Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 8238 (December 30, 2023).

55 Pa. Code § 201.4. Procedures.

§ 201.4. Procedures.

 Eligibility verification. Eligibility verification will be as follows:

   (1)  Initial contacts. Requirements concerning initial contacts are as follows:

     (i)   If the client is unable to obtain the necessary evidence to verify eligibility, the CAO will obtain it from public records, collateral sources and the like. When the collateral contact requires the written consent of the client for release of the desired information, a copy of the authorization to release information form will be used. The authorization to release information form may be used to obtain information from more than one collateral source as required to establish eligibility for assistance and to verify information any time after initial eligibility is established. The written consent of the client, secured on an authorization to release information form, shall be effective to empower any third party to release information requested by the CAO. However, banks and employers are required by section 487 of the Public Welfare Code to provide certain information without client consent upon the request of the CAO.

     (ii)   The authorization to release information form will only be used in those specific instances when the client is unable to provide the evidence to establish eligibility. The client must consent to the disclosure of information as a condition of eligibility.

     (iii)   In certain situations, it may be impossible to secure valid substantiation beyond the statement of the applicant on certain eligibility factors. The worker will then make a reasonable decision based on the worker’s judgment of the available evidence, that is, the credibility of the person, and the validity of other supporting or conflicting evidence. Initial authorization of assistance will not be delayed more than 15-calendar days from the date of receipt of the application for purposes of verification of eligibility, if the applicant has cooperated in the verification attempt.

     (iv)   When the evidence a client supplies is inadequate, or is incomplete, inconsistent, or indeterminate in view of other evidence, the worker will inform the client that additional evidence will be required. Together, the worker and client will determine acceptable sources for further evidence. If the evidence provided by the client is still unacceptable, the worker will consult a collateral source of information using a copy of the authorization to release information form when required.

   (2)  Collateral contacts. Use of collateral contacts will be as follows:

     (i)   Public records, that is, courthouse records, vital statistics, motor vehicle registration and the like and employers and banks for certain information specified in section 487 of the Public Welfare Code may be consulted without requesting or receiving the consent of the client.

     (ii)   To consult other sources of information, the agency will need the blanket consent of the client (a copy of the authorization to release information form when the collateral contact requires it), whether with social agencies, doctors, hospitals and similar resources, or with relatives or other individuals. It shall be a condition of eligibility for assistance that an applicant or recipient sign an authorization to release information form consenting to the disclosure of information about the age, residence, citizenship, employment, applications for employment, income and resources of the applicant or recipient which is in the possession of third parties as follows:

       (A)   The following persons shall sign an authorization to release information form at the times specified:

         (I)   The applicant, regardless of age, at the application interview.

         (II)   An individual applied for who is 18 years of age or older and an emancipated minor 17 years of age or younger, at the application interview or within 30-calendar days of the authorization date.

         (III)   The person, regardless of age, who is the payment name, during the reapplication interview.

         (IV)   A recipient who is 18 years of age or older and an emancipated minor 17 years of age or younger, during the reapplication interview or within 15-working days of the interview date.

         (V)   A mandatory budget group member added to an existing budget who is 18 years of age or older and an emancipated minor 17 years of age or younger, within 15-working days of the authorization date.

       (B)   The information obtained shall be used only in the administration of the PA Program, in accordance with §  105.1(c)(1) (relating to policy).

       (C)   The person who is the payment name shall sign a form within 15-working days of a payment name change or a name change or after an intercounty transfer is completed.

       (D)   The form, when signed, becomes a permanent part of the case record, until replaced by a more recently signed form.

     (iii)   Except in cases of suspected fraud, the CAO shall attempt to notify the applicant or recipient prior to contacting a third party for information about that applicant or recipient.

Authority

   The provisions of this §  201.4 issued under sections 201(2) and 403(b) of the Public Welfare Code (62 P. S. § §  201(2) and 403(b)).

Source

   The provisions of this §  201.4 amended through April 8, 1983, effective April 9, 1983, 13 Pa.B. 1259; amended October 4, 1991, effective October 5, 1991, apply retroactively to November 1, 1991, 21 Pa.B. 4643. Immediately preceding text appears at serial pages (128239) to (128242).

Notes of Decisions

   When it is impossible to secure valid substantiation of an eligibility criterion beyond the client’s statement, the worker must make a reasonable decision based on the credibility of the client and the validity of other supporting or conflicting evidence. Fisher v. Department of Public Welfare, 475 A.2d 873, 877 (1984); reversed 501 A.2d 617 (Pa. 1985).

   Where claimant was unable to obtain documentation substantiating his entire work history, but testified to sufficient employment to meet the 48 month requirement of 62 P. S. §  432(3)(i)(H), the Hearing Officer could not deny ‘‘chronically needy’’ status without considering, and making a factual determination with regard to the claimant’s credibility as required by subsection (a)(1)(iii). Chatham v. Department of Public Welfare, 494 A.2d 18, 22 (Pa. Cmwlth. 1985).

Cross References

   This section cited in 55 Pa. Code §  125.1 (relating to policy); 55 Pa. Code §  133.23 (relating to requirements); and 55 Pa. Code §  167.43 (relating to requirements); and 55 Pa. Code §  299.36 (relating to eligibility requirements for SSP-only).



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