1213 Responsibilities of the Agency

1213 Responsibilities of the Agency

Upon request, the agency must explain the rights and responsibilities of clients and the following requirements placed on the agency.

1213.1 Periodic Reviews

The agency is required to make periodic reviews of eligibility if the application is approved. The agency shall notify the client of the expiration of the review period and shall send the client a renewal form prior to the last month of the review period.

1213.2 Fraud

The agency is required to investigate and refer for legal action any alleged fraud related to the receipt of assistance.

1213.3 Responsibility to Accept an Identifiable Application

The agency shall accept an application containing a legible name and address (unless homeless) and which has been signed. Refer to 1410.

1213.4 Responsibility to Review Recipients Timely

The agency has the responsibility to process all subsequent applications timely so there will be no break in the benefits the client is eligible to receive.

1213.5 Responsibility to Establish Claims of Overstated Eligibility

The agency is responsible for establishing claims for overstated eligibility (either fraud, client, or agency error).

1213.6 Responsibility to Restore Lost Benefits

The agency shall restore benefits to the client if benefits were wrongfully denied, delayed, or terminated.

1213.7 Responsibility for Giving Notice of Action

The agency is responsible for giving adequate and/or timely notice of action when appropriate.

1213.8

Reserved

1213.9

Reserved

1213.10 Case File Documentation

The agency has the responsibility to insure that case file documentation supports the decision to provide, deny or change eligibility, benefits, or services.

1213.11 Cost-Effective Service Provision

Services shall be provided in the most cost-effective manner in order to provide the client with the appropriate services within the resources allowed.