Okla. Admin. Code § 340:60-1-6

Current through Vol. 42, No. 7, December 16, 2024

Section 340:60-1-6 - Program eligibility and procedures

(a)Refugee Resettlement Program components. The federal Office of Refugee Resettlement provides funding to states for time-limited cash and medical assistance and resettlement case management and support services for new arrivals to the United States (U.S.) who meet refugee status, per Oklahoma Administrative Code (OAC) 340:60-1-3.

(1) A contracted service provider is responsible for providing resettlement case management and support services to newly arriving refugees and asylees in Oklahoma.

(2) Oklahoma Human Services (OKDHS) is responsible for determining financial eligibility for refugee medical benefits (RMA), and a contracted provider determines financial eligibility for refugee cash assistance (RCA) throughout Oklahoma. Refer to Appendix C-9, Refugee Resettlement Program Benefit and Service Providers, to determine which contracted provider serves a specific county.

(b)Refugee support services. Refugee support services are provided for up to five-calendar years after the arrival date by OKDHS-contracted providers, per Sections 400.147 through 155 of Title 45 of the Code of Federal Regulations (45 C.F.R. §§ 400.147 through 155). Support services promote economic self-sufficiency through employability services, English language instruction, and social adjustment services.

(c)Cash assistance. Refugees and asylees must be afforded an opportunity to apply for cash assistance, per 45 C.F.R. § 400.50. Eligibility is determined according to Temporary Assistance for Needy Families (TANF) or State Supplement Payment (SSP) program rules. When the refugee or asylee does not meet TANF or SSP cash assistance eligibility requirements, an RCA application is made. When the refugee or asylee is 65 years of age and older, blind, or disabled, the refugee is referred to the Social Security Administration to apply for Supplemental Security Income.

(1)Eligibility requirements for RCA. RCA eligibility requirements are included in (A) through (H) of this paragraph, per 45 C.F.R. §§ 400.25, 400.53, 400.54, 400.59, 400.75 through 400.79, and 400.81 through 400.83.

(A)Limited eligibility period. A refugee or asylee may only receive RCA for the first 12-calendar months the refugee resides in the U.S.

(B)Refugee documentation and status requirements. Refugees and asylees must meet documentation and status requirements, per OAC 340:60-1-3.

(C)Residence requirement. The refugee or asylee must be an Oklahoma resident and not receiving cash assistance in another state. There is no durational requirement. OKDHS and contracted service providers accept the refugee's or asylee's statement that the refugee or aslyee resides in Oklahoma unless it is inconsistent with other known facts.

(D)Student status. A refugee or asylee must not be a full-time student in a higher education institution.

(E)Household composition. Household composition may consist of a family unit that includes:

(i) a single adult. Adults living alone or with other adults are considered as single or separate family units; or

(ii) an adult and the adult's spouse and all minor children, 17 years of age and younger, for whom the family assumes financial responsibility. Spouses living together must be considered in the same family unit.

(F)Income requirements. Maximum countable earned and unearned income for all family unit members must be less than the payment standard for the number of eligible members per Appendix C-1, Maximum Income, Resource, and Payment Standards, Schedule XIV.A. When income is reduced due to overpayment or garnishment recoupment, the gross income before recoupment or garnishment is counted.

(i)Reporting requirements. Family unit members are responsible for reporting all income at application and within 10-calendar days of when:

(I) a family unit member begins employment or starts receiving unearned income; or

(II) the income source, amount, or dates received changes.

(ii)Earned income. Earned income is income a family unit member receives in the form of wages, salary, commission, in-kind benefits received in lieu of wages or in conjunction with wages from an employer, or self-employment for which a person puts forth physical labor. In kind benefits are earned income only when an employee and employer relationship is established.

(I) Earned income is not counted against the payment standard for the first six months of the 12-month eligibility period.

(II) When the person works for an employer, gross earnings for the fifth-calendar month are determined by averaging gross earnings for the most recent 30-calendar day period and converting the earnings to a monthly amount. Gross earnings from an employer are counted dollar-for-dollar against the payment standard.

(III) When the person is self-employed, gross earnings for the fifth-calendar month are determined by averaging income over the number of months the business was in operation and subtracting verified business expenses.

(iii)Unearned income. Income other than earned income is unearned income.

All unearned income received during a month is counted dollar-for-dollar against the payment standard unless disregarded per (iv) of this subparagraph. Unearned income includes, but is not limited to:

(I) dividends and interest;

(II) cash contributions;

(III) retirement, disability, or unemployment benefits;

(IV) worker's compensation;

(V) child support or alimony; or

(VI) rental income.

(iv)Income disregards. Income disregarded when determining income eligibility includes:

(I) earnings received during the first six-calendar months of the refugee's arrival in the U.S.;

(II) benefits received through a cooperative agreement, such as U.S. Department of Justice or U.S. Department of State - Reception and Placement benefits;

(III) loans;

(IV) money received from the sale of personal property, unless it is self-employment income;

(V) income received by someone living in the home who is not included in the family unit;

(VI) tax refunds;

(VII) gifts;

(VIII) lump sum inheritances or insurance payments;

(IX) Supplemental Nutrition Assistance Program food benefits;

(X) a child's earnings, provided the child is younger than 18 years of age and is a full-time student;

(XI) housing and utility assistance;

(XII) income or resources remaining in the country of origin; or

(XIII) matching grant benefits from a resettlement agency.

(v)Verification requirements. Income is verified at application, when a family unit member begins employment or starts receiving unearned income, and as changes occur. The verification process must be explained to the refugee or asylee at application and as new verification is needed, including what verification must be submitted by a certain date.

Assistance in obtaining the required verification must be offered, when needed.

(I) Earned income may be verified by paystubs, an employer statement, or, when self-employed, business records. Self-employed persons must provide expense receipts before business expenses are subtracted from earnings. In-kind benefits' cash value is verified by an employer statement.

(II) Unearned income may be verified by an award letter, a written letter from or verbal contact with the person or agency providing the income, a check stub or a copy of a check, a court order, financial institution statements, or data exchange screens, per OAC 340:65-3-4.

(III) When the family unit fails to provide required verification or fails to ask for assistance to obtain verification, the application may be denied or cash assistance closed.

(G)Resource requirements. Refer to Appendix C-1, Schedule XIV.A(B) for the maximum allowable resource amount per family unit. Countable resources refer to real and personal property that have a monetary value and are available or can be converted to cash for current use. Home property and personal items essential to day-to-day living, such as clothing, furniture, and other similar items of limited value are excluded as resources. Countable resources include, but are not limited to:

(i) cash on hand;

(ii) savings in a financial institution;

(iii) stocks and bonds; or

(iv) equity in an automobile or other vehicles that exceeds $5,000.

(H)Requirement to complete and participate in an employment plan. Non-exempt household members must complete and participate in an employment plan the refugee and the refugee support service provider develop. The employment plan lists an employment goal, barriers to be addressed, and pathways to remove the barriers to meet the employment goal.

(i) Participation in an employment plan includes:

(I) registering with the refugee support service provider providing employment services;

(II) going to a job interview the refugee support service provider arranges;

(III) accepting at any time, from any source, an offer of employment that the refugee support service provider determines to be appropriate; and

(IV) participating in any employability service program that provides job or language training in the area where the refugee resides.

(ii) Household members that meet criteria in (I) through (VIII) of this unit are exempt from the requirement to complete and participate in an employment plan. To be exempt, the household member must be:

(I) younger than 16 years of age or 65 years of age and older;

(II) younger than 18 years of age and a full-time student;

(III) 18 years of age and a full-time student in secondary school or in a technical or trade school at an equivalent level with reasonable expectations to complete the program before the person turns 19 years of age;

(IV) mentally or physically incapacitated. The refugee must provide medical documentation verifying that the incapacity is serious enough to prevent participation in employment services;

(V) caring for another household member with a mental or physical impairment that requires care in the home on a substantially continuous basis and no other appropriate household member is available;

(VI) a parent or relative caretaker of a child younger than one year of age when the person provides full-time care of the child. Only one parent or caretaker relative may be exempt in a household for this reason;

(VII) working 30 hours per week in unsubsidized employment; or

(VIII) pregnant with a due date within the next six-calendar months based on medical verification.

(iii) The refugee support service provider follows criteria in (I) through (IX) of this unit when assisting a refugee with a job placement.

(I) The assignment must be within the scope of the person's employment plan.

(II) The refugee or asylee must be able to meet the job requirements.

(III) Commuting time to and from work may not exceed a total of two hours.

(IV) The assigned work site must not be in violation of applicable federal, state, or local health and safety standards.

(V) Work assignments must not be made on a discriminatory basis.

(VI) Work assignments may be temporary, part-time, full-time, or seasonal.

(VII) The earned wage must meet federal or state minimum wage laws or not be substantially less than the wage normally paid for similar work.

(VIII) The total number of days and hours the person is expected to work must not exceed those customary to the occupation.

(IX) The refugee or asylee is not required to accept work when the position is available due to a strike, lockout, or other bona fide labor dispute or when the work is contrary to the refugee's or asylee's union membership.

(iv) RCA is closed for the entire household when a non-exempt household member without good cause:

(I) refuses to complete an employment plan;

(II) refuses or fails to participate in assigned activities included in the employment plan;

(III) refuses or fails to accept appropriate employment; or

(IV) voluntarily terminates employment.

(v) Examples of good cause may include, but are not limited to:

(I) when appropriate child care is not available;

(II) the illness or incapacity of the participant or any household member who cannot give self-care and for whom special care is unavailable;

(III) a court-required appearance or incarceration of the participant;

(IV) the participant's attendance at parent and teacher conferences;

(V) a family crisis or markedly changed individual or family circumstances;

(VI) the unavailability of planned transportation when needed or the inability to arrange for transportation;

(VII) inclement weather that prevented the participant, and other persons similarly situated, from traveling to, or participating in, the prescribed activity;

(VIII) the lack of necessary social services or work activity;

(IX) when the assignment or job referral does not meet the appropriate work activity;

(X) racial, ethnic, religious, sexual, physical or mental disability, or age discrimination or harassment by an employer or other employees; or

(XI) crisis intervention needed due to domestic violence issues.

(2)Incentive bonuses. Incentive bonuses are available to eligible individuals; however, the maximum total benefit amount, RCA plus incentive bonuses, that any family unit may receive is the payment standard amount times the 12-month eligibility period. When the maximum benefit amount is reached, the family unit is no longer eligible for RCA or incentive bonuses even when the family unit has been in the U.S. less than 12-calendar months.

(A)Early job acceptance bonus. When the refugee or asylee obtains employment within the first 150-calendar days of the U.S. arrival date, the refugee or asylee may be eligible to receive an early job acceptance bonus of up to $750 to assist the refugee with work-related expenses. To receive the bonus, the refugee or asylee must:

(i) request the bonus within 60-calendar days of the employment start date; and

(ii) submit proof of employment and a list of employment-related expenses necessary to successfully perform and maintain employment. Expenses may include, but are not limited to:

(I) a vehicle down payment;

(II) tools;

(III) uniforms;

(IV) driving lessons; or

(V) automobile insurance.

(B)Job retention bonus. A refugee or asylee may be eligible for a job retention bonus of up to $100 per person in the family unit when the refugee or asylee obtains employment within the first 150-calendar days of arriving in the U.S. and retains the employment through the end of the 10th-calendar month following arrival. To qualify for the bonus, the refugee or asylee must:

(i) not have received an RCA cash assistance payment for every month of the 10-month eligibility period;

(ii) submit proof the refugee or asylee retained employment through the end of the 10th-calendar month;

(iii) not re-apply for RCA following benefit closure based on earnings; and

(iv) request the job retention bonus within 60-calendar days from the end of the 10-month eligibility period.

(3)Benefit denial or closure. The family unit's application may be denied or benefits closed when the family unit does not:

(A) meet eligibility requirements per (c)(1) of this Section; or

(B) abide by program terms, such as failing to:

(i) provide required verification;

(ii) keep scheduled appointments; or

(iii) follow employment plans.

(4)Notice requirement. Written notice is sent or provided to a recipient at least 10-calendar days before the date RCA is reduced, suspended, or closed. The contracted provider sends or provides notices to refugees.

(5)Fair hearing requirement. RCA applicants and recipients may request a fair hearing when they disagree with an adverse action. The contracted provider conducts the fair hearings statewide.

(d)Medical assistance. Refugees and asylees must be afforded an opportunity to apply for medical assistance, per 45 C.F.R. § 400.93.

(1) The refugee's eligibility for SoonerCare (Medicaid) must be determined before approving a refugee or asylee for RMA. SoonerCare (Medicaid) eligibility is determined per OAC 317:35 rules.

(2) When the refugee or asylee is not eligible for SoonerCare (Medicaid), RMA eligibility is determined per (e) of this Section.

(3) When a refugee or asylee receiving SoonerCare (Medicaid) becomes ineligible because of earnings and has resided in the U.S. for less than 12-calendar months, the refugee or asylee is transferred to RMA for the remaining months.

(e)RMA. A refugee or asylee is not required to meet categorical relationship rules per OAC 317:35 for the first 12-calendar months from the date of entry into the U.S. Per 45 C.F.R. §§ 400.100 through 400.104, RMA eligibility requirements are listed in (1) through (5) of this subsection.

(1)Limited eligibility period. RMA is limited to the first 12-calendar months the refugee or asylee resides in the U.S. After the first 12-calendar months, the refugee or asylee is referred to the Oklahoma Health Care Authority's online enrollment process to apply for SoonerCare (Medicaid), and Medicaid rules, per OAC 317:35 apply.

(2)Refugee documentation and status requirements. Refugees and asylees must meet documentation and status requirements, per OAC 340:60-1-3.

(3)Student status. A refugee or asylee must not be a full-time student in a higher education institution unless OKDHS approves enrollment as part of the refugee's employability plan.

(4)RCA eligibility. All RCA recipients are eligible for RMA when not eligible for SoonerCare (Medicaid). However, the refugee or asylee is not required to apply for or receive RCA to qualify for RMA.

(5)Income and resource requirements. For RMA, only income and resources available on the application date are considered. Refer to OKDHS Appendix C-1, Schedule XIV for income standards per household size and the resource standard per family unit. No consideration is given to:

(A) in-kind services and shelter provided by a sponsor or a local resettlement agency;

(B) cash assistance payments; or

(C) earnings that start after RMA approval.

(f)Application processing time limit. RCA and RMA applications must be processed within 30-calendar days of the application date to be considered timely. When the application cannot be processed timely, the applicant is notified in writing of the reason for the delay and the right to request a fair hearing, per OAC 340:2-5.

(g)Food benefits. A food benefit application is completed at the same time as the RCA and RMA application and processed using food benefit eligibility rules, per OAC 340:50.

Okla. Admin. Code § 340:60-1-6

Amended at 10 Ok Reg 151, eff 6-25-92 (preemptive); Amended at 10 Ok Reg 103, eff 10-13-92 (emergency); Amended at 10 Ok Reg 2077, eff 5-27-93; Amended at 13 Ok Reg 461, eff 11-14-95 (emergency); Amended at 13 Ok Reg 3007, eff 7-11-96; Amended at 16 Ok Reg 1947, eff 6-11-99; Amended at 23 Ok Reg 1022, eff 6-1-06

Amended by Oklahoma Register, Volume 35, Issue 24, September 4, 2018, eff. 9/17/2018

Amended by Oklahoma Register, Volume 39, Issue 04, November 1, 2021, eff. 7/19/2021

Amended by Oklahoma Register, Volume 39, Issue 24, September 1, 2022, eff. 9/15/2022

Amended by Oklahoma Register, Volume 40, Issue 12, March 1, 2023, eff. 2/9/2023

Amended by Oklahoma Register, Volume 41, Issue 23, August 15, 2024, eff. 9/14/2024