The CAO must make a decision on eligibility within 30 calendar days of the application filing date. If there is enough information to determine eligibility for Medical Assistance, the CAO must not delay authorization of Medical Assistance while waiting for verification of Cash Assistance eligibility.
NOTE: Applications may not be rejected for failure to provide verifications until day 31.
If the applicant has cooperated in trying to get verification and the CAO is waiting for the needed verification from a third party or a domestic relations section, the initial authorization of assistance must not be delayed beyond 30 days after application. See Chapter 178.
NOTE: If documentation of an abusive living situation is not readily available and it appears that third-party verification cannot be gotten within the application processing period, the CAO may authorize assistance on the basis of the person’s statement.
NOTE: The CAO must use the "Comments" section of the record to provide a continuous record of supporting information that is not specifically recorded in the case record.
At application, the CAO must record the following information:
The reason for the application denial if a full application interview is not scheduled.
NOTE: This may be recorded during the screening interview.
Any pertinent information that is not on the PA 600.
The date and place of the interview.
If needed, an additional explanation of reasons for or circumstances of the application that are not already listed on the PA 600 (for example, past management).
Any plans established with the applicant in addition to those recorded.
An explanation of major differences between the information on the PA 600 and the information in the case record.
The application process ends when one of the following takes place:
The applicant does not go on with the application or withdraws.
NOTE: The CAO must discuss any misunderstanding of agency requirements or methods to prevent an applicant from withdrawing when it is not wise or necessary to do so.
The applicant is found ineligible for Cash Assistance, and the CAO determines eligibility for Medical Assistance and SNAP benefits.
The applicant is found eligible and assistance is authorized.
The CAO must send a Notice to Applicant when the eligibility decision is made.
An applicant may voluntarily withdraw his or her application at any time prior to the eligibility determination.
The CAO will discuss any misunderstanding of Cash Assistance requirements or agency procedures to prevent an applicant from unwisely or unnecessarily withdrawing his or her application.
55 Pa. Code § 125.24(c)(7)(vii)(B)
If the applicant withdraws the application, the CAO must take the following actions:
Have the applicant complete and sign a Voluntary Withdrawal Form (PA 1829).
Check the program from which the applicant is withdrawing.
Get the applicant’s signature and record the date.
Record in the "Comments" section the reason for withdrawal, if the applicant gave a reason.
NOTE: The PA 1829 is preferred but if the applicant submits a written statement the following should be included in the statement.
List of person(s) in the household and programs they are withdrawing.
Reason for withdrawal.
Applicant's signature and date.
Deny Cash Assistance benefits using Reason Code 063.
Reject the application in eCIS.
Record in case comments the reason for withdrawal.
Send a Notice to Applicant to notify the applicant that the application was denied because of the withdrawal request.
If the applicant is determined ineligible prior to withdrawing the application the CAO must correctly deny the application for program ineligibility and send proper notice. See Section 104.52 and 104.53.
If the applicant is found ineligible, the CAO must do the following:
Record the appropriate information in the case record.
Send a Notice to Applicant as soon as possible. See Chapter 177.
Review the case for Medical Assistance eligibility.
Review the case for SNAP eligibility.
The applicant is responsible for providing, to the extent that he or she is able, verification required for establishing eligibility.
The CAO must help the applicant, if necessary, to get the required verification or establish a reasonable plan with the applicant for getting the verification on his or her own.
If the applicant fails to cooperate in providing the necessary verification, the CAO must do the following:
Deny assistance.
Use reason code 042 for the denial.
Send a Notice to Applicant that includes:
What information was not provided or what action was not taken;
The regulation requiring this information or action; and
What action the CAO took to help the applicant get this information.
NOTE: Review and authorize Medical Assistance if necessary verification is available. See Medical Assistance Eligibility Handbook Chapter 378.
Do not require a new application or renewal form (paper or electronic) when an application is denied or when ongoing benefits are discontinued for reasons other than income, resources or failure to meet Job Search requirements and the person reapplies within 60 days of the application denial date or closing date.
NOTE: For details on application processing when considering denied applications, reopening closed benefits and reopening benefits closed at renewal see Chapter 179.
Require a new application if the denial is due to excess income, resources or failure to meet Job Search requirements. See Appendix D.
The CAO worker may determine that a new application form is required after considering the following:
The changes in an applicant’s or recipient’s circumstances since the denial of benefits or closure.
The length of time that has passed since the last interview.
Whether required forms have been signed or updated.
A review of criminal history status including fines, costs, restitution, probation, or parole may also be required if there is a change in information or circumstances.
The CAO may have the person complete a new application when it would expedite benefit delivery.
Example: Getting a new application may benefit the person if there are delays in locating or transferring previously completed documents from district to district or from county to county.
NOTE: If a new application form is submitted, process the application as a new application.
Authorization is the process of completing and processing all of the data necessary to issue an assistance benefit.
If the applicant is eligible for a monthly assistance payment, the CAO must do the following:
55 Pa. Code § 125.24(c)(7)(vi)
Explain the amount of the monthly assistance payment and how it was computed.
Explain that the monthly assistance payment is a money payment that the recipient may use in any way he or she chooses.
Explain that a change in Cash Assistance eligibility may not result in a change of Medical Assistance eligibility.
Explain the medical, dental, pharmaceutical, optometric, and burial services.
Explain that the ACCESS card will be mailed by the contractor. Tell the client when to expect it and how it is to be used.
Provide an interim Medical Assistance card to anyone who needs a medical service before an ACCESS card will be received from the contractor. See the Medical Assistance Eligibility Handbook, Section 380.4.
Explain that any third-party medical coverage is to be used before Medical Assistance coverage
Upon request, help the person find medical care by accessing MA CARES and giving the person a list of providers who participate in the Medical Assistance program. See the Medical Assistance Eligibility Handbook, Section 338.51.
Explain the SNAP program
Complete a referral to EPSDT, DAP, LIHEAP, or WIC, if applicable.
Explain the availability of other social services.
Discuss the responsibility for reporting changes by the tenth of the month following the month in which the change occurs. 62 P.S .§ 432.19
Explain the purpose of semiannual reporting (SAR) if the applicant is required to submit semiannual reports.
Explain why the applicant must semiannually report.
Give a copy of the Semiannual Reporting form (SAR form, PA 564) with instructions for completing the form.
Explain how to complete and submit the SAR form.
Explain what needs to be verified and how the information must be verified.
Explain to applicants and recipients the benefits (for example, the EIC) of filing a tax return, and encourage applicants and recipients to file
Explain the distribution of assistance benefits through mail delivery or electronic benefit transfer (EBT).
NOTE: Explain to applicants and recipients that they may not use TANF funds issued through their PA ACCESS card to make electronic benefit transfer (EBT) transactions in liquor stores, casinos (gambling casinos, gaming establishments), or places for adult entertainment. [Title IV of the Middle Class Tax Relief and Job Creation Act of 2012 (P. L. 112-96)]
Provide the appropriate identification card to the recipient to use when getting his or her assistance payment. See Chapter 180, Appendix B.
Explain payment schedules and the meaning of payment day numbers.
Explain special allowances and benefits. See Chapter 138.
Complete the authorization process.
Complete and send a Notice of Eligibility.
If a check is issued, the CAO must read the following certification to the person. Tell the person that every time he or she endorses an assistance check, he or she is signing the certification statement that is on all assistance checks.
READ BEFORE CASHING Caution – Know your endorser. Ink or indelible pencil should be used for endorsement. If endorsement is by mark (X), two witnesses and their addresses are required. By endorsing this check I certify that I have notified my county board of assistance of all changes in the facts as stated in my application for assistance and that neither I nor any member of my family has any earnings from employment or other resources which would affect the eligibility of myself or my family which I have not reported to said board. I know that I can be penalized by fine or imprisonment, or both, for any false statement. |
Updated January18, 2023, replacing June14, 2016