TITLE 8              SOCIAL SERVICES

CHAPTER 102  CASH ASSISTANCE PROGRAMS

PART 120           ELIGIBILITY POLICY - CASE ADMINISTRATION

 

8.102.120.1          ISSUING AGENCY:  New Mexico Health Care Authority.

[8.102.120.1 NMAC - Rp 8.102.120.1 NMAC, 7/1/2024]

 

8.102.120.2          SCOPE:  The rule applies to the general public.

[8.102.120.2 NMAC - Rp 8.102.120.2 NMAC, 7/1/2024]

 

8.102.120.3          STATUTORY AUTHORITY:

               A.           Articles 1 and 2 of Chapter 27, NMSA 1978 authorize the state to administer the aid to families with dependent children (AFDC), general assistance (GA), shelter care supplement, the burial assistance programs and such other public welfare functions as may be assumed by the state.

               B.           Federal legislation contained in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 abolished the AFDC program.  The federal act created the temporary assistance for needy families (TANF) block grant under Title IV of the Social Security Act.  Through the New Mexico Works Act of 1998, the New Mexico works program was created to replace the aid to families with dependent children program.

               C.           Under authority granted to the governor by the federal Social Security Act, the health care authority (HCA) is designated as the state agency responsible for the TANF program in New Mexico.

               D.           Effective April 1, 1998, in accordance with the requirements of the New Mexico Works Act and Title IV-A of the federal Social Security Act, the HCA is creating the New Mexico works program as one of its cash assistance programs.

               E.           In close coordination with the NMW program, the HCA administers the supplemental nutrition assistance program (SNAP) employment and training program (E&T) pursuant to the Food Security Act of 1985 and federal regulations at Title 7, Code of Federal Regulations.

               F.            Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (HCA) as a single, unified department to administer laws and exercise functions relating to health care facility licensure and health care purchasing and regulation.

[8.102.120.3 NMAC - Rp 8.102.120.3 NMAC, 7/1/2024]

 

8.102.120.4          DURATION:  Permanent.

[8.102.120.4 NMAC - Rp 8.102.120.4 NMAC, 7/1/2024]

 

8.102.120.5          EFFECTIVE DATE:  July 1, 2024, unless a later date is cited at the end of a section.

[8.102.120.5 NMAC - Rp 8.102.120.5 NMAC, 7/1/2024]

 

8.102.120.6          OBJECTIVE:

               A.           The purpose of the New Mexico works (NMW) program is to improve the quality of life for parents and children by increasing family income, resources and support.  The further purpose of the program is to increase family income through family employment and child support and by utilizing cash assistance as a support service to enable and assist parents to participate in employment.

               B.           The objective of the education works program (EWP) is to provide cash assistance to a benefit group where at least one individual is enrolled in a post-secondary, graduate or post-graduate institution.  Education and training are essential to long-term career development.  The applicant or recipient benefit group would be otherwise eligible for NMW cash assistance, but chooses to participate in EWP.

[8.102.120.6 NMAC - Rp 8.102.120.6 NMAC, 7/1/2024]

 

8.102.120.7          DEFINITIONS:  [RESERVED]

[8.102.120.7 NMAC - Rp 8.102.120.7 NMAC, 7/1/2024]

 

8.102.120.8          [RESERVED]

 

8.102.120.9          ELIGIBILITY REVIEWS:

               A.           Follow-up reviews:

                              (1)          A follow-up review shall be scheduled during a certification period whenever information becomes known to the county office indicating a possible change in a benefit group's circumstances that may affect eligibility or payment amount.

                              (2)          Review of a specific condition may be made by home visit, office visit, third party contacts or correspondence as needed.

                              (3)          Circumstances which may require follow-up review include, but are not limited to:

                                             (a)          change in NMW participation work requirements;

                                             (b)          school attendance of children age six or older;

               B.           Recertification:

                              (1)          Cash assistance shall be approved for a fixed certification period at the end of which the assistance shall be terminated.

                              (2)          The recertification shall consist of a complete review of all conditions of eligibility; determination of eligibility for an additional period of time and redetermination of the amount of assistance payment.  The recertification requires a redetermination of eligibility on those conditions that are subject to change.  There shall be a prospective determination beginning the month following the month the certification expires.

                              (3)          The caseworker shall ensure that CSSD has been notified of all pertinent information regarding any non-custodial parent who has a child in the benefit group, including but not limited to the current address and work place of the non-custodial parent.

                              (4)          Conditions not subject to change:  Unchanged information shall not be re-verified unless it is incomplete, inaccurate, inconsistent, or outdated.  Outdated is defined as unchanged verification that is more than 60 days old relative to the current month of participation.

                              (5)          Work program:  The caseworker shall give information to the NMW participants about earned income incentives, assistance through the transitional child care program, medicaid transitional benefits, and work program requirements, opportunities and services.  Work program participation shall be reviewed.

                              (6)          Need and payment determination:  The caseworker shall obtain current information about family and benefit group:

                                             (a)          Income:  if the source has changed or the amount has changed by more than $50;                                  (b)          Resources:  if the total of all countable resources for the benefit group exceed the $1500 liquid or $2000 non-liquid resource limit; and

                                             (c)          any other information which has changed or is questionable.

                              (7)          Change reporting:  The caseworker shall review with the client the possible changes in circumstances which must be reported if they occur.

                              (8)          Providing verification:

                                             (a)          If electronic verification is not available, the household has primary responsibility for providing documentary evidence to support statements on the application and to resolve any questionable information.

                                             (b)          ISD shall assist a household in obtaining verification, provided the household is cooperating in the application process.

                                             (c)          A household or their authorized representative may supply documentary evidence in person, by mail, fax, electronic device or through the YES NM web portal.

                                             (d)          A household shall not be required to supply verification in person at the ISD office or to schedule an appointment to provide such verification.

                                             (e)          ISD shall accept any reasonable documentary evidence provided by the household and must be primarily concerned with how adequately the verification proves the statements on the application.

                              (9)          Recertification time standards:

                                             (a)          Timely reapplication:  Applications filed before the 15th day of the expiration month will be considered timely.  A household member or authorized representative that attends an interview and provides all necessary verification by the end of the household's current certification period, will have the opportunity to participate by the household's normal issuance cycle in the month following the end of the current certification period, if all eligibility factors have been met.

                                             (b)          Reapplication after the 15th:  If an application for recertification is submitted after the 15th but before the end of a household's certification period and the household is determined eligible for the first month following the end of the certification period, that month is not considered an initial month and benefits are not prorated.

                                             (c)          Late applications:  An application that is submitted to ISD after the certification period has expired can be accepted within 30 days after the certification period expires or the case has been closed for any reason.  Initial month verification standards will be used for all applications received during this time frame and the benefits for a late recertification will be prorated from the date of approval.

               C.           Certification scheduling:

                              (1)          Each case must have eligibility and payment reviewed at least once during the period specified for that category.  Cash assistance cases, which also receive SNAP, shall be recertified at the same time the SNAP certification is completed.

                              (2)          The certification period shall not exceed the following standards:

                                             (a)          Regular reporting benefit groups:  A benefit group not subject to simplified reporting requirements shall be certified for:

                                                            (i)           five months or less:  education works program;

                                                            (ii)          12 months:  state supplement for SSI recipients in residential care;

                                                            (iii)        eight months from date of arrival: refugee resettlement program.

                                             (b)          Simplified reporting benefit groups:  Certification provisions that apply to a NMW benefit group subject to simplified reporting are set forth at Subsection A of 8.102.120.11 NMAC.

               D.           Interview:

                              (1)          All recertification interviews shall be in person at the local office or, when circumstances warrant, over the phone or at another place reasonably accessible and agreeable to both the recipient/relative or caretaker and the caseworker.  The recipient may bring any individual to the interview.

                              (2)          The interview must be with the recipient, unless the recipient’s physical or mental condition makes the interview impossible or inadvisable.  See 8.100.130 NMAC for instructions on obtaining information.

                              (3)          To help a recipient report changes that may affect the recipient’s eligibility or amount of payment, the caseworker shall make available a change report form upon request, which the client may use to notify the county office of changes in circumstance.

               E.           Scheduling recertification reviews:  The certification period end date shall be scheduled for the appropriate interval indicated in Subsection C of 8.102.120.9 NMAC, starting with the initial month of eligibility, or the month following the month in which previous certification expired.

               F.            Exchange of information with SSA:

                              (1)          If information received during any eligibility review indicates that a participant in NMW or GA may be eligible for supplemental security income (SSI) benefits, (this includes children and adults who appear disabled, and needy adults over 65), the caseworker shall promptly refer the participant to the social security administration district office for application.  An individual found eligible for SSI must participate in that program.

                              (2)          During the review process, ISD will sometimes learn information relevant to the eligibility of a family member who is a SSI recipient.  If there is a clear indication that a SSI recipient's countable income exceeds the maximum allowable under the SSI program, the discrepancy shall be reported to the social security administration (SSA) district office.  SSA shall also be notified when it appears that the resources of an SSI recipient exceed SSI program standards.

[8.102.120.9 NMAC - Rp 8.102.120.9 NMAC, 7/1/2024]

 

8.102.120.10       HANDLING BENEFIT GROUP AND RESIDENCE STATUS CHANGES:

               A.           Change of name or payee:  Whenever there is a change in a participant’s name or the payee for cash assistance, the caseworker shall immediately make the appropriate changes.

                              (1)          New caretaker:

                                             (a)          If a new caretaker assumes responsibility for a dependent child in a case, the case shall be closed and a new application processed.

                                             (b)          If the new caretaker is already payee for other dependent children, the cash assistance case of the children being transferred to the new payee shall be closed, an add-on application shall be processed, and the children added to the existing benefit group.

                              (2)          Payee change after benefits are issued:  The EBT account shall be made accessible to another family member by authorization of a new PIN under the old account.

                              (3)          Changes in name or payee are indicated when:

                                             (a)          a payee legally changes their name and the change has been processed through the social security administration;

                                             (b)          a legal guardian is appointed or dismissed;

                                             (c)          the parent of an incompetent adult client begins to serve as natural guardian; or

                                             (d)          there is a change of payee for an NMW grant.

               B.           Change in benefit group composition:  A request for assistance for a new benefit group member shall be treated as add-on an application.  An add-on application shall be processed using the timeliness and verification standards applicable to regular applications.

               C.           Move to another state:  If a participant advises the county office in advance of the participant’s departure from the state, the participant shall be contacted to determine whether the participant intends to:

                              (1)          be out of the state for a temporary period with a plan to return once the purpose of the visit has been accomplished; or

                              (2)          abandon residence in New Mexico;

                              (3)          the caseworker shall cover the following points:

                                             (a)          whether the client wishes to continue receiving assistance out-of-state during a temporary absence;

                                             (b)          whether the client intends to apply for assistance in another state;

                                             (c)          how long the participant intends to be out-of-state;

                                             (d)          the purpose of the visit;

                                             (e)          whether a place of residence in New Mexico is being maintained in the participant 's absence.

                              (4)          If it appears on the basis of this information that New Mexico residence is being abandoned, assistance shall be terminated.  If absence is temporary, cash assistance shall be continued and the client must keep the HCA informed of the client's address and circumstances.

               D.           Illness:  If a participant who is temporarily visiting outside New Mexico is unable to return to New Mexico because of illness, cash assistance may continue until such time as the participant is able to return.  In this situation, the participant’s inability to return to New Mexico because of illness must be verified by medical report.

               E.           DVR training:  If plans are made in conjunction with DVR for a participant’s participation in a training course in another state, cash assistance may be continued for the duration of the training course for the participant and the participant’s dependents, if they accompany the participant, provided that the benefit group intends to return to New Mexico when training is completed.

[8.102.120.10 NMAC - Rp 8.102.120.10 NMAC, 7/1/2024]

 

8.102.120.11       SIMPLIFIED REPORTING:  Simplified reporting (SR) is a periodic reporting requirement for benefit groups that receive NMW cash assistance.  A benefit group assigned to SR must file an interim report form in the sixth month of a 12-month certification period.

               A.           Certification period:

                              (1)          Initial application:  A benefit group that is applying for both SNAP and NMW, shall be assigned a NMW certification period that ends in the same month as the SNAP certification period with the exception of those SNAP benefit groups assigned to a 24-month certification.

                              (2)          An initial applicant for NMW that is already participating and assigned to simplified reporting in the SNAP program:

                                             (a)          if approved for NMW, shall be assigned a NMW certification period that will end the same month as the SNAP certification period; and

                                             (b)          must file an interim report form in the same month that one is due in the SNAP program;

                                             (c)          if NMW is approved in the same month an interim report form is due in the SNAP program, the requirement in Subparagraph (b), above, is waived for NMW.

                              (3)          A benefit group that is approved for NMW, but does not receive SNAP shall be assigned a twelve-month certification period:

                                             (a)          beginning the first month of eligibility; and

                                             (b)          shall have an interim report form due in the sixth month of the NMW certification period.

                              (4)          A benefit group that is receiving NMW and applies for SNAP shall have NMW eligibility re-determined at the same time that the SNAP eligibility is determined.

                                             (a)          If NMW benefits increase, the increase shall be effective the month following the first month of approval for SNAP and NMW shall be assigned a certification period that ends in the month the simplified reporting SNAP certification ends.

                                             (b)          If approved for SNAP and the NMW benefit decreases, the decrease shall be effective the month following the month the NOAA expires, and the NMW benefit group shall be assigned a certification period that ends in the same month the SNAP certification ends.

                                             (c)          If approved for SNAP and the NMW benefit is terminated, the termination shall be effective the month following the month the NOAA expires, and the SNAP case shall be transitioned to TFS.

                              (5)          Recertification:  A benefit group that is recertifying and is approved and assigned to simplified reporting shall be assigned a certification period that:

                                             (a)          is 12 months long;

                                             (b)          begins the month after the current certification ends; or

                                             (c)          is set to end in the same month as a SNAP case with a common member.

               B.           Excluded from simplified reporting:  The simplified reporting requirement shall be assigned to all NMW benefit groups except programs listed in Paragraph (2) of Subsection C of 8.102.120.9 NMAC.

               C.           Simplified reporting requirements:  A benefit group assigned to simplified reporting shall be required to file an interim report form no later than the tenth day of the sixth month of the 12-month certification period, or in compliance with the SNAP simplified report, whichever is appropriate.  The benefit group must include the following information along with necessary verification, as required at 8.100.130 NMAC:

                              (1)          any change in benefit group composition, whether a member has moved in or out of the home along with the date, the change took place;

                              (2)          a change in the source of income, including starting or stopping a job or changing jobs, if the change in employment is accompanied by a change in income;

                              (3)          changes in either:

                                             (a)          the wage rate or salary or a change in full-time or part-time employment status as defined in Subsection C of 8.102.461.11 NMAC, provided the household is certified for no more than six months;

                                             (b)          a change if earned income of more than one hundred dollars ($100) a month from the amount last used to calculate the household’s allotment, provided the household is certified for no more than six months.

                              (4)          a change of more than $100 in the amount of unearned income;

                              (5)          changes in countable resources if the total of all countable resources for the benefit group exceed the $1,500 liquid or $2,000 non-liquid resource limit;

                              (6)          dependent care expenses;

                              (7)          changes in residence, only if, there has been a change in residence since the last certification;

                              (8)          changes in child support receipt; and

                              (9)          changes in immigration status for a benefit group member.

               D.           Budgeting methodology for simplified reporting at initial application and recertification:

                              (1)          Prospective budgeting shall be used for an applicant benefit group at initial application and at recertification as set forth at 8.102.500.9 NMAC.

                              (2)          At initial application, eligibility and amount of payment for the applicant benefit group shall be determined prospectively for the each of the first six months of the certification.

                              (3)          At recertification, eligibility and amount of payment shall be determined prospectively for six months following last month benefit group's certification period.

               E.           Budgeting methodology for simplified reporting:

                              (1)          At processing the interim report form, eligibility and amount of payment shall be determined prospectively for the six months following the month the interim report form is due.

                              (2)          In determining a benefit group's eligibility and payment amount, the income already received shall be used to prospectively anticipate income the benefit group expects to receive during the certification period according to the following schedule:

                                             (a)          Weekly:  For income received weekly the participant benefit group must submit and ISD shall accept as verification income received from any consecutive past 30-day period that includes 60 days prior to the month the interim report form is due.

                                             (b)          Bi-weekly:  For income received bi-weekly the participant benefit group must submit and ISD shall accept as verification income received from any consecutive past 30-day period that includes 60 days prior to the month the interim report form is due.

                                             (c)          Semi-monthly:  For income received semi-monthly the participant benefit group must submit and ISD shall accept as verification income received from any consecutive past 30-day period that includes 60 days prior to the month the interim report form is due.

                                             (d)          Monthly:  For income received monthly the participant benefit group must submit and ISD shall accept as verification income received from any consecutive past 30-day period that includes 60 days prior to the month the interim report form is due.

                                             (e)          Income received more frequently than weekly:  For benefit groups with income received more frequently than weekly, exact income, rather than averaged and converted income shall be used to determine benefits.  For income received more frequently than weekly the participant benefit group must submit and ISD shall accept as verification income received from any consecutive past 30-day period that includes 60 days prior to the month the interim report form is due.

                                             (f)           If a determination is made that the use of the pay data for the methods described in (a) through (e), above, does not give the most accurate estimate of monthly earnings due to unique circumstances; the caseworker shall use whatever method gives the most accurate estimate of earnings.

                                             (g)          Income received less frequently than monthly:  The amount of monthly gross income that is received less frequently than monthly shall be determined by dividing the total income by the number of months the income is intended to cover.  This includes, but is not limited to, income from sharecropping, farming, and self-employment.   It also includes contract income and income for a tenured teacher who may not have a contract.

                              (3)          Self-employment:

                                             (a)          Requirements for determination of self- employment income are set forth at Subsection E of 8.139.520.10 NMAC, and the verification standards for business and self-employment income are set forth at 8.100.130.25 NMAC.

                                             (b)          A benefit group assigned simplified reporting that has had self-employment income annualized by ISD shall be required to report changes in self-employment income only if the benefit group has filed a tax return subsequent to its last approval or recertification for NMW.

                                             (c)          A benefit group assigned simplified reporting that does not have the self-employment income annualized must report self-employment income on the interim report form.  The income reported on the simplified report form will be calculated in the following manner.

                                                            (i)           If a self-employment enterprise has been in existence for less than one year, the income from self-employment shall be averaged over the period of time the business has been in operation.  The resulting monthly amount shall be projected for the duration of the certification period.

                                                            (ii)          Seasonal income:  Self-employment income that is intended to meet a benefit group’s needs for only part of the year shall be averaged over the time the income is intended to cover.

                                             (d)          A benefit group required to report simplified self-employment income that fails to provide verification of an allowable deduction at the interim or during the month the interim report form is due shall not be allowed the deduction.  ISD shall process the report if all other mandatory verification has been provided.

                              (4)          Use of conversion factors:  Whenever a full month's income is anticipated and is received on a weekly or biweekly basis, the income shall be converted to monthly amount as follows:

                                             (a)          income received on a weekly basis is averaged and multiplied by four;

                                             (b)          income received on a biweekly basis is averaged and multiplied by two;

                                             (c)          averaged income shall be rounded to the nearest whole dollar prior to application of the conversion factor; amounts resulting in $0.50 or more are rounded up; amounts resulting in $0.49 or lower are rounded down.

               F.            Time limits for submission and processing an interim report form:

                              (1)          An interim report form shall be mailed to a benefit group in the month prior to the month the report is due.

                              (2)          A benefit group assigned to simplified reporting shall be required to submit an interim report form by the tenth calendar day of the month the interim report form is due in order to receive uninterrupted benefits.

                              (3)          The interim report form shall be reviewed for completeness within ten days of receipt.

                                             (a)          If the form is complete and all verifications are provided, ISD shall complete the processing of the form within 10 days of receipt.

                                             (b)          If the form is complete and all verifications are provided except for verification of an allowable deduction, the report shall be processed without the deduction.  The household shall be:

                                                            (i)           notified that verification is lacking; and

                                                            (ii)          shall be given 10 days to provide verification of an allowable deduction;

                                                            (iii)        a deduction that is verified within the month the interim report form is due shall be processed as part of the interim report;

                                                            (iv)         a deduction that is verified in the month after the interim report form is due shall be processed as a change reported by the household;

                                                            (v)          a deduction that does not have the required verification shall not be allowed until verification of the expense is provided.

                              (4)          Incomplete interim report form is received:

                                             (a)          An interim report form that is not signed shall be returned to the household for a signature.  The household:

                                                            (i)           shall be notified that the form is incomplete;

                                                            (ii)          what needs to be completed for the interim report form; and

                                                            (iii)        shall be given 10 calendar days to provide the signed interim report form to be reviewed for completeness.

                                             (b)          An interim report form that is incomplete because required verification is not provided shall not be returned to the household.  The household:

                                                            (i)           shall be notified that the form is incomplete;

                                                            (ii)          what information must be provided to complete the interim report form; and

                                                            (iii)        shall be given 10 calendar days to provide the verification to process the interim report form.

                              (5)          The benefit group must return the completed interim report form and all required verification within 10 calendar days to avoid a break in benefits.  A benefit group that fails to submit an interim report form by the end of the month in which it is due, shall be issued a notice of case action.

               G.           Information requirements for the interim report form:

The interim report form shall specify:

                              (1)          the date by which a benefit group must submit the form for uninterrupted benefits;

                              (2)          the consequences of submitting a late or incomplete form;

                              (3)          that verification must be submitted with the interim report form;

                              (4)          where to call for help in completing the form;

                              (5)          the consequences of providing incorrect information; and

                              (6)          notice of rights.

               H.           Requirement to report certain changes between reporting periods:  A benefit group must report changes within 10 days of the date a change becomes known to the benefit group:

                              (1)          a benefit group reports income in excess of eighty-five percent of federal poverty guidelines for size of the benefit group;

                              (2)          a parent must report when a dependent child, age six years or older, drops out of school or has three unexcused absences from school within 14 days of occurrence;

                              (3)          a mandatory adult who is participating in NMW Program has moved in or out of the home;

                              (4)          a mandatory child who has moved in or out of the home;

                              (5)          a household member has passed away;

                              (6)          a mandatory member has moved from New Mexico;

                              (7)          unearned income in excess of the maximum monthly benefit for the size of the benefit group;

                              (8)          changes in countable resources if the total of all countable resources for the benefit group exceed the $1,500 liquid or $2,000 non-liquid resource limit;

                              (9)          in the absence of a written report, a 13-day notice of adverse action is required if the change will result in a reduction or termination of benefits.

               I.            Action on changes reported between reporting periods for benefit groups assigned to simplified reporting:  In addition to changes that must be reported in accordance with Subsection H of 8.102.120.11 NMAC, ISD must act on changes in between interim report forms, if it would increase the household’s benefits.  ISD shall not act on changes that would result in a decrease in the household’s benefits unless:

                              (1)          The household has voluntarily requested that its case be closed;

                              (2)          ISD has information about the household’s circumstances considered verified upon receipt.  Verified upon receipt is defined as:

                                             (a)          information is not questionable; and

                                             (b)          the provider of the information is the primary source of information;

                                             (c)          the trusted data sources must be pulling their own data not from third party information; or

                                             (d)          the recipient’s attestation exactly matches the information received from a third party.

                              (3)          A newborn shall be added to the benefit group effective the month following the month the report is received.

                              (4)          The loss of earned income shall be considered for eligibility in the second month after the loss and ongoing until the next scheduled interim report or end of certification whichever is first, provided that:

                                             (a)          the loss of income was reported to the agency, and verified by the benefit group; and

                                             (b)          the loss of income was not due to voluntary quit.

                              (5)          The loss of unearned income shall be considered for eligibility in the month after the loss and ongoing until the next scheduled interim report or end of certification whichever is first, provided that the loss of income was reported to the agency, and verified by the benefit group.

                              (6)          A household member has been identified as a fleeing felon or probation violator in accordance with 8.102.410.15 NMAC.

               J.            Responsibilities on reported changes outside of the interim report:  When a household reports a change, ISD shall take action to determine the household's eligibility or TANF benefit amount within 10 working days of the date the change is reported.

                              (1)          Decreased or termination of benefits:  For changes that result in a decrease or termination of household benefits, ISD shall act on the change as follows:

                                             (a)          if the household's benefit level decreases or the household becomes ineligible as a result of the change, ISD shall issue a notice of adverse action within 10 calendar days of the date the change was reported unless one of the exemptions to the notice of adverse action in 7 CFR 273.13 (a)(3) or (b) applies.

                                             (b)          when a notice of adverse action is used, the decrease in the benefit level shall be made effective no later than 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.

                                             (c)          when a notice of adverse action is not used due to one of the exemptions in 7 CFR 273.13 (a)(3) or (b), the decrease shall be made effective no later than the month following the change.  Verification which is required by 7 CFR 273.2(f) must be obtained prior to recertification.

                              (2)          Increased benefits:  For changes that result in an increase of household benefits, ISD shall act on the change as follows:

                                             (a)          for changes which result in an increase in a household's benefits, other than changes described in Subparagraph (b) of this section, ISD shall make the change effective no later than the first allotment issued 10 calendar days after the date the change was reported to ISD.

                                             (b)          for changes which result in an increase in a household's benefits due to the addition of a new household member who is not a member of another certified household, or due to a decrease of $50 or more in the household's gross monthly income, ISD shall make the change effective not later than the first allotment issued 10 calendar days after the date the change was reported.

                                                            (i)           in no event shall these changes take effect any later than the month following the month in which the change is reported.

                                                            (ii)          if the change is reported after the last day to make changes and it is too late for ISD to adjust the following month's allotment, ISD shall issue a supplement or otherwise provide an opportunity for the household to obtain the increase in benefits by the 10th calendar day of the following month, or the household's normal issuance cycle in that month, whichever is later.

                              (3)          No change in TANF benefit amount:  When a reported change has no effect on the TANF benefit amount, ISD shall document the change in the case file and notify the household of the receipt of the report.

                              (4)          Providing verification:  The household shall be allowed 10 calendar days from the date a change is reported to provide verification, if necessary.  If verification is provided at the time a change is reported or by the deadline date, the increase in benefits shall be effective in accordance with Subparagraph (a) and (b) of Paragraph (2) above.  If the household fails to provide the verification by the deadline date, but does provide it at a later date, the increase shall be effective in the month following the month the verification is provided.  If the household fails to provide necessary verification, its SNAP benefit amount shall revert to the original benefit amount.

               K.           Resolving unclear information:

                              (1)          During the certification period, ISD may obtain information about changes in a household's circumstances from which ISD cannot readily determine the effect of the change on the household's benefit amount.  The information may be received from a third party or from the household itself.  ISD must pursue clarification and verification of household circumstances using the following procedure if unclear information received outside the periodic report is:

                                             (a)          information fewer than 60 days old relative to the current month of participation; and,

                                             (b)          if accurate, would have been required to be reported under simplified reporting rules, in accordance with 8.102.120.11 NMAC.

                                             (c)          ISD must pursue clarification and verification of household circumstances in accordance with the process outlined in Subsection B of 8.100.130.12 NMAC, for any unclear information that appears to present significantly conflicting information from that used by ISD, at the time of certification.

                              (2)          Unclear information resulting from certain data matches:

                                             (a)          if the HCA receives match information from a trusted data source as described in 7 CFR 272.13 or 7 CFR 272.14, ISD shall send a notice in accordance with Subsection B of 8.100.130.12 NMAC in accordance with 7 CFR 272.13(b)(4) and 7 CFR 272.14 (c)(4).  The notices must clearly explain what information is needed from the household and the consequences of failing to respond to the notice.

                                             (b)          if the household fails to respond to the notice or does respond but refuses to provide sufficient information to clarify its circumstances, ISD shall remove the individual and the individual's income from the household and adjust benefits accordingly.  As appropriate, ISD shall issue a notice of adverse action.

               L.           Failure to report changes:  If ISD discovers that the household failed to report a change as required, ISD shall evaluate the change to determine whether the household received benefits to which it was not entitled or if the household is entitled to an increased benefit amount.

                              (1)          Decreased benefit amount:  After verifying the change, ISD shall initiate a claim against the household for any month in which the household was over issued TANF benefits.  The first month of the over issuance is the month following the month the adverse action notice time limit would have expired had the household timely reported the change.  If the discovery is made within the certification period, the household is entitled to a notice of adverse action if its benefits will be reduced.

                              (2)          Increased benefit amount:  When a household fails to timely report a change which will result in an increased TANF benefit amount, the household is not entitled to a supplement for any month prior to and including the month in which the change was reported.  The household is entitled to an increased benefit amount effective no later than the first benefit amount issued 10 calendar days after the date the change was reported.

               M.          Non-reporting sanctions:  A benefit group assigned to simplified reporting shall be subject to a non-reporting sanction in accordance with regulations at 8.102.620.11 NMAC for failure to provide accurate change information on the interim report form or for failure to report by the tenth calendar day of the month following the month that household income exceeds eighty-five percent of federal poverty guidelines for the size of the benefit group.

[8.102.120.11 NMAC - Rp 8.102.120.11 NMAC, 7/1/2024]

 

History of 8.102.120 NMAC:

Pre-NMAC History:  The material in this part was derived from that previously filed with the State Records Center and Archives:

ISD 272.000, Procedures and Conditions Applicable to Continuing Eligibility for Financial and Medical Assistance, 5/22/80.

ISD FA 520, Eligibility Reviews, 2/11/1988.

ISD FA 510, Monthly Reporting and Changes, 2/10/1988.

ISD FA 510, Changes in Budget Group Circumstances, 4/30/1992.

 

History of Repealed Material:  8 NMAC 3.FAP, Financial Assistance Program - Repealed, 7/1/1997.

8.102.120 NMAC Eligibility Policy - Administration - Repealed, 7/1/2001.

8.102.120 NMAC - Eligibility Policy - Case Administration (filed 6/18/2001) Repealed effective, 7/1/2024.

 

Other:  8.102.120 NMAC - Eligibility Policy - Case Administration (filed 6/18/2001) Replaced by 8.102.120 NMAC - Eligibility Policy - Case Administration effective, 7/1/2024.