subchapter 71W – general program administration

 

section .0100 – general program administration

 

10A NCAC 71W .0101      DEFINITIONS

The following definitions apply to this Chapter:

(1)           "Adjusted Payment" means a payment to the recipient to correct a county‑responsible underpayment.

(2)           "Appeal" means an oral or written request from a client for a hearing to review the action of a county Department of Social Services when the client is dissatisfied with the decision in his case.

(3)           "Application Process" means a series of actions beginning with a signed application and ending the date a check or denial notice is mailed.

(4)           "Assistance Unit" means the total number of persons whose needs are considered in determining the payment amount.

(5)           "Budget Unit" means all those persons for whom application has been made plus anyone in the home who is liable for the support of a member of the assistance unit or whose income is counted as available to the assistance unit.

(6)           "Client" means member of the assistance unit.  It may be used interchangeably with payee, recipient and applicant.

(7)           "Collateral" means a person or organization that can substantiate or verify information necessary to establish eligibility.

(8)           "Determination" means the process of verifying eligibility factors for persons applying for AFDC.

(9)           "Disregard of Earned Income" means the procedure for exempting certain portions of earned income as a resource when determining the amount of payment.

(10)         "Effective Date" means the date for which the benefit is authorized.

(11)         "Eligibility, Initial" means the state of eligibility at time of application.

(12)         "Essential Person" means a person who gives an essential service to a client, and, if in need, is eligible to be included in the assistance unit.

(13)         "Excluded Income" means money received by a member of the budget unit which is not counted in determining eligibility for assistance.

(14)         "Father, Alleged" means the man who is said without proof to be the father of a child.  This includes a father who has admitted paternity when paternity has not been established in a court of law.

(15)         "Father, Legal" means:

(a)           The man who is married to the mother of child at the time of birth of the child, regardless of whether they are living together.  The legal father is not necessarily the natural father, but is legally responsible for support; or

(b)           A man who has been determined by the court to be the father of the child through a paternity suit or by act of legitimation; or

(c)           A man who has legally adopted the child.

(16)         "Father, Natural" means the biological father of the child.  He may be the alleged or legal father.

(17)         "Full‑Time Student" means a student so designated by the school in which he is enrolled.

(18)         "Minor Mother" means a mother who is under the age of 18 who may be payee for an assistance unit or a recipient included in another assistance unit.

(19)         "Needy Spouse" means the husband or wife of a specified relative (other than a parent) who is eligible to be included in the assistance unit if he applies for assistance and meets the requirements of an essential person.

(20)         "Payee" means the person in whose name the AFDC payment is made.

(21)         "Payment Month" means the month for which the payment is made.

(22)         "Prospective Budgeting" means the best estimate of income in the payment month.

(23)         "Reapplication" means a subsequent application when a case has been terminated or suspended.

(24)         "Recipient" means an eligible person whose needs are included in the assistance payment.

(25)         "Remainder Interest" means property which will be inherited in full at a life estate interest holder's death.

(26)         "Revocable Trust" means funds held in trust which are available for the client's use.

(27)         "Verification" means the confirmation of facts and information used in determining eligibility.

 

History Note:        Authority G.S. 108A‑25; 143B‑153; 45 C.F.R. 233;

Eff. February 1, 1984;

Amended Eff. June 1, 1990; August 1, 1988; February 1, 1986;

Temporary Amendment Eff. July 1, 1996;

Recodified from 10 NCAC 49A .0002 Eff. January 1, 1997;

Amended Eff. April 1, 1997.

10A NCAC 71W .0102      GENERAL AFDC PROGRAM PROCEDURES

 

History Note:        Authority G.S. 143B-153;

Eff. February 1, 1984;

Recodified from 10 NCAC 49A .0003 Eff. January 1, 1997;

Repealed Eff. July 1, 2012.

 

section .0200 - coverage

 

10A NCAC 71W .0201      OPTIONAL

 

History Note:        Authority G.S. 108A-25; 143B-153; 45 C.F.R. 233.10;

Eff. February 1, 1984;

Amended Eff. February 1, 1996; June 1, 1990;

Repealed Eff. July 1, 2012.

 

SECTION .0300 - APPLICATION PROCESS

 

10A NCAC 71W .0301      ACCEPTANCE OF APPLICATION

 

History Note:        Authority G.S. 108A-43; 143B-153; 45 C.F.R. 206.10;

Eff. February 1, 1984;

Amended Eff. February 1, 1986;

Repealed Eff. July 1, 2012.

 

10A NCAC 71W .0302      INITIAL INTERVIEW

The applicant shall be allowed to have any person(s) of his choice participate in the interview.  The applicant shall be informed of the following:

(1)           He must provide:

(a)           the names of collaterals, such as landlords, employers, and others with knowledge of his situation;

(b)           information about his resources;

(c)           verification of his earned income and any operational expenses;

(d)           his Social Security number unless he has lost his card;

(e)           medical forms when appropriate;

(f)            work registration card from ESC;

(g)           statement from a dealer when verified equity of a motor vehicle is disputed;

(h)           evidence of good cause claim for non‑cooperation with the child support enforcement agency;

(i)            verification of the amount of a lump sum payment and other required information regarding the lump sum;

(j)            verification of stepparent's income and verification of income of a minor parent's parent or legal guardian; and

(k)           signed statement from a doctor or medical facility substantiating a pregnancy and the expected due date.

(2)           It is the county's responsibility to use collateral sources to substantiate or verify information necessary to establish eligibility.  Collateral sources of information include knowledgeable individuals, business organizations, public records, and documentary evidence.  If the applicant does not wish necessary collateral contacts to be made, he may withdraw the application.  If he denies permission to contact necessary collaterals, the application shall be rejected due to failure to cooperate in establishing eligibility.

(3)           A worker will visit his home at the county's option.  The county's decision to make a home visit will be based on error‑prone characteristics defined by the state using quality control and other management data.

(4)           The applicant has the right to:

(a)           receive assistance if found eligible;

(b)           be protected against discrimination on the grounds of race, creed, or national origin by Title VI of the Civil Rights Act of 1964.  He may appeal such discrimination;

(c)           spend his assistance payment as he wishes, but it must be in his best interest and that of his family.  A substitute payee may be appointed for those individuals who cannot manage the payments;

(d)           receive his monthly check in advance until the payment is terminated by appropriate action;

(e)           have any information given to the agency kept in confidence;

(f)            appeal, if his assistance will be denied, changed or terminated, his payment is incorrect based on the agency's interpretation of state regulations, or his request for a change in the amount of assistance was delayed beyond 30 days or rejected;

(g)           reapply at any time, if found ineligible; and

(h)           withdraw from the assistance program at any time.

(5)           The applicant's responsibilities.  He must:

(a)           provide the county department, state and federal officials, the necessary sources from which the county department can locate and obtain information needed to determine eligibility;

(b)           report to the county department of social services any change in situation that may affect eligibility for a check within 10 calendar days after he learns of the change.  The meaning of fraud shall be explained.  The applicant shall be informed that he may be suspected of fraud if he fails to report a change in situation and that in such situations, he may have to repay assistance received in error and that he may also be tried by the courts for fraud;

(c)           inform the county department of social services of any person or organization against whom he has a right to recovery.  When he accepts medical assistance (included with any AFDC), the applicant assigns his rights to third party insurance benefits to the state.  He shall be informed that it is a misdemeanor to fail to disclose the identity of any person or organization against whom he has a right to recovery; and

(d)           immediately report to the county department the receipt of a check which he knows to be erroneous, such as two checks for the same month, or a check in the wrong amount.  If he does not report such payments, he may be required to repay any overpayment.

 

History Note:        Authority G.S. 108A‑43; 143B‑153; 45 C.F.R. 206.10;

Eff. February 1, 1984;

Amended Eff. June 1, 1990; February 1, 1986;

Temporary Amendment Eff. July 1, 1996;

Amended Eff. April 1, 1997.

 

10A NCAC 71W .0303      ELIGIBILITY DETERMINATION PROCESS

The following steps shall be followed in eligibility determination:

(1)           Each eligibility factor shall be reviewed and verified; and

(2)           A home visit shall be made at county option.  The county department of social services shall use error‑prone characteristics to decide when it is appropriate to make a home visit.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 206.10;

Eff. February 1, 1984.

 

10A NCAC 71W .0304      EFFECTIVE DATE

AFDC payments shall be effective with the date of application.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 206.10;

Eff. February 1, 1984.

 

SECTION .0400 - ELIGIBILITY FACTORS

 

10A NCAC 71W .0401      AGE

10A NCAC 71W .0402      SCHOOL ATTENDANCE

 

History Note:        Authority G.S. 143B-153; 45 C.F.R. 233.39;

Eff. February 1, 1984;

Amended Eff. June 1, 1990; August 1, 1988; February 1, 1986;

Repealed Eff. July 1, 2012.

 

10A NCAC 71W .0403      UNITED STATES CITIZENSHIP

(a)  Eligibility requirement pertaining to United States Citizenship shall be found in 45 CFR 233.50 and this provision is hereby adopted by reference under G.S. 150B‑14(c).

(b)  Verification.  The worker shall accept the applicant's statement unless there is some reason to doubt it.  If there is doubt, documentary evidence shall be required.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 233.50;

Eff. February 1, 1984;

Amended Eff. August 1, 1988; February 1, 1986.

 

10A NCAC 71W .0404      KINSHIP AND LIVING WITH A SPECIFIED RELATIVE

(a)  Eligibility requirements pertaining to kinship and living with a specified relative shall be found in 45 CFR 233.90 and this provision is hereby adopted by reference under G.S. 150B‑14(c).

(b)  Verification of kinship shall be made only at application unless previous documentation appears to be incorrect.

(1)           Kinship of a child to a specified relative except for an alleged father shall be verified by examining:

(A)          birth certificates; or

(B)          hospital records established at birth; or

(C)          marriage record; or

(D)          Social Security Administration records; or

(E)           two of the following:

(i)            school records;

(ii)           Bible records;

(iii)          hospital or physician's records;

(iv)          court records including adoption records;

(v)           immigration records;

(vi)          naturalization records;

(vii)         church documents;

(viii)        passport;

(ix)          military records;

(x)           U.S. census records;

(xi)          signed statement from an individual having specific knowledge about the kinship of the child to the specified relative.  The statement shall include:

(I)            name of child;

(II)          date of birth;

(III)        place of birth;

(IV)         individual's relationship; and

(V)          basis of individual's knowledge.

(2)           Kinship of a child to his alleged father or other alleged paternal relative shall be verified by verifying the child's relationship to the alleged father and if necessary the alleged father's relationship to the alleged paternal relative.  Relation to the alleged father shall be verified by examining:

(A)          court support records; or

(B)          county department of social services support records; or

(C)          statement signed and dated by the father that acknowledges his paternity; or

(D)          two of the following:

(i)            school records;

(ii)           Bible records;

(iii)          hospital or physician records;

(iv)          court records;

(v)           immigration records;

(vi)          naturalization records;

(vii)         church documents;

(viii)        passport;

(ix)          military records;

(x)           U.S. census records;

(xi)          signed statement from an individual having specific knowledge about the kinship of the child to the specified relative.  The statement shall include:

(I)            name of child;

(II)          date of birth;

(III)        place of birth;

(IV)         individual's relationship; and

(V)          basis of individual's knowledge.

(c)  Verification that a child is living within the home of a specified relative shall be made during each determination of eligibility by:

(1)           a home visit when there is evidence of the child living in the home; or

(2)           use of school records; or

(3)           use of day care center records; or

(4)           statement of a social worker employed by the county department of social services when, following a home visit, he is able to substantiate that the child is living in the home; or

(5)           statement from a non‑relative having personal knowledge of the child's living with the specified relative; or

(6)           two of the following:

(A)          medical records, including health department records;

(B)          Social Security or other benefit records;

(C)          rental records;

(D)          church records.

 

History Note:        Authority G.S. 108A‑25; 143B‑153; 45 C.F.R. 233.10;

Eff. February 1, 1984;

Amended Eff. January 1, 1989; August 1, 1988; February 1, 1986.

 

10A NCAC 71W .0405      RESIDENCE

(a)  Eligibility requirements pertaining to residence shall be found in 45 CFR 233.40 and this provision is hereby adopted by reference under G.S. 150B‑14(c).

(b)  County residence eligibility requirement.

(1)           Adult.  An adult has residence in the county in which he resides.

(2)           Child.  A child has the residence of the person with whom he resides.

(c)  Verification.  The worker shall accept the client's statement unless there is some reason to doubt it.  If there is doubt, documentary evidence shall be required.  If any AFDC recipient's visit to another county within the state or to another state exceeds three months, the worker in the responsible county shall verify the following:

(1)           the recipient's intent to return;

(2)           reason for the continuing absence; and

(3)           the continuing maintenance of a home in the first county.

 

History Note:        Authority G.S. 108A‑35; 143B‑153; 45 C.F.R. 233.40;

Eff. February 1, 1984;

Amended Eff. August 1, 1988; February 1, 1986.

 

10A NCAC 71W .0406      DEPRIVATION

 

History Note:        Authority G.S. 108A-25; 143B-153; 45 C.F.R. 233.90;

Eff. February 1, 1984;

Amended Eff. May 1, 1994; June 1, 1990; January 1, 1989; August 1, 1988;

Repealed Eff. July 1, 2012.

 

10A NCAC 71W .0407      RESERVE

(a)  An AFDC assistance unit shall be allowed to reserve resources at a maximum of one thousand dollars ($1,000).  If the reserve level exceeds one thousand dollars ($1,000), the unit is ineligible.

(b)  Only resources that are currently available to the assistance unit shall be counted.  For applications, only those resources that are available during any month prior to disposition are counted to determine eligibility for those months.

(c)  Individuals whose reserve is counted.  Resources owned by budget unit members shall be counted as follows:

(1)           Parent.  Count unless she receives SSI.

(2)           Minor Mother.  Count unless she receives SSI.

(3)           Stepparent.  If the stepparent is included in the payment, his resources shall be counted.  If he is not included, but the parent has access to joint resources, half of the resources shall be counted.

(4)           Specified Relative.  If the specified relative is included in the payment, his resources shall be counted.  Otherwise his resources shall not be counted.

(5)           Child.  If the child is included in the payment, his resources shall be counted.

(6)           Essential Person.  If an essential person is included in the payment, his resources shall be counted.  Otherwise, his resources shall not be counted.

(7)           Jointly owned resources.

(A)          If a budget unit member owns resources jointly with another public assistance recipient, his share shall be counted as an available resource.  The resource shall be divided equally among the owners unless the owners have a signed agreement specifying division.

(B)          If a budget unit member owns resources jointly with a non‑assistance recipient, and he can dispose of the resource without the consent of the other owner, his share shall be counted as an available resource.  The resource shall be divided equally among the owners unless they have a signed agreement specifying division.

(C)          If a budget unit member owns resources jointly with a non‑assistance recipient, and he cannot dispose of the resource without the consent of the other owners, it shall be determined whether the non‑assistance recipient consents to the disposal of the resource.

(i)            If he consents, the budget unit member's share of the resource shall be counted.  Resources shall be divided equally among the owners unless they have a signed agreement specifying division.

(ii)           If he refuses, the budget unit member's share shall not be counted.

(d)  Reserve; items counted:

(1)           cash on hand, including lump sum payments received from the sale of an asset or an income tax refund;

(2)           the current balance of savings accounts;

(3)           that portion of a checking account other than the monthly income deposited to meet the family's needs;

(4)           cash value of life insurance policies;

(5)           equity on nonessential personal property limited to:

(A)          equity in excess of one thousand five hundred dollars ($1,500) for one motor vehicle;

(B)          a mobile home not used as a home site;

(C)          boats, boat trailers, and boat motors;

(D)          campers;

(E)           farm or business equipment;

(6)           stocks, bonds, mutual fund shares;

(7)           revocable trust funds;

(8)           equity in real property including income producing property not used as a home;

(9)           value of revocable prepaid burial contracts;

(10)         net proceeds from a business, including a farm, which has been discontinued;

(11)         life estate interest, if salable; and

(12)         remainder interest, if salable.

(e)  Reserve; items excluded:

(1)           personal effects and household goods;

(2)           a mobile home used as a homesite;

(3)           straight term life insurance;

(4)           burial insurance;

(5)           that portion of a checking account that is the monthly income deposited to meet the family's needs;

(6)           non‑salable life estate or remainder interest;

(7)           heir property, ie, property from an estate which has not been settled;

(8)           equity value of one thousand five hundred dollars ($1,500) or less for one car, truck, or other motor vehicle.

(f)  Verification.  Value and ownership of real property and motor vehicles shall be verified.  The client's statement of value of another reserve property available to members of the budget unit shall be accepted without further verification unless either this statement of value is incomplete, inconsistent, or unclear, or the values stated by the client would cause the budget unit's reserve to exceed the reserve maximum.

 

History Note:        Authority G.S. 108A‑41; 108A‑46; 143B‑153; 45 C.F.R. 233.20;

Eff. February 1, 1984;

Amended Eff. June 1, 1990; February 1, 1986.

 

10A NCAC 71W .0408      INCOME

(a)  Consideration of available income to determine eligibility for and amount of assistance.

(1)           Parent's net income shall be counted unless the parent:

(A)          receives SSI.  Provided that cash contributions from the parent to the assistance unit shall be counted.

(B)          is excluded from the assistance unit because he does not meet eligibility requirements.  Gross income of the parent minus his needs shall be counted if he is excluded because he does not meet eligibility requirements.  If the parent's needs have already been considered in calculating deemed income from a stepparent, the parent's gross income shall be counted.

(2)           Minor mother's net income shall be counted unless she:

(A)          is a student and qualifies for earned and unearned income exclusions.  See unearned or earned income exclusion in (c) and (f) of this Rule.

(B)          receives SSI.  Provided that cash contributions from the minor mother to the assistance unit shall be counted.

(C)          is excluded from the assistance unit because she does not meet eligibility requirements.  Gross income of the minor mother minus her needs shall be counted if she is excluded because she does not meet eligibility requirements.  If the minor mother's needs have already been considered in calculating deemed income from a stepparent, the minor mother's gross income shall be counted.

(3)           Stepparent.  If the stepparent is included in the assistance unit, his net income shall be counted.  If the stepparent is not in an assistance unit, net income shall be counted unless he is an SSI recipient.  If he is an SSI recipient only cash contributions from him to the assistance unit shall be counted.

(4)           Specified relative other than parent.  If the specified relative is included in the assistance unit, net income shall be counted.  If he is not included in the assistance unit, only cash contributions from him to the assistance unit shall be counted.

(5)           Child.  Countable net income of a child who is included in the assistance unit shall be counted.

(6)           Essential person.  Net income of an essential person who is included in the assistance unit shall be counted.

(b)  The following items of earned income shall be included in determining eligibility:

(1)           income from wages, salaries, and commissions;

(2)           farm income;

(3)           small business income including self‑employment;

(4)           rental income;

(5)           income from roomers and boarders;

(6)           earned income tax credit; and

(7)           supplemental payments in excess of state's maximum rates for Foster Care and State Foster Home Funds paid by the county to AFDC recipients who serve as foster parents.

(c)  Earned income exclusions are found in 45 CFR 233.20 and this provision is hereby adopted by reference under G.S. 150B‑14(c).  In addition, the following items of earned income shall be excluded in determining eligibility:

(1)           Foster Care and State Foster Home Payments equal to or below the state maximum rates to AFDC recipients who serve as foster parents;

(2)           Earned income from the 185 percent limitation for up to six months in a calendar year of a child applicant/recipient who is a full‑time student;

(3)           Earned income from census employment under Section 1115 Demonstration Project Approved by the DHHS contingent on receipt of federal regulations in sufficient time for implementation.

(d)  Good Cause Provisions for Failure to Report Income or Return Monthly Report Timely.

(1)           Circumstances that constitute "good cause" for failing to report income in a timely manner are limited to:

(A)          the death of a household member;

(B)          the hospitalization of the applicant or recipient or a dependent child for whom she provides care;

(C)          failure of the applicant or recipient to report a change in monthly income of five dollars ($5.00) or less;

(D)          any other reason determined by the hearing officer based on evidence provided by the recipient.

(2)           Circumstances that constitute "good cause" for failing to return a monthly report form in a timely manner are limited to:

(A)          the death of a household member;

(B)          the hospitalization of the recipient or a dependent child for whom she provides care;

(C)          extenuating circumstances beyond the control of the recipient.  Extenuating circumstances are defined as a natural disaster, a fire, computer breakdown, a postal strike, or postal delay provided the return envelope is postmarked the day prior to the deadline;

(D)          any other reason determined by the county director or his designee based on evidence provided by the recipient.

(e)  The following items of unearned income shall be included in determining eligibility for or the amount of assistance:

(1)           OASDHI benefits;

(2)           Veterans Administration benefits;

(3)           Railroad Retirement benefits;

(4)           pensions or retirement benefits;

(5)           workmen's compensation;

(6)           unemployment compensation;

(7)           support payments and contributions;

(8)           work release payments;

(9)           dividends and income from trust funds;

(10)         private disability or unemployment benefits, including benefits from insurance plans;

(11)         any portion of loans, grants, or scholarships designated or used for maintenance needs which is a duplication of items included in the assistance standard;

(12)         trade readjustment benefits;

(13)         military allotments;

(14)         brown lung benefits;

(15)         black lung benefits;

(16)         lump sum payments;

(17)         deemed income from a stepparent not receiving assistance;

(18)         deemed income to an alien from a sponsor and his spouse if living together;

(19)         any other income unless excluded by federal law of Paragraph (f) of this Rule;

(20)         cash contributions.

(f)  Unearned income exclusions are found in 45 CFR 233.20 and this provision is hereby adopted by reference under G.S. 150B‑14(c).  In addition, the following items of unearned income shall be excluded in determining eligibility for assistance.

(1)           food given to or grown by a member of the household;

(2)           the value of the coupon allotment received under the Food Stamp Program;

(3)           child support being routed to IV‑D Accounting;

(4)           assistance from other agencies and organizations.  This includes financial assistance and in‑kind goods or services received from a governmental, civic, or charitable organization so long as such aid is for rehabilitation purposes, special training or educational opportunities and provided no duplication exists;

(5)           HUD Section 8 payments;

(6)           loans (if there is any agreed upon repayment plan);

(7)           assistance received through the Low Income Energy Assistance Program including the Crisis Intervention Program;

(8)           home energy assistance as defined in 45 C.F.R. 233.53 and this provision is adopted by reference under G.S. 150B‑14(c);

(9)           income paid to a child recipient through Job Training Partnership Act of 1982 as need‑based payments, payments for supportive services, compensation in lieu of wages and payments to Job Corps participants;

(10)         gifts, including but not limited to birthday, Christmas and graduation, up to thirty dollars ($30.00) per calendar quarter per assistance unit member.  If the payee states in writing the gift was intended for the entire assistance unit, the gift shall be divided among assistance unit members.  The gift shall be divided in the manner that is most advantageous to the assistance unit.

(g)  Verification.  The client shall be responsible for providing verification of earned income including operational expenses for farm or self‑employment income.  For gifts, the recipient shall be responsible for obtaining a written statement from the provider of the gift indicating the amount, date given and purpose.  The county department of social services shall be responsible for all other income verifications.

 

History Note:        Filed as a Temporary Rule Eff. March 5, 1990, for a Period of 180 Days to Expire on August

31, 1990;

Authority G.S. 108A‑25; 108A‑33; 143B‑153; 45 C.F.R. 233; 42 U.S.C. 1315;

Eff. February 1, 1984;

Amended Eff. September 1, 1990; June 1, 1990; August 1, 1988; February 1, 1986.

 

10A NCAC 71W .0409      NEED

 

History Note:        Authority G.S. 108A-25; 108A-33; 143B-153; 45 C.F.R. 233; c. 738, 1987 Session Laws;

Eff. February 1, 1984;

Amended Eff. February 1, 1986;

Filed as a Temporary Amendment Eff. January 1, 1988 For a Period of 180 Days to Expire on June 28, 1988;

Amended Eff. June 1, 1990; May 1, 1988;

Repealed Eff. July 1, 2012.

 

10A NCAC 71W .0410      PROSPECTIVE BUDGETING AND QUARTERLY REPORTING

Income shall be budgeted and reported as described below:

(1)           Income shall be budgeted prospectively for determining eligibility for and the amount of AFDC payments. To arrive at a monthly amount to consider, the following processes shall be followed:

(a)           For income that is paid on less than a monthly basis, the pay received from each period during a month shall be averaged and converted to a monthly amount as follows.  Averaged pay shall be multiplied by:

(i)            2 if pay is received twice per month

(ii)           2.15 if pay is received every two weeks

(iii)          4.3 if pay is received weekly

(b)           For income that is received once per month, the amount received from two previous successive months shall be averaged to arrive at one monthly amount.

(c)           Annualized self-employment income shall be averaged over the lesser of the following period: the number of months the business has been in operation or 12 months.

(2)           The monthly income calculated in Paragraph (a) of this Rule shall be used to determine the AFDC payment for three consecutive calendar months.

(3)           Quarterly reporting shall be required for error-prone classes of recipients as defined by the state based on quality control and other management data.  The quarterly reporting process shall follow the processing requirements found in 45 CFR 233.37 which is hereby incorporated by reference including all subsequent amendments and editions.  Copies of this Code of Federal Regulations may be obtained from the Division of Social Services, 325 North Salisbury Street, Raleigh, NC 27603 [telephone number (919) 733-3055] at a cost of ten cents ($.10) per page at the time of adoption of this Rule.

(4)           AFDC families shall be required to report all changes within 10 calendar days after they become aware a change has occurred.

 

History Note:        Authority G.S. 143B-153; 45 C.F.R. 233.28; 45 C.F.R. 233.36;

Eff. February 1, 1984;

Amended Eff. August 1, 1988; February 1, 1986;

Temporary Amendment Eff. July 1, 1996;

Amended Eff. April 1, 1997.

 

10A NCAC 71W .0411      STATE WORK REQUIREMENT

 

History Note:        Authority G.S. 108A-29; 143B-153; 45 C.F.R. 233.10; 45 C.F.R. 233.20; 45 C.F.R. 250.30; 45 C.F.R. 250.34;

Eff. February 1, 1984;

Amended Eff. October 1, 1990; July 1, 1990; May 1, 1988; February 1, 1986;

Repealed Eff. July 1, 2012.

 

10a NCAC 71W .0412      JOBS PROGRAM (JOBS)

(a)  An AFDC applicant or recipient who is not exempt, or who is exempt but volunteers and lives in a county participating in JOBS must participate in the Program.

(b)  Exemptions are mandated in 45 CFR 250.30, which is hereby adopted by reference under G.S. 150B‑14(c).

(c)  Based upon evidence provided by the applicant or recipient, the county director or his designee must determine good cause for refusing to participate, terminating employment, refusing to accept employment or reducing earnings.  Good cause definitions found in 10A NCAC 71W .0411 shall apply.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 250.30;

Eff. October 1, 1990.

 

10A NCAC 74W .0413      TWO-PARENT FAMILIES

(a)  Assistance Units with two able-bodied parents shall be eligible to receive cash assistance only for months during which the parents meet the federal work participation requirement as described in Section 407 of Public Law 104-193 which is hereby incorporated by reference including subsequent amendments and editions.

(b)  The parents shall verify as prescribed by the State, that they have satisfied the federal work requirement.  If the assistance unit is otherwise eligible for a payment, the payment shall be made within five calendar days of the date the county receives the parent's verification.

(c)  The amount of the cash assistance payment shall be calculated for the month as it is for all other assistance units.

 

History Note:        Authority G.S. 108A-25; S.L. 1997-443; P.L. 104-193;

Temporary Adoption Eff. March 1, 1998;

Eff. April 1, 1999.

 

section .0500 - redetermination of eligibility

 

10A NCAC 71W .0501      CHANGES IN SITUATION

 

History Note:        Authority G.S. 143B-153; 45 C.F.R. 206.10;

Eff. February 1, 1984;

Amended Eff. June 1, 1990; February 1, 1986;

Temporary Amendment Eff. July 1, 1996;

Amended Eff. April 1, 1997;

Repealed Eff. July 1, 2012.

 

10A NCAC 71W .0502      INTERVIEW

(a)  An interview shall be held in either the client's home or in the agency at which time all eligibility requirements shall be discussed in understandable terms.

(b)  The recipient's rights and responsibilities shall be explained as specified in 10A NCAC 71W .0302.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 206.10;

Eff. February 1, 1984.

 

10A NCAC 71W .0503      HOME VISITS

The home visit shall be made at county option.  The county department of social services shall use error‑prone characteristics to decide when it is appropriate to make a home visit.

 

History Note:        Authority G.S. 143B‑153;

Eff. February 1, 1984.

 

section .0600 – payment procedures

 

10A NCAC 71W .0601      CHECK ISSUANCE

(a)  The department of social services shall write checks according to authorizations submitted by county directors of social services.

(b)  Except for replacement checks, all checks shall be mailed to the address given by the recipient or substitute payee.

(c)  Replacement checks are mailed to county departments of social services.

(d)  Checks shall be delivered to the post office on the last work day of each month.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 233;

Eff. February 1, 1984.

 

10A NCAC 71W .0602      RECEIPT AND USE OF CHECKS

(a)  The recipient is entitled to his monthly check until the payment is terminated by appropriate action.

(b)  A staff member of a county department of social services shall not act as a witness when a recipient cannot endorse his own check.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 234.60;

Eff. February 1, 1984;

Amended Eff. June 1, 1990.

 

10A NCAC 71W .0603      LOST, STOLEN AND FORGED CHECKS

(a)  If a recipient reports that a state‑issued assistance check has been lost or stolen before he has endorsed it, the county department shall have the recipient sign an affidavit that he did not receive the check.  Within 10 days after the check is reported lost or stolen, the county department shall request a replacement check from the state office.

(1)           If the check has not been paid, the state shall issue a replacement check and issue a stop payment for the original check.

(2)           If the check has been paid, the state shall send to the county a photocopy of the endorsed check and a Forgery Affidavit.  The county shall compare, or shall arrange for comparison by experts in the field of document examination, the endorsement to other known signatures of the payee.

(A)          If forgery is suspected, the county shall submit to the state the completed and signed Forgery Affidavit.  The state shall issue a replacement check.

(B)          After the county makes its analysis and a determination is made that the payee endorsed and cashed the check, it shall notify the state.  The state shall not issue a replacement check.

(b)  If a recipient reports that an assistance check has been lost or stolen after he has endorsed it, the county department will request a replacement check of the state office.  If the check has not been paid by the State Treasurer, a replacement check will be issued and a stop payment will be issued for the original check.  If the check has been paid, a replacement check will not be issued.  It is the responsibility of the recipient to take legal action.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 233.20;

Eff. February 1, 1984;

Amended Eff. June 1, 1990; May 1, 1988.

 

10A NCAC 71W .0604      CORRECTION OF OVERPAYMENTS

(a)  If the recipient is not entitled to all or part of a check which has been issued and fraud is not suspected, the county shall take all reasonable steps to recover promptly any overpayment of thirty‑five dollars ($35.00) or more.

(b)  A county may recoup an AFDC overpayment from a recipient's AFDC check, on account of an overpayment made to the recipient's spouse, parent, child, sibling, or other person, only if the recipient, at the time the overpayment occurred, was:

(1)           18 years of age or older,

(2)           living with the person, and

(3)           part of the assistance unit.

(c)  Overpayments shall be collected as follows:

(1)           voluntary repayment by grant reduction or recipient refund;

(2)           involuntary repayment by grant reduction;

(3)           if an overpayment occurs due to a county error in complying with program regulations, the overpayment shall be recouped by state office adjustment;

(4)           if an overpayment occurs due to a state or county processing error, the overpayment shall be recouped from the recipient providing the recipient was provided proper notification of the amount of AFDC he was eligible to receive;

(5)           if an overpayment occurs due to a state office error in interpreting regulations, the overpayment shall be charged to the state.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 233.20;

Eff. February 1, 1984;

Amended Eff. September 1, 1991; January 1, 1985.

 

10A NCAC 71W .0605      CORRECTION OF UNDERPAYMENTS

Retroactive adjustment of any underpayment that results from county or state errors shall be made.

 

History Note:        Authority G.S. 143B‑153; 45 C.F.R. 233.20;

Eff. February 1, 1984.

 

10A NCAC 71B .0606       CLIENT FRAUD AND INTENTIONAL PROGRAM VIOLATIONS

(a)  County Responsibilities; Fraud Prevention.

(1)           The county department of social services shall develop of an operational program for fraud prevention, detection and investigation.  Fraud program organizational requirements must be established based on the number of (AFDC or Work First) recipients, the effectiveness of the fraud prevention program, the frequency of suspected fraud cases, and the resources available to the agency.

(2)           The county department must designate staff to be responsible for fraud activities.

(3)           The county shall strive to obtain all Social Security numbers and correctly complete them on computer input forms.

(4)           The recipient shall be notified no less frequently than at each eligibility review of his obligation to report within ten days, all changes in income, resources, or other changes which may effect the amount of payment.  Failure to do so within that time may constitute a willful withholding of such information, and permit the county department to recover the overpayment.

(b)  County Department Responsibilities; Detection and Investigation:

(1)           The county department shall investigate any information which indicates that a recipient may be receiving AFDC or Work First to which the recipient is not entitled.

(2)           In the investigation the staff designated for fraud shall:

(A)          verify that all responsibilities have been fulfilled as set forth in the rules governing the AFDC or Work First program;

(B)          determine whether further investigation should be undertaken to support the belief that fraud is suspected;

(C)          evaluate the evidence to substantiate fraud and the intent to defraud;

(D)          determine the amount of the erroneous payment.

(3)           When there is reason to suspect fraud, the county director must ensure that the agency has explained to the client his responsibilities for reporting changes in his circumstances to the agency.  The director shall determine whether the agency should investigate further and shall present the case and fraud summary to the county board of social services for action unless the board has delegated this responsibility to him.

(4)           The fraud summary shall include:

(A)          identifying information;

(B)          a description of the fraudulent act;

(C)          evidence to substantiate fraud and the intent to defraud;

(D)          evidence to substantiate the amount of ineligible assistance received;

(E)           information concerning the client's competency, educational background, ability to know right from wrong, any statement volunteered by the client in response to the accusation and any other information which may help explain the client's current situation.

(c)  County Board's Responsibilities.

(1)           The county board of social services, or its designee, shall determine whether there is a basis for the belief that misrepresentation may have been committed by a person.

(2)           The county board, or its designee, shall determine if the person:

(A)          willfully and knowingly misstated, provided incorrect or misleading information in response to either oral or written questions; or

(B)          willfully and knowingly failed to report changes which might have affected the amount of payment; or

(C)          willfully and knowingly failed to report the receipt of benefits which he knew he was not entitled to receive.

(3)           There must be physical evidence to substantiate a determination that fraud was the reason for the overpayment.

(4)           If the board, or its designee, determines fraud is suspected, it shall instruct the agency to pursue one or more, of the following actions:

(A)          administrative recoupment which is defined as:

(i)            involuntary reduction of the AFDC or Work First grant may be collected from all income and assets of the assistance unit.  The assistance unit shall retain an amount not less than 90 percent of the assistance payment received by a family of similar composition with no other income; or

(ii)           a voluntary grant reduction.  There is no limitation on the amount of the reduction;

(iii)          voluntary recipient refund.  There is no limitation on the amount of the refund;

(B)          administrative disqualification:

(i)            Hearing

(I)            An administrative disqualification hearing shall be initiated by the county department of social services when there is sufficient evidence to indicate that an individual has intentionally violated a program rule in order to receive cash assistance for which the individual is not eligible.  The hearing shall be held and any administrative action initiated within 90 days of the date the individual is notified in writing that the hearing has been scheduled.  No hearing shall be held when the amount of the overpayment is less than one hundred dollars ($100.00).

(II)          The county board of social services shall designate the county director or their impartial county employee to act as the hearings officer.  Duties are to: provide written notification of the hearing date, time, and location to the client at least 30 days in advance of the date of the hearing.  Written notification of the hearing shall include the client's right to have legal representation, a witness or witnesses, or waive the hearing; conduct the hearing to collect all evidence and testimony; render a written decision to the client and DSS within 15 days as to whether an intentional program violation has occurred.  Written notification that the hearing decision will be mailed by Certified Mail Return Receipt Requested.  The notice will inform the client of the right to further appeal to the state (or higher local authority) and the procedures for such appeal.  When an intentional program violation is found, the notification will inform the client of the length of the sanction and that client remains a part of the Work First case and subject to all program requirements.  When no intentional program violation is found, the notification will inform the client that the overpayment will be collected pursuant to 10A NCAC 71W .0604.

(ii)           Sanctions:

(I)            The county department of social services shall apply disqualification sanctions as follows:  12 months of ineligibility for the first offense; 24 months for the second offense; and permanently disqualified for the third offense.

(II)          The sanction shall be applied by reducing the work first cash assistance payment by the disqualified person's share of the payment for the appropriate period of sanction.  The disqualified person remains a part of the work first case and subject to all program requirements.

(iii)          Repayment:

The county department of social services will follow procedures pursuant to Part (c)(4)(A) of this Rule in the collection of overpayments.

(C)          civil court action; or

(D)          criminal court action.

(d)  Board Decision; Agency Follow‑up:

(1)           If the board, or its designee, suspects fraud, the department's findings and actions shall be reported immediately to the assistance payments section.  The county director shall keep the county board and assistance payments section informed on all cases referred for court and repayment action.

(2)           The county department of social services shall support the local prosecutor by accomplishing necessary interviews in accordance with the prosecutor's requirements, recommending possible witnesses, providing necessary investigative reports, and taking other action deemed necessary by legal authorities.

(3)           Regardless of what action is taken by the board or the court, the county shall continue to work with the client and shall promptly notify the client of the action taken in his case.

(4)           The county shall maintain records on the number of cases referred for investigation, the number of suspected fraud referrals, action taken to recover the overpayment and amounts recovered.

(e)  In fraud cases, if a county fails to act promptly on indications of ineligibility, federal and state financial participation shall not be available.

 

History Note:        Authority S.L. 1997-443, Section 12.17; G.S. 108A‑25; 108A‑39; 143B‑153; 45 C.F.R. 233.20; 45 C.F.R. 235.110;

Eff. February 1, 1984;

Amended Eff.; June 1, 1990; February 1, 1986;

Temporary Amendment Eff. June 17, 1998;

Amended Eff. April 1, 1999.

 

10A NCAC 71W .0607      DETERMINATION OF PAYMENT AMOUNT

(a)  To determine the amount of the AFDC payment, once eligibility has been established, the county shall subtract the total countable net income of the assistance unit (excluding the unemployment benefit received by the principal earner in an AFDC‑UP case) from the Need Standard, including any special needs allowances, for the number in the assistance unit.  The AFDC payment amount shall be 50 percent of the deficit.

(b)  If the assistance unit has no countable income, the AFDC payment shall be 50 percent of the Need Standard, including any special needs allowances, for the number in the assistance unit.

 

History Note:        Filed as a Temporary Adoption Eff. January 1, 1988 For a Period of 180 Days to Expire on June 28, 1988;

Authority G.S. 143B‑153; c. 738, 1987 Session Laws;

Eff. May 1, 1988.

 

SECTION .0700 - emergency assistance COVERAGE

 

10A NCAC 71W .0701      ELIGIBILITY FOR COVERAGE

10A NCAC 71W .0702      EMERGENCIES COVERED

10A NCAC 71W .0703      EMERGENCY NOT COVERED

 

History Note:        Authority G.S. 108A-39.1; 143B-153; 45 C.F.R. 233.120;

Filed as a Temporary Rule Eff. November 1, 1986 for a period of 62 days to expire on January 1, 1987;

Eff. January 1, 1987;

Amended Eff. October 1, 1990; June 1, 1990; August 1, 1988;

Filed as a Temporary Amendment Eff. November 7, 1994 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Filed as a Temporary Amendment Eff. January 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. March 1, 1995;

Repealed Eff. July 1, 2012.

 

10A NCAC 71W .0704      BENEFIT LEVELS

(a)  Cash assistance:

(1)           The maximum cash assistance benefit per household is three hundred dollars ($300) during 30 consecutive days.  Assistance cannot be received again within a 12 consecutive month period.

(2)           When the agency purchases in-kind goods or contracts for the purchase of services to alleviate or to prevent destitution of the family, the value of the in-kind goods or contracted services purchased with the cash assistance must be established and considered when authorizing the benefit level.

(A)          For in-kind goods, the value shall be the actual purchase price of the goods.

(B)          For contracted services, the provider shall submit to the agency a written statement of the value of the service purchased with the cash assistance.

(b)  Services:

(1)           There is no maximum benefit level for services but the family must need the services to alleviate the identified emergency.

(2)           Services must be authorized within a single 30 day period no less than 12 months after the beginning of the family's last EA authorization period and are limited to a maximum duration of 364 days.

 

History Note:        Filed as a Temporary Amendment Eff. January 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Filed as a Temporary Amendment Eff. November 7, 1994 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Filed as a Temporary Rule Eff. November 1, 1986 for a period of 62 days to expire on January 1, 1987;

Authority G.S. 108A-39.1; 143B-153; 45 C.F.R. 233.120;

Eff. January 1, 1987;

Amended Eff. March 1, 1995; June 1, 1990; August 1, 1988.

 

10A NCAC 71W .0705      TYPES OF ASSISTANCE PROVIDED

10a NCAC 71W .0706      METHODS OF PAYMENT

10A NCAC 71W .0707      APPLICATION AND DISPOSITION

10A NCAC 71W .0708      RESERVE

10A NCAC 71W .0709      INCOME

10A NCAC 71W .0710      RESERVE AND INCOME FOR SERVICES

10A NCAC 71W .0711      PROCEDURES

 

History Note:        Authority G.S. 108A-39.1; 143B-153; 45 C.F.R. 233.120;

Filed as a Temporary Rule Eff. November 1, 1986 for a period of 62 days to expire on January 1, 1987;

Eff. January 1, 1987;

Amended Eff. October 1, 1990; June 1, 1990; August 1, 1988;

Filed as a Temporary Amendment Eff. November 7, 1994 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Filed as a Temporary Amendment Eff. January 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. March 1, 1995;

Repealed Eff. July 1, 2012.

 

section .0800 - UNEMPLOYED PARENT PROGRAM

 

10A NCAC 71W .0801      GENERAL PROCEDURES

10A NCAC 71W .0802      COVERAGE AND PARTICIPATION

10A NCAC 71W .0803      ELIGIBILITY VERIFICATIONS

 

History Note:        Authority G.S. 108A-28; 143B-153; Chapter 738, 1987 Session Laws;

Eff. January 1, 1988;

Amended Eff. August 1, 1988;

Repealed Eff. July 1, 2012.

 

section .0900 - TRANSITIONAL CHILD CARE

 

10A NCAC 71W .0901      GENERAL REQUIREMENTS

10A NCAC 71W .0902      METHODS OF PROVIDING CHILD CARE

10A NCAC 71W .0903      SLIDING FEE SCALE

10A NCAC 71W .0904      CHILD CARE RATES AND MAXIMUM PAYMENT

 

History Note:        Authority G.S. 108A-25; 143B-153; 45 C.F.R. Part 256;

Filed as a Temporary Rule Eff. April 1, 1990 for a Period of 153 Days to Expire on August 31, 1990;

Temporary Rule Expired Eff. September 1, 1990;

Eff. October 1, 1990;

Repealed Eff. July 1, 2012.

 

10A NCAC 71W .0905      DRUG TESTING

 

History Note:        Authority G.S. 108A-29.1; 143B-153;

Temporary Adoption Eff. November 1, 2014;

Temporary Adoption Expired August 14, 2015.