1430 Written Notice of Case Action - An applicant or recipient of assistance shall be notified promptly of the action taken on his case. The recipient of assistance shall also be notified of other changes such as an increase or decrease in the amount of the benefit or spenddown, family share, scheduled hours, suspension, or reinstatement after suspension.

 

A notice of action shall be sent promptly to the applicant or recipient with a copy of any manually prepared notices filed in the case record. When appropriate, a copy must be made available on approvals, suspensions or closure to social services, CSE, or HCBS case manager. Specialized notice forms are required for all cases involving a spenddown, and for all cases in which the medical program will assume at least partial payment for care situations. In addition, child care providers shall receive notification of termination (prior to the original end date) of child care plans/benefits.

 

Notices shall indicate clearly the action taken, the effective date, and such other information as the situation may require. If an application has been approved for cash, food assistance or child care assistance, the applicant shall be informed of the amount which he or she may expect to receive. If an application has been approved for child care, the client also be informed of the family share, if any, which is deducted before for benefits are issued, the date SRS will begin authorizing benefits and the scheduled hours used for benefit calculation. This information shall be provided via a copy of the child care plan. For all cash, food assistance, child care and medical approvals, notice must include the beginning and ending dates of the review period. For the Work Incentive Payment, notification of the case closure when implementing the payment is appropriate notice of closure. If an application is denied, the applicant shall be informed of the basis for this action. A similar procedure shall be followed for all other changes.

 

For cash or medical notices the statement shall not, however, indicate:

 

  1. That the payment is made with the understanding that it will be used for a specific item or service, or will be paid to a specific person.
     

  2. That the recipient will suffer any loss because of his failure to use the payment or any part of it for a specified purpose.
     

  3. That receipts are required to show how the payment or any part of it was used.

 

1431 Timely and Adequate Notice - "See Policy Memo #99-10-09 re: "Applying penalties to Closed Cases (Cash and Food Assistance)".
 

The agency shall give timely and adequate notice of agency actions to terminate, suspend, or reduce assistance except as provided for in 1432 regarding dispensing with timely notice and in 1434 regarding negative actions resulting from information obtained through federal match data. See 9340 for further information on notice provisions for reviews.
 

Staff shall provide timely and adequate notice before Work Program Support Services or case management services are reduced or terminated.
 

Timely and adequate notice of agency actions must also be given to clients to reduce, suspend, or terminate existing child care benefits.

 

When a child care plan is ended and there is no negative impact on the client (e.g., services will be continued with a different provider with benefits starting the 1st of the next month), timely and adequate notice of the termination of the plan is not necessary. However,the client and provider should be informed of the plan end date. See 7640.
 

NOTE: When a child care plan is initiated, or the plan is suspended or terminated prior to the date originally set, a notice must be sent to the child care provider at the same time as the plan or notice is sent to the client. An approval notice to the provider will simply state that benefits have been approved for particular children for whom they have been named as provider from a beginning date to a date in the future. Notices to providers of benefit suspension or termination will simply state that benefits for particular children are being suspended or terminated effective with a specific date. A client's family share deduction and benefit amount are confidential information and will not be disclosed to the provider. Confidentiality of client case information should be maintained.
 

  1. Adequate Notice - Adequate means a written notice that includes a statement of what action the agency is taking, the reasons for the intended agency action, the specific manual references supporting such action, an explanation of the individual's right to request a fair hearing, and the circumstances under which assistance may be continued if a fair hearing request is made. All notices must be adequate.
     

  2. Timely Notice - Timely means that the notice is mailed at least 10 clear days before the effective date of action. Neither the effective date of action nor the mailing date shall be considered in determining this 10 day period. Closure notices must be mailed no later than the 20th of the month in 31 day months or the 19th of the month in 30 day months to be considered timely since the effective date of action for closures is always the last day of the month. For other negative actions, specifically benefit decreases (including decreases to $0) or spenddown/liability increases, notices must be mailed no later than the 21st of the month in 31 day months or the 20th in 30 day months as these actions take effect on the 1st day of a month.

  3.  

1432 Adequate Notice Only - "See Policy Memo #99-10-09 re: "Applying penalties to Closed Cases (Cash and Food Assistance)".
 

When only adequate notice is required, such notice may be received by the household at the time reduced benefits are received or if benefits are terminated, at the time benefits would have been received if they had not been terminated. The agency is not required to send timely notice but must send adequate notice not later than the date of action when:
 

  1. The agency denies an application for assistance. However, denials resulting from information obtained through federal match data shall be subject to the provisions of 1434.
     

  2. The agency has factual information confirming the death of a client or of the payee when there is no relative available to serve as new payee.
     

  3. The agency receives a clear written statement signed by a client indicating that he no longer wishes assistance, or that gives information which requires termination or reduction of assistance, and the client has indicated, in writing, that he understands that this must be the consequence of supplying such information.
     

  4. The client has been admitted to an institution and further cash, food assistance, child care, and medical assistance will not be provided to that individual.
     

  5. The client has been placed in a Medicaid approved institution for long term care or begins HCBS and will receive Medicaid payment for the cost of care.
     

  6. The client's whereabouts are unknown and agency mail directed to him has been returned by the post office indicating no known forwarding address. The procedures of 9124 must be followed to terminate assistance when the client's whereabouts are unknown.
     

  7. A client has been accepted for assistance in a new jurisdiction and that fact has been established by the jurisdiction previously providing assistance.
     

  8. A child care, TAF or food assistance child is removed from the home as a result of a judicial determination, or voluntarily placed in foster care by his legal guardian.
     

  9. Assistance is approved and negative case action such as a closure or grant reduction is incorporated into the initial notice of action to the client. However, negative action resulting from information obtained through federal match data shall be subject to the provisions of 1434.
     

  10. For food assistance only, the agency takes action based on information the client furnished on the interim report form or because the recipient has failed to submit a complete interim report form. Also see 9122.6.

    NOTE: Timely and adequate notice must be given for any reduction or termination in benefits resulting from information obtained other than through the interim report form.
     

  11. A client is disqualified for fraud through a court of appropriate jurisdiction or the Administrative Disqualification Hearing process. For instances involving Administrative Disqualification Hearings, notice of benefit reduction is sent only by the Administrative Disqualification Hearing Officer. See 11250.12.
     

  12. Termination of food assistance eligibility of residents of a drug or alcohol treatment center or a group living arrangement if the facility loses its certification from the appropriate agency or agencies of the State or has its status as an authorized representative suspended due to its disqualification by FNS as a retailer. However, residents of group living arrangements applying on their on behalf are still eligible to participate.
     

  13. The client has been receiving increased benefits to restore lost benefits, the restoration is complete, and the household was previously notified in writing of when the increased benefits would terminate.
     

  14. A work programs special services allowance or transportation allowance granted for a specific period is terminated and the client has been informed in writing at the time of initiation that the allowance shall automatically terminate at the end of the specific period.
     

  15. A client fails to respond to a written repayment agreement within 10 days of the date the notice is mailed and benefit reduction is invoked. See 11125 (3)(b).
     

  16. A child care plan is being terminated as services are no longer being performed by a particular provider.

NOTE: Adequate notice has been met when a notice has been sent for the Work Incentive payment. See KEESM 1430. Notices A721and A121 meet this requirement.
 

 

1433 Automatic Benefit Adjustments for Classes of Clients - When changes in either state or federal law require automatic adjustment for classes of clients, timely notice of such adjustments shall be given which shall be adequate if it includes a statement of the intended action, the reasons for such intended action, a statement of the specific change in the law requiring such action, and a statement of the circumstances under which a hearing may be obtained and assistance continued.

 

1434 Notice of Actions Resulting from Federal Match Data - Based on the provisions of the Computer Matching and Privacy Protection Act, no immediate action to suspend, terminate, reduce, or deny assistance in the cash, medical and Food Assistance Programs may be taken as a result of information obtained through federal match data which has not been determined to be accurate and reliable by the federal agency producing the data. When the federal information has not been determined to be accurate and reliable, the individual must be given 30 days from the date the notice of action is received to verify or contest the match data. This means that such notice must be sent at least 35 days prior to the effective date of action for recipients or the date the application is to be processed for applicants.
 

Federal matches currently affected by these provisions include the SIEVS (IRS and BEER data) match, VA match, and matches identified via the eDRS. It does not include BENDEX, SDX, SAVE information from INS, and third party queries obtained through SSA as all of these data exchanges are either considered to be accurate and reliable or involve a computer match process between state and federal records. It also does not include Employment Security matches as this is not a direct federal-state match.
 

If the individual does not respond to the notice, final action based upon the match data can be taken upon expiration of the 35 day notice period and allowing for timely and adequate notice of action. All or part of the 10 day timely notice period may run concurrently with the 35 day notice period. However, all BEERS and IRS-related match data is to be considered as a lead only and not to be used as primary verification or evidence without further independent verification.
 

If the individual confirms the validity of the information prior to the expiration of the 35 day period, action can be taken immediately allowing for 10 day timely and adequate notice. In addition, for applicants, action can be taken to deny the application without a 35 day notice period, if the individual has already confirmed the match data through verification provided or information which was incorporated on the application form.
 

If the individual contests the data during the 35 day notice period, no action can be taken until the information is further verified. If the individual cannot provide verification in regard to IRS or BEER data, contact with such sources as the financial institution, employer, etc. will need to be made.

Client cooperation in the verification process will be essential for any action prior to the 35 day notice period. If the client refuses to cooperate and/or contests the information and verification cannot be otherwise obtained, action can be taken on the case following the expiration of the 35 day notice period and allowing for timely and adequate notice of the action.

 

1434.1 Special Provisions for Matches Obtained Via the eDRS (Food Assistance Only) - Prior to any negative action being taken against an applicant based on a match in the eDRS, secondary verification from the other State must be requested. Until the information in the eDRS can be verified, the individual cannot be denied benefits. The only exception to this rule is if the household applying is entitled to expedited services - the information from the eDRS and secondary verification shall not delay benefits beyond the 7 day standard. If verification of a disqualification period that should have been applied is later obtained, a claim would be established against the household for any overissued benefits. States are required to respond to secondary verification requests within 30 days.

 

The following provisions apply if the eDRS shows an applicant in Kansas has a fraud disqualification period from another state that needs to be applied in Kansas.

 

Example: Individual found guilty of a second fraud in Missouri on December 15, 2007. The individual is disqualified for 24 months starting January 1, 2008 through December 31, 2009. The case in Missouri is closed April 30, 2008 and the household with the disqualified person moves to Kansas and applies in May 2008. The disqualified person must be disqualified in Kansas for the remainder of the 24 month disqualification period.

 

  1. If the eDRS indicates that a disqualification period should be applied, a secondary verification of that information is required. The eDRS system contains Locality Contact information (a phone number is included) who can be contacted to verify the information in the eDRS. If the Locality Contact verbally verifies the information in eDRS, the household containing the disqualified person must be given 10 days to respond to the information obtained from the other state. If the household affirms the information, the agency has the necessary information to apply the disqualification without waiting for additional documentation from the Locality Contact. Additional documentation may still be obtained from the Locality Contact should the household decide to request a fair hearing on the agency’s action to apply the disqualification period.

  2. If the household disputes the verbal information from the Locality Contact, the agency must obtain documentation prior to applying the disqualification period. While waiting for this information, the agency can hold the household’s application pending and notify the household of this information. If documentation from the other State is not received in the 30 day application processing time period, the agency must determine eligibility and cannot apply the disqualification period. If documentation is later obtained that a disqualification period should have been applied, an claim shall be established for any overissued benefits. Examples of copies of documents that can be obtained to substantiate a disqualification penalty include:

    Also refer to 1322.3(5) and 11270.