5101:4-7-01 Food assistance: reporting requirements during the certification period.

(A) What is a reporting requirement?

Every assistance group receiving benefits must report certain changes that affect eligibility. Reporting requirements ensure an accurate benefit amount is received and that only assistance groups who remain eligible continue to receive benefits.

(B) What are the requirements for reporting changes?

(1) Assistance groups shall report if their gross income exceeds one hundred thirty per cent of the monthly poverty income guideline for their assistance group size within ten days following the end of the month in which the change first occurred;

(2) All assistance groups shall be required to submit an interim report prior to the end of the sixth month of a twelve month certification period or prior to the end of the twelfth month of a twenty-four month certification period as defined in paragraph (H) of this rule. Assistance groups certified six months or less do not have to submit an interim report; and

(3) Able-bodied adults without dependents with countable earned income subject to the time limit set forth in rule 5101:4-3-20 of the Administrative Code are required to report any changes in work hours that bring an individual below twenty hours per week or eighty hours per month, as defined in rule 5101:4-3-20 of the Administrative Code, within ten days following the end of the month in which the change first occurred.

(C) How are changes reported?

The assistance group may report changes as follows:

(1) By returning a JFS 04196, "Food Assistance Reporting" (rev. 9/2011). The county agency shall pay the postage for return of the form.

(2) In person, electronically or over the telephone. The county agency shall use discretion in determining if further verification is necessary. These changes shall be acted on in the same manner as those reported on a change report form.

(D) When shall the county agency provide a change report form?

A change report form shall be provided to assistance groups at application, recertification, and whenever the assistance group returns a change report form. The county agency can provide the form more often at its option.

(E) How does an assistance group know their reporting requirements?

Assistance groups will be advised of their reporting requirements on the notice of approval and/or notice of change at application, reapplication or any time a change occurs and is reported.

(F) What must an applicant report during the application process?

(1) Once the applicant submits an application, the applicant shall report any changes in the information on the application at the certification interview.

(2) The applicant shall report all changes that occur after the certification interview but before receiving the notice of their eligibility, within ten days of the receipt of the notice.

(G) What are the reporting requirements when the application was taken at the local social security administration?

The county agency shall not impose any additional reporting requirements other than those listed in paragraph (B) of this rule. Assistance groups whose applications were taken by the social security administration are required to report all changes to the county department of job and family services.

(H) What is the interim report and how is it processed?

Assistance groups assigned a twelve or twenty-four month certification period shall be required to complete a JFS 07221 "Cash and Food Assistance Interim Report" (rev. 9/2011) or the client registry information system enhanced (CRIS-E) equivalent. The interim report will provide the county agency with updated information on the assistance group's circumstances.

(1) An interim report will be sent to the assistance group during the fifth or eleventh month of certification, depending on the assistance group's certification period, through CRIS-E.

(2) The assistance group shall return the interim report to the county agency prior to the end of the twenty-first day of the fifth or eleventh month of certification, depending on the length of the certification period.

(3) The county agency shall propose termination of benefits for any assistance group who fails to return a signed interim report by the twenty-first day of the fifth or eleventh month, depending on the assistance group's certification period.

(4) The county agency shall reinstate benefits without a new application for any assistance group whose benefits have been terminated when the county agency receives the interim report within thirty days of the closure date. The county agency shall prorate the assistance group's benefits beginning the day the report was returned.

(I) How does the county agency process changes?

(1) The county agency shall take action within ten days on all reported changes to determine if the change affects the assistance group's ongoing eligibility or allotment. Reported changes include changes reported by the assistance group, changes considered verified upon receipt, and changes known to the county agency. Even if there is no change in the allotment, the county agency shall document the reported change in the case file, provide another change report form to the assistance group, and notify the assistance group of the receipt of the change report. If the reported change affects the assistance group's eligibility or level of benefits the adjustment shall also be reported to the assistance group.

(2) The county agency shall also advise the assistance group of additional verification requirements, if any, and state that failure to provide verification shall result in the reduction or termination of benefits.

(3) The county agency shall document the date a change is reported, which shall be the date the county agency receives a report form or is advised of the change over the telephone, electronically or by a personal visit.

(4) Restoration of lost benefits shall be provided to any assistance group if the county agency fails to take action on a change which increases benefits within the time limits specified in paragraph (K)(3) of this rule.

(J) What are the verification requirements for changes?

(1) Changes reported during the certification period are subject to the verification procedures set forth in rule 5101:4-2-09 of the Administrative Code. The county agency shall verify changes which result in an increase in an assistance group's benefits prior to taking action on these changes.

(2) The assistance group must be allowed ten days to provide any mandatory verification. If the assistance group provides verification within this period, the county agency shall take action on the changes within the time periods described in paragraphs (K)(3)(a) and (K)(3)(b) or paragraph (K)(4) of this rule. The time periods shall begin from the date the change is reported, not from the date of verification.

(3) If the assistance group fails to provide the required verification within ten days after the request date but does provide the verification at a later date, the time periods shall begin from the date verification is provided rather than from the date the change is reported.

(4) In cases where the county agency has determined that an assistance group has refused to cooperate, the county agency shall terminate the assistance group's eligibility after issuing the notice of adverse action as set forth in rule 5101:6-2-04 of the Administrative Code.

(5) During the certification period, the county agency may obtain information about changes in an assistance group's circumstances from which the county agency cannot readily determine the effect of the change on the assistance group's benefit amount. The county agency may receive unclear information from a third party or from the assistance group itself. The county agency shall verify the assistance group circumstances by sending the assistance group a JFS 04219, "Request For Contact" (rev. 4/2010) or its CRIS-E equivalent. The request for contact shall clearly advise the assistance group of the verification it must provide or the actions it must take to clarify its circumstances, notify the assistance group that it has at least ten days to respond and state the consequences if the assistance group fails to respond.

If the assistance group does not respond to the request for contact, does respond but refuses to provide sufficient information to verify its circumstances, or the county agency is unable to obtain the necessary information by contacting the assistance group in the above manner, the county agency shall propose termination of the food assistance benefits and a notice of adverse action shall be issued as described in rule 5101:6-2-04 of the Administrative Code. The county agency shall follow the procedures set forth in rule 5101:4-2-09 of the Administrative Code to verify unclear information received during the certification period. If the assistance group responds to the request for contact and provides sufficient information, the county agency must act on the new circumstances in accordance with paragraph (K) of this rule.

(K) What are the timeframes in which the county agency must act on a change?

(1) Changes in income: If an assistance group reports a change in income, and the new circumstance is expected to continue for at least one month beyond the month in which the change is reported, the county agency shall act on the change in accordance with paragraphs (K)(3) and (K)(4) of this rule.

(2) Changes in medical expenses: During the certification period the county agency shall not act on changes in the medical expenses which it learns of from a source other than the assistance group and which, in order to take action, require the county agency to contact the assistance group for verification. The county agency shall only act on those changes in medical expenses that it learns about from a source other than the assistance group if those changes are verified upon receipt and do not necessitate contact with the assistance group.

(3) Changes that increase benefits:

(a) For changes which result in an increase in benefits, other than changes described in paragraph (K)(3)(b) of this rule, the county agency shall make the change effective no later than the first allotment issued ten days after the date the change was reported to the county agency.

(i) For example, a thirty dollar decrease in income reported on the fifteenth of May would increase the assistance group's June allotment. If the same decrease was reported on May twenty-eighth, and the assistance group's normal issuance cycle was on June first, the assistance group's allotment would have to be increased by July.

(ii) The increase should be included in the assistance group's routine issuance for the first month affected, if possible. If the increase is not included in the routine issuance, a supplement shall be authorized.

(b) For changes which result in an increase in an assistance group's benefits due to the addition of a new assistance group member who is not a member of another certified assistance group, or due to a decrease of fifty dollars or more in the assistance group's gross monthly income, the county agency shall make the change effective no later than the first allotment issued ten days after the date the change was reported. However, in no event shall these changes take effect any later than the month following the month in which the change is reported. Therefore, if the change is reported after the twentieth of a month and it is too late for the county agency to adjust the following month's allotment, the county agency shall authorize supplemental benefits by the tenth calendar day of the following month, or the assistance group's normal issuance cycle in that month, whichever is later.

(i) For example, an assistance group reporting a one hundred dollar decrease in income any time during May would have its June allotment increased. If the assistance group reported the change after the twentieth of May and it was too late for the county agency to adjust the allotment normally authorized on June first, the county agency would authorize a supplementary issuance for the amount of the increase by June tenth.

(ii) Exception: An assistance group reporting the theft of income normally received during the month is not entitled to additional food assistance benefits. It is the responsibility of the provider of the income to make whatever restitution that may be appropriate. The loss is not deducted from income to the assistance group nor is it counted as income when and/or if it is replaced.

(4) Changes that decrease benefits:

If the assistance group's benefit level decreases or the assistance group becomes ineligible as a result of the change, the county agency shall issue a notice of adverse action within ten days of the date of the change unless one of the exceptions to the notice of adverse action in rule 5101:6-2-05 of the Administrative Code applies. When a notice of adverse action is used the decrease in the benefit level shall be made effective with the allotment for the month following the month in which the notice of adverse action period has expired, provided a fair hearing and continuation of benefits have not been requested. When a notice of adverse action is not used due to one of the exceptions of rule 5101:6-2-05 of the Administrative Code, the decrease shall be made effective no later than the month following the change.

(L) When should a county agency reinstate benefits without a new application?

The county agency shall reinstate an assistance group's benefits without a new application if the assistance group returns requested mandatory verifications or takes a required action within thirty days after the food assistance closure date. Benefits shall be prorated from the date the verifications are returned or the required action was taken, following the procedure set forth in rule 5101:4-4-27 of the Administrative Code. However, if the eligibility factor is met or the required action is taken in the last month of the certification period benefits cannot be reinstated. The county agency shall require the assistance group to complete a reapplication.

(M) What happens when a county agency discovers an assistance group failed to report a change?

If the county agency discovers that the assistance group failed to report a required change and, as a result, received benefits to which it was not entitled, the county agency shall file a claim against the assistance group as set forth in rule 5101:4-8-15 of the Administrative Code. If the discovery is made within the certification period, the assistance group is entitled to a notice of adverse action if its benefits are reduced or terminated. An assistance group shall not be held liable for a claim because of a change in assistance group circumstances which it is not required to report.

Effective: 03/01/2012
R.C. 119.032 review dates: 04/01/2015
Promulgated Under: 111.15
Statutory Authority: 5101.54
Rule Amplifies: 329.04 , 329.042 , 5101.54
Prior Effective Dates: 6/2/80, 12/1/80, 4/1/81, 6/18/81, 1/22/82, 9/27/82, 8/16/85 (Emer.), 11/1/85 (Emer.), 1/1/86, 5/1/86 (Emer.), 8/1/86 (Emer.), 10/1/86, 5/1/89 (Emer.), 10/1/89, 10/1/90, 5/1/91 (Emer.) 6/1/91, 12/1/91, 8/1/95, 8/1/95 (Emer.), 10/13/95, 4/1/97 (Emer.), 6/6/97, 8/1/98, 6/1/01 (Emer.), 8/17/01, 3/2/02 (Emer.), 5/13/02, 7/1/02 (Emer.), 8/1/02, 7/10/03, 11/01/03, 12/8/05, 4/1/10