A.
Confidentiality
The Department of Health and Human Services must, by Federal
and State rules, provide for the basic rights and dignity of all applicants or
recipients of financial services regarding their confidentiality. The
Department must ensure that information about the recipient is maintained in a
confidential manner and only released under certain circumstances. All
employees of the Department must adhere to this policy.
The Address Confidentiality Program, administered by the
Secretary of State, provides address confidentiality for victims of domestic
violence, stalking, or sexual assault and requires state and local agencies and
the courts to accept a designated address as the program Participant's address
when creating a public record. When an Applicant or Participant verifies that
they are a certified participant in the Address Confidentiality Program, the
designated address is the only address accepted and provided when staff is
required to release information
Information requested from outside the Department shall be
released by permission, subpoena, or for program administration limited to
programs, which establish eligibility and provide services through agencies
subject to comparable standards of confidentiality. Information may be
released, or obtained, inside the Department when it is directly related to the
administration of the HOPE Program and/or when information reported to the HOPE
Program does not match information previously documented and currently being
used to determine eligibility for another program administered by the
Department.
B.
Application Process and Decisions
(1)
Application Process
a) An application must contain the
Applicant's full name, mailing address, and manual or electronic signature. The
application date is the date the paper or electronic document is received by
the Department.
b) Missing
documentation and verification will be requested in writing. Applicants will
have twelve (12) days from the date of the letter to provide requested
information to the Department. Failure to provide requested verifications
within this timeframe will result in denial of the application. Applicants
denied enrollment in the HOPE program for failure to provide verifications will
have the decision reconsidered without a new application if the verifications
are provided prior to the last day of the month following the month of
denial.
c) Appeals of Department
denials of applications must be filed within thirty (30) days of the date of
the Department's written decision.
d) Completed applications must be received by
the Department within six (6) months of the intended start date of the
remedial, Training, or Education Program, or at any time during
matriculation.
e) After receipt of
an Application, the Department will request additional documentation from the
Applicant in order to make a determination that the Training or Education
Institution or Program is approved, when the Institution or Program is - an
online program, a program without an Adequate Job Outlook, at an institution
located outside of Maine, or at a for-profit entity.
f) Applicants who possess a bachelor's degree
must include, with their application, a written letter petitioning the
Department for a determination that the degree is not marketable in Maine, or
with their current circumstances. An application lacking this petition will be
denied.
g) When the HOPE Program is
at maximum enrollment, new applications received will be denied. Applicants
denied due to maximum enrollment must indicate their desire to be put on
waitlist. The decision will be reconsidered without a new application if a
program position is available prior to the last day of the month following the
month of denial and the applicant requested to be added to the waitlist.
A waitlist for Applicants deemed otherwise eligible for the
Program will be maintained by the Department and will follow these
guidelines:
i. The waitlist will not
exceed ten percent (10%) of maximum HOPE Program enrollment; and
ii. Applications will be processed first,
from the waitlist, based on the date the application document is received. In
the event that two (2) or more applications are received on the same day,
Applicants with the shortest pathway to completion of their Training or
Education Program will be processed first.
iii. An Applicant will remain on the waitlist
until the last day of the month following the month of denial
h) Program enrollment begins with
the first calendar day of the month eligibility is approved by the
Department.
(2)
Application Decisions
The Department will issue a written decision within thirty
(30) days of receiving a completed application. If the decision is to deny the
application, the notice of decision will state the reasons for the denial and
notify the individual of their right to appeal the decision. Appeals will be
processed pursuant to subsection (H) of this section.
C.
Maintaining
Enrollment
(1)
Enrollment
Period
Program enrollment will continue through the last day of the
last month during which the Participant is matriculated in their Training or
Education Program provided the Participant remains eligible or does not
voluntarily withdraw. Individuals graduating from a Training or Education
Program will be eligible for HOPE through the last day of the month of
graduation. For Participants matriculated in an associate or bachelor's degree
program, HOPE Program enrollment will continue if there is a summer break in
classes, provided Participants are eligible and are registered for classes for
the fall semester. The Enrollment Period may be extended for one month at a
time if there is a finding of Good Cause per (3) below.
(2)
Change Reporting
Changes in any eligibility factor expected to last thirty
(30) days or more, or HOPE funded services expected to last fourteen (14) days
or more, must be reported to the Department within ten (10) days of the
Participant being aware of the change. Verification requirements for changes
will be the same as verification requirements during the application
process.
EXCEPTION:Participants must notify the
Department within five (5) days of the date that it becomes known that there is
a Temporary Absence from Home, where a child in the Family Unit will be absent
from the home for 45 days or longer.
NOTE:The Department will request verifications
and render decisions on reported changes consistent with the Application
Process in Section 7(B)(2) for eligibility changes, or the Services process in
Section 7(D) for changes in services.
(3)
Good Cause
A finding of Good Cause allows the Applicant or Participant
to temporarily suspend compliance with HOPE rules and policies for an expected
period of no more than one calendar month. An Applicant or Participant's right
to claim Good Cause will not be limited. Good Cause is the following:
a) Illness of the Applicant or Participant or
the Applicant or Participant's child who resides in the Applicant or
Participant's home and requires the Applicant or Participant to provide their
care; or
b) Court-required
appearance or incarceration; or
c)
Incident or effect of domestic violence; or
d) A crisis, special circumstance, or other
reason beyond the individual's control that causes an Applicant or Participant
to suspend compliance with HOPE rules and policies.
e) For the purpose of extending the HOPE
Enrollment Period, a credential requirement not being offered within the
previously defined Enrollment Period would also constitute Good Cause. (E.g. a
Participant graduates May 10
th, but an exam
necessary to acquire the related credential is not offered until mid-June.)
NOTE: Applicants or Participants may request a
Good Cause determination at the time they report a circumstance or within ten
(10) days of receiving adverse notice. Verifications will be requested, and
decisions rendered by the Department, consistent with the application process
in Section 7(B).
D.
Services
The Department pays the least expensive Support Service that
is accessible for the Participant and is of acceptable quality as determined by
the Department. The amount for Support Service benefits will be limited.
Specific caps for Support Services are included in their descriptions in
Section 4(B). Unused portions of Supports with an annual limit do not carry
over to the next calendar year.
(1)
Eligibility for Support Services
Support Services are paid subject to HOPE Program enrollment.
Students must remain actively engaged in approved education activities for
Support Service benefits to be issued.
(2)
Process for Requesting Support
Services
Requests for Support Services must be made directly to the
Department through telephone, fax, email or mailed communication. A request may
originate from a Participant, or from a Navigator on behalf of a
Participant.
Authorization to pay or reimburse an expense must be obtained
from the Department prior to the Participant incurring the expense.
Missing documentation and verification will be requested in
writing. Participants will have 12 days from the date of the request to provide
such documents or verification to the Department. Failure to provide requested
verifications within this timeframe will result in denial of the Support
Service.
(3)
Authorization of Support Services
Support Services may be authorized, but not necessarily
issued, for a twelve (12) -month period. The HOPE Program will not reimburse a
Participant for an expense paid by another funding source, and the Participant
must disclose all sources of aid.
Authorization of HOPE Program Support Services will follow
these guidelines:
a) All actual
expenses must be verified. Participants are required to provide receipts to the
Department within ten (10) days of funds being issued. If receipts are not
provided for issued payments within the timeframe allowed, or the amounts on
the receipts are less than the Support Service benefit, or the purchase does
not match what was authorized, an overpayment will be processed per Subsection
(F) of this section.
b) The
Department will issue payment or reimbursement for supports directly to a
provider. When payments cannot be made directly to a provider, the Department
will finalize payment to a Participant via EBT or check.
c) Participants seeking reimbursement for
actual expenses paid for supports have the responsibility of requesting
reimbursement within thirty (30) days of purchase to be considered an unmet
need.
E.
Verifications
Verification related to income, assets, Training or
Education, and HOPE funded services is required by HOPE. Applicants and
Participants have the primary responsibility of providing verifications.
Applicants, receiving assistance under other DHHS-OFI Programs, requesting
information on file be used for a HOPE Program determination may be asked to
provide updated verification needed prior to the eligibility determination.
Documents may be photocopied or sent electronically.
Missing documentation and verification will be requested in
writing of the Applicant or Participant. Applicants and Participants will have
twelve (12) days from the date of the request to provide such documents or
verification to the Department. Failure to provide requested verifications
within this timeframe will result in denial of the application or payment of
support, and/or removal from the program. HOPE requires the following
verifications:
(1)
Non-financial
Eligibility
a) Pregnant Person:
Pregnancy must be verified by a medical statement that includes the expected
date of birth.
b) Working Age:
Proof of age may include a valid driver's license, a State identification card,
or an official document showing birth date.
c) Maine Resident: Proof of Maine residency
may include a valid State of Maine driver's license or identification card, a
current residential lease agreement or mortgage document, a W-2 document not
more than 18 months old, or a current utility bill in the Applicant or
Participant's name.
d) U.S.
Citizen: If not already verified by the Systemic Alien Verification for
Entitlements (SAVES) Program, proof of a qualifying alien status may include a
United States Immigration and Customs Enforcement (USCIS) document verifying
identity, alien number, and status.
e) Social Security Number: All adult members
of the Family Unit reporting income must provide a SSN or proof of application
for a SSN.
f) Aptitude: Proof of
aptitude is acceptance to the Training or Education Program except for those
matriculated in for-profit institutions or lacking aptitude for reasons other
than lacking training or education.
i. For
those attending programs at for-profit institutions, proof of aptitude
includes:
a. Current grades earned in the
Training or Education Program; or
b. Prior certifications or previous
postsecondary course work completed within the past 24 months; or
c. Verification of standardized adult student
assessment scores within the past 24 months as recognized by Maine Department
of Education; or
d. Letters of
recommendation from Training or Education Institutions or employers written
within the past twelve months; or
e. Verification of access to appropriate
accommodations for disclosed physical or cognitive disability; or
ii. In situations where the
Department is notified that even with training or education the individual
would not meet the standards required by the professional licensing or
regulatory board for the individual's chosen industry, proof of aptitude
includes an employer's statement or documentation from a professional licensing
entity that a waiver has been granted or showing training or education is the
only barrier to employability within the desired industry that cannot be
overcome with reasonable accommodations.
g) Lack of a marketable Bachelor's Degree:
Proof that no currently held bachelor's degree is marketable may include:
i. copies of Maine licensing requirements for
qualified individuals in the specified professional area as outlined by the
Maine Office of Professional and Occupational Regulation,
ii. an employer statement,
iii. determination from worker's compensation
board, or
iv. medical records
supplied by a licensed medical or behavioral health provider.
h) Training or Education
Institution
i. Eligible Institution: Proof of
acceptable institutions may include a statement from the Navigator, proof of
accreditation from a regional or national accrediting body recognized by the
U.S. Department of Education as providing quality education per standards
equivalent to those most currently in effect, used by, and published on the
website of the New England Commission of Higher Education (NECHE), (A link to
these standards can be found at
https://www.maine.gov/dhhs/ofi/programs-services/hope/do-i-qualify5.)
, a state licensing board, or an industry trade association's
website.
ii. Matriculated Status:
Proof of acceptance and matriculation may include an acceptance letter with
intended start date, a conditional acceptance letter, proof of registration,
unofficial transcript with declared major and anticipated date of graduation,
attendance record, or grades from the Training or Education Program.
i) Training or Education Program
i. Cost-Effective: Proof that demonstrates
lower total costs to the Department and the Applicant or Participant includes,
but is not limited to: scholarship/financial aid awards from the institution;
unofficial transcript showing successful completion of previous postsecondary
coursework; school documents that show improved access to required courses,
clinical placements, or internships; and/or documents that demonstrate improved
access to, accommodations for a verified physical or cognitive disability, or
necessary supports.
ii. Need for,
and Participation in, Remedial Coursework: Proof of required remedial
coursework includes, but is not limited to, letters as provided by the
institutions outlining the mandated remedial services as a condition of
matriculation in a particular program of study and remedial course
descriptions, and/or attendance records from remedial course
providers.
iii. Acceptability of
Baccalaureate Program: Proof of an acceptable program includes school documents
identifying the Applicant or Participant's declared major.
iv. Acceptability of programs that lead to a
universally recognized and accepted credential that is not considered to lead
to a job with an Adequate Job Outlook: Proof of an acceptable program includes,
but is not limited to, an employer's statement showing wages, demand and
employability within the desired industry; a bona fide job offer contingent
upon securing the credential; or documentation from a workforce development
entity indicating a labor market shortage in the specified industry.
v. Acceptability of a Career Pathway:
a. Proof that the combination of training and
education aligns with the skill needs of employers within the individual's
geographic region and trade of choice including, but not limited to:
1. CWRI or O*NET data showing that these
skills are needed by employers; or
2. A statement from an employer within the
individual's geographic region and trade of choice that these skills or
credentials align with the needs within the region and trade and would lead to
increased employability or wages; or
3. A statement from an approved Training or
Education Institution or employer within the individual's geographic region and
trade of choice detailing how the combination of these skills or credentials
lead to a final outcome acceptable under (1) or (2) above.
and
b. Proof that the
intended career would result in a Substantial Improvement in Earnings and
Benefits including but not limited to:
1. CWRI
adjusted median wage information,
2. Paystubs from a current employer and a
statement from a current or potential employer showing the new credential will
result in a substantial increase in total compensation,
3. Statements from child care or other
providers showing a substantial decrease in work related or family related
expenses,
4. Verification of
decreased mileage for commutes to work and other work related or family related
services related to the credential, or
5. Government data showing substantial
improvement to the Social Determinants of Health for the individual or their
minor child(ren).
vi. Acceptability of programs exclusively
online: Proof of an acceptable program includes, proof of the educational
institution providing a local Maine contact support person and one or more of
the following:
a. An employer's statement;
or
b. an unofficial transcript
showing successful completion of previous postsecondary coursework;
or
c. documentation demonstrating
prior experience in the field of study; or
d. medical records supplied by a licensed
medical or behavior health provider verifying a medical condition of the
individual or their minor child that would prohibit them from attending
in-person classes; or
e. school
documents that show improved access to required courses; or
f. documents that demonstrate improved access
to accommodations for a verified physical or cognitive disability or necessary
supports.
j)
Satisfactory Progress: Proof of satisfactory progress may include unofficial
transcript, proof of registration, or attendance record or grades from the
Training or Education Program.
(2)
Financial Eligibility
Applicants and Participants have the responsibility of
providing verification of income and assets. Some examples of acceptable
verifications for income include, but are not limited to, pay stubs, signed
statement from an employer, award letters, worker's compensation records,
General Assistance records, Beneficiary and Earnings Data Exchange (BENDEX),
State Data Exchange (SDX), or support and alimony payments evidenced by court
order, divorce or separation papers, check copies, income tax records, or
self-employment records.
(3)
Support Services
a) Tuition and
Fees: Proof of unmet need for outstanding tuition and fees that prevent a
Participant from matriculating, re-matriculating, or transferring credits must
be supplied to the Department. This proof may include a school invoice that
includes a statement of locked credits. Participants requesting support for
tuition and fees must provide a current invoice and financial aid award letter
from the Training or Education Institution. If either the outstanding tuition
balance or the current tuition owed exceeds the HOPE limits, the Participant
must verify their ability to pay the remaining unpaid balance before the
Department will release funds.
b)
Child Care: A completed DHHS child care packet must be supplied to the
Department. The requested provider must pass a background check if unlicensed.
If BMV records show the need, the provider will sign a form acknowledging they
will not drive with children.
c)
Transportation: Proof of the need for transportation supports must be supplied
to the Department. This proof may include a copy of the Participant's course
schedule, receipts for travel expenses, and mileage calculations.
d) Books, Supplies, Tools, Equipment, home
access to Technology or Software, and cost-effective Internet Access: Proof of
the need for required items must be supplied to the Department. This proof may
include a copy of the training or class schedule, a course description, a copy
of the course syllabus, or a letter from the instructor or institution stating
the item(s) is/are required of all students and is/are not supplied or
available through the institution. Proof of unmet need for the item(s)
includes-
i. Proof that the Participant has no
financial aid to cover this expense such as a financial aid award letter or
evidence of no financial aid; and
ii. An itemized copy of one or more of the
following:
a. an estimate,
b. receipts showing proof of purchase,
or
c. receipts showing payment of a
bill.
e)
Vehicle Inspection, Registration, and Repairs: Proof of necessary repairs from
a licensed mechanic validating the need must be supplied to the Department.
When a repair is required to pass inspection, the mechanic must supply a
statement that the repair will lead to a valid inspection. If the cost of the
request exceeds the HOPE limit, the Participant must verify their ability to
pay the remaining balance before the Department will release funds. The
Participant must provide a copy of their proof of current vehicle registration
(except when the support request is for payment of vehicle registration), valid
Maine driver's license, and proof of current liability insurance
coverage.
f) Vehicle Insurance:
Proof of an estimate or receipt from the insurance provider must be supplied to
the Department along with a copy of the Participant's current Maine driver's
license, current registration, and a copy of the insurance declaration
page.
g) Corrective Eyewear: Proof
of cost of the eyewear must be submitted to the Department prior to the eyewear
being ordered. This proof may include an estimate from the eyewear
vendor.
h) Dental Care: Proof from
the dental provider verifying the cost and the need for the service must be
submitted to the Department prior to the work being performed.
i) Other Supports: Proof of the need and
necessity of the support to matriculate or remain matriculated in the Training
or Education Program must be submitted to the Department. This proof may
include a statement from the Navigator or Training or Education
Institution.
(4)
Questionable Items
Any other factors relevant to the HOPE Program eligibility or
the authorization of Supports will need to be verified if the Department deems
them questionable.
a) Factors will be
considered questionable if:
i. The Department
has received a community complaint in contradiction to circumstances as
attested to by the Applicant or Participant; or
ii. The circumstances vary greatly from those
previously known to the Department; or
iii. The circumstances as attested to by the
Applicant or Participant are not consistent with those publicly known or that
could reasonably be assumed.
b) Questionable items can be verified through
the least restrictive and reasonable method available to the Applicant or
Participant.
i. Preference will be given to
documentary evidence such as bank statements or tenant agreements.
ii. Third party attestations are acceptable
if:
a. Other documentary evidence is not
readily accessible; and
b. The
individual providing the attestation is a non-relative who can reasonably be
assumed to know the circumstances.
Third party attestations can be written or verbal.
F.
Overpayments
Program Participants will be responsible and accountable for
the appropriate use of Support Service benefits paid. Individuals are
responsible for repaying any overpaid benefits regardless of whether the
overpayment was the result of an error on the part of the agency, the
Participant or a Family Unit member; or an act by the Participant or Family
Unit member with the intent of supports being overpaid.
The Department will notify the Participant, in writing, of
the potential overpayment. This notice will state the potential overpayment
amount, the details of the potential overpayment, and will allow the
Participant twelve (12) calendar days from the date of the notice to respond to
the Department. When a Participant does not respond to the notice, the
overpayment information will be referred to the Department's FIRU. FIRU will
determine the final overpayment amount and establish the method for
recoupment.
When a Participant responds with updated verification that
resolves the overpayment claim a written notice will be issued to the
Participant stating the overpayment has been resolved. When a Participant
responds to the potential overpayment notice with a claim of Good Cause for
failure to submit receipts for Support Service payments issued directly to
them, the Good Cause decision will be determined by the Department. The
Participant will be notified in writing of the decision on the claim of Good
Cause.
If an overpayment is made directly to a provider who misled
or misrepresented the volume or amount of services provided or fees, the
overpayment will be referred to the FIRU for further action and will not be
imposed on the program Participant.
If a Participant withdraws or otherwise ceases attending
their Training or Education Program during an academic period without Good
Cause or without receiving a refund, the Department may establish an
overpayment for the amount of the tuition paid and will follow the overpayment
process regardless of the individual's enrollment status with the HOPE
Program.
G.
Intentional Program Violations (IPV)
When the Department determines that an Applicant or
Participant took an action with the intention of receiving HOPE Program
supports for which they knowingly were not eligible or spent support payments
in a way that was not authorized, the Applicant or Participant will be referred
to FIRU to decide if an IPV hearing is warranted.
The Department's FIRU must review the evidence that is
provided to determine if an allegation that an Applicant or Participant has
committed an IPV requires further action. When documentary evidence
substantiates the allegation, an Administrative Disqualifications Hearing (ADH)
is initiated by FIRU. The ADH procedures will follow the regulations set forth
in the Maine Administrative Procedure Act, 5 MRSA §§ 8051 -10004. A
guide to Administrative Hearings Regulations is available through the Office of
Administrative Hearings. (https://www.maine.gov/dhhs/about-us/administrative-hearings6)
A HOPE Program Applicant or Participant who has been found to
have committed an IPV will be disqualified from the HOPE Program for the
following time periods: one year for the first violation; two years for the
second violation; and permanently for the third violation. The Disqualification
penalties imposed under the IPV affect the individual's HOPE eligibility and
has no effect on HOPE eligibility of others in the Family Unit.
H.
Appeals and
Administrative Hearings
(1) HOPE
Program decisions may be appealed by Applicants or Participants, in writing; or
via telephone, fax or email within thirty (30) calendar days of the date of the
HOPE written decision or Final Informal Review decision. Appeals are made to,
or sent to, the HOPE Program Manager.
(2) The Applicant or Participant can request
either an Informal Review or an Administrative Hearing.
(3) Informal Review
Once the request is received by the Department, the
Department has ten (10) days to communicate with the Applicant or Participant
and gather facts related to the appeal.
The Applicant or Participant has the responsibility of
submitting verification of statements made to dispute a decision and will have
twelve (12) days from the date of the request to provide such
information.
The HOPE Program Manager or designee shall notify the
Applicant or Participant, in writing, of the decision made as a result of the
Informal Review.
If the Applicant or Participant disagrees with the results of
the informal review, they may request an Administrative Hearing.
(4) Administrative Hearing
The hearing will be held in conformity with the Maine
Administrative Procedure Act, 5 M.R.S. §8001 et
seq. and the Department's Administrative Hearings Regulations.
The hearing will be conducted at a time, date and place
convenient to the parties and at the discretion of the Office of Administrative
Hearings, and a preliminary notice will be given at least ten (10) calendar
days from the mailing date. In scheduling a hearing, there may be instances
where the hearing officer shall schedule the hearing at a location near the
Applicant or Participant or by telephone.
The Department and Applicant or Participant may be
represented by others, including legal counsel, and may have witnesses appear
on their behalf.
An impartial official will conduct the hearing.
The decisions, rendered by the hearing authority, in the name
of the Maine Department of Health and Human Services will be binding upon the
Department, unless the Commissioner directs the hearing officer to make a
proposed decision reserving the final decision-making authorization to the
Commissioner.
Any Applicant or Participant who is dissatisfied with the
hearing authority's decision has the right to judicial review under Maine Rules
of Civil Procedure, Rule 80C.
If the disputed decision involves suspension or termination
of HOPE services which have been previously granted, and the Participant
requests an Administrative Hearing within ten (10) days of the decision, HOPE
services will continue pending outcome of the Administrative hearing. In cases
where the Hearing decision rules in favor of the Department, the Department may
seek recoupment for the Support Services paid on behalf of the
Participant.
5 Individuals unable to access
this link may request the information from the HOPE Program by mailing a
request to DHHS OFI-HOPE Program, 11 State House Station, Augusta, ME 04333;
calling (207) 624-4170; faxing a request to (207) 287-3455; or e-mailing a
request to HOPE.DHHS@maine.gov
6 Individuals unable to access
this link may request the information from the HOPE Program by mailing a
request to DHHS OFI-HOPE Program, 11 State House Station, Augusta, ME 04333;
calling (207) 624-4170; faxing a request to (207) 287-3455; or e-mailing a
request to HOPE.DHHS@maine.gov
