The CAO is required to conduct a case review as often as the budget group’s circumstances indicate. The CAO will establish a control method.
55 Pa. Code § 133.24(a)(2) & 55 Pa. Code § 133.24(b)
NOTE: When a client reports a change, the CAO will get information from the client to determine if any other conditions have changed. The CAO will review the change itself plus any conditions that may be affected by the change.
If the client reports an increase in earned income of $100 or less within the semiannual period, a grant adjustment is required. Although the earned income is less than $100 and not required to be reported (See CAH 170.2), because the client reports the change in income the CAO must take action to adjust the income.
Update the narrative to reflect the client’s report.
For a household with known earned income, a reported and verified change of more than $100 in gross monthly earned income in the semiannual period that is expected to continue results in a benefit change. The benefit changes with the first payment that can be met with proper notice.
Reminder: The CAO will act on all reported changes, regardless of whether the client was required to report the change. The CAO should remind the client of his or her reporting requirements. The requirement to act on all reported changes includes changes reported through the TANF random sampling process.
Changes reported for other programs, including LIHEAP, SNAP and MA are applied to the cash budget.
Example 1: Ms. Wallace receives TANF (or Medical Assistance) for herself and four children. Her only income source is in an unearned income sick benefit of $150 a month. In August, the insurance company notifies Ms. Wallace that she will receive an increase of $30 in her sick benefit, beginning with the September payment. Ms. Wallace is not required to report this increase until her next SAR review or renewal. Ms. Wallace is required to report if she receives a new source of earned or unearned income. She must also report if her sick benefit is more than $200 a month. If Ms. Wallace reports the change, the CAO must act on the reported change and remind Ms. Wallace of her reporting requirements.
Example 2: Ms. Pike receives TANF (or Medical Assistance) for herself and her four children. Her only source of unearned income is $135 a month. Ms. Pike is notified that she will begin to receive $30 a month in a disability pension. She must report this change by the tenth of the month that follows the month when she receives her first payment. Her unearned income adjustment becomes $165 a month. She must report changes in her unearned income if her total gross unearned income is more than $215 a month.
Example 3: Ms. Johnson receives TANF (or Medical Assistance) for herself and four children. Her only source of income is an unearned income sick benefit of $150 a month. In August, the insurance company notifies Ms. Johnson that she will receive an increase of $30 in her sick benefit beginning, with the September payment. In October, the insurance company notifies Ms. Johnson that she will receive another increase of $25 a month in her sick benefit, beginning with the November payment. She usually receives the benefits on or around the 15th of each month. Ms. Johnson is required to report the increased income by December 10, the 10th of the month following the month in which the change occurred (November). In November, her gross monthly unearned income increased by more than $50 ($55, to $205 a month) from the amount used to determine her benefit ($150). If Ms. Johnson had reported the $30 increase in September, even though she was not required to report, the CAO is required to make the change and remind her of her reporting requirements. Ms. Johnson would not be required to report the $25 change, since the new reporting requirement is to report if her income is more than $230 ($50 more than $180 used to determine her benefit).
Example 4: Ms. Wallace is working and receives TANF for herself and four children. In August, her gross monthly earned income of $455 is used to determine her monthly benefit. Ms. Wallace’s semiannual period is from August to January. Ms. Wallace is required to report if her gross monthly earned income is more than $555 within any month of the semiannual period. Ms. Wallace’s average gross monthly earned income increased by $98 in October. Ms. Wallace did not report and is not required to report this change. If Ms. Wallace had reported the increase, a benefit adjustment would be required. The IMCW should remind the client of her reporting requirements.
Example 5: A Cash Assistance SAR household of four with known earned income reports that gross monthly earned income has increased by $90 and one child is no longer in the home. The income is adjusted and the child is removed from the Cash Assistance case. The IMCW should remind the client of reporting requirements.
NOTE: An overpayment occurs for Cash Assistance if the recipient does not report that the child has left the home and is living elsewhere. There is no overpayment if the client does not report the $90 increase in earned income.
Example 6: Ms. Jones receives TANF for herself and her two children. She calls the CAO to report a new address. The CAO asks about her living arrangements and learns that she is moving in with her boyfriend. The court has established that he is the father of the younger child. The younger child's TANF eligibility was based on absence of a parent. Absence no longer exists. The CAO must complete a partial renewal to determine if the younger child meets any other TANF deprivation condition and take action.
Example 7: Ms. Marks, who is pregnant, receives TANF for herself and one child. After the baby’s birth, the hospital completes a Newborn Eligibility Form (MA 112) and sends the form to the CAO within 10 days of the birth. The CAO processes the MA 112. Since the newborn qualifies as a TANF child, the CAO sets a control for 30 days. The newborn must be added to the existing TANF budget group as a mandatory budget group member.
Example 8: Mr. Thomas receives TANF for himself and three minor children, ages four, seven, and nine. He is employed 17 hours a week and is scheduled for a compliance review. He earns $7 an hour. After his interview, he reports his work hours have increased to 20 hours a week. Even though the increase in income is less than $100 per month and is not required to be reported for SAR, Mr. Thomas reports to show compliance with the RESET requirement. Mr. Thomas’s voluntary report will result in a TANF grant adjustment.
The CAO will conduct a case review promptly, but no later than 10 calendar days after any of the following occurs:
The client or someone acting on his or her behalf reports a change in circumstances or requests a special items allowance.
The CAO learns of changes from a responsible source.
NOTE: An employment and training contractor is considered a responsible source.
The CAO learns through a caseload alert of a conviction for welfare fraud.
NOTE: A person is ineligible for TANF if convicted of welfare fraud in TANF, Medical Assistance, or SNAP for a period of:
6 months from the date of the first conviction.
12 months from the date of the second conviction.
Permanently from the date of the third conviction.
See Supplemental Handbook, Chapter 910, Overpayment Recovery.
The CAO must get information about a conviction of welfare fraud through CIS. The OIG will update this information as necessary.
Information received from another state differs from information on the PA 600.
NOTE: If a court finds that a client fraudulently misrepresented his or her residence to get benefits or services in two or more states in the TANF, MA, SNAP or SSI program, the client is ineligible for TANF for 10 years. The 10 year ineligibility period begins on the date the court convicts the client.
A request is received from a state or local law enforcement office regarding the address of a fugitive felon, parole violator or probation violator.
Information is received from a federal or state court concerning persons convicted for a drug-related felony and persons who fail to appear at a criminal court proceeding when issued a summons or bench warrant.
21 U.S.C. § 862a & 62 P.S. §481.1
The CAO knows that a change was expected.
A change in regulations has made a renewal necessary.
Information discovered by IEVS is not consistent with information in the record.
The person who is the payment name requests that a mandatory budget group member be added to an existing budget group. See Chapter 176, Redetermination.
A face-to-face interview is not always required for a review. It is up to the CAO to make the decision about this. The CAO may conduct the partial renewal by telephone or by mail if the review focuses on changes and the client is credible and reliable such that the CAO accepts his or her statements without face-to-face contact. The client may submit verification later.
When the reported change is an increase or decrease in income, the CAO will do the following:
Request verification.
Make a plan with the client to provide the requested verification within 10 days of the report or within 10 days of receipt of the income if the report is made before receipt of the increased or decreased income.
55 Pa. Code § 133.23(b)(3) & 55 Pa. Code § 133.23(b)(4)
If verification of the change is not provided within the 10-day period, the CAO may increase or decrease the cash benefit after proper notice, using a best estimate of income based on the information provided by the recipient under the following conditions:
Verification is not immediately available.
The facts presented by the recipient are consistent and reasonable.
The change in the payment has been approved by a supervisor before data entry.
A plan has been made with the recipient to provide verification of the change no later than 15 working days after the effective date of the assistance benefit change. If the recipient does not provide verification and does not claim good cause for failure to comply, the CAO must close the cash budget with proper notice.
If the CAO determines that the above conditions do not apply, the CAO will serve proper notice to close the cash budget.
Example 9: Ms. Parris receives cash assistance for herself and her three children. On Oct. 5 she reported that her hours increased in September and her gross monthly income increased by more than $100. She also reports that the increase in hours will continue. The CAO asks Ms. Parris to provide verification of the change by Oct. 15 or contact the CAO if she cannot.
If Ms. Parris provides verification of the change in income by Oct. 15, the CAO decreases her cash grant after proper notice.
If Ms. Parris fails to provide verification of the change and does not contact the CAO to explain her failure to comply, the CAO discontinues the cash grant after proper notice.
If Ms. Parris contacts the CAO and claims good cause for failure to comply (usually because verification is not immediately available), the CAO makes a plan with Ms. Parris to provide verification within 15 working days following the effective date of the decrease. The CAO changes the benefit amount, with supervisory approval and after proper notice, using information from Ms. Parris to determine a best estimate of continuing income.
If Ms. Parris fails to provide the necessary information within the established 15-day time period, the CAO discontinues the cash benefit with proper notice.
Example 10: On May 5 the CAO receives notification from an employment and training contractor that Ms. Greenwood, a TANF recipient, will start a job on May 17. The CAO must contact Ms. Greenwood by May 15 and make a plan with her to verify her income within 10 days of the receipt of her first pay.
Reissued September 19, 2012; replacing January 31, 2012; reviewed October 7, 2013