340:50-9-5 - Changes after application and during the certification period

340:50-9-5. Changes after application and during the certification period

(a) Change reporting requirements. Section 273.12 of Title 7 of the Code of Federal Regulations (7 C.F.R. § 273.12) contains change reporting requirements after application and during the certification period described in (a) through (i) of this Section.

(b) Applicant households. Applicant households must report all changes related to their food benefit eligibility and benefit amount. Households must report changes that occur after the interview but before the date of the notice of eligibility, within 10-calendar days of the date of the notice.

(c) Annual reporting households. Annual reporting households are households in which all adult members are elderly or disabled with no earned income.

(1) Certification period. A 24-month certification period is automatically assigned to annual reporting households. Annual reporting households must complete a mid-certification renewal between certification periods to report current household circumstances.

(2) Change reporting between renewal periods. Between the mid-certification renewal and certification renewal reporting months, the household must report gross income changes when the household's income exceeds the maximum gross income scale for household size shown on Form 08MP006E, Information for Benefit Renewal, and when the household wins substantial lottery or gambling winnings as defined, per 7 C.F.R. § 273.11(r) and Oklahoma Administrative Code (OAC) 340:50-7-1, within 10-calendar days of receipt of the first payment attributable to the change. The maximum gross income scale is based on 130 percent of the monthly poverty income guidelines.

(3) Action taken on reported changes. The worker must act on all changes reported by households.

(A) The computer system determines if the change results in an increase, decrease, or no change in benefits.

(B) Between the mid-certification renewal and certification renewal months, the changes the worker makes do not decrease or close benefits until the mid-certification renewal is due unless the:

(i) household's income increase exceeds the maximum gross income scale for household size shown on Form 08MP006E;

(ii) household requested benefit closure;

(iii) worker has information about the household's circumstances considered verified upon receipt, per (g) of this Section;

(iv) a household member is identified as a disqualified or ineligible person, per 7 C.F.R. § 273.12(a)(5)(vi) and OAC 340:50-5-10.1; or

(v) the worker verifies the household won substantial lottery or gambling winnings as defined, per 7 C.F.R. § 273.11(r) and OAC 340:50-7-1.

(C) The computer system applies all changes that increase benefits. Before entering a change that increases benefits, verification supporting the change must be provided, when required.

(d) Mid-certification renewal for annual reporting households. Annual reporting households are sent notification in the 11th month of certification that the mid-certification renewal is due. The notice explains methods the household may choose to complete the renewal and required verification needed. An interview is not required.

(1) When the mid-certification renewal is due. The household must complete the benefit renewal and provide required verification by the last day of the 12th month of certification.

(2) Completion of mid-certification renewal. The worker reviews benefit renewal information and verification provided to determine completeness and continued eligibility.

(A) When the renewal is complete and the household remains eligible, the worker acts on all reported changes and the computer system applies any increase or decrease in benefits.

(i) When the household fails to provide sufficient information regarding a deductible expense requiring verification, the worker processes the mid-certification renewal without regard to the deduction.

(ii) When benefits are decreased, an advance notice is sent, per the Oklahoma Department of Human Services (DHS) Appendix B-2, Deadlines for Case Actions.

(B) When the household is no longer eligible, the worker closes food benefits effective the next advance-notice deadline date, per DHS Appendix B-2.

(C) When the renewal is incomplete, the computer system closes food benefits effective the next advance-notice deadline date, per DHS Appendix B-2.

(3) When benefits may be reopened. Food benefits may be reopened following closure when criteria is met per (j) of this Section.

(e) Semi-annual reporting households. Food benefit households are considered semi-annual reporting households unless they meet criteria per (b) or (g) of this Section.

(1) Certification period. A 12-month certification period is automatically assigned to semi-annual reporting households.

(2) Change reporting between renewal periods. Between the mid-certification renewal and certification renewal reporting months, the household must report when:

(A) the household's gross income exceeds the maximum gross income scale for household size shown on Form 08MP006E and when the household wins substantial lottery or gambling winnings as defined, per 7 C.F.R. § 273.11(r) and OAC 340:50-7-1 within 10-calendar days of receiving the first payment attributable to the change. The maximum gross income scale is based on 130 percent of the monthly poverty income guidelines; and

(B) a decrease in work hours below an average of 20 hours per week or 80 hours per month occurs for any household member meeting the able-bodied adults without dependents (ABAWD) work rules, per OAC 340:50-5-100 by the 10th of the following month.

(3) Action taken on reported changes. The worker must act on all changes reported by households.

(A) The computer system determines if the change results in an increase, decrease, or in no change in benefits.

(B) Between mid-certification renewal and certification renewal months, the changes the worker makes do not decrease or close food benefits until the mid-certification renewal is due unless:

(i) the household's income increase exceeds the maximum gross income scale for household size shown on Form 08MP006E;

(ii) the household requested benefit closure;

(iii) the worker has information about the household's circumstances considered verified upon receipt, per (h) of this Section;

(iv) an ABAWD must be removed from the food benefit household because he or she does not meet the ABAWD work rule, per OAC 340:50-5-100;

(v) a household member is identified as a disqualified or ineligible person, per 7 C.F.R. § .27312(a)(5)(vi) and OAC 340:50-5-10.1;

(vi) a household member is identified as failing to meet work registration requirements, per OAC 340:50-5-85 through OAC 340:50-5-87; or

(vii) the worker verifies the household won substantial lottery or gambling winnings as defined, per 7 C.F.R. § 273.11(r) and OAC 340:50-7-1.

(C) The computer system applies all changes that increase benefits. Before entering a change that increases benefits, verification supporting the change must be provided, when required.

(f) Mid-certification renewal for semi-annual reporting households. Semi-annual reporting households are sent notification in the fifth month of certification that the mid-certification renewal is due. An interview is not required.

(1) When the mid-certification renewal is due. The household must complete the benefit renewal and provide required verification by the last day of the sixth month of certification.

(2) Completion of mid-certification renewal. The worker reviews benefit renewal information and verification provided to determine completeness and continued eligibility.

(A) When the renewal is complete and the household remains eligible, the worker acts on all reported changes and the computer system applies any increase or decrease in benefits.

(i) When the household fails to provide sufficient information regarding a deductible expense requiring verification, the worker processes the mid-certification renewal without regard to the deduction.

(ii) When benefits are decreased, the worker sends an advance notice, per DHS Appendix B-2, Deadlines for Case Actions, deadline dates.

(B) When the household is no longer eligible, the worker closes food benefits effective the next advance-notice deadline date, per DHS Appendix B-2.

(C) When the renewal is incomplete, the computer system closes food benefits effective the next advance-notice deadline date, per DHS Appendix B-2.

(3) When benefits may be reopened. Food benefits may be reopened following closure when criteria is met per (i) of this Section.

(g) Change reporting households. Change reporting households are assigned a certification period other than 12 or 24 months. These households are required to report changes within 10-calendar days of when the change occurred.

(1) Household characteristics. Households not approved for a 12- or 24-month certification period include households approved for:

(A) expedited services for one or two months because the interview and/or verification were postponed, per OAC 340:50-3-2; and

(B) a three- or four-month certification period because the household includes one or more ABAWDs that do not meet the work rule, per OAC 340:50-5-100.

(2) Required change reporting. These households must report changes in:

(A) sources of income;

(B) unearned income of $100 per month or more;

(C) earned income of more than $100 per month;

(D) household composition, such as an addition or loss of a household member;

(E) residence and shelter costs;

(F) the legal obligation to pay child support;

(G) the work hours of an ABAWD subject to benefit time limits, per OAC 340:50-5-100 when they fall below 20 hours per week; and

(H) resources when the household wins substantial lottery or gambling winnings as defined, per 7 C.F.R. § 273.11(r) and OAC 340:50-7-1.

(3) Action taken on case changes. The worker must act on changes reported by the household within 10-calendar days of the date the household reported the change and provided necessary verification.

(A) When the household fails to report a change within the 10-calendar day period and, as a result, receives benefits to which it is not entitled, an overpayment claim is referred to Adult and Family Services (AFS) Benefit Integrity and Recovery, per OAC 340:50-15.

(B) When the worker fails to take timely action on a reported change and benefits are lost, the worker supplements the household's food benefits.

(4) Changes that increase benefits. When the household reports a change that increases benefits the household must verify the information before the worker makes the change. The worker gives the household 10-calendar days to verify the information.

(5) Changes that decrease or close benefits. When the household reports a change in household circumstances that decreases or closes food benefits, the worker gives or sends the household Form 08AD092E, Client Contact and Information Request, giving the household 10-calendar days to provide verification of the change. When the household provides required verification, the worker reduces or closes food benefits based on the verification provided. When the household does not provide required verification, the worker closes the food benefits based on the household's failure or refusal to provide verification.

(A) When a household's benefit decreases or closes, an advance notice of adverse action is required unless exempt from such notice for a reason listed in (i) or (ii) of this subparagraph. Per 7 C.F.R. § 273.13, advance notice of adverse action is considered timely when the notice is mailed at least 10-calendar days before the action becomes effective. The household retains its right to a fair hearing and continuation of benefits when a fair hearing is requested within 10-calendar days of the change notice. An adverse action notice may be mailed just prior to the date the household receives or would have received benefits when the:

(i) DHS receives a clear written statement signed by a responsible household member:

(I) stating the household no longer wishes to receive food benefits; or

(II) giving information that requires closure or reduction of food benefits and stating that the household understands the food benefit will be reduced or closed; or

(ii) worker closes or reduces food benefits per notice requirements at (k)(3)(A) of this Section.

(B) When an advance notice is required, the benefit decrease or closure is effective the next advance notice deadline date, per DHS Appendix B-2. When the household reports a change:

(i) 10-calendar days or more before the advance-notice deadline, per DHS Appendix B-2, the worker decreases or closes the food benefit effective the first of the following month; or

(ii) less than 10-calendar days before the advance-notice deadline, per DHS Appendix B-2, the worker must take action before the advance-notice deadline the following month.

(C) When a reported change increases food benefits, the worker makes the change by the non-advance-notice deadline date, per DHS Appendix B-2.

(h) Changes considered verified upon receipt. Verified upon receipt means the information is not questionable and the provider is the primary source of the information. For example, when DHS receives Social Security and Supplemental Security Income verification through data exchange with the Social Security Administration (SSA), it is considered verified upon receipt because SSA is the primary source. When the worker receives information considered verified upon receipt, he or she makes the change within 10-calendar days of notification using DHS Appendix B-2 deadline dates.

(i) Required action on unclear information. During the certification period, the worker may obtain unclear information about a household's circumstances that may affect the household's continued eligibility or benefit amounts. The worker may receive the unclear information from a third party, such as a data exchange discrepancy, an employer, or a person claiming knowledge of the household's circumstances. Unclear information is information that is not verified or is verified but the worker needs additional information before acting on the change.

(1) Per 7 C.F.R. § 273.12(c)(3)(i), when the worker receives unclear information in a non-report month for semi-annual or annual reporting households or any month for change reporters, he or she sends Form 08AD092E to the household to verify its circumstances within 10-calendar days only when the unclear information:

(A) significantly conflicts with the information used at the time of the certification, indicating the household may have failed to report eligibility information at application; or

(B) is fewer than 60-calendar days old, relative to the current participation month and when true, must be reported under the household's reporting responsibilities.

(2) When the household provides the requested verification in a non-report month, the worker determines whether to take action, per requirements at (c)(3) and (e)(3) of this Section.

(3) When the worker sends Form 08AD092E, per (i)(1)(A) or (B) of this Section, and the household does not respond or responds but refuses to provide sufficient information to clarify its circumstances, the worker closes the household's food benefits effective the next advance-notice deadline date, per DHS Appendix B-2;

(4) Per 7 C.F. R. § 273.12(c)(3)(iii), when the worker receives a data match that indicates a household member may have died or may be incarcerated for more than 30-calendar days, the worker sends Form 08AD092E to the household notifying it of the discrepancy and requesting information regarding the household member.

(A) When the household is a change reporting household and:

(i) fails to respond to Form 08AD092E or responds but refuses to provide sufficient information to clarify the person's household status, the worker closes the household's food benefits;

(ii) responds and verifies the person is not dead or incarcerated, no action is taken; or

(iii) responds and confirms the accuracy of the data exchange information, the worker removes the person from the food benefit and determines if an overpayment referral is needed, per OAC 340:50-15.

(B) When the household is an annual or semi-annual reporting household and:

(i) fails to respond to Form 08AD092E or responds but refuses to provide sufficient information to clarify the person's household status, the worker removes the person and his or her income from the household and adjusts the food benefits;

(ii) responds and verifies that the person did not die or is not incarcerated, no action is taken; or

(iii) responds and confirms the accuracy of the data exchange information, the worker removes the person and his or her income from the household, adjusts the food benefits, and determines if an overpayment referral is needed, per OAC 340:50-15.

(j) When benefits may be reopened following closure. The food benefit may be reopened following closure using current eligibility information, when:

(1) DHS did not administer policy and procedures correctly. The food benefit is reopened effective the first day of the month of closure;

(2) the household fails to complete the mid-certification renewal timely, but provides all required verification by the first day of the month of closure. The food benefit is reopened effective the first day of the month of closure; or

(3) the household fails to complete the mid-certification renewal timely, but provides all required verification by the last day of the month of closure. The food benefit is reopened and prorated from the date the household completes the mid-certification renewal and provides all required verification.

(k) Notice requirements. DHS is required to send a notice to the household when food benefits increase, reduce, or close.

(1) Advance notice of adverse action required. Prior to reducing or closing food benefits during the certification period, per 7 C.F.R. § 273.13, the worker must provide timely advance notice unless circumstances described in (k)(2) or (3) of this Section occur.

(A) Advance notice of adverse action is considered timely when the notice is mailed at least 10-calendar days before the action becomes effective. Refer to DHS Appendix B-2 for advance notice processing deadlines.

(B) When the household reports a change:

(i) 10-calendar days or more before the advance notice of adverse action deadline, the worker decreases or closes the food benefit effective the first of the following month. For example, when the household reports a change on May 18th, the effective date of the change is June 1st; or

(ii) less than 10-calendar days before the advance notice of adverse action deadline, per DHS Appendix B-2, the worker decreases or closes the food benefit effective the first of the month after the following month. For example, when the household reports a change on May 25th, the effective date of the change action is July 1st.

(2) Notice requirement when benefits increase. When a reported change increases food benefits, the worker makes the change by the non-advance notice deadline date, per DHS Appendix B-2. When the change is reported after the non- advance notice deadline, the worker supplements food benefits.

(3) Advance notice of adverse action not required. Advance notice of adverse action is not required for actions (A) through (H) of this paragraph, per 7 C.F.R. § 273.12(e) and 7 C.F.R. § 273.13(b).

(A) Mass changes. When DHS initiates mass changes because of changes or requirements in federal or state law, the computer system closes benefits by the non-advance-notice deadline, per DHS Appendix B-2. In these situations, the individual notification requirement is waived and AFS mails generic notices to the affected households informing them of the changes that are about to be made.

(B) Deceased household members. When the worker determines, based on reliable information, that all members of the household are deceased, the worker closes benefits by the non-advance-notice deadline, per DHS Appendix B-2.

(C) Moved out of state. When the worker determines, based on reliable information, the household moved out of state, the worker closes benefits by the non-advance-notice deadline, per DHS Appendix B-2.

(D) Unfinished issuance certification. When the unfinished issuance process is used at certification, the worker adjusts the benefit to take into account changes anticipated at the time of certification. The certification notice informs the household of all benefit changes included in this process.

(E) Disqualified household member. When the only household member is disqualified for an intentional program violation or fraud, per OAC 340:50-15-25, food benefits are closed by the non-advance-notice deadline, per DHS Appendix B-2. When there is more than one person in the household, the remaining household members' benefits are reduced or closed because of that household member's disqualification by the non-advance-notice deadline, per DHS Appendix B-2.

(F) Facility loses approval. When a household's food benefit closes because the drug or alcohol treatment center or group home facility where the household resides is no longer approved, the worker closes benefits by the non-advance-notice deadline, per DHS Appendix B-2.

(G) Household provides written statement. The worker closes or reduces benefits by the non-advance-notice deadline, per DHS Appendix B-2, when the household provides a written statement:

(i) stating the household no longer wants to receive food benefits; or

(ii) requesting closure or reduction in food benefits to avoid or repay an overpayment.

(H) Case transfer. When the worker closes food benefits in one case in order to transfer the food benefits to another case without a decrease or disruption in benefits, the worker closes benefits by the non-advance-notice deadline, per DHS Appendix B-2.

(l) Action on changes when fair hearings are requested. When a household requests a fair hearing within 10-calendar days of the date shown on an adverse action notice, the worker must reopen or restore food benefits to the previous level pending the outcome of the hearing unless the household specifically waives continuation of benefits, per 7 § C.F.R. 273.15(k). Refer to OAC 340:2-5 for fair hearing procedures.

(Amended by Oklahoma Register, Volume 33, Issue 24, September 1, 2016, eff. 9/15/2016 Amended by Oklahoma Register, Volume 34, Issue 24, September 1, 2017, eff. 9/15/2017 Amended by Oklahoma Register, Volume 35, Issue 24, September 4, 2018, eff. 9/17/2018 Amended by Oklahoma Register, Volume 36, Issue 24, September 3, 2019, eff. 9/16/2019 Amended by Oklahoma Register, Volume 37, Issue 24, September 1, 2020, eff. 9/15/2020)

Amended at 9 Ok Reg 3843, eff 8-24-92 (emergency) ; Amended at 10 Ok Reg 1821, eff 5-13-93 ; Amended at 11 Ok Reg 345, eff 10-15-93 (emergency) ; Amended at 11 Ok Reg 2667, eff 6-13-94 ; Amended at 11 Ok Reg 4587, eff 9-1-94 (emergency) ; Amended at 12 Ok Reg 1723, eff 6-12-95 ; Amended at 14 Ok Reg 3416, eff 8-1-97 (emergency) ; Amended at 15 Ok Reg 1491, eff 4-1-98 (preemptive) ; Amended at 17 Ok Reg 473, eff 10-12-99 (preemptive) ; Amended at 19 Ok Reg 202, eff 12-1-01 (emergency) ; Amended at 19 Ok Reg 1767, eff 6-14-02 ; Amended at 20 Ok Reg 2924, eff 10-1-03 (emergency) ; Amended at 21 Ok Reg 244, eff 11-7-03 (emergency) ; Amended at 21 Ok Reg 841, eff 4-26-04 ; Amended at 21 Ok Reg 3166, eff 9-1-04 (emergency) ; Amended at 22 Ok Reg 805, eff 5-12-05 ; Amended at 22 Ok Reg 2767, eff 9-1-05 (emergency) ; Amended at 23 Ok Reg 1896, eff 7-1-06 ; Amended at 24 Ok Reg 1040, eff 6-1-07 ; Amended at 26 Ok Reg 1269, eff 6-1-09 ; Amended at 28 Ok Reg 850, eff 6-1-11 ; Amended at 29 Ok Reg 794, eff 7-1-12 ; Amended at 30 Ok Reg 679, eff 6-1-13

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