CASE MAINTENANCE  4.6

Recertification 4.6.1

Alliance program recipients must recertify for benefits yearly. Recertifications will be completed in compliance with the policies and procedures detailed in Part VIII: Chapter 4, Case Maintenance, Recertification.

If the recipient provides all information needed to re-determine eligibility, confirming that s/he continues to meet all financial and nonfinancial eligibility requirements, the SSR will recertify Alliance benefits for an additional 12 months.

Reporting Changes  4.6.2

Alliance program recipients must report changes that affect their eligibility for benefits by the 10th day of the month following the month of the change. If the group reports an additional group member, the SSR will make the change for the month of the change, if otherwise eligible. If the group reports that a group member has left or that a change has occurred that makes the group ineligible, the SSR will make the change for the month following expiration of adequate and timely notice.

A person who fails to report a change timely may lose his/her benefits and face civil and criminal penalties.

Case Termination  4.6.3

If the recipient fails to return a recertification form or fails to provide requested verifications that are needed to confirm continuing eligibility, the SSR must send timely and adequate notice of the agency's intent to terminate Alliance benefits. If the recipient does not respond within 15 days, the SSR should terminate the Alliance benefits for the next available month. 

If the recipient reports (and verifies when necessary) a change at Alliance recertification that results in  termination of Alliance benefits and affects the  person's eligibility for other program benefits also, the SSR should re-evaluate his/her eligibility for those programs.

Notices of Alliance program termination must meet all requirements listed in Part VIII: Chapter 10, Case Maintenance, Notice of Adverse Action.

Fair Hearings 4.6.4

An applicant/recipient dissatisfied with an action taken by the Department which affects Alliance benefits, participation or requirements can request a fair hearing. The hearing process outlined in Part VIII: Chapter 7, Case Maintenance: Grievances and Fair Hearings should be used.  

Fraud in Obtaining Benefits 4.6.5

An applicant, or his/her authorized representative, must give true, accurate and complete documents and information. A person who gives a false, deceptive or misleading document or information may lose his/her benefits and face civil and criminal penalties.

Non-cooperation in Eligibility Review  4.6.6

An applicant and his/her authorized representative must cooperate with District investigators and their duly authorized agents who review the applicant’s eligibility record. The requirement for cooperation includes being interviewed by investigators, but the applicant may still refuse entry in his/her home. An applicant who fails to cooperate may lose his/her benefits. An applicant and his/her authorized representative may face civil and criminal penalties.

VERIFICATION   4.7

Except where noted earlier, the SSR should use standard verification procedures to verify financial and nonfinancial eligibility requirements.