Current through Register Vol. 39, No. 6, September 16, 2024
(a) The Caseworker
shall explain that eligibility for the State/County Special Assistance Program
provides:
(1) a cash payment; and
(2) Medicaid as set forth in
42 C.F.R.
435.232 and
10A NCAC 23D .0102(2). Neither
42 U.S.C.
1382e,
20 C.F.R. 416.2001,
42 C.F.R.
435.232, nor
10A NCAC
23D .0102(2) shall apply to
the State/County Special Assistance In-Home Program nor to the State/County
Special Assistance for the Certain Disabled Program.
(b) The Caseworker shall explain the
eligibility requirements for the State/County Special Assistance Program and
the applicant's rights and responsibilities. The Caseworker shall inform the
applicant of the following:
(1) The applicant
shall provide the name of collateral sources of information such as landlords,
employers, and others who can substantiate or verify the applicant's
eligibility information.
(2) It is
the County Department's responsibility to use collateral sources to
substantiate or verify information necessary to establish eligibility.
Collateral sources of information include knowledgeable individuals, business
organizations, public records, and documentary evidence. If the applicant does
not wish the County Department to contact such collateral sources, he or she
may withdraw the application. If the applicant denies permission for the County
Department to contact such collateral sources and does not withdraw his or her
application, the application shall be denied.
(3) The County Department staff shall verify
the applicant's residence.
(4) The
applicant has the right to:
(A) receive the
State/County Special Assistance Program payments if he or she is found eligible
for such assistance;
(B) be
protected against discrimination on the ground of race, color, or national
origin by Title VI of the Civil Rights Act of 1964: if the applicant believes
he or she was a victim of such discrimination, he or she may file a civil
rights complaint in writing to the United States Department of Health and Human
Services, Director, Office for Civil Rights, Room 506-F, 200 Independence
Avenue, S.W., Washington, D.C. 20201 or by calling (202) 619-0403 (voice) or
(202) 619-3257 (TTY). Further information can be found on the U.S. Department
of Health and Human Services website "How to File a Civil Rights Complaint" at:
http://www.hhs.gov/civil-rights/filing-a-complaint/complaint-process;
(C) designate a Substitute Payee as set forth
in Rule .0501 of this Subchapter;
(D) have any person or his or her Authorized
Representative participate in the application process and receive
notices;
(E) have any information
given to the County Department kept in confidence;
(F) appeal, if:
(i) his or her State/County Special
Assistance Program application is denied;
(ii) the applicant believes that the payment
is incorrect based on the county's interpretation of State regulations;
or
(iii) if the applicant's request
for a review of his or her eligibility decision was delayed more than 30
calendar days;
(G)
reapply at any time, if found ineligible; and
(H) withdraw the application at any time or
withdraw from the State/County Special Assistance Program at any
time.
(5) The
applicant's responsibilities. The applicant or Authorized Representative shall:
(A) provide the County Department with the
collateral sources from which the County Department can locate and obtain
information needed to determine eligibility, including furnishing his or her
social security number;
(B) not
provide false statements or withhold information that relates to the
applicant's eligibility;
(C) report
to the County Department any Change in Situation, within five calendar days of
such change, that may affect his or her eligibility for the State/County
Special Assistance Program payment;
(D) cooperate with the County Department in
support of any right of subrogation the State may have pursuant to State or
federal law; and
(E) report within
five business days to the County Department the receipt of a payment which the
recipient knows to be erroneous, such as two payments for the same month or a
payment in the wrong amount. If the recipient does not report such payments, he
or she may be required to repay any overpayment.
(c) The application for the
State/County Special Assistance Program shall include:
(1) the applicant's full name;
(2) the applicant's address;
(3) the signature of the applicant or his or
her Authorized Representative. The signature shall assure that he or she
understands his or her rights and responsibilities as set forth in Rule .0602
of this Subchapter; and
(4)
sufficient information as set forth in Rule .0601(7) of this Subchapter in
order for the Caseworker to determine eligibility for the State/County Special
Assistance Program. For the State/County Special Assistance In-Home Program,
the application shall also include the results of the comprehensive functional
assessment that shall include the areas set forth in
10A NCAC
71A .0208.