zz – Obsolete

2040.005.15 Determining the Claim Time Period

The amount of the claim is computed by determining the number of months of overpayment and the amount of overpayment for each month.

The first month of overpayment is determined by applying the change reporting rules that would have applied to the case situation if all facts and figures required to be reported had been reported to the agency within the proper time frames.

  • If the overpayment occurred because incorrect information was given or an incorrect determination was made at the time of an application, the first month benefits were overpaid is the beginning month of benefits.

EXAMPLE: Mr. B applies for Child Care Subsidy on August 5 and determined eligible. He does not report income from employment. The claim for over issuance when the income is budgeted begins with August 5 because the income was not reported at application.

  • If the Eligibility Unit does not report the change within ten (10) days and action cannot be taken to close the grant the next month, the overpayment is effective the month of the maximum advance notice period, if applicable. This is the month the adverse action notice would have expired without the Eligibility Unit requesting a fair hearing.

EXAMPLE: Ms. B. is currently receiving Child Care Subsidy. On September 12 she became employed and her income put her over the 85% state median income. She did not report this change until she reapplied for food stamps on January 21. Taking into account the 10-10-10 rule, Ms. B. should have reported employment by September 22. The eligibility specialist completes a budget by October 2 and sends an adverse action to close Child Care Subsidy. The adverse action expires on October 12 and action could have been taken to affect for November. The overpayment begins with November.

  • If the Eligibility Unit reports the change timely and action is required, but the eligibility specialist fails to act on the change, the first month of overpayment is the first month the agency should have made the change effective. If the notice of adverse action was required but was not sent, the agency shall assume that the maximum advance notice period, if applicable, would have expired without the Eligibility Unit requesting a fair hearing.

The eligibility factors and budget process in effect during the period of the claim are used in determining the amount of overpayment.

2040.005.20 Optional Members Cause Claims

To determine the Child Care Subsidy amount the Eligibility Unit was eligible for, the following policy applies:

  • Optional Inclusion in Eligibility Unit:

In those cases where a Eligibility Unit receives an overpayment because of income received by an optional member whose needs were included in the eligibility determination, the overpayment will be the lesser amount of the correct determination, after determining the amount, if the person:

    • had been left in the Eligibility Unit; or
    • was removed from the Eligibility Unit.

These steps are to be followed even in those cases where additional income was not reported.

Examples of optional inclusions in a Eligibility Unit include: grandchildren, nieces and nephews.