Okla. Admin. Code § 340:65-3-4

Current through Vol. 42, No. 6, December 2, 2024

Section 340:65-3-4 - Investigation of eligibility conditions and services planning

The worker is responsible for collecting information necessary to determine the client's benefit eligibility and address the client's social service needs. When proof is necessary to determine eligibility, the worker uses sources described in this Section.

(1)Home visits. Home visits are sometimes necessary for Adult and Family Services (AFS) staff to provide services and benefits and promote safety and stability for families. Workers plan all home visits with the client in advance.

(A) AFS staff makes home visits or other client contacts during normal work hours whenever possible. Home visits may occur outside of normal business hours when the client's needs dictate and a supervisor, field manager, or field manager's designee approves the home visit.

(B) The AFS worker makes a home visit when:

(i) he or she is unable to obtain necessary documentation from other sources;

(ii) a face-to-face interview is required and an office visit creates a hardship for the household;

(iii) a Temporary Assistance for Needy Families (TANF) benefit closes due to failure to cooperate, per Oklahoma Administrative Code (OAC) 340:10-2-2;

(iv) it is the best method to complete or review the TANF employability plan;

(v) the client needs protective services; or

(vi) the worker deems it necessary for another reason and the supervisor concurs.

(2)Collateral contact. A collateral contact is a person outside of the household that confirms the household's circumstances. The collateral contact may occur in person or over the phone.

(A) A collateral contact is not restricted to a particular person, but may be anyone able to provide an accurate third party confirmation of the household's circumstances. Examples of acceptable collateral contacts are:

(i) employers;

(ii) agencies, businesses, or community action groups;

(iii) migrant service agencies;

(iv) the household's neighbors;

(v) landlords; or

(vi) other persons outside of the household with knowledge of the household's circumstances.

(B) The client's signature on the application or renewal authorizes the worker to secure the required information or verification from collateral contacts. When the collateral contact requires additional written authorization before supplying information to Oklahoma Human Services (OKDHS) the client or the affected adult household member signs Form 08AD060E, Request for Release of Information, to give authorization.

(C) The worker informs the person contacted for information how OKDHS plans to use the requested information and why OKDHS needs it.

(i) When the collateral contact requests anonymity, the worker does not record the person's name in the case record or reveal the person's name to the client.

(ii) When the collateral contact requests anonymity, the worker may not use information obtained from the collateral contact to reduce or close benefits unless the worker is able to verify the information by another source.

(D) When the collateral contact provides information related to the client's eligibility that conflicts with information the client provides, the worker gives the client the opportunity to resolve the inconsistency.

(3)Public records. The worker may obtain information from public records that affects the person's eligibility without obtaining the person's consent.

(4)Data exchange. Automated data exchange provides household members' benefit status, wages, income, taxes, Social Security numbers, incarceration status, current address, and death information to OKDHS. Data matches allow eligibility staff to consult this information when making an eligibility decision during an application or renewal or to identify unreported changes. Refer to OAC 340:65-1-2 for information regarding practices for safeguarding case information and raw tax data. The worker:

(A) reviews data exchange information at application and eligibility renewal. Available data exchange information screens include:

(i) Beneficiary and Earnings Data Exchange System (BENDEX);

(ii) Buy-In Data Exchange (BIL);

(iii) New Hire Employee lists (including the State New Hire (SNH) and National New Hire (NNH) list;

(iv) Social Security Administration (SSA) Death Master File Data Exchange (DOD);

(v) SSA Prisoner Data Exchange (PRS);

(vi) Social Security Number (SSN) Verification - SSN Enumeration;

(vii) Supplemental Security Income (SSI)/State Data Exchange System (SDX);

(viii) Unemployment compensation (UIB);

(ix) Unearned Income Eligibility Verification System (IEVS) income report (IEVS-IRS) and resource data from the Internal Revenue Service (IRS); and

(x) Wage Data Exchange; and

(B) initiates appropriate queries; and

(C) resolves data exchange discrepancy messages within:

(i) "verified upon receipt" processing timeframes;

(ii) the unclear information timeframes per 340:50-9-5(i) for Supplemental Nutrition Assistance Program (SNAP) cases; and

(iii) 45-calendar days of the date on the data exchange inquiry screen.

(5)Systematic Alien Verification for Entitlement (SAVE). All applicants and recipients of the TANF, SoonerCare (Medicaid), SNAP, Low Income Home Energy Assistance Program, State Supplemental Payment, 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 USCIS Alien Status Verification Index (ASVI).

(6)Workers' compensation. AFS staff reviews copies of all Workers' Compensation Commission documents by matching SSNs with OKDHS records. Any court action that appears to potentially impact eligibility is forwarded to the applicable OKDHS office for clearance.

(7)Birth verification. For persons born in Oklahoma, OKDHS has an agreement with the Oklahoma State Department of Health to electronically verify birth for persons with an open SoonerCare (Medicaid) benefit.

(8)Food stamp disqualification (FSD). When a client 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.

(9)Asset Verification System (AVS). Per Section 1396w of Title 42 of the United States Code, an applicant or recipient, a spouse, if applicable, a parent or guardian, or other person whose resources or assets OKDHS must verify for Soonercare (Medicaid) for a person who relates to the aged, blind, or disabled (ABD) categories must authorize OKDHS to access their financial assets and resources through an AVS.

(A) Before entering a person's information into AVS, the worker obtains a signed authorization using Form 08MP001E, Rights, Responsibilities, and Signature for Benefits, an online application, or Form 08MA014E, Asset Verification System Authorization, before entering a person's information into AVS.

(B) When asking for an AVS authorization, the worker explains the authorization remains effective until:

(i) OKDHS denies or closes the ABD Soonercare (Medicaid) application; or

(ii) the signer notifies OKDHS in writing that the signer wishes to revoke the authorization.

(C) When a person who must sign refuses, the worker denies or closes the ABD Soonercare (Medicaid).

Okla. Admin. Code § 340:65-3-4

Amended at 9 Ok Reg 97, eff 10-17-91 (emergency); Amended at 9 Ok Reg 2755, eff 7-13-92; Amended at 10 Ok Reg 1147, eff 3-9-93 (emergency); Amended at 10 Ok Reg 2303, eff 6-11-93; Amended at 10 Ok Reg 4347, eff 7-19-93 (emergency); Amended at 11 Ok Reg 1687, eff 5-12-94; Amended at 14 Ok Reg 3112, eff 7-1-97 (emergency); Amended at 15 Ok Reg 179, eff 11-1-97 (emergency); Amended at 15 Ok Reg 1644, eff 5-11-98; Amended at 18 Ok Reg 2096, eff 7-1-01; Amended at 20 Ok Reg 2059, eff 7-1-03; Amended at 22 Ok Reg 827, eff 5-12-05; Amended at 24 Ok Reg 1042, eff 6-1-07; Amended at 26 Ok Reg 1272, eff 6-1-09; Amended at 28 Ok Reg 880, eff 6-1-11; Amended at 29 Ok Reg 812, eff 7-1-12

Amended by Oklahoma Register, Volume 33, Issue 24, September 1, 2016, eff. 9/15/2016

Amended by Oklahoma Register, Volume 38, Issue 24, September 1, 2021, eff. 9/15/2021

Amended by Oklahoma Register, Volume 41, Issue 23, August 15, 2024, eff. 9/16/2024