Adult Medicaid Manual MA-2375 CHILD SUPPORT

IV. DETERMINING GOOD CAUSE FOR NOT COOPERATING WITH Child Support Enforcement

The parent/caretaker may have good cause not to cooperate in the state's efforts to establish paternity or collect medical support or medical payments for a child. The a/r may be excused from cooperating if he believes that cooperation would not be in the best interest of the child or the caretaker, and if evidence can be provided to support this claim. Always inform the parent/caretaker of his right to establish good cause.

Note: Assistance will not be denied, delayed or discontinued pending a determination of good cause for refusal to cooperate if the a/r has complied with the requirements of evidence and information. The IMC makes the final determination of good cause.

REVISED 11/01/11 – CHANGE NO. 17-11

(IV.)

A. Good Cause for not making a referral:

1. Cooperation can reasonably be expected to result in physical or emotional harm to the child for whom assistance is requested, or to the caretaker which would reduce his capacity to adequately care for the child.

a. Physical harm must be of a serious nature to justify good cause.

b. Emotional harm may only be found if the emotional impairment substantially affects the individual’s functioning. Consider the following:

(1) The present emotional state of the caretaker.

(2) The emotional health history of the caretaker.

(3) The degree of cooperation to be required.

(4) The extent of involvement of the child in the establishment of paternity or support enforcement activity.

2. At least one of the following circumstances exists which would make cooperation detrimental to the child:

a. The child for whom medical support or medical payments is sought was conceived as a result of incest or rape.

b. Legal proceedings for the adoption of the child are pending before a court of competent jurisdiction.

c. The caretaker is currently being assisted by a public or licensed private social agency to resolve the issue of whether to keep the child or relinquish him for adoption, and the discussions have not gone on for more than three months.

B. Establishing Good Cause

If the parent/caretaker claims to have good cause for not making a referral, give the parent/caretaker the DSS-8104, Second Notice of Right to Claim Good Cause for Refusal to Cooperate in Child Support Enforcement. The caretaker claiming good cause must provide evidence to establish his claim.

REISSUED 04/01/10 – CHANGE NO. 07-10

(IV.B.)

1. Evidence:

a. Birth certificates or medical or law enforcement records which indicate that the child was conceived as the result of incest or forcible rape.

b. Court documents or other records which indicate that legal proceedings for adoption are pending before a court of competent jurisdiction.

c. Court, medical, criminal, child protective services, social services, psychological, or law enforcement records which indicate that the putative father or non-custodial parent might inflict physical or emotional harm on the child or the caretaker.

d. Medical records or records of a mental health professional which indicate the emotional health history and present emotional health status of the caretaker or child for whom medical support or medical payment is being sought. A written statement from a public or licensed private social agency that the caretaker is being assisted by the agency to resolve the issue of whether to keep the child or relinquish him for adoption.

f. Sworn statements from individuals other than the caretaker with knowledge of the circumstances which provide the basis for the good cause claim.

2. Request evidence necessary to determine if good cause exists. Set a date for the a/r to return the evidence. Allow twenty calendar days and offer assistance if needed.

3. Upon receipt of evidence, determine if good cause exists.

4. If you determine that additional evidence is necessary:

a. Notify the client that additional evidence is needed, and

b. Advise him how to obtain the documents and offer to assist in obtaining documents he or she cannot readily obtain without assistance.

5. If the evidence has not been provided by the deadline, approve the application if all other eligibility criteria are met. Indicate that good cause was denied on the Required Client Data screen. Refer to EIS 4900, Appendix C.

Document the findings on the base document.

6. If the good cause claim was due to anticipated physical harm and proper supportive evidence is not provided by the caretaker, the agency may investigate and accept the claim if:

REISSUED 04/01/10 – CHANGE NO. 07-10

(IV.B.6.)

a. It is believed that evidence is unavailable, or

b. It is believed that the claim is credible without evidence.

7. If the good cause claim and the evidence provided are insufficient for making a determination of good cause, the agency may conduct its own investigation. The IMC may:

a. Contact the non-custodial parent from who support would be sought.

b. Notify the caretaker of the necessity of this contact in order that he may present additional evidence, withdraw the good cause claim or the application for assistance, or have the good cause claim denied.

8. If good cause is established:

a. Indicate that good cause is approved on the Required Client Data Screen. Refer to EIS 4900, Appendix C.

b. Document the findings in the case record and attach any supporting evidence.

9. If good cause does not exist, indicate that good cause was denied on the Required Client Data screen. Refer to EIS 4900, Appendix C.

10. The IMC makes the final determination of good cause.