DEPARTMENT OF HEALTH AND SOCIAL SERVICES

Division of Social Services

Statutory Authority: 31 Delaware Code, Section 512 (31 Del.C. §512)

FINAL

ORDER

2007 Stop Payments and 2008 Replacement Benefits - TANF, GA, RCA

Nature of the Proceedings:

Delaware Health and Social Services (“Department”) / Division of Social Services initiated proceedings to amend policies in the Division of Social Services Manual (DSSM) as it relates to case processing procedures. The Department’s proceedings to amend its regulations were initiated pursuant to 29 Delaware Code Section 10114 and its authority as prescribed by 31 Delaware Code Section 512.

The Department published its notice of proposed regulation changes pursuant to 29 Delaware Code Section 10115 in the March 2006 Delaware Register of Regulations, requiring written materials and suggestions from the public concerning the proposed regulations to be produced by March 31, 2006 at which time the Department would receive information, factual evidence and public comment to the said proposed changes to the regulations.

Summary of Proposed Changes

DSSM 2007, Stop Payments for TANF, GA and RCA Benefits and DSSM 2008, Replacement Benefits – TANF, GA, RCA: Procedurally, DSS has denied requests for replacement checks when the requests were made after the stale date on the check. The stale date is sixty (60) days from the date of the check.

Stale date means the date the check is no longer valid for cashing. If the issue date is 1/1/06, the check is good for sixty (60) days until 3/1/06 and, 3/2/06 becomes the stale date. If a client cashes the check after the stale date, they will not receive reimbursement from the state. DSS is updating the DSSM to reflect this procedure.

DSS also added the requirement to sign and return an affidavit within ten (10) days of the date of the reported loss to align the procedures with the food stamp program.

Currently, a client could request a benefit replacement for a check they claim they did not receive a year ago. The client could request a replacement check in December but not sign an affidavit until three months later.

Summary of Comments Received with Agency Response and Explanation of Changes

The Governor’s Advisory Council for Exceptional Citizens (GACEC) and the State Council for Persons with Disabilities (SCPD) offered the following observations and recommendations summarized below. DSS has considered each comment and responds as follows:

The impact of the proposed regulations could be quite onerous; especially if one considers that loss of benefits such as General Assistance may be life threatening and that, many beneficiaries have mental disabilities and limited understanding of DSS procedures.

60 Day Rule

The 60-day time period to report non-receipt of a check may generally be reasonable. However, there are some situations in which it would be unfair to penalize a beneficiary for not reporting lack of receipt within 60 days. For example, a beneficiary may be unclear on when to expect an initial benefit check after filing the application. Sixty days could pass after issuance of a check and the beneficiary may simply believe that DSS is still processing the application. If that check is misdirected, lost in the mail, or stolen, the beneficiary would be forever barred from obtaining replacement benefits despite the lack of any fault. Alternatively, there may be confusion if the beneficiary has been advised that DSS may be adjusting/withholding benefits due to a past overpayment. The beneficiary may believe that absence of a check is indicative of lack of issuance based on a past overpayment or other eligibility issue. It would be preferable to retain the 60-day rule but allow exceptions for good cause.

Agency Response: At application, staff informs clients that DSS has 30 days to act on an application.  Staff encourages clients to return their mandatory verifications as quickly as possible. If a client fails to return verifications at the end of the 30 days, a denial notice is sent to the client. If a client has not received a notice after returning their verifications, they do call their worker. When checks are recouped due to overpayments, the calculation information is on a notice sent to the client. The client will know the amount of the recoupment and the net check. Rarely, if at all, would a recoupment take the full check, as recoupment is 7% or $15, whichever is greater. DSS maintains that the 60-day rule is reasonable and should stand as is.

10 Day Rule

Adoption of a 10-day standard for submission of an affidavit after report of loss may likewise unfairly penalize some beneficiaries.

At a minimum, DSS should clarify how and when beneficiaries would be notified of the requirement. If a 10-day rule is applied, the beneficiary should be advised of the rule no later than the date of the reported loss.

The regulation does not address how and when the beneficiary is provided with Form 124. If a beneficiary called to report loss on a Friday afternoon, and DSS mails out the form on Monday, several days may pass before the beneficiary actually obtains the form after reporting the loss. The beneficiary must then find a notary and not simply mail it back to DSS (since it will not be received in time) but somehow hand deliver it. The 10-day rule appears to presume that all beneficiaries have a Form 124 on hand.

Access to a notary, especially for “home-bound” beneficiaries, could be a major barrier. As a practical matter, query how a homebound beneficiary will entice a notary to perform a home visit? 5 DE Reg. 1927 (April 1, 2002) and 8 DE Reg. at 1152 (February 1, 2005) [DSS may conduct telephone interviews for homebound Food Stamp and TANF applicants]. For non-homebound beneficiaries, it would be preferable to include a regulatory requirement that each State Service Center have a notary available during normal business hours and that beneficiaries be notified of such availability.

A “good cause” exception should be authorized. For example, if a beneficiary reported a loss and then became hospitalized for 10 days, there is no authorization for an exception. Indeed, if the hospitalized beneficiary called DSS on the 10th day and asked the worker for an extension, the worker would have no authority to grant an extension irrespective of hardship or fairness. Indeed, if the DSS office were unexpectedly closed on the 10th day (e.g. due to snow or state of emergency), there is no authorization for an extension. The beneficiary is simply out of luck.

The following standard could be added to the end of Section 2008 to address both the 60-day and 10-day rules: “A DSS supervisor may grant reasonable extensions of the above time limits based on good cause (e.g. unforeseen hospitalization; reasonable belief benefit check not issued).”

Agency Response: Workers routinely inform clients at application what to do when a check is not received. They inform clients to report the loss right away, and that client will have to come into the office to sign the affidavit. A notary is located at each office location. A person who cannot come into the office can have a worker go to the hospital or to the home to take the affidavit. DSS has not had any problem with these procedures.

Staff is flexible with clients who experience circumstances that prevent them from meeting certain deadlines. DSS always try to give the client the benefit of the doubt. DSS will add the following statement at the end of Section 2008:

A DSS supervisor may grant reasonable extensions of the above ten-day time limit based on good cause.

Timetable for Replacement Benefits

The timetable for replacement benefits is inconsistently described. Section 2008 indicates that “DSS will provide replacement benefits within ten days of the reported loss or within four working days of receiving the affidavit, whichever is later.” In contrast, Section 2007, Part 4, adopts a “mailbox” approach in which replacement benefits will be mailed within four working days of receipt of the affidavit. For consistency, DSS may wish to consider substituting “issue” for “provide”.

Agency Response: “Issue” has been substituted for “provide” at Sections 2007 and 2008.

Findings of Fact:

The Department finds that the proposed changes as set forth in the March 2006 Register of Regulations should be adopted.

THEREFORE, IT IS ORDERED, that the proposed regulation to amend the Division of Social Services Manual (DSSM) as it relates to case processing procedures is adopted and shall be final effective May 10, 2006.

Vincent P. Meconi, Secretary, DHSS, 4/12/2006

DSS FINAL ORDER REGULATIONS #-6-17

REVISIONS:

2007 Stop Payments for TANF, GA and RCA Benefits

The following procedures are used to place a stop payment on a check that is reported by a client as lost, stolen, or not received by the 5th of the month.

1. The client must sign the affidavit form Affidavit of Forgery and Request for Replacement of Lost Checks (Form 124) indicating that the check was not received, or was lost or stolen. Form 124 must have the benefit number and the benefit amount to be replaced. Form 124 is to have a notary signature.

2. The worker completes Form 230., Stop Payment or Rescind Payment, in the case of either for each TANF, General Assistance, and RCA checks not received.

3. Form 230 and Form 124 are forwarded to DMS.

4. DMS investigates claims of checks that were not received, lost, or stolen. DMS will [mail issue] a replacement check to the recipient four working days after the receipt of the affidavit and Form 230, if the original check has not been cashed. (Note: In rare instances, DMS will send a replacement check to the pool must be specified and a when requested. A reason must be given for distribution by the pool.)

9 DE Reg. 1756 (05/01/06)

2008 Replacement Benefits - TANF, GA, RCA

The client must sign the Affidavit of Forgery and Request for Replacement of Lost Check (Form 124) attesting to the loss and submit the affidavit to DSS within ten days of the report of the loss.

The household will not receive a replacement check if the affidavit is not received by DSS within ten days of the report of the loss. If the tenth day falls on a weekend or holiday, DSS will consider the affidavit as received timely if it is received on the next business day.

The household will not receive a replacement check if the date of request exceeds the stale date on the check. The stale date on checks is sixty (60) days [from the date of the check.]

DSS will [provide issue] replacement benefits within ten days of the reported loss or within four working days of receiving the affidavit, whichever is later.

The procedures listed below are followed in order to replace benefits. They apply to both closed and open cases.

1. The DCIS II screen that reflects the current status of the case (open or closed), Form 124, and Form 230 (in the case of an assistance check) are sent to the Payments Section, DMS, Third Floor Annex, Administration Building, Herman M. Holloway, Sr. Health and Social Services Campus.

If the replacement is to be issued in an amount different from the original benefit, the pool supervisor must indicate on a separate sheet of paper the amount of the replacement benefit, the reason for the different amount, and sign it.

2. Upon receipt of Form 124 and Form 230, the Payments Section will issue the benefit via the DCIS II system and mail it to the recipient. Note: in In order to issue a replacement benefit for a closed case, the Payments Section will have to reopen the case. Once the replacement benefit has been issued, the Payments Section will return the case to a closed status.

[A DSS supervisor may grant reasonable extensions of the above ten-day time limit based on good cause.]

9 DE Reg. 1756 (05/01/06) (Final)