(a) Change reporting requirement for Temporary Assistance for Needy Families (TANF), State Supplemental Payment (SSP), and SoonerCare (Medicaid). Recipients of TANF, SSP, and SoonerCare (Medicaid) for the aged, blind, and disabled must report within 10-calendar days any changes in circumstances that increases, reduces, or closes benefits.
(1) The worker:
(A) gives the client 10-calendar days to provide proof to verify the reported change; and
(B) acts on changes that increase, reduce, or close benefits within 10-calendar days of the date the change is reported and required proof is received. •
(2) Failure to report changes timely may result in a client error overpayment. • 2
(3) Examples of changes the client must report include:
(A) household income; •
(B) household resources; •
(C) household composition; • 5
(D) the client's address or phone number; • 6
(E) legal alien status of non-citizens; • 7
(F) insurance coverage per Oklahoma Administrative Code (OAC) 317:35-5-43; and
(G) in addition, for TANF program:
(i) deprivation of parental support, per OAC 340:10-10-1 through 340:10-10-4;
(ii) when a TANF Work activity stops or starts, per OAC 340:10-2-1 through 340:10-2-8; and
(iii) when a child in the assistance unit stops attending school, per OAC 340:10-13-1.
Change reporting for the Supplemental Nutrition Assistance Program (SNAP). SNAP has three categories of households with different change reporting responsibilities; annual reporters, semi-annual reporters, and change reporters. Refer to OAC 340:50-9-5 for change reporting requirements. • 8
Change reporting for the Child Care Subsidy Program. Child care subsidy recipients must report income changes within 10-calendar days
when the household's gross income exceeds federal income guidelines for the household size per
OAC 340:40-9-2(a). Refer to
Oklahoma Department of Human Services (DHS) Appendix C-4, Child Care Eligibility/Copayment Chart, Schedule II for the federal exit income threshold.
Change processing deadline. After certification, all reported changes must be processed per DHS Appendix B-2, Deadlines for Case Actions, to be effective the first day of the month following the deadline date.
Notices. A computer-generated notice is sent to the client when the action taken increases, reduces, suspends, or closes benefits. A computer-generated notice is not sent when the action taken does not affect the benefit level.
(1) Advance notice is required when the action taken reduces, closes, or suspends benefits for a reason other than those listed per (2) of this subsection.
When advance notice is required, refer to DHS Appendix B-2 for advance notice deadline dates.
When advance notice is not required, refer to DHS Appendix B-2 non-advance notice deadline dates. Advance notice is not required when the action taken does not suspend, close, or reduce benefits, or when:
(A) all members included in the benefit die;
(B) the TANF payee dies and there is not a relative available to serve as a new payee;
(C) benefits are transferred from one category of assistance to another without a resulting reduction or interruption in benefits, such as changing from disability to aged benefits; • 10
(D) care is approved in a skilled nursing facility or an intermediate nursing care facility that requires closure of the person's SSP benefit or the SoonerCare (Medicaid) Qualifying Individuals - group 1 (QI-1s) benefit;
(E) the household moves out of state;
(F) an automatic increase in income occurs because of federal legislation, such as a cost-of-living increase to all beneficiaries of Social Security, Supplemental Security Income, Railroad Retirement, or Veterans' benefits;
(G) the client is admitted to a public institution where his or her needs are fully supplied;
(H) the client provides a signed, written statement:
(i) stating he or she no longer chooses to receive assistance; or
(ii) requesting closure or reduction of benefits to avoid or repay an overpayment;
(I) the client's whereabouts are unknown. This may occur when DHS mail directed to the client is returned by the post office indicating no known forwarding address. SNAP and Child Care Subsidy benefits are not closed for this reason; • 11
(J) a TANF child is removed from the home because of a judicial determination or voluntary foster care placement by the legal guardian for more than 30-calendar days;
(K) a change occurs in federal or state law;
(L) SSP benefits must be reduced to comply with federal law pertaining to maintenance of effort or a state mandate; • 12 or
(M) the client requests a reduction in or closure of the child care benefit or a change in child care provider for the Child Care Subsidy program per OAC 340:40-9-2 and 340:40-9-3.
Reinstating or reopening benefits. Within 30-calendar days of notice issuance, the client may request reduced benefits be reinstated or closed benefits be reopened at the previous benefit level due to an incorrect action or a change in circumstances. • 13
(1) When benefits were reduced and the worker determines the client remains eligible at:
(A) the previous benefit level, the worker restores benefits to the previous benefit level for all Adult and Family Services (AFS) programs;
(B) an increased benefit level, benefits are increased based on specific program rules; or
(C) a reduced level than the last action taken, the worker reduces benefits further:
the next advance notice deadline date for TANF, SSP, and SoonerCare (Medicaid);
when the renewal is due for Child Care Subsidy and SNAP. When the renewal is not due:
(I) benefits are not reduced for Child Care Subsidy, per OAC 340:40-9-2(a); or
(II) reduced in limited circumstances for SNAP. Refer to OAC 340:50-9-5 for appropriate circumstances.
(2) For TANF, SSP, and SoonerCare (Medicaid), when benefits were closed or suspended and the client remains eligible, but at a reduced benefit level, benefits are reopened using current eligibility information. • 14
(3) When Child Care Subsidy benefits are reopened and the renewal is not due, benefits are not reduced below the benefit level at closure. Child care benefits may only be reduced at renewal, per OAC 340:40-9-2(a).
(4) When SNAP benefits are reopened and the benefit renewal is not due, benefits may only be reduced in limited circumstances. Refer to OAC 340:50-9-5 for appropriate circumstances.
Fair hearing information. When the client requests a fair hearing within 90-calendar days of the date action is taken for SNAP or 30-calendar days for all other AFS programs, the worker follows fair hearing procedures per OAC 340:2-5.
(1) When the client requests a fair hearing within 10-calendar days following the notice issuance date and requests benefits be reinstated at the same benefit level pending the outcome of the hearing, the worker reopens benefits at the same benefit level and explains to the client if the appeal is not decided in the client's favor, he or she is expected to repay the benefits. Benefits remain open unless another change occurs before a hearing decision is made that requires benefits be reduced or closed. • 15
(2) When the client does not request the fair hearing within 10-calendar days of the notice date, the worker does not restore benefits unless the client provides information verifying the client remains eligible at the previous benefit level, the worker determines an incorrect action was taken, or the hearing is decided in the client's favor. • 16
(3) Per OAC 340:2-5, the DHS Legal Services Appeals Unit makes a decision regarding the fair hearing and sends a decision letter to the client and the county office.
(A) The worker is responsible for taking the action needed to carry out the hearing decision. • 17
(B) When benefits were reinstated or reopened and the hearing decision is not in the client's favor, benefits are continued through the end of the month in which the final decision on the fair hearing is reached and an overpayment referral is sent to AFS Benefit Integrity and Recovery, when appropriate.