Current through Register Vol. 54, No. 44, November 2, 2024
(a)
Recipients required to report. A recipient shall submit a
Monthly Reporting Form if the budget group contains a person who meets one or
more of the following:
(1) Has earned income
except the following:
(i) A full-time or
part-time student who is employed part-time.
(ii) A dependent child whose sole earnings
are from a program carried out under the Job Training Partnership Act (JTPA),
the act of October 13, 1982 (Pub.L. No. 97-300, 96 Stat. 1322), irrespective of
student status.
(2) Has
income deemed available to the recipient, as provided under Chapter 183
(relating to income) from an individual with earned income living in the common
residence.
(3) Is designated by the
Department to participate in monthly reporting based on Quality Control
findings or other objective criteria applied Statewide.
(4) Meets one of the requirements indicated
in paragraph (1), (2) or (3), but who does not receive cash assistance due to
one or more of the following:
(i) Prohibition
on payments of less than $10 as specified in §
225.24(b)
(relating to procedures).
(ii)
Application of the recoupment provision as specified in §
255.4 (relating to
procedures).
(iii) Enforcement of
suspension status as specified in §
183.105 (relating to increases in
income).
(b)
Special assistance. When requested, the CAO shall make
provision for special assistance in completing and filing monthly reports to
assistance units in which one of the following occurs:
(1) The adult members are either mentally or
physically handicapped.
(2) The
adult members are non-English speaking or otherwise lacking in reading and
writing skills so that they cannot complete and file the required
reports.
(c)
Information provided to recipients required to submit monthly
reports. A recipient who is required to submit monthly reports shall
be provided with the following:
(1) An
explanation of the purpose of monthly reporting.
(2) An explanation of the reason why the
recipient is required to report monthly.
(3) A copy of the Monthly Reporting Form and
an explanation of how to complete and file it.
(4) An explanation of what the recipient
shall verify when he submits a monthly report and how it shall be
verified.
(5) Instructions
regarding whom the recipient may call at the CAO to ask questions or to obtain
help in completing the monthly report.
(d)
Timely Monthly Reporting
Form. The Monthly Reporting Form shall be submitted to the CAO on a
timely basis. A Monthly Reporting Form is considered timely if it is received
in the CAO by the due date indicated on the form.
(e)
Complete Monthly Reporting
Form. A Monthly Reporting Form is considered complete if all of the
questions are answered, the form is dated after the end of the reporting
period, the person who is the payment name has signed the form and the required
verification is attached.
(f)
Submission of a timely and complete Monthly Reporting Form.
When the recipient submits a timely and complete Monthly Reporting Form,
eligibility and the amount of the assistance payment are determined based on
information provided on the form. If the recipient is ineligible, assistance is
terminated or suspended as set forth in §
183.105 and subsections (k) and
(l).
(g)
Failure to submit
a timely and complete Monthly Reporting Form. If the recipient fails
to submit a timely and complete Monthly Reporting Form, assistance is suspended
and a Late/Incomplete Notice, as set forth in §
133.4 (relating to procedures), is
sent to the recipient in time to be received by the regular payment date. The
CAO may contact the recipient to clarify information contained on the Monthly
Reporting Form.
(1) If the CAO receives a
complete Late/Incomplete Notice or complete Monthly Reporting Form by the
Extended Due Date indicated on the Late/Incomplete Notice, eligibility and the
amount of the assistance payment are determined based on information provided
on the form. If the recipient is eligible, assistance is reinstated. If the
recipient is ineligible, assistance is terminated or suspended, as set forth in
§
183.105 and subsections (k) and
(l).
(2) If the recipient fails to
submit a complete Late/Incomplete Notice or complete Monthly Reporting Form by
the extended due date, the assistance case is terminated.
(i) If good cause, as defined in subsection
(i), does not exist for failure to submit a timely and complete Monthly
Reporting Form, the client who is still in need shall reapply. At
reapplication, the client shall complete the Monthly Reporting Form which the
client failed to submit or complete entirely when assistance was terminated. If
the client is eligible, the application is processed under §
125.24(a)-(c)
(relating to procedures).
(ii) If
good cause, as defined in subsection (i), exists for failure to submit a timely
and complete Monthly Reporting Form and the recipient continues to be eligible,
the case is reinstated if suspended or reopened if closed for the payment month
in accordance with procedures on reinstatement or reopening.
(h)
Penalties.
(1) When the
recipient submits an untimely complete Monthly Reporting Form or a complete
Late/Incomplete Notice by the extended due date, eligibility is determined
based on the information provided on the form. If the recipient is determined
eligible, assistance is reinstated; however, the assistance payment may be
late.
(2) When the recipient
submits an untimely complete Monthly Reporting Form, a timely Monthly Reporting
Form which is incomplete with respect to earnings, or a complete
Late/Incomplete Notice by the Extended Due Date the earned income disregard,
deductions and dependent care expenses are not allowed for the payment month
affected if the recipient cannot show good cause, as defined in subsection (i)
for the untimeliness or incompleteness.
(i)
Good cause for failure to submit
a timely and complete Monthly Reporting Form or Late/Incomplete
Notice. Good cause exists in situations when the circumstances causing
the failure are beyond the control of the recipient, making it impossible for
the recipient to comply with the monthly reporting requirements.
(1) Good cause includes, but is not limited
to, the following situations: serious illness, accident, death or postal delay.
If, in subsequent months, a recipient continues to claim good cause for failure
to submit a timely and complete Monthly Reporting Form for reasons set forth in
this paragraph, the claim shall be reevaluated each month.
(2) Good cause also includes the following
situations: illiteracy, language problem or physical or mental handicap.
(i) If good cause is established for any of
the reasons listed in this paragraph, the CAO worker provides assistance or
makes a referral to a community resource. The worker shall document the
referral in the case record.
(ii) A
claim of good cause as set forth in this paragraph is reevaluated if the
community resource to which the referral was made is no longer available. If
good cause continues to exist, apply the requirements as set forth in
subparagraph (i).
(3) A
finding of good cause shall be approved by the supervisor, and documented in
accordance with Departmental procedures.
(4) If good cause for an incomplete or late
Monthly Reporting Form is established within 30 days from the date of notice on
the Late/Incomplete Notice, benefits are reinstated if suspended or reopened if
closed.
(j)
Notification of change in benefits. The recipient is notified
with a confirming notice of a change in eligibility or the amount of the
assistance payment, if the change is the result of information reported on the
Monthly Reporting Form or the Late/Incomplete Notice.
(k)
Temporary ineligibility.
If the recipient is ineligible for 1 month due to a periodic increase in
income, or due to other circumstances, assistance is reinstated the following
month as set forth in §
183.105 without a new application,
if the client has complied with Monthly Reporting requirements and continues to
be eligible, MA benefits continue during the period of temporary
ineligibility.
(l)
Termination of benefits. Benefits are terminated if the
information provided on the Monthly Reporting Form or Late/Incomplete Notice
indicates ineligibility which is expected to last for more than 1 month or for
failure to comply with the monthly reporting requirements. A new application
shall be completed if program benefits are terminated as a result of
ineligibility or noncompliance, as set forth in this subsection.
(m)
Appeal and fair
hearings. A recipient subject to the Monthly Reporting requirements is
entitled to the appeal and fair hearing process as set forth in Chapter 275
(relating to appeal and fair hearing and administrative disqualification
hearings).
The provisions of this §142.23 amended under section
403(b) of the Public Welfare Code (62 P. S. §
403(b)).
This section cited in 55 Pa. Code §
125.24 (relating to procedures);
55 Pa. Code §
141.21 (relating to policy); and
55 Pa. Code §
229.24 (relating to
procedures).
