. Staff
should be aware that various vital statistics, such as birth,
marriage and death certificates, can be verified at no cost to the
client, through the use of the VS-75, Application for Copy or
Verification as well as through electronic interfaces in the State’s
integrated electronic eligibility system.
C. The
applicant is required to read or have read to him/her the Declaration
of Applicant/Recipient in the DHS-2 and to sign the form in the
yellow section of the page. The agency representative must witness
the signature of the applicant. Due to the Rhode Island Emergency
Declaration, the Department will temporarily accept applications
signed by the applicant without being witnessed by staff prior to
submitting to the department for review and accept applications
signed by the applicant prior to submitting to the department for
review.
D. The
applicant is advised that s/he must present the agency with some
personal identification such as driver's license, Social Security
number, birth certificate or other identification.
E. If
it appears that a resource exists, or the applicant neglected to
bring in the necessary verification, or further verification is
needed, the applicant is advised of the necessary steps s/he, or the
staff member, must take to obtain the information.
F. The
applicant is also advised that the agency uses on an ongoing basis:
public records, other State agency files, (such as State employee
payrolls, UCB records, TDI records, State Income Tax records) and
Social Security information to document the applicant's information.
1. If
the applicant is unwilling to provide other verification, the
determination of eligibility cannot be made.
a. In
this instance, the applicant may choose to have his/her application
rejected.
G. The
applicant is further advised that s/he is responsible to inform the
agency within ten (10) days of any changes in his/her financial or
living situation which directly affects his/her continued eligibility
for GPA and/or the GPA level of payment. This requirement may be
adjusted and/or suspended during the COVID-19 emergency declaration,
depending on the individual’s situation.
H. If
the applicant is also an SSI applicant, or if s/he has been denied
SSI but did not appeal within the time limitation and is now
reapplying for SSI, such applicant is informed of the repayment
agreement for any GPA funds authorized to her/him in the interim
period, and the requirement to complete an AP-175 and an AP-175a.
1. If
the GPA applicant is also a potential SSI recipient, the procedure
for applying for SSI is followed as outlined in § 3.11 of this
Part.
I. If
the application for GPA is necessary by reason of accident, injury or
illness for which a third party may be liable, such applicant is
advised that the DHS-2, Application for Assistance, contains an
assignment of rights to the Department for Human Services (DHS), for
and on behalf of the applicant and any person for whom s/he may
legally act, for repayment limited to the amount of financial
assistance furnished by the Department (see § 3.12 of this
Part).
1. All
applicants are informed of the requirement to enter into such an
assignment and their further responsibility to report a pending
settlement which may occur during the receipt of assistance.
J. During
the intake interview, the applicant's rights and responsibilities, as
outlined on the DHS-2, Application for Assistance, are reviewed with
the applicant.
3.10.1 Forms
and Materials Used at Intake
A. The
forms and materials which may be used at the intake interview are:
1. DHS-2
Application for Assistance
2. UHIP
LF-1 Application for Health Care Coverage
3. MA-63
Medical Statement
4. AP-70
Information for Determination of Disability
5. AP-175
Authorization for Reimbursement
6. AP-175b
Collateral Assistance Information
B. The
agency representative reviews the DHS-2 for completeness, helping the
applicant, as needed, to complete any omissions.
3.11 Potential Eligibility for SSI
A.
Due to the Rhode Island State of Emergency concerning the COVID-19
virus, the Department of Human Services has temporarily suspended all
in person transactions as well as all face-to-face interviews for
benefit screenings, applications. Referrals to agencies to complete
the application process will be discussed during the phone interview.
If needed, the allotted time frame will be adjusted to compensate for
the COVID-19 crisis. All documents received via mail or drop box will
be scanned in and retained in the electronic case record.
.B. An
applicant for GPA who will be 65 years of age within one (1) month,
or an applicant who is disabled as noted on the MA-63 and as defined
below, is required to file for and cooperate in the eligibility
determination for SSI.
1. Disability
is defined by the Social Security Administration (SSA) as the
inability to do any substantial gainful activity by reason of any
medically determinable physical or mental impairments which can be
expected to result in death or which has lasted or can be expected to
last for a continuous period of not less than twelve months.
a. To
meet this definition, a person must have a severe impairment which
renders him/her unable to engage in the previously performed work or
in any other substantial gainful activity which exists in the
national economy.
b. To
determine whether the person is able to do any other work, the SSA
considers the person's residual functional capacity and his/her age,
education and work experience.
C.. At
the Intake Interview, such applicant is advised of the Repayment
Agreement, as described in § 3.11.3 of this Part.
3.11.1 SSI
Application Procedures
A. Once
the Authorization for Reimbursement (AP-175) is explained, the
caseworker obtains the applicant's signature on all four (4) copies
of the form.
B. The
caseworker completes the RI/DHS/SSA-1 referral form in triplicate.
This form contains pertinent information about the applicant:
1. The
original is attached to SSA's copy of the AP-175;
2. One
copy of the form is given to the client; and
3. One
copy is retained in the case record.
C. The
caseworker refers the applicant to the correct SSA district office to
file an SSI application.
1. SSA
district offices providing walk-in appointments should be utilized
when such arrangement is advantageous to the applicant, particularly
for an applicant with a special need such as an individual
accompanied by and/or requiring an interpreter.
2. An
application for SSI may be filed at any SSA district office.
3. The
application is forwarded to the appropriate servicing SSA office on
the applicant's behalf. However, it is preferable to initiate the
application process at the correct SSA district office.
3.11.2 Forms
and File Instructions
A. Within
twenty-four (24) hours of the date the AP-175 is signed by the
applicant, the GPA caseworker sends both the original RI/DHS/SSA-1
and the SSA copy of the AP-175 to the servicing SSA district office.
1. The
forms will generate a contact with the applicant from the SSI claims
representative should the applicant fail to keep the arranged
appointment. The GPA caseworker's name, address, and telephone number
must be included on the form.
2. Case
reminder instructions should be followed whenever needed.
3. The
worker should also note in the eligibility system the date the AP-175
was signed and sent to the SSA.
a. Reminder
instructions may be inputted into the eligibility system regarding
the date on which a follow-up on the application process is due.
B. The
applicant is expected to file a written application for SSI within
thirty (30) days from the date of the GPA intake appointment.
Similarly, a GPA recipient who is advised by her/his GPA worker that
s/he must apply for SSI, must file an application within thirty (30)
days of notification.
1. The
SSI claims representative returns the RI/DHS/SSA-1, within thirty
(30) days, to the GPA caseworker.
a. The
form should contain the claim representative's name, whether or not
the client has completed the application, and if so, the date of
filing, and any other pertinent information.
2. If
the individual does not apply within thirty (30) days, or applies and
subsequently refuses to cooperate in the determination of SSI
eligibility, a notice of GPA ineligibility is sent, and the case is
closed due to non-compliance.
3. The
AP-175 remains valid for one (1) year from the date signed, except
when one of the events listed in § 3.11.3 of this Part occurs.
a. However,
the signed AP-175 must be forwarded to SSA within thirty (30) days of
the date the individual signed the form to be binding.
b. Furthermore,
in order to protect the SSI filing date (which is the date the AP-175
is signed), the SSI application must be filed at an SSA office within
sixty (60) days. This allows sufficient time for the applicant to
complete the SSI requirement.
3.11.3 Repayment
Agreement for SSI Applicants
A. When
an SSI applicant applies for and accepts a GPA payment to meet
her/his needs while the Social Security Administration (SSA) is
determining eligibility for the SSI program, s/he is advised that
Pub. Laws 92-368 provides for repayment of funds expended by the
State to any SSI applicant who is awaiting a decision on eligibility
for SSI and who accepts a GPA payment in the interim.
1. "Interim
assistance" begins with the day on which the individual files an
application for SSI benefits and is found eligible for SSI benefits.
It ends when the individual receives the initial SSI check.
2.
The Authorization for Reimbursement, form AP-175, is used by the
State to obtain an SSI applicant's written permission for the
Commissioner of SSA to withhold the individual's initial SSI payment
and send such payment to the State.
3. In
the event that SSA does not send the initial SSI payment to the
State, the individual agrees to endorse such payment to the State in
accordance with R.I. Gen. Laws § 40-6-28.
4. The
AP-175 is binding on the individual and the State for one (1) year
beginning with the date it is signed by the individual and received
by DHS, provided, however, that the form is transmitted to the Social
Security Administration (SSA) within thirty (30) days of the date it
was signed by the individual.
a. It
ceases to have effect at the end of one (1) year unless the
individual files an application for SSI benefits within that time or
one of the following events occurs earlier, in which case the
authorization ceases to have effect as of the date of such event:
(1) The
Commissioner of SSA makes an initial payment on the individual's
claim;
(2) The
Commissioner of SSA makes a final determination on the claim and no
timely request for review is filed; or
(3) The
State and the individual agree to terminate the authorization.
(4) The
form is completed in four (4) copies with the client's original
signature on each copy when the GPA application is filed. The copies
are distributed as follows:
(AA) The
original is sent to the DHS Office of Financial Management;
(BB) One
copy is sent to the appropriate Social Security Administration (SSA)
district office;
(CC) One
is filed in the case record; and
(DD)
One copy is given to the client.
3.11.4 DHS
Office of Financial Management
A. The
DHS Office of Financial Management has the responsibility to:
1. use
the AP-175 form as the authorizing document to receive and disburse
funds from the individual's retroactive check, for the repayment of
GPA monies paid to her/him; and
2. coordinate,
with the appropriate certifying officer, the amount of the GPA
disbursement to the individual.
B. The
DHS Office of Financial Management is responsible for assuring the
prompt accounting of GPA payments made to SSI applicants.
C. The
AP-175 repayment agreement also applies to any GPA recipient who
receives an SSI retroactive check directly.
D. Only
GPA monies paid and vouchers actually issued to the recipient after
the date of execution of the AP-175 are deducted from the retroactive
check.
1. Any
balance of the recipient's retroactive monies will be paid to him/her
by the Department within ten (10) days of receipt of the retroactive
check.
2. In
addition to the retroactive check, an itemized accounting of the
amount of the retroactive check retained by DHS for GPA monies and/or
vouchers paid will be sent to the recipient.
3. The
AP-175 form states that in the event of a disagreement between the
DHS and the recipient regarding the amount of reimbursement, the
recipient has a right to a hearing from the State with respect to
such apportionment of her/his retroactive payment.
3.11.5 SSI
Denial
A. If
upon review by the worker, or if the client reports to the worker
that his/her SSI application has been denied, the worker should
instruct the client that s/he has sixty days (60) from the SSI denial
date in which to file for reconsideration.
1. If
the reconsideration is completed and subsequently denied, the client
should be aware that, according to SSA policy, the client has sixty
(60) days from the reconsideration denial to file a hearing.
2. Workers
should encourage their potential SSI applicants to appeal an SSI
denial.
3. If
the client fails to apply for a hearing within the prescribed time
period, but intends to pursue the application for SSI, a new AP-175
must be completed and processed according to the above procedure.
3.12 Application for Payment –
Collateral Source
A. A
collateral source is a third party who may be liable for accident,
injury or illness of GPA applicants awaiting a decision on an
application for payment.
1. When
an applicant needs and accepts a GPA payment during the period in
which application for payment from a collateral source is pending,
the applicant is advised that repayment to the State of Rhode Island
may be required if the applicant is subsequently found eligible for
monies from the collateral source.
2. When
the DHS-2, Application for Assistance, is signed by the applicant,
s/he assigns all rights to the Department of Human Services (DHS) for
and on behalf of herself/himself and any person for whom s/he may
legally act, for amounts recoverable from a third party equal to the
amount of financial and/or medical assistance provided as a result of
said accident, injury or illness.
3. The
assignment policy and procedure are as follows:
a. Collateral
Sources. Such collateral sources (third parties) include but are not
limited to:
(1) insurance
companies, employers, property owners, business establishments,
service providers, and the like who may be liable for personal injury
to the applicant as a result of on- the-job accidents, automobile
accidents, slip-and-fall accidents malpractice claims, etc. and
(2) insurance
companies liable for Worker's Compensation and other insurance who
may be liable for payment to the insured. Generally, these payments
are retroactive payments covering a period of time GPA was paid
because the income from the collateral source was not available.
b. RSDI
benefits are not subject to reimbursement.
c. Funds
Subject to Assignment and Agreement Funds subject to such assignment
and agreement may extend to and are limited to all GPA payments
(monies and vouchers) provided to such applicant, any family members
included in the applicant's GPA standard of assistance, and all GPA
vendor payments made on behalf of the applicant for medical care
related to the accident, injury or illness for which the third party
may be liable.
(1) The
applicant is informed of her/his right to a hearing regarding the
apportionment of such funds.
4. AP-175b.
Form AP-175b, Collateral Assistance Information, is prepared in four
(4) copies, with each copy dated, signed by the applicant and
witnessed by the worker. It is important to include the complete
address of the third party.
a. The
AP-175b is routed as follows:
(1) the
original is sent to the Collections, Claims and Recoveries Unit;
(2) one
copy is given to the applicant; one copy is retained in the case
record; and
(3) one
copy is forwarded to the certifying officer.
3.13 Collections, Claims and
Recoveries Unit
A. The
Collections, Claims and Recoveries Unit has responsibility to:
1. use
the AP-175b as a notice to the parties and units involved, as
required by each individual case;
2. to
use this form as an authorizing document to receive and disburse
funds from the individual's settlement check, for repayment of all
GPA monies and vouchers; and
3. after
making such repayments, to send the remainder, if any, to the
recipient.
B. The
fiscal clerk and certifying officer are responsible for identifying
cases separately in the GPA fiscal files to assure prompt accounting
of GPA payments made to such applicants.
1. The
date of the occurrence of the accident or injury, or the onset of
illness, must be verified so that fiscal accounting of the GPA funds
expended can be properly identified.
2. An
accounting of such GPA funds expended will be furnished during the
settlement process or upon request by the recipient.
3.14 Determination of Initial
Eligibility
A. All
items on the DHS-2 which were not verified at intake must be verified
in the following contact.
1. The
worker should review the list of necessary documents (if any) that
were not available at the initial intake to ensure all verifications
have been obtained so the application can be completed in a timely
manner.
2. If
there is any question about the DHS-2, the agency representative
gives the applicant the opportunity to clarify or complete it by
whichever is the most appropriate method: telephone, mail, or an
office or field interview.
a. Due
to the COVID-19 Pandemic, the applicant will be encouraged to call
or mail the Department to provide clarification as all State Offices
are closed during this crisis.
3. If
the applicant is unable, either alone or with the help of the agency
representative, to clear up any inconsistencies or to provide any
additional information needed, the agency representative advises the
applicant that it will be necessary to use other sources, and plans
with the applicant how this is to be done.
3.15 Decision on Application
A. Due
to the COVID-19 Pandemic, there may occur a decrease in department
staff which could delay the decision on an application. The applicant
may verbally request an extension to protect the filing date while
documentation is gathered during this crisis.
B. The
agency representative and the applicant both have responsibilities
regarding the decision on the application.
1. The
agency representative has the responsibility to act promptly upon the
application.
a. A
decision on eligibility and payment is made within thirty (30) days
from the date of the receipt of the signed application.
b. The
only exception to this regulation occurs when an applicant requests,
in writing, that s/he be granted an extension to protect the filing
date of his/her application while s/he obtains needed documentation.
c. The
validity of the request must be determined by the casework
supervisor.
d. In
no event will more than a fifteen-day extension period be granted.
2. Within
thirty days (30), the applicant is responsible to fulfill any
eligibility requirements as prescribed in Section 3.16 and to provide
such verifying documentation as may be necessary to complete the
application.
a. If
the applicant does not comply with the above procedural requirements,
the case is rejected and the applicant is notified of her/his right
to reapply.
3. When
the applicant is found ineligible, the agency representative notifies
him/her of the rejection through the use of the Rejection Letter
(GPA-167).
a. This
letter also informs the applicant of her/his right to appeal the
decision, and the method by which the applicant can request a fair
hearing.
b. In
addition, the GPA intake worker gives the recipient the information
packet on the Lifeline Assistance Program and the Link-up-America
Program. The certification card and letter are distributed at this
time.
4. Refer
to 210-RICR-30-00-1.5,
1.6, and 1.7 for eligibility for Medicaid
Affordable Care Coverage Groups and 210-RICR-30-00-3.1
for the Medicaid Application process.
3.16 Eligibility Requirements for
GPA
A. General
Public Assistance (GPA) is provided only to those persons who meet
the eligibility requirements for GPA as set forth in § 3.16.
B. GPA
shall not be provided to any individual who is eligible or who would,
but for income and resources, be eligible for assistance from the RI
Works Program.
C. Also,
GPA shall not be provided to any individual who has been determined
eligible for Supplemental Security Income (SSI).
D. GPA
shall not be provided to any individual who has been found eligible
for Medicaid.
E. In
addition, GPA eligibility may not exist for certain persons who are:
in the care of; confined by; or, in the custody of; another State
Agency, such as, the Department of Corrections, the Department of
Children, Youth and Families or the Department of Behavioral
Healthcare, Developmental Disabilities & Hospitals (BHDDH).
3.16.1 Residence
Requirements
A. To
be eligible for GPA, a person must be a resident in a city or town in
the state of Rhode Island.
B. No
person is eligible for GPA who moves out of Rhode Island.
C. HOMELESS
PERSONS. A person does not have to reside in a permanent dwelling or
have a fixed mailing address to be considered a resident of a city or
town. To facilitate the application process of homeless persons for
GPA, a sworn statement submitted by the applicant/recipient is
acceptable verification of residence.
D. CHANGE
OF RESIDENCE. When a recipient moves to another city or town in Rhode
Island, the GPA payment is continued if eligibility continues to
exist. GPA case records are transferred between DHS offices in
accordance with established procedures.
E. CASE
RESPONSIBILITY FOR GPA APPLICANTS AND RECIPIENTS IN TREATMENT
FACILITIES. For admissions in approved short-term treatment
facilities (defined as less than thirty days (30)), the district
office responsible for servicing a case is determined by the
applicant's or recipient's living arrangement prior to admission into
the treatment facility.
1. If
an otherwise eligible applicant/recipient was homeless prior to
admission, the district office that serves the city or town where the
facility is located handles the case.
2. For
admissions in approved long-term treatment facilities (defined as
thirty days (30) or longer), GPA records are to be maintained by the
district office that serves the facility.
3.16.2 Citizenship
and Alienage Requirements
A. To
be eligible for GPA, an otherwise eligible applicant must be either a
U.S. citizen or a non-citizen lawfully admitted for permanent
residence or otherwise residing in the United States under color of
law.
B. GPA
benefits shall not be provided to undocumented or illegal
non-citizens.
1. A
non-citizen is any person who is not a citizen or a national of the
U.S.
2. There
are legal permanent resident (LPR) non-citizens, non-resident
non-citizens, and undocumented non-citizens.
C. The
following gives the definition of legal permanent resident and non-
resident and undocumented non-citizens and the policies to be
followed for each.
1. LEGAL
PERMANENT RESIDENT (LPR) NON-CITIZENS. For a person who is applying
as an individual for GPA, a LPR is defined as one who was lawfully
admitted for permanent residence in accordance with the immigration
laws, such status not having changed since admission.
a. An
LPR, sponsored by an individual or an organization and applying for
GPA within three (3) years following entry into the United States, is
requested to obtain the cooperation of the sponsor, if possible, for
the purpose of determining what income and resources, if any, are
available.
b. Income
and resources are counted only to the extent that they are actually
available to the resident alien.
2. NON-RESIDENT
NON-CITIZENS. Non-resident non-citizens are foreign nationals who
have applied for admission to the United States with the intention of
merely visiting this country for a specific purpose (non-immigrants).
Non-resident non-citizens include the following:
a. diplomats
b. visitors
to the United States who come for business or for pleasure (tourists)
c. people
who are in transit through the United States
d. crewmen
aboard ships
e. qualified
students who are here to pursue a full course of study at an
established institution of learning
f. a
fiance(e) who seeks to marry a United States citizen within ninety
(90) days after entry and
g. certain
other people who were admitted to this country by the United States
Immigration and Naturalization Service on temporary status.
h. An
applicant who is a non-resident alien is not eligible for GPA.
3. UNDOCUMENTED
NON-CITIZENS. Undocumented non-citizens are those people who are not
legally in this country.
a. An
applicant who is illegally in this country is not eligible for GPA.
3.16.3 Verification
of Citizenship and Alienage
A. To
reduce barriers to eligibility for applicants/recipients, the
Department will attempt to verify citizenship and identity via the
State Verification and Exchange System (SVES) interface with the
Social Security Administration.
1.
If the interface reveals a discrepancy or is unable to provide
verification of citizenship or identity, it is the responsibility of
the applicant/recipient to provide the required verification.
B. Any
document submitted as evidence of United States citizenship must show
either the applicant's U.S. birthplace or indicate U.S. citizenship
(e.g., a U.S. Passport).
1. When
needed, assistance in obtaining the necessary document(s) is provided
to applicants by GPA staff.
C. Acceptable
documents which may be used as evidence of U.S. citizenship by birth
or naturalization include the following:
1. Birth
Certificate (including INS Form I-197);
2. Naturalization
Papers;
3. United
States Passport;
4. Hospital
record of birth;
5. Baptismal
record (only when the place and date of birth are shown);
6. Military
service records;
7. Indian
census record;
8. Voter
registration record;
9. Applicant's
name and place of birth on his/her child's birth certificate;
10. Bureau
of Vital Statistics or local government records of an applicant's
place of birth; or
11. Family
Bible (the date of publication should be prior to the applicant's
birth date).
D. When
a question of authenticity arises, the document(s) is reviewed by the
Casework Supervisor.
1. A
document is questionable when information in it is inconsistent with
information in the application or information obtained from another
documented source.
2. Staff
should be aware, however, that various "documents" issued
by an organization called the World Council of Washington, D.C. are
considered bogus and unacceptable as evidence of identity,
citizenship, age, etc., for enumeration or other official purposes.
These "documents" include:
a. World
Birth Certificates
b. World
Citizen Cards
c. World
Identity Cards and
d. World
Marriage Certificates.
3.16.4 Use
of Affidavit to Establish Citizenship
A. When
verification of U.S. Citizenship is unobtainable from one of the
sources listed in § 3.16.3 of this Part, and the applicant can
provide a reasonable explanation as to why such verification is
unobtainable, an affidavit from a third party may be accepted as
evidence of U.S. citizenship, age, and identity.
1. The
affidavit from the third party is a signed and sworn statement
indicating the facts that would demonstrate the probable U.S.
citizenship of the applicant.
2. This
affidavit is required from a person who is a U.S. citizen and who has
first-hand knowledge of the facts indicating the probable U.S.
citizenship of the applicant. It is not merely hearsay or a statement
of belief based on the applicant's appearance. It must contain a
statement of the basis of the third party's knowledge.
3. The
facts attested to must be consistent with the information provided in
the application and must not contradict other records or evidence in
the case record.
4. The
affidavit from the third party must be notarized and must contain the
following:
a. Name
and address of the applicant;
b. Name,
address, occupation and length of time the third party has resided at
the address indicated;
c. Relationship
to the applicant (e.g., friend, cousin, doctor, employer, teacher);
d. How
long s/he has known the applicant; and
e. Statement
of the basis of the third party's knowledge of the applicant's
citizenship.
B. An
affidavit from a third party is not the first source of verification.
The applicant, together with the GPA social caseworker, must explore
the availability of other sources of documentation.
C. Prior
approval for the use of an affidavit to verify U.S. citizenship must
be obtained from the Regional Manager, who reviews the affidavit,
circumstances, availability of records and the efforts made to obtain
documentary evidence, e.g., a letter to the state's bureau of vital
statistics to obtain a birth certificate. When the review has been
completed, the Regional Manager renders a decision to:
1. Deny
the use of the affidavit as verification of U.S. citizenship; or
2. Grant
a provisional thirty-day (30) approval during which the affidavit is
used as temporary evidence while efforts continue to obtain one of
the acceptable documents used to verify U.S. citizenship; or
3. Approve
the use of the affidavit as permanent verification of U.S.
citizenship.
3.16.5 LPR
Documentation
An
alien registration card (INS form I-151, I-551, AR-3 and AR-3a) or a
re-entry permit constitutes acceptable documentation of citizenship,
age, and identity. See the General Provisions, §
10-00-1.3(B)(12)
of this Title , for additional information
concerning U.S. Citizenship and Immigration Services (USCIS)
documentation.
3.16.6 Age
and Verification of Age
A. The
minimum age requirement for individuals and couples is eighteen (18).
B. Verification
of age is obtained through birth certificates, baptismal
certificates, marriage certificates, or other vital records
documents.
C. Other
acceptable documents on which age is specified are:
1. award
letters for Retirement Survivors Disability Insurance (RSDI)
2. insurance
polices
3.
passports
4. naturalization
papers and
5. employment,
school, or military records.
D. When
verification of age is unobtainable from such documents, a third
party affidavit is acceptable evidence if the criteria set forth in §
3.16.4 of this Part are met.
3.17 Interim Cash Assistance
Bridge Fund Program
A. Disabled
individuals may be eligible to receive cash assistance in the form of
a semi-monthly payment while they are awaiting the determination of
SSI eligibility. This program of interim cash assistance is referred
to as the "Bridge" fund or program.
B. This
program is limited to individuals who have applied for and been found
eligible for Title XIX Medicaid as disabled and who have applied for
and are actively pursuing a claim for Supplemental Security Income
(SSI) benefits.
C. The
income and resource limits for the Bridge fund are found in §§
3.18 and 3.19 of this Part.
D. A
determination for Medicaid affordable care coverage (MACC) must be
completed under MAGI rules prior to a determination of eligibility
under a disability.
E. Refer
to 210-RICR-30-00-1.5, 1.6, and 1.7 for
eligibility for Medicaid Affordable Care Coverage Groups and
210-RICR-30-00-3.1
for the Medicaid Application process.
3.17.1 Bridge
Fund Eligibility Requirements
A. Eligibility
for the Interim Cash Assistance for Disabled (Bridge Fund) is
restricted to individual applicants only.
B. Couples
may apply as individuals (one or both could be found eligible as
individuals). If both are eligible, each would receive individual
bridge payments.
C. Applicants
must meet the following eligibility requirements:
1. Must
have filed an application (Bridge Fund-1 form) for Bridge Fund;
2. Must
have applied for Medicaid affordable care coverage (MACC) through the
UHIP LF-1, Application for Health Care Coverage or online at
www.healthsourceri.com .
for eligibility under MAGI rules;
3. Must
have been found eligible because of disability for Title XIX
Medicaid;
4. Must
have filed a claim for Supplemental Security Income (SSI) benefits
and be actively pursuing the claim. (See § 3.11.5 of this
Part);
5. Must
have signed an agreement that if the SSI claim is waived in favor of
Title II Social Security Disability Insurance (SSDI), the individual
will repay DHS to the extent DHS would have been reimbursed through
the SSI claim;
6. Must
have completed the AP-175 Authorization for Reimbursement form before
any benefits can be paid. (See § 3.11.3 of this Part); and
7. Income
and resources must be within the same limits (and subject to the same
exclusions) established for GPA Medical. (See §§ 3.18 and
3.19 of this Part).
3.17.2 Filing
Applications for Bridge Program
A. The
Bridge Fund-1 form is the application for the Interim Cash Assistance
Program (Bridge Fund).
B. These
applications are available at any local GPA office and may be picked
up in person or requested by phone or mail (see locations below).
C. Although
the Bridge Fund-1 form is the basic document for filing for Bridge
payments, several other forms and documents must also be filed. They
are:
1. DHS-2
(Application for Assistance
2. UHIP
LF-1 (Application for Health Care Coverage)
3. AP-175
(Authorization for Reimbursement)
4. Verification
of the filing of an application for Supplemental Security Benefits
(SSI) with the Social Security Administration
D. Although
there is no recertification filing required for continuing
eligibility for the Bridge program, GPA workers are required to
verify on a regular basis that individual's application for SSI
benefits is still active.
3.17.3 Forms
Used in the Bridge Program
A. The
following forms are used exclusively in the Interim Cash Assistance
(Bridge Fund) Program:
Bridge
Fund-1
The
application for
the Bridge
Fund.
Bridge
Fund-2
The
denial/termination
notice to
individuals.
Bridge
Fund-3
Notice
of reduction
of payment
level or
termination of
benefits sent to
all recipients
because of
inadequate funds
for the
program.
Bridge
Fund-4
Notice
of acceptance
and payment
level.
Bridge
Fund-175
Notice
to applicants
of the
need to sign
the AP-175 at the local GPA office.
3.17.4 Bridge
Fund Payments
A. Payments
under the Bridge Fund will be made semi-monthly (approximately the
1st and 16th of the month). The payment level is $200 per month but
is subject to change.
B. According
to R.I. Gen. Laws § 40-6-28, the Director of the Department of
Human Services is authorized to limit both the amount and the
duration of Bridge Fund payments if the annual appropriation by the
Rhode Island General Assembly is not adequate to provide cash
assistance to eligible individuals.
1. Consequently,
it is possible that payments could either be reduced from the $200
per month level or terminated altogether at some point.
C. The
level of payments in force at the time of acceptance will be clearly
indicated in the acceptance letter that is sent to eligible
applicants.
1. If
there is a reduction in the amount or termination of Bridge payments
to active recipients, notification with appeal rights (Bridge Fund-3
form), must be sent to the recipient ten (10) days before any action
is taken.
D. Eligibility
for Bridge payments will not begin until all eligibility requirements
have been met. This means that:
1. an
application for the Bridge fund must have been filed
2. eligibility
for Title XIX Medicaid based on disability must have been determined
3. the
AP-175 form must have been completed and signed by the applicant and
4. an
application for SSI benefits must have been made with the Social
Security Administration.
E. All
payments to eligible applicants will be made prospectively beginning
with the next effective payroll after the above eligibility
requirements have been met and approval granted.
F. Bridge
payments will be limited to those otherwise eligible individuals
whose monthly income is $200 or less.
3.17.5 Hearings
and Continuation of Payments
A. When
the Department intends to take an action to deny, terminate, change,
or suspend Bridge payments, a written notice (Bridge Fund-2 or Bridge
Fund-3 form as appropriate - see § 3.17.3 of this Part), must be
sent to the applicant/recipient.
1. This
notice will be mailed to the applicant/recipient's last known address
at least ten (10) days prior to the date of the intended action.
B. The
applicant/recipient will be afforded an administrative hearing to
contest the Department's intended action provided the written request
for hearing is received by the Department within ten (10) days of the
mailing date of the Department's notice to the applicant/recipient.
1. This
request for hearing should be made on the DHS-121 (Request for
Hearing form) although any written request will be acceptable.
2. The
DHS-121 will be mailed to the recipient/applicant together with
either the notice of denial/termination (Bridge Fund-2 form) or the
notice of reduction/termination (Bridge Fund-3 form).
3. In
order for benefits to be continued, an active recipient must indicate
in writing that he/she wants to continue to receive Bridge payments
until the administrative hearing decision is issued.
3.18 GPA Resources
The
GPA caseworker must explore the possible ownership of resources by
individuals and couples at the initial application for assistance and
at all subsequent determinations of continuing eligibility
(Recertifications). Ownership of real and personal property
disqualifies an individual from receiving GPA unless the resource is
specifically exempted.
3.18.1 DETERMINATION
OF RESOURCES
A. Resources
are defined
in terms
of real
and personal
property.
1. Real
property is any interest in real estate and what is attached or
affixed thereto.
2. Personal
property pertains to such items as household furnishings,
automobiles, and boats.
3. Also
considered personal property are liquid assets such as cash, bank
accounts, cash value of life insurance policies and similar
properties.
B. Jointly
held resources are considered to be those of the applicant/recipient.
However, the individual is given an opportunity to rebut the
presumption of ownership (see 210-RICR-50-00-6.6.2 ).
1. The
Administrator for General Public Assistance is consulted when a
question of ownership of resources cannot be resolved.
C. The
individual's resources include those of the eligible or ineligible
spouse in the home.
1. However,
in a joint GPA/SSI household, the resources that are solely the SSI
recipient's are not considered in determining eligibility for GPA.
2. A
sponsored alien's resources include any resources of the sponsor and
sponsor's spouse (if living together) actually contributed to the
alien.
3.18.2 EXEMPTED
RESOURCES
§§
3.17.1 and 3.18.7 of this Part discuss the resources that are
exempted, that is, the real and personal property which an
applicant/recipient may retain without resulting in disqualification
for GPA. Ownership of real or personal property not exempted renders
the individual or family ineligible for General Public Assistance.
3.18.3 Exemption
of Home
A. The
home occupied by the individual or family is exempted.
B. It
is further defined as:
1. The
home, the usual residence of the assistance unit.
2. The
home exemption applies to any land that appertains to the home and
any other buildings located on such land, for example, a barn or a
shed.
a. To
appertain to the home, the real property must adjoin the plot on
which the home is located and not be separated from it by intervening
real property owned by others.
3. The
home, the usual residence, from which the assistance unit is only
temporarily absent.
a. The
home exclusion applies, for example, to the home an individual or
family leaves because of a catastrophic fire to reside in a shelter,
with relatives or elsewhere, pending restoration of the property to
habitable condition and with the intention of resuming residence
there as soon as possible.
4. Owned
by a married couple:
a. If
the deed indicates the property is held by them as tenants by the
entirety; and
b. If
the property is not the home of the assistance unit (as defined
above); and
c.
If the spouse of the applicant/recipient refuses to sell his/her
interest in the property.
d.
To ascertain if these conditions are met, the social caseworker must
verify, by examination of the deed, that the parties own the property
as tenants by the entirety and determine if the parties are still
married. A divorce (but not a legal separation) automatically
dissolves a tenancy by the entirety.
e.
If the three conditions specified above appear to be met, the
caseworker must refer the case, through the Administrator for General
Public Assistance, to the Department's Office of Legal Counsel for a
determination whether the property should be excluded.
(1) The
referral should include copies of the deed to the property and any
other relevant documents.
3.18.4 Exemption
of One Automobile
A. Automobile
means a passenger car, truck or other motor vehicle used to provide
transportation of persons or goods.
B. An
exemption is provided for one automobile which:
1. has
an equity value not exceeding four thousand six hundred fifty
($4,650) dollars, or;
2. is
necessary to transport a family member with a disability, where the
vehicle is specially equipped and/or of a special type to meet the
specific needs of the disabled person.
C. Equity
value is determined by establishing the wholesale/average trade- in
value of the vehicle as listed in the N.A.D.A. Official Used Car
Guide.
1. The
difference between the wholesale/average trade-in value and the
amount of any encumbrances (legal debts) is the equity value.
2. If
no listing for the vehicle can be found or the applicant/recipient
disputes the value as stated in the guide, due to the automobile's
physical condition, a written appraisal by a licensed automobile
dealer may be accepted.
D. Assistance
Unit with One Automobile
1. If
the equity value is $4,650 or less, no further determination is
necessary.
2. If
the equity value is more than $4,650, the vehicle is exempt if and
only if it is specially equipped (e.g., wheelchair lift equipped) or
of a special type and necessary to transport a disabled family
member.
3. Eligibility
does not exist if the vehicle does not meet either criteria listed
above.
E. Assistance
Unit with More than One Automobile
1. Eligibility
does not exist when the applicant/recipient is the owner of more than
one automobile.
3.18.5 Exemption
on Household Items and Effects
Household
furnishings, appliances, clothing, personal effects and keepsakes of
limited value are exempted.
3.18.6 Exemption
of Income-Producing Property
A. Tools
of the Trade not to exceed an aggregate value of one thousand dollars
($1,000) actually used or reasonably expected to be used to produce
self-employment income may be exempted from consideration as a
resource. Examples of such property are farm tools, carpenter tools
and painter's equipment used in the production of goods and services.
B. Vehicles,
even though used in the course of employment, are not considered
tools of the trade and therefore may not be exempted under
income-producing property. (See § 3.18.4 of this Part for
automobile exemption).
C. In
addition to cases in which the property is currently being used to
produce self-employment income, situations in which the
applicant/recipient is temporarily unable to use the property are
examined.
1. The
GPA caseworker evaluates the individual's potential for utilizing the
resource in the future to again become self- supporting.
2. If
the aggregate value does not exceed one thousand dollars ($1,000) and
the property had previously been used by the applicant/recipient to
generate income and a reasonable expectation exists that it will be
used for that purpose in the foreseeable future, the property is
exempted.
3. The
statement of the applicant or recipient recorded on the DHS-2 as to
the value of tools of the trade will be accepted when determining the
aggregate value unless there is reasonable doubt regarding the value
stated.
4. The
Administrator for General Public Assistance is consulted when the
value of the resources cannot be resolved.
3.18.7 Exemption
of Liquid Assets
A. For
individuals, couples and families, the resource limit for cash and
other liquid assets is four hundred ($400) dollars.
B. Liquid
assets include, but are not limited to, cash, savings accounts,
checking accounts, stocks, savings bonds, mutual fund shares, time
deposit shares, money market certificates, promissory notes,
mortgages and the cash value of life insurance policies.
C. The
combined value of all cash and liquid assets owned by each member of
the assistance unit is counted toward the $400 limit. If cash and
other liquid assets exceed this limit, eligibility for GPA does not
exist.
1. Any
cash value of life insurance policies must be included in this
computation.
3.18.8 Life
Insurance Policies
A. Life
insurance policies are available in several different types.
B. Common
examples are whole life, universal life, group and term insurance.
Generally, group and term life insurance policies have no cash
surrender value and therefore are not counted as resources for GPA.
C. All
life insurance policies should be examined to determine whether or
not a cash surrender provision exists.
1. Usually
the policy contains a "Table of Value" which can be used to
determine the current cash value.
2. In
other cases, it may be necessary for the applicant/recipient to
obtain a statement from the issuing company indicating the current
cash surrender value of the policy.
3.18.9 MEDICAL
INSURANCE
A. Medical
insurance, such as Blue Cross/Blue Shield, Major Medical, Federal
Medicare (Part A, Part B), Delta Dental or other medical insurance is
not considered a resource in the determination of eligibility.
B. Information
regarding medical insurance must be entered on the electronic
eligibility system.
3.18.10
RESOURCES ACQUIRED WHILE RECEIVING GPA
A. If
at any time during the receipt of GPA, an individual acquires income
or resources in excess of the amount previously reported, it shall be
his/her responsibility and a condition of eligibility to notify the
Department of this fact within ten (10) days of the receipt or
possession of additional resources or income.
B. For
example
1. If
a recipient inherits real property which is being used, or is to be
used by the recipient as his/her home, there is no barrier to
continuing eligibility.
2. Ownership
of any additional real property or personal property not exempted
renders the assistance unit ineligible for GPA.
3.19 GPA Income
3.19.1 DEFINITION
OF INCOME
A. Income
is the receipt of money, goods, services or money's worth which is
available to the assistance unit.
1. The
prospective budgeting method is used to determine the income which
will exist during the period of eligibility for GPA.
a. This
means that weekly income is converted to a monthly amount using the
4.3333 conversion method or the AP-79 conversion chart.
3.19.2 DOCUMENTATION
OF INCOME
A. The
information the client supplies on the DHS-2 about income is
documented.
B. The
document sources are business records, wage stubs, Income Tax
returns, Award letters, or other similar documents, as well as
reports from Social Security, Veterans' Administration, and other
agencies. In some instances, when the client is unable to obtain the
information requested, the agency's forms (Wage Report - AP 50, Bank
Clearance - AP-91, Clearance with VA - AP-150 and AP-151) are used.
3.19.3 INCOME
INCLUDED IN DETERMINING ELIGIBILITY
A. All
available income, both presently available and potentially available,
unless excluded by policy, is considered in determining eligibility.
This includes:
1. All
income, both earned and unearned, of any person for whom assistance
is being sought; and
2. All
income of a spouse in the home, unless the spouse is an SSI
recipient.
a. The
income of such SSI recipient(s), including the SSI benefit, is
explicitly excluded in the determination of the household income (see
§ 3.20 of this Part).
3.19.4 Potential
Sources of Income
A. When
there appears to be potential eligibility for a benefit that an
applicant/recipient does not yet have, such as RSDI, UCB, TDI, VA
benefits, etc., the applicant/recipient is required to file for such
benefits.
1. Before
GPA assistance can be provided, an applicant is required to verify
that s/he has filed for the potential source of income.
2. However,
if the applicant does file for the potential benefit(s) within thirty
days, GPA assistance is provided retroactive to the official GPA
filing date providing eligibility existed in the retroactive period.
(See § 3.7 of this Part for treatment of potential SSI
applicants.)
3. If
verification of filing is not received by the agency representative
within thirty (30) days of application, the case is rejected (see §
3.7 of this Part).
4. Recipients
who may be eligible for an alternate source of income must apply for
that benefit within ten (10) days of the date the agency becomes
aware of the potential benefit.
a. Failure
by the recipient to comply with the referral results in termination
of eligibility. (See § 3.7 of this Part).
3.19.5 EARNED
INCOME
A. Earned
income is income, in cash or in kind, earned by an individual through
the receipt of wages, salary, commissions, or profit from activities
in which s/he is engaged as a self-employed individual or as an
employee.
1. It
is counted as income only when it is received (or would have been
received except for the decision of the recipient to postpone
receipt) rather than when earned.
B. Earned
income does not include returns from capital investment with respect
to which the individual is not himself/herself actively engaged, such
as dividends and interest. It also does not include benefits such as
individual pensions, RSDI, UCB, TDI or Veterans' Benefits.
C. Earned
income does include:
1. Earnings
over a period of time for which settlement is made at one given time.
2. Income
which the individual produces as a result of the performance of
service, including managerial responsibilities, is classified as
earned income. (Examples are income from a roomer or boarder and
income from real property.)
3. Earned
Income Credit (EIC), including advance payments which the
applicant/recipient actually receives.
4. Training
incentives under JTPA (Job Training Partnership Act) as well as wages
from JTPA employment.
3.19.6 Earned
Income From Wages
A. When
earned income is from wages, the GPA worker must determine an average
weekly wage by reviewing the gross amount of wages for a four week
period.
B. Any
legal attachment on wages is considered unavailable and is not
counted.
1. Under
law, the first $50 of any pay is exempt from attachment and no
attachment can be placed on the wage of a current or a former
Assistance Payment recipient for one year following the termination
of assistance.
2. If
an attachment exists, the recipient must be referred to Rhode Island
Legal Services.
C. If
check stubs or pay envelopes are not available, the client is helped
to obtain a statement from the employer. If the client is unable to
obtain this information directly, the client may request the agency
to obtain this for him/her. An AP-50 is used for this purpose.
D. In
determining the income to be applied to the assistance plan, the
average weekly wage anticipated is used.
1. The
past wage is a good indication of the future income, unless the
reason for the GPA application is due to a reduction in the work
schedule and/or the hourly or weekly wage. In doing the computation
of the countable income, the average weekly wage must be converted to
a monthly amount by using the 4.3333 conversion method or the AP-79
conversion chart.
2. If
the recipient has not worked for a four-week period, or is unable to
provide wages for a four-week period, the amount of gross income is
determined by multiplying the rate of pay by the number of hours of
work.
E. The
recipient is advised that any change in income must be reported
within ten (10) days.
1. Upon
receipt of verification of actual wages received, a payment to make
up any deficit is authorized when income is less than anticipated.
3.19.7 EARNED
INCOME FROM SELF-EMPLOYMENT
A. When
earned income is from self-employment, the client provides the
information on gross income and the actual costs of operating the
business on a yearly basis.
1. When
a business is carried on at home, no part of the overhead is
considered a business expense.
2. Those
self-employed work expenses directly relating to producing the goods
or services and without which the goods or services could not be
produced are allowed as deductions.
3. However,
items such as depreciation, personal expenses, i.e. personal
transportation, the purchase of capital equipment and payments on the
principal of loans for capital assets or durable goods, are not
allowed as deductions.
4. Income
considered from self-employment is the difference between the amount
of gross income and the amount of allowable operating expenses for
producing the income.
5. In
the initial determination of eligibility, either the reported income
for the prior year or the estimated income for the current year,
based on at least three months' operation, may be used, as
appropriate.
6. The
Regional Manager is available to assist staff in determining income
from self-employment. In a memorandum directed to the Regional
Manager, the GPA worker must identify the type of assistance needed
along with the necessary information on the business (i.e., last
year's income tax form, current book-keeping records and check
books).
7. If,
at the end of 60 days, the business is not providing the recipient
with enough income to be independent, the case must be submitted to
the Regional Manager for review of continued eligibility.
3.19.8 INCOME
FROM ROOMER OR BOARDER
A. When
a client receives income from a roomer or boarder, the amount
considered as income is computed by subtracting from the amount paid
the following cost of maintaining such roomer or boarder. However, if
the household can document cost in excess of this amount, the actual
cost is considered:
Month
Week
Roomer
$
25.00
$
5.83
Boarder
$115.00
$26.56
B. Board
Payment for a foster child(ren), paid by the Department for Children
and Their Families to a GPA recipient, is disregarded.
C. The
net income, after the above expenses are considered, is subject to
the appropriate disregards for applicants and recipients.
3.19.9 INCOME
FROM
REAL PROPERTY
A. When
the client lives in the same dwelling from which s/he receives rental
income, the tenant's share of the following property expenses is
deducted from the gross rental income to determine the amount of
money to be applied as net income to the recipient:
1. mortgage,
interest on mortgage, taxes, insurance, water, sewer charges and
special monthly assessments for sewer installation; and
2. the
cost of the tenant's heat, gas and electric if provided in the rent
by the homeowner.
B. To
determine the net income of a property owner-recipient living in a
two-family dwelling, one half of the expenses in (1) plus the
expenses in (2) are deducted from the gross rental; in a three-
family dwelling, two thirds of the expenses in (1) plus the expenses
in (2) are deducted; in a four-family dwelling, three fourths of the
expenses in (1) plus the expenses in (2) are deducted.
3.19.10 UNEARNED
INCOME
A. Unearned
income may be accessed from many sources, including but not limited
to: UCB, TDI, RSDI, Workers' Compensation, Veterans' Benefits,
alimony and/or child support, lump sum death benefits, employment
pensions, insurance settlements, income-in-kind (see § 3.19.24
of this Part), interest, dividends and income from legally liable
sponsors.
B. Since
unearned income is not derived from employment, no earned income
disregards are applicable.
3.19.11 FEDERAL
AND STATE INSURANCE - UCB AND TDI
A. An
applicant or recipient of GPA who has worked in the past 52 weeks is
required to file a claim for either Unemployment Compensation
Benefits (UCB) or Temporary Disability Insurance (TDI) and advise the
GPA worker of the results.
B. The
requirements for each program are listed below.
1. Unemployment
Compensation Benefits
a. A
person must be able to and be available for work in order to be
eligible for UCB benefits.
b. S/He
must have worked in covered employment for 20 weeks with earnings of
at least $80 per week, or
c.
must have earned $4,800 in covered employment in any number of weeks
during the first 52 of the 53 calendar weeks immediately preceding
her/his period of unemployment.
d. Civilian
employees of the federal government, ex- servicemen, and most
ex-state employees are also eligible for benefits.
e. If
a person quit a job without good cause, no benefits are paid until
the person has returned to the job market and worked at least four
(4) weeks at earnings of at least $80 per week before being separated
for good cause.
f. A
person who refuses suitable work without good cause or is discharged
for proven misconduct, will not be paid benefits until s/he has
returned to the job market and worked at least four (4) weeks at
earnings of at least $80 per week before being separated for good
cause.
g. The
Department of Labor and Training (DLT) recomputes the benefit level
each year to establish a maximum that can be paid.
(1) Maximum
rates are set at 67% of the average weekly wages of workers in
employment covered by the Employment Security Act.
(2) An
eligible claimant receives 60% of her/his average weekly wages, not
to exceed the maximum established benefit for that year.
h. A
claimant is entitled to a dependent's allowance for each dependent
child under the age of 18 years (or over 18, if the child is mentally
or physically incapacitated) up to a maximum of five (5) children.
i. Benefits
are payable up to a maximum period of 26 weeks in any one benefit
year.
2. Temporary
Disability Insurance (TDI)
a. To
be eligible for TDI benefits, a claimant must be unable to work
because of illness and must have worked in covered employment for 20
weeks with earnings of at least $85 each week, or
b.
must have earned $5,100 in covered employment in any number of weeks
during the first 52 of the 53 calendar weeks immediately preceding
her/his period of unemployment due to illness.
c. The
DLT recomputes the benefit level each year to establish the maximum
benefit that can be paid.
(1)
Maximum rates are set at 70% of the average weekly wages of workers
in covered employment.
(2) An
eligible person receives a benefit of 60% of her/his average wage,
not to exceed the maximum established benefit for that year.
d. The
actual number of weeks a claimant may collect benefits is based not
only on benefit credits but also on the specific length of time that
the claimant's physician certifies that s/he is unable to work up to
a maximum of 30 weeks in any benefit year.
e. The
benefit year is the 52 weeks following the effective date of an
initial claim.
f. A
claimant is also entitled to a dependent's allowance for each
dependent child including an adopted or stepchild under the age of 18
years (or over 18, if the child is mentally or physically
incapacitated) up to a maximum of five (5) children.
g. An
otherwise eligible individual who is unemployed due to sickness
resulting from pregnancy is entitled to receive benefits in the same
manner as any other non-work-related illness.
3.19.12 RETIREMENT,
SURVIVORS & DISABILITY INSURANCE
A. In
considering Retirement, Survivors and Disability Insurance (RSDI),
the total amount of benefit received from RSDI is considered as
income.
B. §§
3.19.13 through 3.19.16 of this Part provide a guide for identifying
those who may be eligible.
C. A
person or a specific relative must have been a wage earner or a
self-employed person for a certain length of time in employment
covered by the Social Security Act.
D. Persons
eligible for specific benefits are as listed in the following
sections.
E. Referral
to SSA must be made for determination of eligibility, and GPA
eligibility is dependent upon acceptance of this income.
3.19.13 RETIREMENT
BENEFITS
A. Retirement
Benefits can be paid to:
1. The
insured wage earner or self-employed person who is eligible or can
elect to receive benefits reduced by actuarial at age 62. Although
the Social Security Act makes this provision elective (receipt of
benefits age 62), eligibility for Assistance Payments is dependent
upon acceptance of this source of income at age 62.
2. The
spouse of a retired or disabled worker who is age 62 or over, or has
in care a child under age 16 or over age 16 and disabled, who is
entitled to benefits on the worker's Social Security record.
3. A
spouse is eligible if the marriage has been in effect for one year
and, in some instances, less than a year.
a. Spouses
of defective ceremonial marriages entered into in good faith are also
eligible.
4. The
divorced spouse of a retired or disabled worker if age 62 or over and
married to the worker for at least ten years.
5. The
divorced spouse of a fully insured worker who has not yet filed a
claim for benefits if both are age 62 or over and have been finally
divorced for at least two continuous years.
6. The
dependent, unmarried child of a retired or disabled worker entitled
to benefits, if the child is under age 18; or age 18 or over but
under a disability which began before age 22.
a. This
includes children born of natural parents, adopted children,
step-children or children born out of wedlock.
3.19.14 SURVIVORSHIP
BENEFITS
A. Relatives
of a deceased insured wage earner or self-employed person who may be
eligible to receive monthly survivorship benefits include:
1. The
surviving spouse, including a surviving divorced spouse) if the
widow(er) is age 60 or over.
2. The
disabled surviving spouse, including a surviving divorced spouse in
some cases) if the widow(er) is age 50 to 59 and becomes disabled not
later than seven (7) years after worker's death, or in case of a
widow(er), within seven (7) years after s/he stops getting checks as
a widow(er) caring for a worker's children.
3. The
surviving spouse, or surviving divorced spouse if caring for an
entitled child (under age 16 or disabled) of the deceased.
4. The
dependent, unmarried child of a deceased insured worker if the child
is under age 18, or age 18 or over but under a disability which began
before age 22.
5. The
dependent parents of a deceased worker at age 62 or over.
3.19.15 LUMP
SUM DEATH BENEFITS
A. A
lump sum death benefit of $255 is payable upon the death of an
insured worker. This payment is made in the following order of
priority:
1. To
the spouse who was living in the same household with the worker at
the time of death;
2. To
the spouse (excluding a divorced spouse) who is eligible for a
widow(er)'s benefits for the month of death; and
3. To
children who are eligible for benefits on the worker's record for the
month of death.
3.19.16 DISABILITY
BENEFITS
A. A
worker who becomes severely disabled before age 65 can get disability
benefits.
1. The
disability must be a severe physical or mental condition which
prevents employment and is expected to last (or has lasted) for at
least 12 months, or is expected to result in death.
B. Benefits
may begin as early as the sixth full month of disability and continue
as long as the disability exists.
1. If
a person is severely disabled, benefits can be paid even though the
person can do some work.
C. Dependent's
benefits may be paid to certain members of a disabled worker's family
as in the case of a retired worker (see § 3.19.13 of this Part
on Retirement Benefits).
D. Non-Payment
of Disability Benefits Affecting Prisoners and Their Families:
1. Disability
benefits are not paid for the months a person is confined to jail
because of conviction for a felony.
2. A
person who is under the control and jurisdiction of the jail, prison,
correctional facility or penal authority is considered confined.
3. The
only exception to the rule disallowing payment of benefits to a
prisoner occurs when s/he is actively and satisfactorily
participating in a rehabilitation program "specifically
approved" by a court of law for the person (not for a class of
prisoners) and expected to result in the person's being able to do
substantial and gainful work within a reasonable period after
release.
4. If
the person is still disabled when released, monthly checks will begin
again, effective with the first full month the prisoner is no longer
confined.
5. Entitled
family members continue to receive their monthly benefits, even
though the disabled worker does not because of confinement, unless
their benefits are excluded by a provision of the law, e.g., child
disabled prior to age 21 and imprisoned for a felony conviction, or a
student incarcerated for conviction of a felony committed after
October 19, 1980.
E. Disabling
Condition Occurs During Confinement
1. A
physical or mental impairment or the aggravation of such that occurs
while a person is imprisoned for conviction of a felony, committed
after October 19, 1980, cannot form the basis for paying disability
benefits as long as the person is confined to prison.
2. Even
if a person can be found disabled because the impairment was not
associated with prison, benefits are not paid while s/he is confined.
3. In
the case of a disabled worker, an impairment that occurs during
confinement can be used to establish a disability freeze.
a. Benefits
can begin upon release from prison provided the person continues to
be disabled.
b. The
benefits are then effective with the first full month the prisoner is
no longer confined.
c. To
receive these benefits a person must file a second application upon
his/her release from prison.
4. For
children disabled prior to age 22 and widows/widowers who become
disabled prior to age 60, disabling impairments occurring during
imprisonment cannot form the basis for the disability decision.
a. Upon
release from prison, all impairments can be considered in determining
whether a person is disabled and eligible for benefits.
5. Unlike
the provision regarding non-payment of benefits above, no benefits
are payable to other family members under this provision.
F. Disabling
Condition Occurs in Connection with a Felony
1. No
impairment or aggravation of an impairment that occurs in connection
with the commission of a felony after October 19, 1980, for which the
person is convicted, can ever be used in determining disability.
2. This
restriction applies to the disability decision for disabled workers,
children disabled prior to age 22, and widows/widowers under age 60
who are claiming benefits because of disability.
3. No
benefits are payable to other family members.
G. Ineligibility
of Certain Prison Inmates for Student Benefits
1. No
one is considered in full-time school attendance while imprisoned for
conviction of a felony committed after October 19, 1980.
2. No
monthly benefits are paid to students under this provision.
3.19.17 INFORMATION
FROM THE SSA
Information
from the Social Security Administration Master Beneficiary Record and
Supplemental Security Record about the amount of benefits a recipient
is receiving is displayed through the INTERFACE function of the
state’s electronic eligibility system.
3.19.18 EMPLOYMENT
PENSIONS
A. Many
employers provide for retirement or disability pensions for their
employees under specific conditions. Among these are local
governments, industrial plants, stores, railroad and steamship
companies.
B. If
an applicant/recipient has had employment of ten (10) or more years
with any one employer, the possibility of eligibility for a pension
exists and should be determined.
3.19.19 VETERANS
ADMINISTRATION BENEFITS
A. All
applicants and recipients who have been other than dishonorably
discharged from any branch of the armed services should apply for VA
benefits and/or services.
B. An
individual may be eligible as a veteran who has served during wartime
or specific periods of qualifying peacetime, disabled or
non-disabled, whether the disability is service-connected or not.
C. Dependents
and survivors of the veteran may also be eligible. Stepchildren may
receive an allowance based on the stepparent's benefits, if living
with the stepparent.
D. Individuals
who may be eligible may be referred directly to the Veterans
Administration Regional Office, 380 Westminster Street, Providence,
RI 02903, Telephone 800-827-1000.
E. If
the individual questions whether there is eligibility for a specific
program or benefit, or needs help in completing the application,
referral may be made to the RI Office of Veterans Affairs,560
Jefferson Blvd, Warwick, RI 02886, telephone 401-921-2119.
F. See
the RI Veterans Home: General Rules of the Rhode Island Veterans Home
for information regarding the periods designated for the various
wars.
3.19.20 DEPENDENTS
OF MEN/WOMEN IN ARMED SERVICES
A. The
armed forces expect military personnel to provide for the support of
their legal dependents unless they can prove exemption from this
responsibility by court order or mutual consent.
B. The
following dependents may receive an allotment:
1. A
lawful spouse, including a common-law spouse;
2. Unmarried
legitimate children under the age of 21 or unmarried legitimate
children over the age of 21, if incapable of self-support because of
mental or physical disability, if dependent upon the military person
for over one-half of their support; and
3. Unmarried
stepchildren and adopted children under the age of 21, if dependent
upon the military person for 30% or more of their support, as
determined by military authorities.
C. Required
allotments are paid directly to eligible dependents of military
personnel in some instances.
1. In
others, military personnel may provide for their dependents either by
a direct contribution or by allotment of pay, or both.
D. When
a military person is not contributing to the support of his/her
dependents, a referral to OCSS is made.
1. Red
Cross Home Service may be consulted about the appropriateness of the
amount being received.
2. They
are also available to the dependents of military personnel in
resolving any problems.
3.19.21 WORKERS'
COMPENSATION
A. Under
the Workers' Compensation Act, benefits are payable if an employee
sustains a personal injury arising out of or in the course of
employment or develops an occupational disease.
B. The
possibility of this resource should be discussed with the injured
client and follow up made if this is a potential income.
C. As
a probable third party liability, Workers' Compensation benefits are
subject to the assignment and reimbursement provisions described in
§§ 3.7 and 3.25 of this Part.
3.19.22 INSURANCE
A. Money
received from an insurance settlement is considered income unless it
is used to replace exempt resources.
B. If
the insurance settlement is received as a result of fire, flood,
lightning or severe wind, and if it is used to replace, within a
reasonable time, the loss caused by the fire, flood, lightning or
severe wind, it is not considered as income.
1. If
only part of the money is used to replace the loss, any remaining
balance is considered as available income.
3.19.23 CONTRIBUTIONS
A. Regular
and substantial contributions are considered income.
B. Gifts
and contributions of small value and occurring infrequently and
unpredictably as expressions of affection are not related to support
and are not considered income.
3.19.24 Income-in-Kind
A. Regular
payment of rent or mortgage expenses made by non-legally liable or
legally liable relatives or friends on behalf of a recipient is
considered as income.
B. The
table below, by plan size, is used to determine the amount of monthly
income to be considered unless the in- kind shelter payment is less
than this amount. In that instance, the actual amount of the payment
is considered.
C. This
policy does not apply in the situation where a recipient is living in
the home of another whether or not s(he) is paying toward the rent,
or where the client is sharing rent with another.
Plan
Size
Weekly
Shelter
Plan
Size
Weekly
Shelter
2
$90.89
7
$115.48
3
$105.20
8
$113.55
4
$109.18
9
$109.44
5
$113.07
10
(and over)
$119.11
6
$115.02
3.19.25 INTEREST
AND/OR DIVIDENDS
When
a recipient retains resources in accordance with § 3.18 of this
Part and receives interest or dividends, they are considered income,
when available, and are applied to the assistance plan.
3.19.26 INCOME
FROM LIABLE SPONSORS
Income
actually available from a liable sponsor is treated in the same
manner as any other unearned income in determining the amount of the
GPA assistance payment.
3.20 Income Exclusions
A. In
determining the amount of GPA assistance payment, the following kinds
of income are excluded:
1. All
the weekly earned income of each child under the age of 18 receiving
GPA, if the child is a full-time student or a part-time student who
is not a full-time employee. The child cannot be attending a school
beyond the level of secondary education.
2.
The income of an SSI recipient (including the SSI benefit.)
3.
Income equal to expenses attributable to the earning of the income
of a self-employed individual (see § 3.19.5 of this Part).
4. The
value of home produce of an applicant/recipient utilized by him/her
and his/her household for their own consumption.
5.
The value of U.S. Department of Agriculture donated foods.
6.
Any benefits received under Title VII, Nutrition Program for the
Elderly, of the Older Americans Act of 1965, as amended.
7.
The value of supplemental food assistance received under the Child
Nutrition Act of 1966, as amended, and the special food service
program for children under the National School Fund Act, as amended,
(Pub. Law 92-433 and Pub. Law 93-150).
8.
The value of SNAP benefit allotments.
9.
Foster care payment paid by the Department of Children, Youth and
Families.
10.
Any grant
or loan
for
an undergraduate
student for
educational purposes
made or
insured under
any programs
administered by
the U.S.
Commissioner of
Education.
11.
Loans and grants, such as scholarships, obtained and used under
conditions that preclude their use for current living costs.
12.
The value
of government
rent and/or
housing
subsidies.
13.
Payments or
allowances received
under the
Federal Low-Income
Home Energy
Assistance Program.
14.
Assistance, in the form of cash or vendor payments from other
agencies and organizations, is disregarded if the assistance is for a
different purpose, goods, or service not provided in the Consolidated
Standard. No duplication may exist between assistance provided by
other agencies and that provided by this agency for the former to be
excluded.
15.
Payments for reimbursement of out-of-pocket expenses made to
individual volunteers serving as foster grandparents, senior health
aides or senior companions, and to persons serving in the Service
Corps of Retired Executives (SCORE) and Active Corps of Executives
(ACE) and any other program under Title II and Title III of the
Domestic Volunteer Service Act of 1973.
16.
Payments to individual volunteers under Pub. Law 96-143, the
Domestic Volunteer Service Act of 1979, which governs the Volunteers
in Service to America (VISTA) Program.
17.
Income from any source, when Federal Law prohibits its inclusion.
The applicant/recipient must present evidence of the Federal
prohibition.
3.21 GPA Standards of Assistance
3.21.1 STANDARDS
OF ASSISTANCE
A. The
GPA Standards of Assistance are used to determine eligibility for
individuals/couples.
B. Income
is applied to the standard after deductions specified in policy are
made and eligibility is then determined.
3.21.2 CONSOLIDATED
STANDARD-INDIVIDUALS/COUPLES
A. The
consolidated standard of assistance is computed according to the
number of eligible persons in the GPA household.
B. The
table below lists the GPA Monthly Standards for an individual and for
a married couple.
1. The
couple must be married by virtue of a ceremonial or other legal
marriage.
2. When
only one spouse is eligible, eligibility is based on the couple
standard.
3. Income
available to the couple is compared to the couple standard to
determine eligibility.
4. TABLE
I - INDIVIDUALS/COUPLES
PLAN
SIZE
GPA
MONTHLY STANDARD
Individual
$327.00
Couple
$449.00
3.22 Standards for Vendor Payments
3.22.1 ELIGIBILITY
FOR FUNERAL AND BURIAL EXPENSES
A. Eligibility
for the expenditure of GPA funds for a funeral or burial does not
exist for anyone who at the time of their demise, was confined by
and/or in the custody of the Department of Corrections, the
Department of Children, Youth and Families or the Department of
Behavioral Healthcare, Developmental Disabilities & Hospitals
(BHDDH).
B. For
the Department to consider granting assistance to those persons who
may be eligible, application for payment of funeral and burial
expenses must be made on behalf of the deceased within thirty (30)
days of the date of death.
C. An
application for payment of funeral and burial expenses shall also be
deemed as received on behalf of a decedent when a person with custody
of an unclaimed body contacts the Department of Human Services (DHS)
to report the unclaimed body.
3.22.2 Conditions
of Eligibility
A. Payment
is made to meet the cost of funeral and burial expenses up to the
cost standard for any person who dies and leaves no, or insufficient,
resources and/or income to meet these expenses.
B. Resources.
All resources of the deceased are deducted from the cost standard in
determining the amount of payment. A deceased's resources include,
but are not limited to:
1. life
insurance policies, and/or fraternal insurance, when the beneficiary
is the deceased's estate or a legally liable relative;
2. cash,
securities, bonds, patient accounts for those in a nursing home, or
other assets left by the deceased; and
3. any
real property not being used as a home by dependent survivors.
C. For
the purposes of determining eligibility for GPA burial assistance,
the following are EXCLUDED:
1. Veterans'
benefits
2. Social
Security lump sum death benefits
D. Note
that proceeds of life/fraternal insurance policies are not deducted
from the cost standard in determining the amount of payment if the
beneficiary is not the deceased's legally liable relative or the
deceased's estate. However, see § 3.22.4 of this Part for policy
regarding private supplementation toward funeral expenses.
E. Non-exempt
resources (§ 3.18 of this Part) in excess of four hundred
dollars ($400.00) of legally liable relatives (i.e., parents for
minor children and spouses who were living together for each other)
are considered available to meet the cost of funeral and burial
expenses.
F. Income.
The income of legally liable relatives, except for a relative on
RIW, GPA, or SSI, must be considered in determining eligibility for
and the amount of payment.
1. The
determination is made on a monthly basis.
2. From
the gross monthly income, certain deductions, listed in § 3.22.3
of this Part are made.
3. The
amount remaining, after applying the appropriate deductions, is
compared to the approved funeral and burial cost expenses.
4. If
a deficit exists, that amount is met through the GPA Program.
3.22.3 Income
Disregards
A. The
following are deducted from the monthly gross income of the legally
liable relative in determining the amount of the payment for funeral
or burial expenses.
1.
Work Expense Disregard. From the monthly gross earned income,
disregard ninety dollars ($90) from the monthly gross income for each
person employed.
2.
Dependent Care Disregard. From the monthly gross earned income,
disregard the actual cost, if any, of care for each dependent child
under thirteen (13) years of age or incapacitated person who is
living in the home and is claimed or could be claimed as a dependent
for the purposes of Federal personal income tax liability.
a. For
the legally liable relative employed full- time (100 hours or more
per month), this disregard may not exceed one hundred sixty dollars
($160.00) per month per child or incapacitated person.
b. For
the legally liable relative employed part-time (less than 100 hours
per month), this disregard may not exceed eighty dollars ($80.00) per
month per child or incapacitated person.
3. Consideration
of dependent care expenses is only given when the care is provided by
a person not living in the dependent's household.
4. Maintenance
Expense Disregard. An amount is also disregarded for the support of
the legally liable relative and any other individuals who are living
in the home and are claimed or could be claimed as dependents for
purposes of determining Federal personal income tax liability.
a. The
amount disregarded equals the appropriate monthly GPA consolidated
standard for individuals and couples or the appropriate RIW standard
based on the size of the legally liable relative's family group.
5. Medical
Expense Disregard. A deduction is made to meet the cost of specific
incurred medical expenses or medical services verified as needed for
the month.
a. Such
medical expenses include the amount paid for health insurance plus
the amount of verified required monthly medical services that are
within the scope of the GPA program.
b. EXAMPLE:
(1)
In December a parent applies for funeral and burial expenses for a
child age 15. The family is comprised of a father, mother and a
surviving sibling, age 10. The father works 40 hours per week and
grosses two hundred dollars ($200.00) per week. Since the mother is
at home, there are no child care expenses. The family has Blue Cross
purchased on their own at a cost of fifty dollars ($50.00) per month.
(2) The
ten-year old child has a chronic medical problem and must visit the
doctor once a month and take medication at a cost of forty dollars
($40.00) monthly. The equity value of the family's automobile is
below one thousand five hundred dollars ($1,500.00) and therefore is
an excluded resource. The only other resource is the parents' joint
three hundred and fifty dollar ($350.00) bank account. Since this is
below the four hundred dollar ($400.00) resource limit, it does not
prohibit eligibility. The approved cost of the funeral and burial
expenses is one thousand three hundred and fifty dollars ($1350.00).
(3) Computation
is as follows:
Father's
Monthly Gross Income
($200
x 4.3333)
$866.66
Less
Work Expense Disregard
90.00
776.66
Less
deduction for the Monthly Standard Plan Size of three (3)
$554.00
$222.66
Less
deduction for Medical Expenses ($50 monthly health verified
medical expense)
-90.00
Amount
available
$
132.66
(4) The
one hundred thirty-two dollars and sixty-six cents ($132.66) is
considered available from the legally liable relative and is applied
to the one thousand three hundred and fifty dollar ($1350.00) cost of
funeral and burial expenses. The balance of one thousand two hundred
seventeen dollars and thirty-four cents ($1217.34) is paid through
the GPA Program.
3.22.4 Private
Supplementation of Funeral Expenses
A. Friends
or family of the decedent (other than legally liable relatives) may
privately contract with the funeral director for additional or
upgraded services and merchandise.
B. Those
individuals may contribute up to one thousand six hundred dollars
($1,600.00), for additional funeral home services and merchandise,
without affecting eligibility for the nine hundred dollar ($900.00)
basic allowance.
C. For
each additional one dollar ($1.00) that those individuals contribute
over the one thousand six hundred dollar ($1,600.00) allowable
supplement, a corresponding one dollar ($1.00) is deducted from the
basic allowance to be paid by the state.
D. The
following are examples of items which might be contracted for
privately by the family:
1. Preparation
of deceased for viewing (embalming, hairdressing, etc.);
2. Use
of funeral home for visitation or funeral services;
3. Transportation
for family members or friends to funeral services;
4. Additional
or upgraded funeral merchandise (casket, vault, cards, etc.).
E. Payment
of fees by the family or friends to clergy, church musicians,
florists, newspapers, state officials, or city officials for
certified copies of death certificates in no way diminishes the
amount that the family is permitted to supplement toward services or
merchandise provided by the funeral director.
3.22.5 Funeral
and Burial Arrangements
A. Relatives
and/or friends have a choice among those undertakers willing to
provide a quality of service in accordance with the cost standard.
1. Church
and municipally-owned cemeteries often provide, free of charge,
burial lots and/or the cost of opening and closing graves for persons
unable to pay.
2. The
Rhode Island Veterans Cemetery also provides the above to eligible
veterans and their eligible dependents.
3. These
resources must be explored and utilized, where available.
4. Additionally,
if a city or town provides burial space free of charge, or if the
Director of Public Welfare is able to arrange for burial free of
charge, this resource must be used.
5. If
the above resources are not available, burial costs can be met in
accordance with the cost standards.
B. Payment
of funeral and burial expenses by the department is not considered
unless an application is filed on behalf of the deceased within
thirty (30) days of the date of death.
C. When
no relatives or friends are available, the local Director of Public
Welfare or the Administrator of the GPA Program makes the
arrangements appropriate to the faith of the deceased, when known.
3.22.6 Application
for Payment of Burial Costs
A. The
application is made in the city/town of the residence of the
deceased.
B. When
a client dies in a nursing/group home, the community in which the
home is located is responsible for burial if need exists.
C. For
Active Recipients:
1. If
the deceased was a recipient of RIW, GPA, MA, SNAP, or Long Term Care
at the time of death, the information in the eligibility system is
used to determine eligibility for GPA burial assistance.
2. If
the deceased was a recipient of SSI at the time of death, contact is
made with Social Security to determine available resources to
document the application.
3. If
this information is unobtainable, and there are no relatives or
friends, the application is filed by the Local Director or by the
Administrator of the General Public Assistance Program to the best of
his/her ability in behalf of the decedent.
D. For
Non-Recipients:
1. If
the deceased had filed an application within ninety (90) days prior
to death, and the current information is available to the agency, a
determination of eligibility may be made from the information on
file.
2. If
the deceased was not previously known to the agency, an application
must be made on behalf of the deceased to obtain information to
determine eligibility.
3.22.7 Cost
Standard for Burial
A. The
agency can provide payment up to its cost standard minus the
resources and/or income of the deceased, including any amount deemed
from legally liable relatives.
B. The
cost standard covers at least the following services and merchandise:
1. Professional
Services;
2. Basic
management and supervisory services of the funeral director and staff
in handling all arrangements relative to final disposition;
3. Use
of Facilities and Equipment;
4. Transportation
(includes local (within ten-mile radius) transfer of deceased to
funeral home, local transfer of deceased to church and/or cemetery or
crematory;
5. Merchandise
(includes minimum burial casket (generally flat-top grey cloth
covered) or appropriate cremation container; and casket name plate
(when required by the cemetery);
6. A
bill must be submitted by the funeral director, itemizing the cost of
services, by category, as indicated above.
a. The
bill must also include the amount non-legally liable relatives and/or
friends have paid or agree to pay toward the expense.
b. If
eligibility exists, the department meets the balance, up to the cost
standard, less any resources that must be considered.
c. Refer
to § 3.22.4 of this Part for specific items for which family
and/or friends may pay, without diminishing the amount the Department
may pay as defined by this section.
7. Cemetery
and/or crematory expense is separate and distinct from the funeral
director/funeral home expense and should be treated as such.
a. Although
the funeral director will often coordinate the arrangements with the
cemetery, the cemetery should be recognized as a separate vendor,
which will bill the Department of Human Services.
3.22.8 Standards
for Funeral and Burial Expenses
A. Basic
standards for funeral and burial expenses follow:
1. Stillborns.
An amount up to twenty-five dollars ($25.00) may be authorized for
the funeral and an additional amount up to forty dollars ($40.00) may
be authorized for the burial of a stillborn. These amounts are
authorized regardless of the duration of the pregnancy.
2. Adults
and Children. For adults and children, the following standards
apply:
a. An
amount up to nine hundred dollars ($900.00) may be authorized to meet
funeral expenses of an adult or child.
b. Further,
with regard to burial or cremation of an adult or child, when the
cost of the lot, opening and closing of the grave and/or cement grave
liner is required, or when a crematory fee is required, in lieu of
opening and closing the grave, consideration is given to these costs
according to the following maximum amounts:
(1) Cost
of a lot - one hundred fifty dollars ($150.00);
(2) Opening
and closing of the grave - one hundred seventy-five dollars
($175.00);
(3) Cement
liner, if required by the cemetery - one hundred twenty-five dollars
($125.00); and
(4) Crematory
fee - one hundred fifty dollars ($150.00).
B. Note
that payment to meet burial or crematory costs in excess of these
amounts may be authorized only when the Administrator of the GPA
Program ascertains and documents the existence of special
circumstances.
3.22.9 Example:
Application of Cost Standards
A. An
indigent adult dies. Within two (2) weeks his family applies for GPA
to help defray the cost of funeral and burial expenses.
B. The
funeral director submits the following itemized bill:
Cost
Actually Agency Incurred
Agency
Standard
Professional
Services, including:
Removal
and basic body preparation:
$
800
$
900
Transportation:
(Extra charge incurred for transporting relatives to the funeral
services).
$
200
Casket:
(non-standard version)
$
900
900
Use
of Facilities and Equipment: (for visitation, incurs an added
Cost).
$
250
$-200
Actual
and countable donations by non-legally liable relatives and
friends.
-1800
$
700
Burial
Expenses, including:
Cemetery
Lot
$250
150
Opening
and Closing of Grave
175
175
Cement
Liner
125
125
550
450
C. Payment
of the Funeral Bill
1. In
the example, the two hundred dollars ($200.00) over the maximum one
thousand six hundred dollar ($1600.00) donation is deducted from the
agency standard resulting in a balance of seven hundred dollars
($700.00).
a. Since
that amount would be in excess of the actual balance of three hundred
fifty dollars ($350.00), only the actual balance is payable.
D. Payment
of the Burial Expenses
1. No
contributions were made that would decrease the maximum burial costs.
However, the five hundred fifty dollar ($550.00) bill incurred is in
excess of the agency cost standard of four hundred fifty dollars
($450.00). Therefore, only the four hundred fifty dollars ($450.00)
is payable.
2. In
the example, if the standard services were requested for an indigent
individual with no legally liable relatives and no contributions from
friends or relatives, a maximum of one thousand three hundred and
fifty dollars ($1,350.00) could be allocated.
a. Of
the maximum, nine hundred dollars ($900.00) would be directed to
professional services and merchandise and four hundred and fifty
dollars ($450.00) for the cost of the cemetery lot, opening and
closing of the grave and the cement liner, if required.
3.22.10 Additional
Costs in Special Circumstances
A. With
the approval of the Administrator of the GPA Program, the following
costs can also be met.
1. Transportation.
If a funeral director must transport a body from one community to
another, beyond a radius of ten miles, the mileage above and beyond
the ten miles is reimbursable at the following rate:
a. Travel
by road: $2.00 per mile - one way.
b. Travel
by train or air: the verified train or air fare.
2. Special
Expenses. Funeral and burial expenses in excess of the basic
standard because of individual needs such as, but not limited to, a
special sized casket and special sized outer container to accommodate
the casket are taken into consideration when such need is documented
by the undertaker and approved by the Administrator of the GPA
Program.
3.22.11 Payment
of Funeral and Burial Expenses
A. The
Department makes payment only to service providers and does not
reimburse any other person for payment of funeral and burial
expenses.
B. As
indicated in § 3.22.9 of this Part, a bill presented for payment
must be itemized.
C. GPA
payment of the expenses may not exceed the appropriate cost standards
and, after application of the total resources available to the
deceased, is limited to either the actual balance or the cost
standard, whichever amount is less.
D. If
payments for funeral and burial expenses are made by non-legally
liable relatives or friends, the GPA payment in such cases may not,
in combination with payments made by friends and/or non-legally
liable relatives, exceed the two thousand five hundred dollar
($2500.00) maximum for funeral expenses, and may not exceed the
separate maximum for burial and/or crematory fees as described in §
3.22.8 of this Part.
E. In
determining the maximum payment for financial expenses, refer to §
3.22.4 of this Part for items that are independent of and not counted
toward the maximum payment.
F. Determination
of eligibility and authorization of payment for approved burial
expenses are the responsibility of the district office GPA Unit. If
the deceased was a recipient of assistance other than GPA, the GPA
worker bases the determination of eligibility on the information
contained in the eligibility system (see § 3.22.6 of this Part).
3.22.12 Recoupment
of Funeral and Burial Expenses
A. If,
subsequent to payment of funeral and burial expenses on behalf of a
decedent by DHS through the GPA Program, resources are discovered,
the Director or his/her designee shall determine if efforts will be
made by the Department to recoup the cost of funeral and burial
expenses from the resources of the decedent or legally liable
relative, or, if applicable, recovery in accordance with R.I. Gen.
Laws § 40-8-15 is to be made, DHS shall file necessary Petitions
with probate Court.
B. Recoupment
of expenses by DHS may be made by acceptance of cash, or any of its
generally accepted equivalents, including checks money orders and
credit/debit cards.
3.23 GPA Burial of Unclaimed
Bodies
A. Payment
of funeral and burial expenses by the department is not considered
unless an application is filed on behalf of the deceased within
thirty (30) days of the date of death, or if the Department is
contacted by a person, entity, agency, or funeral director to request
a public expense burial.
1. In
such instances, the person having custody of the unclaimed body shall
attempt, within the first twenty-four (24) hours after death, to
locate relatives or friends of the decedent who will assume
responsibility.
a. If
no such person is found within twenty-four (24) hours after death,
the person having custody of the dead body shall notify the director
of the Department of Human Services or his or her designee who shall
arrange for the removal of the unclaimed body.
b. If
a body is unclaimed at or before the expiration of thirty (30) hours,
DHS shall make a reasonable effort to find relatives or friends of
the decedent.
c. If
no one is located, the Director or his/her designee shall have the
authority to authorize a public expense burial in accordance with
R.I. Gen. Laws Chapter 23-18.1.
d. For
the purpose of these rules, a public expense burial may be treated as
a General Public Assistance (GPA) burial.
e. After
a reasonable period of time, the Director or his/her designee shall
have decision-making authority for the funeral and burial
arrangements, appropriate to the faith of the deceased, when known.
2. If
a non-legally liable relative or friend of a decedent comes forward,
that contact shall be deemed a request for a general public
assistance burial on behalf of the decedent.
a. This
person is encouraged to make application for general public
assistance burial on behalf of the decedent. The application shall
be processed in accordance with § 3.22.6 of this Part.
3. Application
made by a legally liable relative shall be processed in accordance
with § 3.22.2 of this Part. DHS shall make every attempt to
ascertain income and resources of the decedent in either case.
4. If
there are relatives unwilling to authorize burial, or unwilling to
pay for the decedent's burial, the GPA burial application shall be
processed and the Director or his/her designee shall determine if
recovery of the decedent's assets shall be made by DHS.
5. To
the extent that the Department of Human Services makes payment of the
burial expenses, it shall have the right to recover the burial
expenses from the estate of the deceased person if there are
resources.
a. If
the Director or his/her designee determines recovery should be made
to reimburse DHS for payment of burial expenses or for estate
recovery in accordance with R.I. Gen. Laws § 40-8-15, then an
affidavit shall be obtained from the relative(s) not willing to
authorize burial, stating the names and addresses of all known
relatives, and a statement attesting to the fact that they that
particular relative(s) waives their rights to the decedent's estate,
if any.
3.24 GPA Check Replacement
Procedures
3.24.1 STAFF
RESPONSIBILITIES
A. Checks
which have been undelivered/lost/stolen or destroyed may be replaced
in accordance with the procedures listed in this section.
B. Agency
personnel have responsibility in the authorization process to assure
that recipients are properly assisted as determined by the provisions
of the policy.
3.24.2 UNDELIVERED/LOST/STOLEN/DESTROYED
GPA CHECKS
A. When
a recipient reports to the agency that s/he has not received a GPA
check, including an Interim Cash Assistance/Bridge Fund check, or
that such check was lost, stolen, or destroyed after its receipt in
the mail, the worker must enter the date of this notification in the
eligibility system.
1. This
date serves as the control for any future replacement of the check.
B. Undelivered
in Mail (Incorrect Address). When a recipient reports the
non-receipt of a GPA check, including an Interim Cash
Assistance/Bridge Fund Check, in the mail, the worker verifies the
client's current address and the address to which the check was
mailed (also reviewing Alternate Issuance to see if the check was
sent to the local office).
1. If
the check was mailed to an incorrect address, the worker must first
determine if the check has been returned by the Postal Service by
viewing the "Distribution History Display" or DISD panel
under the CASE function.
2. In
the event that the check has been returned by the Postal Service, the
worker re-mails the check.
3. If
the check has not been returned by the Postal Service, the worker
immediately requests a stop payment on the check by sending an
electronic mail message addressed to "STOPPAY".
a. The
mail message must contain the case I.D. number, the name, the date of
the check, the amount of the check, and check number.
b. The
worker then follows the procedures outlined in "Replacement of
Checks", § 3.24.3 of this Part.
C. Undelivered
in Mail. If the check was mailed to the correct address and less
than 24 hours have elapsed since the expected delivery time, the
client is asked to wait until the next scheduled delivery date and
then to inform the agency if the check has still not been received.
1. The
client is advised to notify the local post office of the
non-delivery. Notification of non-delivery provides an opportunity to
learn from postal officials of any problem that has occurred in
her/his area or it may serve to alert officials of a potential
problem of which they were not aware.
2. Verification
of client contact with the postal authorities is not required.
3. If
the check has still not been received after 24 hours, the worker then
requests a stop payment on the check by sending an electronic mail
message addressed to "STOPPAY".
a. The
case I.D. number, the name, the date of the check, the amount of the
check, and check number are to be included in the mail message.
b. The
worker then follows the procedures outlined in § 3.24.3 of this
Part for check replacement.
D. Lost,
Stolen, or Destroyed after Receipt in Mail. When a recipient reports
that a GPA, including Bridge, check was lost, stolen, or totally
destroyed (meaning that there are no remnants of the check remaining)
after its receipt in the mail, the worker immediately requests a stop
payment on the check by sending an electronic mail message addressed
to "STOPPAY".
1. The
case I.D. number, the name, the date of the check, the amount of the
check, and check number are to be included in the mail message.
2. The
worker then follows the procedures outlined in § 3.24.3 of this
Part.
3. The
recipient is directed to file a report of loss or theft with the
local police department.
a. The
worker must verify that a report has been made to the police by
obtaining a copy of the report from the recipient.
b. This
activity is recorded in the SPEC/CLOG. The worker then follows the
procedures outlined in § 3.24.3 of this Part for check
replacement.
E. If
a previously lost or stolen check is subsequently recovered and
returned to the agency, it is sent to the E&SS Business Office at
Central Office for cancellation.
1. Staff
should write "VOID" on the check and return it with an
AP-59.
3.24.3 Replacement
of Checks
A. When
a recipient reports that a GPA check, including a Bridge Fund check,
has not been received (is undelivered in the mail) or has been lost,
stolen, or totally destroyed (after its receipt in the mail), the
stop payment procedures in § 3.24.2 of this Part are followed.
1. The
recipient is told that a replacement check cannot be issued until at
least three (3) business days after the date of the report of the
non-delivery, loss, theft, or total destruction.
B. The
worker must not approve the request for replacement until at least
three (3) business days after the date of the client's report (not
date of issuance or date of expected delivery in the mail).
1. For
example, the recipient reports the non-receipt, loss, or theft on a
Monday. The earliest day a replacement could be approved would be
Thursday. If the report was made on a Wednesday, the earliest day a
replacement could be approved would be the following Monday.
C. The
recipient is required to sign an affidavit (DHS Form AP-55 or AP-
55S) in duplicate attesting to the non-receipt, loss, or theft of an
assistance check.
1. The
worker should fully review the contents of the AP-55/55S with the
recipient at the time of its completion.
2. Both
copies are filed in the case record.
3.24.4 Replacement
Procedures
A. Prior
to authorizing a replacement check, the worker must telephone the
Department of Human Service, Office of Financial Management
(401-462-6870) to determine whether the original check has been
cashed.
B. If
the check has not been cashed, the worker proceeds with the check
replacement.
1. The
payment will be scheduled for the day of the approval and the check
will be issued as part of the nightly payroll run and mailed to the
client.
C. If
the assistance check has been cashed, the worker obtains a copy of
the transacted check and two (2) copies of R.I. Department of
Treasury form entitled Forged Check Affidavit.
1. These
documents will be sent to the worker by the Business Office as soon
as a copy of the check is received from banking officials.
D. Prior
to authorizing a replacement check, the recipient is scheduled for an
office interview and shown the transacted assistance check.
1. If
the recipient maintains that s/he did not cash or receive money from
the check, s/he signs both copies of the Forged Check Affidavit
(original signatures only).
2. The
worker then proceeds with the check replacement process.
3. The
payment will be scheduled for the day of the approval and the check
will be issued as part of the nightly payroll run and mailed to the
client.
E. Both
copies of the Forged Check Affidavit are returned to the Business
Office at Central Office along with one copy of the AP-55/55S that
the recipient signed when the non receipt, loss, or theft of the
assistance check was reported to the district office.
1. The
Business Office then forwards the packet to appropriate authorities
for further investigation.
F. If
the missing check is cashed subsequent to the issuance of a
replacement, the Business Office will initiate the sending of the
packet (copy of the canceled check and Forged Check Affidavit) to the
local district office. The same procedures as above are followed.
1. However,
if the recipient acknowledges having cashed the check or having
received money from it, the Forged Check Affidavit is not completed.
Instead, the case must be referred to the Fraud Investigation Unit
for a determination of the means of recovering the duplicate payment.
3.24.5 Precautions
for Securing Future Checks
A. When
a recipient reports a lost or stolen check, the worker must advise
him/her to take precautions to reduce the chances that future checks
will be similarly lost. For example, the recipient is instructed to
meet the mailman on check day, if possible, or make sure that the
mailbox is locked.
B. If
two (2) checks are reported lost or stolen in the same six month
period, the case is referred to the Program Administrator or his/her
designee, who reviews the case history of reported lost or stolen
checks and any measures the recipient has taken to secure future
checks.
1. At
the Administrator's discretion, a conference may be scheduled to
discuss the problem. If a conference is held, the participants
include, but are not limited to, the Program Administrator (or
his/her designee), supervisor, social worker, and the recipient and
her/his representative.
2. If
after a thorough review it appears that the recipient's checks remain
susceptible to loss or theft and no other solution presents itself,
the Administrator may decide that the recipient's checks must be sent
to the district office and picked up there by the recipient.
a. This
arrangement continues until the recipient can show that checks can be
safely mailed to the home.
3.24.6 LOST
OR STOLEN CASH
A. A
recipient who has lost money or from whom money has been stolen and
who is without food or SNAP benefits, may be given assistance to
obtain food only, pending the receipt of the next assistance check or
receipt of other income, whichever is first.
1. The
food need is computed based on the standard from the table below for
the appropriate number of days that food is required for each person
in the GPA assistance unit.
B. The
recipient must report the loss or theft to the police department and
sign an affidavit (AP-55) attesting to the loss or theft before the
payment can be authorized.
C. Payment
is authorized via the state’s electronic eligibility system.
1. WEEKLY
STANDARD FOR FOOD
PLAN
SIZE
AMOUNT
1
$16.30
2
29.80
3
42.00
4
52.40
5
65.50
6
78.60
7
91.70
8
104.80
9
117.90
10
(and over)
131.00
2. Add
$13.10 for each person in the plan size over 10.
3.25 Payment Changes and Closings
3.25.1 CHANGES
IN CIRCUMSTANCES
A. Due
to the RI State of Emergency and the COVID-19, the DHS may exercise
discretion in regards to changes-in-circumstances reporting
requirements until three business days from the withdrawal of the
State of Emergency for Rhode Island.
B. In
the initial contact with the agency, and in any subsequent contacts,
the recipient is made aware of his/her responsibility to report
changes in circumstances within ten (10) days.
1. Financial
need is subject to change whenever there is a change in the plan
size, the living arrangement, or in income or assets.
2. There
are changes in factors other than need which can affect eligibility,
some of which the agency may be aware of in advance, and others which
are unexpected and the agency can learn about only when the recipient
or another source makes the information known.
3. When
it is anticipated that changes in circumstances such as income,
assets, plan size, living arrangements, or eligibility factor will
occur at a specific time, the worker utilizes the state’s
electronic eligibility system to remind him/her of the change a month
before that date.
4. The
worker will then review the situation and take appropriate action for
the next effective date. Information on such changes as well as forms
completed are noted in the state’s eligibility system.
3.25.2 PAYMENT
CHANGES
A. Whenever
a change in circumstances results in a reduction of the payment or
ineligibility for the program, the client must be notified.
1. The
GPA-56, Notice of Agency Action, is mailed to the client which
notifies him/her of the date and reason for discontinuance. See the
General Provisions, § 10-00-1.3 of this
Title , for information about the client appeal process.
3.25.3 Notification
of Changes in Assistance
A. When
it is determined that a change in the recipient's circumstances will
result in a reduction, suspension, or discontinuance of assistance,
the recipient must be notified by mailing a GPA-56 at least 10 days
prior to the effective date.
1. The
case notes must show the date that the notice was mailed. The notice
must:
a. contain
the reason for the proposed action and the agency policy which
requires this action;
b. explain
the opportunity to discuss the action with the staff person
authorizing discontinuance, suspension, or reduction in the payment;
c. explain
the opportunity to have an Adjustment Conference with the casework
supervisor or program administrator;
d. explain
the provision for continuation of the payment only if a hearing is
requested within the ten-day period of the date of the notice and a
written request for continuation of the payment is included in the
request for hearing;
e. explain
the opportunity the client has to request a Fair Hearing within 10
days of the date of the notice.
2. An
advance or ten day notice is not required when:
a. the
agency has factual information concerning the death of a recipient or
the payee when there is no relative available to serve as new payee;
b. the
agency receives a clear written statement signed by a recipient that
s/he no longer wishes assistance, or that gives information which
requires discontinuance or reduction of assistance, and the recipient
has indicated, in writing, that s/he understands that this must be
the consequence of supplying such information;
c. the
recipient has been admitted or committed to an institution and there
is no other person included in the payment;
d. the
recipient has been placed in skilled nursing care, intermediate care,
or long-term hospitalization;
e. the
claimant's whereabouts are unknown and agency mail directed to
him/her is returned by the post office indicating no known forwarding
address. The claimant's check must, however, be made available to
him/her if his/her whereabouts become known during the payment period
covered by a returned check;
f. a
recipient is accepted on RIW, SSI, or assistance in another state and
that fact has been established; or
g. a
child is removed from the home as a result of a judicial
determination, or voluntarily placed in foster care.
h. However,
adequate notice must be sent not later than the date of action. The
record and/or Case Log must show that the GPA-56 has been sent.
3.25.4 Required
Action
A. Due
to the novel Coronavirus Disease (COVID-19), the Executive Office of
Health and Human Services, Office of Appeals, may temporarily delay
scheduling hearings during crisis, for sixty (60) days or until the
termination of the COVID-19 declaration of emergency, whichever is
longer.
B. A
client has a right to request a hearing within ten (10) days of the
agency's notice of action regarding an impending reduction,
suspension, or discontinuance of assistance.
.C. If
a request for a hearing is made within the ten-day advance notice
period of the date of the notice and a written request for
continuation of assistance is included in the request for hearing, no
action for reduction, suspension, or discontinuance is taken until
the hearing decision is reached except in the following instances:
1. When
the reduction, suspension or discontinuance is caused by a change in
State law that requires automatic grant adjustment for classes of
recipients, a timely notice of such grant reduction can be issued by
mass mailing, and the payment is not continued and no hearing need be
granted.
2. However,
a hearing is granted and the payment is continued when the reason for
the appeal is incorrect grant computation.
3. The
casework supervisor will review the issue to determine this and will
inform the recipient, in writing, of the action that will be taken.
a. If
the payment is continued and, at the hearing, a determination is made
that the sole issue is one of State law or policy or change in State
law and not one of incorrect grant computation, assistance is
reduced, discontinued or suspended immediately and the recipient must
be promptly informed, in writing, of the action.
b. However,
the formal hearing decision is issued within the time limits for
hearing decisions.
4. When
a second change occurs while the hearing decision is pending, and the
recipient does not request a hearing within the advance notice period
on the second issue, assistance is reduced, suspended or discontinued
and the recipient must be promptly informed of this in writing.
5. At
the end of the ten-day period, the action remains in force if the
client has not responded and requested a hearing and submitted a
written request for continuation of benefits.
6. No
hearing will be granted unless requested within ten (10) days of the
date of the notice.
3.25.5 Conditions
Under Which Assistance Continued
A. If
the request for a fair hearing is made within the ten (10) day
advance notice period and a written request for continuation of
assistance is included in the request for hearing, no action for
reduction, suspension, or discontinuance is taken until the fair
hearing decision is rendered.
B. If
the reduction, suspension, or discontinuance is caused by the
application of a change in agency policy which affects all
recipients, a timely notice can be issued by mass mailing.
1. If
the client requests a hearing regarding the change in policy itself,
assistance is not continued.
2. However,
when the request is based on improper determination of benefits in
the individual situation, assistance is continued.
3.26 Renewal/Reapplication
3.26.1 RENEWAL
AND REAPPLICATION REQUIREMENTS
A. Because
no formal redetermination of continuing eligibility process is
required for GPA recipients, if the agency becomes aware of a change
in the financial circumstances of the recipient that would result in
ineligibility, GPA will be terminated.
B. For
GPA applicants, initial eligibility may be granted for a period of up
to six (6) months, renewable for a period of up to an additional six
(6) months.
1. Prior
to the expiration of the initial period of eligibility, the GPA field
staff must notify the client of the procedures to be followed to have
another period of eligibility considered.
C. In
order to receive GPA for a period greater than twelve (12) months,
individuals must reapply for General Public Assistance.