921 KAR 2:040. Procedures for determining initial and continuing eligibility.

 

      RELATES TO: KRS 205.010, 205.200, 205.245, 42 U.S.C. 601-619

      STATUTORY AUTHORITY: KRS 194A.050(1), 205.200(2)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 194A.050(1) requires the secretary to promulgate administrative regulations necessary to implement programs mandated by federal law or to qualify for the receipt of federal funds and necessary to cooperate with other state and federal agencies for the proper administration of the cabinet and its programs. KRS Chapter 205 requires the Cabinet for Health and Family Services to administer the Kentucky Transitional Assistance Program (K-TAP) and the State Supplementation Program (SSP). KRS 205.200(2) requires the cabinet to prescribe, by administrative regulation, the conditions of eligibility for public assistance, in conformity with Title IV-A of the Social Security Act, 42 U.S.C. 601-619, and federal regulations. This administrative regulation establishes the procedures used to determine initial and continuing eligibility for assistance under these programs.

 

      Section 1. Eligibility Determination Process. (1) A household shall, for the month payment is intended to cover the household, meet the eligibility criteria in:

      (a) 921 KAR 2:006 and 921 KAR 2:016 for K-TAP; or

      (b) 921 KAR 2:015 for SSP.

      (2) A household shall not receive assistance until approval of the application for benefits.

      (3) Each decision regarding eligibility for assistance shall be supported by facts recorded in the applicant's or recipient's case record.

      (4) The applicant or recipient shall be the primary source of information and shall be required to:

      (a) Furnish verification of:

      1. Income;

      2. Resources; and

      3. Technical eligibility; and

      (b) Give written consent to contacts necessary to verify or clarify a factor pertinent to the decision of eligibility.

      (5) If informed in writing of the appointment or necessary information to be provided, failure of the applicant or recipient to appear for a scheduled interview or present required information when requested shall be considered a failure to present adequate proof of eligibility.

      (6)(a) An application shall be considered filed if a PA-77, Intent to Apply for Medicaid and/or K-TAP (Cash Assistance), or a PA-100, Application/Recertification for K-TAP, Kinship Care, and Family/AFDC Related MA, containing the name, address, and signature of the applicant is received by a DCBS office.

      (b) An application shall be processed after the:

      1. Applicant or representative is interviewed;

      2. Required information and verification for the application is provided to the Department for Community Based Services (DCBS) office; and

      3. Application and related documents, pursuant to subsection (4) of this section, are received by the DCBS office.

      (c) If an electronic form is not used, the cabinet shall record information for recertification to determine continuing eligibility for K-TAP by using form PA-100.

 

      Section 2. Continuing Eligibility. (1) The recipient shall be responsible for reporting, within ten (10) calendar days, any change in circumstances which may affect eligibility or the amount of payment.

      (2) Eligibility shall be redetermined:

      (a) If a report is received or information is obtained about changes in circumstances;

      (b) Every twenty-four (24) months for SSP cases; and

      (c) Every twelve (12) months for K-TAP cases.

 

      Section 3. Incorporation by Reference. (1) The following material is incorporated by reference:

      (a) "PA-77, Intent to Apply for Medicaid and/or K-TAP (Cash Assistance)", 11/11; and

      (b) "PA-100, Application/ Recertification for K-TAP, Kinship Care, and Family/AFDC Related MA", 11/13.

      (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Community Based Services, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. (PA-52.3, 54, 70; 1 Ky.R. 1283; eff. 7-2-75; Am. 7 Ky.R. 71; 569; 650; eff. 2-3-81; 8 Ky.R. 1190; eff. 6-25-82; 16 Ky.R. 243; eff. 9-20-89; 2569; eff. 6-27-90; 18 Ky.R. 3262; eff. 6-24-92; 21 Ky.R. 136; eff. 9-21-94; 981; 1529; 1682; eff. 2-17-98; Recodified from 904 KAR 2:040, 10-30-98; 29 Ky.R. 1415; 1824; eff. 1-15-2003; 37 Ky.R. 866; Am. 1213; eff. 11-17-2010; 38 Ky.R. 411; eff. 10-19-11; 40 Ky.R. 466; 849; eff. 10-16-2013.)