COMMENT DUE DATE:
March 17, 2016
DATE:
February 16, 2016
Laura Brown, Programs manager (405) 521-4396
Dena Thayer, Programs administrator (405) 521-4326
RE:
APA WF 15-02
The proposed policy is Permanent . This proposal is subject to Administrative Procedures Act
A public hearing is scheduled for 9:00 a.m. on March 25, 2016 at the Oklahoma Department of Human Services, Sequoyah Memorial Office Building, 2400 N. Lincoln Boulevard, Oklahoma City, OK73105, Room C-48. Anyone who wants to speak must sign in at the door by 9:05 a.m.
SUBJECT:CHAPTER 65. PUBLIC ASSISTANCE PROCEDURES
Subchapter 3. Eligibility for Benefits
OAC 340:65-3-1 through 340:65-3-2 [AMENDED]
OAC 340:65-3-4 [AMENDED]
(Reference WF 15-02)
SUMMARY:The proposed revisions to Chapter 65 Subchapter 3 amend the rules to:(1) update and clarify information regarding the eligibility determination process, application processing, collateral contacts, and data exchange; (2) add and update policy cite references; (3) remove outdated language regarding near real time benefit processing; (4) remove unnecessary language regarding the application process and food benefit payee; (5) remove information regarding Adult Protective Services (APS) home visits; and (6) update terminology.
PERMANENT APPROVAL:Permanent rulemaking is requested.
LEGAL AUTHORITY:Director of Human Services; and Sections 162, 167, 167.1, and 168 of Title 56 of the Oklahoma Statutes.
OKLAHOMA DEPARTMENT OF HUMAN SERVICES |
Rule Impact Statement
To:Programs administrator
Office of Intergovernmental Relations and Policy
From:Jim Struby,Director
Adult and Family Services
Date:January 20, 2016
Re:Chapter 65. PUBLIC ASSISTANCE PROCEDURES
Subchapter 3. Eligibility for Benefits
OAC 340:65-3-1 through 340:65-3-2 [AMENDED]
OAC 340:65-3-4 [AMENDED]
(Reference WF 15-02)
Contact:Laura Brown 405-521-4396
A.Brief description of the purpose of the proposed rule:
Purpose:The proposed revisions to Chapter 65 Subchapter 3 amend the rules to:(1) update and clarify information regarding the eligibility determination process, application processing, collateral contacts, and data exchange; (2) add and update policy cite references; (3) remove outdated language regarding near real time benefit processing; (4) remove unnecessary language regarding the application process and food benefit payee; (5) remove information regarding Adult Protective Services (APS) home visits; and (6) update terminology.
Strategic Plan Impact.
The proposed amendments achieve DHSgoals by continuously improving systems and processes and improving communication with DHS clients and staff.
Substantive changes.
Subchapter 3. Eligibility for Benefits
Oklahoma Administrative Code (OAC) 340:65-3-1 is amended to:(1) add clarifying and updated information regarding the eligibility determination process; and (2) add policy cite references.
OAC 340:65-3-2 is amended to:(1) remove outdated language regarding near real time benefit processing; (2) remove unnecessary language regarding the application process and food benefit payee; (3) update policy cite references; and (4) add clarifying information.
OAC 340:65-3-4 is amended to:(1) remove information regarding Adult Protective Services (APS) home visits; (2) update and clarify information regarding collateral contacts and data exchange; and (3) update terminology.
Reasons.
The proposed amendments provide clients and staff with clear, concise, and updated rules reflecting current processes to facilitate the accurate delivery of benefits and services to persons who are in need.
Repercussions.
The proposed amendments provide clients and staff with clear, concise, and updated rules reflecting current processes to facilitate the accurate delivery of benefits and services to persons who are in need.If the proposed amendments are not implemented, rules will not be updated to reflect current processes and may affect service delivery.
Legal authority.
Director of Human Services; and Sections 162, 167, 167.1, and 168 of Title 56 of the Oklahoma Statutes.
Permanent rulemaking approval is requested.
B.A description of the classes of persons who most likely will be affected by the proposed rule, including classes that will bear the costs of the proposed rule, and any information on cost impacts received by the Agency from any private or public entities:The classes of persons most likely to be affected by the proposed amendments are clients receiving benefits administered by Adult and Family Services (AFS) and AFS staff.The affected classes of persons will bear no costs associated with implementation of the rules.
C.A description of the classes of persons who will benefit from the proposed rule:The classes of persons who will benefit are clients receiving benefits administered by AFS and AFS staff.
D.A description of the probable economic impact of the proposed rule upon the affected classes of persons or political subdivisions, including a listing of all fee changes and, whenever possible, a separate justification for each fee change:The revised amendments do not have an economic impact on the affected entities.There are no fee changes associated with the revised rules.
E.The probable costs and benefits to the Agency and to any other agency of the implementation and enforcement of the proposed rule, the source of revenue to be used for implementation and enforcement of the proposed rule and any anticipated effect on state revenues, including a projected net loss or gain in such revenues if it can be projected by the Agency:The probable cost to DHS includes the cost of printing and distributing the rules estimated to be less than $20.The revised rules will result in enhanced delivery of services for clients.
F.A determination whether implementation of the proposed rule will have an impact on any political subdivisions or require their cooperation in implementing or enforcing the rule:The proposed amendments do not have an economic impact on any political subdivision, nor will the cooperation of any political subdivisions be required in implementation or enforcement of the rules.
G.A determination whether implementation of the proposed rule will have an adverse economic effect on small business as provided by the Oklahoma Small Business Regulatory Flexibility Act:There are no anticipated adverse effects on small business as provided by the Oklahoma Small Business Regulatory Flexibility Act.
H.An explanation of the measures the Agency has taken to minimize compliance costs and a determination whether there are less costly or nonregulatory methods or less intrusive methods for achieving the purpose of the proposed rule:There are no less costly or non-regulatory methods or less intrusive methods.
I.A determination of the effect of the proposed rule on the public health, safety, and environment and, if the proposed rule is designed to reduce significant risks to the public health, safety, and environment, an explanation of the nature of the risk and to what extent the proposed rule will reduce the risk:Implementation of the proposed rules will reduce health risks for households by facilitating the delivery of benefits and services to persons who are in need.
J.A determination of any detrimental effect on the public health, safety, and environment if the proposed rule is not implemented:If the proposed amendments are not implemented, no detrimental health or safety effects are anticipated.
K.The date the rule impact statement was prepared and, if modified, the date modified:Prepared May 22, 2015; modified September 1, 2015; modified December 17, 2015, modified 1-6-2016; modified January 20, 2016.
SUBCHAPTER 3. ELIGIBILITY FOR BENEFITS
340:65-3-1. Determination of eligibility
Revised 6-1-139-15-16
(a) Eligibility determination.The process of determining eligibility includes the applicant filing an a signed application, the worker certifying or denying benefits, and all subsequent activities required to receive continuous benefits.¢ 1The applicant has the right and responsibility to participate in the eligibility determination and is relied on as the first source of information.
(1) Someone acting on the applicant's behalf, such as an authorized representative or a person with power-of-attorney, may complete the application for all programs except for Temporary Assistance for Needy Families (TANF).The applicant must personally complete the application for and sign a TANF application.¢ 2
(2) When someone other than the applicant applies on behalf of the applicant, he or she must bring a signed statement from the applicant giving this person permission to act on the applicant's behalf or the applicant must have designated this person as his or her authorized representative on the signed application.¢ 3The SoonerCare (Medicaid) programs allow others to apply for the applicant without a written designation.
(b) Filing an application.Each household wishing A household must complete an application to apply for the Child Care Subsidy Program, Low Income Home Energy Assistance Program (LIHEAP), SoonerCare (Medicaid) program Program, Supplemental Nutrition Assistance Program (SNAP), State Supplemental Payment (SSP), Supplemental Security Income Disabled Children's Program (SSI-DCP), or TANF must complete an application.The applicant may request one or more benefits on the same application with the exception of LIHEAP, which as LIHEAP is not an ongoing benefit.¢ 4
(1) The applicant may apply for benefits in the a local county office of his or her choice.When someone applies on behalf of the applicant and lives in a different county, the person may apply in his or her county of residence or in the applicant's county of residence.¢ 5
(2) When the applicant applies for TANF cash assistance in a county in which he or she does not live, the applicant's TANF Work activities are assigned in the county where the applicant states creates the least barrier to offering more participation opportunities for the client.¢ 6
(3) The system auto-assigns the application to a specific Oklahoma Department of Human Services (OKDHS) office when When the applicant applies online via okdhslive.org, the system auto-assigns the application based on the applicant's ZIP code.
(c) Signature requirements.The applicant, guardian, or someone acting on the applicant's behalf, such as an authorized representative or a person with power-of-attorney must sign the application, prior to benefit approval.
(1) TANF applications must be signed by the applicant. If When the TANF applicant is living lives with his or her spouse, both spouses must sign the application.¢ 7
(2) The applicant may voluntarily withdraw the request for benefits or services either before or after signing the application.
(3) An applicant who is:
(1)(A) eligible for Medicare signs the application using the name on his or her Medicare Health Insurance Benefits (HIB) card; or¢ 8
(2)(B) not eligible for Medicare signs the application using the name shown on his or her Social Security card.
(d) Interview requirements.Whether an interview is required varies depending on the Interview requirements vary by program.¢ 9
(1) Prior to benefit approval for benefits, the applicant must complete a face-to-face interview for:
(A) SNAP.Exceptions are found at OAC 340:50-3-2;¢ 10 or
(B) the TANF program.
(2) A The applicant must complete a telephone or face-to-face interview is required for the:
(A) Child Care Subsidy program Program;
(B) SSP program Program;
(C) SoonerCare (Medicaid) long-term care programs, such as Advantage ADvantage Waiver, nursing home care, or personal care; or
(D) SoonerCare (Medicaid) programs that categorically relate to the aged, blind, and disabled population, such as Qualified Medicare Beneficiary Plus (QMBP), Specified Low-Income Medicare Beneficiary (SLMB), or Qualified Disabled and Working Individuals (QDWI); or
(E) SNAP.¢ 10
(3) An interview is not required prior to approval for the when a person applies for:
(A) LIHEAP; or
(B) SoonerCare (Medicaid) population in online enrollment with when the Oklahoma Health Care Authority (OHCA) or LIHEAP benefits is responsible for determining eligibility per Oklahoma Administrative Code (OAC) 317:35-5-63.¢ 11
(e) Worker responsibilities.The During the eligibility determination process, the worker is responsible for:¢ 12
(1) advising informing the applicant during the application process of the:
(A) OKDHS Oklahoma Department of Human Services (DHS) responsibility for reaching a decision and notifying the applicant of eligibility or ineligibility within the appropriate time limits per OAC 340:65-3-5;¢ 13
(B) applicant's right to request a fair hearing per OAC 340:2-5, either orally or in writing, and be represented at the hearing by any person the applicant chooses per OAC 340:2-5.A The applicant may request a fair hearing may be requested when there is a:
(i) delay beyond the established time limits for determining eligibility per OAC 340:65-3-5; or¢ 14
(ii) disagreement with any action taken on the case;
(C) applicant's legal responsibility for reporting all facts pertinent to eligibility;
(D) types of changes the applicant must report within ten 10-calendar days;
(E) penalty for failure failing to report changes;
(F) information needed to establish eligibility.When requesting information or verification from the applicant, the The worker uses Form 08AD092E, Client Contact and Information Request, to request an interview or verification and gives the applicant at least ten 10-calendar days to respond to the request comply per OAC 340:65-3-2.1;¢ 15
(G) type of assistance provided by OKDHS DHS provides in establishing eligibility;
(H) permission the applicant gives OKDHS DHS to obtain information from sources other than the applicant by signing the application; and
(I) requirement that the applicant must applicant's responsibility to cooperate with state and federal officials if when the applicant's case is selected for a Quality Control review;
(2) collecting information necessary for determining the applicant's initial and continuing eligibility.Information is considered verified upon receipt if that information is when not questionable or inconsistent with known facts, and the provider of the information provider is the primary source of the information, is.The worker accepts, without further verification, the:
(A) applicant's statement concerning:
(i) residency;
(ii) relationship;
(iii) age;
(iv) living in the home of a relative payee;
(v) a minor parent living in the home of a relative;
(vi) Social Security number (SSN);
(vii) non-liquid resources;
(viii) household members;
(ix) school attendance; and
(x) third party insurance;
(B) unearned income information obtained through:
(i) Beneficiary and Earnings Data Exchange System (BENDEX), from the Social Security Administration (SSA);
(ii) Supplemental Security Income (SSI)/State Data Exchange System (SDX), from SSA;
(iii) Unemployment Insurance Benefits (UIB), from the Oklahoma Employment Security Commission (OESC); and
(iv) workers' compensation documents from Workers' Compensation Court; and
(C) alien status information obtained through Systematic Alien Verification for Entitlements (SAVE), from the United States Citizenship and Immigration Services (USCIS);
(3) contacting other persons who may be able to help in establishing establish eligibility if when the applicant is unable to participate in the eligibility determination because of physical or mental disability, inability to speak English, or other difficulties;
(4) determining whether the applicant is currently receiving benefits from another state when he or she has lived resided in Oklahoma for less than 12 months;¢ 16
(5) recognizing expressed or implied needs which includes that include:
(A) determining whether if there is a need for crisis intervention;
(B) addressing the applicant's social services needs; and
(C) making appropriate referrals;¢ 17 and
(6) denying the application if when sufficient facts are available to substantiate ineligibility.¢ 18
(f) Requirement for SSN requirement.¢ 19A The applicant must provide a verifiable SSN or application for a pending SSN is required application for every person whose needs are included for requesting food benefits, SSP, SSI-DCP, LIHEAP, or TANF benefits.The requirement for a verifiable SSN also applies to all persons whose needs are included for SoonerCare (Medicaid) benefits, except newborn children deemed eligible per OAC 317:35-6-60 and undocumented aliens who are residing in the United States (U.S.) unlawfully requesting emergency medical services per OAC 317:35-5-25.¢ 20
(1) The worker accepts the applicant's statement to document the each household member's SSN unless the information is inconsistent or there are other facts or observations which that cause the worker to question the statement.¢ 21
(A) Persons for whom a SSN is required, but not available must be referred to the appropriate SSA office for SSN enumeration.
(i) The worker uses Form 08AD101E, SSN Enumeration Referral, to refer persons to the SSA office for a SSN application.
(ii) The return of Form 08AD101E to OKDHS DHS validates the application(s) or indicates which persons have not provided SSA appropriate original evidence of age, identity, and citizenship.¢ 22
(B) Parents of newborns who participate in Enumeration at Birth (EAB) receive from hospital personnel Form SSA-2853-OP3, Message From Social Security, from hospital personnel.This receipt form is verification the newborn was enumerated at birth.
(2) The worker denies the application or does not include the person for benefits if When the person fails or refuses to furnish or to apply for a SSN, the worker takes action per (A) and (B) of this paragraph.
(A) For TANF purposes, the person's needs are included; however, the worker imposes a 25% percent payment standard reduction penalty is imposed until an application for or a SSN is provided.¢ 23
(B) For food benefit and SoonerCare (Medicaid) purposes, only the needs of the person for whom a SSN is not provided or applied for are not included.¢ 24
(g) Citizenship requirement.All persons applying for federal or state or federal public assistance benefits, such as child care subsidy Child Care Subsidy, SNAP food benefits, LIHEAP, SoonerCare (Medicaid), SSP, or TANF must declare the citizenship or alien status for each household member applying for such benefits on the application or benefit renewal.¢ 25When the payee requests benefits for additional household members between application and benefit renewal, the payee completes and signs Form 08MP022E, Declaration of Citizenship Status, to declare the citizenship or alien status of the additional household members.¢ 26Citizenship and alien status for persons applying for SoonerCare (Medicaid) benefits is determined using specific program requirements found at per OAC 317:35-5-25.
(1) When the applicant declares that some or all of the household members applying for benefits are aliens, the worker must follow SAVE procedures described at per OAC 340:65-3-4 to determine if the validity of documents provided to verify legal alien status are valid.
(2) The worker also must follow specific program each program's policy regarding citizenship and alien status requirements to determine benefit eligibility found at per:
(A) OAC 340:40-7-5 for child care subsidy Child Care Subsidy benefits;
(B) OAC 340:50-5-67 for SNAP food benefits;¢ 27
(C) OAC 340:20-1-8, 340:20-1-10, and 340:50-5-67 for LIHEAP;
(D) OAC 317:35-5-25 for SSP; and
(E) OAC 340:10-15-1 for TANF.
(3) The citizenship requirements at per (g)(3)(A) through (C) and (g)(4) of this Section are pursuant to Section 71 of Title 56 and Section 20j of Title 74 of the Oklahoma Statutes.
(A) Lawful status in the United States (U.S.) is considered verified if each when:
(i) the person applying for benefits has furnished provides a SSN or SSA completed Form 08AD101E from SSA indicating SSA accepted the person has completed the person's SSN application to apply for a SSN.OKDHS; and
(ii) DHS, through an the automated SSN enumeration data exchange transaction with SSA, attempts to match SSN data exchange information with SSA is able to verify the person's SSN.¢ 28
(B) Prior to receiving benefits, when OKDHS DHS is unable to match verify the SSN with SSA for a person 14 years of age or older who is applying for benefits, that the person must:
(i) sign provide a signed and have notarized Form 08MP005E, Citizenship Affidavit, attesting to his or her U.S. citizenship or alien status; or
(ii) provide a U.S. birth certificate, U.S. passport, or a Certificate of Naturalization.Documents or other acceptable as verification of citizenship for SoonerCare (Medicaid) described at document per OAC 317:35-5-25 are also acceptable as verification of to verify lawful status.¢ 29
(C) When the person fails or refuses to sign provide a signed and have notarized Form 08MP005E or provide one of the documents described at per (g)(3)B)(ii) of this Section, the worker denies or closes benefits are denied or closed for that person.¢ 30
(4) The application, benefit renewal, and Form 08MP022E contain a statement advising informing the applicant that DHS reports fraudulent claims of citizenship or lawful alien status are reported to the U.S. Attorney and the person may be subject to criminal prosecution.
(5) When the worker finds that discovers a person who signed Form 08MP005E attesting to U.S. citizenship or legal alien status made a false claim:
(A) the worker sends to Adult and Family Services (AFS) any applicable evidence and a memo that includes and supporting documentation to Adult and Family Services (AFS).The memo must include:
(i) the benefits time frame, benefit type, and amount the person fraudulently applied for or obtained; and
(ii) the time frame benefits were received; and
(iii) how the worker knows discovered the claim was false;
(B) AFS staff in consultation with Office of General Counsel Legal Services staff, review the memo and any evidence provided by the worker supporting documentation; and
(C) when AFS and Office of General Counsel Legal Services staff determine the person made a false claim, Legal Services staff files a complaint is filed with the U.S. Attorney for the applicable district based upon the venue in which the affidavit was executed.
(h) Eligibility determination.The worker determines eligibility after the applicant or other authorized person signs the application, completes an interview, when required, and provides required proof.
INSTRUCTIONS TO STAFF 340:65-3-1
Revised 12-1-15
1.(a) Except for children in Oklahoma Department of Human Services (DHS) or tribal custody whose cases remain in the county of jurisdiction, applicants may apply for and receive benefits in a local county office of their choice or, when known to DHS, apply online via okdhslive.org.Known to DHS means the applicant was previously listed as a payee or spouse on an existing case.
(b) The timeframe needed to determine eligibility varies depending on the capabilities of the applicant and the amount of verification required.Refer to Oklahoma Administrative Code (OAC) 340:65-3-5 for application processing time limits for all Adult and Family Services (AFS) benefits.
(c) When the applicant informs the worker he or she does not have the information needed to determine eligibility, the worker offers to assist the applicant in obtaining the information.The worker's assistance may range from explaining how or where to obtain proof to the worker obtaining proof when the applicant is unable to do so.The worker is not required to obtain proof for an applicant who is simply unwilling to do so.
2.(a) The authorized representative's role is defined in Supplemental Nutrition Assistance Program (SNAP) rules per OAC 340:50-3-1 and in Child Care Subsidy program rules per OAC 340:40-3-1.
(b) Due to the Temporary Assistance for Needy Family (TANF) program requirement to assess employment barriers and service needs of the family, the applicant must complete the application.The worker makes a home visit when it is difficult for the applicant to come to the county office.
3.(a) For the Child Care Subsidy program, when the natural or adoptive parent lives in the home but is too incapacitated to apply, another person living in the home may apply for the parent.The other person must provide proof of the parent's inability to apply per OAC 340:40-3-1(a)(2)(E).
(b) For SNAP, any responsible household member may apply or designate an authorized representative.When children live with someone else while the parent is temporarily out of the home, the worker determines the children's eligibility based on the responsible person's eligibility.
4.(a) Methods the applicant may use to apply for SNAP and Child Care Subsidy include:
(1) completing the application electronically by:
(A) accessing www.okdhslive.org; or
(B) getting help from DHS or a community partner to complete the application on www.okdhslive.org;
(2) downloading a paper application from DHS-Forms and Applications for Service and completing, signing, and bringing, mailing, or faxing it to DHS; or
(3) going into the local county office to complete the application with a worker using the Family Assistance/Client Services (FACS) system.
(b) Methods the applicant may use to apply for SoonerCare (Medicaid) when the Oklahoma Health Care Authority (OHCA) is responsible for determining eligibility per OAC 317:35-5-63, include:
(1) completing the application electronically by:
(A) accessing OHCA online enrollment at www.okhca.org;
(B) accessing www.okdhslive.org; or
(C) getting help from DHS staff or a community partner to complete the application on www.okdhslive.org or online enrollment; or
(2) going into the local county office to complete the application with a worker using FACS.
(c) Methods the applicant may use to apply for SoonerCare (Medicaid) when DHS is responsible for determining eligibility, State Supplemental Payment, Supplemental Security Income-Disabled Children's Program (SSI-DCP), and TANF include:
(1) downloading Form 08MP001E, Request for Benefits, Form 08MP002E, Eligibility Information for Benefits, and Form 08MP003E, Rights, Responsibilities, and Signature for Benefits from DHS-Forms and Applications for Service and completing, signing, and bringing or mailing them to the local county office; or
(2) going into the local county office to complete the application with a worker using FACS.
(d) Methods the applicant may use to apply for the Low Income Home Energy Assistance Program (LIHEAP) include:
(1) downloading Form 08LH002E, Low Income Home Energy Assistance Program (LIHEAP) Walk-In Application, from DHS-Forms and Applications for Service and completing, signing, and bringing, mailing, or faxing it to DHS;
(2) going into the local county office to complete the application with a worker; or
(3) completing and signing the computer-generated form sent to certain recipients per OAC 340:20-1-19 and 340:20-1-20 and bringing, mailing, or faxing it to DHS.
5.(a) The nursing facility may prefer the application be handled locally, but the needs of the applicant take precedence.
(b) Cases for children in DHS or tribal custody must remain in the county of jurisdiction.
6.(a) When the applicant applies for TANF in a county other than the one in which he or she lives, the worker and applicant together determine whether the applicant is best served by referring him or her to TANF Work activities in the county of residence or in the county in which he or she applied.Determining factors may include the availability of:
(1) services that best fit the applicant's skills and abilities;
(2) transportation;
(3) appropriate child care; or
(4) where the applicant's support network is located.
(b) When indicated, workers in both counties confer to develop the most appropriate TANF Work plan for the applicant.
7.(a) A signature submitted on Form 08MP001E through email or a fax is acceptable to establish a request date for the Child Care Subsidy program or the application date for the SNAP, TANF, and SoonerCare (Medicaid) programs.Form 08MA005E, Notification of Needed Medical Services, may also preserve the application date for SoonerCare (Medicaid) eligibility groups for which DHS is responsible for determining eligibility per OAC 317:35-5-63.
(b) In addition to an original signature, a signature submitted on an imaged document by email or fax is acceptable.
(c) An electronic signature submitted through OKDHSLive is considered the same as a pen and ink signature.
8.In rare situations, an applicant's name may not match records used to establish Medicare buy-in and/or data exchange.
(1) When an applicant has Medicare, the worker uses the name on the Medicare Health Insurance Benefits (HIB) card as the case name to facilitate matching Medicare records and completing Medicare buy-in activities.
(2) When, after certification, county staff or the state buy-in coordinator discovers that the case name and the Medicare HIB card name do not match, he or she changes the case name to match the HIB card.When county staff changes the name, he or she reports the name change to the state buy-in coordinator to avoid or resolve Medicare buy-in issues.
(3) When the applicant does not receive Medicare, the worker uses the name on the Social Security card.
9.(a) When an interview is required for SNAP, the:
(1) county worker sends Form 08AD091E, Interview Notice, to schedule the interview because:
(A) it provides the option of an office or telephone interview; and
(B) advises the applicant to send proof to the local county office address; and
(2) support center worker sends Form 08AD093E, Support Center Interview Notice, because it only provides the telephone interview option and advises the applicant to send proof to the Customer Services Center address.
(b) Workers scheduling interviews for all programs except SNAP, send Form 08AD092E, Client Contact and Information Request, because Form 08AD092E allows the worker to schedule an office or a telephone interview and request required proof at the same time.
10.(a) Per OAC 340:50-3-2, staff may conduct SNAP initial and certification renewal interviews by phone.When a household meets expedited services criteria per OAC 340:50-11-1, staff may approve benefits and postpone the interview for up to 30-calendar days.
(b) The worker conducts a face-to-face interview when the household does not have a phone or requests a face-to-face interview.
11.When OHCA is responsible for determining eligibility, the OHCA rules engine approves SoonerCare (Medicaid) benefits.
12.The worker is responsible for:
(1) explaining the availability of child care subsidy benefits and child support services that may help the applicant achieve the expected outcomes of self-support and self-sufficiency;
(2) giving applicants applying for SoonerCare (Medicaid) or cash assistance for a child under 21 years of age the DHS Pub. No. 87-36, Early Periodic Screening, Diagnosis and Treatment, and the DHS Pub. No. 91-25, Oklahoma Child Support Services Handbook; and
(3) giving applicants applying for Soonercare (Medicaid) and a State Supplemental Payment (SSP) for a child under 18 years of age the DHS Pub. No. 86-150, Where to Turn for Help for Children with Disabilities.
13.The worker determines the month and effective date of the applicant's eligibility or ineligibility and the system issues the notice based on the reason for the case action.
(1) The system does not issue a computer-generated notice when the worker denies an application using the reason code of "death or code 01" or "other or code 69."
(2) When the worker uses the reason code of "other or code 69," the worker issues Form 08MP038E, Notice of Action Taken, to explain the reason for the denial.
14.Refer to OAC 340:2-5 for fair hearing information.
15.When the worker completes Form 08AD092E, he or she only checks the items required to determine eligibility based on program specific policy.For example, the worker does not require proof of resources to determine eligibility for a SNAP food benefit application or self-employment records when no one is self-employed.
16.When the household lived in another state(s) within the last 12 months, the worker contacts the former state(s) to determine if the household currently receives assistance from that state(s).When the household receives cash assistance or food benefits from the other state, the worker does not approve the household for assistance in Oklahoma until the month after the assistance ends in the other state.
(1) Per OAC 340:10-1-4, TANF receipt is limited to 60 months when an adult is included in the benefit.Refer to OAC 340:10-7-1 for residency information.
(2) When the applicant plans to remain in Oklahoma, Child Care Subsidy benefits may be approved for the same month benefits are approved in the other state provided there is a planned closure date.This is possible because the benefit is paid to the child care provider not the recipient.
(3) Per OAC 340:50-5-28, a person residing in a domestic violence shelter included in an active food benefit household may participate as a separate household in the same month when the active household includes the person who subjected the shelter resident to abuse.
(4) SoonerCare (Medicaid) may be approved for nursing care in Oklahoma for the same month the person received nursing home care in another state when the applicant intends to remain in Oklahoma.When approved, the worker subtracts the verified nursing home vendor payment paid by the client in the other state from the vendor payment in Oklahoma.
17.When the applicant requests help with social service needs, the worker may give or send the applicant DHS Pub. No. 09-454, Statewide Helpline Numbers, or DHS Pub. No. 09-454SV, in Spanish.The publication contains statewide hotline numbers and space for the worker to enter the statewide 211 information and referral phone number and contact information for local community services.
18.Refer to OAC 340:2-5 for fair hearing information and OAC 340:65-3-7 for denial information.
19.The worker informs the applicant that DHS matches the Social Security number (SSN) of each person included for benefits with data from the:
(1) Social Security Administration (SSA) on benefits and wages;
(2) Oklahoma Employment Security Commission on unemployment benefits and wages;
(3) Internal Revenue Services on unearned income;
(4) Workers' Compensation Court on workers' compensation benefits;
(5) financial institutions that participate in the Asset Verification System when the applicant requests a SoonerCare (Medicaid) program for aged, blind, and disabled populations; or
(6) other agencies.
20.(a) A SSN is not required for undocumented aliens who are eligible for SoonerCare (Medicaid) emergency services per OAC 317:35-5-25(a)(3) and (4).
(b) Per OAC 340:50-5-68 for food benefits, a newborn child is not required to have a SSN or pending SSN application until the next certification renewal or within six months following the baby's birth month, whichever is later.
(c) Per OAC 340:40-7-4 for Child Care Subsidy benefit rules, the applicant is not required to provide a SSN for any member of the household.
21.(a) When the worker questions the applicant's statement, the worker is required only to verify that the SSN is valid and the name and SSN given by the applicant appear on the document supplied as proof.The applicant may provide a copy of each household member's Social Security card or another document that contains the person's name and SSN, such as an award letter or W-2 form as proof.The worker may use documentation in other public assistance case records or the data exchange files as proof.The worker documents the source used in FACS Case Notes.
(1) When the document provided appears to be false or altered, the worker requests a secondary proof document.
(A) When the person's name and SSN match on both documents, the worker accepts the information.The worker includes the person in the benefit when he or she meets all other factors of eligibility.
(B) When the SSN enumeration (ENU) transaction returns a discrepancy message because the SSN was not verified through data matching with SSA, the applicant must supply a copy of the person's Social Security card or proof from SSA that a SSN application is pending for the person.
(C) Additional information ENU regarding the SSN process is located on the Infonet under Job Functions/Adult and Family Services/Tools/Systems Help/Data Exchange.
(2) The worker takes appropriate action per paragraph (3) of this Instruction when the applicant:
(A) does not provide the initial or secondary proof document;
(B) provides secondary documentation that appears to be false or altered; or
(C) states he or she is using a name or SSN that is not his or hers.
(3) Appropriate action includes:
(A) applying a 25 percent program penalty to the TANF benefits per OAC 340:10-12-1;
(B) denying or closing food benefits for the person per OAC 340:50-5-68; and
(C) denying or closing SoonerCare (Medicaid) benefits for the person per OAC 317:35-5-27.
(b) When the applicant's citizenship status is in question, refer to OAC 340:65-3-1(g) and OAC 340:65-3-4(5).
22.(a) The worker gives or mails Form 08AD101E, SSN Enumeration Referral, and Form 08AD092E, Client Contact and Information Request, to the applicant to request proof the applicant applied for a SSN.
(b) The SSA does not assign a SSN to an alien who does not have authorization from the United States Citizenship and Immigration Services (USCIS) to work in the United States (U.S.) unless the alien has a valid non-work reason for needing a SSN.The SSN requirement for receiving benefits or services is a valid non-work reason.When making a referral to SSA for a SSN, the worker indicates the alien status on Form 08AD101E.
(1) When the applicant fails to return Form 08AD101E, no further referral is necessary.Appropriate action is taken.
(2) When SSA staff accepts Form 08AD101E for processing, the returned form indicates SSA staff acceptance of the SSN application.
(A) When SSA accepts the SSN application, a Social Security card is normally issued within two weeks for persons younger than 1 year of age.It may take up to 14 weeks to issue an original Social Security card for a person 1 year of age or older.The worker advises the applicant to notify the worker when the Social Security card is received so the SSN may be recorded in the case record.
(B) When SSA does not accept the applicant's SSN application because the applicant:
(i) was unable to provide the required evidence, the worker makes every effort to assist the applicant in obtaining the evidence; or
(ii) failed to cooperate or was not eligible for a SSN, the person's needs are not included for benefits.
(c) The Case Worker Activity (CWA) Report 21 lists the names of recipients who received benefits for at least 60-calendar days, are 1 year of age or older, and do not show a SSN on FACS.Children younger than 1 year of age do not appear on the CWA report until they receive benefits for six months.
(1) The worker contacts recipients listed on the CWA report to determine if they received a SSN number.
(2) When a SSN number was not received, the worker gives or mails Form 08AD092E requesting the recipient provide a SSN within 10-calendar days.
(3) When the recipient does not provide the SSN within 10-calendar days, the worker takes appropriate, negative action.
(4) Initial referrals using Forms 08AD092E and 08AD101E are made for children not required to provide a SSN or proof of a SSN application at certification.
23.Refer to OAC 340:10-3-57(g) for TANF benefit reduction as a result of program violation.
24.(a) There is no SSN requirement for a newborn child deemed eligible for SoonerCare (Medicaid).Refer to OAC 317:35-6-60.
(b) For food benefits, when it is determined failure to provide or apply for a SSN is due to non-cooperation, refer to OAC 340:50-5-68.
25.The applicant is not required to declare the citizenship or alien status of household members not applying for benefits.The worker must determine if the income and resources of the excluded household members are considered using household composition rules, per:
(1) OAC 340:40-7-6 for the Child Care Subsidy program;
(2) OAC 340:50-5-1 through 340:50-5-10.1 for SNAP;
(3) OAC 340:20-1-10 for LIHEAP;
(4) OAC 340:15-1-5 for the SSP program;
(5) OAC 317:35-7-36 for SoonerCare (Medicaid) programs for persons categorically related to the aged, blind, and disabled; and
(6) OAC 340:10-3-56 for TANF.
26.(a) Between renewal periods, the payee must complete Form 08MP022E, Declaration of Citizenship Status, before the worker adds the person to benefits.
(b) When the payee reports the additional household member at benefit renewal, Form 08MP022E is not required because the payee declares the citizenship status of the person when completing and signing the benefit renewal.
(c) When the person is 14 years of age and older, a data match with SSA must occur or the person must meet requirements per OAC 340:65-3-1(g)(3) before the worker approves the person for benefits.
27.Only the applicant's identity must be verified prior to the issuance of expedited food benefits per OAC 340:50-11-5.The worker and applicant must make reasonable efforts to verify other eligibility factors prior to benefit issuance.
28.Refer to OAC 340:65-3-1(e)(2) and Instructions to Staff (ITS) # 6 through 11 of this Section and OAC 340:65-3-4(4)(A) and ITS # 9 for information about SSN ENU and the penalty for not furnishing a verifiable SSN.
29.(a) The local county office must make notary services available to the applicant.
(b) When the worker is unable to match the SSN for a person 14 years of age or younger, benefits may be approved when allowed by the program.Refer to OAC 340:65-3-1(f) and ITS # 12 in this Instruction for more information.
(c) The worker does not issue for persons 14 years of age and older until lawful status is verified.
30.The worker uses reason codes 31 or 40 from DHS Appendix U, Reasons for Negative Benefit Actions, when denying benefits for the entire household.When the worker denies or removes one or more persons from the benefits, the worker uses the reason "failed or refused to provide proof of citizenship" for the person.
340:65-3-2. Definitions
Revised 6-1-119-15-16
The following words and terms when used in this Subchapter shall have the following meanings, unless the context clearly indicates otherwise:
"Applicant" means a person who directly, or through a person acting responsibly on the applicant's behalf, requests a formal eligibility determination of eligibility for one or more programs administered by the Oklahoma Department of Human Services (DHS) Adult and Family Support Services Division (FSSD) (AFS) of the Oklahoma Department of Human Services (OKDHS).
"Application process" means the process by which the applicant's request is formalized applicant requests benefits, completes program requirements, provides necessary proof, and the worker determines eligibility.The applicant may start the application process with a worker using the Family Assistance/Client Services (FACS) system or by submitting an online or paper application.The application process may require an interview with a worker, either face- to-face or by telephone, depending on the program.Any person who fraudulently represents facts, acts without authority, or exceeds his or her authority to perform a transaction may be prosecuted under all applicable criminal and civil laws.
"Client" means a person who is applying for or receiving services, cash assistance, or other benefits.
"Date of application" means, for:¢ 1
(A) child care benefit Child Care Subsidy applications, the date the applicant or a person acting on the applicant's behalf completes the child care interview and provides all necessary verification, including the name of the child care provider the applicant wishes wants to use.
(B) Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP) food benefits, SoonerCare (Medicaid), State Supplemental Payment (SSP), and the Low Income Home Energy Assistance Program (LIHEAP), the date the applicant or a person acting on the applicant's behalf signs the application.
(i) If When the application is initiated outside of OKDHS DHS, the application date is the date the application is stamped in the local county office or received electronically in the human services center (HSC) through okdhslive.org.
(ii)Receipt of Form 08MA005E, Notification of Needed Medical Services, preserves the date of application for SoonerCare (Medicaid) populations not included in Oklahoma Health Care Authority OHCA Online Enrollment eligibility groups for which DHS is responsible for determining eligibility, per Oklahoma Administrative Code (OAC) 317:35-6-15(b) 317:35-5-63.
(C) When DHS staff receives a verbal request is received prior to the signature date of signature on the application, the date of the staff enters the verbal request is entered date in red above the signature date.¢ 2The date of the verbal request date is the application date of application for the TANF, SSP, and the SoonerCare (Medicaid) Programs not included in the Online Enrollment eligibility groups for which DHS determines eligibility.¢ 3
(i) Per OAC 340:50-3-1, a verbal request for food benefits does not preserve the application date.The only exception is when unless the applicant advises staff a hardship exists that prevents him or her from signing a request on that date.
A hardship may exist when the applicant states no one can come to the local county office because of a situation beyond the applicant's control such as illness, disability, or lack of transportation and the applicant is unable to file the application electronically at www.okdhslive.org or call 1-877-653-4798 to file by telephone.¢ 4
(ii) A verbal request for LIHEAP does not preserve the application date as funding for the program is limited.
(iii) When the The verbal request date preserves the application date for a program, it is protected only if when the applicant signs the application is signed within 30-calendar days.
(I) If When the applicant fails to sign the application within 30-calendar days, no application request is considered made.¢ 5
(II) If When the applicant subsequently contacts OKDHS DHS after 30-calendar days and completes the application process, the application date is the date the applicant completes and signs the application.
(D) When the applicant comes to the HSC local county office to request benefits and cannot stay to complete the application with a worker or no appointment times are available that day, OKDHS staff advises the applicant to must submit a completed and signed Form 08MP001E, Request for Benefits, to the HSC to preserve the application date.When the applicant does not leave a completed and signed Form 08MP001E at the HSC, an application date is not preserved and an appointment for an interview is not set.
"Inquiry" means a request for information but does not imply a request for assistance.
"Near real-time (NRT) benefit processing" means the application for child care benefits is processed within two business days of receiving verification needed to determine eligibility for assistance.
"Payee"means the person in the household in whose name benefits are issued.The person considered the payee varies depending on the requested programs.The payee may or may not be included in the benefit.¢ 6
(A) For the Child Care Subsidy Program, the payee must be the person responsible for the child for whom benefits are requested.The payee does not have is not required to be related to the child.If When the parent of the child is in the home, the parent is considered must be the payee, per OAC 340:40-3-1(a)(3) 340:40-3-1(a)(2).
(B) For the TANF Program, the 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.
(C) For the Supplemental Nutrition Assistance Program (SNAP), the payee may be any responsible adult living in the home per OAC 340:50-3-1.If the only adult living in the home is a non-household or ineligible member, that person is shown as the payee on the case per OAC 340:50-3-1, 340:50-5-5, and 340:50-5-8.1.
(D) For the SoonerCare (Medicaid) Program, the payee is the person for whom benefits are requested or the person responsible for the minor child for whom benefits are requested.The payee does not have is not required to be related to the child.If When the parent of the child is in the home, the parent is considered must be the payee, per OAC 317:35-7-15.
(E) For the SSP Program, the payee is the person for whom benefits are requested.If When the person for whom benefits is requested is a minor child, the child is coded as a payee with a guardian.¢ 7
(F) For LIHEAP, the payee may be any responsible adult living in the home.When the household receives other benefits, the payee is the same person shown as payee for the other benefits.
"Recipient" means a person who receives services, cash assistance, or other benefits.
INSTRUCTIONS TO STAFF 340:65-3-2
Revised 6-1-119-15-16
1.The applicant or person acting on the applicant's behalf may sign the application electronically when using OKDHSLive.
2.The worker documents the date of the oral verbal request using Case Notes in the Family Assistance/Client Services (FACS) system.
3.A verbal request does not preserve the application date for a person in an eligibility group for which the Oklahoma Health Care Authority (OHCA) determines SoonerCare (Medicaid) clients in Online Enrollment cannot be approved for medical benefits prior to the date an application is received by the Oklahoma Health Care Authority (OHCA) eligibility.
4.The worker must document why the oral verbal request date was used.
5.The worker documents the applicant's contact with the Oklahoma Department of Human Services (OKDHS) (DHS) in FACS Case Notes.When a case record does not exist, the worker documents the contact as information and referral only.
6.In most instances, once a payee is chosen and the case name and case number established, it is not changed as long as the payee still meets the criteria to be a payee for the household.The worker does not change the payee because case name and number when a different household member signs the recertification Supplemental Nutrition Assistance Program (SNAP) certification renewal or review other program renewal unless the household specifically requests a change.Changing the case name and number when it is not necessary can may create problems in accessing benefits and in keeping all information about the household together benefit access or retrieval problems when there are multiple case records for the same household.
7.If When the person for whom State Supplemental Payment (SSP) benefit is requested is a minor child, the worker:
(1) selects "applicant or recipient with guardian, conservator, or substitute payee" in the "relationship to payee" field of the FACS Interview Notebook Household tab;
(2) enters the name of the child's guardian in the "guardian, substitute payee, conservator, authorized representative, other responsible person, or extra address line" field in the FACS Interview Notebook Case Information tab; and
(3) selects the indicator of "natural guardian, legal guardian, or other responsible person."
340:65-3-4. Investigation of eligibility conditions and services planning
Revised 7-1-129-15-16
The worker is responsible for collecting information necessary for determining the client's eligibility for benefits and addressing the client's social services needs.¢ 1When verification of information proof from a source other than the client's statement is necessary, the sources described in this Section are used.¢ 2
(1) Home visits.Home visits are sometimes necessary for Field Operations Division (FOD) Adult and Family Support Services (FSS) (AFS) staff to provide services and benefits and to promote safety and stability for families.All home visits must be are planned and coordinated to prevent duplication of efforts.¢ 3
(A) FOD, Adult Protective Services (APS) staff may make home visits and client contacts outside normal working hours within policy as outlined in OAC 340:5.
(B) All other FSS workers may make AFS staff makes home visits or other client contacts during normal work hours whenever possible.Home visits may be made outside normal working business hours when it is in the best interest of planned with the client and approved by appropriate supervisory personnel.¢ 3
(B) Home visits are made The AFS worker makes a home visit when:¢ 2
(i) there is a need to confirm the accuracy of statements made by the client and documentation cannot be obtained he or she is unable to obtain documentation from other sources;
(ii) an office visit would create creates a hardship for the household;
(iii) a Temporary Assistance for Needy Families (TANF) case is closed benefit closes due to failure to cooperate per Oklahoma Administrative Code (OAC) 340:10-2-2;¢ 4
(iv) it is the best method to complete or review the TANF employability plan;
(v) protective services are needed; or
(vi) the worker deems it necessary for another reason and the supervisor concurs.
(2) Collateral contact.A collateral contact is verbal confirmation of a household's circumstances by a person outside of the household that confirms the household's circumstances.The collateral contact may be made either in person or over the phone.
(A) The acceptability of a A collateral contact is not restricted to a particular person, but may be anyone that can be expected able to provide an accurate third party verification of the household's statement.Examples of acceptable collateral contacts are:
(i) employers;
(ii) agencies, businesses, or community action groups;
(iii) migrant service agencies;
(iv) neighbors of the household;
(v) landlords; or
(vi) other persons outside of the household.
(B) The client's signature on the application or review is the necessary authorization for securing renewal authorizes the worker to secure the required information or verification from collateral contacts.This authorization includes the permission of the client's spouse for information regarding his or her circumstances to be given in connection with the same application or review and of the client's parents when the client is a dependent child who is blind or disabled.
(i) If When the collateral contact requires additional written authorization before supplying information to the Oklahoma Department of Human Services (OKDHS) (DHS) regarding:
(i) the client or a dependent child, the client signs Form 08AD060E, Request for Release of Information, to give authorization.
(ii) When information is needed regarding another adult household member, that person may need to sign signs Form 08AD060E before the collateral contact agrees to release information for another adult household member give authorization.
(C) The worker advises persons informs the person contacted for information related to the client's eligibility of how the DHS will use the requested information is used and the reason it is needed.If When the person is unwilling for does not want the client to know his or her identity, the worker does not record the person's name is not recorded in the case record and is not revealed nor reveal the person's name to the client.¢ 5
(D) When someone contacts OKDHS DHS with information related to the client's eligibility and requests anonymity, that the worker does not record the person's name is not recorded in the case record nor revealed nor reveal the person's name to the client.¢ 5
(E) The When the collateral contact provides information related to the client's eligibility that conflicts with information provided by the client, the worker is responsible for discussing with gives the client any inconsistent information obtained from collateral contacts related to the client's eligibility.The client is given the opportunity to clear up conflicting information resolve the inconsistency when possible.¢ 6
(3) Public records.Sources of The worker may obtain information in the form of from public records that provide essential information may be obtained that affects the person's eligibility without obtaining the person's consent from any person whose transactions are involved.
(4) Data exchange.Automated data exchange with other agencies provides DHS with benefit, wage, tax information, and verification of regarding household members' benefits, wages, taxes, Social Security numbers, and current addresses.The system compares information obtained is electronically compared with data stored within OKDHS DHS electronic records to determine if there are discrepancies that need to be addressed.Automated data exchange information is also available within the OKDHS DHS system to determine discrepancies.¢ 7Refer to OAC 340:65-1-2 for information regarding practices for safeguarding case information and raw tax data.The worker is responsible for:
(A) reviewing data exchange information at the time of application and review of eligibility renewal.Data Available data exchange information screens available are include:
(i) Beneficiary and Earnings Data Exchange System (BENDEX);¢ 8
(ii) Buy-In Data Exchange (BIL);¢ 9
(iii) Supplemental Security Income (SSI)/State Data Exchange System (SDX);¢ 10
(iv) Social Security Administration (SSA) Beneficiary Earnings Exchange Record (BEER/BWG);¢ 11
(v) New Hire Employee list (NHL);¢ 12
(vi) Social Security Number (SSN) Verification - SSN Enumeration;¢ 13
(vii) Wage Data Exchange;¢ 14
(viii) Unemployment compensation;¢ 15 and
(ix) Unearned Income Eligibility Verification System (IEVS) income report (IEVS-IRS) and resource data from the Internal Revenue Service (IRS);¢ 16
(B) initiating appropriate queries; and¢ 17
(C) resolving data exchange discrepancy messages within 45-calendar days of the date the message is posted on the data exchange inquiry screen.¢ 18
(5) Systematic Alien Verification for Entitlement (SAVE).All applicants and recipients of the TANF, SoonerCare (Medicaid), Supplemental Nutrition Assistance Program (SNAP), Low Income Home Energy Assistance Program (LIHEAP), State Supplemental Payment (SSP), and Child Care Subsidy Program benefits are required to declare their citizenship status.Persons who declare themselves or their minor child non-citizens must present documentation of their legal alien status from the United States Citizenship and Immigration Services (USCIS) or other acceptable source.The status, as determined from the documentation, must be verified through the Alien Status Verification Index (ASVI) maintained by USCIS.¢ 19
(6) Workers' compensation. Family Support Services Division (FSSD) AFS staff reviews copies of all Workers' Compensation Court documents by matching SSNs with OKDHS DHS records.Any court action that appears to potentially impact eligibility is forwarded to the servicing OKDHS DHS office for clearance.A copy of the document is retained in the case record.¢ 20
(7) Birth verification.For persons born in Oklahoma, OKDHS DHS has an agreement with the Oklahoma State Department of Health to electronically verify birth electronically for persons with an open SoonerCare (Medicaid) benefit.¢ 21
(8) Food stamp disqualification (FSD).When a client has been is disqualified for SNAP food benefits due to fraud, the FSD screen shows the date the disqualification began and the length of the disqualification period.¢ 22
INSTRUCTIONS TO STAFF 340:65-3-4
Revised 12-1-15
1.When the client requests help with social service needs, the worker may give or send the client Oklahoma Department of Human Services (DHS) Publication No. 09-454, Statewide Helpline Numbers, containing statewide hotline numbers.There is space on Publication No. 09-454 for the worker to enter contact information regarding appropriate local community services and the statewide 211 information and referral phone number.
2.(a) When the client fails to present complete or consistent proof needed to determine eligibility, the worker attempts to contact the client to:
(1) resolve the remaining questions; and
(2) decide if the worker or the client will obtain necessary proof.
(b) When the client is unwilling to help resolve the question or permit the worker to seek necessary information, the worker denies or closes the benefit per Oklahoma Administrative Code (OAC) 340:65-3-1 or OAC 340:65-3-8.
(c) The Office of the Attorney General administers the Address Confidentiality Program (ACP) to assist victims of domestic violence.
(1) Per 60.14 of Title 22 of the Oklahoma Statutes, the ACP prohibits state agencies from requiring an ACP participant to provide his or her finding address.
(2) The ACP provides victims of domestic violence with an ACP authorization card.The ACP authorization card includes the:
(A) participant's name;
(B) participant's date of birth;
(C) participant's authorization number;
(D) participant's substitute address; and
(E) ACP toll-free telephone number.
(3) The substitute address may be used as the participant's residence, school, and work addresses.It may also be used when applying for public utilities, registering to vote, or transferring school records.The substitute address is a post office box number and the same address is assigned to all participants.
(4) When the client presents an ACP authorization card, the worker:
(A) does not require the client to provide his or her actual address;
(B) does not make a home visit; and
(C) uses the substitute address as if it were the client's actual address when inputting information into the DHS system, sending DHS forms or notices to the client, or when making service referrals.
(5) For more information concerning ACP refer to the Oklahoma Office of the Attorney General E. Scott Pruitt - Victim Services.
3.When the worker needs to contact a client outside of normal business hours because of an emergency, the worker obtains permission from his or her immediate supervisor or the county director or designee prior to contacting the client.When the immediate supervisor and county director or designee are not available, the worker takes care of the client's emergency need and notifies appropriate supervisory personnel of the situation as soon as possible.
4.Per OAC 340:10-2-2, the worker makes a home visit to determine the family's circumstances and social service needs following benefit closure.
5.When a collateral contact requests anonymity, information obtained from the collateral contact cannot be used to reduce or close benefits unless the worker is able to verify the information by another source.
6.(a) The worker documents in the Family Assistance/Client Services (FACS) Case Notes, information obtained from collateral contacts and the client's explanation regarding inconsistencies.
(b) When the worker unsuccessfully attempts to contact the client to explain inconsistencies, the worker documents what attempts were made and the action taken in FACS Case Notes.
7.(a) Data exchange information is obtained by matching the client name, Social Security number (SSN), Social Security claim number, date of birth, and address from DHS records with other state and federal agency records.The results of the match are posted to the Information Management System (IMS) and are viewed by using various transactions.An online description of any IMS transaction is viewed by entering M space and the transaction name.For example, M space PY.
(b) PY is an index of data exchange information and case data for a particular person.
(1) To access the information, the user enters PY space and the SSN of the person being queried or enters PY space case number and person code.
(2) The user may also access PY from the EF page of the PS-2 for the person being queried by typing PY at the bottom of that page and pressing the enter key.
(A) The upper portion of the PY screen lists records from the PS-2 database for the SSN queried.
(B) The middle portion of the screen lists records from the ALFX client database.
(C) The lower portion of the screen lists types of data exchange information available for the person.
(3) The user may also enter the PY transaction code at the bottom of any data exchange screen and return to the PY screen.
(4) The worker views data exchange information by:
(A) moving the cursor to the line of information desired, typing in the transaction code, and pressing the enter key; or
(B) entering a transaction code and SSN of the person at the top of a blank IMS screen.
(c) DXL is a history screen of all data exchange discrepancy messages found on a particular person.The user may access this screen by entering DXL space SSN.The DXL screen lists the:
(1) type of error;
(2) date error was discovered;
(3) date AFS staff resolved the error;
(4) system code; and
(5) comparison between case income and income shown on the data exchange system.
(d) The worker is able to obtain AXL/G1DX, Case Scan and case worker activity (CWA) from the automated caseload evaluation system (ACES) by clicking on the Infonet Job Functions tab/Adult and Family Services/ and ACES under Tools.When the worker clicks on AXL/G1DX, he or she is able to request an AXL or a G1DX report by entering the county number/supervisor number/worker number and clicking on the type of report needed.
(1) AXL generates a list of all cases assigned to the worker by case name, case number, Zip code, open benefits, and the phone number listed on the case.
(2) G1DX shows the differences between information reported to DHS and information reported to agencies that share information with DHS through data exchange, including the Oklahoma Employment Security Commission, Social Security Administration (SSA), the Internal Revenue Service (IRS), and the United States Post Office.
(A) G1DX generates a report showing a list of discrepancies on cases assigned to the worker by case number.The report shows the name and SSN of the person with discrepant information, the type of discrepancy, the date the discrepancy posted, and the number of days pending.
(B) After analyzing the discrepancy and updating case information as needed, the worker clears the discrepancy using DXL.
(3) When the worker clicks on case scan, he or she is able to select up to six CWA reports to view or may request a case scan on up to six cases.The case scan shows the:
(A) case number, name, status, address, phone number; and
(B) SSN, date of birth, age, gender, and any data exchange information available for each person on the case.
(4) When the worker clicks on CWA, he or she may enter the county office number, supervisor number, worker number, check all reports, and types ok to view current CWA reports available for his or her caseload.
(5) When the worker clicks on MICAL, he or she can calculate income for a person and print the results for the case record.
8.Beneficiary and Earnings Data Exchange System (BENDEX).BENDEX provides verification of Social Security benefits and Medicare entitlement.To view, enter BEN space Social Security claim number.The worker may view BENDEX code information by clicking on the Infonet Job Functions tab, choosing Adult and Family Services, and clicking on Systems Help under Tools/Data Exchange/BENDEX.
(1) When using BENDEX to verify Social Security benefits, the worker drops any cents from the gross benefit amount in BENDEX Field B27 and uses only the whole dollar figure.For example, round $349.50 to $349.00.(2) When a person is dually entitled to receive Social Security benefits under two claim numbers, the person may receive benefits under one or both claim numbers.
(A) When the person receives a combined benefit, BENDEX displays two records for the person.Each record displays a D for dual entitlement in Field C21 and the cross referenced claim number in BENDEX Field B20.
(i) The worker counts the income displayed under the BENDEX record with a CP payment status code in Field B20.The CP means current pay.The person receives the combined Social Security benefit amount under this claim number.
(ii) The worker does not count the income displayed in the BENDEX record with the AD in payment status code Field B20.The AD means adjusted for dual entitlement and the person does not receive income under this BENDEX record.
(B) The benefit issuance process used by the SSA may cause a $1 or $2 difference in the actual payment made to a person who receives combined benefits.
(C) When the person receives benefits under both claim numbers, each BENDEX record displays a CP in the payment status code Field B20.The worker adds the whole dollar figures in Field B20 together and drops the cents to arrive at the person's SSA income.For example, when one record shows $202.51 and the other shows $361.23, the worker adds $202 to $361 to arrive at the person's countable income of $563.
9.Buy-in data exchange (BIL).To view buy-in data for Part A and Part B Medicare, enter BIL space Medicare claim number.Additional information is located at the DHS InfoNet/Job Functions/ Adult and Family Services/Systems Help/Data Exchange/Buy-in.
10.(a) SSI/State Data Exchange System (SDX).The SDX file contains data for Supplemental Security Income (SSI) applicants and recipients that is viewed by entering SDX space SSN.When using SDX to verify SSI income, the worker rounds the amount shown to the nearest dollar.For example, 1¢ to 49¢ is rounded down and 50¢ to 99¢ is rounded up.
(b) SDX list (SDL).The SDL transaction is a shortcut that reduces keystrokes and provides a history list of the current and previous SDX records.To view, enter SDL space SSN.To view a particular record, move the cursor to the line of the record date selected, type SDX, and press the enter key.
11.SSA Beneficiary Earnings Exchange Record (BEER/BWG).AFS staff accesses the SSA earnings record file through the BENDEX system for all applicants by entering BWG space SSN.SSA earnings record data is from 18 to 24 months old when received.
12.New Hire Employee list (NHL).The NHL transaction provides information obtained from employers reporting new hires to the Oklahoma Employment Security Commission (OESC).AFS staff enters NHL space SSN to view new hire data.
13.SSN enumeration (ENU) transaction.ENU sends the client's name, birth date, and reported SSN to SSA to match with SSA records when the person is required to have a SSN and the SSN is not shown or is shown but not verified.SSA returns one of 12 possible messages to indicate the results of the match.The message is posted to ENU, G3, and PY.When the SSN is verified, ENU updates the FACS Interview Notebook/Household tab/SSN field, PS-2 block F42, with Y.Detailed information regarding ENU is available at the DHS InfoNet/Job Functions/Adult and Family Services/Systems Help/Data Exchange/SSN enumeration.
14.Wage Data Exchange (OWG).DHS receives wage data from OESC and compares it to case data.Discrepancies are posted to the G1DX screen.When a discrepancy exists, the worker contacts the client or employer to confirm the employment, wages earned, and available medical insurance information on the employee and his or her dependents.To view available data, enter OWG or OWC space SSN.
15.Unemployment Compensation (UIB).A computer match is made weekly of DHS cases in active or application status with Unemployment Insurance Benefits (UIB) files.To view, enter UIB space SSN.
16.Federal Tax Information (FTI).Select Adult and Family Services staff, designated as FTI specialists, may view certain FTI received through IRS matched records by using the IEV transaction.
(1) The IEV transaction displays unearned income as reported by the tax payer on a federal income tax return.The unearned income may include income types not considered on the case or income already reported and used in determining benefit amounts.
(2) The FTI specialists may view more detailed information on the FTI, such as the payer's address and a brief explanation of the document type code by using the WGD transaction.
(3) Local county office and support center staff must not delay processing application and renewal determinations because of an IEV discrepancy.
(4) FTI specialists are responsible for clearing IEV discrepancies.Until the client provides independent verification of FTI shown on the IEV screen, the FTI specialist does not:
(A) document or reference anything about FTI in FACS case notes, imaged documents, or the physical case record; or
(B) reference FTI on any form or notice sent to the client.
(5) Once the client provides independent proof of the unearned income, it is no longer considered FTI and staff may document the income in FACS case notes and the case record.
(5) When staff must prepare an overpayment referral, hearing documents, or an investigative report that includes FTI, the FTI specialist assists in preparing and securing necessary documents as appropriate.The case record must indicate that such documents were secured by the FTI specialist and do not reference the specific FTI.
17.Online query transactions available on IMS for requesting specific types of data on a person are:
(1) Oklahoma Wage Link (OWL).The OWL transaction is an online query received from OESC that lists the last two quarters of employment and current UIB information.The worker MUST access available data at initial application and at each renewal by entering OWL space person's SSN;
(2) Quarters covered (QTRC/QTRI).The worker uses the QTRC transaction to query the SSA earnings file for a determination of covered quarters of employment.When requesting the information, the worker enters QTRC space SSN.
(A) The worker enters identifying information about the person on the screen and presses enter.
(B) After a confirmation screen appears, the worker presses the enter key a second time to release the query.Normally, the response is returned in two- to three-business days and displays on the QTRI screen.
(C) To access the data, the worker enters QTRI space SSN or by using the PY screen.When using PY, move the cursor to the line marked QTR, type in QTR, and press the enter key.This screen displays the number of covered quarters for the person as well as other information.
(D) When information does not return within three-business days, the worker re-initiates the request; and
(3) Third Party Query (TPQYC/TPQYI).Verification of SSI, Social Security cash benefits, Medicare, and the person's SSN may be obtained through the automated Third Party Query procedure.This procedure accesses the same file that produces SDX and BENDEX data.A SSA verification record may also be requested by using the TPQYC transaction.
(A) To access this online transaction, type TPQYC, space, and case number, enter the SSN when prompted, and confirm the information entered.
(B) When no response is received within 48 hours of the request, repeat the process.
(C) The TPQYC transaction generates online data that is returned to the requester electronically.
(i) Information verified with this procedure is generally the most current because Social Security records may be updated at various times during any given month.Therefore, data on TPQYC responses may or may not agree with data appearing on the SDX or BENDEX file for the same person.
(ii) To view the returned data, the worker enters TPQYI space SSN or enters the TPQ transaction code while on the PY screen.A detailed explanation of this procedure is available on DHS Infonet/Job Functions tab/Adult and Family Services/Systems Help/Data Exchange/TPQY.
(iii) When using TPQYC to verify:
(I) Social Security benefits, the gross benefit amount is rounded down to a whole-dollar figure; or
(II) SSI income, net amounts are given.This figure is rounded to the nearest dollar.For example, 1¢ to 49¢ is rounded down and 50¢ to 99¢ is rounded up.
18.Data exchange information is routinely compared with DHS records.When discrepant information is detected, an automated system of notification posts discrepancy messages to IMS.These messages are accessible by using transactions G1DX, G3, and PY.All discrepancy messages must be cleared using the DXD transaction within 45-calendar days of the error posting.
(1) G1DX displays a list of discrepancy messages by DHS office number.The worker accesses discrepancies by entering G1DX space DHS office number and location code.A more detailed list is obtained by entering G1DX space, DHS office number, location code, supervisor number, and district number.Refer to Instructions to Staff # 8 of this Section for more information.
(2) G3 displays an expanded message.The user accesses this screen by entering G3 space case number.
(3) One of the G1DX discrepancies that may appear on a worker's G1DX report is an address discrepancy.An address discrepancy starts with the letters 'AD.'When an address discrepancy appears, the worker must contact the client to verify the current address before updating the address in FACS and clearing the discrepancy.More information regarding address validity and integrity is available under Systems Help/Data Exchange/Address Validity and Integrity.
(4) The worker uses DXD to clear the data exchange discrepancy after documenting the information in FACS case notes and taking appropriate action.The user accesses this screen by entering DXD space case number.When the screen appears, the user enters his or her SSN, system type, and a reason code to show the error caused a reduction (reason code 7), an increase (reason code 9), or no change in benefits (reason code C) and presses enter.After pressing enter, the system requests confirmation.When the user selects Y, the transaction clears the error from G1DX and G3 and posts a resolution date on the DXL screen.
19.(a) The worker accesses the Alien Status Verification Index (ASVI) through a web-based online system at https://save.uscis.gov/Web/vislogin.aspx?JS=YES.Online responses are returned for the initial verification inquiry and the additional verification inquiry.The worker images and files the online verification number or entire verification record in the case record or copies and pastes the information into FACS Case Notes.
(1) Initial verification responses are returned in three to five seconds.Initial verification is initiated when at least one of the documents in (A) through (J) appears to be valid, is available, and has an A-number of A0000001 through A59999999, A70000000 through A79999999, or A90000000 through A9999999.Documents include forms:
(A) I-551;
(B) I-151;
(C) AR-3A;
(D) I-688, I-688A, or I-688B;
(E) I-689;
(F) I-766;
(G) I-327;
(H) I-571;
(I) I-181a, less than 1 year of age; or
(J) I-94, endorsed, in a foreign passport, less than 1 year of age.
(2) The worker uses the same website to request additional verification as initial verification or submits Form G-845, Verification Request, to the United States Citizenship and Immigration Services (USCIS).The website method is preferred since a response is returned in three-federal business days as opposed to a 10-business day paper response time using Form G-845.Benefits of persons who are otherwise eligible are not delayed, closed, or reduced due to the non-receipt of a response from USCIS.
(3) The worker initiates additional verification immediately, when:
(A) the person provides documents that appear counterfeit or altered;
(B) there is no A-number on any document;
(C) an A-number in the A60000000 or A80000000 series appears on any document;
(D) any USCIS fee receipt other than I-689 is presented; or
(E) Form I-181a or I-94 in a foreign passport has an endorsement processed more than one year ago from the current date.
(b) USCIS is responsible for determining immigration status.AFS reports the names and addresses of persons applying for or receiving benefits who are determined to be residing in the U.S. unlawfully to USCIS.The worker reports to AFS program staff the names and addresses of applicants or recipients who:
(1) admit illegal aliens are present in the household and present USCIS information that appears to be forged; or
(2) present a formal order of deportation or removal.
20.The worker images and files the court document in the case record and documents any case action in FACS Case Notes.
21.The availability of new birth records within a previous five-month period is dependent upon reporting time frames of hospitals, midwives, and birth centers.When a data match occurs, the system updates the "citizenship verification" and "citizenship verification date."
22.To display the FSD screen, enter FSD space SSN.
(1) The FSD is indicated on the PY screen so a separate transaction is not necessary when the PY transaction is used first.
(2) When fraud is determined for the Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for Needy Families (TANF) this information is updated on the FSD screen.
(3) For SNAP rules, refer to OAC 340:50-15-25 and 340:65-9-4 for TANF Program rules.
