Sec.17b-198-14. Continuing eligibility

(a) The renewal process. The department shall periodically determine whether an assistance unit's eligibility for assistance pursuant to SAGA should be renewed and whether such assistance unit is receiving the appropriate level of assistance. The department shall provide notice of its intention to begin the renewal process not later than during the month preceding the month in which such renewal process will occur.

(b) Renewal frequency. (1) The department shall begin the renewal process for an assistance unit as necessary based on the likelihood that such assistance unit's eligibility status has changed or will change, provided (A) the first renewal shall occur not later than during the twelfth month after the month in which the assistance unit became eligible for assistance, and (B) each subsequent renewal shall occur not later than the twelfth month after the month in which the previous renewal occurred.

(2) Notwithstanding the provisions of subdivision (1) of this subsection, an eligibility renewal shall occur not later than the third month after the month in which a person became eligible for assistance for any person (A) who was granted assistance without filing a new application after requesting such assistance not later than thirty days after being released from a correctional or mental health facility, as described in subdivision (2) of subsection (b) of section 17b-198-3 of the Regulations of Connecticut State Agencies, and (B) whose eligibility for assistance would have been subject to the renewal process prior to the expiration of the month in which renewal is required by this subsection, had such person not been institutionalized in such facility.

(c) Renewal interviews. As part of the renewal process, the department shall interview the assistance unit by telephone or, at the assistance unit's request, in person. The renewal interview shall be conducted in the same manner as, and pursuant to the same rules that apply to, the application interview, as described in subsection (g) of section 17b-198-3 of the Regulations of Connecticut State Agencies. The department shall include in the notice required pursuant to subsection (a) of this section the date and time by which such interview shall be conducted. An assistance unit shall be responsible for rescheduling any renewal interview that such assistance unit is unable or fails to attend. Any renewal interview that is rescheduled shall be rescheduled to occur by a date that ensures the renewal process is completed in a timely manner, as described in subsection (b) of this section.

(d) Renewal form required. The department shall attach to the notice required pursuant to subsection (a) of this section a renewal form. Such form shall be completed by the assistance unit member, such member's authorized representative or, in the case of an incompetent or incapacitated assistance unit member, a court-appointed fiduciary. Such form shall be completed and returned to the department by the date provided in the notice described in subsection (a) of this section. To be considered sufficiently complete for purposes of the timely filing requirements of this subsection, such form must bear a legible name and address and be signed by the assistance unit member or other person authorized to complete such form.

(e) Renewal verification. The assistance unit shall provide verification of any information requested by the department as part of the renewal process not later than the fifteenth day of the renewal month or ten days after the date the department sends the assistance unit a request for such verification, whichever is later.

(f) Renewal processing standards. (1) For any case in which all necessary verification has been timely received and additional information is not needed, the department shall complete the renewal process not later than the last day of the renewal month and provide notice of its decision to the assistance unit. If eligibility is renewed, the department shall continue to issue benefit payments according to the established payment cycle beginning on the first day of the month following the renewal month, provided that such payments shall reflect any increase in assistance deemed appropriate during the renewal process. If the department determines that an assistance unit is no longer eligible for assistance or that a reduction in assistance is necessary, the department shall, prior to discontinuing or reducing such assistance, comply with the provisions of section 17b-198-15 of the Regulations of Connecticut State Agencies.

(2) If a renewal decision has not been completed by the end of the renewal month, the department shall continue to issue benefit payments according to the established payment cycle if none of the circumstances described in subsection (c) of section 17b-198-15 of the Regulations of Connecticut State Agencies are true and: (A) The department is responsible for not completing the renewal in a timely manner; (B) the assistance unit failed to comply with the requirements of this section in a timely manner, but complied with such requirements not later than the last day of the renewal month; or (C) the assistance unit provides verification demonstrating that there was good cause for failing to timely comply with the requirements of this section. For purposes of this subsection, good cause shall exist when such failure was due to illness, severe weather, a death in the assistance unit member's immediate family or other circumstances beyond the assistance unit's control. Whenever assistance is continued pursuant to this subdivision, the assistance unit shall complete all requirements of the renewal process not later than the last day of the month following the renewal month, unless the circumstances constituting good cause continue to delay the renewal process. The department shall continue to issue benefit payments to the assistance unit according to the established payment cycle as long as none of the circumstances described in subsection (c) of section 17b-198-15 of the Regulations of Connecticut State Agencies are true and the circumstances constituting good cause continue to delay the renewal process.

(3) Whenever the assistance unit fails to file a renewal form, provide necessary verification or participate in a renewal interview prior to the end of the renewal month, assistance shall be discontinued on the last day of such month. If assistance is discontinued pursuant to this subdivision due to an assistance unit's failure to file a renewal form during the renewal month, any renewal form filed in the month following the renewal month shall be treated as a new application for assistance pursuant to SAGA unless such assistance unit verifies circumstances constituting good cause for such untimely filing. When an assistance unit files a renewal form during the renewal month but is discontinued assistance for failure to complete the renewal interview or provide all necessary verification during the renewal month, such assistance unit's completion of the renewal interview and verification of all necessary information in the month following the renewal month shall result in the renewal form being treated as a new application for assistance pursuant to SAGA unless such assistance unit verifies circumstances constituting good cause for such untimely compliance. If good cause is verified, the department shall process such case as a renewal and make a renewal decision not later than five business days after the date the assistance unit completes all required actions.

(g) Interim eligibility changes. Each assistance unit granted assistance pursuant to SAGA shall report any change that could impact eligibility for continued assistance or the appropriate level of assistance not later than ten days after the date of such change. A change is considered reported on the day any department regional office or case worker receives notification of such change. An assistance unit receiving assistance pursuant to multiple programs administered by the department shall not be required to report a change separately for each such program. After reporting a change, the assistance unit shall verify any information concerning such change not later than ten days after the date on which the department sends a request for such verification, and the department shall assist in obtaining any verification that would be difficult for the assistance unit to obtain prior to such deadline. Changes that shall be reported pursuant to this subsection include, but are not limited to:

(1) Changes in the source of income;

(2) Changes in the amount of income or assets, regardless of whether such income or assets are countable;

(3) Changes in the status of excluded income or assets that may become countable;

(4) The acquisition of a motor vehicle;

(5) Changes in the household or needs group composition;

(6) Address changes and any change in the cost of shelter;

(7) Changes in the amount of deductible expenses;

(8) Changes with respect to the status of an authorized representative;

(9) Changes concerning special benefits; and

(10) Any other change impacting eligibility criteria set forth in sections 17b-198-5 to 17b-198-7, inclusive, of the Regulations of Connecticut State Agencies.

(h) Method for reporting interim changes. An assistance unit may notify the department of any change that must be reported pursuant to subsection (g) of this section in person, in writing, by telephone or by any other method approved by the department, provided such assistance unit shall subsequently verify such change as required by the department.

(i) Failure to report or verify an interim change in a timely manner. Failure to timely report or verify a change, as required pursuant to subsection (g) of this section, may result in the discontinuance of assistance if eligibility is contingent upon verification of the circumstance that changed. The department shall not discontinue assistance pursuant to this subsection if there was good cause, as defined in subsection (f) of this section, for such assistance unit's failure to timely report or verify such a change. When circumstances constituting good cause are verified, the department may afford the assistance unit additional time to report or verify such change prior to discontinuing assistance, but may take future corrective action to prevent benefit error.

(j) Processing standards for interim changes. Any programmatic change affecting continued eligibility or the appropriate level of assistance that is necessary due to a change in state law shall be completed within the time constraints imposed by such law and notice shall be provided to each assistance unit impacted by such programmatic change. For all other interim changes, the department shall determine whether such change affects an assistance unit's eligibility for continued assistance or the appropriate level of assistance within a reasonable amount of time after being notified of such change. The department shall attempt to make such determination not later than thirty days after such notice is received, and shall act promptly to determine the accuracy of any information provided to the department and to require verification of any reported information that appears questionable. Notice shall be sent to an assistance unit whose eligibility or level of assistance is adversely impacted by such determination not later than ten days after the department receives information verifying the need for such adverse action.

(k) Effective date of benefit and eligibility changes. (1) When the department becomes aware of a change that renders an assistance unit member ineligible for assistance pursuant to SAGA or reduces such member's benefit level, the effective date of such ineligibility or reduction shall be determined as follows:

(A) For such a change that is timely reported, the effective date shall be:

(i) The first day of the month following the month in which the change was reported if no advance notice is required under the provisions of section 17b-198-15 of the Regulations of Connecticut State Agencies; or

(ii) The first day of the month following the month in which the ten-day adverse action period described in subsection (b) of section 17b-198-15 of the Regulations of Connecticut State Agencies concludes; and

(B) For such a change that was not timely reported, the effective date shall be the first day of the month the change would have been effective under the provisions of subparagraph (A) of this subdivision, had the change been timely reported.

(2) When the department becomes aware of a change that increases an assistance unit member's benefit level, the effective date of such increase shall be determined as follows:

(A) For such a change that is reported and satisfactorily verified in a timely manner, the effective date shall be the day such change occurred;

(B) For a change that is not reported and verified in a timely manner, the effective date shall be:

(i) The first day such change has been both reported and satisfactorily verified; or

(ii) The day the change occurred if there was good cause for such member's failure to timely report and verify such change. For purposes of this subparagraph, “good cause” has the same meaning as provided in subsection (f) of this section.

(3) An overpayment subject to recoupment occurs whenever (i) an assistance unit member fails to timely report a change affecting eligibility and benefits to which such member is not entitled are incorrectly issued by the department as a result, or (ii) an assistance unit timely reports a change adversely affecting eligibility or benefit level, but the department fails to act in a timely manner according to the effective-date provisions of subdivision (1) of this subsection. When a change entitling an assistance unit to an increased level of assistance occurs, the department shall issue a supplemental payment in an amount calculated by taking into consideration the effective-date provisions of subdivision (2) of this subsection.

(Effective October 11, 2016)