9 Colo. Code Regs. § 2503-5-3.550
Current through Register Vol. 47, No. 22, November 25, 2024
Section 9 CCR 2503-5-3.550 - FINANCIAL REDETERMINATIONA. A redetermination of eligibility shall mean a case review/determination of necessary information and verifications to determine ongoing eligibility every twelve (12) to twenty-four (24) months for OAP and at least every twelve (12) months for AND. The eligibility period for OAP shall be determined by the statewide automated system based on the following factors: 1. OAP cases shall be redetermined, at a minimum, every twenty-four (24) months when: a. There is no earned income; and,b. The value of the client's countable resources are at least two hundred dollars ($200) under the client's resource limit, as defined in Section 3.520.72.A.2. All other OAP cases shall be redetermined every twelve (12) months, at a minimum.B. Clients shall file their redetermination with the county department by the fifteenth (15th) of the month as specified in the redetermination packet.1. A client's failure to file a redetermination timely may delay the determination of benefits and grant payments.2. The county department must make an eligibility decision on complete, timely-received forms on or before the last day of the month in which the forms were due.3. Complete forms received between the 16th and the last day of the month the redetermination is due must be approved or denied as soon as possible. The county department will have ten (10) days to act on such redeterminations, to include scheduling and conducting the interview and requesting any necessary verification. The county must make an eligibility decision on redetermination forms received between the 16th and last day of the month within thirty (30) days from receipt of such redetermination.C. The county department shall schedule and conduct an interview with the client at each redetermination. 1. The client shall be offered an in-person interview.2. If the client does not elect an in-person interview, the county shall schedule a phone interview.3. The client shall be provided written notice at least four (4) days in advance of the scheduled interview. The client may provide a written or verbal waiver that written notice of the scheduled interview is not necessary when the county department is able to conduct the interview during redetermination processing. Written notice shall include: a. The date and time for the interview;b. Identification of any documentation that may be needed; andc. The opportunity to reschedule the appointment or make other arrangements in the event of good cause.4. When the client does not keep the interview appointment and does not request an alternate time or arrangement, as described in Section 3.520.4.C, grant payments will be discontinued following the policies outlined in Section 3.554.D. To redetermine eligibility a case review must be conducted and necessary verification must be received to determine ongoing eligibility.1. If the client is approved and is receiving SSI benefits and has no other earned or unearned income, the income and resources received through the Federal State Data Exchange (SDX) or the Federal State Verification Eligibility System (SVES) interface shall be considered verified upon receipt. a. The county department shall review non-financial eligibility and verify any changes; and,b. If the county department has obtained or received information related to income, resources, or non-financial eligibility requirements that is contrary to the SDX or SVES interfaces, the county department shall independently verify the information; and,c. The county department shall forward such contrary information to the local Social Security Administration office.2. During the redetermination process and prior to eligibility determination, the county worker shall: b. Explain the purpose of the interview and the use of the information supplied by the client on the redetermination form and any additional required forms;c. Inform the client in writing that Social Security Numbers will be used to request and exchange information with other agencies as part of the eligibility process, including the Department of Labor and Employment (State wage and unemployment data), and the Social Security Administration;d. Have the client complete the form(s) or provide assistance to the client in completing the form(s);e. Explain the appeal rights to the client as outlined in Section 3.587;f. Witness the signature of the client and sign as a person who helped complete the form(s), when applicable;g. Review documents, verifications, and any other information supplied by the client with the client in order to obtain clarification if needed;h. Request updated verifications for income, resources, and non-financial eligibility requirements which have changed. This may include, but is not limited to: 1) Newly declared, such as a new vehicle;2) Previously declared, such as a change in marital status; and,3) Changes from the previous redetermination, such as closure of a bank account.E. Any time while receiving Adult Financial program grant payments, if there is questionable information regarding the circumstances of a household or the county department receives information about changes in a household's circumstances but cannot determine the effect of those changes on grant payments, the county worker can request a contact. The county department shall send a request for contact notice requesting the client attend an interview appointment. The interview should be in-person unless good cause applies which would allow for a phone interview in lieu of the in-person interview. If the client does not attend the interview appointment or request an alternate time or arrangement, as specified in Section 3.520.4.C, the case shall be discontinued. The county department shall make a request for contact when: 1. It receives information that would contradict eligibility or that is questionable; or,2. It suspects possible fraud; or,3. It receives direction to do so from the State Department; or,4. It is otherwise reasonable to do so under the prudent person principle.F. Forms that the client is required to complete shall be mailed to the client at least thirty (30) calendar days prior to the first of the month in which the eligibility redetermination is due. This is considered the prior notice period. A review of the case record will indicate the forms required based on individual case circumstances. Mail-out redeterminations shall be conducted as follows: 1. A redetermination form shall be mailed to the client;2. Form(s) shall be completed, signed by the client, and returned to the county department no later than redetermination due date; and,3. When the client is unable to complete the form(s) due to physical, mental, or emotional disabilities, and has no one to help, the county department shall assist the client to complete the form(s), unless there is another available legal or other resource that is willing and able to assist the client.4. When the client is unable to complete the redetermination packet in a timely manner due to good cause, the county department shall extend the due date up to thirty (30) calendar days. The assistance or referral action of the county department shall be recorded in the case record.G. When the county department receives the completed redetermination packet, it shall: 1. Date stamp the redetermination form(s) and corresponding verification.2. Thoroughly review the redetermination packet for completeness, accuracy, and consistency. All factors shall be evaluated as to their effect on eligibility and payment. a. If the client failed to sign the redetermination packet, the redetermination packet shall be returned to the client for signature with instructions to return the signed packet before the end of the client's eligibility period. An unsigned redetermination packet shall be considered incomplete and shall not be processed by the county department.b. If the redetermination packet is incomplete, the county department shall ask additional clarifying questions and request all necessary verification.3. Review the Redetermination packet for changes to: a. Non-financial eligibility requirements, as outlined in Section 3.520.6; and,b. Resources, as outlined in Section 3.520.72; and,c. Income, as outlined in Section 3.520.78.4. Document verifications in the case file, utilizing the process described in Section 3.520.4.D . The case file shall be used as a checklist in the redetermination process, and shall be used to keep track of matters requiring further action. When additional information is needed: a. Due to incomplete form(s) or lack of verification, a notice shall be mailed to the client. The notice shall specify the items that are required for a redetermination to be completed in order to determine eligibility and/or payment;b. Due to inaccurate or inconsistent data, the client may be contacted by telephone or be requested to make an office visit, to secure the proper information. Collateral contacts and interfaces shall be used to gather information whenever possible.H. If the redetermination form is timely received but is incomplete, a correction notice shall be sent to the client advising the client that the redetermination form is incomplete and must be corrected by the last day of the month in which the forms were due to avoid termination and/or the county department shall work with the client to complete the form.I. When the information provided on the redetermination form, or otherwise provided by the client, is the basis for reduction in the amount of assistance or in termination of assistance follow the policies outlined in Section 3.554.37 CR 13, July 10, 2014, effective 8/1/201437 CR 17, September 10, 2014, effective 10/1/201438 CR 04, February 25, 2015, effective 3/20/201538 CR 04, February 25, 2015, effective 4/1/201538 CR 09, May 10, 2015, effective 6/1/201538 CR 15, August 10, 2015, effective 9/1/201538 CR 23, December 10, 2015, effective 1/1/201639 CR 17, September 10, 2016, effective 10/1/201640 CR 03, February 10, 2017, effective 2/14/201741 CR 05, March 10, 2018, effective 4/1/201841 CR 15, August 10, 2018, effective 9/1/201841 CR 19, October 10, 2018, effective 11/1/201842 CR 01, January 10, 2019, effective 2/1/201943 CR 01, January 10, 2020, effective 1/1/202043 CR 03, February 10, 2020, effective 3/1/202043 CR 11, June 10, 2020, effective 7/1/202043 CR 23, December 10, 2020, effective 1/1/202144 CR 03, February 10, 2021, effective 3/2/202144 CR 13, July 10, 2021, effective 8/1/202145 CR 03, February 10, 2022, effective 3/2/202245 CR 05, March 10, 2022, effective 4/1/202245 CR 13, July 10, 2022, effective 7/1/202245 CR 15, August 10, 2022, effective 8/10/202245 CR 15, August 10, 2022, effective 8/30/202246 CR 01, January 10, 2023, effective 12/10/202246 CR 01, January 10, 2023, effective 1/1/202346 CR 03, February 10, 2022, effective 3/2/2023