Skip to main content

Oklahoma Department of
Human Services
Oklahoma Department of Human Services
75th Anniversary
Stronger Families Grow
Brighter Futures
Oklahoma Department of Human Services
Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd. • Oklahoma City, OK 73105
(405) 521-3646 • Fax (405) 521-6684 • Internet: www.okdhs.org
 
Careers    Calendar   Contact Us    Newsroom   
 
Programs and Services    County Offices    Divisions and Offices     Online Services     Library
 
OKDHS Hotlines
Document Readers
OKDHS Home > Library > Policy > OAC 340 > Chapter 65. Public Assistance Procedures > 5. Procedures Relating to Case Changes > 1. Case changes
340:65-5-1. Case changes
Back 
|
Next

Revised 6-1-11

    

(a) The client must report within ten calendar days any changes in his or her circumstances that would result in an increase or decrease in benefits.  For the Supplemental Nutrition Assistance Program (SNAP), see OAC 340:50-9-5 for reporting exceptions.  • 1  The worker gives the client ten calendar days to provide any required proof.  The worker promptly acts on changes that increase or decrease benefits or result in benefit closure.  To be considered prompt, the change must be made within ten calendar days of the date the change was reported and required proof was received.  • 2  Failure to report changes timely may result in an overpayment assessment against the client.  • 3  Examples of changes the client must report include:

  • (1) household income;  • 4
  • (2) household resources;  • 5
  • (3) household composition;  • 6
  • (4) the client's address or telephone number;  • 7
  • (5) legal alien status of non-citizens;  • 8
  • (6) insurance coverage;  • 9
  • (7) in addition, for the for the Temporary Assistance for Needy Families (TANF) Program:
    • (A) deprivation of parental support; • 10
    • (B) when the TANF Work activity stops or starts;  • 11
    • (C) when a child in the assistance unit stops attending school;  • 12 and
  • (8) in addition for the Child Care Subsidy Program:  • 13
    • (A) the names of household members in child care;
    • (B) the reason child care is needed for the Child Care Subsidy Program;
    • (C) the parent's or caretaker's work or school schedule or any other change affecting the days and hours child care is needed;
    • (D) the name of the child care facility the child is attending.

(b) After certification, all reported changes, except those reported prior to certification, must be processed by the deadline date shown on Oklahoma Department of Human Services (OKDHS) Appendix B-2, Deadlines for Case Actions, to be effective the first day of the month following the deadline.  • 1  A computer-generated notice is sent to advise the recipient of any increase or decrease in benefits.  Advance notice of adverse action may be required.

  • (1) Advance notice required - when fraud is not probable.  If the reason for the suspension, termination, or reduction is other than one of the items listed under paragraph (3) and there is no indication of probable fraudulent acts on the part of the client, a computer-generated notice is sent to the client.
    • (A) If advance notice is required, action must be taken by the date shown on Schedule I, of OKDHS Appendix B-2 to be effective on the first day of the following month.
    • (B) Following the issuance of the advance notice, the recipient may present information to show that the action is incorrect and request reinstatement until the last day of the month of closure.  • 14
    • (C) When the client requests a fair hearing regarding the action and wants benefits to be reinstated at the same level until a hearing decision is made, he or she must request the fair hearing within ten calendar days following the issuance of the advance notice.  The worker is responsible for explaining to the client that if benefits are continued and the appeal is not decided in the client's favor, he or she will be expected to repay the benefits.  • 15
      • (i) If the Office of General Counsel Appeals Unit denies the appeal, benefits are continued through the end of the month in which the final decision on the fair hearing is reached.
      • (ii) The human services center (HSC) is responsible for taking the action needed to carry out the decision of the Appeals Unit.
      • (iii) The Appeals Unit sends a letter of decision to the client.  • 16
  • (2) Advance notice required if fraud is probable.  When the suspension, termination, or reduction in benefits is necessary because of probable fraudulent acts on the part of the recipient and the actual facts have been verified, the same policies and procedures as in subparagraph (1) of this Section apply except the advance notice period is five calendar days instead of ten calendar days.
  • (3) Advance notice not required.  Advance notice of action is not required if the suspension, termination, or reduction in benefit resulted from:
    • (A) death of a recipient or Temporary Assistance for Needy Families (TANF) payee when there is not a relative available to serve as a new payee;
    • (B) transfer from one category of assistance to another without a resulting decrease or interruption in benefits;
    • (C) benefit reduction because the spouse included in the TANF benefit is being removed and certified for a State Supplemental Payment (SSP) for the aged, blind, or disabled without a resulting decrease in assistance to the family or interruption in assistance;
    • (D) approval of care in a skilled nursing facility or intermediate care facility;
    • (E) certification of assistance in another state with no interruption in benefits;
    • (F) an automatic increase in benefits brought about by federal legislation, such as to all beneficiaries of Social Security, Railroad Retirement, or Veterans' benefits;
    • (G) admission of the recipient to a public institution where his or her needs are fully supplied;
    • (H) receipt of a clear written statement signed by the recipient that states he or she no longer wishes assistance or that gives information which requires termination or reduction of assistance and the recipient has indicated in writing that he or she understands this will cause a reduction or termination of his or her benefits;
    • (I) the recipient's whereabouts being unknown and OKDHS mail directed to him or her has been returned by the post office indicating no known forwarding address.  The recipient's benefit must be made available to him or her if his or her whereabouts become known during the payment period covered by the returned benefit;
    • (J) a TANF child being removed from the home as a result of a judicial determination or voluntarily placed in foster care by the legal guardian for a period in excess of 30 calendar days;
    • (K) a change in state or federal law that affects all households; or
    • (L) a reduction in SSP benefits that is necessary to comply with federal law pertaining to maintenance of effort or a state mandate.

INSTRUCTIONS TO STAFF 340:65-5-1

 

Revised 6-1-11

 

1.  Per OAC 340:50-9-5, changes to food benefits made in months other than the review or recertification month may not affect the benefit amount.  The worker processes the change and the system decides whether benefits are increased, decreased, or remain the same.

2.  The worker is responsible for updating the applicable Family Assistance/Client Services (FACS) tabs and recording in FACS Case Notes a brief explanation of the action taken and reason for taking the action.  In addition to rules in this Section, rules regarding case changes are found at:

(1) OAC 340:40-9-2 for the Child Care Subsidy Program;

(2) OAC 317:35-7-63 for the SoonerCare (Medicaid) Program; and

(3) OAC 340:50-9-5 for the Supplemental Nutrition Assistance Program (SNAP).

3.  For rules regarding overpayments, refer to:

(1) OAC 340:65-9 for the Temporary Assistance for Needy Families (TANF) and State Supplemental Payment (SSP) Programs;

(2) OAC 340:40-15 for the Child Care Subsidy Program;

(3) OAC 317:35-13-5 for the SoonerCare (Medicaid) Program; and

(4) OAC 340:50-15 for the SNAP.

4.  For rules regarding income, refer to:

(1) OAC 340:10-3-26 through 340:10-3-40 for the TANF Program;

(2) OAC 340:15-1-4, 340:15-1-6, and 317:35-7-38 for the SSP Program;

(3) OAC 340:40-7-10 through 340:40-7-13 for the Child Care Subsidy Program;

(4) OAC 317:35-5-42 for the populations related to the aged, blind, or disabled (ABD) including long term care and OAC 317:35-10-26 for the Online Enrollment population; and

(5) OAC 340:50-7-22 through 340:50-7-31 for SNAP.

5. For rules regarding resources, refer to:

(1) OAC 340:10-3-1 through 340:10-3-10 for the TANF Program;

(2) OAC 340:15-1-14 and 317:35-7-38 for the SSP Program;

(3) OAC 340:40-7-5 for the Child Care Subsidy Program;

(4) OAC 317:35-5-41 through 317:35-5-41.11 for populations related to ABD, OAC 317:35-17-10 and 317:35-19-20 for the long term care population, and OAC 317:35-10-10 for the Online Enrollment population for the SoonerCare (Medicaid) Program; and

(5) OAC 340:50-7-1 for SNAP.

6.  (a) For rules regarding who must, who may, and who cannot be included in household composition to determine the benefit amount, refer to:

(1) OAC 340:10-3-56 and 340:10-3-57 for the TANF Program;

(2) OAC 340:15-1-5 and 317:35-7-36 for the SSP Program;

(3) OAC 340:40-7-6 for the Child Care Subsidy Program;

(4) OAC317:35-7-36 for the population related to ABD, OAC 317:35-17-9 and 317:35-19-20 for the long term care population, and OAC 317:35-6-36 for the Online Enrollment population for the SoonerCare (Medicaid) Program; and

(5) OAC 340:50-5-1 through 340:50-5-10.1 for SNAP.

(b) For TANF, when the client requests benefits for an additional person prior to certification, a new application is not needed.  When the client requests benefits for an additional person after certification, a new application must be completed.

(1) To evaluate whether the person is eligible, the worker must first determine if the person is required to be a member of the assistance unit per OAC 340:10-3-56.

(A) If the person is required to be a member, the worker is also determining continued eligibility for the rest of the assistance unit.

(B) If the person is not required to be a member or is not eligible to be included in the assistance unit, the client decides whether to include the person.  Before making this decision, the worker advises the client whether including the additional person increases or decreases benefits.

(C) After certification, when the client chooses not to include the person or the person is not eligible for another reason, a worker sends Form 08MP039E, Notice to Client of Action Taken, to advise the client of the denial.

(2) When the additional member is eligible, the person is added to the TANF benefit effective the date of request.

(A) If the TANF benefit increases when the person is added, the initial month's supplemental benefits are prorated per OAC 340:65-3-5.

(B) If the additional member must be included and has countable income that reduces the TANF benefit, the reduction is effective the first day of the month following the deadline date on OKDHS Appendix B-2, Schedule I.

(C) When the additional member must be included and the addition of this person causes the assistance unit to no longer be eligible for TANF benefits, the worker closes the TANF benefit effective the first day of the month following the deadline date on OKDHS Appendix B-2, Schedule I.

(3) The worker is responsible for updating the applicable FACS tabs and recording in FACS Case Notes the date the client requested benefits for the additional person, when the person moved into the household, details about the person's eligibility, and how the person affects the benefit amount for the assistance unit.

(c) For TANF, when the client reports that a person included in the assistance unit has left the home, the person's needs are removed effective the first day of the month following the deadline date on OKDHS Appendix B-2, Schedule I.  If the reason for removal is death, the removal date is the date of death.

(d) For all programs, when the client reports that a household member's name has changed or it was misspelled, the correct name is updated in FACS after the client provides the person's Social Security card showing the current name.

(e) For TANF, if after certification a different person who is not currently included in the assistance unit asks to be made payee for the TANF benefit, the person must complete a new application and eligibility for the household must be reviewed.  FACS Case Notes must include information about why the person is requesting this change, including why the current payee must be removed.  The person requesting to be made payee must have a certain degree of relationship to the child for whom benefits are requested per OAC 340:10-3-56 and 340:10-9-1.

(f) For rules regarding who can be payee for programs other than TANF, refer to:

(1) OAC 340:65-3-2 for the SSP Program;

(2) OAC 340:40-3-1 and 340:65-3-2 for the Child Care Subsidy Program;

(3) OAC 317:35-7-15 and 340:65-3-2 for the SoonerCare (Medicaid) Program; and

(4) OAC 340:50-3-1, 340:50-5-5, 340:50-5-8.1, and 340:65-3-2 for SNAP.

7.  (a) Except for children in the Oklahoma Department of Human Services (OKDHS) or tribal custody whose cases remain in the county of jurisdiction, a client may apply for and/or receive services in the human services center (HSC) of his or her choice.

(1) A client may request a transfer of his or her case record(s) by contacting the HSC that has the client's case or the HSC to which the client is requesting transfer.

(2) If the request for transfer is due to an address change or planned address change, the client must provide his or her new address before a transfer is initiated. EXCEPTION: Clients who are participating in the Address Confidentiality Program (ACP) are not required to provide a finding address.  Refer to FSS Memo 10-02 regarding the ACP program.

(b)  The county director is responsible for developing a plan to ensure HSC staff:

(1) use the appropriate FO transfer folders in Microsoft Outlook for sending messages concerning case transfers;

(2) check the appropriate FO transfer folder for messages a minimum of twice daily every day the office is open, once each:

(A) morning; and

(B) afternoon;

(3) accept the client's request and initiate the transfer of all active cases, pending applications, and closed cases involving Family Support Services Division (FSSD) programs by posting a message in the appropriate FO transfer folder or by phoning a HSC to expedite a transfer and posting a message in the appropriate FO transfer folder.

(A) When posting a message, show the case name, case number, and the name and number of the initiating HSC as the subject.  If expedited or emergency services are involved, the message is marked with a high level of importance.

(B) The text of the message must explain that the client is requesting the transfer and, when applicable, include the date of the phone request, the client's phone number, new address, and new supervisor and district numbers;

(4) give priority to phone requests from HSCs requesting to expedite a case transfer;

(5) notify the initiating HSC when a case transfer cannot be completed within two business days of receiving a transfer request;

(6) complete the procedures in (A) through (D) of this Instruction when transferring case(s) to another HSC.  HSC staff:

(A) update FACS with any changes needed, such as a change of address, or new supervisor and district numbers;

(B) ensure the case record is in order with material filed in the proper section or deleted as appropriate;

(C) prepare a brief summary of what action, if any, is currently needed on the case record; and

(D) mail the case record(s) and post a message in the appropriate FO transfer folder giving the mailing date and any information relevant to the transfer.  If the sending office is also the office that initiates the request, the procedures for requesting and sending are combined.  The sending or requesting office must not transfer the case(s) until the receiving office has posted an acceptance of the transfer in the appropriate FO transfer folder;

(7) complete the procedures in (A) through (B) of this Instruction when transferring cases(s) in from another HSC.

(A) If the receiving office is not the initiating office, the receiving office acknowledges acceptance of the case(s) and provides the supervisor number and district number within two business days of receiving a request by posting a message in the appropriate FO transfer folder.

(B) The receiving office acknowledges receipt of the case(s) by posting a message in the appropriate FO transfer folder; and

(8) delete messages in the HSC's own FO transfer folder upon completion of a transfer; and re-enter the effective date of the negative action when transferring a case that is in denied, closed, or suspended status.  When a case being transferred is a case which has been deleted from the ALFX file, the case number assignment transaction, PS1-B is used.

(c) When more than one number has been assigned to a client:

(1) if no benefits or notices have been issued, the worker denies the application using reason code of "other," combines the cases, and sends an electronic message to the FSSD HelpDesk via Remedy Web requesting cancellation; or

(2) if benefits or notices have been issued, the worker closes the case and combines the two records under the correct case number.

8.  For rules regarding legal alien status of non-citizens, refer to:

(1) OAC 340:65-3-1 for all programs;

(2) OAC 340:10-15-1 for the TANF Program;

(3) OAC 340:40-7-5 for the Child Care Subsidy Program;

(4) OAC 340:317:35-5-25 for the SoonerCare (Medicaid) Program; and

(5) OAC 340:50-5-67 for SNAP.

9.  For rules regarding insurance coverage, refer to OAC 317:35-5-43 for the TANF, SSP, and SoonerCare (Medicaid) Programs.

10.For rules regarding deprivation for the TANF Program, refer to OAC 340:10-10-1 through 340:10-10-4.

11.For rules regarding TANF Work participation, refer to OAC 340:10-2-1 through 340:10-2-8.

12. For rules regarding school attendance for the TANF Program, refer to OAC 340:13-1.

13.For rules regarding changes for the Child Care Subsidy Program, refer to OAC 340:40-9-2.

14.For rules regarding reopening or reinstating benefits, refer to:

(1) OAC 340:65-5-6 for the TANF and SSP Programs;

(2) OAC 340:40-9-2 for the Child Care Subsidy Program; and

(3) OAC 340:50-9-5 for SNAP.

15.Refer to OAC 340:2-5 for rules regarding fair hearings.

16.If the appeal results in benefit termination, the worker terminates the benefit.  A reason code of 69 or "other" is used to prevent issuing a computer-generated notice.  The worker is responsible for issuing a notice manually to the client explaining the action taken.
Back
|
Next


Last Updated:  10/19/2011
Oklahoma Department of Human Services
Street address: Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd., Oklahoma City, OK 73105
Mailing address: P.O. Box 25352, Oklahoma City, OK 73125
(405) 521-3646
Help | Web site Policies | Feedback | Accessibility