CABINET FOR HEALTH AND FAMILY SERVICES

Department for Community Based Services

Division of Family Support

(Amendment)

 

      921 KAR 2:046. Adverse action; conditions.

 

      RELATES TO: KRS 205.010, 205.200, 205.245, 605.120(5), 42 U.S.C. 601-619

      STATUTORY AUTHORITY: KRS 194A.050(1), 205.200(2), 605.120(6)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 194A.050(1) requires the secretary to promulgate administrative regulations necessary to implement programs mandated by federal law or to qualify for the receipt of federal funds and necessary to cooperate with other state and federal agencies for the proper administration of the cabinet and its programs. KRS Chapter 205 requires the Cabinet for Health and Family Services to administer public assistance programs including the Kentucky Transitional Assistance Program (K-TAP)[or "K-TAP"] and mandatory and optional supplementation of persons who are aged, blind, and have a disability. KRS 205.200(2) requires the cabinet to promulgate administrative regulations concerning the conditions of eligibility for public assistance, in conformity with the Social Security Act, 42 U.S.C. 601-619 and federal regulations. KRS 605.120(6) requires the Cabinet for Health and Family Services to promulgate administrative regulations to establish uniform conditions and requirements for kinship care. This administrative regulation establishes the conditions under which an application is denied or assistance is decreased or discontinued and advance notice requirements.

 

      Section 1. Definitions. (1) "Applicant" means an individual applying for:

      (a) State Supplementation Program (SSP) benefits;

      (b) K-TAP benefits; or

      (c) Kinship Care Program benefits.

      (2) "Application" means the process set forth in:

      (a) 921 KAR 2:035 for K-TAP or SSP[State Supplementation Program]; or

      (b) 922 KAR 1:130 for Kinship Care Program.

      (3) "Recipient" means a:

      (a) Person who is aged, blind, or has a disability receiving SSP[State Supplementation Program] benefits;

      (b) Member of a K-TAP assistance group as defined in 921 KAR 2:016; or

      (c) Member of a Kinship Care Program assistance group as defined in 922 KAR 1:130.

 

      Section 2. Reasons for Adverse Action. (1) An application shall be denied if:

      (a) Income or resources exceed the standards for the specific assistance program as set forth in 921 KAR 2:016, 921 KAR 2:015, or 922 KAR 1:130;

      (b) The applicant does not meet technical eligibility criteria or fails to comply with a technical requirement as set forth in 921 KAR 2:006, 921 KAR 2:015, 921 KAR 2:370, or 922 KAR 1:130;

      (c) The applicant fails to provide sufficient information or clarify conflicting information necessary for a determination of eligibility despite receipt of written notice detailing the additional information needed for a determination;

      (d) The applicant fails to complete[keep the appointment for] an interview;

      (e) The applicant requests in writing voluntary withdrawal of application;

      (f) Department staff is unable to locate the applicant; or

      (g) The applicant is no longer domiciled in Kentucky.

      (2) Assistance shall be discontinued or decreased if:

      (a) Income or resources of the recipient increase or deductions decrease resulting in reduced or discontinued benefits as set forth in 921 KAR 2:016, 921 KAR 2:015, or 922 KAR 1:130;

      (b) The recipient does not meet technical eligibility criteria or fails to comply with a technical requirement as set forth in 921 KAR 2:006, 921 KAR 2:015, 921 KAR 2:370, or 922 KAR 1:130;

      (c) The recipient fails to provide sufficient information or clarify conflicting information necessary for a redetermination of eligibility despite receipt of written notice detailing the additional information needed for a redetermination;

      (d) The recipient fails to complete[keep the appointment for] an interview;

      (e) The cabinet is recovering K-TAP or Kinship Care Program overpayments through recoupment;

      (f) Department staff is unable to locate recipient;

      (g) The recipient is no longer domiciled in Kentucky; or

      (h) Change in program policy adversely affects the recipient.

 

      Section 3. Notification of Denial of an Application. (1) If an application is denied, the applicant shall be given a notice of such action[form as follows:

      (a) KIM-105-Adult MA for a State Supplementation Program recipient;

      (b) KIM-105-KC for a Kinship Care applicant; or

      (c) KIM-105-KTAP for a K-TAP applicant who does not concurrently apply for the Supplemental Nutrition Assistance Program (SNAP)].

      (2) The notice pursuant to[A form listed in] subsection (1) of this section shall include:

      (a) The reason for the denial;

      (b) Citation of the applicable state administrative regulation; and

      (c) Information regarding:

      1. The opportunity to confer with the worker; and

      2. The right to a fair hearing as provided by 921 KAR 2:055.

 

      Section 4. Advance Notice of a Decrease or Discontinuance. (1) The recipient shall be given ten (10) days advance notice of the proposed action if a change in circumstances indicates:

      (a) A money payment shall be:

      1. Reduced;

      2. Suspended; or

      3. Discontinued; or

      (b) An individual shall be removed from the K-TAP or Kinship Care Program grant, even if the grant increases.

      (2) The ten (10) days advance notice of the proposed action shall:

      (a) Be given in accordance with[on a form listed in] Section 3[(1)] of this administrative regulation;

      (b) Explain the reason for the proposed action;

      (c) Cite the applicable state administrative regulation; and

      (d) Extend the opportunity to confer with the worker or to request a fair hearing pursuant to 921 KAR 2:055.

      (3) A hearing request received during the advance notice period may result in delay of the decrease or discontinuance pending the hearing officer's decision, as provided in 921 KAR 2:055.

 

      Section 5. Exceptions to the Advance Notice Requirement. An advance notice of proposed action shall not be required, but written notice of action taken shall be given[on a form listed] in accordance with Section 3[(1)] of this administrative regulation, if:

      (1) A decrease or discontinuance results from:

      (a) Information reported by the recipient, if the recipient signs a waiver of the notice requirement indicating understanding of the consequences;

      (b) A clear written statement, signed by a recipient that the recipient no longer wishes to receive assistance from the department;

      (c) Factual information received by the department that the:

      1. State supplementation recipient has died; or

      2. K-TAP payee has died and a new payee is unavailable;

      (d) Whereabouts of a recipient are unknown and mail addressed to the recipient is returned indicating no known forwarding address; however, a returned check shall be made available if whereabouts of the recipient becomes known during the payment period covered by the returned check;

      (e) Establishment by the agency that assistance has been accepted in another state;

      (f) Removal from the home of a K-TAP or Kinship Care Program child by judicial order or voluntary placement in foster care by his legal guardian;

      (g) The person who is aged, blind, or has a disability and is an SSP[a State Supplementation Program] recipient, enters a nursing facility resulting in vendor payment status;

      (h) The recipient enters a:

      1. Penal institution;

      2. Tuberculosis hospital, if under sixty-five (65); or

      3. Psychiatric hospital, if between twenty-one (21) and sixty-five (65); or

      (2) A recipient is granted a special allowance, or time limited assistance, that is terminated at the end of a specified period.

 

      [Section 6. Incorporation by Reference. (1) The following material is incorporated by reference:

      (a) "KIM-105-Adult MA", 11/13;

      (b) "KIM-105-KC", 11/13; and

      (c) "KIM-105-KTAP", 11/13.

      (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Community-Based Services, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m.]

 

TERESA C. JAMES, LCSW, Commissioner

AUDREY TAYSE HAYNES, Secretary

      APPROVED BY AGENCY: July 7, 2015

      FILED WITH LRC: July 9, 2015 at 11 a.m.

      PUBLIC HEARING AND PUBLIC COMMENT PERIOD: A public hearing on this administrative regulation shall, if requested, be held on August 21, 2015, at 9:00 a.m. in the Health Services Auditorium, Health Services Building, First Floor, 275 East Main Street, Frankfort, Kentucky. Individuals interested in attending this hearing shall notify this agency in writing by August 14, 2015, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. The hearing is open to the public. Any person who attends will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to attend the public hearing, you may submit written comments on the proposed administrative regulation. You may submit written comments regarding this proposed administrative regulation until August 31, 2015. Send written notification of intent to attend the public hearing or written comments on the proposed administrative regulation to:

      CONTACT PERSON: Tricia Orme, Office of Legal Services, 275 East Main Street 5 W-B, Frankfort, Kentucky 40601, phone 502-564-7905, fax 502-564-7573, email tricia.orme@ky.gov.

 

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT

 

Contact person: Elizabeth Caywood

      (1) Provide a brief summary of:

      (a) What this administrative regulation does: This administrative regulation establishes the conditions under which an application is denied or assistance is decreased or discontinued and advance notice requirements.

      (b) The necessity of this administrative regulation: This administrative regulation is necessary to establish notice requirements and the conditions under which an application is denied or benefits decreased or discontinued for an applicant or recipient of K-TAP, Kinship Care, or SSP.

      (c) How this administrative regulation conforms to the content of the authorizing statutes: This administrative regulation conforms to the content of the authorizing statutes by establishing the notice requirements and conditions for application denial or benefit decrease or discontinuance for an applicant or recipient of K-TAP, Kinship Care, or SSP.

      (d) How this administrative regulation currently assists or will assist in the effective administration of the statutes: The administrative regulation assists in the effective administration of the statutes by establishing the conditions under which an application is denied or assistance is decreased or discontinued and advance notice requirements.

      (2) If this is an amendment to an existing administrative regulation, provide a brief summary of:

      (a) How the amendment will change this existing administrative regulation: The amendment to this administrative regulation updates notice requirements with the new forthcoming web-based eligibility and enrollment system. Forms incorporated will be obsolete upon implementation of the new system. In addition, the amendment makes technical corrections in accordance with KRS Chapter 13A.

      (b) The necessity of the amendment to this administrative regulation: The amendment to this administrative regulation is necessary to align with the requirements of a new web-based enrollment and eligibility system. This system promises further programmatic modernization, greater efficiency in the eligibility determination process and ongoing case maintenance, and enhanced reporting and archiving functionalities.

      (c) How the amendment conforms to the content of the authorizing statutes: The amendment conforms to the content of the authorizing statutes through its update to notice requirements if public assistance benefits are denied, decreased, or discontinued.

      (d) How the amendment will assist in the effective administration of the statutes:    The amendment to this administrative regulation will assist in the effective administration of the statutes by assuring process and policy alignment, resource maximization, and programmatic accountability.

      (3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation: In March 2015, there were 20,590 K-TAP families, 4,687 Kinship Care recipients, and 2,893 State Supplementation recipients.

      (4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:

      (a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment: The amendment to this administrative regulation will require no new or additional action by applicants or recipients.

      (b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3): The amendment to this administrative regulation will create no new or additional cost to applicants or recipients.

      (c) As a result of compliance, what benefits will accrue to the entities identified in question (3): Regulated entities will benefit from the updates and clarity provided within the regulatory amendment and the enhanced programmatic efficiencies promised by the new web-based eligibility and enrollment system. The criteria and requirements for adverse actions have otherwise remained unchanged.

      (5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:

      (a) Initially: The amendment to this administrative regulation is technical and conforming in nature and is anticipated to impose no new or additional cost to the administrative body to implement.

      (b) On a continuing basis: The amendment to this administrative regulation is technical and conforming in nature and is anticipated to impose no new or additional ongoing costs to the administrative body to implement.

      (6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: Federal Temporary Assistance for Needy Families (TANF) Block Grant funds under Title IV-A of the Social Security Act and General Funds used to meet Maintenance of Effort requirements are the funding sources for both K-TAP and Kinship Care. General Funds are the source of funding for the State Supplementation Program (SSP).

      (7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment: An increase in fees or funding will not be necessary to implement this amendment.

      (8) State whether or not this administrative regulation established any fees or directly or indirectly increased any fees: This administrative regulation does not establish fees or directly or indirectly increase any fees.

      (9) TIERING: Is tiering applied? Tiering is not applied. This administrative regulation will be applied in a like manner statewide.

 

FEDERAL MANDATE ANALYSIS COMPARISON

 

      1. Federal statute or regulation constituting the federal mandate.

42 U.S.C. 601-619

      2. State compliance standards. KRS 194A.050(1), 205.200(2), 605.120(6)

      3. Minimum or uniform standards contained in the federal mandate. 42 U.S.C. 601-619

      4. Will this administrative regulation impose stricter requirements, or additional or different responsibilities or requirements, than those required by the federal mandate? This administrative regulation will impose no stricter requirements, or additional or different responsibilities or requirements, than those required by the federal mandate.

      5. Justification for the imposition of the stricter standard, or additional or different responsibilities or requirements. This administrative regulation will impose no stricter requirements, or additional or different responsibilities or requirements, than those required by the federal mandate.

 

FISCAL NOTE ON STATE OR LOCAL GOVERNMENT

 

      1. What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation? The Cabinet for Health and Family Services will be impacted by this administrative regulation.

      2. Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation. KRS 194A.050(1), 205.200(2), 605.120(6), 42 U.S.C. 601-619

      3. Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.

      (a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year? This administrative regulation will not generate revenue for state or local government during the first year.

      (b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years? This administrative regulation will not generate revenue for state or local government in subsequent years.

      (c) How much will it cost to administer this program for the first year? No new or additional costs are necessary to administer this program in the first year.

      (d) How much will it cost to administer this program for subsequent years? No new or additional costs are necessary to administer this program in any subsequent years.

      Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.

      Revenues (+/-):

      Expenditures (+/-):

      Other Explanation: