44-270.D. Processing the SAR 7

 

Table of Contents

Section

Topic

44-270.D.1

Timely and Late SAR 7 Reports

44-270.D.2

Required Notification

44-270.D.3

Required Balderas Personal Contact

44-270.D.4

Processing a Late SAR 7

44-270.D.5

Processing Changes Reported Mid-Period

44-270.D.6

Providing Assistance

44-270.D.7

Accepting Clarification via Phone Call

44-270.D.8

Good Cause Determination

44-270.D.9

Restoration of Aid

CPG 295 (8/13)

 

44-270.D.1
Timely and Late SAR 7 Reports
Top

The SAR 7 is due by the 5th day of the SAR Submit Month (Month 6) following the initial application or annual redetermination.  It is considered late if received after the 11th day of the Submit Month.

Benefits will be discontinued effective the end of the SAR Submit Month unless a complete SAR 7 is received before close of business on the first working day of the following month (extended filing date).

·         If a complete SAR 7 is received after the extended filing date, the HSS will first determine if Good Cause exists per CPG 44-270.D.7.  

·         If Good Cause does not exist, the HSS will evaluate for CalWORKs restoration of aid as outlined in CPG 44-270.D.8 and 40-125.B.

ACL 12-25

 

44-270.D.2
Required Notification
Top

Unless a 10-day waiver is signed by the recipient, 10-day notice must be given before benefits may be decreased or discontinued.  This is the timely notice requirement.  Timely notice is not required for any increases in benefits.

Adequate notice refers to a written notice that informs the applicant/recipient of the intended action (such as a decrease or discontinuance of benefits) and reason(s) for the action, the applicable state regulations that support the intended action, information regarding state hearing rights and aid paid pending requests, and notification that any aid paid pending must be repaid if the county action is upheld.

The following notices will be sent timely and adequately when a complete SAR 7 is not received by the 11th day of the SAR Submit Month:

If ...

Then ...

No SAR 7 is received by the 11th day of the SAR Submit Month

An X-NOA (NA 960X SAR) will be sent to the household.

An incomplete SAR 7 is received by the 11th day of the SAR Submit Month

A Y-NOA (NA 960Y SAR) will be sent to inform the household of:

·   What specific information or required verification is still needed; and

·   The deadline (the extended filing date) for the household to provide the information.

An incomplete SAR 7 is received in response to a timely and adequate X or Y-NOA

No further notice will be sent as long as the original X or Y-NOA was sent timely and adequately.

NOTE:  The Y-NOA is not considered an adequate notice if it fails to identify what was incomplete about the SAR 7, either in the notice using freeform text or by attaching a copy of the SAR 7 with circled items.

Example 1:  Inadequate Discontinuance Notice

Scenario

·   A household reports work and a new household member on their SAR 7, but fails to verify the new earnings.

·   The Y-NOA informs the household that their SAR 7 was considered incomplete for failure to provide income verification.

·   Another SAR 7 is submitted with verification of the new income, but does not report the new household member.

Outcome

·   Between the two SAR 7s, the reporting will be considered complete.

 

Example 2:  Untimely Discontinuance Notice

Scenario

·   A household provides an incomplete December SAR 7 in January.

·   On January 20th, an inadequate Y-NOA is sent to the household.  This notice does not identify why the SAR 7 was considered incomplete.

·   On January 24th, an adequate Y-NOA is sent to the household.

Outcome

·   Without timely notice or a signed 10-day waiver, February benefits must be issued at the prior January level.

·   If a complete SAR 7 is received by the extended filing date, the discontinuance will be rescinded.

-  February benefits will be reevaluated using information from the complete SAR 7.

-  A CalWORKs overpayment (OP) and/or CalFresh overissuance (OI) will be calculated for any February benefits that were overpaid due to Administrative Error (AE).

·   If a complete SAR 7 is not received by the extended filing date, the entire month of February will be an OP/OI.

·   If a complete SAR 7 is later received in the month following the discontinuance (after the extended filing date), the discontinuance will be rescinded if Good Cause exists or aid restored if there is no Good Cause.

-  Affected benefit months must be reevaluated to adjust any OP/OI claims previously created due to the X or Y case discontinuance.

ACL 12-25; CDSS Policy Inquiry

 

44-270.D.3
Required Balderas Personal Contact
Top

After sending the X or Y-NOA, a Balderas personal contact must be attempted, either in person or by phone, and documented in CalWIN case comments.  If the Assistance Unit (AU) cannot be reached, then a written reminder will be sent no later than 5 days before the end of the SAR Submit Month.

The CalWORKs discontinuance due to X or Y-Suspense is not valid unless:

1.    An attempted Balderas personal contact is made (after the X or Y-NOA is sent); and

2.    The attempted Balderas personal contact is documented in CalWIN case comments; and

3.    A Balderas reminder notice is sent no later than 5 days before the end of the SAR Submit Month if the AU cannot be reached.

ACL 12-25

 

44-270.D.4
Processing a Late SAR 7
Top

When a complete SAR 7 is received after the 11th of the Submit Month but by the extended filing date; or if Good Cause is established per CPG 44-270.D.7, the discontinuance (X or Y-suspense) will be rescinded and benefits reinstated at the prior level.  An OP/OI will be established if unable to decrease benefits with timely notice.

Example 1:  Complete SAR 7 received late in Submit Month

Scenario

·   A household is currently in SAR Payment Period January – June and is assigned to SAR Cycle 1.

·   The CalWORKs grant amount is $638 for AU = 3.  The CalFresh benefit allotment is $404.

·   Their May SAR 7 is not received by June 11th and an X-NOA is issued timely.

·   A complete May SAR 7 is provided on June 29th and the CalWORKs/CalFresh discontinuance is rescinded.

·   On the SAR 7, a new part-time job that started in May is reported with earnings of $500/mo that are expected to continue at the same amount.

Outcome

·   The new income results in a decrease in CalWORKs and CalFresh benefits effective July.  The recalculated benefit amounts for the new SAR Payment Period are $444 for CalWORKs and $317 for CalFresh.

·   Since 10-day notice cannot be given, July CalWORKs and CalFresh benefits will be issued at the prior level.

·   An OP/OI will be established for any July benefits that the household was not entitled to receive.

When a complete SAR 7 is received after the extended filing date and Good Cause does not exist, the case will be processed for restoration of aid based on the date the complete SAR 7 is received, per CPG 44-270.D.8 and 40-125.B.  The SAR cycle and RRR will remain unchanged.

Example 2: Complete SAR 7 received after Extended Filing Date

Scenario

·   A family is currently in SAR Payment Period: January – June and is assigned to SAR Cycle 1.

·   An incomplete May SAR 7 is provided June 12th.

·   Mom reports her 17-yr old son returned to the home and has income but does not provide the income verification.

·   A Y-NOA is sent to explain what verification is needed to make the SAR 7 complete.

·   The income verification is provided after the extended filing date on July 3rd.

Outcome

·   If Good Cause exists, benefits will be reinstated without a break in aid.

·   If Good Cause does not exist, the case will be processed for restoration of aid with benefits prorated based on the date the SAR 7 was considered complete (July 3rd).

 

Example 3:  Incomplete SAR 7 received Late

Scenario

·   A family is currently in SAR Payment Period:  January – June and is assigned to SAR Cycle 1.

·   Their May SAR 7 is not received by June 11th and an X-NOA is issued timely.

·   On June 25th, a May SAR 7 is submitted.

·   Mom reports that Dad has moved into the home.  He has income but no verification is provided.

Outcome

·   The May SAR 7 is considered incomplete and the X-NOA discontinuance remains in effect.

·   If the required information to add Dad to the case is received by the extended filing date, Dad will be added to the case effective July 1st.

·   If eligible, a supplement for July will be issued and a new benefit amount will be calculated for the remainder of the semi-annual period.

If information reported on the SAR 7 results in a decrease in benefits and timely notice cannot be given, benefits will be issued at the prior level and an OP/OI will be established.

Example 4:  Untimely Decrease in Benefits

Scenario

·   Same scenario as Example 3 above, except that adding Dad to the case will result in a decrease in benefits.

·   The required verification is provided by the extended filing date and the discontinuance is rescinded.

Outcome

·   Since there is no timely notice to decrease benefits for July, benefits will be issued at the prior level unless a 10-day waiver is signed by the recipient.

·   Benefits will be decreased effective August 1st allowing for timely and adequate notice.

·   An OP/OI will be calculated for July due to Client Error for CalWORKs and/or Inadvertent Household Error (IHE) for CalFresh.

NOTE:  There will be no OP if a signed 10-day waiver is obtained from the recipient.

If information on the SAR 7 results in an increase in benefits, the increase will be effective the first month of the new SAR Payment Period.  Timely notice is not required to increase benefits.

ACL 12-25

 

44-270.D.5
Processing Changes Reported Mid-Period
Top

Information from a mid-period report is considered part of the case, regardless if any action was taken mid-period.

When processing the SAR 7, the HSS must review case comments and the “Search for Held Changes” page in CalWIN to determine if any change was reported mid-period.

NOTE:  If a mid-period report was previously verified, it will be treated as reported and the SAR 7 will not be considered incomplete if the recipient does not re-report the information on the SAR 7 per CPG 44-270.C.6; however, verification of gross income received in the Data Month must be provided per CPG 44-270.C.5.

The following table describes the HSS actions needed when reviewing information reported mid-period with information on the SAR 7 and associated verifications:

If information from the mid-period report is ...

Then ...

Consistent with information reported on the SAR 7 and   associated verifications

·   No additional action is required.

·   The SAR 7 will be considered complete if all criteria are met per CPG 44-270.C.6.

Inconsistent with information reported on the SAR 7 and associated verifications; or

The mid-period change was not verified

·   The HSS must resolve the discrepancy and obtain the required verification before the SAR 7 can be considered complete per CPG 44-270.C.6.

·   See CPG 44-270.C.5 for required verifications and CPG 44-270.D.7 for clarifying SAR 7 information via phone call.

 ACL 12-25; CalWIN R34

 

44-270.D.6
Providing Assistance
Top

The Human Services Specialist (HSS) will assist the recipient in completing the SAR 7, if requested.  The HSS will also assist in obtaining required verifications, including the payment of third party fees if required for determining CalWORKs eligibility, per CPG 40-100.J, after determining that a good faith effort was made and the third party has failed or refused to provide verification.

If assistance is requested and not provided prior to the proposed discontinuance date, then benefits will not be discontinued. Any resulting OP/OI will be considered an AE.

NOTE:  Reasonable accommodations must be provided to individuals with disabilities, as outlined in CPG 44-270.C.3.  This includes providing assistance and making a Good Cause determination, without the recipient’s specific request, if there is a disability-based reason that prevented the recipient from submitting a complete SAR 7 timely.

ACL 12-25

 

44-270.D.7
Accepting Clarification via Phone Call
Top

A Y-NOA must be issued if necessary questions on the SAR 7 pertaining to CalWORKs eligibility are not answered or if required verifications as outlined in CPG 44-270.C.5 are not provided.

Clarification via phone call will not be accepted if a required question on the SAR 7 is not answered or if required verifications are not provided.  See CPG 44-270.C.6 for completeness criteria.

If there is a discrepancy, like a partially answered question or a discrepancy between the SAR 7 and a mid-period report, then clarification from the recipient may be obtained via phone call and documented in CalWIN case comments.

CDSS Policy Inquiry

 

44-270.D.8
Good Cause
Determination
Top

The discontinuance will be rescinded when the recipient cannot reasonably be expected to fulfill his/her reporting responsibilities due to factors outside of his/her control.

Good Cause exists in the following situations:

·         The recipient has a mental or physical condition that prevents him/ her from submitting a timely report;

·         The late report is directly attributable to Administrative Error (AE); or

·         Other extenuating circumstances exist, such as domestic violence, which might have contributed to the recipient’s inability to submit a timely report.

NOTE:  When making a Good Cause determination, the HSS must consider if the recipient had a good understanding of his/her reporting responsibilities.  See CPG 44-270.C.3 for HSS responsibilities.

WITHIN ONE MONTH OF DISCONTINUANCE

If a recipient reapplies for CalWORKs or requests restoration of aid (CPG 40-125.B) during the month following a SAR 7-related discontinuance, the HSS is required to first review if the recipient had Good Cause for failing to submit a complete SAR 7.

·         If Good Cause exists, the discontinuance will be rescinded and the SAR 7 will be used to redetermine eligibility and benefit amounts for the new SAR Payment Period.

·         If Good Cause does not exist, eligibility will be established and benefit amount prorated using restoration of aid rules.

NOTE:  A recipient may choose to reapply for aid, rather than request restoration of aid.  The HSS will document this information in CalWIN case comments.

AFTER ONE MONTH OF DISCONTINUANCE

If a recipient requests restoration of aid after a month has passed, a Good Cause determination will be made if specifically requested by the recipient.

Good Cause may be determined, without the recipient’s specific request, when the HSS is aware that:

·         The recipient has a mental or physical condition which impedes timely and complete reporting, or

·         The failure to submit a timely and complete report is due to Administrative Error; or

·         Other extenuating circumstances exist.

The burden of proof is on the household to prove they had Good Cause for not submitting a complete and timely SAR 7.

ACL 12-25

 

44-270.D.9
Restoration of Aid
Top

When benefits have discontinued for failure to submit a complete SAR 7, aid may be restored if a complete SAR 7 is received any time during the month following the discontinuance and Good Cause does not exist, per CPG 40-125 B.

Continuing eligibility must first be established before benefits are restored.  Restoration of aid will not be processed if information provided on the complete SAR 7 results in ineligibility to CalWORKs.

The restored benefits will be prorated based on the date the complete SAR 7 was received without requiring a new application or interview.  The SAR Cycle and redetermination date will remain unchanged and recipient budgeting rules will apply.

ACL 12-25; 12-35