9 Colo. Code Regs. § 2503-5-3.540

Current through Register Vol. 47, No. 22, November 25, 2024
Section 9 CCR 2503-5-3.540 - AID TO THE NEEDY DISABLED STATE ONLY (AND-SO) PROGRAM

The Aid to the Needy Disabled State Only (AND-SO) program provides interim assistance to clients age eighteen (18) through fifty-nine (59) years of age (unless diagnosed with blindness, then age zero (0) through 59 years of age); who are disabled or blind but have not been approved for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Individuals are required to meet the total disability requirements identified in this section, in addition to the non-financial and financial eligibility requirements. Individuals who are partially disabled or have a short-term disability are not eligible.

A. The total AND-SO grant standard is $248.00, effective April 1, 2022.
B. The grant standard for AND-SO shall be adjusted as needed to remain within available appropriations. Appeals shall not be allowed for grant standard adjustments necessary to stay within available appropriations.
3.540.1DEFINITIONS

"Blind or blindness" means central visual acuity of 20/200 or less in the better eye with the use of a correcting lens. An eye which has a limitation in the field of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees shall be considered as having a central visual acuity of 20/200 or less.

"Employment which exists in the community" means there are jobs for which the client has competence located within an area where the client might reasonably be expected to commute (see definition of "reasonable commute"). It does not mean that there are actual job vacancies that the client could fill or that the client would be hired to fill a job vacancy.

"Improvement" related to the client's medical condition means that in comparison to the most recent medical certification, the physical or mental impairment(s) which prevented the client from engaging in SGA has decreased to the point that the client is able to engage in SGA or the client's residual functional capacity has increased to the point that the client is able to engage in SGA.

"Medical provider" means a Colorado licensed physician, psychiatrist, licensed psychologist, licensed clinical social worker, licensed professional counselor, physician's assistant, advanced practice nurse, or registered nurse. The physician may be a general practitioner or a specialist. A medical provider determining blindness shall be an ophthalmologist licensed in Colorado. A medical provider may be licensed in a bordering state when the nearest Colorado provider is more than one hour from the client's home and the provider in the bordering state is closer.

"Reasonable commute" means a commute no further than one hour one way.

"Residual functional capacity" means the client's maximum remaining ability to perform work of any type on a regular and continuing basis despite some disabling limitations.

"Substantial gainful activity (SGA)" means the performance of significant physical and/or mental activities in work for pay or profit, or in work of a type generally performed for pay or profit, regardless of the legality of the work. "Significant activities" are useful in the accomplishment of a job or the operation of a business, and have economic value. Work may be substantial even if it is performed on a part-time basis, or even if the individual does less, is paid less, or has less responsibility than in previous work. Work activity is gainful if it is the kind of work usually done for pay, whether in cash or in kind, or for profit, whether or not a profit is realized. Activities involving self-care, household tasks, unpaid training, hobbies, therapy, school attendance, clubs, social programs, etc., are not generally considered to be SGA.

"Total disability" means a physical or mental impairment which is disabling and which, because of other factors such as age, training, experience, and social setting, substantially precludes the person having such disability from engaging in a useful occupation as a homemaker or as a wage earner in any employment which exists in the community for which he or she has competence, as defined in Section 26-2-103(14)(a), C.R.S.

3.540.2AID TO THE NEEDY DISABLED-STATE ONLY (AND-SO) DISABILITY NAVIGATION SERVICES
A. AND-SO disability navigation services are available in counties that choose to participate in the program. Counties choosing to participate in the program must enter into an agreement with the state department. The agreement will outline:
1. Data tracking and evaluation requirements.
2. Ongoing training requirements for staff offering navigation.
3. The amount of funds allocated to the county.
B. Annually, funds to operate AND-SO disability navigation services are made available via the following allocation:
1. The department will allocate appropriated funds based on the most recent annual average AND-SO caseload.
2. Counties will indicate if they will operate the program or regionalize and which county will serve as the fiscal agent.
3. Any allocated and unspent funds will be pooled and redistributed to counties through the close out process.
4. The state, with input from counties and stakeholders, will review the allocation formula following each evaluation, but no greater than every five (5) years.
C. In counties which operate AND-SO disability navigation services, the following services are made available to any AND-SO client residing in the county or service area with a pending AND-SO application or approved AND-SO program. Services may be provided individually or in a group setting, when appropriate.
1. For AND-SO clients who do not have a current pending SSI application, services provided shall include:
a. Assistance securing a protected filing date for the SSI application date as soon as possible, but no later than fifteen (15) calendar days from the date of referral to navigation services.
b. Assistance developing a thorough, quality application for SSI benefits.
c. Assistance submitting the application for SSI benefits when requested by the client and/or serving as the client's appointed representative with the Social Security Administration (SSA), when requested by the client.
2. For AND-SO clients who have a pending SSI application, are denied SSI, or who are appealing a denial through SSA, services provided shall include:
a. Provide prompt response to the SSA and Disability Determination Services (DDS) inquiries, within ten (10) calendar days of the inquiry.
b. Outreach to the client as needed to stay connected throughout the determination process.
c. Assistance filing reconsiderations and/or appeals of federal disability benefits when requested by the client.
3. Additionally, services to all AND-SO clients may include:
a. Serving as the client's appointed representative for interactions with the SSA, when requested by the client.
b. Communicating as needed with the SSA and DDS regarding the status of clients' claims.
c. Writing a comprehensive function report and gathering supporting medical opinions when available.
d. Participating in the SSA interview process.
e. Making referrals to appropriate medical providers and other professionals whose assessments are required as part of an application for federal disability benefits.
f. Collecting medical records, assessments, case management notes and collateral contact information.
g. Appointment coordination with doctors, therapists, SSA, etc.
D. Counties shall ensure that AND-SO disability navigation services are offered by people with an appropriate level of expertise and who are not disqualified or suspended from acting as a representative with the SSA and are not prohibited by any law from acting as a representative. Expertise can be demonstrated by at least one of the following:
1. Being an attorney licensed in Colorado or licensed to appear in any U.S. federal court, in good standing;
2. Obtaining or having SSI/SSDI Outreach, Access, and Recovery (SOAR) certification;
3. Receiving adequate training by a licensed attorney or SOAR certified person and having submitted at least ten applications to the SSA in the past year; or
4. Other certifications or experience approved by the state department in writing or electronically.

9 CCR 2503-5-3.540

37 CR 13, July 10, 2014, effective 8/1/2014
37 CR 17, September 10, 2014, effective 10/1/2014
38 CR 04, February 25, 2015, effective 3/20/2015
38 CR 04, February 25, 2015, effective 4/1/2015
38 CR 09, May 10, 2015, effective 6/1/2015
38 CR 15, August 10, 2015, effective 9/1/2015
38 CR 23, December 10, 2015, effective 1/1/2016
39 CR 17, September 10, 2016, effective 10/1/2016
40 CR 03, February 10, 2017, effective 2/14/2017
41 CR 05, March 10, 2018, effective 4/1/2018
41 CR 15, August 10, 2018, effective 9/1/2018
41 CR 19, October 10, 2018, effective 11/1/2018
42 CR 01, January 10, 2019, effective 2/1/2019
43 CR 01, January 10, 2020, effective 1/1/2020
43 CR 03, February 10, 2020, effective 3/1/2020
43 CR 11, June 10, 2020, effective 7/1/2020
43 CR 23, December 10, 2020, effective 1/1/2021
44 CR 03, February 10, 2021, effective 3/2/2021
44 CR 13, July 10, 2021, effective 8/1/2021
45 CR 03, February 10, 2022, effective 3/2/2022
45 CR 05, March 10, 2022, effective 4/1/2022
45 CR 13, July 10, 2022, effective 7/1/2022
45 CR 15, August 10, 2022, effective 8/10/2022
45 CR 15, August 10, 2022, effective 8/30/2022
46 CR 01, January 10, 2023, effective 12/10/2022
46 CR 01, January 10, 2023, effective 1/1/2023
46 CR 03, February 10, 2022, effective 3/2/2023