DHS 251.05DHS 251.05 Procedures for eligibility determination. A relief agency shall do all of the following related to determining eligibility for relief: DHS 251.05(1)(1) Establish written criteria for determining dependency, and review these written criteria at least annually for appropriateness. DHS 251.05(2)(2) Define and report to the department procedures for verification of eligibility. These shall be sufficient to substantiate the fundamental information upon which a determination of eligibility is based. DHS 251.05(3)(3) Establish written standards to be used to determine the type and amount of relief to be furnished. DHS 251.05(4)(4) Develop written policies defining the amounts of income, assets and income and asset disregards allowed for use in determining eligibility. A relief agency, in determining eligibility, shall disregard the following resources: DHS 251.05(4)(c)(c) Any other resources prohibited by law from being considered. DHS 251.05(5)(5) Comply with the requirements of s. 49.015, Stats., in determining an applicant’s eligibility for relief. DHS 251.05 HistoryHistory: Register, May, 1996, No. 485, eff. 6-1-96. DHS 251.06DHS 251.06 Standards for waiver of certain eligibility requirements. DHS 251.06(1)(1) A relief agency may waive the eligibility requirement under s. 49.015 (2) or (2m), Stats., in accordance with relief agency rules, as follows: DHS 251.06(1)(a)(a) Waiver of the prohibition against receiving AFDC or SSI may be granted in cases of unusual misfortune or hardship as determined by the relief agency director. DHS 251.06(1)(b)(b) Waiver of the medical assistance divestment barrier to eligibility may be granted only if all attempts at recovery of the divested property have been made and no other resources or assistance is available to the person and unusual misfortune or hardship exists. DHS 251.06(2)(2) A relief agency shall report all waivers to the department in the manner prescribed by the department. The department may deny reimbursement to the county for relief provided as a result of a waiver that the department determines is inappropriate. DHS 251.06 HistoryHistory: Register, May, 1996, No. 485, eff. 6-1-96. DHS 251.07DHS 251.07 Procedures for permitting appeal of eligibility determinations. DHS 251.07(1)(1) Notice. If a relief agency denies an application for relief, or discontinues, suspends or reduces the relief benefit, the relief agency shall provide adequate written notice to the recipient. The notice shall contain all of the following: DHS 251.07(1)(c)(c) A statement that the action may be appealed to the relief agency and providing a reasonable period of time for the individual to appeal and a place for an appeal to be filed. DHS 251.07(2)(2) Fair hearing. If the relief agency denies, terminates, suspends or reduces a relief benefit, the relief agency shall permit and enable an applicant or recipient to request a fair hearing. A fair hearing shall do all of the following: DHS 251.07(2)(a)(a) Permit the applicant or recipient or his or her representative, at a reasonable time before the hearing, to examine records to be used at the hearing. DHS 251.07(2)(b)(b) Permit the applicant or recipient to present his or her case personally or with the aid of others, including an attorney. DHS 251.07(2)(c)(c) Permit the applicant or recipient or representative to establish facts and circumstances pertinent to his or her case. DHS 251.07(2)(d)(d) Provide an impartial decisionmaker who is familiar with the relief program who may not communicate outside the hearing with either party. DHS 251.07(2)(e)(e) If determined necessary by the impartial decisionmaker, permit the applicant or recipient or his or her representative to subpoena witnesses or compel the attendance of a witness or the production of evidence. A subpoena issued by an attorney shall be in substantially the same form as provided in s. 805.07, Stats. DHS 251.07(2)(f)(f) Provide for procedures that permit the applicant or recipient or representative to question or refute any testimony or evidence, including permission to confront and cross-examine adverse witnesses. DHS 251.07(2)(g)(g) Provide, if desired by either party, for the party to make a record of the hearing by means of an electronic device, either sound or video or both, through the services of a court reporter or other means acceptable to both parties. DHS 251.07(2)(h)(h) Provide for procedures that permit the relief agency or the applicant or recipient to limit the hearing to the written reason for the hearing, the facts in the case and the requested remedy sought. DHS 251.07(3)(3) Decision. The relief agency shall issue its decision in writing in a timely manner. The hearing decision shall: DHS 251.07(3)(a)(a) Be based exclusively upon evidence presented at the hearing and the written policies in effect on the date of the action being appealed. DHS 251.07(3)(b)(b) Inform the applicant or recipient of the evidence and policies relied upon in reaching the decision and whatever rights to review are available and the time limits for the review. DHS 251.07(3)(c)(c) Inform the applicant or recipient of any remedy provided. The remedy may be the one sought by the individual requesting the hearing or a more appropriate remedy as determined by the impartial decisionmaker. DHS 251.07 HistoryHistory: Register, May, 1996, No. 485, eff. 6-1-96.
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Department of Health Services (DHS)
Chs. DHS 250- ; Economic Support
administrativecode/DHS 251.07(2)(h)
administrativecode/DHS 251.07(2)(h)
section
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