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Change #5-2010
September 1, 2010
A. Categorical eligibility refers to Food and Nutrition Services (FNS) households who are exempt from meeting the resource, gross and net income limits.
B. FNS households are categorically eligible when:
1. All members of the Food and Nutrition Services unit (FNSU) are authorized to receive Work First Cash Assistance (WFFA), or all members receive a combination of WFFA and Supplemental Security Income (SSI) benefits. This includes WFFA payment types 1, 2, and Benefit Diversion.
2. At least one member of the FNSU is authorized to receive an available service from Work First Employment Services. This includes FNSU’s that are at or below 200% of the federal poverty level and at least one member of the FNSU is authorized to receive Work First Services available through the Temporary Assistance for Needy Families (TANF) Block Grant. The individual may receive services available for working low-income families or for non-custodial parents.
“Authorized to receive” means that an individual has been determined eligible for benefits and has been notified of this determination, even if the benefits have been authorized but not received, authorized but not accessed, suspended, or recouped.
Develop verification procedures within the agency to determine individuals that are authorized for Work First Employment Services. Some options include use of the Services Information System (SIS), DSS-8194’s, Work First Services Worksheet, contacting the Work First Employment Services Section in your agency, or any other method that will ensure that these households are deemed categorically eligible. Document the case file that the individual is authorized for Work First Employment Services.
NOTE: This policy applies only to counties that provide these services within their agency and have submitted a Work First Plan indicating they are providing these services. Welfare-to-Work and other contracted employment services are not considered Work First Employment Services for categorical eligibility determination.
3. All members of the FNSU are authorized to receive SSI benefits.
NOTE: An Alien can be eligible for SSI but ineligible for FNS benefits due to his/her alien status. Refer to Section 225, Citizenship and Alien Status, to first determine FNS eligibility for aliens.
4. The income of the household is at or below the 200% maximum allowable gross income limit and the household does not meet the criteria for 1, 2 or 3 above. These households are provided information regarding TANF funded services.
C. A household is not eligible for categorical eligibility if:
1. Any member of the household is disqualified for an intentional program violation (IPV); or
2. The head of household is disqualified for failure to comply with work program requirements as required in Section 240, Work Requirements; or
3. Any member of the household is disqualified for conviction of a drug felony since August 23, 1996, for an act committed on or after August 23, 1996
D. Categorically eligible FNSU’s are subject to all FNS eligibility requirements with the exception of the resource, gross and net income limits. FNS Citizenship/Alien status and other eligibility requirements must be met prior to evaluating for categorical eligibility. Categorically eligible FNSU’s are also subject to all benefit provisions.
A. Verify the type of assistance received and the authorization period. Document in the case record that an individual is authorized for:
1. WFFA (payment type 1);
2. WFFA (payment type 2);
3. Benefit Diversion;
4. Work First Employment Services for Working Low-Income Families;
5. Work First Employment Services for Non-Custodial Parents; or
6. SSI Benefits
B. Categorically eligible households, who receive WFFA and/or SSI, have met certain eligibility requirements through the certification process that has been used for WFFA and/or SSI benefits. Do not require additional verification of the following eligibility factors, unless questionable.
1. Resources – The household automatically passes the resource test. Verification of resources in not required.
2. Gross and Net Income – The FNSU is exempt from the gross and net income limits test.
3. Enumeration
4. Residency – No further verification is required. The household must reside in the county in which it applies for FNS benefits.
C. Verify eligibility factors required for determination of benefit level that are not verified by WFFA or SSI as listed:
1. Income disregarded for WFFA or SSI but not disregarded for FNS benefits.
2. Household composition, if questionable.
D. Refer to Section 225, Citizenship and Alien Status, to determine FNS eligibility for aliens. An individual can be eligible for SSI, WFFA, or Work First Employment Services but ineligible for FNS benefits due to his/her alien status. Aliens are not automatically categorically eligible.
Document in the case file that the household was provided information for Healthy Marriages and Teen Pregnancy Prevention, which are TANF funded services, at each application, reapplication, recertification and change in situation by use of the DSS-8207, DSS-8550, DSS-243R or DSS-2435I.
A. Approving a FNS Application Pending WFFA, SSI, or Work First Employment Services Approval
1. Follow regular FNS policy verification procedures for eligibility factors that are needed solely for determining FNS eligibility. If the household’s income is at or below the 200% maximum allowable gross income limit the household meets the categorical eligibility criteria and the application is processed.
2. If the FNSU has provided sufficient verification to meet FNS verification requirements but has failed to provide sufficient verification for WFFA, SSI, or Work First Employment Services approval, process the FNS application following regular FNS Program rules. Do not deny the FNS application for failure to provided sufficient verification or for failure to comply with processing requirements.
3. If a FNSU’s categorical eligibility cannot be established due to a pending WFFA, SSI, or Work First Employment Services application, and the FNSU does not meet the 200% maximum allowable gross income limit criteria, pend the FNS application until the 30th day unless the FNSU is entitled to expedited service. This only applies when categorical eligibility is needed to establish FNS eligibility.
4. Once WFFA, SSI, or Work First Employment Services is approved, the FNSU is considered categorically eligible if all other eligibility criteria are met.
5. If the WFFA or SSI approval can be reasonably anticipated, include the monthly payment amount as income. “Reasonably anticipated” means that the WFFA application-processing deadline is approaching and no processing delays are expected or an SSI award letter has been issued.
6. Do not include WFFA or SSI payments intended for prior months as income.
7. If the amount and/or date of receipt of the initial WFFA or SSI benefits cannot be reasonably anticipated, do not count the payment as income. Consider the WFFA or SSI approval as a change in situation.
8. For pending Work First Employment Services applications, and the FNSU does not meet the 200% maximum allowable gross income limit criteria, the FNSU is not categorical eligible until at least one member of the FNSU is authorized for Work First Employment Services. If authorization can be reasonably anticipated, consider the FNSU categorically eligible. If authorization cannot be reasonably anticipated, follow regular FNS eligibility rules.
B. Denying a FNS Application Pending WFFA, Work First Employment Services, or SSI Approval
Do not deny the application of a potentially categorically eligible household until the 30th calendar day following the date of application if pending for an eligibility factor that is related to categorical eligibility. If the household’s income is at or below the 200% maximum allowable gross income limit the household meets the categorical eligibility criteria and the application is processed.
If a household is ineligible based on FNS eligibility criteria and the WFFA, Work First Employment Services, or SSI eligibility decision is still pending on the 30th day, take the following actions.
1. Deny the FNS application on the 30th day using regular FNS rules.
2. Ensure that the denied application of a potentially categorically eligible household is easily retrievable. A manual tracking system, or any method that will provide accessibility as needed, may accomplish this task. Continue to monitor the pending SSI, WFFA, or Work First Employment Services application until a determination is made regarding eligibility. This can be accomplished by monitoring SSI applications for a period of 90 days (the period of time that the Social Security Administration has to approve or deny SSI benefits) and by monitoring WFFA or Work First Employment Services applications for 45 days (the period of time allowed to approve or deny a WFFA application). If the SSI, WFFA, or Work First Employment Services application pends longer than the allowable time frames, inform the household of their responsibility to provide notification of the approval or denial.
C. Reopening a Previously Denied FNS Application Upon WFFA, Work First Employment Services, or SSI Approval
If the household becomes categorically eligible after the FNS application is denied, reevaluate the original application upon request or when you become aware of the household’s SSI, WFFA, or Work First Employment Services approval. Take the following actions:
1. Reopen the application. The date of application is either the original date of application or the effective date of the WFFA, Work First Employment Services, or SSI approval, whichever is later.
2. Do not reinterview the household. Update the original application using available information. Contact the household via telephone or mail to explore changes in situation.
3. If information obtained from the household differs from original information or changes have occurred, a household member or authorized representative must initial all changes, resign and date the updated application, and provide necessary verification.
4. Allow deductions for specified persons beginning with the date of the FNS application or the effective date of the SSI payment, whichever is later.
5. Authorize FNS benefits back to the date of the FNS application for FNSU’s that are determined eligible for WFFA, SSI, or Work First Employment Services for a period of time within the 30-day FNS processing time.
6. If a FNSU files a joint application and is determined categorically eligible after being denied FNS benefits under regular program rules, prorate FNS benefits from the date of the FNS application or the date the public assistance (PA) benefits are authorized, whichever is later.
D. Allotments for Categorically Eligible Households
1. All categorically eligible one or two-person FNSU’s are entitled to at least a $16 allotment.
2. There is no minimum allotment for categorically eligible households with three or more members. FNS budgeting procedures may determine these households ineligible based on a zero allotment amount as determined by the FNSU’s income level.
3. If the household is ineligible for an allotment, the DSS-8590, Client Record, displays the following message: “Case suspended – Categorical eligibility – allotment less than $1.00.” Verify entries and close the case.
A. Prior to July 1, 2010, if a categorically eligible household of three or more was ineligible for an allotment, the case was suspended. Effective July 1, 2010, if categorically eligible households suspends due to ineligibility for a payment, the case will be terminated.
B. When a categorically eligible household that was suspended prior to July 1, 2010 has a change in circumstances and becomes eligible for an allotment, authorize benefits effective the date the change is reported or becomes known to the agency.
1. Document the change in situation that makes the household eligible for an allotment in the case file.
2. Process the change within ten calendar days of the date the change is reported or otherwise becomes known to the agency.
3. Prorate benefits for the first month the household becomes eligible for an allotment. Prorate from the date the change becomes known to the agency. Enter the change date in field 8 of the DSS-8590 and the month of the change in field 14 to authorize benefits.
4. Use the DSS-8562, Effect of Change, to notify the household of the allotment amount.
5. Issue benefits via the DSS-8593.
C. Terminate a suspended categorically eligible household if the reported change does not result in eligibility for an allotment.
D. Terminate a suspended categorically eligible household at the end of the certification period unless:
1. The household reports a change that makes it eligible for an allotment, or
2. The agency becomes aware of a change that makes the household eligible for an allotment, or
3. The household applies for recertification.
A. A household is no longer categorically eligible if:
1. WFFA, Work First Employment Services, and/or SSI benefits, Benefit Diversion terminates; AND the income of the household exceeds the 200% maximum allowable gross income limit;
When the FNS household loses WFFA (payment type 1 or 2), evaluate for transitional benefits.
2. A household member becomes disqualified due to one of the reasons listed in Section 620.01 C.
Loss of categorical eligibility is not a required reportable change. When the FNS household loses categorical eligibilty status as the result of a change, consider resources that have been excluded during the current certification period. Address only resources that are known and documented in the file that exceed the resource limit. If the known resources exceed the resource limit, terminate assistance. If the resources are questionable, address at the next certification. The agency does not interview the household about resources until the next certification. For policy regarding reacting to changes during the certification period, refer to Section 450.04.
B. If WFFA, SSI, or Work First Employment Services benefits are terminated but the household is still eligible for FNS benefits, advise the FNSU of the appropriate work requirements.
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office. |
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