DAR File No. 32388

Human Services, Recovery Services

R527-39

Applicant/Recipient Cooperation

NOTICE OF PROPOSED RULE

DAR File No.: 32388
Filed: 02/19/2009, 10:42
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this amendment to add a purpose and authority section and renumber the following sections.

Summary of the rule or change:

Section R527-39-1 was changed to Authority and Purpose. The former "Definitions" section was divided into two sections: "Definitions" and "Cooperation Requirements" to more accurately reflect the content. All sections were renumbered due to these changes.

State statutory or constitutional authorization for this rule:

Sections 62A-1-111, 62A-11-104, 62A-11-107, 62A-11-307.2, 63G-4-203, and 63G-4-302

Anticipated cost or savings to:

the state budget:

The proposed changes to the rule are only to add the authority and purpose of the rule and do not affect the current procedures. There is no anticipated change in cost or savings due to this amendment.

local governments:

Administrative rules of the Office of Recovery Services/Child Support Services (ORS/CSS) do not affect or apply to local government; therefore, there are no anticipated costs or savings for any local government due to this amendment.

small businesses and persons other than businesses:

Because the proposed amendment does not affect the current procedures, there will be no financial impact for small businesses.

Compliance costs for affected persons:

Because the proposed amendment does not affect the current procedures, there will be no financial impact for affected persons.

Comments by the department head on the fiscal impact the rule may have on businesses:

Passage of this proposed amended rule will have no fiscal impact on local business. Lisa Michelle Church, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Human Services
Recovery Services
515 E 100 S
SALT LAKE CITY UT 84102-4211

Direct questions regarding this rule to:

LeAnn Wilber at the above address, by phone at 801-536-8950, by FAX at 801-536-8833, or by Internet E-mail at lwilber@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

07/06/2009

This rule may become effective on:

07/13/2009

Authorized by:

Mark Brasher, Director

R527. Human Services, Recovery Services.

R527-39. Applicant/Recipient Cooperation.

R527-39-1. Authority and Purpose.

1. The Department of Human Services is authorized to create rules necessary for the provision of social services by Section 62A-1-111 and 62A-11-107.

2. The purpose of this rule is to define the terminology related to client cooperation as required for eligibility for IV-A or Medicaid assistance, to identify the cooperation requirements, and to describe the review process available to a client if the client disagrees with the office's assessment that the client is or is not cooperating as required.

 

R527-39-2. Definitions.

1. IV-A recipient means any individual who has been determined eligible for financial assistance under title IV-A of the Social Security Act.

2. Non-IV-A Medicaid recipient means any individual who has been determined eligible for or is receiving Medicaid under title XIX of the Social Security Act but has not been determined eligible for, or is not receiving, financial assistance under title IV-A of the Social Security Act.

3. IV-A agency means the State agency that has the responsibility for administration of, or supervising the administration of, the State plan under title IV-A of the Social Security Act.

4. Medicaid agency means the State agency that has the responsibility for administration of, or supervising the administration of, the State plan under title XIX of the Social Security Act.

 

R527-39-3. Cooperation Requirements.

[5.]1. An applicant/recipient of IV-A or Non-IV-A Medicaid services, with some Medicaid program exceptions, must cooperate with the Office of Recovery Services/Child Support Services (ORS/CSS) in:

a. identifying and locating the parent of a child for whom aid is claimed;

b. establishing the paternity of a child born out of wedlock for whom aid is claimed;

c. establishing an order for child support;

d. obtaining support payments for the recipient and for a child for whom aid is claimed unless a Good Cause determination has been made by the IV-A or Medicaid agency, or the Non-IV-A Medicaid applicant/recipient has declined child support services;

e. obtaining any other payments or property due the recipient or the child; and

f. obtaining and enforcing the provisions of an order for medical support.

[6.]2. The applicant/recipient must cooperate with ORS/CSS with specific actions that are necessary for the achievement of the objectives listed above, as follows:

a. appearing at the ORS/CSS office to provide verbal or written information, or documentary evidence, known to, possessed by, or reasonably obtainable by the recipient;

b. participating at judicial or other hearings or proceedings;

c. providing information;

d. turning over to ORS/CSS any support payments received from the obligor after the Assignment of Collection of Support Payments has been made.

e. complying with a judicial or administrative order for genetic testing.

 

R527-39-[2]4. Request for Review.

1. When ORS/CSS notifies a IV-A or Non-IV-A Medicaid applicant/recipient that she/he is not cooperating in a case, the applicant/recipient may contest the determination by requesting that ORS/CSS conduct an office administrative review. Such a review shall not be subject to the provisions of the Utah Administrative Procedures Act (UAPA), or be considered an adjudicative proceeding under Section 63G-4-203 and Rule R527-200. The applicant/recipient may choose instead to request an adjudicative proceeding under UAPA, or petition the district court to review the noncooperation determination and issue a judicial order based on its findings. If an administrative review is requested, the senior agent designated to conduct the review shall examine the case record, talk to the agent assigned to the case, consult with the team manager, and consider any new information the applicant/recipient provides to determine whether she/he has or has not met the cooperation requirements listed in Section 62A-11-307.2 or is not able to meet the requirements and is cooperating in good faith.

2. If a IV-A or Non-IV-A Medicaid applicant/recipient disagrees with the results of an administrative review conducted by an ORS/CSS senior agent, she/he may request that an ORS/CSS Presiding Officer conduct an adjudicative proceeding, or the applicant/recipient may petition the district court to review the initial noncooperation determination and the results of the administrative review, and issue a judicial order based on its findings.

3. If a IV-A or Non-IV-A Medicaid applicant/recipient disagrees with the Decision and Order issued by an ORS/CSS Presiding Officer after the close of an adjudicative proceeding, she/he may request reconsideration within 20 days after the date the Decision and Order is issued as provided in Sections 63G-4-302 and R527-200-14, or petition the district court to review the Decision and Order and issue a judicial order based on its findings.

 

KEY: child support

Date of Enactment or Last Substantive Amendment: [April 21, 2003]2009

Notice of Continuation: January 10, 2008

Authorizing, and Implemented or Interpreted Law: 62A-1-111; 62A-11-104[(11)]; 62A-11-107; 62A-11-307.2; 63G-4-203; 63G-4-302