63-274 Timely, Late, and Incomplete QR 7

Table of Contents

	Section
Timely and late QR7s	274.1
QR7 not received or is incomplete	274.2
QR 7 Notices of Action	274.3
Saldivar v. McMahon & Overissuances	274.4
Good Cause Determination-Failure to Submit a Complete QR 7	274.5
Good Cause Determinations-Timely Notice and Overissuances	274.6
Restoration of Eligibility Waiver-Regulations	274.7
Restoration of Eligibility Waiver-QR 7 Examples	274.8

63-274.1 Timely and Late QR 7

The QR 7 is due by the 5th of the Submit Month and is considered timely if it is received by the 11th calendar day of the QR Submit Month but not before the first calendar day of the QR Submit Month. The QR 7 is late if it is received after the 11th day of the QR Submit Month. · The household will be discontinued: o There is no longer eligibility for CalFresh in the upcoming Payment Quarter; o A complete QR 7 is not submitted by the 1st working day of the new Payment Quarter; o There is failure to comply with a non-financial eligibility requirement, such as the work registration requirements; or o Termination of benefits is requested in writing.

63-274.2 QR 7 Not Received or is Incomplete

When a QR 7 is not received by the 11^th day of the QR Submit Month, or it is received but determined to be incomplete the worker will provide a timely notice of action to discontinue the case effective the end of the Submit Month. The notice of action will inform the household: · That the QR 7 either is overdue or incomplete; · What the household must do to complete the QR 7; · If any verification is missing and the effect on the household's benefit level; · Of the extended filing date; and · That the worker will assist the household in completing the report. If the household submits a QR 7 by the date the worker mails the notification of the missing QR 7 but fails to provide the required verification/information with the QR 7, the worker will notify the household of the need to submit the missing verification and/or information by the extended filing date. (Refer to Section 63-273.4, Verifications Required with the QR 7). · The worker will not delay benefits if the missing verification and/or information is for a deduction. If the household fails to provide the missing verification and/or information, other than for income, by the extended filing date, the worker will not consider the QR 7 incomplete. Any deductions for which the verification or information is missing and required shall be disallowed with timely notice (QR 377.4, Proposed Change in Benefits). Note that verification of changes in shelter cost are only required to be verified at application as explained in Sections 63-117.18 and 63-117.22. · If the household writes on the QR 7 or states that they have “no idea” what income they expect to receive in the next quarter; or report “$0” income and the worker is aware the recipient does occasional work, the worker should not return the QR 7 to the recipient immediately as incomplete, but should attempt to contact the recipient and discuss their potential income for the next three months and decide if any income can be reasonably anticipated. Refer to Section 63-281.4. The worker should not treat QR 7’s with zero anticipated income as incomplete unless there is some discrepancy. For example, if the recipient had regular income last quarter and they anticipate zero income this quarter but do not state on the QR 7 that anything has changed since last quarter, then the worker should follow-up with the recipient to resolve the discrepancy. Furthermore, if the worker does not accept the recipient’s estimate of anticipated income the worker will document why the recipient’s estimate is not being accepted, explain the basis for the worker’s estimate, issue timely notice and document in CalWIN Case Comments. ACL 09-41 Under Modified Categorical Eligibility (MCE), Non-assistance CalFresh (NACF) households are not required to submit verification of resources after receiving the TANF/MOE-funded service “Family Planning – PUB 275” brochure. The worker shall not consider the QR 7 incomplete if a household does not provide verification of resources with the QR 7 and will not evaluate or request verification of resources. However, the household is required to answer question #6 on the QR 7. Refer to Section 63-203.19 for additional MCE information.

63-274.3

QR 7 Notices of Action

To notify the household that the QR 7 is missing or incomplete, the worker shall use the following notices of action:

· The NA 960X QR to notify the household that a QR 7 has not been received, or

· The NA 960Y QR to notify the household the QR 7 is incomplete, the specific information and/or documentation needed to consider the QR 7 complete, and the deadline by which the recipient is required to submit to avoid being discontinued.

The worker will send the notice of action no later than 10 days before the end of the Submit Month and give the household until the extended filing date to provide a complete QR 7.

If the household ...	Then the worker ...
Sends a complete QR 7 after the 11th of the Submit Month, but prior to mailing the suspense notice,	Will not send the notice.
Submits an incomplete QR 7 after NOA deadline and after the worker has issued a timely NA 960X QR,	Is not required to send a suspense notice (NA 960Y) to the household. The worker will call the household, or send written notice, to let the household know that: · The QR 7 was received, but it is incomplete, · Why it is incomplete, · CalFresh benefits will discontinue on the effective date, and · What the household is required to do to complete the QR 7.
Submits another incomplete QR 7 after the worker has issued a timely NA 960Y QR clearly explaining what information and documentation was needed to complete the QR 7,	Is not required to send a second NA 960Y QR to the household. The worker is required to call the household, or send written notice, to let the household know that: · The QR 7 was received, but it is incomplete, · Why it is incomplete, · CalFresh benefits will discontinue on the effective date, and · What the household must do to complete the QR 7.
Does not submit a complete QR 7 by the extended filing date,	The discontinuance remains in effect and the recipient must reapply for CalFresh benefits unless good cause is established or the case can be Restored as outlined in Sections 63-274.7 and 63-274.8.

Refer to the following sections for information on the Restoration of Eligibility and Benefits Waiver:

· 63-274.7, Restoration of Eligibility Waiver-QR Regulations

· 63-274.8, Restoration of Eligibility-QR 7 Examples

· 63-303.13, Exemptions for Providing a Timely Notice

63-274.4 Saldivar v. McMahon and Overissuance

Under the Saldivar v. McMahon court order, workers are to continue to provide timely and adequate notice to households in order to decrease benefits. Under QR/PB rules, an overissuance (O/I) will be established when the worker is unable to decrease benefits due to the Saldivar v. McMahon 10-day noticing provisions.

63-274.5 Good Cause Determination: Failure to Submit a Complete QR 7 Timely

Quarterly Reporting households that have been discontinued for failing to submit a timely or a complete QR7 must be evaluated first for good cause when the household reapplies in the calendar month following the discontinuance. If the household does not meet good cause criteria, the worker will evaluate for Restoration of Eligibility as explained in Sections 63-274.7-8. Good cause must be determined using the criteria listed under MPP Section 40-181.23. Good cause exists only when the household cannot reasonably be expected to fulfill his/her reporting responsibilities due to factors outside of his/her control. The burden of proof rests with the household. A good cause exemption will only be granted if the request is made by the responsible member of the household, or the authorized representative. A request is defined as any clear expression to the county, whether verbal or written, that the household wants an opportunity to present his/her explanation for not meeting the quarterly reporting requirements. · A request for a State Hearing also may be considered a request for good cause determination when the issue is QR 7 related. Good cause exists in only the following situations: · When the recipient is suffering from a mental or physical condition which prevents timely and complete reporting. · When the recipient's failure to submit a timely and complete report is directly attributable to county error. · When the county finds other extenuating circumstances. MPP Section 40-181.23 After determining the household had good cause for failing to submit the QR7 by the extended filing date, the worker will rescind the discontinuance action and determine CalFresh eligibility and benefit amount based on the information on the QR 7. The recipient’s QR cycle remains unchanged. Once a full calendar month has passed since the QR 7 discontinuance date, the household may not claim good cause and must reapply for benefits.

63-274.6 Good Cause Determination: Timely Notice & Overissuances

If information reported on the QR 7 results in a decrease in benefits, the worker must provide 10-day notice before taking action to decrease benefits. · Once good cause has been determined and the discontinuance rescinded, benefits must be released to the household at the previous higher amounts until a 10-day notice can be sent to the recipient. · An overissuance will be established when benefits are released at a previous higher level as a result of the worker's inability to decrease benefits without 10-day notice. · If the QR 7 information results in an increase in benefits, and the worker cannot increase benefits by the first month of the next QR Payment Quarter, a supplement will be issued for that month and benefits increased for the remaining months of the QR Payment Quarter. NOTE: There is no opportunity for the recipient to claim good cause once a full calendar month has passed since the discontinuance date. EXAMPLE: A household is receiving $200 in CalFresh benefits. In the October/November/December quarter. The mother fails to submit her QR 7 for the month of November by December 11^th. After sending an appropriate discontinuance notice, the household still does not submit a QR 7 and benefits are discontinued effective December 31^st. The household comes in on January 4th to reapply for aid. The worker determines that the household had good cause for not turning in the November QR 7, due to mail delivery and pick up problems in the area. In the November QR 7, the household reports having been approved for UIB in the amount of $100 per week, which is new income not previously budgeted. With the receipt of UIB, the household is eligible to $100 in CalFresh benefits. The worker must restore benefits at the previous higher level of $200 because a 10-day notice to reduce January’s benefits cannot be provided. The worker must make a mid-quarter adjustment for the Jan/Feb/March Payment Quarter by sending the household a 10-day notice to decrease benefits effective February 1. There is a $100 O/I for the month of January. Refer to Section 63-450 for information on Claims Determination Requirements.

63-274.7 Restoration of Eligibility Waiver-QR Regulations

The Restoration of Eligibility Waiver does not amend the criteria for determining good cause. The worker will first determine if the household had good cause for failure to submit a complete and timely QR 7 for the previous quarter as specified in sections 63-274.2-6, above. If the household does not meet good cause criteria for failing to submit a complete QR 7, the worker will restore eligibility if the household provides the complete QR 7 the month after the discontinuance, and issue prorated benefits effective the date the household provides the complete QR 7 (the date the complete QR 7 is received at the Family Resource Center (FRC). · The worker: o Is required to send adequate notice regarding restoration approval or denial. Issue Notice of Action (NOA): § QR 2104 when approving restoration of eligibility or § DFA 389 when denying restoration, and o Will issue benefits as soon as administratively possible. Restoring discontinued benefits is considered a “positive action.” Therefore, a 10-day notice to decrease benefits is not required to resume benefits. Households who have had their eligibility restored under this waiver: · Are not considered applicants. Therefore they are not entitled to expedited services; · Shall not begin a new certification period; · Will be reinstated for the remaining months of their previous certification period; · Are considered continuing cases. Therefore, they shall not be: o Interviewed, or o Required to submit a new application, and · The QR cycle shall not change. NOTE: The household has the option to file a new application instead of being restored. In some instances it could be more advantageous and convenient for the household to reapply for benefits (e.g., the date of the household’s recertification is approaching). Refer to Section 63-117.3.

63-274.8 Restoration of Eligibility Waiver-QR 7 Examples		Quarterly Reporting households that have been discontinued for failing to submit a timely or a complete QR 7 must be evaluated first for good cause as explained in Section 63-274.5. If the household does not meet good cause criteria, the worker will evaluate for Restoration of Eligibility. Below, are a series of regulations and examples pertaining to QR 7 related discontinuances:
	Regulation	Description	Example
	Data Month	If a QR household that has been discontinued for not submitting or providing an incomplete QR 7, submits a complete QR 7 the month immediately after discontinuance, the HSS will determine eligibility and allotment based on the information pertaining to the QR data month.	The QR quarter is January/February/March (QR cycle 1). The household does not submit the QR 7 by the extended filing date (April 1^st) and the case discontinues March 31^st. On April 15^th, the household submits the complete February QR 7. The worker will determine eligibility and benefits for the April/May/June payment quarter based on the QR data month (February). If the household is eligible based on the QR data month (February) information, the worker will restore eligibility, prorate benefits effective April 15^th and issue Notice of Action QR 2104. A 10-day notice to decrease benefits is not required.
	QR Cycle	When a QR household is discontinued due to a QR 7 related issue, resolves the discrepancy and has eligibility restored under the guidelines of the waiver, the household’s QR cycle will not change.	A household applied for and is approved for CalFresh on February 26^th. The household is cycle 2 with a 12-month certification period. The household is discontinued April 30^th for failure to provide proof of earnings as reported on the QR 7. Subsequently, the household provides the necessary documentation of earnings to the worker on May 7^th. The worker will restore eligibility and benefits to the household effective May 7^th, not change the QR cycle and keep the existing certification period. A 10-day notice to decrease benefits is not required.
	Ineligibility	The HSS will not restore eligibility when a QR household is determined ineligible after submitting the missing information and/or verification the month after a discontinuance. In this case, the original discontinuance will remain in effect.	The QR quarter is January/February/March (QR cycle 1). The household does not submit the QR7 by the extended filing date (April 1) and the case discontinues March 31^st. On April 15^th, the household submits a complete February QR 7. The worker determines eligibility and benefits applying QR rules for the April/May/June payment quarter based on data month (February) information. The income reported on the QR 7, which can be reasonably anticipated for the next payment quarter, renders the household ineligible. The worker will not restore eligibility and issue Notice of Action DFA 389 denying restoration.
	Voluntary Mid-Quarter Report	When a household voluntarily provides updated or additional information during the restoration process (from what has been reported on the QR 7); the HSS will treat this information as a voluntary mid-quarter report and apply QR regulations according to Section 63-283: “The HSS will only take mid-quarter action on those voluntary reports that result in an increase in benefits.” Note: QR households are still responsible for complying with QR mandatory changes.	The QR quarter is October/November/December (QR cycle 1). The household submits the November QR 7 timely but does not provide income verification. The worker correctly discontinues the household for lack of verification. On January 21^st, the household provides the missing verification and informs the HSS that a new household member, who has income, moved in on January 19^th. Since the new household member was not required to be reported on the November QR 7, the worker will treat this information as a voluntary mid-quarter report. In this situation, adding the new household member with income would decrease benefits. Therefore the eligibility and benefits will be restored based on November data month information effective January 21^st and will not add the new household member for the January/February/March payment quarter. The worker will issue Notice of Action QR 2104 and remind the household to report the new member on the next QR 7 via no-change notice QR 377.4 as explained in Section 63-283.7. Note: If the addition of the new household member would have increased benefits, the new member would have been added the month following restoration, February 1^st.
	Re-Establishing Eligibility	The HSS may restore eligibility when a QR household that has been discontinued due to ineligibility reports changes in circumstances that re-establish CalFresh eligibility the month following the discontinuance.	The QR quarter is June/July/August (QR cycle 3). The household submits the QR 7 timely in August and reports anticipated income that exceeds the maximum gross income limits. The worker correctly discontinues the household effective August 31^st for being over income. On September 10^th, the household reports and provides proof of the loss of the income reported on the QR 7. The worker will determine eligibility and benefits based on the new income information and restore the household effective September 10^th. The worker will not change the QR cycle and the existing certification period.