10-144-301 Me. Code R. § 200-FS 222-6

Current through 2024-51, December 18, 2024

Section 144-301-200-FS 222-6 - Time Standards/Procedures

1.OPPORTUNITY TO PARTICIPATE

An opportunity to participate includes the authorization of benefits and access to those benefits through an EBT card.

The Department shall give eligible households that complete the initial application process an opportunity to participate as soon as possible but no later than 30 calendar days following the date of application (Section 999-1) . In instances where a card must be ordered for the household, authorization any later than the 27th day from the date of application, will not provide the household an opportunity to participate within the 30 day standard.

NOTE: The Department will mail a decision or card to the designated address of a participant in the Address Confidentiality Program (ACP) within the same timeframe consistent with this section. The administrators of the ACP will then forward the mail to the ACP participant.

Therefore, the ACP participant might experience delays in receiving decisions and cards.

2.DENYING THE APPLICATION

The Department shall send households that are determined to be ineligible a notice of denial as soon as possible but not later than 30 days following the date of application. If the household fails to complete a scheduled interview and makes no effort to reschedule the interview or pursue the application, the Department shall send a notice of denial on the 30^th day following the date of application.

In cases where the interview was conducted and all necessary verification was requested on the date of application, the Department shall send a notice of denial no sooner than the tenth day or later than the 30th day if the household was provided assistance as outlined in Section 222-5, but failed to provide the requested verification.

3.DELAYS IN PROCESSING

If the Department does not determine eligibility and provide an opportunity to participate within 30 days following the date of application, the cause of the delay is determined using the following criteria:

A. A delay is considered the fault of the household if they have failed to complete the application process and the Department has taken all of the required actions to assist the household. The following actions must have been taken by the Department before a delay can be considered the fault of the household:

(1) For failure to complete the application, the Department must have offered or attempted to offer assistance in its completion.

(2) For failure to comply with work registration requirements, the Department must have informed the household of the need to register members and the household must have been given at least ten days from the date of such notification to register these members.

(3) Where verification is incomplete, the Department must have offered assistance as outlined in Section 222-5 and the household must have been allowed sufficient time to provide the missing information (at least ten days from the date of the initial request for the particular verification).

(4) For failure to complete an interview, the Department must have attempted to reschedule the initial interview within 30 days following the application date by sending a notification of missed interview (NOMI) to the household informing the household it missed the interview appointment and that it is the household's responsibility to contact the Department to reschedule the interview.

NOTE: If the household failed to complete the first scheduled interview and a subsequent interview is postponed at the household's request or the household cannot otherwise be rescheduled until after the 20th day but before the 30th day, the household must complete the interview, bring verification, and register members for work/training by the 30th day. Otherwise, the delay is the fault of the household. If the household failed to complete the first scheduled interview and a subsequent interview is postponed at the household's request until after the 30th day the delay is the fault of the household. If the household missed both scheduled interviews and requests another interview any delay is the fault of the household.

B. Delays that are the fault of the Department include, but are not limited to, those cases where the Department failed to take the actions described in Subparagraph A, above.

C. Actions to be taken on processing delays--

(1) Delays beyond the 30^th day--

If, by the 30th day, further action cannot be taken on the application due to the fault of the household, eligibility for benefits for the month of application is lost. The Department shall send the household a notice of denial which advises them that if the required action is taken within 60 days following the application date a new application is not necessary. If the household is found eligible, benefits will be authorized from the date the household takes the required action.

Whenever a delay in the initial 30 day period is the fault of the Department, it shall take action immediately to correct the situation. It shall notify the household by the 30th day that their application is being held pending. The Department shall notify the household of any action they must take to complete the application process. If the household is found to be eligible during the second 30 day period, eligibility must be determined back as far as the date of application.

(2) Delays beyond the 60^th day--

If the Department is at fault for not completing the application process by the end of the second 30 day period, and the case file is otherwise complete, the Department shall continue to process the original application until an eligibility determination is reached. If the household is determined eligible, and the Department was at fault for the delay in the first 30 day period, eligibility must be determined back as far as the date of application.

If, the initial delay was the household's fault, eligibility must be determined back as far as the date the household took the required action. The original application may be used to determine the household's eligibility in the months following the 60 day period.

If the Department is at fault for not completing the application process by the end of the second 30 day period but the case file is not complete enough to make an eligibility determination, the Department shall continue to process the original application.

If the household is at fault for not completing the application process by the end of the second 30 day period, the Department shall deny the application and the household is required to file a new application if they wish to participate. The household is not entitled to any lost benefits even if the delay in the initial 30 day period was the fault of the Department.

EXCEPTION: Expedited services (Section 222-2) .

4.DELAYS CAUSED BY THE DEPARTMENT

When a delay is the fault of the Department, the Department shall--

A. not deny the application until--

(1) sufficient information is received to render a decision, or

(2) the household fails to comply with a requirement;

and

B. take prompt action to process the application;

C. determine eligibility back to the date of application; and D. if the household is eligible, authorize benefits back to the date of application or the date the household takes the required action per the standards established in (3)(C) above.

5.DELAYS CAUSED BY THE HOUSEHOLD

A. When a delay is the fault of the household, the Department shall deny the application.

B. If the household takes the required action within 60 days of the date of application, a new application is not necessary. The Department shall determine eligibility and if the household is eligible authorize benefits back to the date the household takes the required action.

10-144 C.M.R. ch. 301, § 200-FS 222-6