Okla. Admin. Code § 340:65-3-5

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

Section 340:65-3-5 - Application process

The worker certifies or denies applications received online or in Oklahoma Human Services (OKDHS) offices within time limits specified in (1) of this Section.

(1)Application processing time limits. OKDHS workers process applications within program specific time limits. Refer to Oklahoma Administrative Code (OAC) 340:65-3-2.1, when the time limit's last day occurs on a day OKDHS is not open for business. The time limits are:

(A) Temporary Assistance for Needy Families (TANF) - 30-calendar days;

(B) Title IV-E Foster Care - 30-calendar days;

(C) Supplemental Nutrition Assistance Program - 30-calendar days unless the household is eligible for expedited service. When the household is eligible for expedited service, OKDHS workers must complete the application within seven-calendar days, per OAC 340:50-11-1;

(D) State Supplemental Payment (SSP) for persons:

(i) categorically related to Aid to the Aged - 30-calendar days; and

(ii) categorically related to Aid to the Blind or Disabled - 60-calendar days; and

(E) SoonerCare (Medicaid) benefits for:

(i) persons categorically related to Aid to the Aged - 30-calendar days;

(ii) persons categorically related to Aid to the Blind or Disabled - 60-calendar days;

(iii) Optional Tuberculosis (TB) Coverage group - 45-calendar days; and

(iv) persons requesting long-term care services - 45-calendar days; and

(F) TANF Emergency Assistance - five -working days;

(G) Low Income Home Energy Assistance Program, per OAC 340:20-1-14:

(i) 60-calendar days of the application date for winter heating and summer cooling; or

(ii) no later than 18 hours of the application date for an Energy Crisis Assistance Program (ECAP) application involving a life-threatening medical situation or 48 hours for all other ECAP applications; and

(H) Refugee Medical Assistance - 30-calendar days;

(I) Child Care subsidy benefits - two-business days from the interview date and required proof is provided or, when not provided, within 30-calendar days; and

(J) Diversion Assistance - seven-working days.

(2)Delayed applications. When it is not possible to process the application timely, the worker sends the applicant Form 08MP038E, Client Notice of Action Taken, to inform the applicant of the reason for the delay and the applicant's hearing rights. An application is not denied when it cannot be processed timely due to:

(A) the applicant's failure or delay in providing needed information because of circumstances beyond the applicant's control;

(B) an examining physician's failure or delay in supplying needed information;

(C) the Social Security Administration's failure or delay in making a disability decision; or

(D) the worker's failure to take timely action.

(3)Certification for cash assistance. When TANF eligibility is established for the application month, certification is effective from the application date and benefits are prorated per (5) of this Section. When SSP eligibility is established for the application month, certification is effective from the first day of the month and the SSP is not prorated.

(A) When a TANF applicant requests benefits for an additional person after the application date, but before certification, the worker approves benefits for the additional person effective on the same date as the rest of the assistance unit.

(B) When a TANF recipient requests benefits for an additional person after certification, the recipient must complete a new application before adding the additional person to the TANF benefit. When eligible, the worker prorates benefits for the additional person from the application date per (5) of this Section.

(C) A retroactive payment may be authorized for any month the worker establishes eligibility prior to the current month. An application denied in error must have payment authorized for the period eligibility is established.

(D) A certification is valid even when a month of ineligibility is determined between application and the date the certification action is taken. An applicant who is ineligible for the month of application and eligible for a subsequent month is certified effective the first day of the subsequent month.

(4)Notice of ineligibility. When an applicant is ineligible, a computer-generated denial notice is sent to the applicant explaining the reason. The applicant may request a fair hearing within the time period specified in the notice.

(5)Proration of TANF benefits. When eligible, the worker certifies a TANF application from the application date and prorates the initial month's benefit, unless the applicant applied on the first day of the month or received a TANF benefit for the previous month and is eligible to be reopened, per OAC 340:65-5-6. Proration also applies for the first month the worker adds an additional person to an open TANF cash assistance benefit. The family is eligible for the full TANF benefit effective the following month, when applicable.

(A) The worker refers to OKDHS Appendix C-1, Maximum Income, Resource, and Payment Standards, Schedule IX to determine the full monthly TANF benefit before computing the prorated benefit.

(B) The worker uses Appendix B, Prorated TANF and Food Benefit Payment, to compute the prorated benefit amount or the formula: 31 - application date x full monthly TANF benefit, 30 = the prorated payment. The prorated payment is rounded down to the lower dollar amount.

(i) When the prorated benefit is less than $10, the family is not eligible for a money payment, but is eligible for SoonerCare (Medicaid) benefits for the entire month.

(ii) When the worker certifies food benefits in the TANF case at the same time or after the TANF certification for the month the TANF payment is prorated, the food benefit unearned income shows the TANF benefit before proration.

(iii) The computer-generated client notice shows the benefit amount for the initial month and following month.

Okla. Admin. Code § 340:65-3-5

Amended at 10 Ok Reg 471, eff 11-30-92 (emergency); Amended at 10 Ok Reg 2343, eff 6-11-93; Amended at 10 Ok Reg 4465, eff 8-5-93 (emergency); Amended at 11 Ok Reg 1347, eff 3-14-94 (emergency); Amended at 11 Ok Reg 4363, eff 7-8-94 (emergency); Amended at 11 Ok Reg 4501, eff 8-1-94 through 7-14-95 (emergency); Amended at 13 Ok Reg 353, eff 12-11-95; Amended at 14 Ok Reg 2412, eff 5-1-97 (emergency); Amended at 15 Ok Reg 1644, eff 5-11-98; Amended at 15 Ok Reg 3546, eff 7-1-98 (emergency); Amended at 16 Ok Reg 1019, eff 4-26-99; Amended at 18 Ok Reg 2096, eff 7-1-01; Amended at 19 Ok Reg 1918, eff 4-29-02 (emergency); Amended at 20 Ok Reg 300, eff 1-1-03 (emergency); Amended at 20 Ok Reg 918, eff 6-1-03; Amended at 26 Ok Reg 1272, eff 6-1-09; Amended at 28 Ok Reg 880, eff 6-1-11; Amended at 30 Ok Reg 689, eff 6-1-13

Amended by Oklahoma Register, Volume 34, Issue 24, September 1, 2017, eff. 9/15/2017

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

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

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