Current through Register No. 40, October 3, 2024
(a) For all
categories of financial assistance:
(1) The
following documents shall be used to verify that a resource is legally
unavailable to the applicant or recipient, pursuant to
RSA
167:81, IV(e):
a. For irrevocable trust funds, the trust
instrument or agreement;
b. For
irrevocable burial funds, the bank account, agreement, trust instrument, or
similar document which clearly states that the burial funds are not legally
available to the individual; and
c.
For property in probate, written or verbal contact with the register of probate
in the appropriate county indicating that the property is currently in probate
and legally unavailable to the applicant or recipient or a letter from the
attorney handling the property indicating the property is legally unavailable
to the applicant or recipient;
(2) Acceptable verification of income tax
refunds or lump sum earned income tax credit payments shall be a copy of the
tax refund check or the applicant's or recipient's submitted tax
return;
(3) Acceptable verification
of the value of IRA and non-contractual Keogh accounts and penalty for early
withdrawal shall be a written statement from the financial institution where
the account was issued indicating the current balance in the account and
penalty for withdrawal of the entire amount in the account;
(4) Acceptable verification of the type of
Keogh account, such as contractual or non-contractual, shall be a written
statement from the individual's employer or the financial institution where the
account was issued indicating whether it involves a contractual relationship
with other individuals and if money can be withdrawn without affecting the
other individuals involved;
(5)
Acceptable verification of the face value of life insurance shall be:
a. The actual policy itself; or
b. Written or verbal contact with the
insurance company when the face value cannot be determined using the actual
policy;
(6) Acceptable
verification of the equity value of life insurance shall be determined by
written or verbal contact with the insurance company;
a. Using the cash value or non-forfeiture of
benefits table, if there is no loan on the policy; or
b. Written or verbal contact with the
insurance company, if there is a loan on the policy;
(7) Acceptable verification of lump sum death
benefits shall be a letter of award, written contact with the agency providing
the benefit or with the funeral director arranging for payment of the benefit,
or if written documentation cannot be furnished, department of health and human
services (DHHS) verbal contact with the agency or funeral director;
(8) Acceptable verification of resources
resulting from an accumulation of types of income which are excluded by federal
mandate shall be letters of award, written statements from the source providing
benefits, or, if written documentation cannot be furnished, DHHS verbal contact
with the source providing the benefits;
(9) Acceptable verification of stocks and
bonds shall be the market value of the stock or bond in the financial section
of a current newspaper or, if written documentation cannot be located, DHHS
verbal contact with a stock broker; and
(10) Good faith effort to sell a personal
property asset that cannot be readily converted to cash shall be newspaper
clippings or evidence of other means of advertising showing that the asset is
for sale at a price commensurate with the property's fair market
value.
(b) For
verification of resources for the FANF category of financial assistance the
following shall apply:
(1) For equity value
of a vehicle:
a. The fair market value of an
automobile or truck shall be verified by using the "trade-in value" in the most
recent edition of the NADA Official Used Car Guide, also known as the "Blue
Book";
b. The fair market value
shall not be increased because of special equipment for the handicapped, low
mileage, or optional equipment;
c.
If the applicant or recipient states that the fair market value in the Blue
Book does not apply to the vehicle because of body damage or other factors, the
individual shall present verification of the true fair market value of the
vehicle from an auto dealer or an individual who is engaged in a vehicle sales
or service business; and
d. If a
vehicle is custom made, too old, or too new to be included in the Blue Book,
the applicant or recipient shall verify its fair market value by:
1. Obtaining an appraisal from an automobile
dealer or an individual who is engaged in a vehicle sales or service
business;
2. Submitting a tax
assessment on the vehicle indicating its value; or
3. Submitting a newspaper advertisement which
indicates the amount for which like vehicles are being sold;
(2) The applicant's or
recipient's written statement shall be acceptable verification of the fact that
a vehicle is a junk vehicle, provided the statement gives an accurate and
complete description of the vehicle's condition; and
(3) Acceptable verification of the fact that
farm machinery and vehicles are necessary for subsistence, maintenance, or
employment shall be a written statement from the applicant or
recipient.
(c)
Acceptable verification of incurred unpaid medical expenses for adult category
financial assistance shall be bills which substantiate the amount of unpaid
medical expenses that the applicant or spouse have incurred and that the
applicant or spouse is still liable for the unpaid medical expenses.
(See Revision Note #1 at Chapter Heading He-W 600)
#5171, eff 6-26-91; ss by #5392, eff 5-11-92, EXPIRED: 5-11-98