Code of Vermont Rules
Agency 13 - AGENCY OF HUMAN SERVICES
Sub-Agency 170 - DEPARTMENT FOR CHILDREN AND FAMILIES (DCF)
Chapter 220 - REACH UP (2200)
Section 13 170 220 - REACH UP (2200)
Current through February, 2024
Section 2200 Reach Up
The purpose of the Reach Up program is to:
Section 2201 Eligibility and Payment Process
The eligibility and payment process for Reach Up financial assistance consists of steps an applicant takes to request assistance and procedures the department follows to determine eligibility and payments. Steps within the process include:
Section 2202 Eligibility and Payment Definition
The department defines eligibility according to state and federal laws and regulations that apply to receipt of Reach Up financial assistance.
The department defines payment as the form, frequency, and method used to pay Reach Up financial assistance to eligible individuals. The department pays assistance to or on behalf of eligible individuals through:
* money grants for Reach Up financial assistance;
* vendor payments from administrative funds for necessary expenses to establish eligibility for or to assure proper use of assistance; or
* vendor payments from Reach Up funds in lieu of money payments.
Section 2203 Case Records
Permanent written records on each individual case shall be maintained and shall include applications for assistance, factual data, verification of information, budgetary computations, eligibility decisions, payment authorizations and copies of all correspondence.
Case information may contribute in statistical or other general terms to material needed for planning, research, and overall administration of department programs. Individual case data shall, however, be held in confidence under department regulations limiting disclosure of such information identifying a specific applicant/recipient.
Retention of records shall be subject to Federal and State requirements for audit and/or review.
Section 2204 Authorized Representative
An authorized representative may under specific conditions act on behalf of an applicant/recipient (individual, family group or household group) to carry out specific activities related to establishing eligibility for, obtaining and using aid or benefits made available through department programs.
A judicially appointed legal guardian or legal representative automatically meets the criteria for an authorized representative.
A relative, friend, or other knowledgeable interested party with authority to act for the individual(s), may act on behalf of an applicant/recipient for ANFC, who is unable to act for himself/herself due to physical or mental incapacity.
An applicant for ANFC may, in an emergency precluding the presence of the applicant at a required interview, designate a representative to act on his/her behalf by addressing a letter, naming the individual designated and bearing the applicant's signature, to the welfare office.
Section 2205 Fraud
Fraud is defined by statute ( 33 VSA 141 ) as:
The following criteria will be used to evaluate cases of suspected fraud to determine whether they should be referred to a law enforcement agency.
Examples of instances where fraud might be suspected and referral considered are as follows:
The above examples are intended as a guideline; each case will be evaluated individually.
Any investigation of a case of suspected fraud shall be pursued with regard for confidentiality and protection of the legal and other rights of the individual.
Procedures are established for review and documentation in the case record at all supervisory levels.
Intent to defraud must be proven beyond a reasonable doubt to convict under the law; the final decision regarding referral to a law enforcement agency shall be the responsibility of the Commissioner.
The department will maintain such records and submit such reports as deemed necessary by appropriate Federal agencies
Section 2206 Quality Control Review
Continuing validation of the accuracy of information obtained through the simplified method and resulting decisions on eligibility and amount of aid or benefits is carried out through a Quality Control review of a random sample of each month's ANFC caseload, at which time all items of eligibility are verified with the applicant and collateral sources. The focus is on the eligibility and correctness of payment of the case as of the review month from which the sample was selected.
The primary purpose of the validation review is assurance that department policies are clear and consistently applied and that applicants are able to understand and furnish accurate information. Whenever such review indicates possible wilful [willful] fraud, further investigation and appropriate action shall be initiated.
Section 2207 Domestic Violence
The department recognizes that families experiencing the effects of domestic violence may face a threat to the health, safety, and well-being of one or more family members as well as a barrier to economic independence. To encourage and help such families to address the effects of domestic violence, the department shall explain to applicants and participants that they:
* may ask for a deferment or modification to the work requirement (2365);
* may ask for a waiver of the requirement to cooperate in the pursuit of child support (2332);
* have a right to confidentiality unless the law requires a report of abuse; and
* may limit voluntary waivers of confidentiality based on criteria they choose, such as time periods or named collateral contacts.
The department shall provide this explanation at the time of application and eligibility review and at any time the department receives information indicating that the applicant or participant, or a dependent child, may be or may have been a victim of domestic violence.
Domestic violence is defined at 2341.
Section 2210 Application
Application for Reach Up is the specific action of completing, signing and submitting an application form furnished by the department that conveys a desire to receive financial assistance or benefits from the department or to have eligibility for such assistance or benefits considered. An application for Reach Up may be considered as an application for Reach First when required or allowed by Reach First rules (2117, 2118). Application forms shall be signed by:
The date of application, which governs the time limit for rendering and implementing a decision on the application, is the first date on which a signed application form is received in any department office, regardless of whether such application is sufficiently complete for an immediate decision on eligibility. Since an individual's initial contact(s) with the department may not always result in immediate submittal of a signed application form, all contacts (e.g., in person, by telephone, by mail, by referral from another agency) shall be considered inquiries up to the point of department receipt of a signed application form. Department response to inquiries shall include:
A signed formal application for Reach Up furnished by the department is required to begin action on a request for financial assistance or benefits. Such application may be obtained by calling, writing, or visiting any of the Department's offices.
Any individuals, previously found ineligible for assistance and/or benefits, who believe their circumstances to have changed or who desire to have eligibility reconsidered, may reapply by submitting an up-to-date signed application form to the Department.
The formal application gives individuals the means to furnish information necessary for a decision, protects them from being ruled ineligible without formal application, informs them of their rights and responsibilities, and provides a basis for appeal if they are dissatisfied with any action of or lack of action by the department.
A relative, friend, or other interested party may assist an applicant in completion of necessary forms. The applicant or spouse, authorized representative, or legal guardian must sign the form and thereby assume responsibility for all information entered.
If an applicant has difficulty in completing an application or statement of need and no other person is available to assist, a department employee may record on a department form information furnished by the applicant. In such cases special care must be exercised to review the information entered before the applicant signs and assumes responsibility for the information.
The individual in whose name an application is filed is designated the applicant, or the head of the applicant group. When a group of individuals apply together for assistance or benefits from more than one department program, it is preferable, although not mandatory, that the same member be designated head of the group for all programs.
For an application to be considered complete, the applicant must provide information about whether any members of the family have been convicted of a felony involving possession, use, or distribution of a controlled substance for an act committed after August 22, 1996.
If a family's Reach Up was terminated because of countable child support in excess of the financial assistance grant, either alone or in combination with another reason affecting income eligibility, the department shall reinstate the family's participation in Reach Up effective the first day of the month when all the following conditions are met:
-- The family becomes eligible for Reach Up during that month solely because of a loss or reduction of child support within the period of 12 consecutive calendar months beginning with the first full calendar month following the effective date of the Reach Up termination.
-- The family has been ineligible for Reach Up since the termination.
-- The family requests reinstatement by the 20th day of the month following the month in which the loss or reduction of child support first occurred.
- The family returns the forms required for reinstatement by the end of the month in which they request reinstatement.
During the 12-month administrative period, the Office of Child Support (OCS) shall distribute current child support collected on behalf of the family to the family within two days of receipt.
If, during the 12-month administrative period, the amount of monthly child support collected by OCS falls below the minimum amount that would have made the family ineligible when they were terminated from Reach Up, the department shall mail a Reach Up application to the family, along with other forms required to reinstate the family's eligibility.
An applicant who is eligible for both Reach Up financial assistance and Supplemental Security Income (SSI), with or without the state AABD supplement, shall have free choice to select either program of financial assistance. No individual may, however, receive Reach Up financial assistance concurrently with receipt of federal SSI or state AABD. This prohibition does not preclude designation of a recipient of SSI as payee of a Reach Up grant on behalf of other eligible individuals.
Applicants and participants who apply for SSI or are pending a decision on an SSI application shall sign an agreement authorizing the department's recovery of Reach Up from SSI retroactive payments (rules 2330, 2335 ). Any family whose Reach Up is funded with state funds will reimburse the department according to the specifications in rule 2391.4.
Action on applications shall be completed as soon as possible but not later than within 30 days from date of application for Reach Up. Within this deadline a decision must be made concerning the application and a notice of that decision in writing sent to the applicant.
The above program deadline applies except in unusual circumstances (e.g., where a decision cannot be reached because of failure or delay on the part of the applicant or because of some administrative or other emergency that could not be controlled by the agency, in which instances the case record must document the cause for the delay). Failure to meet the established deadline shall not constitute the sole reason for denial of assistance unless it can be established and documented in the case record that such failure is the result of non-cooperation on the part of the applicant.
Section 2211 Methods of Investigation
(02/01/2009, 08-10)
The applicant is the primary source of information about his need and eligibility for aid or benefits. Verification of information furnished on the signed application and through interviews is not required except as specified at 2211.3 Verification or elsewhere in rules.
Reliance on the applicant as the primary source of information to establish eligibility recognizes the right to privacy, but also places responsibility on the applicant to furnish necessary information completely and accurately or, when needed, to give consent to obtain such information elsewhere. The signature of an applicant or spouse, authorized representative, or legal guardian on an application must certify under penalty of perjury that information on the application pertaining to all members of the assistance group is correct and complete. Only one adult applicant signature is required (2208, Application). Department responsibility to assist an applicant to establish eligibility requires careful explanation and interpretation of program eligibility criteria and information needed to assess the applicant's circumstances against such eligibility criteria.
An applicant has a right to refuse to give information, or to submit required proof. Such refusal of information or action necessary to establish eligibility will result in denial or closure of aid or benefits. Willful misrepresentation of applicant circumstances will also result in legal action under fraud statutes. Department staff shall make every effort to assure full applicant understanding of the consequences of refusal to take necessary action to establish eligibility and/or misrepresentation of individual circumstances.
An individual may apply for aid or benefits through another person; for example: an authorized representative; a person acting responsibly for an incompetent or incapacitated individual; surviving relative or estate administrator of a deceased person. The individual acting for the applicant is, in such situations, considered the primary source of information, subject to the same rights, responsibilities and consequences for the applicant as an applicant acting directly for himself.
(02/01/2009, 08-10)
The applicant's signed statement of need, contained within the application forms for the programs applied for, is the primary source document for information about the applicant's circumstances.
Application forms are designed to be as clear and simple to complete as possible, with due regard for the information necessary to establish eligibility. Appropriate descriptions of applicant rights and responsibilities, including penalties for willful misrepresentation of circumstances, are set forth immediately before the applicant's signature.
A signed Application form shall be sufficient to apply for Reach Up.
(05/08/2018, 17-20)
An interview is required for all Reach Up applications. The department shall conduct interviews via phone. A face-to-face interview may be provided at the applicant's request.
The department may waive the interview requirement for applicants who are not mandatory members of the assistance group when they apply for financial assistance only on behalf of the children in the household (for example, caretaker guardians whose income or resources exceed the limits for inclusion in the assistance group or parents who are not included in the assistance group because they receive SSI/AABD benefits) if the following criteria are met:
(05/08/2018, 17-20)
Verification, defined as a written entry in the case record of third-party or documentary confirmation of facts stated by an applicant, shall be required for the items listed below when the department is processing an initial application or eligibility redetermination for Reach Up financial assistance. Verification of individual items on this list is required when the participant reports a change in circumstances relating to that item or when the department receives information from some other source that indicates the most recent information reported by the participant may not be correct.
Verification may be required for the following, if questionable:
Written verification statements shall include sufficient detail to enable independent reviewer evaluation of the reasonableness of the resulting eligibility decision, including but not limited to a description of method used, dates, sources, summary of information obtained, and any computations required. If the wage earner cannot furnish complete pay stubs or similar verification, a statement of wages must be obtained from the employer.
The department shall verify and document earnings received in the prior 30 days for applicants and participants. For continuing eligibility, earnings must be verified at least once every six months.
However, if the earnings received in this 30-day period are not representative of current or future circumstances, then a best estimate must be made based on information and documentation obtained during the eligibility determination or redetermination. In such cases this alternative figure will be used to estimate monthly earnings.
When earnings have just begun or changed, available pay stubs, a statement from the employer on wages and predicted hours of employment, or similar verification shall be used to make a best estimate of future earnings.
A change in dependent care costs is defined as a change in one or more of the following circumstances relating to the care provided:
A variation in dependent care costs caused solely by a school vacation, or illness or vacation on the part of the employed participant, lasting no longer than two weeks, shall not be considered a change in dependent care costs.
The following standard is to be applied when monthly dependent care costs vary as a result of minor fluctuations in the amount of employment-related dependent care required. If total dependent care costs paid in the reporting month are no greater than 25 percent above or no less than 25 percent below the most recent monthly dependent care costs, the variation in dependent care costs will not fall within the department's definition of a change in dependent care costs and, therefore, will not require verification.
Verification of income from self-employment requires careful evaluation by the eligibility worker considering the following:
Denial or closure shall result if an applicant or recipient:
-- fails without good cause to submit documentation necessary for verification;
-- fails without good cause to consent to verification of any eligibility factor;
-- fails without good cause to cooperate in any investigation necessary to support an affirmative decision of eligibility.
Good cause reasons include:
Other reasons may be found to constitute good cause with the approval of the District Director or his or her designee.
Contact with sources other than the applicant may be made concerning his eligibility for aid or benefits. These contacts are limited to interviews, telephone calls, or correspondence necessary to obtain information required to make a decision on eligibility. Information requested from collateral sources is limited to the specific eligibility factors in question and may be made without the consent of the client when information by the client is either questionable or insufficient to determine eligibility.
Common collateral sources are relatives, landlords, employers, town officials, Town Service Officers, public records, doctors, medical facilities, etc. Other agencies which have worked with the client are generally the best source of collateral information.
Section 2212 Continuing Eligibility
Reach Up benefits continue, as authorized, until changed or terminated due to:
* a change in circumstances,
* expiration of a period of eligibility,
* failure of a participant to provide sufficient information to allow a review of eligibility,
* failure of an adult subject to sanctions to comply with Reach Up services component requirements.
An active participant who refuses to participate in a quality control field review shall become ineligible for continued benefits.
Section 2213 Review of Eligibility
A complete review of eligibility for continuing benefits shall be conducted periodically, as specified in 2220.1, for all Reach Up assistance groups. An eligibility review using application investigation methods encompasses all conditions and factors of eligibility. Each applicable factor shall be considered, and a decision made and recorded that the factor continues to be met or is no longer met.
An eligibility review shall be complete when all the following applicable actions have been completed:
All assistance groups shall complete a full review of eligibility every 6 months or, at the discretion of the commissioner, every 12 months.
The eligibility review or period of eligibility for households may be scheduled at intervals shorter than that specified to coincide with known anticipated changes. A scheduled review interval or period of eligibility may not, however, exceed the 12-month limit.
Section 2214 Change of Circumstances
The department has the responsibility of notifying the applicant of the requirement to report any changes in circumstances within 10 calendar days of the date the change becomes known to the assistance group. Applicants shall report changes that might affect eligibility or the amount of benefits (e.g., changes in income or resources, changes in the size or membership of the assistance group, new address, or termination of school attendance).
Applicants and participants shall notify the district office serving their area, by mail, telephone, or office visit, of any change in individual, family, or assistance group circumstances that may affect continuing eligibility for, or amount of, aid or benefits authorized under any department program. Such changes include, but are not limited to: residence location, family or assistance group composition, employment, income, and resources.
When a change is the addition of an adult to a financial assistance group, all eligibility conditions apply (2201) and are reconsidered for the new assistance group formed by the change.
A change reported for one program shall be considered to have been reported for all programs in which the assistance group is participating; for example, a change reported affecting Reach Up shall be considered reported for Medicaid and 3SquaresVT as well.
The district office shall, upon receipt of a report of changed circumstances, consider such changes in relation to all eligibility factors for all programs through which aid or benefits are currently authorized. If a reported change results in an assistance group's becoming ineligible, assistance shall be terminated for the earliest date for which the processing and notice deadline has not passed. The department shall reduce or terminate financial assistance without minimum advance notice for assistance groups sanctioned for noncompliance with services component requirements.
A description of payment cycles is given at rule 2222.
Reductions and closures resulting from changes reported fewer than ten days before the adverse action approval deadline may take effect for the next following benefit period. This ensures that recipients have a ten-day period in which to provide required verification and that department staff have a ten-day administrative period in which to complete whatever work is necessary to process the change. However, Eligibility Specialists should place a high priority on processing case actions before the next adverse action approval deadline.
When a scheduled review of eligibility will be due in the near future, or when the nature or extent of the change reported otherwise makes a full eligibility review desirable, the District Office may initiate a review in advance of the scheduled time limit.
A recipient of Reach Up shall notify the district office immediately of any change in his domicile advising of his new location and mailing address. Changes of domicile for other than visiting purposes shall require a review of circumstances and recomputation of budgeted need. Failure to so notify the district office may cause delay in receipt of assistance or benefits, can result in incorrect payments or render the department unable to determine continued eligibility to receive assistance. Visits away from his/her domicile of less than 30 days shall not generally warrant a change of address.
A recipient of assistance or benefits who moves outside Vermont with the intent to domicile outside the state shall become ineligible upon abandonment of Vermont residence (rule 2233 ). Assistance shall continue for one full month following abandonment of Vermont residence to enable the recipient to apply for assistance at his/her new residence.
Eligibility of an individual recipient terminates upon death. Notice of death, processed through the applicable payment system(s), shall automatically cancel continuing payments and/or benefits to or on behalf of the deceased individual. Vendor payments for services incurred by eligible individuals before death shall, however, be authorized and paid, when billed within fiscal time limits.
Surviving members of an assistance group or household may continue eligible for aid or benefits following death of a group member. Continuing eligibility and resulting payment adjustments shall be established through appropriate eligibility review action.
Section 2215 Assistance Pending Fair Hearing
Requests for fair hearings must be made within 90 days of the mailing date of the notice of decision.
Except where indicated below, benefits continue without change if the participant requests a hearing before the adverse action date (i.e., no later than the 15th day of the month for midmonth adverse actions or the last day of the month for end-of-the-month adverse actions) and wishes to have benefits continue during the appeal process. However, the participant may request that the adverse action be implemented pending the outcome of the fair hearing.
If the 15th day of the month is on a weekend or holiday, the participant has until the end of the first working day after the 15th of the month to appeal the decision and receive continuing benefits.
If the last day of the month is on a weekend or holiday, the participant has until the end of the first working day in the new month to appeal the decision and receive continuing benefits.
If an adult sanctioned for failure to comply in full with the Reach Up services component requirements fails to comply with sanction requirements, receives a notice of termination, and requests a hearing within 10 calendar days of the notice, benefits for the month in question must be reinstated at the adult's request to the current month's level pending the outcome of the hearing. Assistance for subsequent months is dependent on compliance with sanction requirements (see 2373).
If aid or benefits continue at the same level and the Human Services Board decision is favorable to the department, then any overpayment received by the participant pending the fair hearing will be subject to recoupment (for recoupment methods see 2234.2).
If the participant requests that benefits not be continued at the present level (i.e., the adverse action is implemented) and the Human Services Board decision is favorable to the participant, the department must retroactively pay any underpayments to the participant.
If the participant withdraws from the fair hearing process prior to the hearing, the department will seek recoupment or recovery of any overpayment received by the participant as a result of the fair hearing request.
Benefits do not continue without change in the following circumstances:
Section 2216 Decisions, Notification and Authorization
By law, the commissioner is empowered to decide upon applications for benefits and to prescribe the amount of aid to be given. Authority to make case decisions is assigned to district directors or their designees.
Except for the situations listed in 2228.1, applicants and participants receive advance written notice of case actions affecting receipt and amount of benefits.
The department shall use appropriate procedures to authorize benefits and meet immediate and continuing need through the programs for which the applicant or participant is found eligible.
Decisions on applications or reapplications for assistance or benefits are classified as:
Reach Up financial assistance shall be granted in the amount specified by department regulations and continue until changed. Provided all eligibility factors are met, money payments are granted effective the date of authorization, when the worker actually approves an eligibility decision, or 30 days from (and including) the date of application, whichever is earlier. This effective date applies to all applicants or reapplicants who apply after their eligibility for benefits has ended, except that families meeting the conditions specified in 2334 for reinstatement shall be granted effective the first of the month child support was reduced or terminated.
The initial grant shall be computed by multiplying the monthly amount of assistance to be granted (obtained by subtracting total net income from the precomputed payment standard) by the percentage below, which corresponds to the calendar day on which the grant is effective. This table is to be used no matter how many days there are in the month.
PERCENTAGE OF MONTHLY GRANT
|
Effective |
Percentage |
Effective |
Percentage |
Effective |
Percentage |
|
Date |
Date |
Date |
|||
|
1 |
100 |
11 |
67 |
21 |
33 |
|
2 |
97 |
12 |
63 |
22 |
30 |
|
3 |
93 |
13 |
60 |
23 |
27 |
|
4 |
90 |
14 |
57 |
24 |
23 |
|
5 |
87 |
15 |
53 |
25 |
20 |
|
6 |
83 |
16 |
50 |
26 |
17 |
|
7 |
80 |
17 |
47 |
27 |
13 |
|
8 |
77 |
18 |
43 |
28 |
10 |
|
9 |
73 |
19 |
40 |
29 |
7 |
|
10 |
70 |
20 |
37 |
30-31 |
3 |
Decisions on review of continuing eligibility for assistance or benefits are classified as follows:
Review decisions shall be effective on the next date for which the case action can be processed, subject to any applicable advance notice requirement. If a change becomes known to the Department fewer than ten days before the next adverse action approval deadline, the Eligibility Specialist should attempt to process the necessary case action before this adverse action approval deadline. However, if this is not possible, the decision will be effective for the benefit period which follows the benefit period affected by the adverse action approval deadline described above.
Section 2217 Notice of Decision
Applicants, for and recipients, of ANFC. shall be furnished, prior to implementation of any decision affecting their receipt of such aid or benefits, a written notice which:
Unless specifically exempt, a decision resulting in termination or reduction in the amount or scope of aid or benefits or changing a grant to a protective payment system requires advance written notice of the proposed action. Advance notice must be mailed no less than 10 days prior to the effective date of the proposed action.
The requirement for minimum advance notice of termination, reduction, or change in method of payment shall not apply to decisions resulting from the following:
Except as indicated below, the notice to the participant must specify that benefits may not be continued pending the decision on an appeal, and the reason why.
Written notice of assistance denied shall include the specific reason for denial.
Written notice of assistance continued shall state that assistance continues "as is" or include the following specific information regarding a change:
Written notice of assistance closed shall include the following specific information:
Section 2220 Money Grants
A money grant is a direct payment of assistance to or on behalf of, an eligible individual or family to meet need, as established under department regulations.
Reach Up money grants shall be made payable to the caretaker responsible for care and supervision of the eligible child, except when an alternate payee has been designated by court action or under Department regulations. Although the payee of the Reach Up grant is generally a member of the assistance group, a non-recipient caretaker may be designated payee to meet needs of eligible child in his/her care in the following situations:
A recipient of a money grant shall not knowingly use or access assistance in any electronic benefit transfer transaction in a:
A recipient who uses or accesses assistance in any of the above prohibited electronic benefit transfer transactions shall reimburse the department for the amount of assistance used or accessed in the prohibited transaction.
State law ( 33 VSA § 124 ) prohibits assignment, transfer, attachment, trustee process or execution with regard to money grants.
When funds available for payment of SSI/AABD and Reach Up grants are insufficient to provide assistance to all eligible individuals, State law ( 33 VSA § 114 ) requires reduction of assistance until sufficient funds become available.
Section 2221 Alternate Payee
Money grants shall be payable to the following individuals on behalf of a recipient under the conditions specified:
Payment of assistance to a protective payee, or vendor payment of ANFC assistance in lieu of payment to a protective payee, shall be authorized by the district director upon receipt of signed protective payment agreement.
Section 2222 Method of Payment
Regular monthly payments in the amount of the authorized grant will be made as follows:
60 -40 Percent Payment Cycle All other assistance groups shall receive their grant amount in two payments. They will receive 60 percent at the beginning of the month to cover the first 15 days of the month and 40 percent on or about the 16th to cover the remainder of the month.
Daily payments for the authorized amount will be made in the following situations:
* grants authorized after the regular monthly payments (60 percent or 100 percent) are made for that month or the following month.
* increases authorized for the current month or the following month when payroll closing precludes implementation of the change through the regular monthly payment system.
* other authorized situations, such as controlled vendor payments or benefits issued to correct an underpayment.
Section 2222.1 Vendor Payments
Vendor payments are defined as all payments made directly to a third party who has furnished goods and/or services to, or on behalf of, an applicant for, or recipiant of, aid, benefits or services under Department programs. Vendor payments cover the following types of authorized expendatures:
Vendor billing, as defined under 1 and 2 above, shall require proir written authorization by designated Department staff. In specified emergency situations, oral authorization may be given; in such instances, confirming written authorization or approval of a designated staff member shall be required for payment.
Itemized bills shall be submitted in duplicate to the appropriate district office, when so directed, for aproval. All other bills shall be submitted, itemized and in duplicate, and accompanied by appropriate written authorization to the State Office in Waterbury. Payment shall be made through established Department and State channels.
Contracts with specified vendors to provide goods and/or services shall specify acceptable methods of authorization, billing and payment for items covered under the contract.
Section 2222.2 Maintenance Assistance
Vendor payments for maintenance assistance are currently limited to maintenance items authorized, in accord with ANFC protective payment regulations, by a district office employee in lieu of disbursement of the assistance grant to an alternate third party payee.
Vendor bills shall be paid upon receipt of an itemized bill, in duplicate, accompanied by written prior or confirming authorization.
Section 2222.3 Administrative Expense
Administrative expense required to establish eligibility for assistance is currently limited to professional examination, evaluation and report on medical factors related to eligibility. Payment of reasonable charge for such examination and report shall be approved on receipt of the required written report and itemized bill.
Administrative expense required to assure effective use of assistance payments is currently limited to court costs (but not services if an attorney) incidental to appointment of a legal guardian or legal representative to safeguard the interests od a recipiant of assistance. Payment to the court for necessary costs shall be approved on receipt of an itemized bil. Reimbursement to the individual appointed shall be approved on receipt of a written request accompanied by receipted itemized bills.
Section 2223 Deceased Payee
A deceased recipient shall not be entitled to payment for any month following the month of death. Funds remaining from a grant paid before death of the payee remain available for use on behalf of the deceased recipient and/or eligible survivors.
Needs of deceased ANFC recipients shall be removed from the ANFC grant through the eligibility review process, with assistance continuing in the amount required to meet needs' of surviving eligible members.
A payment for a period before the death of the payee will, upon notification, be reissued to one of the following specific individuals:
If a benefit is paid for a period after the death of the payee, a replacement payment shall not occur until the original payment is credited to the department.
Section 2224 Underpayments
Department errors that resulted in underpayment of assistance shall be promptly corrected retroactively under the following conditions:
Corrective payments shall be retroactive to the effective date of the incorrect action, not subject to the above limitations, when:
Retroactive corrective payments will be applied first to any outstanding unrecovered overpayment. The amount of corrective payment remaining, if any, shall be paid to the assistance group.
Section 2225 Overpayments
Overpayments of assistance, whether resulting from administrative error, client error or payments made pending a fair hearing which is subsequently determined in favor of the Department, shall be subject to recoupment. Overpayment amounts from undisclosed earnings shall be determined in accordance with rule 2275.4. Recovery of an overpayment can be made through repayment by the recipient of the overpayment, or by reducing the amount of payment being received by the Reach Up group of which he is a member.
Except for a case involving fraud, no recoupment need be carried out for individuals no longer eligible for Reach Up if the amount of the overpayment is less than $ 35.00. Any overpayments of $ 35.00 or more should be recovered from individuals no longer eligible for Reach Up. However, if after an attempt has been made to recover the amount and continued attempts at recovery would cost as much or more than the amount of the overpayment, further attempt at collection may be waived, with approval of the commissioner or the commissioner's designee.
Overpayments of assistance that are subject to recoupment from a participant's program benefit shall be recouped from the program in which the overpayment occurred. When participants who have been overpaid in one program transfer to--or subsequently apply for and are found eligible in--another program, the overpayment and recoupment shall not transfer to that other program. Any outstanding overpayment amounts may be recovered in other ways authorized under these rules and shall be recouped if the participant returns to the program in which the overpayment occurred.
No recoupment shall be attempted for months of overpayment occurring more than 12 months prior to the date of discovery unless the overpayment was caused by the recipient's willful withholding of information which affected the amount of payment. When a recipient's willful withholding of information caused the overpayment, recoupment of overpayments that took place within a three-year period prior to the date of discovery can be attempted. When an overpayment not caused by the recipient's willful withholding of information began more than 12 months prior to discovery, the department shall recoup only those overpayment amounts occurring during the 12 months prior to discovery.
Recoupment shall be made each month from any gross income (without application of disregards), liquid resources and Reach Up payments so long as the assistance unit retains from its combined income 90 percent of the amount payable to an assistance unit of the same composition with no income. For assistance units with no other income, the amount of the recoupment will equal 10 percent of the grant amount.
If, however, the overpayment results from Department error or oversight, the assistance unit must retain from its combined income 95 percent of the amount payable to an assistance unit of the same composition with no income. For assistance units with no other income, the amount of the recoupment will equal 5 percent of the grant amount.
If the individual responsible for the overpayment is no longer eligible or moves to another assistance group, recovery shall be either from that individual, the original assistance group, the new assistance group or both, at the Department's option as determined by the commissioner or the commissioner's designee.
If through the Department's administrative oversight certain requirements in the Child Support Program are not met, such as support payments not deducted from the first Reach Up benefit, the Department may recoup from the individual or assistance group. If a fraud referral is made, recoupment must be delayed pending the outcome of the fraud investigation.
Section 2226 Protective Payments
Protective payments are management of assistance by a third party outside of the assistance group to meet the needs of a dependent child and the adults with whom the child is living. This is necessary when payment of assistance to an adult living with the child would be contrary to the welfare of the child, or when such payments are required as a sanction as indicated below. Management of assistance through controlled vendor payments is optional when the family requests direct payment for housing, utilities, or other basic needs and meets the requirements at rule 2226.5.
Protective payments are used as follows:
The benefit is paid to a protective payee who is interested in, or concerned with, the welfare of the family. If an acceptable protective payee cannot be found, a substitute form of protective payment known as Controlled Vendor Payments (CVP) is used (rule 2226.5 and Procedures Manual Protective Payments).
Families with money management problems as determined by the department, should be referred to money management counseling, if available in the community.
When mental or physical limitations preclude capacity to improve management of funds, legal alternatives shall be pursued. There must be documentation of inadequate physical capability or of mental incapacity that precludes self-care and concern for family welfare. Petition for appointment of a legal guardian or legal representative for an adult living with the child may be initiated by the department.
The District Director will evaluate evidence of money mismanagement, determine whether the recipient demonstrates the capacity to overcome these problems, and decide whether or not, based on these factors, a protective payment plan is warranted.
If failure to pay bills is threatening the loss of shelter or necessary services, this condition is sufficient to justify authorization of protective payments.
A determination that protective payments are necessary may be made if a pattern of nonpayment of rent, either alone or in combination with nonpayment of other basic financial obligations, is established.
A determination of money mismanagement may not be based solely upon the fact that bills are not paid on a timely basis. For purposes of this section, a bill shall be considered paid on a timely basis if paid within ten days of its due date. However, when either the provider issues a second bill for a new service (e.g., a bill for a separate oil delivery), or the bill for a succeeding time period becomes due (e.g., the next month's rent), the issue shall no longer be that of timely payment. The issue shall be whether nonpayment of bills is threatening the loss of services, thereby jeopardizing the welfare of the children.
Prior to determining the eligibility of an ANFC family for payment of rental or mortgage arrearage assistance in the Emergency Assistance program at 2813.3, the department shall determine whether money mismanagement exists under the criteria in this section of ANFC policy and initiate rent vendor payments where indicated. Potential eligibility for payment of rental or mortgage arrearage shall neither nullify nor affect in any other way any determination made under 2235.
The determination of money mismanagement made under criterion 1 or 2 above may be rebutted when a recipient can demonstrate one of the following:
A dispute is considered legitimate when:
* the landlord fails to comply with the landlord's obligations of habitability, and
* the tenant gave the landlord actual notice of the noncompliance, and
* the landlord fails to make repairs within a reasonable time and the noncompliance materially affects health and safety, and
. the noncompliance, is not caused by the negligent or deliberate act or omission of the tenant or a person on the premises with the tenant's consent.
Resolution of the dispute is considered achieved when that noncompliance is corrected.
Rent which is not paid to a landlord but which is diverted to make a repair to the recipient's shelter not made within a reasonable time by the landlord or to pay for fuel or utilities for which the landlord is responsible but has failed to pay shall not be considered unpaid rent in the determination of money mismanagement. The repair must be one which materially affects the health and safety of the children. The recipient must present receipts of repairs or purchase of fuel, etc. to document this claim.
If a recipient is already in a protective payment status, including parents sanctioned under WAM 2351.2, when a legitimate landlord-tenant dispute arises, the recipient must set up and pay rent into an escrow account with an attorney or with a bank (if the landlord agrees) or pay rent to the court, if so ordered, to hold the rent pending resolution of the dispute. If a recipient on CVP does not arrange an escrow account, the Eligibility Specialist holds the money in the recipient's ANFC account pending resolution of the dispute.
Rent payments set aside to pay rent pending resolution of a legitimate landlord-tenant dispute are excluded as a resource (see WAM 2264). Once the dispute has been resolved, withheld rent payments not paid for shelter are counted as a resource.
Income and benefits would include all those benefits available to the family to meet needs including, but not limited to, all earned and unearned income, the Reach Up benefit, child support payments and the child support passalong, the Lifeline telephone benefit, the Fuel Program line of credit or crisis benefit, the food stamp benefit, and the WIC benefit.
The fact that a Reach Up financial assistance payment does not include full rent does not by itself preclude a finding of money mismanagement.
Selection of the protective payee shall be with the parent or caretaker's participation and consent to the extent possible and based on the following considerations:
The following individuals, when qualified through interest in and concern for the welfare of the family, may be selected as protective payee:
Qualified employees of the department may serve as protective payees only when no other suitable individual is available. When a department employee is selected, efforts to find another payee outside the department should continue. The case record must show continuing effort to secure a payee outside the department and the reason such efforts have not been successful.
To avoid conflict of interest situations, the following individuals are prohibited from serving as payee:
Services of a protective payee shall be terminated when:
- the client is considered able to manage funds in the best interests of the children, or
- a legal guardian or legal representative is appointed to serve the best interests of the recipient, or
- in the judgment of the Eligibility Specialist, with approval of the District Director, the payee is not performing his/her responsibilities in the best interests of the recipient.
The protective payee has the authority to make decisions about the expenditures of the assistance payment. S/he may make the actual expenditures himself/herself, make them after joint discussion with the recipient, or supervise the recipient's spending. Actual current shelter costs should be met first, then other basic needs such as food, heat, water, and electricity and clothing. Any balance may be applied toward other needs.
Assumption of payments on behalf of the client by a protective payee shall not constitute a contractual arrangement between the Department or the protective payee and any providers of service to the client.
The eligibility worker manages the grant through the controlled vendor payment system (CVP) by authorizing payments or vendor authorizations to pay bills and obtain basic needs. The department places families on CVP when:
- a determination of money mismanagement (rule 2226.1 ) precludes payment of benefits directly to the family and
- no protective payee has been appointed; or
- a parent is sanctioned for noncooperation with services component requirements (rule 2370 ), and housing costs must be vendored; or
- a parent or caretaker is temporarily absent from the home (rule 2230.3 ) and housing costs must be vendored; or
- a parent or caretaker requests direct payment and
The worker cannot spend more than the authorized grant amount, but can spend less and carry an unspent balance forward to a future month as necessary to budget for one-time expenses such a property taxes, mortgage insurance, and one-time resolution of a landlord-tenant dispute.
In making payments on behalf of the family, the worker shall first pay actual current shelter expenses before other disbursements are made.
Sixty percent of the benefits are available on the first of the month, and forty percent on the 16th. At the discretion of the worker and taking into consideration the portion of benefits available at a given time of the month, a schedule of rent payments will be established to insure that rent payments are kept current.
Any balance remaining in the account when the protective payee is appointed is paid to the payee.
Assumption of payments on behalf of the family by the department shall not constitute a contractual arrangement between the department and any providers of service to the family.
Reconsideration of the need for protective payments and the way in which a protective payee's responsibilities are carried out shall be as frequent as indicated by the family's circumstances, as specified in the Procedures Manual, Protective Payments section.
Once a determination of money mismanagement is made (see 2235.1), protective payments will continue until the family's essential expenses are current or, in the case of vendor payments made under 2235. 1 A 3, at the end of the heating season.
Steps toward judicial appointment of a guardian or other legal representative should be sought (see Procedures Manual P-2230) if, at any time, it appears that the parent or caretaker cannot benefit from the protective payee arrangement. Such steps should also be taken if CVP appear likely to continue beyond two years because efforts have not resulted in improved use of assistance on behalf of the family.
If a protective payment system is used, the participant may appeal to the Human Services Board for a fair hearing concerning the following protective payment decisions:
In cases of a presumption of mismanagement due to nonpayment of rent as determined under criterion 1 of 2226.1 or where housing costs have been vendored due to the parent or caretaker's temporary absence, protective payments shall continue pending the decision of the Human Service Board on the appeal request even if a request for a fair hearing is made before the decision goes into effect.
Determinations of a need for protective payments that are not based on a presumption of mismanagement due to nonpayment of rent, but are:
Section 2230 Eligible Child
(03/01/2017, 17-02)
An eligible child is defined as an individual who meets all Reach Up criteria of need, age, and residence. An individual qualifies under the age criterion as a child if he or she is under 18. In addition, an 18-year old child is eligible if he or she is a full time student in a secondary school or an equivalent level of vocational or technical training and is expected to complete high school or the equivalent program before reaching his or her nineteenth birthday. Children who are eligible for Reach Up on the day before their eighteenth or nineteenth birthday remain eligible for Reach Up for the full calendar month during which their eighteenth or nineteenth birthday occurs.
An eligible child must also be living with a parent or a qualified caretaker. A parent or qualified caretaker may apply and be found eligible to participate in Reach Up on behalf of a child who is not yet in the home or is temporarily absent from the home. Eligibility for Reach Up assistance may continue, in certain circumstances, during the temporary absence of either the child or parent/caretaker from the home.
Physical aspects of the home and care of the child that appear to be below minimum standards of health and decency shall not limit eligibility as long as the child lives with the relative or qualified caretaker. Improvement of detrimental conditions shall be attempted through casework and related services; if hazardous conditions continue, protective action shall be initiated under applicable laws and regulations.
The parent or caretaker responsible for care and supervision of the child shall be a person of sufficient maturity to assume this responsibility adequately. Parents and children living together must be included in the same assistance group (see rule 2240 for exceptions). Another relative or caretaker living in the same household with the parents and children, who has assumed responsibility for the care and supervision of the children, can only be added to the assistance group if the parents are incapable of providing care and supervision for some reason, such as mental incapacity.
(7/1/2015, 15-08)
A qualified caretaker is a relative or unrelated adult acting in loco parentis (taking the role of a parent). A caretaker may be defined as a qualified caretaker if he or she meets the following conditions:
If a parent of the child(ren) can be reached (for example, the parent is incarcerated), the decision to name a designated caretaker will be made after consultation with that parent.
Best interest of the child will be presumed when the child's life is able to continue as normally as possible in the absence of one or both parents, where there is no substantiated evidence of child abuse or neglect or other evidence of violence or criminal behavior by the caretaker, and where there is a pre-existing relationship with the child and the parent.
A home is defined as the family setting maintained, or in process of being established, in which the parent or caretaker assumes responsibility for care and supervision of the child(ren). However, lack of a physical home (i.e. customary family setting), as in the case of a homeless family is not by itself a basis for disqualification (denial or termination) from eligibility for assistance.
The child(ren) and parent or caretaker normally share the same household. A home shall be considered to exist, in certain circumstances, during the temporary absence of either the child or parent/caretaker from the customary family setting.
In all cases where a child or parent/caretaker is or will be absent from the home for a period of 30 days or more, the parent or caretaker must notify the department, advising of the reason for the absence, the designation of the alternate payee (if applicable), and the parent/caretaker's intent to maintain a home for the child during the absence. All temporary absences of a parent or caretaker exceeding 30 days shall be subject to verification and approval by the department. Temporary absences of a child or parent/caretaker must not be expected to exceed 180 consecutive days. The 180-day count shall begin from the date the child or parent/caretaker leaves the home.
Benefits may be approved for an applicant if the child and parent or caretaker will be living together in the home within 30 days after disbursement of the first Reach Up payment. The department may exercise its discretion to extend this time period up to 180 days in order that unique situations may be addressed on an individual basis, but has no obligation to do so.
Section 2231 Eligible Parent
(03/01/2017, 17-02)
An eligible parent is defined as an individual who:
The parent of a disabled child receiving SSI/AABD is also an eligible parent. Both parents, if living in the same household with eligible children, must be included in the Reach Up assistance group, unless subject to the five-year bar for qualified aliens, or another exception, as specified in rule 2240.
In the case of a pregnant woman having no children in her household, the pregnant woman's expected delivery date must fall within the next 30 days or, if she meets at least one of the conditions specified in 2240 C2, within the three month period following the month of application, and it has been determined that the child, if born, would be eligible for Reach Up. In addition, a Reach Up grant to an assistance group that includes a pregnant woman cannot be increased solely on the basis of her pregnancy.
When a pregnant woman with no children is living with her spouse or the biological father of her expected child, the department shall not include the needs of the spouse or biological father in the assistance group. The income and resources of the spouse, however, shall be considered in determining the pregnant woman's eligibility for Reach Up.
A parent whose parental rights have been terminated does not qualify as an eligible parent.
When two parents share custody of a child, and both parents have applied for Reach Up and have claimed the same child as a member of their household, the eligible parent shall be determined according to the following table. In most cases, the eligible parent will be determined according to the Parental Rights and Responsibilities (PR&R) Agreement, regardless of where the parents claim the child is actually livings
|
Custody Situation |
Eligible Parent |
|
One parent has sole legal and physical responsibility pursuant to a Parental Rights and Responsibilities (PR&R) Agreement |
The parent with sole legal and physical responsibility is the eligible parent. |
|
One parent has physical responsibility for the child more than half of the time pursuant to a PR&R agreement. |
The parent with physical responsibility for more than half of the time is the eligible parent. |
|
The parents share physical responsibility for the child equally pursuant to a PR&R agreement. |
The parent who applies first is the eligible parent. |
|
The parents share physical responsibility for the child equally in the absence of a PR&R agreement. |
The parent who applies first is the eligible parent. |
When a parent, who does not have physical responsibility for a child more than half of the time, is the only parent to apply for Reach Up financial assistance, that parent will remain the eligible parent until the other parent applies for assistance and claims the child as a member of the household.
When there is a dispute between the parents as to the division of physical responsibility, in the absence of a PR&R agreement, the first parent to apply for assistance will remain the eligible parent until the other parent provides sufficient evidence to verify that the child primarily lives in the second household. This evidence includes, but is not limited to:
When adequate verification has been submitted by the other parent that is sufficient to prove that the child primarily lives in the second household, the first household shall be given 10 days to provide verification proving that the child primarily resides in the first household. If the first household does not provide verification proving that the child primarily resides in the household, the parent in the second household shall be the eligible parent.
Minor parents living in the same household as their parents shall be permitted to have their eligibility determined separately from their parents, regardless of whether the parents are eligible for Reach Up financial assistance. One of the parents shall be designated as the alternate payee, unless the minor parent chooses to be the payee of the grant. However, minor parents may choose to be included in their parents' assistance group. Minor parents who choose to be included in their parents' assistance group shall be subject the requirements in rule 2336. Minor parents receiving their own grant do not meet the definition of "eligible child" under rule 2230 because they are not considered in need as defined by rule 2250, and therefore, the minor parent's parents do not qualify as eligible parents in relation to the minor parent.
Section 2232 Needy Essential Person
An individual (other than the parent of an eligible child whose relationship automatically qualifies him or her for inclusion in the Reach Up assistance group) is deemed as an essential person and shall be included in the assistance group if he or she fulfills all of the following criteria:
To determine the need of an essential person who is not the spouse or parent in the assistance group, see 2242.5.
The determination of the essential person must be approved by a supervisor.
When an "essential" person qualifies for either SSI/AABD or Reach Up, his/her needs shall be met only through application for and grant of aid in his/her own right. Such individuals shall not be included in an assistance group as a "needy" essential person.
Section 2233 Residence
State law (33 VSA 1101) provides that, to be eligible for ANFC an individual shall be a resident of Vermont at the time of application for such assistance. A "Vermont resident" is defined as an individual who is domiciled voluntarily within Vermont regardless of the duration of such domicile. (To be "domiciled" is to be physically present in Vermont and to have an intent to make Vermont one's home, that is, not to be in the State for a temporary purpose, or with respect to a child, the state in which he or she is living on other than a temporary basis.) If such a person applies for ANFC in Vermont and is eligible but is receiving benefits from another State, the grant should be computed for the overlapping periods. If the payment level in the other State equals or exceeds that of Vermont the application should be denied. If Vermont's payment level exceeds that of the other State, the balance can be given in a grant for the overlapping period.
A resident can also be one who is living in the State, and is not receiving assistance from another State and entered the State with a job commitment or seeking employment in the State (whether or not currently employed). A child living with a caretaker who qualifies under this definition is a resident of the State in which the caretaker is a resident.
For an individual coming into Vermont and going to a medical facility (e.g., hospital, nursing home, or mental hospital) to acquire medical care, see WAM 2421.
Vermont has no citizenship requirements. An alien lawfully admitted for permanent residence or permanently residing in the United States authorized by law according to Immigration and Naturalization Service (INS) records, is eligible for ANFC provided he or she meets all applicable eligibility factors. Aliens illegally residing in the country are not eligible for assistance.
Residence is retained until abandoned. "Abandonment" of Vermont residence is defined as a move outside Vermont with the intent to domicile outside Vermont.
A recipient of public assistance shall retain Vermont residence during temporary absence from Vermont for any of the following purposes:
Incentive or higher education.
Intent to return to Vermont upon achieving the purpose of such temporary absence shall be supported by appropriate substantiating facts. In all cases where a recipient is to be absent from the state for a period of 30 days or more, the recipient must notify the District Director responsible for his case, advising of her/his new location, mailing address, and his/her intent in respect to residence. Failure to so notify the District Director may cause delay in receipt of assistance or Department inability to determine continued eligibility to receive assistance.
The residence of a child committed by a Vermont Juvenile Court to the care and custody of the Commissioner of Social Services is Vermont, regardless of where the child is actually living. Eligibility on the basis of Vermont residence continues as long as the commitment order is in effect.
A child committed to the care and custody of another state shall be considered a resident of that state, even though actually "living" in Vermont, and thus ineligible for assistance (ANFC) from Vermont.
Federal and State law ( section 406 of the Social Security Act: 33 VSA 1101 and 1102) require that, to be eligible for ANFC, a committed child shall be living:
Foster care placement and supervision under applicable Child Services regulations shall meet the criteria of residence in foster care.
Section 2234 Social Security Numbers
The department will notify applicants or participants that it uses social security numbers in the administration of the Reach Up program.
The department will advise applicants how to apply for social security numbers and will not delay, deny or discontinue assistance while the issuance and verification of such numbers is pending.
Refusal of any member of the assistance group to furnish, verify, or apply for a social security number shall make that individual ineligible for assistance.
Section 2235 Support Obligations and Payments
(03/01/2017, 17-02)
Physical absence of a parent from the home, for any reason, does not relieve the parent of legal responsibility for support of dependent children. Any payment of Reach Up financial assistance made to or for the benefit of a dependent child creates a debt due and owing to the Department for Children and Families (D) by any noncustodial parent. The amount of said debt shall equal the amount of Reach Up paid, unless the Family Court rules otherwise, or unless the Office of Child Support (OCS), on behalf of the commissioner, enters into a voluntary agreement with the responsible parent to limit the debt, or unless the noncustodial parent presents a court order that limits said debt.
Participating parents who receive assistance through a Solely State Funded Program (see rule 2390 ) shall assign all child support rights to the D. The participating parent shall apply for services from the OCS, if not already receiving such services, and cooperate fully with the OCS in their efforts to collect the assigned support. The department shall deny or terminate assistance to participating parents, caretaker relatives and guardians who fail or refuse to apply for services from OCS.
Assignment of support rights is the legal procedure by which a person receiving public assistance agrees to turn over to the state any right to child support, including arrearages, paid by the noncustodial parent in exchange for receipt of a financial assistance grant and other benefits. The state will use a portion of such child support to defray or recoup its expenditures for Reach Up financial assistance.
Assignment of support rights is a condition of eligibility for Reach Up financial assistance. This requirement applies to parents and other caretakers and may not be waived. Assignment of support rights to the department means all rights to support from any other persons applicants for financial assistance may have, including rights to support in their own behalf or on behalf of any members of the Reach Up assistance group.
The biological parent will sign the assignment of support rights when one of the parents is a stepparent, regardless of which parent is the applicant.
A parent or other caretaker of a child included in the Reach Up assistance group shall be required to cooperate in all practical and feasible means of establishing parentage and pursuing support from any noncustodial parent, unless good cause for refusal to cooperate is claimed and the decision is pending or granted.
Failure to cooperate, as determined by OCS, shall result in a 25 percent reduction in the amount of the family's Reach Up grant.
Areas in which the applicant's active cooperation is required include, but are not limited to:
The department shall notify OCS of all noncustodial, legally liable relatives of children included in the Reach Up assistance group within two working days of the time assistance is granted, unless a request for a waiver from the requirement to cooperate is pending. The department must notify the applicant or participant of the right to request a waiver based on good cause (rule 2235.3 ) as an exception to the cooperation requirement.
Information provided to OCS is subject to verification with the applicant or participant.
The department shall excuse a Reach Up financial assistance applicant or participant from cooperating with the establishment of parentage and pursuit of support when there is, in the department's judgment, good cause for noncooperation. Good cause exists when the department determines that cooperation is not in the best interest of the child for whom assistance is requested and is reasonably anticipated to result in any one of the following:
A parent or other caretaker requesting a waiver of the cooperation requirement must provide evidence of a good cause circumstance or sufficient information to permit the department to determine the circumstances. A grant to a potentially eligible assistance group shall not be denied, reduced, or delayed pending a good cause decision.
When good cause is claimed, the penalty for noncooperation (rule 2235.2 ) will not be imposed as long as the individual is fully cooperating in obtaining evidence necessary to support waiver of the cooperation requirement. Upon request, the eligibility worker will provide reasonable assistance in obtaining evidence to support the claim.
At its discretion, the department may verify the evidence received or seek additional evidence necessary to evaluate a good cause claim. In processing requests for waiver of the cooperation requirement, the department will:
Acceptable evidence upon which the department will base a determination of good cause includes, but is not limited to, documents such as law enforcement records; court documents; criminal records; birth certificates; medical records; social service, child protective services; or psychological records; records of adoption proceedings; and sworn statements from individuals, other than applicant or participant, with knowledge of the circumstances. Statements must be sworn to before a person authorized to take sworn statements, such as a notary public, justice of the peace, or county clerk.
If additional evidence is needed, the applicant or participant must be promptly notified of the type of documentation required.
Whenever the waiver request is based in whole or in part upon the anticipation of emotional harm to the child, the participant parent, or the caretaker, the present emotional state and health history of the individual subject to emotional harm must be considered as well as the extent of involvement of the child in the establishment of parentage or support enforcement activity to be undertaken. A finding of good cause for emotional harm may only be based upon a demonstration of an emotional impairment that substantially affects the individual's functioning.
When a claim is based on the applicant's or participant's anticipation of serious physical harm, no evidence is submitted in support of the claim, and the eligibility worker believes the claim to be credible, the claim will be investigated by the eligibility worker, with assistance from the child support worker if appropriate, to determine whether the applicant or participant has good cause for refusal to cooperate. The request and any available documentation should be submitted to the commissioner or the commissioner's designee.
On the basis of the evidence, the commissioner or the commissioner's designee will determine whether cooperation would be against the best interest of the child for whom support would be sought. This determination will be made within a time frame that does not exceed 30 days from the day good cause claim is made, except when the required verification cannot be obtained within that time frame. The department will not deny, reduce, or delay assistance pending good cause determinations if the requester is cooperating in the collection of evidence.
OCS is prohibited from attempting to establish parentage or collect support in cases where the caretaker claims good cause for refusal to cooperate until a decision has been made regarding the waiver request. OCS may, however, attempt to establish parentage and collect support without the cooperation of the parent or other caretaker following a decision by the commissioner or the commissioner's designee that this can be done without risk to the child.
A review of the continued existence of good cause circumstances upon which the waiver was granted is required no less frequently than at each redetermination of eligibility for those cases in which determination of good cause is based on a circumstance that may change. A formal decision based upon resubmission of evidence shall not be required, however, unless the eligibility worker determines that significant change of circumstances relative to good cause has occurred.
Section 2236 Citizenship
As a condition of eligibility for Reach Up an individual must be:
Exception: Certain qualified aliens are barred from Reach Up for five years.
Reach Up applicants must declare citizenship and alien status on the application. Non-citizens must provide documentation of immigration status. The state may undertake to document citizenship or identity through one or more data-system cross matches that may be available for such purposes. If the state obtains the needed documentation, the individual need not provide additional proof in this regard.
A "U.S. citizen" is:
A "national of the United States" is an individual who:
As a practical matter, non-citizen nationals include individuals born in American Samoa or Swain's Island. For purposes of determining Reach Up eligibility, including verification requirements, citizens and non-citizen nationals of the United States are treated the same.
A "qualified alien" is:
To qualify as a "battered alien" for purposes of establishing qualified alien status, the following conditions must be met:
Immigrants who enter the United States on or after August 22, 1996 as qualified aliens are not eligible to receive Reach Up for five years from the date they enter the country. If they are not qualified aliens when they enter, the five-year bar begins the date they become a qualified alien. The following qualified aliens are subject to the five-year bar:
The following qualified aliens are not subject to the five-year bar:
Section 2237 Special Cases of Ineligibility
Regardless of whether they meet all other eligibility requirements for Reach Up, certain families and individuals are ineligible for Reach Up. The following subsections define these special cases.
The term "strike" includes any strike or other concerted stoppage of work by employees, including a stoppage by reason of the expiration of a collective bargaining agreement, and any concerted slowdown or other concerted interruption of operations by employees.
Participating in a strike means the act of stopping, slowing, or otherwise interrupting work in concert with others to obtain demands from the individual's employer.
The department will deny or terminate assistance to a family in which a parent is on strike. If another member of the assistance group is on strike, the needs of that individual will be removed from the assistance grant payable to the family. The department will consider such individual's income and resources available to the family if the individual is legally liable for the child.
Closure or reduction of the Reach Up grant will apply to the period in which the individual is participating in a strike as soon as administratively possible.
The department will deny or terminate assistance to individuals convicted in federal or state court of having made a fraudulent statement or representation with respect to their place of residence to receive assistance simultaneously from two or more states. Such individuals shall be ineligible for a 10-year period beginning with the date of conviction. The department will consider such individuals' income and resources available to the family. For any month beginning after the President of the United States grants a pardon with respect to the conduct which was the subject of the conviction, the individual shall be deemed eligible.
The department will deny or terminate assistance to individuals who flee from justice to avoid detection, prosecution, or punishment after a felony conviction or who violate a condition of probation or parole imposed under federal or state law. The department will consider such individuals' income and resources available to the family. For any month beginning after the President of the United States grants a pardon with respect to the conduct which was the subject of the conviction, assistance will be not be denied.
Section 2238 Time Limits
(03/01/2017, 17-02)
A month in which financial assistance is received does not count toward the 60-month time limit if the participant is deferred from his or her work requirement for a full calendar month for one or more of the following reasons:
(05/08/2018, 17-20)
For families who have received 60 or more countable, cumulative months of assistance, noncompliance with Reach Up services component requirements, without good cause, or not fulfilling the work requirement, without good cause, will result in termination of the family's Reach Up grant. Good cause shall be determined according to rules 2372 and 2373.
(03/01/2017, 17-02)
Section 2240 Formation of the Assistance Group
(03/01/2017, 17-02)
An "assistance group" is defined as one or more individuals whose requirements, income, and resources are considered as a unit to determine need for financial assistance.
A Reach Up assistance group must include one or more eligible dependent children. In addition, the assistance group must include all siblings. including half-siblings, living with the dependent child or children and qualifying under the age criteria, as defined in policy. A parent must be included in the assistance group if the parent lives in the home with a child included in the assistance group unless the child's legal guardian is receiving assistance on behalf of the child, in which case the legal guardian may choose to not have the parent included in the child's assistance group. A parent whose residence in the home is interrupted by active duty in the uniformed services of the United States or by education, training, or employment away from home must be included in the assistance group.
There are three exceptions to the requirement that a Reach Up assistance group include at least one eligible child. They are:
-- The pregnant woman is a minor. In addition, when a woman has been eligible for and receiving Reach Up financial assistance as a pregnant minor, and her 18th birthday falls before the 30th day immediately preceding her expected delivery date, her eligibility for Reach Up on the basis of being a pregnant minor continues through the end of the pregnancy.
-- The pregnant woman is not a minor and requests consideration for early Reach Up eligibility on the basis of her belief that she is unable to work due to a high-risk pregnancy and is found eligible on this basis. '
A pregnant woman who has been determined disabled by the state's disability determination agent for Medicaid in accordance with applicable requirements of the Social Security Act shall be presumed to be unable to work due to a high-risk pregnancy.
The ability to work of all other pregnant women having no children in their household who seek Reach Up benefits before the 30th day immediately preceding the pregnant woman's expected delivery date (and who are not eligible as minors and not members of the grandparented group identified in the following bullet) shall be determined on the basis of a case-by-case assessment of the medical conditions present, to what degree those conditions are controlled or modified by treatment, and other relevant medical factors.
This determination shall be made by the commissioner or his or her designee on the basis of medical evidence provided by the woman's obstetrician, nurse-midwife, or other qualified medical professional (as determined by the commissioner or his or her designee) and obtained by the pregnant woman, and additional medical data when deemed necessary by the commissioner or his or her designee, which he or she shall obtain from the treating obstetrician, nurse-midwife, or other qualified medical professional, or on a consultative basis.
Medical professionals who perform examinations required to enable the department to determine a pregnant woman's ability to work due to a high-risk pregnancy will be provided reasonable reimbursement from administration funds.
The determination of a pregnant woman's ability to work shall be based on whether she can perform any substantial gainful activity which exists in the local or adjacent labor markets and shall not be limited to a determination of whether she is able to perform work in which she is currently or has been previously engaged. Non-medical factors, including but not limited to previous employment history, current employment status and availability of alternative sources of income support, and health-related factors, such as a pattern of substance abuse on the part of the pregnant woman, or other high-risk behaviors on her part, shall not be the basis of a determination that a pregnant woman is unable to work due to a high-risk pregnancy.
In the case of a pregnant woman seeking Reach Up benefits on this basis, the department shall determine eligibility no later than 10 calendar days following receipt of all information necessary to make the eligibility decision.
-- The pregnant woman is eligible for and receiving Reach Up benefits on the basis of pregnancy on June 30, 1996, and continues to be eligible on that basis.
The assistance group may also include the following individuals when they are living in the same household:
The assistance group shall not include an individual receiving benefits under the SSI/AABD program. Income and resources of a SSI/AABD recipient shall be excluded from consideration in determining income and resources for the Reach Up financial assistance group, except that $ 115.00 of the SSI payment received by a parent shall be counted as unearned income when determining the amount of the family's benefits. If both parents receive SSI, a maximum of $ 115.00 of the parents' combined SSI payments will be counted. Parents who receive SSI will continue to be excluded from the Reach Up assistance group for all other purposes. A child's SSI payment will not be counted, even if a parent receives the payment on behalf of the child. Caretakers' SSI payments will not be counted.
For purposes of this rule, the terms "SSI/AABD recipient" and "individuals receiving benefits under the SSI/AABD program" include disabled individuals who received SSI/AABD, became gainfully employed, and were subsequently granted 1619(b) status by the Social Security Administration. They shall continue to be considered SSI/AABD recipients during any months in which their 1619(b) status remains in effect, whether or not they receive an SSI/AABD payment during those months.
An individual participating in the Job Corps program who normally returns home on weekends is entitled to be a member of the Reach Up financial assistance group.
The assistance group shall not include a sibling or a parent subject to the five-year bar for qualified aliens. The income and resources of such a sibling shall not be considered in determining the eligibility and payment of otherwise eligible dependent children. The income of such a parent is considered available to otherwise eligible children after applying the following disregards.
- the basic needs standard for a family size corresponding to the number of individuals, including the parents, who are or could be claimed as dependents for income tax purposes by the parents and
- the actual shelter expense up to the maximum applicable to the family's county of residence.
Section 2241 Caretaker
(7/1/2015, 15-08)
A caretaker is defined as an individual other than a natural, step, or adoptive parent whose relationship to one or more eligible children qualifies the caretaker for inclusion in the Reach Up assistance group. If a parent living in the home is incapable of exercising parental obligations, both the parent and a caretaker living with the children and responsible for the children's care and supervision may be included in the assistance group. There can be only one person designated as the caretaker for the assistance group at any given time.
The needs of caretakers eligible for either SSI/AABD or Reach Up shall be met only through such financial assistance in their own right.
The department shall take the following steps to determine eligibility for one or more children living with a caretaker other than a parent and for the caretaker.
If the children's assistance group is not eligible for Reach Up, the caretaker is not eligible either.
To determine whether the caretaker meets these criteria, the department considers the income and resources of the caretaker and the following persons, if any, living with the caretaker and one or more eligible children: the caretakers spouse, minor children, and other tax dependents. The caretakers group does not include the children eligible for Reach Up.
For the caretaker to be considered needy, the combined countable resources of the caretakers group, as defined above, must not exceed the Reach Up resources maximum. Countable resources are determined according to Reach Up rules.
The combined countable income of the caretakers group is determined according to the rules for initial Reach Up eligibility, as if the caretakers group were the assistance group. Payments made by a member of the group to a person outside the home who is or could be claimed as a tax dependent may be deducted from that members earned income.
For the caretaker to be considered needy, the combined countable income of the caretakers group must not exceed the ratably reduced needs of the caretakers group, determined according to Reach Up rules. The housing allowance included in this determination, combined with the housing allowance included in the eligibility determination for the children's assistance group with the caretaker, must not exceed the caretakers total housing costs.
If the income and resources of the caretakers group meet the financial criteria described in this subsection, the caretaker is needy. If they do not, the caretaker is not needy and is not included in the children's assistance group.
If the caretakers income exceeds the difference between the ratably reduced needs for the children's assistance group without the caretaker and the ratably reduced needs for the same group with the caretaker, the caretaker should not be included in the assistance group. This insures that the caretaker's income is not used to support a child for whom the caretaker has no support obligation.
Resources of a caretaker who does not have the legal responsibility of a parent to support the child are not considered available to the child. The caretaker's income is also not considered as available to the child unless the caretaker has indicated a commitment to make ongoing monetary contributions toward the support of the child. In such cases only the income actually contributed to the child, considered unearned income to the child, would be counted.
Section 2242 Unmarried Parent with a Child-in-Common
In situations where unmarried parents eligible in their own right have a child-in-common whose paternity has been established by birth certificate, court order, or written acknowledgement by both parents, the grant shall be budgeted as a single assistance group. For example, if a father with a child by a previous marriage shares a home with a woman with a child by a previous marriage, each is eligible in their own right. If subsequently they have a child, the entire household shall be rebudgeted as a single assistance group.
Section 2250 Need Determination
Need is defined as the lack of income or other resources in sufficient quantity to provide a reasonable subsistence compatible with decency and health. Establishment of need is a basic eligibility requirement and, therefore, shall be determined at initial application or reapplication and at each subsequent review of eligibility, including changes of circumstances.
Section 2251 Method for Determination of Need
Financial need is established through the following computations:
Standards for basic requirements, common to all individuals and families, have been established to simplify determination of need and to ensure equitable consideration for all individuals in similar circumstances.
Financial need, and the amount thereof, shall be established when budgetary computation shows a deficit (e.g., requirements exceed income) and resources are within the maximum allowed. If either condition is not met (e.g., budgetary computation shows surplus or resources total above maximum), the applicant/recipient shall be ineligible, due to lack of financial need.
Section 2252 Ratable Reduction
Because funding is insufficient to meet 100 percent of the need standard, payment to an eligible Reach Up assistance group is based on a calculation that limits it to 49.6 percent of the group's needs.
The group's Reach Up grant is determined according to the following steps:
Section 2253 Eligibility Computation
Financial eligibility is computed for an initial application, or a reapplication, and each time an assistance group's circumstances change.
Eligibility based on income is determined as follows:
For families reapplying for Reach Up solely because of loss of child support see rules at 2334.
Section 2254 Prospective Budgeting
Whenever the following terms are used in ANFC policy, these definitions shall apply:
"Budget month" means the calendar month from which the household's income is used to compute the amount of assistance.
"Payment month" means the calendar month for which an assistance payment is made. Payment is based on income in the budget month.
"Prospective eligibility" means that eligibility for any given month is determined by estimating as accurately as possible whether all eligibility factors will be met during that month.
"Prospective budgeting" means that the amount of payment for any given month will be based on the best estimate of income and circumstances which will exist in that month. In prospective budgeting the budget month and payment month are the same.
All factors of eligibility and the basic need standard, including shelter costs, shall be determined prospectively for all assistance groups for all payment months.
Payment shall be determined prospectively for all assistance groups, including those sanctioned for failure to comply in full with the Reach Up services component requirements, based on the department's best estimate of the assistance group's circumstances. This estimate is derived from information collected and documented during the initial eligibility determination, periodic reviews, and the processing of reported changes in circumstances.
Income not received on a monthly basis shall be averaged, if fluctuating, and converted to monthly income separately for each income source. Weekly income and expenses shall be converted to monthly using a multiplier of 4.3 weeks per month. Biweekly income and expenses are converted to monthly using a multiplier of 2.15.
Information about circumstances during the most recent calendar month shall be the basis of the estimate of the assistance group's circumstances during the remainder of the review period until and unless a change in circumstances is reported or otherwise identified.
When an individual has been determined eligible and is added to an existing Reach Up assistance group, assistance based on the individual's needs and income will be effective for the date on which the individual joined the assistance group provided that a timely report of the change was made. A report of change is considered timely if it is reported within ten calendar days of the date the change became known to the assistance group. If the change was not reported in a timely manner, assistance based on the individual's needs and income shall be effective for the date on which the change was reported.
Section 2255 Amount of Payment
The amount of assistance payment shall be the amount of the budgetary deficit rounded down to the nearest lower whole dollar amount. Except for families receiving parent share payments (2333.2), no payment shall be made to a family in any month in which the amount of assistance is determined to be less than $ 10.00 for that month, prior to any recoupment applied to the grant. An assistance group not receiving payment solely because the payment would be less than $ 10 shall be considered eligible for Reach Up for all other purposes (i.e., shall be eligible for Medicaid and services provided through the services component of the Reach Up program). This will also apply in cases where an assistance group's payment of 99 cents or less has been rounded down to zero.
Section 2256 Income Deficits Prohibited
Assistance funds shall not be granted to meet income deficits. Examples of income deficits are:
* farm or business operating deficit due to operating costs in excess of gross receipts;
* nonrecipient household member's unpaid share of household expenses.
Section 2260 Needs
Certain requirements, basic to all individuals, shall be accounted for in budgetary computation. These include:
Each of these basic requirements shall be accounted for in one of the following ways:
No budgetary allowance is made for purchase, maintenance or related expenses of operating an automobile, except that such expenses may be allowable business expenses for self-employment.
Basic requirements are budgeted as indicated in the following sections.
Section 2261 Need Standards
Total basic monthly requirement of each assistance group shall be computed using the following:
When non-recipient members of a household fail to contribute to household expenses, their needs shall not be budgeted as a need of the recipient group(s). Department eligibility staff shall encourage and assist, if necessary, applicant(s)/recipient(s) to obtain contributions from such non-recipient household members at least equal to their share of household expense, as computed above.
The following table contains the combined basic need standards used to determine eligibility for Reach Up. The combined basic standards include food, fuel, utilities, clothing, personal needs and incidentals (e.g., soap, toothpaste, cosmetics, etc.), chore (e.g., snow removal, lawn maintenance, household cleaning supplies, etc.), and special needs (e.g., telephone, life insurance premiums, water, sewer, and municipal assessment costs, fire insurance premiums, household appliances, etc.) required by assistance group members regardless of the total number of individuals residing in the household.
|
Number in Assistance Group |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 or more |
|
Basic Needs |
$ 475 |
$ 680 |
$ 891 |
$ 1064 |
$ 1247 |
$ 1372 |
$ 1589 |
$ 1769 each person |
Add $ 170 for additional |
Allowance for an eligible ANFC group member in long-term care (i.e., in a nursing home, or if under 21 or over 65 in a public institution for mental disease) shall be the Other Basic Need Standard (including clothing, personal and special needs and incidentals) allowed for an individual in WAM 2246. This amount shall be added to the Combined Basic Need Standard for Eligibility for the other members of the assistance group.
Allowances for an ANFC child who is away from home to attend school shall be included in full when the parent or other caretaker is responsible for the child's expenses at the school.
When a school or institution agrees to accept a child and be responsible for the child's needs during residency at the school or institution, a decision must be made as to whether that child should continue as part of the ANFC assistance group. If responsibility for the care and control of that child remains with the parent, stepparent or caretaker and the parent/child relationship is maintained, then the child is considered to be living in the household and should be included in the ANFC assistance group.
If the parent, stepparent or caretaker is no longer responsible for the care and control of the child (e.g. child is committed to SRS) then that child does not meet the requirements for living in the household and he or she cannot be included in the ANFC assistance group.
These services may include, but are not limited to budgeting, nutrition, food preparation, child birth education, assistance in obtaining permanent housing, and counseling.
This special needs allowance may include the cost of room and/or board provided to the family or individual by the residential facility.
Section 2262 Living Arrangement
Budgetary computation of need for any payment month shall include allowances for all maintenance items required in the living arrangement of the individual or family group during the payment month, except that allowances for maintenance of prior living arrangement pending return shall be continued, under specified conditions, during temporary absence required by illness or other emergency.
Standard allowances and budgeting policies are classified according to the following major patterns of living:
Most Reach Up participants reside as families in a household or housing unit; therefore Reach Up budgeting, with limited exceptions, shall be based on household living, either as a single family unit or through sharing expenses with other household members.
Individuals residing in institutions shall meet all eligibility conditions of the program through which assistance is granted.
Section 2263 Housing Allowance
(05/08/2018, 17-20)
Housing expense is defined as the total of all verified costs incurred for any of the following: rental (house, apartment, lot), real estate (or equivalent personal property) taxes, maintenance and repairs, mortgage payments, homeowners insurance, and condo and association fees. (To include allowances for maintenance and repairs within the housing expense the property must be owned and listed in the name of the applicant/recipient.) Housing allowances shall be budgeted "as incurred" to cover recurring shelter expenses necessary to maintain a home, not to exceed the current maximums stated below. The housing allowance portion of a Reach Up financial assistance grant is limited to expenses incurred for the current month; overdue expenses for prior months cannot be included in the grant for the current month. Expenses incurred less frequently than monthly (i.e., real estate taxes) shall be prorated into monthly amounts for the period covered. (See rule 2263, on the special needs housing allowance.)
Maximum Monthly Housing Allowance
|
Outside Chittenden County |
Chittenden County |
|
$ 400 |
$ 450 |
The expense for shelter when shared may be included based upon the client's cost not to exceed the maximums.
When housing is provided in full (i.e., at no cost) and is considered unearned income-in-kind, no housing allowance and no unearned income are budgeted. When housing is provided in part (i.e., at reduced cost) and is considered unearned income-in-kind, only the assistance group's incurred cash obligation for housing is budgeted as the housing allowance (not to exceed the applicable housing maximum) and no unearned income is budgeted.
In the case of housing received as in-kind earned income, the housing allowance budgeted should be the maximum monthly housing allowance for which the assistance group is eligible or the sum of the assistance group's incurred monthly cash obligation, if any, for allowable housing costs and the amount of in-kind earned income received in the form of housing, whichever is less. The monetary value to be budgeted as in-kind earned income shall be that portion of the housing allowance attributable to earned income-in-kind, ratably reduced (i.e., the housing allowance amount is not ratably reduced; the earned income-in-kind is ratably reduced). This ensures that earnings received in the form of housing do not reduce the amount of assistance provided to meet the assistance group's other basic needs.
A standard amount which, in most cases, represents a portion of the fuel and/or utility subsidy used by Housing and Urban Development (HUD) in the calculation of rent for Reach Up families in subsidized housing will be considered unearned income for Reach Up purposes, according to rule 2271. The standard amount for those families who must pay for fuel or fuel and utilities is $ 70. The standard amount for those families who must pay for utilities only is $ 30. An applicant or recipient who documents an actual subsidy amount less than the standard may have the actual amount counted as unearned income in benefit and eligibility calculations.
In no case shall the provision of fuel and/or utilities as part of an assistance group's housing be considered either unearned or earned income-in-kind. Nor in these instances shall these items be shown in the budget as furnished. This policy applies irrespective of whether or not the assistance group incurs a cost for housing.
Nonpayment of all or a portion of shelter expense will be evaluated against the criteria for need of protective payments and subject to the limitations outlined in rule 2226.
Recipients who live in or are moving into subsidized housing shall have their shelter expenses budgeted in the Reach Up grant as stipulated below.
The most common types of subsidized housing are:
-- Section 8
-- Section 23
-- F. H. A (Farmer's Home Administration) rental assistance units.
-- Section 236
-- Housing owned and operated by the local public housing authority.
The Reach Up budget is computed as one would normally for a Reach Up family, except that the amount used for shelter will always be the maximum housing allowance permitted for a rental located in the county in which the family resides.
For examples see Procedures P-2210 E.
Total monthly requirements of each assistance group which shares a household or housing unit with one or more separate assistance groups and/or non-recipient members shall be computed in accordance with the following rules.
Please note that the limits described below do not apply to assistance groups eligible for the room and board standard because the housing cost portion (i.e. room rent) of this standard cannot be identified separately.
Exception: If an assistance group member(s) is the only person(s) on the lease or mortgage, but a different Reach Up group living in the household regularly pays a share of the rent or mortgage payment, the housing allowance for each assistance group shall not exceed the amount for which it is in practice responsible.
NOTE: If one Reach Up group is renting part of their housing unit to another Reach Up group and the first group is paying rent to a landlord for the entire unit, or is paying a mortgage as the home owner, the total shelter allowed for both budgets cannot exceed the total shelter paid for the housing unit, or the actual home owner costs (i.e., mortgage and taxes), regardless of the fact that the second Reach Up group considers the first Reach Up group as their landlord. Also, as in the above situations, each group's shelter cannot exceed the maximum allowed.
Exception: If an assistance group member(s) is the only person(s) on the lease or mortgage, but a different Reach Up group living in the household regularly pays a share of the rent or mortgage payment, the housing allowance for each assistance group shall not exceed the amount for which it is in practice responsible.
Exception: If an assistance group member(s) is the only person(s) on the lease or mortgage, but a different Reach Up group living in the household regularly pays a share of the rent or mortgage payment, the housing allowance for each assistance group shall not exceed the amount for which it is in practice responsible.
Room and board as a living arrangement for Reach Up participants shall be budgeted in the amounts established by the table below. Additional amounts are allowed for other basic needs, which include clothing, personal needs and incidentals, chore, and special needs.
Room and Board Allowances
|
number in Assistance Group |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 or more |
|
Room and Board |
$ 379 |
$ 547 |
$ 725 |
$ 853 |
$ 1008 |
$ 1098 |
$ 1265 |
$ 1403 |
Add $ 138 for each additional person |
|
Other Basic Needs |
$ 96 |
$ 133 |
$ 166 |
$ 211 |
$ 239 |
$ 274 |
$ 324 |
$ 366 |
Add $ 32 for each additional person |
The total budgeted requirement (room and board standard plus other basic needs standard) is subject to the ratable reduction.
Payments for Reach Up children who qualify for Reach Up foster care shall be provided by the Family Services Division through Title IV-E of the Social Security Act, as amended.
Individuals residing in institutions have the majority of their basic needs (other than clothing and other individual needs) met through one of the following methods:
The vendor payment for care in a nursing home or mental hospital is a form of medical assistance; the cost of such care shall not, therefore, be considered in establishing need for assistance. Allowances for basic personal needs in the institution, when appropriate, shall be budgeted to establish need for Reach Up assistance.
Need of a child, who qualifies for Reach Up foster care and who is placed in a child-care institution shall be budgeted in accord with payment policies currently in effect for care of children in department custody.
Eligible children placed in foster homes at State expense have their basic requirements met through vendor payment covering allowances for board, clothing, incidentals, personal spending and special needs made to one of the following:
Payments are made by the Family Services Division (FSD) under Title IV-E. FSD notifies ESD since Title IV-E recipients are automatically eligible for Medicaid. (See Interpretive Memo opposite rule 4300 and P-2412 for procedures).
Since by State statute, parents are legally responsible for support of their minor children, no vendor payment shall be allowed on behalf of a committed child placed in the home of his/her parent(s). A financially needy parent may apply for and, if eligible, receive Reach Up assistance on behalf of such child(ren).
The housing allowance for recipients of General Assistance or Emergency Assistance (GA/EA) temporary housing assistance is the maximum housing allowance permitted for a rental located in the county in which the family resides, in addition to the special needs housing allowance (if applicable). The housing allowance will always be the maximum housing allowance, in addition to the special needs housing allowance (if applicable), regardless of whether the participant is required under the GA/EA program to contribute a percentage of their income toward the cost of temporary housing (see General Assistance rules § 2652.2 and 2652.3; Emergency Assistance rules § 2852.2 ).
The housing allowance for residents of a shelter or transitional housing is the maximum housing allowance for a rental located in the county in which the shelter or transitional housing is located, in addition to the special needs housing allowance (if applicable). The housing allowance will always be the maximum housing allowance, in addition to the special needs housing allowance (if applicable), regardless of the family's incurred housing expenses.
Section 2264 Temporary Absence - Illness
When a caretaker has been or will be absent from the home for 30 days or more, due to illness requiring hospitalization or care outside the home, but remains able to provide continuing supervision of the child(ren), needs shall be budgeted as follows:
Section 2265 Temporarily Uninhabitable Home
When the home owned by an applicant or recipient is temporarily not habitable, the shelter expenses for the home may continue to be budgeted for up to six months. A home may be temporarily not habitable because of a fire, the heating system is inoperable, the water pipes are frozen, it is in a remote area where roads are not routinely snow plowed, etc.
The shelter expenses of the temporary living arrangement may also be budgeted, however, the total of the home expenses and the temporary shelter expenses may not exceed the shelter maximum.
Section 2270 Income
(12/01/2006, 06-24)
Income is defined as any cash payment or equivalent "in kind" which is actually available to the applicant or recipient. Sources of income include, but are not limited to, earnings from employment or self-employment, and "unearned" income (pensions, benefits, interest, or return on investments, contributions, assistance from other agencies, etc.).
All income except that specifically excluded shall be evaluated to establish net income available to meet need. When spouses are maintaining a common living arrangement, their joint incomes shall be evaluated and considered for availability to meet their joint needs, even though only one applies for or receives assistance under any Department program. Verification of all income except that specifically excluded shall be required in the Reach Up Program.
Transfer of assignment of income for the purpose of qualifying for a larger amount of assistance than that of which the individual would otherwise be entitled is prohibited. Voluntary transfer of income within two years before date of application or while in receipt of Reach Up shall result in ineligibility unless the income is reconveyed to the applicant or recipient.
Future and potential sources of income shall be identified and developed, when feasible. (See Potential Income and Resources.) State assistance in the amount needed based on currently available income shall, however, continue until such income becomes in fact available, at which time appropriate budgetary adjustment shall be completed.
(05/08/2018, 17-20)
The applicant or recipient of Reach Up is responsible for notifying the Department promptly upon receipt of any lump sum payment of earned or unearned income.
Lump sum payments, including windfall payments, shall be counted as income unless excluded under an exception cited below. Windfall payments shall not include sums resulting from the conversion of an existing asset (i.e. acquired when the individual was not in receipt of Reach Up benefits) to a liquid asset. However, money resulting from the sale of a vehicle acquired when the individual was in receipt of Reach Up benefits shall be treated as a resource and not as a windfall payment. Lump sum payments, including windfall payments, which have been set aside in a trust fund and which are excluded in accordance with Reach Up policy relating to "Trust Funds" shall not be counted as income.
Additional exceptions to the above regulation are:
Lump sum payments which are not excluded should be added together with all other non-Reach Up income received by the assistance group during the month. When the total less applicable disregards exceeds the standard of need for that family, the family will be ineligible for Reach Up for the number of full months derived by dividing this total income by the need standard applicable to the family. Any remaining income will be applied to the first month of eligibility after the disqualification period.
The period of ineligibility due to a lump sum benefit may be recalculated if
Eligible expenses under "7" above are as follows and are restricted to those of the primary residence and would include any late charges described in payment agreements or allowed by Public Service Board rules.
(07/01/1989, 89-24)
Income-in-kind is defined as any basic requirement, such as food, shelter, etc., which is furnished regularly at no cost to the applicant or recipient.
In computing the requirements, if any item is furnished in full and is considered unearned income-in-kind, it is shown in the budget as "furnished" and no unearned income-in-kind is budgeted. In computing the requirements, if any item is furnished only partially and is considered unearned income-in-kind, it is not to be shown in the budget as "furnished" and no unearned income-in-kind is to be budgeted.
In computing the requirements, if any basic need item is furnished in part or in full and considered as earned income-in-kind, the item should not be shown in the budget as "furnished," but it shall be given a monetary value by the employer, and treated as earned income in the budget computation. However, in no case shall the monetary value assigned to a need item received as in-kind earned income exceed the ratably reduced amount specified for that item in the ITEMIZED NEED STANDARD TABLE for an assistance group of equal size.
In the case of housing received as in-kind earned income, the housing allowance budgeted should be the maximum monthly housing allowance for which the assistance group is eligible or the sum of the assistance group's incurred monthly cash obligation, if any, for allowable housing costs and the amount of in-kind earned income received in the form of housing, whichever is less. The monetary value to be budgeted as in-kind earned income shall be that portion of the housing allowance attributable to earned income-in-kind, ratably reduced (i.e. the housing allowance amount is not ratably reduced; the earned income-in-kind is ratably reduced). This ensures that earnings received in the form of housing do not reduce the amount of assistance provided to meet the assistance group's other basic needs.
In no case shall the provision of fuel and/or utilities as part of an assistance group's housing be considered either unearned or earned income-in-kind. Nor in these instances shall these items be shown in the budget as "furnished." This policy applies irrespective of whether or not the assistance group incurs a cost for housing.
Section 2271 Unearned Income
(03/01/2017, 17-02)
Unearned income includes the following:
The full amount of available unearned income shall be applied to the payment standard, except for disregards specified under certain federal programs. (rule 2276 )
Any nonexcluded income from student loans or grants shall also be converted to a monthly amount by averaging the total amount of the grant or loan over the period it is intended to cover.
The full amount of Social Security or Railroad Retirement benefits awarded to members of the assistance group shall be considered, except that the Medicare Part B premium of a new recipient, which continues to be withheld from his benefit check pending completion of his transfer to the Department's "Buy-In" agreement, shall be disregarded until the benefit check increase is actually available to the recipient.
Regular and predictable contributions (cash or in-kind) shall be considered unearned income. Occasional small gifts and/or irregular contributions shall be disregarded in budgetary computations, provided the amounts do not exceed $ 30 per recipient per calendar quarter. (For calendar quarters see WAM 2333.2 #4; for monetary contributions in shared households see WAM 2245.5).
Section 2272 Distribution of Child Support
OCS distributes current child support collected on behalf of Reach Up assistance groups to PATH. PATH distributes family bonus and parent share payments to these Reach Up assistance groups for receipt on or about the first day of the second month following the month in which the child support was received by OCS.
The family bonus payment is the first $ 50 from child support collected by OCS in any calendar month and distributed to PATH on behalf of a Reach Up participant. PATH pays the family bonus to the custodial parent without affecting Reach Up eligibility or decreasing the amount of the grant. The maximum family bonus payment paid to an assistance group in a single calendar month without affecting its Reach Up eligibility is $ 50, even when more than one noncustodial parent pays child support on behalf of that assistance group for that calendar month. In no case shall the family bonus amount exceed the amount of child support paid on behalf of the members of the assistance group.
The parent share payment is the amount in excess of $ 50 from child support collected by OCS in any calendar month and distributed to PATH on behalf of a Reach Up participant. The parent share payment shall be:
* deducted from the Reach Up grant prior to any recoupment for the second month following the month in which OCS received the child support and distributed it to PATH; and
* paid to the assistance group according to the Reach Up financial assistance payment schedule (see 2232).
Arrearage is past due child support owed by a noncustodial parent. Arrearage collected by OCS from the noncustodial parent shall be distributed according to federal rules governing the distribution of child support. In general, arrearage collected on behalf of a Reach Up assistance group is applied to unpaid support obligations accumulated while the family was on assistance. When the arrearage collected from the noncustodial parent represents an accumulation of the support obligation during a period of Reach Up financial assistance (prior to July 1, 2001, Aid to Needy Families with Children [ANFC]), the department may retain an amount up to the financial assistance payment for that period.
Child support will be treated as advance payments only if current and past support obligations are paid in full.
Section 2274 Earned Income
Earned income shall include all wages, salary (cash or in-kind), commissions or profit from activities in which the individual is engaged as an employee or a self-employed person, including but not limited to active management of capital investments (e.g., rental property).
Earned income is defined as income prior to any deductions for taxes, if applicable, FICA, insurance, or any other deductions, voluntary or involuntary, except that in determining earned income for self-employed individuals, allowable business expenses shall be deducted first (see 2253.2).
Self-employment income will be determined by the client's most recent tax return unless the tax return is not indicative of the current situation, a tax return has not been filed, or the client has earned income not subject to taxation. In these circumstances, the department will use the client's records and other available sources to determine self-employment income. For determining monthly self-employment income, see 2211.3 and P-2210 C.
Earnings over a period of time, for which settlement is made at one given time are also included) (e.g., sale of farm crops, livestock, poultry).
Payments to individuals under the following programs shall be treated, as described below:
The Vermont Earned Income Tax Credit is paid only as a lump sum following the end of the tax year. See rules at 2255.1, Excluded Income and 2264, Excluded Resources.
Payment to individuals under any of the following programs, whether as partial and temporary beneficiaries or as employees, shall be considered earned income:
Work-Training Program (Title I, Part B)
Community Action Programs (Title II)
Voluntary Assistance Programs for Needy Children (Title II)
Income from employment as a teacher's aide, lunch room worker, clerical aide, etc. under a Title I project funded by the Elementary and Secondary Education Act shall be considered earned income.
Workforce Investment Act (WIA) programs prepare youth and adults to participate in the labor force by providing job training and other services expected to increase employment, earnings, and educational and occupational skills.
Some WIA programs pay participants wages, treated as unsubsidized earned income for adults.
Gross earned income must be verified as specified at 2211.3.
To determine eligibility and benefits, all income figures are converted to monthly figures, using a multiplier of 4.3 weeks equal to one month. A multiplier of 2.15 weeks per month is used for income received biweekly.
Items are deducted from the gross earned income of each member of the assistance group, whose total earned income is not otherwise excluded, in the sequences listed below. Whenever the sum of these deductions exceeds the gross earned income of the individual, the maximum allowable deduction is the amount of the gross earned income. Child care provided under Support Services to Participating Families does not constitute dependent care expenses and is not an allowable deduction.
If an individual has earnings from both subsidized and unsubsidized employment, the computation follows the sequence in A above. Only the earned income disregard is allowed. If less than $ 90 is deducted from unsubsidized earnings, however, the remainder of the $ 90 ($ 90 minus the amount deducted from unsubsidized earnings) will be deducted from any subsidized earnings.
Items such as depreciation, personal business and entertainment expense, personal transportation, purchase of capital equipment and payment on the principal of loans for capital assets or durable goods, are not business expenses.
Tax returns and business records are considered appropriate sources of accurate figures for farm and business receipts and expenses.
The income of a household owning or operating a commercial boarding house shall be treated as any other business income. A commercial boarding house is defined as an establishment licensed as a commercial enterprise offering meals and lodging for compensation. In areas without licensing requirements, a commercial boarding house shall be defined as a commercial establishment offering meals and lodging with the intention of making a profit.
Exception: No computation is required for providing foster care to children in custody of and placed by the Family Services Division of the Department for Children and Families. The rate of payment is established to cover expenses only, with no allowance for profit; therefore, no earned income is considered available from this source.
The room-and-board portion of income received by developmental home providers furnishing qualified foster care to individuals placed by the State of Vermont or by a developmental or mental health services agency under contract with the state is established to cover expenses only, with no allowance for profit. Therefore, no earned income is available from this portion of the income. Compensation received in addition to that intended to cover room and board, considered difficulty-of-care payments, is earned self-employment income. Payment for respite care services from this source of income is an allowable business expense.
For a household that is not a commercial boarding house, the business expense of furnishing room and board, alone or as part of custodial care, shall be allowed, provided that the amount shall not exceed the payment the household receives from the roomer/boarder for lodging/meals. (See procedures for Business Expenses - Providing Room and Board.) If the assistance group can document that actual expenses for providing room and board are greater than the standard business expenses allowed, the actual expenses may be allowed as a business expense.
A standard business expense deduction is provided for the expenses associated with providing meals to children receiving child care in the assistance group's home. To receive this deduction the assistance group must report the number of children receiving meals; the number of days on which meals were provided; and the type of meals provided. The standard business expense deduction for child care meals shall be used unless the assistance group requests a higher business expense deduction for child care meals and fully documents expenses which substantiate costs which exceed the standard deduction.
Assistance groups which include providers of child care are also entitled to a business expense deduction for non-meal-related expenses incurred in the course of providing child care as a form of self-employment. All non-meal-related expenses must be determined on a case-by-case basis and must be fully documented by the assistance group. These non-meal-related expenses may include, but are not limited to, a portion of rent, interest on mortgage, non-cooking-related utility expenses, cost of toys, and purchase of non-meal-related supplies.
Assistance groups may receive the standard business expense deduction for meals and an individually determined deduction for non-meal-related business expenses; individually determined business expense deductions for both meal-related expenses and non-meal-related expenses; only a deduction for meals (no other expenses are claimed and documented); or only a deduction for non-meal-related expenses (no meal-related expenses are claimed). See the Procedures Manual under procedures for Business Expenses - Providing Day Care.
Section 2275 Earned Income Deductions
(7/1/2015, 15-08)
The department shall allow certain deductions from an individual's earned income to cover employment expenses (rules 2275.1 - 2275.2) or provide an incentive disregard for employed participants (rule 2275.3 ). For income not reported timely without good cause, however, no disregards are allowed (rule 2275.4 ).
Total deductions and disregards shall not exceed the amount of earned income to which they are applied.
The standard employment expense deduction of $ 90 is used in lieu of the amount of actual expenses for taxes, insurance, retirement, union dues, fees, and other reasonable employment expenses. Only one deduction is allowed per individual with earned income.
The deduction shall be applied to:
-- subsidized earned income in determining continuing eligibility;
-- earned income of an individual ineligible for the earned income disregard, as specified in rule 2275.4; and
-- earned income of an individual whose needs are not included but whose income and resources are counted.
The department shall not apply both the standard employment expense deduction and the earned income disregard to the earned income of any individual at the same time.
A deduction from the earned income of an assistance group member is allowed to cover the cost of care for an assistance group member who is an incapacitated adult, when all the following conditions are met:
Paid expenses converted to a monthly amount shall be deducted up to a maximum of $ 175 per month. If a participant's dependent care expenses are below the maximum, transportation to and from the dependent care facility may be deducted as part of the expense.
The cost of employment-related child care needed by assistance groups is provided either:
- as a support service reimbursement subject to the conditions and limitations described in rule 2271; or
- as an exclusion from gross earned income, if the child is not a member of the assistance group, as described in rule 2276.
The department shall disregard the first $ 250.00 per month of the total unsubsidized earned income of each eligible assistance group member plus 25 percent of the balance remaining. The disregard includes a standard allowance used in lieu of the amount of actual expenses for taxes, insurance, retirement, union dues, fees, and other reasonable employment expenses.
No disregard is allowed for any new or increased earned income the participant fails without good cause to report by the end of the calendar month following the month in which the new or increased income was first received. Circumstances considered good cause for failure to report timely are limited to the following:
This provision has no effect on an assistance group's responsibility to report all changes in circumstances within 10 days of their being known to the group or on the groups liability in the case of an overpayment.
Section 2276 Excluded Income
(03/01/2017, 17-02)
Examples of excludable income sources: Basic Educational Opportunity Grants, Vermont Student Assistance Corporation grants or loans, Senatorial Scholarships, Supplemental Educational Opportunity Grants (SEOG), and College Work-Study Programs (CWSP).
That portion of any Veterans Administration Educational Assistance Program payment that is for the student and is actually used for tuition, books, fees, child care services necessary for enrollment, etc., is also excluded.
Examples of programs in Title IV of the Higher Education Act include:
The provider of care must be at least 18 years of age, or at least 16 years of age if the provider has a high school diploma or GED or attends secondary school full time, and must meet the conditions specified under rule 2316 for providers of child care.
The actual amount paid or the FSD maximum payment rate for child care, whichever is less, shall be deducted from the parents or caretakers countable gross earned income.
The dependent care must be necessary for the employment of the nonparental caretaker. Payments for dependent care provided by a member of the assistance group, other legally liable relative or legal guardian do not qualify as necessary dependent care expenses under this policy.
The provider of care must be 16 years of age or older and submit a completed and signed form 218 P. The child must meet the age requirements in rule 2316.1.
The actual amount paid, up to a maximum of $ 175 per month, shall be deducted from the household's gross earned income.
The room-and-board portion of income received by developmental home providers furnishing qualified foster care to individuals placed by the Department of Developmental and Mental Health Services (DDMHS) or by a developmental or mental health services agency under contract with DDMHS. (See 2253.2).
Payments or reimbursements for child care expenses provided under Child Care Assistance for non-participants in Reach Up are also excluded as income in determining eligibility for or the benefit amount in Reach Up
Section 2280 Resources
Resources are defined as any assets, other than income, that a Reach Up applicant or member of an assistance group has available to meet need. Such assets generally take the form of real or personal property the applicant or participant owns individually or jointly with other persons.
The Department shall evaluate the total equity value of all resources, except items specifically excluded, to establish their combined value for comparison with the resource limitation below. When a member of the assistance group and one or more persons who are not members of the same assistance group own resources jointly, the department shall consider at least a pro rata share of the resources available to the assistance group unless the assistance group can demonstrate that such resources are inaccessible to the assistance group. When the assistance group can demonstrate that it has access to only a portion of the resource, the value of that portion shall count toward the assistance group's resource limitation. The resource shall be considered totally inaccessible to the assistance group if the resource cannot practically be subdivided and the assistance group's access to the value of the resource is dependent upon the agreement of the joint owner.
When a member of an assistance group receives any liquid asset during a period of Reach Up participation (including periods of participation with zero benefits) and the asset is not otherwise excluded from consideration as income or resources in the determination of eligibility for Reach Up the department shall treat the asset as Lump Sum Income subject to the regulations under that heading. This includes liquid assets obtained as a result of the sale of a non-excluded or excluded resource unless the participant acquired the resource while not participating in Reach Up.
The department shall disregard from the combined resource limitation any portion of a bank account, cash on hand, or other liquid asset, that an applicant or participant has set aside for currently incurred expenses, such as property taxes or fire insurance premiums, included in the family's Reach Up basic needs and housing allowance for which payment is not yet due. The department shall disregard from the combined resource limitation an amount equal to the applicant or participant family's monthly income if it is established that this income constitutes cash on hand or money in a checking account to be used to meet current monthly expenses.
Future or potential resources shall be identified and developed, when feasible, (see Potential Income and/or Resources). Assistance needed, based on currently available resources, shall, however, continue until such resources become, in fact, available.
Section 2281 Combined Resources Limitation
(05/08/2018, 17-20)
The maximum allowable resources, including both liquid and non-liquid assets, of all members of the household shall not exceed $ 9000 for the household.
The total equity value of all real and personal property, except excluded items, may not exceed the above amount.
(07/01/1994, 94-12)
Any individual who, or whose spouse, has voluntarily assigned or transferred property or income for the purpose of qualifying him/her for such assistance or for a larger amount than that to which he would otherwise be entitled is disqualified. Property affected includes any or all real or personal property subject to consideration as total resources subject to limitation.
Property transfers which occurred more than two years before the date of application for assistance shall not affect eligibility; this time interval affords reasonable presumption that such transfer was not made contrary to regulation.
Property transfers which occurred less than two years before the date of application for assistance shall not disqualify the individual if
If the applicant cannot establish eligibility by facts supporting use of his/her equity, he/she may qualify by having the property reconveyed to him/her for consideration as an available resource.
(10/01/1990, 90-35)
NOTE: The client retains the option of selling the mortgage, or accepting a lump sum settlement (see A. above) which is subject to the Lump Sum Income policy.
(07/01/2001, 01-06F)
Any resources in excess of the allowable maximum and not treated as lump sum income (rule 2270.1 ) shall be considered available to the assistance group for use.
An assistance group shall become ineligible until such excess is exhausted. If the excess, however, is equal to or exceeds the grant amount that the assistance group would receive, the assistance group is ineligible for a period of 30 days or until resources fall below the maximum, whichever is longer.
Section 2282 Real Property
(03/01/2017, 17-02)
Real property is defined for purposes of public assistance eligibility as land or property (i.e. buildings) affixed thereto. All mobile homes shall be considered "real" property.
Real property owned, used and occupied as a home by the applicant or recipient or spouse or minor child(ren), regardless of value shall be excluded from combined resources subject to limitation.
The value of the applicant's or recipient's equity in real property which is owned, but is not being occupied as a home by the applicant or recipient or spouse or minor child(ren), may be excluded from the total combined resources for a period of up to 6 months provided the family is making a good faith effort to sell the property. Assistance paid during this period shall be considered an overpayment, since Reach Up would not have been granted had the owner had the proceeds of the sale in hand. The recipient must agree that the proceeds of the sale shall be used to repay the Reach Up paid. The balance shall be counted as a resource.
If at the end of six months the property has not sold, and the recipient continues to demonstrate a good faith effort to sell, the equity may be excluded from resources for a further period of 3 months with the approval of the District Director. At the end of that time the equity in the property, if still unsold, must be considered as a resource.
When an applicant or recipient and eligible child(ren) are temporarily living at a location other than property owned, and that property was previously used and occupied as their home, expenses necessary to maintain their former home for their return shall be allowed in accord with "temporary absence". (rule 2264 ) When absence continues beyond six months, exemption of the property as "a home" must be re-evaluated in light of the circumstances precluding their return to the home and the expected duration of their absence from the home.
For treatment of any real property which is transferred, see "Transfer or Assignment Prohibited" (rule 2281.1 ).
Section 2283 Personal Property
(01/01/1984, 83-61F)
Personal property includes all liquid or non-liquid assets, other than real property.
In cases where payments are being received on notes and mortgages according to a time payment contract and are being considered as income, it is not necessary for the client to agree to convert to liquid assets, although that option is available.
If payments are not being made on a time contract and steps are not being initiated to foreclose, the entire equity remaining in a mortgage shall be considered as a resource. If such resource exceeds the maximum allowable, the case will be closed.
Liquid assets are defined as cash or assets which can readily be converted to cash. Examples include: bank accounts (savings or checking); postal savings; credit union or building and loan shares; contents of safe deposit boxes; savings bonds; stocks and other securities; notes or mortgages payable to the applicant/recipient; etc.
Interest on savings accounts shall be considered only at time of initial application and at each regularly scheduled review. In those cases where resources are close to the maximum allowed, up-to-date verification of accrued interest shall be required. If, at time of review, recipient has excess resources, the recipient will be determined ineligible until excess resources have been used to meet need.
Stocks, bonds (including savings bonds) and other securities shall be evaluated at the current market or redemption value.
The principal due on outstanding notes and/or mortgages payable to an applicant/recipient and/or spouse shall be considered.
Loans and grants (such as scholarships) obtained and used, regardless of source, for a specific purpose which precludes their use for current living costs shall be excluded.
(11/01/1984, 84-54F)
Evaluation of trust funds or trust accounts shall take into account the terms of the trust. The value of principal which can he made immediately available to the applicant/recipient and/or spouse shall be considered. The value of principal which cannot be made available shall be excluded; however, any special provisions for use of principal (such as payment of medical expenses, upkeep of property, etc.) shall be evaluated as a future or potential resource, including but not limited to recovery potential. It is also necessary to take into consideration the value and possible use of interest accruing from trust funds. Unless prohibited by terms of the trust, accrued interest shall be considered as income in the month received and a resource thereafter.
(11/01/1984, 84-54F)
One burial plot for each individual in the Reach Up unit may be excluded as a resource. One funeral agreement per member may also be excluded provided the equity value of the agreement does not exceed $ 1500.
(05/08/2018, 17-20)
Annuities must be included as a family resource unless the applicant or participant can demonstrate that these funds are not and cannot be made available to the family. In counting resources of households with annuities, the total cash value must be counted minus the amount of penalty, if any, for early withdrawal.
(07/01/2001, 01-06F)
A vehicle is defined as a passenger car, truck or jeep, motorcycle, camper, van, snowmobile or boat that is stored on blocks or is operable (i.e., includes all major operating parts, such as engine, transmission, wheels, steering mechanism, etc.).
A nonoperable vehicle minus operating parts is considered junk and thus does not come within the definition of a vehicle; however, the salvage value of a junked vehicle may represent a substantial resource requiring individual evaluation.
The equity value of one operable motor vehicle per assistance group with one adult (rule 2301 ) and of two operable motor vehicles per assistance group with more than one adult is excluded as a resource. In situations where the assistance group owns additional vehicles, the applicant or participant shall identify each vehicle to be excluded. The equity value of all remaining vehicles owned by members of the assistance group, unless otherwise excluded, must be counted towards the resource limitation. Equity value equals fair market value minus debt owed.
If a vehicle excluded under this provision is sold and then replaced within 30 days of the date of the sale with another vehicle, the proceeds from the sale will be disregarded as a resource during this 30-day period.
To determine the fair market value of all countable vehicles, see Procedures, P-2211.
In situations where the applicant or participant disagrees with the determined value of the vehicle being considered, a written appraisal of the value submitted by a licensed dealer will be accepted.
(07/01/2001, 01-06F)
Personal property used as a means of livelihood (i.e., to produce income) is excluded from total value of combined resources (rule 2284 ).
Income-producing property may include vehicles, tools, livestock, equipment, machinery and similar goods owned, usually in quantities beyond the customary needs of normal living, and in fact, used by members of an assistance group to produce income for support of the group. This may include income-producing property owned by a participant who is currently unemployed, but can reasonably be expected to return to work. If, however, there is no expectation that the participant will return to work, at least in that particular field, then the personal property shall be considered as a resource (rules 2281.2 and 2282 ).
Section 2284 Excluded Resources
(05/08/2018, 17-20)
The following items are excluded from consideration to determine total resources:
Examples of excludable resources include: Basic Educational Opportunity Grants, Vermont Student Assistance Corporation grants or loans, National Direct Student Loans, Senatorial Scholarships, Supplemental Educational Opportunity Grants, and College Work Study Program income.
Liquid assets excluded under this policy must be kept in a separate bank account from other liquid assets, unless to do so would create a hardship. A hardship exists when there is no bank within a reasonable distance from the earner's residence or place of work that allows a bank account without charging fees.
If a family reapplies for assistance after Reach Up terminates, assets accumulated during the time the family was not participating in Reach Up are excluded, provided that all other criteria specified for exclusion are met.
Examples of student financial assistance authorized by Title IV of the Higher Education Act are:
- Pell Grants;
- Supplemental Educational Opportunity Grants (SEOG); State Student Incentive Grants (SSIG);
- College Work-Study (CWSP);
-- Guaranteed Student Loans (or GSLP including PLUS loans and Supplemental Loans for Students); and
-- Perkins Loans (formerly National Direct Student Loans). These are different from loans under the Carl D. Perkins Vocational and Applied Technology Education Act, (see #22 above).
Settlement payments to victims of Nazi persecution or their legal heirs resulting from the confiscation of assets during World War II.
Section 2290 Potential Income and Resources
Potential sources of income or resources to meet current or future needs of applicants or recipients shall be explored.
Practical and feasible steps in identifying and developing potential income or resources include:
Section 2291 Pension and Benefit Programs
Entitlement to social security, Supplemental Security Income, railroad retirement, veterans' benefits or similar benefits will be explored with the applicant/recipient. Current age, physical or mental conditions, and survivor/dependent status of applicants/recipients, together with employment and military service history of such individuals and their legally liable relatives, may indicate potential or future entitlement of such benefits.
If any member of an ANFC family is an elderly or disabled adult or the child of a deceased or disabled parent and has not already applied for social security or Supplemental Security Income benefits, the family shall be referred to the nearest social security office to apply for these benefits.
Section 2292 Insurance and Liability Claims
Insurance, in general, provides protection against specific future or unanticipated expense or loss of income. Provisions of the following types of insurance owned by applicant(s)/recipient(s) shall be evaluated for immediate or future potential income or resources.
Potential liability of a third-party shall be identified and appropriate claim action initiated in cases involving personal injury and/or property damage. When appropriate, such claims shall be referred to the Quality Control Division for recovery action.
Section 2293 Support from Relatives
The Department stresses both the moral and legal support obligation of spouses for each other and parent(s) for child(ren).
Potential sources of support from the following legally liable relatives shall be identified during the application/review process:
Applicants/recipients shall be encouraged to take the initiative in securing support from other interested relatives and/or friends when appropriate.
All available information about the alleged father of a child born out-of-wedlock, including but not limited to his name, shall be obtained from the mother or other caretaker of such child and referred to the Office of Child Support for confidential evaluation of and recommendation to the Commissioner of practical and feasible action to establish paternity or secure support. If the district worker feels it is not in the best interest of the child to have paternity established, or support pursued, a notation to this effect must be included with the referral specifying the reason for the recommendation and a waiver request completed.
In all other cases, essential information concerning support potential and location shall be obtained from the applicant/recipient. Information obtained shall be referred to the Office of Child Support for initiation of action to secure support.
However, if the non-custodial parent is a stepparent to the child(ren) in the assistance group and is divorced, legally separated, or living apart from the applicant/recipient spouse, support from the stepparent is not pursued because absence results in the termination of his or her financial obligation to the children.
33 VSA § 1104 requires prompt notice to the appropriate law enforcement officials when assistance is granted due to desertion or abandonment of a child by a parent. Responsibility for legal action in accord with 15 VSA § 201 - 210 rests with the dependents of the deserting parent and the state's attorney, the official charged with enforcing laws relating to the abandonment or desertion of children or minors.
Notification is required in all cases of desertion by a natural, step or adoptive parent. This includes any married parent even though "allegedly" not the father of a child or children, since by law children born in wedlock are presumed legitimate until proven otherwise.
The Office of Child Support enlists the aid and cooperation of law enforcement officials in pursuit of support; locates the deserting parent, if possible, and contacts him to encourage voluntary assumption of his legal responsibility for his family: provides information necessary for legal action in accord with efficient administration of the program to law enforcement officers.
The applicant/recipient must be informed of the Department of Social Welfare's legal obligation under 33 VSA § 1104 to report the receipt of assistance to the appropriate law enforcement official. If the applicant is unwilling to have the report made, he has the choice of withdrawing his/her request for assistance. Clear interpretation of this legal requirement, including the possibility that testimony may be required, is needed to enable applicant to make an informed choice.
An Office of Child Support staff member shall contact by the most practical means, the non-custodial parent, from whom regulations require pursuit of support, when assistance is granted initially and until regular payments are being received by the Department, as long as assistance continues. An Office of Child Support staff member shall contact the alleged father of an out-of wedlock child where action to establish paternity is contemplated.
Child Support contact with parents shall cover the following points:
Contact with legally liable parents shall be made by the most practical means available (personal interview, letter or telephone). If the parent is located outside Vermont, an interview by a representative of an out-of-state public social agency may be requested or by the commanding officer of an individual in military service.
A written summary of recipient information and/or action and all Child Support contacts with legally liable parents shall be maintained in the Office of Child Support.
A concerted effort to locate and contact non-custodial parent(s) whose whereabouts are unknown to the recipient, shall be required. A similar effort to locate the alleged father of a child born out-of-wedlock shall be required except in those cases where action to establish paternity has been determined not to be in the best interests of the child.
The Commissioner has legal authority ( 33 VSA § 113 ) to request information to assist in locating parents involved in desertion and non-support cases through a record search by other state agencies. Assistance may be requested through the Federal Parent Location Service (FPLS) in the manner and form prescribed by the Secretary of Health and Human Services. The Office of Child Support will maintain a parent locator service and process all requests to the FPLS for both recipients and for persons not otherwise eligible for ANFC.
The Office of Child Support is responsible for pursuit of support from legally liable parents. Referral by completing specified forms shall be required when Reach Up has been granted or continues to a family in which a parent is absent from the home for any reason other than death.
Participating parents who receive assistance through a Solely State Funded Program (2180-2183.1) shall assign all child support rights to the D. The participating parent shall apply for services from the OCS, if not already receiving such services, and cooperate fully with the OCS in their efforts to collect the assigned support. The department shall deny or terminate assistance to participating parents who fail or refuse to apply for services from OCS.
The OCS reviews information concerning alleged parentage as furnished by the custodial parent of an out-of-wedlock child, evaluates the legal and social factors involved, and pursues support as appropriate based on the facts of the case. A representative of the OCS contacts the alleged noncustodial parent when OCS concludes that action to establish parentage is in the best interests of the child.
The Office of Child Support as the State Information Agency under URESA carries out the following duties: ( 15 VSA § 405 ):
Families with children not receiving Reach Up financial assistance may request child support collection and parentage establishment services from OCS.
STATUTORY AUTHORITY:
33 V.S.A. §§ 105, 1103, 1901
