Rule-Making Standards and Procedures s17

Title of Proposed Rule: / Aid to the Needy Disabled State Only (AND-SO) Changes to the Supplemental Security Income (SSI) Application Requirement and Working with a County Navigator Pursuant to S.B 14-012
Rule-making#: / 14-8-26-1
Office/Division or Program: Office of Economic Security/ Employment and Benefits Division / Rule Author: Danielle Dunaway / Phone: 303-866-2788
E-Mail:

[postponed]

STATEMENT OF BASIS AND PURPOSE

Summary of the basis and purpose for the rule or rule change. (State what the rule says or does, explain why the rule or rule change is necessary and what the program hopes to accomplish through this rule.)

The purpose of this rule is to implement provisions of Senate Bill 14-012 which states that the State Department may promulgate rules allowing a county to waive the requirement that a person apply for Supplemental Security Income (SSI) benefits prior to receiving Aid to the Needy Disabled State Only (AND-SO) under such conditions and for such period of time as the State Department deems appropriate to ensure that a person has the opportunity to submit a thorough and complete SSI benefits application.

The proposed rules allow for certain exceptions for an AND-SO applicant to delay application for SSI benefits when working with a county approved navigator. These rules are also developed in order to effectively implement the “Federal Supplemental Security Income Application Assistance Pilot Program” identified in SB 14-012. The purpose of the pilot program is to increase the federal income assistance reimbursement rate for Aid to the Needy Disabled and to evaluate best practices for ensuring that accurate and complete applications for SSI and Social Security Disability Insurance (SSDI) benefits are submitted by persons applying for or receiving AND.

One of the primary components of the pilot progam is to ensure assistance is provided to persons applying for or receiving AND-SO in completing applications for SSI and SSDI benefits in a thorough and timely manner. The Senate Bill does not specifically use the term “navigator”; however, the State Department has chosen to utilize this term when identifying the person(s) responsible for assisting AND-SO clients with the SSI application process. While assistance will be provided to some individuals as a part of the pilot program, it is also going to be broadly available throughout the state. This assistance will be accomplished by utilizing navigators chosen by the AND-SO clients if such navigators meet the requirements established in these proposed rules and are approved by the county departments.

An emergency rule-making (which waives the initial Administrative Procedure Act noticing requirements) is necessary:

to comply with state/federal law and/or
to preserve public health, safety and welfare

Explain:

Initial Review / 01/22/2015 / Final Adoption / 02/06/2015
Proposed Effective Date / 04/01/2015 / EMERGENCY Adoption / N/A

DOCUMENT 3

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[Note: “Strikethrough” indicates deletion from existing rules and “all caps” indicates addition of new rules.]

STATEMENT OF BASIS AND PURPOSE (continued)

Authority for Rule:

State Board Authority: 26-1-107, C.R.S. (2014) - State Board to promulgate rules; 26-1-109, C.R.S. (2014) - state department rules to coordinate with federal programs; 26-1-111, C.R.S. (2014) - state department to promulgate rules for public assistance and welfare activities

Program Authority: (give federal and/or state citations and a summary of the language authorizing the rule-making)

Collectively, Sections 26-2-111 and 26-2-119, C.R.S. (2014) create the AND program; 26-2-111, C.R.S. (2014), - eligibility for public assistance, allows waiver of SSI requirement

Yes / X / No
Yes / X / No

Does the rule incorporate material by reference?

Does this rule repeat language found in statute?

If yes, please explain.

The program has sent this proposed rule-making package to which stakeholders?

County Human Services Directors Association; Colorado Commission on Aging; Colorado Legal Services; The Legal Center; Colorado Senior Lobby; Single Entry Point agencies; Community Centered Boards; Economic Security Sub-PAC; Colorado Cross-Disability Coalition; All Families Deserve a Chance (AFDC) Coalition; Colorado Coalition for the Homeless; Colorado Gerontological Society

Attachments:

Regulatory Analysis

Overview of Proposed Rule

Stakeholder Comment Summary

REGULATORY ANALYSIS

(complete each question; answers may take more than the space provided)

1. List of groups impacted by this rule:

Which groups of persons will benefit, bear the burdens or be adversely impacted by this rule?

Individuals working with a county approved navigator will be granted an exception to the requirement for application for SSI benefits be made prior to approval for AND-SO and will be given conditional approval.

2. Describe the qualitative and quantitative impact:

How will this rule-making impact those groups listed above? How many people will be impacted? What are the short-term and long-term consequences of this rule?

Those utilizing navigation services will have the assistance to fully gather all necessary medical documentation to submit complete and thorough applications for SSI benefits. The SSI grant is substantially more than the AND-SO grant. By attaching to SSI sooner, clients will receive greater economic stability than what is provided through the AND-SO program.

Long-term, modifying the rule to allow for flexibility in the SSI application process when working with a county approved navigator will allow for more timely SSI reimbursements to the state. The navigator will be able to assist the client upfront to gather a comprehensive and detailed medical history. When a complete application is submitted to the Social Security Administration, the eligibility process may be expedited for federal SSI benefits.

3. Fiscal Impact:

For each of the categories listed below explain the distribution of dollars; please identify the costs, revenues, matches or any changes in the distribution of funds even if such change has a total zero effect for any entity that falls within the category. If this rule-making requires one of the categories listed below to devote resources without receiving additional funding, please explain why the rule-making is required and what consultation has occurred with those who will need to devote resources.

State Fiscal Impact (Identify all state agencies with a fiscal impact, including any Colorado Benefits Management System (CBMS) change request costs required to implement this rule change)

S.B. 14-012 provides funding for changes to the Colorado Benefits Management System (CBMS) as well as to implement the pilot program.

County Fiscal Impact

None

Federal Fiscal Impact

None

Other Fiscal Impact (such as providers, local governments, etc.)

None

REGULATORY ANALYSIS (continued)

4. Data Description:

List and explain any data, such as studies, federal announcements, or questionnaires, which were relied upon when developing this rule?

None.

5. Alternatives to this Rule-making:

Describe any alternatives that were seriously considered. Are there any less costly or less intrusive ways to accomplish the purpose(s) of this rule? Explain why the program chose this rule-making rather than taking no action or using another alternative.

Taking no action would put CDHS out of compliance with statutory mandate from S.B. 14-012 and the required implementation of the “Federal Supplemental Security Income Application Assistance Pilot Program”.

No other alternatives were explored due to this mandate.

OVERVIEW OF PROPOSED RULE

Compare and/or contrast the content of the current regulation and the proposed change.

Section Numbers / Current Regulation / Proposed Change /

Stakeholder Comment

3.510 / Definitions / New definition of county approved navigator / _X__ / Yes / No
3.520.71, C / Financial eligibility requirement regarding verification of proof of application for SSA benefits prior to approval / Allows for conditional approval if working with a county approved navigator / _X_ / Yes / No
3.542, J / Eligibility determination / Allows for delay in completing the paperwork and appointment process with SSI if working with a county approved navigator / _X_ / Yes / No

STAKEHOLDER COMMENT SUMMARY

DEVELOPMENT

The following individuals and/or entities were included in the development of these proposed rules (such as other Program Areas, Legislative Liaison, and Sub-PAC):

None

THIS RULE-MAKING PACKAGE

The following individuals and/or entities were contacted and informed that this rule-making was proposed for consideration by the State Board of Human Services:

Are other State Agencies (such as Colorado Department of Health Care Policy and Financing) impacted by these rules? If so, have they been contacted and provided input on the proposed rules? Rules were sent to Marivel Guadaramma with the Colorado Department of Health Care Policy and Financing

X / Yes / No

Have these rules been reviewed by the appropriate Sub-PAC Committee?

X / Yes / No

Date presented _ September 4, 2014_. Were there any issues raised? ___ Yes _X_ No

If not, why.

Comments were received from stakeholders on the proposed rules:

X / Yes / No

If “yes” to any of the above questions, summarize and/or attach the feedback received by specifying the section and including the Department/Office/Division response. Provide proof of agreement or ongoing issues with a letter or public testimony by the stakeholder.

A stakeholder group was held November 25, 2014. The request was made to add “in Colorado” at the end of 3.510 definition for County Approved Navigator in A, 1.

STAKEHOLDER COMMENT SUMMARY (continued)

Additional feedback received prior to the stakeholder group is as follows:

● Feedback from Michelle Trujillo, Mesa County Division Director:

1) For the definition: Is the county required to verify that the person meets the requirements or is declaration sufficient?

Response: Verification of the Navigator’s credentials is not required unless questionable; however, the county department may request verification at any time.

2) Is the conditional approval two months from date of interview or date of application or date of approval?

Response: Conditional approval would be two months from the date of the county department’s eligibility interview.

● Feedback from Julie Reskin, Colorado Cross Disability Coalition:

Thanks for sending the rule. I have a couple questions: Before I start I want to disclose that the Colorado Cross-Disability Coalition does help people with applications on rare occasions. We do not have resources to do this and our knowledge of the need for this service is why we helped start Colorado Disability Benefits Supports (DBS). Not all of our advocates are SOAR trained. While we do not do SSI applications as a rule, there may be cases we do want to do an application for someone. We have done application assistance over the years and do know what it takes. We are not interested in applying for any program to do this on a large scale through S.B. 12 and this is not and never has been our primary business. The people that do this work are our volunteers. S0--here are the questions followed by a couple recommendations.

1) What are similar credentials for the advocate? Is this meant to include organizations like CCDC that do this on occasion but are not part of the SOAR process or the other organizations that serve populations other than homeless that do application assistance? SOAR is specifically targeted to homeless individuals but the process can work for others. If this is not the case is it meant for something else?

Response: The “Similar Credentials” section will be changed to allow for individuals who have demonstrated experience and success in assisting with the SSI application process.

2) What instruction will be given to counties about disallowing someone from being a qualified application assistant? Will there be appeal rights?

Response: The rule provides pretty specific guidance on how to evaluate the navigator. There are no appeal rights. Rules will be modified to reflect due process if there is a dispute. The disqualified navigator can request a formal review through the Employment and Benefits Division.

STAKEHOLDER COMMENT SUMMARY (continued)

3) Will clients or agencies that help people need to be credentialed or qualified by someone before trying to help a client and using this provision?

Response: This will be based on declaration unless questionable or unless required by the county department.

● And the following requests:

1) If an agency is deemed acceptable by one county to provide assistance then other counties should presume that this agency is capable and should not deny AND based on lack of SSI application. If a county wants to say that the individual or agency is not appropriate they should have to prove specific wrongdoing. In other words, the agencies and individuals who help people apply for SSI and AND should not have to prove their worthiness to numerous counties. That becomes very burdensome especially for statewide organizations. There needs to be some process to get credentialed.

Response: The current process would be to provide SOAR credentialing to whichever counties you are with.

2) If someone has an advocate that is helping them and the county decides the advocate is not qualified or otherwise excludes that advocate, then the county should take some responsibility to help the client get another advocate or the county should help themselves. The client should not be penalized because the county and the advocacy agency have some problem. If the advocate is excluded by SSA, it would be nice if the county helped but I do not know that it is fair to require it.