In early sumer of 1990, Me. Bernadette Quevedo-Mendoza informedBetty Strecker, of the department's Medical Sètvices Division, ofthe existence of a copy of North Dak.ota's 1972 Medicaid State.c ~ :_, ¡~-';'Plan. Ms. Quevedo":Mendoza indicated that this copy exi~t~d_in 'ii'.~:;- '~'file in the HCFA Regional Office. Ms. Strecker. was $'PlJ~~~a,t._..:. .:surprised at this information, havinq0previously;rècêlved':setjêral~requests from HCFA Regional officials for a copy of this' docu-ment. She asked Me. Quevedo-Mendoza that North Dak.qta;dlP~ßur::nished with a copy. During a December 1990 Vis;it+t.~.N~'t,th""DW.kò~a" 1',,..'-'.,.'by Mr. Dave Selleck and Mr. Mark Gilbert, a copy of-that documentwas provided to Ms. Strecker. Since that time, I have had anopportunity to review the document provided to Ms. Streaker. ".Also, on January 24, 1991, I telephonically discussed'~he docu~ment and its origination with Qoth Ms. Qu~vedo-~endoz~'.~fld Mr.Selleck. . . .. ,

- ----""NORTH DAKOTA DEPARTMENT OF HUMAN SERVICES

ST A TE CAPITOL - JUDICIAL WING

600 E BOULEVARD AVENUE

BISMARCK, NORTH DAKOTA 56505-050

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January 28, 1991Georg. A, Sinner. Governor.1M A Graham. Execulive Direclor

Mr. Gary WilksAssociate Regional AdministratorDivision of Medicaid, HCFAFederal Bldg., Room 11851961 Stout StreetDenver, CO 80294

RE: 1972 North Dakota State PlanDear Mr. wilks:

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Initially, I must observe that it. is a.pparent that~ the materiá;iia , _;, ' .: ,.tfurnished do not include all of the North ,Dakt)ta"state plan '..;',. ,,":' 1" .è:riapprayect and in ,~ffect on Januaryl l l~72. Tne depärtrrënt ,'¡ ¡J . ':.;;. ,

:'.req~r.Ai. any page of sta~e plan m..tet:+~l.. wbich ~nol'Udes,.~.~.tamd ',~' -boiKdhdl,c:ating t,e su:mi.ttal nuitand ~ffeeti.ve.,.datei 'an~an .. ""I

. indta1L;-?n.''ft th'es:~it.tlll n~.:r~ñiph"ol?soi~\:èd.th~ J?'à9.e anæ:~,"j~: -,' _an.i.n~i.Cati..Qn of the-,'date it was, ()bsoleted~;tQ be a part o£..ae:'- . ""C Ö .....statepla."'ln effêl:t. on -d~m';ary l~f/ 1~7í f ~_if :~he. effectivé t;lát\7 ' r"'f," ..1and the obsoleted date are i.nci~siv,s of Janua.ryl, 1972".:.r.MY. ',' .' x'docwnent whicn doeS not inolude that in'fQrÌatlori oantitJ:iâ,i,'.. "\,reasonably regarded #8 a portion o~ the' statê' plan '1n e££èct ~d.. ... à

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Mr. Gary \.¡ilksJanuary 28, 1991Page 2

approved on January 1, 1972. The bulk of the materials furnishedby Mr. Selleck and Mr. Gilbert do not include any indication thatthey are a part of any state plan, let alone the plan in èffecton January 1, 1972.

When I discussed the content of the materials with Ms. Quevedo-Mendoza on January 24, she indicated that the materials were in afile with a label which indicated the contents to be 1972 stateplan and policies. That file label is consistent with thematerials furnished. Me. Quevedo-Mendoza also advised me thatthat file had been secured from the Social Security Administra-tion, by A. W. Schnellbacher, during the course of an admin-istrative review which Mr. Schnellbacher conducted several yearsago.

This letter is written so that your staff may avoid reliance uponthe materials in that file as constituting North Dakota's 1972state plan. It is also written so that a copy of this letter maybe inserted in the file and thus inform any person who reviewsthe file or who may, in the future , receive a copy of the file,that it cannot be relied upon as constituting North Dakota's 1972state plan.

Finally, I wish to call your attention to some pages which aremissing from the materials furnished by Mr. Selleck and Mr.Gilbert. Those materials, which are not a part of the stateplan, included several policy manual chapters. Pages weremissing from three of the policy manual chapters. ~he missingpages are Social Work Chapter 314, pp. 23 and 24; Social WorkManual Chapter 319, p. 20; and Social Work. Manual Chapter 361,pp. 15 and 16. Please review the file, determine if thosemissing pages are present in that file, and, if they are present,send copies to my attention. ' .If you have any questions about this correspondence, please calL.

2? ?1¿~~Blaine L; Nordwall ...Assistant Attorney General

law /cc: VBetty Strecker

19'72 STATE PLAN

RECE I VED FROM

REGIONAL OFFICE

DECEMBER 1990

, .i-~

D-2100,D- 2.2.00,

0-4000,D-4200,D-4700,D-4800,

0-5100,D-S200,

D..5300,D-5400,

0-5500,0-5600,0-5700,

D-6100,D-6200,D-6300,

0-6400,D-6500,

-D-66oo,D-6700,D-6800,

....

TABLE OF CONTENTS

I. State Or~anizat1on (0-2000)

Single State AgencyState-wide Operation

II. Application. Determination of Elbibilitv,and Furnishing Assistance (D-3000)

III. Coverage and Conditions ofEli~ibility (D-4000)

GeneralFinancial EligibilityBlindnessPer:nent and Toi:~l Disability

iv. Medical Assistan~e (D-5000)

Amount, Duration, and Scop~ of AssistanceAssistance to Aged Individuals in Institutions

for Mental DiseasesPayment for Medical and Remedial C~re and ServicesLimitation on Charges to Recipients and Paymnt ofTitle XVIII Deductibles

Use of Insurance and Fiscal Agent ContractAssistance to Residents Out of the StateLiens and Recovries

v. Administration (D-6000)

Methods of AdinistrationSocial Services.Relationship With Helth and Vocational

aehabl~~tation Aa.~c1esStandard~Settin Authority for 1ntitutioD8'ait Heari,iSafegurdùÎ InformtionReports and Maintenace of Reco~d.Fraud

VI. Personnel Administration' CD7000)

1)7100, Personnel Adinbtration on a Merit kaiaD-7200, Staffing for Adinistration of Kedic~i

Aa.istance Program

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1V-41V-6

1V-81V-8IV" 9

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IV-9

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V-lV-2V-2V-3V-4.V-4

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D.7300~ Staffing for Administration of Assistance for AgedIndividuals in Institutions for Mental Diseasei VI-2

D-7500) Staff Development VI" 2

D-8100)Do. 8300)D..8400)

VII. Fiscal Administration (D-8000) VII-l.

State Financial ParticipationFiscal Policies and AccountabilityCost Allocation

VII" i

VII.. 1VlI..l

VIII. Related Responsibi1itie~ (0-9000) viii..iD-9300. Nondiscrimination in Federally Assisted Programs

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VIII.. 1

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-1-1

Title XIX - Medical Assistance Pro~rarns

State Plan for Medical Assistance

State of North Dakota'

As a condition to the receipt of Federal funds under title xix of theSocial Security Act, the Public Welfare Board of North Dakota submitsherewith the State plan for medical assistance, effective January 1,1966, and hereby agrees to administer the medical assistance programin accordance with the provisions of this State pl~n, title XIX of theSocial Security Act, and the policies and interpretations as containedin Handbook Supplement D - Medical Assistance Programs, and in relatedregulations and policies.

The Public Welfare Board of North Dakota certifies as follows:

I. State Or~anization (D-2000)

A. SinRlé State ARenCy (0-2100)

1. The Public Welfare Board is the single State agency withauthority to supervise the administration of the plan.

2. Attached, and made a part hereof, is a certification of theAttorney General of the ,State of North Dakota identifyingthe Public Welfare Board as the single State agency andciting the legal authority under which such agency super-vises the administration of the State plan on a State-widebasis, inclUding the authority to make rules and regulationsgoverning t~e administration of the plan by such agency, orrules and regulations that are binding on the political sub-divisions, if the plan is administered by them.

B. State-wide Operation (Ð-2200)

1. The State plan will be in operation, through a system oflocal offices on a State-wide basis, in accordance withequitable stanards for assistance and administration thatare mandatory throughout the State.

2. The State plan will be administered by the political sub-divisions of the State and will be mandato~ on such poli-tical subdivisions.

,3. The Public Welfare Board, hereinafter referred to as the

State agency, will assure that the plan 1s cantinuously inoperation in all local offices or local agencies through

a. Methods for info~ing staff of State policies, standards,procedures, and instructions; and

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b. Regular planned examination and evaluation of operationsin local offices by regularly assigned State staff, includ-ing regular visits by such staff; and through reports,controls or other necessary m~thod8.

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n-iII. Application, D~termination of Eligibility,

. and Furnishini.Assistance (D-3000),

1. All individuals wishing to make application for medical assistanceunder the plan shall have an opportunity to do so, without delay.

2. A decision will be made promptly on applications, within 30 day.,except in unusual situations.

3. Individuals found eligible for medical assistance will qualify forassistance, beginning at least with the date of application, a8foiiow~: Seven days prior to the date of application.

4. Standards and methods for determination of eligibility will beconsistent with the objectives of the program, will respect therights of individuals under the United States Constitution, theSocial Security Act, Title VI of the Civil'Riehts Act of 1964,and all other relevant provisions of Federal and State laws, andwill not result in practices that violate the individual's privacyor personal dignity or harass him or violate his constitutionalrights.

s. The policies and procedures of the State agency will assure thateligibility for medical assistance will be determined in a mannerconsistent with s~plicity of, administration and the best interestGof the recipients.

6. The medical care and services included in the plan will.' be furnishedpromptly to eligible individuals without any delay attributable tothe agency's admin1strativeprocesses t which will be strpl. and inthe best interests of the recipient.

7. Where ,an individual has been determined to be eligible, eligibilitywill be reconsidered or redetermned: (a) when required on thebasis of informtion the agency had obtained previously aboutanticipated, changes in the individual's situation; (b) promptly,within 30 days, after a report is obtained whieh indicates thatchanges in the individual' 8 circumstances may a,ffect the amt ofassistance to which he is entitled or may make htm ineligible; and

(c) periodieallYt no 1e88 often than every 12 months.

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III. Covera~e and Conditions ofEli~ibility (0-4000)

"

A. General (0..4000)

1. Medical assistance will ,be available to the fOllowing individ--l.als as "categorically needyll, with medical care and servicesavailable in the same amount, duration, and, scope for;

a. All individuals receiving aid or assistance under the State'sapproved plans under titles I. iV, X, and xiv (or iv andXVI) .

b. All residents of the State who. would be eligible for aidor assistance under one of the other State plans exceptfor the durational residence requirements for the particu-lar program.

c. All, persQns who would be eligible for aid ar assistanceunder one of the other State plans except fo.r any-,othereligibility condition or other requirement in such planthat is specifically prohibited in a prqeraw for medicalassistance under title xix.

d~ The spouse of (person essential to) the individual receivingaid or assistance under the State's appraved plan for TitleXVI, who is living with the individual and whose needs aretaken into. accaunt in determining, the amount of assistancefurnished to such individual under the State i s approved planunder Title XVI and who is considered under the State's TitleXVI plan to be essential to the. well-being of the individual. 1/

'.

2. The following are other groups of individuals, based on reason-able classifications that will be included in the program. Eachaf the fallowing groups include the categorically needy andmedica lly needy as defined in D-4020, item 2:

a. All persons who wold be eligible for assistance underTitles IV and XVI, as outlined in item 1 above.

b. All children under 21 who, except for age and not being eitherdisabled or attending high school or vocational training wouldbe depedent children under the State iS AFe- plan, includingthe caretaker of these children.

c. Individuals who are 65 years of age or older and are patient.in the state institutian far mental diseases or who are re-ceiving care and treatmnt in an institution for ~uberculo8il. 1/

,ll1.1

d. Children under 21 who are residing in foster homes approvedby the Division of Children and- Youth or in private childcare institutions licensed by the Division of Children and

Effective date is January 1, 1968.

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Effective date 18 July 1, 1966.

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..Youth whether the cost of care in such living arrangementsis being met in whole, or 1n part, by public or privateagency funds. 1/

e. Children in Subsidized Adoptive Homes -- Children under age21 who are residing in adoptive homes and who have beendetermined under the Subsidized Adoptive Program to beeligible for subsidized payments and/or medical care asprovided under State taw and in accordance with regulationsadopted by the Social Service Board of North Dakota.

3. The following are all of the conditions of eligibility that mustbe met by individuals 1n all groups specified in item 2, above:

a. No age, residence Or citizenship requirement will be imposedthat is prohibited by title XIX. The conditions specifiedin part II of the plan, "Application, Determination ofEligibility, and FurniShing Assistance", and under partIII B, "Financial Eligibilityll, will apply toaH individualsin this group and where relevant, part III C and D, pertainingto "Blindness" and "Permnent and Total Disability" 1 will, beapplied to individuals. ' .

B. Financial ElidbUity (D-4200)

ii.

1. The following levels of income and resources for maintenance, intotal dollar amonts, will be used as a basis for establishingfinancial eligibility for medical assistance, and are 1n accord-ance with D-4220. item 1 a, b. c, and d:

a. Income -- The income levels applicable to families of varioussizes in determining eligibility for medical assistance areal £0 Hows :

Nuberof Pel'S ons Income Levels

12..4S67

$ 1800240030003600410046005100

.An additional $400 increment is added for eachbeyond seven. The income level for persOn infacilities 1s $96 (eight dollars per month).

1/ Effective date is October 1, 1966.

.. ..

111-3...

b. Property The following property provisions will be appliedin determining eligibility for medical assistance:

.1) The Home - The home of the individual or family will beexempt in determining eligibility for medical assistance.The home is defined as including the land on which it islocated, providing the acreage does not exceed 160 con-tiguous acres if rural, or two acres if located in tow.Acreage in excess of the 160 (rural) or two, (if locatedin tow) \,ould be declared "Real Property Other ThanHome. "

2) Real Property Other Than The Home - Real property otherthan the home may not exceed an equity of $2,500, exceptthat real property which is essential to earning a liveli-hood shall be exempt from the limitation, if the liqui-dation of such assets would cause undue hardship. Liqui-dation of income producing real property, which would re-sult in reducing annual income below the established in-come levels, would be considered undue hardship. If un-due hardship is not a consideration, equity in e.cesi!1)Lthe $2,500 would be considered available for m~~ting ,"medical costs, providin the property is saleable. Theperson would have the option of liquidating the excessproperty or borrowing funds on. it.

3) Personal Properti ~ Personal pr~perty is, defined as in-cluding cash, savings, and redeemble stocks and bonds,vehicles, machinery, livestock, at cetera, but does notinclude personal effects, wearing apparel, household goods lfurniture, or trailer homes' being used for living quarters.Cash surrender value of life insurance policies will be con-sidered personal property but not cash.

Personal property may not exceed an equity of S2,500 exceptthat such property which is essential to the earning of alivelihood shall be exempt from the ltmitatiou if the li-quidation of such excess assets would cause undue hard-ship. Liquidation of income producing personal propertywhich would result in reducing annual income below the es-tablished income levels would be considered unue hardship.If undue hardship 1s not found to be a consideration, eqù1tyin excess of the $2,500' would be considered available formeeting medical costs providing the property 1s saleable.The person would have the option of liquidatins the excessproperty or borrowing funds on it.

. In all instances, real and personl property must be realis-tically evaluated in acc,ord with curt'ent market value, andin conidering net equity, any possible costs which may beassQciated with liquidation of th~ excess property must betaken into acc.ount. '

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With respect to cash, savings, redeemable stocks andbonds, and other liquid assets, the following levels willbe applicable to famt lies of various sizes: $300 for oneperson, $600 for two persons, $50 for each family memberthrough ten, and $25 for each additional family member.These amounts wiii not be considered as being availablefor medical expenses.

For convenience, the following table is included which in-dicates the various leve'18 of cash and other liquid assetsas applicable to families ranging in size from one totwelve. Beyond twelve, it would be necessary to add $25per person in deteriiningthe total amount of cash to beprotected for emergencies:

2. There will be a flexible measurement of available income which willbe applied in the following order or priority:

a. First, for maintenance, sO that any income in an amount at orbelow the established level will be protected for maintenancej

b. Next, income in excess of that needed for maintenance will beapplied to costs incurred for necessary medical or remedialcare recognized under State law and not encompassed withinthe State plan for medical auistance; and

c. All of the remaining excess incom will be applied to costsof medical asststance included in the State plan.

3. All incom and resources (after all State policies governing thedisregard, or .etting aside for future needs, of income and re-.curces in the approved State plan. under titles IV and XVI havebeen applied) vill be considered in ..tablishing eligibility,and in the flexible application of income to medical costs notin the State plan. and paymnt toward the medical assistance coats.

a. The State agency or local agency under supervision of the Stateagency, will take reasonable measures to ascertain any legalliability for third partie' ari.ing after March 31, 1968, forthe medical care and service' included 'uner the plan. the needfor which arises out of injury, disease, or disability ofapplicants for or recipients of medical assistance.

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The State or lòcal agency, in determining whether medicalassistance is payable, wiii treat any! third party liability as

a current resource when such liability is found to exist and

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b. Proper tv ~.. The following property provisions ~iii be appliedin determining eligibility for medical assistance:

.1) The Home.. The home of the individual or family ~ill beexempt in determining eligibility for medical assistance.The home is defined as including the land on which it islocated7 providing the acreage does not exceed 160 con-tiguous acres if rural, or two acres if located in tow.Acreage in excess of the 160 (rural) or two, (if locatedin tow) would be declared "Real Propert)' Other ThanHome. "

2) Real Property Other Than The Home - Real propert)' otherthan the home ma)' not exceed an equity of $2..500. exceptthat real property which is essential to earning a liveli-hood shall be exempt from the limitation, if the liqui-dation of such assets would caUSe undue hardship. Liqui-dation of income producing real property, which would re-sult in reducing annual income below the established in-come levels, would be considered undue hardship. If un-due hardship is not a consideration, equity in excess~fthe $2,500 would be considered available for m3t"ting , 'medical costs, providing the property is saleable. Theperson would have the option of liquidating the excessproperty or borrowing funds on, it.

3) Personal Pro~ertx - Personal prpperty is, defined as in-cluding cash. savings, and redeemble stocKS and bonds,vehicles, machinery, livestock, et cetera, but does notinclude personal effects, wearing apparel, household goods.furniture, or trailer homes' being used for living quarters.Cash surrender value of life insurance policies will be con-sidered personal property but not cash.

Personal property may not exceed an equity of $2.500 exceptthat such property which is essential to the earning of alivelihood shall be exempt from the limtation if the li-quidation of such eXCess alBets would cause undue hard-ship. Liquidation of income producing personl propertywhich wold result in reducing annual income below the es-tablished income levels would be considered unue bardship.If unue hardship is not found to be a consideration. equityin excess of the $2.500'would be considered available formeeting medical costs providin the property is saleable.The person would have the option of liquidating the excessproperty or borrowin funds on it.

. In all instances, real and personl propert)' must be reali.-ticall)' evaluated in acc,ore with current market value, andin conidering net equity, any possible costs which may beassociated with liquidation of th~ excel8 property mu.t betaken into account. '

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-111-4

With respect to casht savings, redeemable stocks andbonds, and other liquid assets, the following levels willbe applicable to families of various sizes: $300 for oneperson, $600 for two persons, $50 for each family memberthrough ten, and $25 for each additional family member.These amounts will not be considered as being availablefor medical expenses.

For convenience, the following table is included which in-dicates the various levels of cash and other liquid assetsas applicable to families ranging in size from One totwelve. Beyond twelve, it would be necessary to add $25per person in determining the total amount of cash to beprotected for emergencies:

Number Numerof Persons Cash Levels of Persons Cash Leve 1s

1 $ 350 7 $ 9502 700 8 10003 750 9 10504 800 10 . "11005 850 11 '11256 900 12 usa

2. There will be a flexible measurement of available income which willbe applied in the following order or priority:

a. First, for maintenance, so that any income in an amount at orbelow the established level will be protected for maintenance;

b. Next, income in excess of that needed for maintenance will beapplied to costs incurred for neces.ary medical or remedialcare recogni~ed under State law and not encompassed withinthe State plan for medical assistance; and

c. All of the remaining excess income will be applied to costsof medical as.istance included in the State plan.

3. All income and resources (after all State policies governing thedisregard t or setting aside for future needs, of income and re-aources in the approved State plans under titles IV and XVI havebeen applied) will be considered in establishing eligibility,and in the flexible application of income to medical coat. notin the State plan. and payment toward the medical assistance costs.

a. The State agency or local agency under supervision of the Stateagency, will take reasonable measures to ascertain any legalliability for third parties arising after March 31, 1968, forthe medical care and services included 'uner the plan, the needfor which arises out of injury, disease, or disability ofapplicants for or recipients of medical assistance.

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The State or local agency, in determining whether medical .a.slatance is payable, wiii treat any'third party liability as

a current resource when such llability is found to exist and

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payment by the third party has been made or. will be madewithin a ~easonable time.

c. The State or local agency will not withhold payment in behalfof an eligible individual because of the liability of a thirdpa~ty when such liability or the amount thereof cannot becurrently established or is not currently available to paythe individual's medical expense. '

d. The State or local agency will seek reimbursement from a thirdparty for assistance provided when the party's liability isestablished after assis tance is granted and in any other casein which the liability of ath1rd party existedt but was nottreated as a current resource.

4. Only such income and resources as are a~tual1y available wiii beconsidered; income and resourceS will be reasonably evaluated; andonly such income and resources will be considered as will be "inhand" within a period of three months ahead, including the monthin which the services were rendered for which payment 'will be madeunder the plan.

s. The financial responsibility of any individual for any applicant"crrecipient of medical assistance will be ltmited to the responsibilityof spouse for spouse, ,and parents for children under age 21t or blind.or permanently and totally disabled. Such responsibility is tmoaedon applicants and recipients of medical assistance as a condition ofeligibility under the State plan.

c. Blindness (D~4700)

1. The following is the State's definition of blindness in te~s ofophthalmic measurement: (Attached)

2. In any instance in which a determination is to be made whether anindividual is blind according to the State l s definitiont there willbe an examination by a physician skilled in the diseases of the eyeor by an optometristt whichever the individual may select.

3. . Each eye examination report form will be reviewed by a State 8uper~vising ophthalmologist who 1s responsible for the agency's decisionthat the applicant doe. or does not meet the State' sdefinition ofbU,ndness .

D. Permanent and Total Disability (0-4800)

1. The following is the State' s' definition of permanent and totaldisability, showing chat: (a) Ilpermnently" is related to theduration of the tmpairment or oombination of tmpairments; and

(b) "totally" is related to the degree of disability: (Attached),

2. Each medical report form and social 'history will be r~viewed byteohnically competent persons. not less than a physician anda social worker qualified by professional training and pertinentexperience ~ acting cooperatively, who are ¡responsible for the

"+' .,r ,ag~nc¥' 8 dad, s10n that the applicant does or does not meet the 1.1 ti n L 1'S'!~te . definition of petlnent and total disabilit~.. L. ..'~

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IV. Medical Assistance (D-5000)

A. Amount. Duration. and Sco~e of A$$istance (D-S100)

1. Eligible recipients may obtain the following services as definedin D-514l from any qualified institution, agency, comunity phar-macy, or person, who undertake. to provide such services wi thou tlimitation on the amount or duration.

a. lnps tient Hos pi ta 1 Be rvices (Other than services in aninstitution for tuberculosis or mental disea!le8~

b. Outpatient Hospital Services

c. Other Laboratory and X-ray Services

d. Skilled Nursing Home Services (Other than services in aninstitution for tuberculosis or mental diseases) forindividuals 21 years of age or older.

e . Ski lIed Nurs ing Home

f. Physician's Services, whether furnished in the office.patient' 8 home, a hospital, a skilled nursing home, orelsewhere.

g. Medical Care or any other type of remedial Cáre recognizedunderState Law, furnished by licensed practitioners withinthe scope of their practice as defined by State Law.

h. Home Health Care Services

1. Private Duty Nursing Services

j. Clinic Services

k. Dental Servces

1. Physical Therapy and Related Services

m. Prescribed Drugs, Dentures, and Prosthetic Devices; andeyeglasses prescribed by a physician skU led in diseasesof the eye or by an optometrist, whichever the individualmay eelect.

n. Other Diagnostic, Screening. Preventive" and RehabilitativeServices

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o. Inpatient Hospital Services and Skilled Nursing Home Ser-vices for individuals 65 years of age or over in an insti-tution for tuberculosis or mental diseases

p'. As prescribed by the SecretarYt the State will provide suchearly and periodic screening and diagnosis of individualswho are eligible under the plan and are under the age of 21to ascertain their physical or mental defects and such healthcaret treatment and other measures to correct or amelioratedefects and chronic conditions discovered thereby. 1/

Any other medical care and any other type of remedial carerecognized under State lawt specified by the Secretary

q.

1) Transportationt including expenses for transpottationand other related travel expenses necessary to securingmedical examinations and/or treatment when determinedby the agency to be necessary in the individual case.IITravel expenses" are defined to include the CO'Bt of

transportation for the individual by ambulancet taxicab,co-.ion carrier or other appropriate means; the cost of...outside meals and lodging enroute to, while receiving. 'medical care, and returning from a medicàl resource; and,the cost of an attendant to accompany h~. if medical orotherwise necessary. The cost of an attendant may in-clude transportation, mealst lodging, and salary of theattendantt except that no salary may be paid a memer ofthe patient i 8 family.

2) Family planning services. drugs t supplies. and devices.when such servces are under the supervision of aphysician.

3) Whole blood. including items and services required inCOllection. storage. and administratioot when it hasbeen recomended by a phy~ician and when it i8 notavailable to the patient from other sources. :9Skilled nursing home serv" ice.. a. d~f1ued 1u. 0:514,1, ~ite= 4. provided to patients uner 21 years of .

2. Th. medical and remdial care and servces made available to anycategorically needy individual included under the plan will not bele.. in amount, duration. or scope than those made available toother individuals included under the program. Except that, asspecified in item I. above. services to persons in institutionsfor tuberculosis or iiental dbe..e. are Umited to persons 6S yearsof age or over.

4)

3. The medical and remedial care and servces made available to a

1/ Effective July 1, 1969

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-VI-!

VI. Personnel Administration (D-7000)

A. Personnel Administration on a Merit Basis (D-7100)

1. The State agency will establish and maintain methods of person-nel administration as are set forth in the "Standards for aMerit System of Personnel AdminiGtration", issued by theDepartment of Health, Education, and Welfare, the Departmentof Labor, and the Department of Defense.

2. Merit rules and regulations f as adopted by the North DakotaPublic Welfare Board in December; 1939, Classification Planand Compensation Plan as adopted in January, 1940; and asamended at intervals; which are approved by and currentlyon file in the RegionAl Office (also found in all chaptersin the 600 series of the North Dakota Public Welfare Manual)and are currently applicable to titles IV and XVI, are. herebyincorporated in this title XIX plan.

B. StaffinR for Administration of Medical Assistance Programs (D-7200)

1. The State agency will establish a medical assistance unit inthe State agency ptfi~e which will include as a minimum:

~~ A full-time director graduated from an accredited in-stitution with a graduate degree in social work.

/ b. A half-time physician graduated from an accreditedschool, who is licensed to practice mediCine.

_, c. A full-time social worker graduated from an accreditedschool of social work with a master's degree, who hasadministrative, supervisory, or consultative experiencein medical care and health progr~.

d. Part-time servces of a dentist graduated from anaccredited dental school and licensed to practicedentistry.

/ e.' Part- time &ervces of a pharmcis t gradua ted from anaccredited 8chool of pharmcy and licensed to practicepharmcy.

J f. A full-time consultant on adult caTe facilities has beenadded to the Medical Services Division. He has a master'sdegTee in admnistration (education), was a superintendentof schools for many years and was a nursing home admini.stratorfor four years just prior to joining the State agency staff.

2. The State agency will establish a formla which will provide forobtaining sufficient qualified staff, on a progressive basis, byJuly 1, 1975, in the State medical assistance unit and in regionlor local units.

3..

Provide for the establishment of an advisory comttee to the, , IC.L~tt11

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State agency director on health and medical care services,appointed by the director of the State agency or a higherState authority.

c. Staffin~ for Administration of Assistance for A~ed Individuals inInstitutions for Mental Diseases (D"7300)

1. The State agency will provide the following staff in the Stateagency office:

a. A. full-time social worker graduated from an accreditedschool of social work with a master's degree, who hasadministrative, supervisory, or consultative experiencerelated to mental health problems and services; and isbeing actively recruited and will be added when such aperson becomes available.

b. The part..time services of a psychiatrist who is eertifiedto practice psychiatry or is Board eligible, with profes-sional'Pperience which shall include consultation on oradministration of mental he~lth services.

2. The State agency will provide sufficient qualified social workand supporting staff, based on a fo~uia, to serve as liaisonwith individual institutions for mental diseaSeS and' provideconsultation to local agency staff.

D. Staff Development (0.7500)

1. The State agency will provide for a staff development programwhich tnc ludes :

a. An organized program of in-service training available toall staff in State and local ageneies administering themedical assistance program;

b. Technical and professional education for medical, technicaland other professional staff necessary for the administra-tion of the medical auistance program, including:

(1) Paid educational leive for employees, uner a progres-sive pla which includes provision for

(a) continued eutitlemnt to emloyee rights andbenefits, and retentiou of position rightø, and'

(b) appropriate reduction of duties for employees od1ess-than-fu1l-time educationl leave.

(2) Policies govrnin paymts for the various types ofleave and the conditions relating to work with theagency.

.'....(3) Proviçion that leåve for attendance at educatiodal in-

stitutions will be granted only if the institution isaccredited by the appropriate accrediting organization.

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2. The State agency will provide for progressive extension of staffdevelopment activities. including progressive increase in thenumber of individu3ls on educational leave, to the end that, byJuly 1, 1975, there will be qualified staff in all positionsunder the medical assistance program.

3. The State agency will establish a formula for increasing thenumber of staff development personnel with appropriate educa-tional qualifications and experience, So that, by July 1, 1970,there will be sufficient staff with sUèh qualifications, havingresponsibility for planning, directing and administering thestaff development program described in item 1, above.

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PUBLIC WELFARE BOAR OF NORTt DAKOTAiSTATE PLAN ~~~~l..;l. -- ~,~,

E. Training and Use of Subprofessionals and Vo1unteersP ñ 10.

I. SUBPROFESSIONALS

For titles iv Parts A and B (AFDC and CWS), V (MCH and CC), XVI (AAD)and XIX ~) of the Social Security Act:

(a) The Public Welfare Board of North Dakota will provide for thetraining and effective use of subprofessional staff as communityservice aides through full-time or part-time employment ofpersons of low income and. where applicable, of recipients ofservice or financial assistance, including:

(1) such methods of recruitment and selection as willoffer opportunity for full-time or part-time employmentof perSOnS of low income and little or no forml edu-cation, including 'employment of young and middle-agedadtflts, older persons, and the phy~1ca1ly and mentallydisabled. and recipients of public assistance; and willprovide that such subprofessional positions are subjectto merit system requirements, except where special ex-emption 1s approved on the basis of a State alternativeplan for recruitment and selection among the disadvantagedof persons who have the potential ability for trainingand job performnce'to help assure achievement of programobj ectives;

(2) 'an administrative staffing plan to include the range ofservce personnel of which subprofessional staff are anintegral part;

(3) a career service plan permitting persons to enteremployment at the subprofessional level and, accordingto their abilities, through work exerience, pre-serviee and in-servce training and educational leavewith pay, progress to positions of increasing responsi-bility and reward;

(4) an orssuized training program, supervision, and supportiveservces for subprofessional staff;, and

(5) annual progressive exansion of the plan to assure utili-zation of inereas1na number. of subprofessional staff .scommunity iervic. aidee. until an appropriate number andproportion of 8ubprofe..10nal ataff to profe.sional ataffare achieved to lDke mamum use of subprofe8øion.i. Úlprogram operation.

Ôi-J7L(-1-i

....

- 2 -

II. VOLUNEERS

For titles iv parts A and B (AlOe and CWS), V (MeR and CC), XVI (AAD)and XIX (MA) of the Social Security Act:

(a) The Public Welfare Board of North Dakota will provide for the useof non-paid or partially paid volunteers in providing servicesand in assisting any advisory committees established by the Stateagency including:

(1) designation of a position in which rests responsibilityfor the development, organization, and administration ofthe volunteer program, and for coordination of tpe programwith related functions;

(2) methods of recruitment and selection which will assureparticipation of volunteers of all income levels inplanning capacities and service provision;

(3) a program for organized training and, supervision of suchvolunteers;

(4) meeting the costs incident to volunteer service and assurinithat no individual shall be deprived of the opportunity toserve because of the expenses involved in such service; and

,.(

(5) annual progressive expansion of the numbers of volunteersutilized, until the volunteer program is adequate for theachievement of the agency's iervice goals.

III. REPORTING

(a) The Public Welfare Board of North Dakota w11 make such reports, in suchform and contaiini such informtion as may be required by the'SRS.

6-26-69

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VII. Fiscal Administration (D-8000)

A. State Financial Participation (D-8100)

1. The State agency will provide for distribution of funds fromState and Federal sources. for carrying out the State plan,on an equalization or other basis which will assure that thelack of adequate funds from local sources will not result inlowering the amount, duration, scope, Or quålity of care andservices available under the plan.

2. State funds will be used in both assistance and administration.

3. State and Federal funds will be apportioned among the politicalsubdivisions on a basis consistent with equitable treatment. ofindividuals in similar circumtances throughout the St~te.

B. Fiscal Policies and Accountability (D-8300)

The State agency, in discharging its fiscal accoutability, willmaintain an accounting system and supporting fiscal records adequateto assure that cla~s for Federal fùnds are in accor¿ with app1iwcable Federal requirements.

c. Cost Allocation (D-8400)

The State agency will establish and maintain a cost allocation planthat:

1. Is effective from the effective date of the plan approved unertitle XIX¡

2. Enables the State agency to clatm Federal financial participa-tion in the cost of administration, services, and trainingunder title XIX only for such expenditures under the plan asare properly chargeable to the medical assistance programunder established policy;

3. Identifies; within the total amount of expnditures under theplan subject to Federal financial participation under title XXX.the amoùnt that is subject to 7S percent Federal financial

participation under established policy;

4. Precludes including in the claim for Federal finaneiai participa-tion for costs of administration, services. and training unerany of the other public assistance titles. any such costs asare properly chargeable to title XIX uner established policy.

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VIII-l

VIII. Related Responsibilities (D*9000)

Nondiscrimination in Federallv AssistedProsirams (D-9300)

A. Attached, and made a part hereof, are:

1. A statement certifying the applicability of both the Statementof Compliance (Form CB-FS 5022) and the State agency's tmple-menting methods of administration to the medical assistanceprogram. submitted on February 25, 1965, and

2. No additional methods are deemed necessary to 'assure compliancewith all applicable requirements.

Februry 8, 1967 lie O. OveExecutive DirectorPublic Welfare Board of North Dakota

Attachments:

1. Statement of Attorney General (1 A 2)2. Definition of Blindness (III C 1)3. Definition of Permnent and Total Disability (111 D l)4. Institution for Mental Diseases (IV B 1)5. Agreement with Division of Vocational Rehabilitation (V C 2)6. Nursing Home and Hospital Standards (V D 2 3)

Also see attachment #57. Letter of Acceptance by Executive Director of the Pulic Welfare Board

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stATE PLA FOI K!lCA ASSISTANCEUNEI Tl'LE XIX OF TH SOCIAL SECURIT Acr

STATE OF NORTH DAKOTA

Plan Aiendrent: FT.e Choice of Providen of Medical Servicei; 4S en249.11; sas Progr.., aegulation 40-18, June S. 1970

Any individuai eligibl. for medical a"iitance under the plan .., obtainthe iervlee. available under the plan from any in.tltution, asency,pharmcy, or practitloneT l qualified to perform .uch .irvlc.. andparticipating under the plan, including an organization which provideiiuch .ervice. or arrangei for their availability on a prepay..nt b..ii.

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STA?S ?LAll FOR

TITLE r 0 IV-A ø X D xiv 0 XVI ø XD: øOF l::: SOCrA S!.C1JRITY ACT.

STATE OF NORTH DAKOTA

Plan amendment: Fair hearings; Application, detei-.dnation of el:i.gibili ty,and funishir~ assistance; Recoupment of o7~rpay~ents and. correctionof underpayments; 45 CFR 205.10, 206.10, 233.20(,)(12); SRS,?rogramRegulation 10-2(C-4), 10-3(C-3), 10-11(C-9), and 20-7(C-7)

A. The state agency has a system for fair hearins 'Whien meets all therequire:ients of 45 CFR 205.10 published Aug si ~5, 1972 (38 Fa 22001).

Under tbis system:

(1) Evidentiar hearings at the local leyel are used.§Noo ,Yes, State-¡ridt!

o Yes, in acme ~oiitica1 Dubdi visions

(2) The exceptions to the tL"tely nôtice require.ent :'istt"l: 1.45 CPR 205.l0(a)(4)(ii)(A) through (r) are in effect.

ø Yes - a. of those listed in the Feciei:al regula:t ion..

DYes - but onl those listed in Atta.c.nt A of' this'amdment.

, D No exceptions are in ettec~.

(,3) When chaes in Federal or State la.w requie automtic grant 'adustmets. for classes of recipieDts:

ø Hearings a.e granted on &p)ealG of the é,ãjustment.

D Hea.ir~s are deiaèd with respect to. the adjustientexcept when the r-eason for the indi vid~ appee. isincorrect computation.

(4) Request for hear'" !,.g& iit be in writing

øYesOno

.

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(5) Time clowed fer cla::-!lts 'to file a:i appeal is 30 ¿~'St'rotl

L: date of action

~ date of notice

(6) Assistance is reinz~s.ted ..hen a. appeal is i'ile¿ Cling anaddi tiona period tollo-..r.. the date c:' a.ct iou, a.d is cen-tinued until the heariIl decision, u."Ùess it is dB'¡;~-:ned

. at the hearing that the issue is solely one of Fe¿&ral orState law or policy.

DYes - The additiPa. period provided isø i;o addtional period is proVided.

êays.

B. The State agency :ieets e. the requrements ot' 45 CFR.2().iO p.ìo1:sh2dAugst 15, 1973 (38 FR 22009), on 8.?plication, deter:dation oi:. ,e.~igi-bility an fUnishing assistancè.

The Statewide tim standad for a.ction on applications is 45 ô.sfor all a:plications except those for AP, J._A;D (for the disabled),and Medicaid for the disabled, for w!iich the tine sta.ndAd is60 days.

c. Under its policies on need a.nd amunt of assistance, t~p ~ta.te agency:

(1) Has uniform State'l"ide policies on recoup:ent of overpS!J"menzsof assistance.

D 1~0. There is no recoupre:t of overp~rment$

ø Yes. Al requirements of 45 CFR 233.~O(aì(l2)(i) pUblished

:August 15, 1973 (38 FR 22010).

Recoupment is trom:

/l Avalable income and resources

ø Current e.ssistance payments

Attacent :B describes the recoupment policies, i.oludingthe circu.sta."lces, if 8."ly, u:er whicl reco~p::ent is '\;~ived,and the littations established to prevent undue harè.b.pif recoupment is made from curr~~t assistance.

6

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(2) Has unform Statevide Standads for pro:pt correction o~underia~'ments resulting tram adinistrative error.

D No. The State plan does not provide for recoup:ent ofoveriaymeits nor correction of underp~ents.

ti Yes. Al requirements of 45 erR 233.20(a)(12)(ii) " publishedAugust 15, 1973 (38 Fa 2005) are met.

Ãttachment C describes the policies on correction of under-payments.

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..A ttac Ii"ient B

.. Pnr, 10. R("c0vcr... of (h'('ri';'..:-t"nt~ -- The county ..clf..re boa.rd sh;;ll r.;ir:èever)' reascn;;1:l;-;ffor: tc rcco'..er tat' a:'ount of o~'erpn)'1~nt made to n ri:-ci,':..::1t, \:;',dher prccipit.:tcG ry .:;ency or rt;ciri'2:~t error. O':crpny::cr,ts ¡ .\'

~~ ~cc~~~r0~ fr~~ t~~ r~cf~icnt 's Av~ilablc fuu¿s (includi~ç 8~Y cash rescr~~)e:-;c:-.i't e;i::ncd ir.cc~''l and/or future assiRtel'Ca pilYTI,ents.

R~co"'ery is .limited to overpayments made dur1n£ the six months preceding the~onth in ~hich the overpa~~ent ~as discovered excep; ..hen there is evidenca,dccu~ented by the county w~lfare board, clearly indiçating the recipient will-fully \;ithheld or falsified information about his inco~e or resources. In this1nst~nce, there is no linitñtion on the retroactive period fo~ t:hich recoverymay be sought. v~en overpa)~ent appeàrs to be the result of a deliberate at-tempt by a recipient to obtain assistance to ~hich he ~as not entitled. thematter shall be referred to the states attorney in the manner åescribed inChapter 364. Section 3.

In all instances in which the county ~e1fare board plans an action to recoveroverpaynents, the recipient must be given an opportunity to show that the pro-posed nction is improper.

\~en an overpayment is to be recovered from future assistance pà)~entst thecounty welfare board as a safeguard against creating undue hardship maY~~9treduce a month's grant by more than iox of the total basic requirement.. Norcan a reduction be made in more than six AFDe pa)~lents exr.ept in those in-

stances in which a court may have ordered grant reductions of longer durat1o~.

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Attach:nent C

Par. 11. Corr~ction of lr.¿erpaynentf. -- The county welfare board shall

take prompt ac't1on to correct i.mdcrpay"¡;ients to current recipients. Retroac tive

corrective payment zhaii be ~ade only for the six months preceding the month

in ~hich the ~nèerpaymcnt is discovered unless so ordered by a court or the

fair hearing authority. For purposes of determining continued eligibility

and amount of assistance, retro~ctive corrective payrents shall not be con-

sidered as income or resource in the month paid or in the next fo1:10wing month.

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..STATE PL FOR

MEDICAL ASSISTANCE UNDER TITLE xn- OF THE SOCIAL SECURITY ACT

STM' OF NORTH DAKOTA

Plan Amendment: Periodic Medical Review and Medical Inspections inSldled Nursin Homes and Mental Hospitals; 45 eFR250. 23; 8RB Prgram Reguation 40-21, Fe bruar ,17, 1m.

Effective May 3, 1971 , , vith respect to patienti eligible'.Wlder this Statepían 'Wo 8.e adtted to a sklled nuiing home or who .iiake application tor assiitance under the plan whUe in such & home., , tbeState agency vUl:' .1.. prôvide for a medical review (includin medica. evaluatian) or' the

need for care in such a home, 9. written plan of care, and~ ..ereapplicable, a plan of rehabilitation. Such review and plan willbe made by the patient's attending physician. Methods and procedur,'Wll be followed in each case which &Gsure that; prior to adssionor to authorization of pa,ent, as may be appropriate, the requemta"of 45 CrR 250.23(8.)(1) 'Wth respect to complete medical evuation, .'.' " :_'plan of care and writt.en reports are met. ' "

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....~..2~ provide for periodic inspections, to be mae in a. sk.ed nusing.... '~.

homes carin for patients under the plan; by one or more medicalreview team whch are comsed ot one or more phsicians and otherappropriate health and social servce personnel; tuction uner thephsician member' 8 supervsion, an hav no m.emers emyed b7 or,with lU fiancial intereit in a. nursing bome.

3. provide for methods and procedurs in i,cordance vith 45 eFR 250.23(a)(3)whch will auure that: ' . !

j,,.

. a. inspections can be made at appropriate interval. in e. homscarin tor such patients, with at least one inspction mae in eahome ~ May 31 1972 ad there&tr at interva -detenec1 'b ',,' ", " . ,the teMl in the liSt of the qu't ot care ~ &D th " ..'. ,..., '. , ,conditions ot patients C&ree to uner the pl,' but DO le.. .;:..':0" .otten than umU&J " . "

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b.. no pbcia. membe ot a team 1.ct. th oar of pat1eit. tor'",vbom he ,is attend1 ph.~c1an;

c., no facilty ii not1nec1 of 'iiCtiOD i-e ,tei i. hou Wore',.,'team arva; &D 'd. the inpection ine1u4èl peraona COtat 'Wth ei4o'b.ant1

ot ,eac neb patient u4 :rY.ft ot bú aeC& r-co. '

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L. '?~.: 'ide for ::ethods and prl)c(;.:l.:'~'~, ..n accord6Jce with 45 CFr 250... :,.aì(4)~~ìi ,h will &$sure 'that req.,ir~m~:r.-.. for content, promtt submittal andprocessing of reports are ~et a~d .~at the State agency takes appropriatefollow-up action.

This State plan includes medic&. Mor.1stance in 'behalf ot' ind:V"......als 65years of age or older who are patients in institutions for mental diseases.

il YES. .D NO

*Effective May:3, 1971 , with respect to such padents eligibleunder the State plan who are adtted to a mental hospital or who makeapplication for assistance under the plan while in such a hospital, theState agency .."ill:

1. provide for a medical review (includi medical evaluation) of 'theneed for care in such a hospital, and. a 'Wi tten plan of c.arê. ,:...clreview and plan will be mad.e by the patient 's at:tená. ;"c. .." ,:::', C:"t..or i:e hospital staf physician. MethuG~ &.J(; ..~_O~i;;'~ç,.Lowed in each ease which assue that, prior to a,.._..~.:..1: ¡;r...au~horization of payent, as appropriate, the requiremen~s cf 4~eFR 250.23(a)(1) with respect to comlete medical eva:ua~ion, p~ar.':-: ~are, and .psychiatric and social evaluations are met.

~. Jt::vide for periodie inspections, to be made in el r:ental hc.spi'¡alacar:J tor such patients, by one or more med1cfÙ review teaiG which';',. comsed of one or more psychiatrists or physicians know.:edgeableS.~'IO..t mental in.n.itutions and other appropriate mental health anå~~~ial servce ~ersonnel, fuction under the physician memberl.i:-":~i.rvt;ion, and have no members 'Wo have a financial interest in¿,.:", menu.: ;;nstitution or are emloyed by a mental institutionrE:\"'eved '0'1 the team on whch they serv.

3. pj,'ovide for methods and procedures in accordace with 45 erR 250.23(a) (3),which will assue that:

a. inspections can be mae at appropriate interv. in au .antalhot;itaii car1n tor such patients, with at least one inspection:iaèe in, each taeilt) 'b May 3, 1972 and thereaftr at interva'le,&ermed 'bJ'- 'te team tor a facility in the lit of the quity.it ~are :.E:~c:~red end the conditions ot patients cared tor unertihe :lla, w'Ç not le.. otten thai ai;

'ò. no pby.lcian aebe of .. team inspt. the care of patients torwhOl be is attend plaician;

c. no facUity i8 not1fed of inspction more than 48 hou. before'team arival; ai '-i/-33....,_.. J;-; _~/ t~ 11

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d. ~he inspec'tion :.ncluo.es r,:.'J.::.;,t each such patient's medi.:alrecord, if 1v contains 'the perioc1c ~,ssessments requir-d by~ection 1902 (~ì (20) of ~~e Soci&l Secuity Act, or in the absenceor inadequacy of such assessments, personal contact w~,t.'i andobservation of each patient.

4. provide for methods and procedures 1n accordance ~~tb 45 CF 250.23( a) (4)whicb will assure that requemnts for content, prompt submitta. andprocessin of r~rtø are met and that the State agency takes appropriatefollow-up action.

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STATE PLAN FOR

SOCIA SECITY ACT: Title I 0 IV-A fl IV-B !i

X D X'N D XVI K1 XIX fi

VOCATIONAL REILITATION ACT: Six'lON 5 D sæTION 15 D

METAL RETARDATION FACILITIE AN CONMUNITY. METAL HEAL'l CENERS CONSTRUCTION ACT, ~ I D

OLDER AMICANS ACT, TITL III DJUILE DELINQ'CY PRON

AN C01llO¡' ACT OF 1968, TITLE I

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DSTATE OF: NORTH DAKQTA

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.Plan Amendment: Submittal of state plans tor Governor' 8 review,

45 eFR 204.1; SRS Program Reguation 1-3,Februar 27, 1971

The State agency will provide opportu't for the office of thestate Gcyernor to review an amendments' to this Sta.te plan, annew State plan and subsequent amendments, and long-range programplan projections or other periodic reports thereon~ Ancomments made wi be tl'fmsmi tted to the Social and Rehabill ta-tion Servce with such docuents. .

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group (i.e., either the categorically needy or the medicallyneedy) will.be equal in amount, duration, and scope for allindividuals within the group (with the pe~issable 'exceptionsspecified in item 2, above).

4. The State agency will establish processes of utilization reviewfor each item of care and service included in the State's medicalassistance program in accordance with the requirements set forthin SRS Program Regulation 40~9. The Medical Assistance Unit ofthe single State agency will be responsible for all utilizationreview plans and activities in the program.

The following is a description of the methods that will be usedto assure that the medical and remedial care and services areof. high quality, and a description of the standards establishedby the State to assure high quality care:

a. Standards

(1) There is no limit On scope and duration with regard tohospital and nursing home days, diagnostic and/or thera-peutic procedures, and the number of vis its made by orto a licensed medical practitioner. /

(2) Payment can be made only to licensed medical' institutionsand practitioners and for goods and Services recomended bythe licensed practitioner. .

(3) Drugs are authorized only as recomended and prescribedby a licensed practitioner.

(4) Needed transportation is provided in order that medicalcare be made accessible to all persons who are eligibleunder the State plan.

(5) Specialists and consultative medical serviceß are pro-vided when needed at the discretion of the medical prac-titioner when the nature of the illness and person t s con-dition indicates this to be needed within the best judg-ment of the practitioner.

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(6) Semi-private and private accomodations constitute themajority of hospital beds in the state and are assignedto persons (whether public or private pay) on the basis ofthe individual t s medieal condition. Multi-bed accomoda-tions are relatively few in number; range £r~ four toeight beds an are usually only foun in the larger hoi-pita ls.

(7) For patients rec~ving long-term carè in medical institu-tions, clinical records are maintained by the individual 'ipersonal physician. Ongoing medical care of a routinenature'is provided by skilled nursing., and other ancillarypersonnel, at the institution a8 ordered by the .attending" , tphysicians_ Visits to such 'institutions by the patient S A f, L-personal physician are made as requested by the patient or 6l;~l:by the skilled staff at the institution. A med:lcal-llocial 7"1-/'Lplan is developed for long-teon care patients by the in-

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div1dual's caseworker. who also participates with the phy-sician and institutional personnel in periodically assessingthe treatment plan including consideration of alternatetypes of care.

(8) Direct service workers are informed of the medical care re-ceived by persons under the plan through the process of re-ceiving copies of detailed medical bills presented in theperson's behalf by the medical vendor. This provides theworker with informtion as to the nature and frequency ofthe medical services received by the person on an ongoingba s is .

(9) CUrrent planning in the area of staff development will begeared to providing supervisors and direct seryices workerswith additional knowledge pertaining to health problems andways to assist people to secure medical and remedial careservices. within the total framework of developing the State'ssocial service program.

b. Methods

(1) Advisory Comittee

(2) Drug Audit

./

(3) Systematic program of review of data geared to determiningpatterns of medical care and problems in quality as a basisfor establishing further standards or initiating other actiona8 to:

(a) Continuity of care, especially in chronic situations.

(b) Extent of participation of all licensed practitionersincluding the extent to which each of the variousspecialties participate.

(c) Extent of preventive health service.

(d) Exination. in depth, of selected samples of individualsa. to adequacy and appropriation of care provided.

S. The State agency will provide for broadening the scope of the medicaland remedial care and services made available under the plan, to theend that, by July 1. 1975, comprehensive medical and rémedial care and.erviceø will be furnished to all eligible individuals.

6. With regard to medical and remedial care and services in relation tofamily planning, there will be freedom frÒm coercion or pressure ~fmind and conscience and freedom of choice of method, so that individualscan choose in accordance with the dictates of their consciences.

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B. Assistance to A:iied Individuals in Institutions for Mental Diseases (D-5200)

1. The State Hospital at Jamestow, North Dakota is the only institutionfor mental diseases in which medical assistance is provided in behalfof patients therein who are 65 years of age or older: (Attachment)

2. The State agency will provide for showing that the State is makingsatisfactory progress toward developing and únplementing a compre-hensive mental health program, for all age groups, through appro-priate mental health and public welfare resources, including alter-natives to care in public institutions for mental diseases; and willprovide for arrangements for joint planning with the State authorityfor this purpose and for annual reports showing the progress made.

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.3 . The State agency will make written agreement with the Stateauthority concerned with mental diseases that Sets forth therespective responsibilities of the State agency and the Stateauthority or institution with respect to the recipient-patientsfor whom assistance payments are made, specifically including:

a. Provisions to assure a plan of treatment and care that servesthe best interests of each individual patient, 1.e., maintainsthe patient at, or restores him to, the greatest possibledegree of health and independent functioning, including:

(1) Ini t ia I and period ic review of his med iea l, psychia tricand social needs;

(2) Appropriate medical treabment by the instituti.ou;

(3) Periodic joint determination of his need for continuedtreatment in the institution, and for alternate carearrangement; and

(4) Provision of social services.

b. Provision for acceSS by appropriate representatives of theState agency to the medical facility, the patient, and thepatient 1 S records as necessary for carrying out the Stateagency i s responsibilities.

c. Provision for arrangements that assure necessary readmittanceto the institution without undue delay.

d. With respect to agreements with State mental health auth.orities, provision for the development of alterna te methodsof care and for joint planning for aged recipients who other.wise would need care in a mental institution and for therelease of patients no longer requiring institutional careto appropriate alternte plans of care.

e. Provision for nece..ary recording, reporting, and otherprocedure. .

4. The State agency ~ill provide for appropriate utilization of thecurrently available alternte methods of eare, and the developmentor extension of alternte care arrangements, to assure ready avail-ability of appropriate alternte care when needed.

s. The State agency will provide for making available appropriatesocial services, as specified in D-S230 E, item 3, to all agedrecipients in such alternte care arrangements.

6. The State agency will maintain caseload standards not exceeding60 per worker, supervisory standards not exceeding 5 workers persupervisor and a standard for visits as often as necessary but at

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least every month in respect to all such aged recipientsalternate care arrangemnts, defining, where appropriatetypes of situations that require less frequent visits.

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IV-6

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7. The State agency will provide for the progressive developmentof resources to meet fully the medical assistance and financialneeds of aged recipients in alternate care arranements.

8. The State agency will establish methods of determining thereasonable cos t of institutional care for such patients, withthe cost of care for each institution computed on the basis ofcosts for all services provided to all patients.

9. The State agency will establish methods of administrationnecessary to assure that the responsibilities of the Stateagency under the State plan with respect to suc~recipientsand such patients will be effectively carried out.

Payment for Medical and R~edial Care' and Services (0~5300)

1. Fee structures will be established which are designed to enlistparticipation of a sufficient number of providers of servicesin the program so that eligible persons can receive the moJica1care and services included in the plan at least to the extentthese are available to the general population.

2. Payments will be made only to medical vendors who sign agree-ments with the State under which the vendor agrees (a) to acceptas payment in full, the amounts paid in accordance with the pay-ment structures of the State; (b) to keep such records as arenecessary fully to disclose the extent of the services providedto individuals receiving assistance under the State plan, and (0)to furnish the State agency with such informtion. regarding anypayments claimed by such person or institution for providingservices under the State plan, as the State agency may from ttmeto time request.

Reasonable Cost of Inpatient Hospital Services (0..5360)

3. The State agency will pay the reasonable cost of inpatient hos-pital services provided under the plan.

4. In reimbursing hospitals for the cost of inpatient hospital8e~ices provided to recipients of medical assistance.

a. For each hospital also participating in the Health Insurancefor the Aged program under title XVI¡I of thè Social ,SecurityAct, the State agency yill apply the same standards and 'principles, and the method of computing payments currentlyapplicable to such hospital, as set forth in the regulations,IIPrinciples of Reimursement for Provider Costs", under title,

XVII¡ (HI.. 5.. Rev. ) issued by the Social Security Administra-tion, except for adaptations permitted in chapter D-5360 of,Handbook Supplement D.

b. For each hospital not participating in the title XVIII pro..gram, the State agency will apply the standards and prin-ciples described in sections 1..1 through 1-12' of "Principles

Oi~7,1~J 2-

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of Reimbursement for Provider Costs", except for adaptationspermitted in chapter D-5360, and either (1) one of themethods of computing payment. described therein, or (2)the "Cross RCC MethodlT of payments (described in D-5364.2,item b).

5. The State agency will provide for a system to assure that theclaims by providers for reimbursement for inpatient hospitalservices meet the requirements for reasonable colt, a8 set forthin chapter D-5360.

6. The following 1s a description of the policy and methods usedin establishing payment rates for each type of care and service,other than inpatient hospital service, included in the State plan.In no instances will the amount of paymnt under the plan exceedcharges made to the genera 1 pub lic for identfea 1 services.

a. Outpatient hospital services .. reason~~le charges, which shallnot exceed paymnts received by provider. in behalf ofbeneficiaries under Title XVIII of the Social Security Act.PR-40-4 (C- 2)

b. Other laboratory and X-ray servh.u! - reasonable chargés u.p"::,to a maximum of $5.00 per relative value unit."

c. Skilled nursing home services - cost up to a reasonablemaxtmum of $12.33 per day consistent with the intent thatupper ltmits of payment do not exceed amounts paid underTitle XVIII~A for 8imilar servicei. For those providersparticipating under Title XVIII, pa~ent shall not exceed,payments received by providers in behalf of beneficiarieiunder Title XVIII of the Social Security Act. PR-40-4(C-2)

d. Physician's .ervlce. ~ reasonable charge. up to . maximu of$5.00 per relative value unU.

e. Chiropractic services ~ negotiated fee schedule.

f. Optometric aervice. - reasonable charies up to a maximu of$ .10 per unit under a relative value schedule of ..rvlce.

i. Osteopathic services .. negotiated fee schedule.

h. Phrmceutical services .. reasonable charges up to the matmeitablbhed by "Public Welfare Bord Uniform, Kaim Uru ..PriciUS Schedule".

i. Poiatry servicei .. negotiated fee icbedule.

j. Hom health care services - fee for service as es tab 1i s hed byTitle XVIII coat determilUtion.

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Dental aervicei - reaiolUble charges up to maximui of $ .10per unit under "Unit Value System for Dentai Pr~:~~'~;:"-., 7~:-

Phyiical tberapy and related iervlce. .. I ~ _ ,H' /- I ~l 1.",- "___.i

l) Physical therapy'" nesotiated fee .cbedale.:

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2) Occupational therapy" reasonable charges.

J) Sp~ech therapy" reasonable charges.

m. Private duty nursing services .. reasonable charges based onthe prevailing rate for these services in the comnity.

n. Prosthetic devices .. reasonable charges.

o. Eyeglasses" invoice cost for materia 18 used.

p. Transportation" reasonable charges for private carrier andpreva i ling common carrier rates.

q. Clinic services" reasonable charges consistent ~1th theintent that upper limits of payment do not exceed amountspaid under Title XVIII-A of the Social Security Act forsLmilar services. PR-40..4(C..2)

1

7. The sing Ie S ta te agency wi i 1 take ~ha tever measures a re necessaryto insure appropriate audit of records ~herever reimbursement i.based on costs of providing care of service, or fee plus cost. ofmaterials.-

D. Limitations on Charges to ReCipients and Payment of Title XVIII De-duct ib lea (D~ 5400)

1. No deductions, cost sharing, or similar charge, with respect toany medical or remedial care and Services furnished under theplan, will be imposed on any categorically needy individual,or On any medically needy individual (whose excess income andresources, if any, have been otherwise applied under the plan),nor ~ill any enrollment fee, premium, or s~ilar charge beimposed under the plan on such. individual.

2. The full cost, or the full remining portion, of any deductibleunder part A of title XVIII, incurred by any categorically needyor medically needy individual included under the plan, will bemet.

E. Use of Insurance and Fiscal ~ent Contract (D-SSOO) 1/

1. The premium rate will be reasonable in relation to the amount,duratiOn, and 8cope of medical care and servces provided therecipients.

2. As a minimum the contract will:

a. Identify the amount of the premium to be paid by the Stateor local agency, when the premium is to be paid, for whom,and the coverage period.

b. Specify the amount, duration, and .cope of medical careand services recipients will obtain, together w tk th~ !~.schedule or other basis on which the contractor WSJ.:i ~ke ?L)..Ji '3payaent. t,='':~7.~:~ _I' 21" 7/ I11 \ C::_~:!:.!L- \

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c. Include provision for appropriate utilization and qualityof medical care and services.

d. Provide that the premium payment constitutes full dischargeof all responsibility by the State or local agency forcosts of covered medical care and services provided tocovered eligible recipient. during the contract period.

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\ Su:' ~~~, ~i.7..' ,J */5.70 IV.. 9'-":~¡:l,f. ' ~e. Provide the parties to the contract with opportunity for

renegottRtion of the premium rate and/or medical Care andservices furnished under contract.

f. Provide that the contractor shall maintain and providesuch records as are necessary for the State or local agencyto meet the requirements for rep9rting placed on the Stateby the Federal agency under law and, also, provide thatthe contractor shall furnish such other reports as requiredby the State or local agency.

g. Include tbe period of ttme the contract will be in effect.together with provisions for termination.

3. The State or local agency will assure itself that the provisionsof the contract are beioS complied with.

F. Assistance to Residents Out of the State (D-5600)

1. Medical assistance will be furnished to eligible individualswho are residents of the State, but are absent therefrom to the. same extent that such assistance is furnished under the planto meet the cost of medical care and services rendered to eligibleindividuals in such State, at least to the extent that medicalcare and services are needed in any other State under any of thefollowing circumstances:

a. Where an emergency arises from accident or illness;

b. Where the health of the individual would be endangered ifthe care and services are postponed until he retursto the State in which he resides; or

c. Where his health would be endangered if he undertook travelto return to such State.

2. Medical care and services will be provided outside of the Stateto eligible residents of the State, at least in the followingsituations:

a. When it 1s general practice for residents of a particularlocality to use medical resources outside the State; or

b. When the medical care and services available. or theavailability of needed supplementary resources, make itdesirable for the individual to use medical facilitiesouts ide the State for short or long periods. in accordancewith plans developed, jointly by the agency and the ind1vid~Wll. consistent with medical advice.

3. The agency will facilitate the meeting .of medical needs within theState for residents fram other States.

G. LieDs and Recoveries (D-S700)

1. No lien or encumbrance of any kind will be required from or betmposed against the property of any individual prior to his death () ~tJ

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because of medical assistance paid or to be paid on his behalfor at any ttme if he was under 65 years of age when he receivedsuch assistance (except pursuant to the judgment of a court Onaccount of benefits incorrectly paid on behalf of such individuals)

2. There will be no adjustment or recovery of medical assistancecorrectly paid, except from the estate of an individual who was65 years of age or older when he received such assistance l andthen only after the death of his surviving spouse, if any, andonly at a tûne when he has no surviving child who is under age 21or is blind or permnently and totally disabled.

~~Jr' Institutional Services (P.R. 40-16)t,f..r r n Payments to skilled nursing homes on or after July 1, 1970, will be~~ limited to skilled nursing homes operating under the supervision of

~ l-dministrators licensed in accordance with 45 CFR 252.40 of the~ I ~ ~ Federa 1 Register.

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V. Administration (D-6000)

A. Methods of Administration (D-6100)

The State agency will provide for such methods of administration asare found necessary for the proper and efficient operation of theplan. as set forth in Handbook Supplement D.

B. Social Services (D-6200)

1. The State agency will provide for the development of necessary socialservices to the end that, by July 1, 1975, families and individualsincluded in the plan will have (a) needed assistance in having accessto and making maximum and appropriate use of medica 1 care and ser-vices, and (b) rehabilitation and other services to assist them inattaining or retaining capability for independence or self-care tothe fullest possible extent.

2. With respect to social services in relation to family planning,there will be freedom from coercion or pressure of mind and conscienceand freedom of choice of method, so that individuals çan choose inaçcordance with the dictates of their consciences.

Relationshi~ With Health and Vocational Rehabilitation A~enciesr*)

(D-6300)

1. The State agency will make written agreements with State healthand State vocational rehabilitation agencies (including agencieswhich administer or supervise a health or vocational rehabilitationservice) which clearly establish the working relationship betweenthe agencies involved.

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~y'~¡' C\ 2. The following is a description of the cooperative arrangement8 withL ~ I the State health and State vocational rehabilitation agencies by

\\\ ~ Iv" means of which the aervices administered Or supervised by those~~ \~~ agencies will be utilized to the maximum degree and will be coordinated

X / v" with the medical care and services provided by the State agency under~~'~t. the plan:(y' a. The working agreement with the Division of Vocational Rehabili-

tation i8 attached hereto and made a part of the State plan.

b. An, agreement with the State Department of Health has not beenformlized with regard to overall working relationships. Directservicè8 provided by the health department are few and are avail-able to all citizens of the state and do not exclude recipientsof medical assistance. M4tters of joint concern have always beenhandled on an informl cooperative basis both at the seate ad-ministrative level and at the county welfare board - public healthnurse level in the various counties within the state.

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3. The State agency will also enter int,o an agreement with the StateDepartment of Health under which the Department of Health will provideconsultative services to hospitals, nursing homes, home. health agencies,

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clinics, laboratories, and such other institutions as the Secretarymay specify in order to assist them (a) to qualify for paymentsunder the Social Security Act, (b) to establish and maintain suchrecords as may be necessary for the proper and efficient admin~.istration of the Social Security Act, and (c) to provide informtionneeded to determine payments due under the Act on account of careand services furnished to individuals.

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STATE PLA FOR

MEICAL ASSISTANCE UNER TITL XI

OF THE SOCIAL SECURITY ACT

State of NORTH DAKOTA

Plan Amendment: Interrelations with State Health and S"tateVocational Ræha~11itntion ARenc1es, and~~th Title V Grantees; 45 CPR 251.10;SRS Pro6riu Regiation 40~i9, January 20, ,,1971

i. The State agency wil make cooperat1 ve aranements with .State health and State vocational rehabilitation agencies

(including ageneies Whieh adnister or supervse healthurvocational rehabilitation servces) diected toard maxutilization of such servces in the provsion ot medical 'assistance under the plan.. Attached are descriptions ot thecooperative arranements.

2. The State agency will make cooperative aranements withgrantees under title V of the Social Security Act to providefor utUizin such grantee agencies in 1'nish~; to medicalassistance recipients, care and servces ~nich are avaiaòleunder title V plans or projects and are included in the Sta.teplan for title XIX. Such aranements wi include, where re-quested by' the title V grantee, prosion for reimbus~ theti tle V grantee for cere or servces t\sbed by or througsuch grantee to individuas elgible therefor under the title XIplan, and wi be in iritin.

3. The arranemnts 'Wth State health and State vocationarebab111 tat10n agencies, and 'Wth title V grantees that requatprovsion tor re1mbuaement wi inlude lo deacript10nl aeapproria.te, or the 1tei "Pec1t 1i 45 en 251.10(&)(3).

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4. provide for methods .and procedures in accordance with 45 eFR 250.23(a)(4)which will assure that requirements for content, prompt submittal andprocessing of reports are met and that the State aaency takes appropriatefollow-up action. .

'Tis State plan ino1udes medical assistance in behalf of individuals 65 'years of ase or older who are patients in institutions for mente. disease8.

il YE* UNO*Effective Hay 3, 1971 , 'Wth respect to such patients eligibleunder the State plan 'Wo are ø.tted to a mental hospital or who makeapplication for assistance under the plan While in such a hospital, theState ßßency will:

1. provide for a medical revie'" (includig medical eve.uation) of theneed for care in such a hospital, and a written plan of care. Suchreview eid plan will be made by the patient i s attending physicianor the hospi taJ staff physician. Methods and procedures -dll befollowed in each case 'Wich assure that, prior to adssion or toauthorization of payment, as appropriate, the requrements of 45eFR 250.23(a) (1) with respect to comlete medical evaluation, planof care, and .psychiatric and soe1al evaluations are met.

2. provide for periodic inspections, to be made in al mental hospi talacaring for such patients, by one or more med:lcR. review teams 'Wichare composed of one or more psychiatrists or physicians knowledgeableabout mental institutions and other appropriate ment.al health andsocial servce personnel, fUction under. the physician, member i.supervsion, and have no members wo have a financial, interest inany mental ~nst1tution or are emloyed by a mental institutionreviewed by the te8i on which they aerv.

3. provide for methods an procedures' in accordance with 45 CF 250.23(&) (3),'Wch will auure that:&. inspections can be iiade at appropriate intervals in al mental

hospitals caring for such patients, with at least one inspectionmade in each facilty by May 3, 1972 and thereafter at interv.determied by the tea for a facility in the llt of the qua':U:tyof care rendered and the condtions ot patient. ear for underthe pl&D,wt not leii otten than a:uay;

b. no physician mem~ of a team 1icta the car ot patients fol''Wom be i. at'tend pbaiciai;

c. no £&0 11 i 't i. notifed ot inspetion more thm 48 hou. Dereteam a.l vaJ; ai , ' .Ii'.:.ii. .'j d· C.;~, ;'.!7/- i,' ___l -' t'. :' '. ,.K;ro_: 7/

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d. the inspection includes review of each such patient i s medicalrecord, if it contais the periodic assessments req\ired bysection i9Q2 (a) (20) of the Social Secuity Act, or in the absenceor inadequacy of such assessments, personal contact with andobservation of each patient.

4. provide for methods and procedures in accordace with 45 eFR 250.23(a)(4)which will a86ure that requements tor content, prompt Bub.mttal andproceulng or reprt. a:e met ai that the State e¡enc; tak. approriatttoUov-up action.

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D. Standard-Settini; Authority for Institution (D-6400)

1. The following are the types or kinds of institutions in whichmedical care and services may be provided under the plan bysuch institutions:

a. Hospitals

b. Nursing Homes - Public or private skilled nursing homes thatare licensed as such by the officially designated Statestandard-setting authority and in addition have been deter-mined to meet the requirements for skilled nurs ing homs asspecified in SRS Program Regula tions 40-11 and 40- 12 (C-L) .

c. State Hospital

d. Tuberculosis Hospital

2. The types of institutions specified above are subject to thefollowing standard-setting authority:

a. State Health Department

The following citations to State legislation show (a) that theauthority i8 a State authoritYt as distinguished from a localauthority; and (b) that the authority is empowered and hasthe duty to establish and maintain standards for the types ofinstitutions where medical care and services may be providedunder the State plan as contained in the standards attachedhereto.

3. Attached, and made a part hereof. is a copy of the s tends rdsto be utilized by such State authority for these medical in-stitutionst which include standards related to the factorsspecified in 0-6420, item 3.

4. The State agency will provide for cooperative arrangements withthe standard-.etttn authori ty to upgrade and extend neededin~titutional care.

E. Consultative Servces to Medical Institutions (PR 40-17)

1. The State Title XIX Flan will provide for consultative servicesby health agencies and other appropriate agencies of the Stateto hospital.. nursing homst home health agenciest clinics andlaboratories in order to assist such facilities to:

8. Qualify for payments under the Soeial Security Act.

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Establish and maintain such fiscal records as may benecessary for the proper and efficient administrationof the Act.

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Frovide informtion needed to determine paymnts due underthe Act for care and services furnished to indlviduals.

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2. S~ilar services may also be provided to other types offacilitiea specified in plans which provide medical care toindividuals made under payment of the Social Security Act.

F. Fair Hearin~$ (D-6500)

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74-12.

1. The State agency will be responsible for fulfillment of fairhearings provisions; the hearing authority will be appealsreferee for the Public Welfare Board of North Dakota.

2. An opportunity for a fair hearing before the State agency willbe granted to any individual requesting a hearing becaUSe hisclaim for medical assistance is denied, 1s not acted upon withreasonable promptness, or because he is aggrieved by any otheragency action affecting his receipt of medical assistance orby agency policy as it affects his situation.

3. Decisions by the hearing authority rendered in the name of theState agency will be binding on the State and local agency.

4. The hearings will be conducted by an impartial official of theState agency.

5. Hearings procedures will be issued and publicized, by the Stateagency, for the guidance, of all concerned.

6. Every individual will be informed in writing: Of his right toand the method for obtaining a fair hearing; that he may berepresented by others, including lega 1 counse 1; and of theState's provision for legal fees, when applicable.

7. The hearing will be conducted at a time, date, and place con-venient to the claimnt, and adequate preliminary writtennotice will be given.

8. When the hearing involves medical issues, a medical assessmentother than that of the person or persons involved in makingthe original decision will be obtained and made a part of therecord if the hearing officer or appellant eonsiders itneceiisary.

9. Prompt, definitive, and final administrative action will betaken within 90 day. between the request for a fair hearingand the rendering of the decision in the nae of the Stateagency, and the clàimnt will be notified of the decisionand, to the extent it is available to htm, of his right tojudicial review.

10. The claimant will have the opportunity (a) to examine all docu.ments and records used at the hearing; (b) at his option, topresent his case himself or with the aid of others, includinglegal counsel; (c) to bring witnesaes; (d) to establish allpertinent facti and circumstances; (e) to advance any arguments~ithout undue interference; and (f) to question or refute any

,~e'ttmony Or evidence.

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11. The verbat~ transcript of testimony and exhibits. Or an offi-cia 1 report by the hearing officer. containing the substanceof what transpired at the hearing, together with all papersand requests filed in the proceeding, and the hearing officer' 8or panel's recomendation. will constitute the exclusive recordfor decision and will be available to the claimant at any

. reasonable time.

G. Safe~uardin~ Information (D-6600)

l. Pursuant to State statute which imposes adequate legal sanctions:

a. The use or disclosure of informtion concerning applicantsand recipients will be limited to purposes directly con-nected with the administration of the medical assistanceprogram;

b. The State agency has authority to implement and enforce theprovisions for safeguarding informtion about applicantsand recipients; ând

c. Publication of lists or names of applicants and recipientswili be prohibited.

2. The State agency will provide clearly defined criteria whichgovern (a) the types òf informtion that are safegurded, and(b) the conditions under which such informtion may be releasedand used.

3. The State agency will publish provisions governing the confi-dential nature of informtion about applicants and recipients,including the legal sanctions imposed for improper disclosureand use.

4. All ma terial sent or d is tributed to applicants" recipients ormedical vendors will De directly related to the administrationof

' the medical assistance program and will not have political

implications.

H. ~e~ort. and Maintenance of Record. (D-6700)

1. 'l. State .seney will maintain administrative and case record...ceasary for the proper and efficient operation of the plan,including recorda regarding applications. determination ofeligibility, and the provision of medical assistance and socialservces; and atatistical, fiica1 and other records necessaryfor reporting and accountability required by the Secretary.

2. The State agency will make such report., in such form and cOn-taining such info~tlon. as the Secretary may from time totim require, and comply with such provisions as he may frotime to time find necessary to assure the correctness andverification of such reports.

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....

V-5

I. Fraud (PR 40-14)

1. The State agency will establish and maintain methods and criteriafor identifying situations in which a question of fraud in theprogram may exist.

2. The State agency will establish and maintain procedures developedin cooperation with State legal authorities for referring to lawenforcement officials, situations in which there is valid reasonto suspect that fraud has been practiced.

3. The State agency will provide for methods of investigation ofs1 tuat10ns in which there is a question of fraud that do notinfringe on the legal rights of persons involved and are consis-tent with principles recognized as affording due process of law.

4. The State agency will provide for staff positions that areresponsible for referring situations involving suspected fraudto the proper authorities.

5. The State agency will establish and maintain procedures,effective January I, 1970, for reporting promptly to SRS eachcase of suspected fraud by a provider which has been referredby the State or local agency to law enforcement officials forappropriate action and for reporting subsequently the disposi-tion thereof by such law enforcement officials.

6. The State agency will provide for imprinting on all providerclatm form statements, or alternate wording approved by thesas Regional Comssioner, required by part 250.80 of theFederal Register.

J. Internal Revenue Report1n~ Requirements (PR 40-15)

1. The State agency will provide for identification of providersof service by social security number or by employer identifi-cation.

2. The State agency will comply with informtion reporting require-ments of the Internl Revenue Code (Title 26 U.S.C. 6041).

3. The State agency will establish a basis for verifying withrecipients whether services billed by providers were actuallyrecd ved.

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- I). D... r .J.. 40-14 (C-l)

TITLE 45 - l'LIC v1EARCHAPER II - SOC!A AN REH1LITATION SERICE

(AS~ISTANCE PROGRA), ,DEPAR'lT OF H:m, EDUCATION, .AD WEFAR

'PART 2;0 - AmINISTRON OF MEICAL ASSISTANCE PROGRA

Freid :i the Medical Assistance Prgram

,Interim policy which sets forth regutions to imlement Section

1902 (a)( 4 )(A) of 'the Social Secuity Act with respect to i'au

in, the Medica. Assistance Prgram wa pulished in the Federal

Register ot December 17, 1969 (34 r .R. 1975). AfercoZUider.....

tion of views prsented by interested perøona, the fOl."

ches in the reguations were made:

1. Interim polley Section 250.80(a)(4) hu been revied

to indicate that states, in reprtin eac cue oti

suspected traud by a provider whch ha been referd

to UV enforcemt oi'cials, shal 1dent1i the pr-

vide by a numberin sTstem 'Woh does not diøclose'f

the Id.t1't ot the prr, uness the Social aD

Rebabil~ation Servce spc11ca. requests web . ,

disclosue. (See Section 250.80( d) (i) .)

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,

2. Inte polie; Section 250.80(a)(5) ha been amde to' ;

,

IiL 'I,

a1 Ul alternti V& metbd tor certification ''b pr- ',' .

t- ",

Ti. rear ;pti ot their cla..' A statemt, '

.oIM") lo to th an re~4 on the el.,,., foru em~

ft_ ",.~ e.-.. ',' . .

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P.k. 40-14(C-1)..

1rs-;ead be l':,inted abo..e the claiant's endorsement on

the reverse of checks or warrants payable to a.

providers. (See Section 2;0. Bo( e) (2) . )

3. A requirement for a system to verify that servces biled

were received by clients, published Febru 28, 1970

(35 F .R. 3898) as part of 'te interim poliey on inorm-

tion reporting requements, is incorprated in this

regulation (Section 250.8o(r)' as a more apppriate

location.

AeeordilY, the reguations as 80 amended and set fort below ar

hereby cod1ed &s Seeti~n 2;0.80" of' Chçter II of Title 45 ot

the Code of Federal Reguations.

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.. P.R. 40..i4(C.l)

1250.80 Fraud in the medical assistance program.

State plan requirements. A state plan tor medical assistance

under t~tle XIX of the Social Secuity Act must:

"

(a.) Provide that the State agency will establish and

mantain (1) methods ànd criteria for identity

situations in which a question offrøud in the

program me. exst, and (2) procedes developed in

cooperation with State legal authoTities for

referring to law enforcemnt of'fieiali s1 tuations

in whch there is valid reuon to suspect that

fraud has been practiced. The-defition ot :faud

accordce wi tb stete law.

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for puses of' ths section wi be determed in

(b) Prde for methods ot investiaa.tion ot situtionsin whch there ii a question ot trau that do not

inine on the legal rigts ot perlOnB involved

and s.e consistent with principles recogzed as

a:tordi due proc... ot la. ' '

(~) . Pidl that th State aae~9Y wi deii¡te posi-

, :',: tfØl that ar Tespnaible tor rete~ d tuations- 'bni~ -u~edt.aùd' to' ~~"~ autbritiei.

113 -11"''' " Al_ ~ '" r./,,,

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....

- 2 -

.. P.R. 40"4(C-l)

(d) Prcv:de tha.t the Ste;';e aeency will establish and

mairitdn proced.ures for reprting proirptly to the

Social and Rehabilitation Servce (1) by a numberin

system which does not disclose identity of the

providcr (uness the Social and Rehabiltation

Servce ~ecifica1 requests such di8clo~e) each

case of suspected fre:d by a provider whch ha.s been

referred by the State or local sgencyto law enforce-

ment of'ic1aJs tor çpropriate action an subsequentJ

(2) the disposition thereot by such la.w e.orce:t

ottc1ell.

(e) (1) Prvide for the follow stateents (oralternate wordi approved by the Social cd

RehbUita:t1on Semce Regional Cossioner)

to be imrited in bod-face tye on al

proder c1a1 torm abe the c1a1t' isigat\Ue:

(i) "'la ii to cerif that the foregoininormtion ii tré.., accuate, and comlete."

- "I underitand tht pamt an satisfactionot ths cl w1 be fr Fedeal an statetw, aD tht ar talie c1ai, itatemta,or docuts, or concealnt at .. material,'tac, JU ~ proiecute unclr aplicable,'eder&1 or Stat. las"; 'or- a:terti~, '

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(2) Prde tor the rOl1ow.ng worcl to appear on the

reverse of checks (or ,al.ll4ants) payable to aU

providers above thi: cl~.ii6Jt' s endorsement:

"i understend tbs.t endorsement hereon ordeposit to the accounts of the' wi tbinname payee is done. with the understand-

in that payment will be frm Federe.and state fuds and that e. false clais,stateints, or docuents, or concealentot a materi&1 tact, m8 be prsecuted widerappcable Federal or state laws."

(r) Prvide for establishin a basis for verifYng 'Wth

recipients wether servces b1Jed by providers were.

actu received. Such basis i: be by random sa.e

of patients for eac provider who ii paid signficant

amunts under the prgram and for grous ot providers, j,

f

none of 'Wom receive a signficent amt.

Etfective date: The reguations set forth abo shall be ef'ective

on dAte of publication in the Federal Register, except tor section

2;o.80(d) and (e) whch shal become ef'~ctive l2 dai e.er date

ot publication.

(See. 1l02, 49 Stat. 647, 42 U.S.C. 13()

~-~

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DA: Feb. 16. 1911

!

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1

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/1/ John D. TwamAdmstrator, Socal an

Rehbiltation Serce

APVE: Ma 17, 1m ~

/./ El L. ~~:1¿:'ø:='Secret8. . .

li-ii-

.. .

.o--Social Work MaualChapter 305

AID TO AGED, BUN,OR DISAB LED PROGRA

50-24-0150-24-0250-24-0350-24-03.1 -50- 24- 0550- 24- 0650-24-0750-24-0850- 24- 0950- 24-10-50- 24- 1150-24-1250- 24-1350-24-1450-24-1550-24-1650-24-17

50-24-1850-24- 19

50-24-2050-24-2150- 24- 2250-24-2350-24-2550-24-2650-24-2750-24-285Q-24-29,

50-24-3050-24-3150- 24- 32

50..24-33 ..

50-24-3450-24-35

to. CHAPER CONTENT

ChpterContents

!:305- i305- 2

305- 3

305-4305-4305-5305-5305- 5

305-6305-6305-6305-6305- 7

305- 8

305- 8

305- 8

305- 9

305- 9

305-10305-10305-10305- 11

305-11305-11305-11305-12305- 12

305..12305-12305-13

305-13

305- 14

305- 14

305-14

Defintions . . . .. .........Duties of state departent . . . . . . . . . . .Eligiility. . . . . .. ... ...How residence in state lost. . . . .. ...Application for assistae. ... ....Investigations of applications . .'. . . . . . . .

Power of state and county agertcies on investigation. . .

Blid aid u Examnation. . . . . . . . . .Supplementary servces -- When provided. . . .Denial or withdrawal of assistance when tratment refusedFindigs of county agency on investigation. . . .

Amount of aid - - Detennination . . . . . . . . .Owership of propert --Transfer in trt. . . . . ;Life inurance policy-- Agement for payment of premiumsHomestead of applicant for assistace not encumred. .Rejection of application-- Notice of.. Contents . .Power of state departent to change determtion ofcounty agency . . . . . . . . . . . .. . . .Appeal to state departent-.. When taken . . . .

Appeal..How heard . . . . . . . . . . . . .County share of assistace . ... ...How county's share paid. . . .. .....COWlty appropriation. . . . . . . . . . .When county's share of fud furnshed by state

Indis -- When state fuds used . . . . . . . . .Welfare special fund . . . . . . . . . . . . .Disbursements for assistance to the aged, blid, or disabledPerson hadlig money to fush bond . . . . . . .Recovery of assistace to the aged, blid, or disabled

from person liable for support. . . .. ...Autority to compromise and sette . . . . . .Confdenti character of records-- Penal. . . . . .Recipient to noti the state departent of receipt of

proprt or income-- Assistance altered or canceled . .

Recovery from estate of recipient of assistace to theaged, bli, or disabled. . . . . . . . . . . .Division of monies received . . . . . . . . . .Guardian appointed- - Payments to guia. . . .

Social Service Board

of North DakotaTranmitted by

Maual Lettr #847

November, 1971

305- i

..

..Socia Work MauaChapter 305

AID TO AGED, BLI,OR DISABLED PROGRA

ChapterContents

.

50.24..3650-24-3750-U-3850-24-3950-24-4050-24-41

Aid not assigntblenCashig checks afr death of payee .No fees to be chaged. . . + . . . . . . .Statute of litations shall not run . . . . . . . .Fraudulent acts" Penalty. . + . .. ....Litations of chapter. .. . . . .Suspension of chapter. . . . . . . . .

305-14305-14305-14305-14305-15305-15

..+

Novembr. 1971 Transmitted by

Mauall£tter #847Social Servce Boa

of Nort Dakota

305- il

*.. . 11

-. .-4 ..

Social Work MauaChapter 305

AI TO AGED. BUN,OR DISABLED PROORAM

SOURCE: Nort DaotaCentur Cod

( AI 70 AGED, BUN, OR DISABLED PROGRAM(Heading of Code Chapter 50.24)

50-24-01. Definitions.-- In ths chapter, uness the context or subject mattrotherwse requires:

1. "State departent" shall mean the Public Welfare Board of Nort Dakota;

2. "County agency" shall mean the coUnty we"l!are bord of each of theseveral counties of the state;

3. "Applicant" shall mean a person who has applied for assistace under ths

chapter; ..4. "Recipient" shall mean a person who has received assistace under the

terms of ths chapter;

5. "Assistace" shall mean money payments to or good or servces provided

for recipients uner the terms of ths chapter;

6. "Assistance to the aged. blid, or disabled" shall mean money payment toor in behalf of persons eligile under the provisions of ths chapter an thservces that will improve thir weU.being and aid them in increasing thir

capability tor self-care, self-support. and self-relice; th term "assistaceto aged, blid. or disabled" shall be understoo and interpreted as a

general term referrg. to "old age assistace", "aid to th blid", and "aidto th pennnently and totally disabled"; (S. L. 1971, ch. 470, 8.1.)

7. tlOld Ag Assistance" shall mean money payments to or goo and servcesprovided to or in behalf of needy aged persons;

8. "Aid to th Blid" shall mean money payments to or go and servces toor in beha of needy blid;

9. "Aid to th Permanently and Totally Disabled" shall mean money paymntsto or goo an servces provided to or in behalf of needy persons deter-mfed to be permanenty and'totlly disabled;

Social Servce Bordof North Daota

Transmitted by

Maual.tter #847Novembr, 1971

305- i

..

--

Social Work ManualChapter 305

AID TO AGED, BLL'I,OR DISABLED PROGRAM

SOURCE: Nort DaotaCentury Code

50-24.02. Duties of stâte department. d The state departent shall:

1. Take such action and make such ruls and reguations as may become

necessary to entitle the state to receive aid from the federal governeiÍtfor assistace for the aged, blid, and disabled in Nort Dakota;

2. Supervise the adminstration of the assistace for th aged, blid, or

disabled throughout ths state;

3. Take such action, give such directions, and promulte such rues and

regutions as may be necessary or desirable to carr out the provisionsof ths chapter, includig the adoption and application of suitale stand-

ards and procedures "to inure unform and equitable treatment of allapplicats;

4. Cooperate with the federal governent in matters of mutual concernpertini to assistace for the aged, blid or disabled, includig the

adoption of such method of adminstration as are found by the federalgovernent to be necessary for the effcient opration of the progrm;

5. Provide such qualified employees and representatives as may be

necessary;

6. Prescri the form of and print for and supply to the COWlty agencies

blanks for applications. reports, and such other forms as it may deemnecessary and advisable;

7. Have authority to establish and maintain personnel stards on a merit

basis for personnel employed by the state and county public assistaceagencies not covered by a state'.vidc merit systemj".

8. Make such reports in suchfederal governent. from time to time, may require;

9. Comply with such provisions, rues and regulations as the federalgovernent, from tie to time, may find it necessary to require;

10. Publish a biennal report and such interim reports as may be deemed

necessary; and

1 1. Administer all fuds appropriated or made availale to it for the purposeof carryng out the provisions of ths chapter.

Novembr. 1971 Transmitted by

Manual Letter #847Social Service Board

of Nort Dakota305-2 ,

Social Work MaualChapter 305

""..AI TO AGED, BUND,

OR DISABLED PROGRASOURCE: Nort Daota

Century Cod

50-24:.-03. Eligiility. -- Assistance shall be grted under ths chapter to anyperson who shall meet th followig requirements:

1. Has resided ten years in the United States, or is a citin of the United

States.

2. Has not sufcient income or other resources to provide a reasonale

subsistence compatile with decency and health.

3. Has no chld or other relative of sufcient ficial ability to support

mm who is responsible under the law for his support, provided, however,tht if such child or other relative refused or neglects to provide

necessary assistace, such refual or neglect sha not make such ap-

plicant ineligile for assistace to the aged, blid or disabled.

4. Has not at any time before or afr mag application for assistae to

th aged, blid or disabled made an assignent or transfer of propert

for th purpose of renderig hiself eligile for assistace unr ths

pian.

5. Is not a patient in any medical intitution as a result of a diagnosis of

turculosis or psyhosis with respect to an period afr th recipient

has been a patient in a medical instituon as a result of such dignosisfor fort-two days.

6. Is notan inte of, nor bein maintad by any muncipal, state or

national intituton at the time of receivi assistace~ provided,however, tht th state departent sha have autority to mak pay-ments as provided in ths chapter to residents of such public institutionsas are approved by the state departent.

7. Applicants for old age assistae sha in addtion have attd th

age of six-five yeas. A county in whch an applicant has residece

for poor relief puroses will be ficialy responsible for th county- s

sha of any assistace provided under ths chapter. (S.1. 1971, ch.471, I. 1.)

Social Servce Bordof Noxt Dakota

Tranmitted byMaua Ùltter #847

Novembr, 1971

305- 3

..

..Social Work MaualChapter 305

AI TO AGED, BUìio,OR DISABLED PROORAM

SOURCE: Nort DaotaCentuJ. Code

8. Or applicants for-aid to the blind shall in addition have;

a. No vision or vision with correctig glasses is so defective as to pre-

'vent the perfonnance of ordinary activities for which eyesight isessential.

9. Or applicants for aid to th pennanently and toty diabled shall in

addition have:

a. Attaned the age of eighteen years.

b. Been detenned J. the maer prescrid in federa regutions tobe pennanently ånd totaly disabled.

c. A county in which an applicant has residence for poor relief purposes

will be ficially responsible for the county's sha of any assistaceprovided wider ths chater. (5. L. 1971, ch. 471, 8.2.)

50-24-03. 1. How residence in state lost. n If any person not receivig publicassistace but havi legal residence in ths state for poor relief puroses voluntariymoves from ths state, lûs residence for public assistace purses is lost, destroyedor defeated in the same maner and upon like conditions as the residence of a personÙ1 that state voltmtarily moved to tls state would be lost. destroyed or defeated.

A legal resident of ths state receivig public assistace who voluntarily moves fromths state continues to be eligile for public assistace on a residence basis fromths state unti he becomes eligile in the state to which he moves, uness the other

state does not have a public assistace program for which he is eligile. In ths

event, eligiility contiues for one year afer he moves from ths state. A personnot a legal resident receivig public assistace from ths state loses eliility for

public assistace upon voluntarily movig from tls state.

5O-24"05.~plication for assistace. -- An application for assistace to theaged. blid, or disabled under th provisions of tls chapter shall be made to the

county agency of the county in whch th applicant resides. It shall be in wrtig or

reduced to wrtig in the manr and upon the fonn prescrid by the state depart..ment and shall be ver1ed by the oath of the applicat. The application sha conta:

1. A statement of the amount of propert, both persona and real, which

th applicant ow or in which he has an interest;

2. A statement of all the income whch the applicant has at th time of the

filg of the applications; and

3. Such other 1nomiation as may be prescribd by the state departent.

November, 1971 Transmitted by

Manual Letter #84iSocial Service Board

of Nort Dakota305-4

k: '. tf

.... .. "4..

Social Work MaualChapter 305

AI TO AGED, BUN,OR DISABLED PROGRA

SOURCE: Nort DakotaCentury Code

50-24-06. Inveltgations of al'plications. h Whenever a county agency receives

an application for assistace to the aged, blid, or disabled, an investigation of the

circumstaces of the applica,nt shall be made to ascert:

L ' The facts supportng the application; and

2. Such other inonnation as may be required by the state departent.

If the county agency believes that, assistace has become necessary byreason of the action of any person contrary to law, the agency shaadvise the state's attorney of the fact and sha give to hi the na ornames of the offendig person or persons together with their last knownaddress. ..

50-24-07. Power of state an county agencies on investigation. -- Th eountyagency and state departent and the offcers and autorid employees thereof autor-ized to make investigations under the provisions of ths chapter shall have th poerto:

1. Conduct exmintions ~

2. Require the attendace of witnesses and the production of books. records,

and papers; and

3. Make application to the mstriet cour of the county to compel the atten-dace of witnsses and the production of books, records. and papers.Th offcers and employees designted by the county agency and the statedepartent also may admster oaths and atations.

50-24-08. Bld aid--Exintion. -- No application for aid to the blid underthe provisions of ths chpter shall be approved unl the applicant has been exdby an ophthologist. physicia skilled in th diseases of the eye, or optometristdesignted or approved by the state departent to mak exations. The ex..ing ophthOlOgist, physicia skill in th diseases of the eye, or optometrst shacert in wrtig, upon forms provided by th state departent, the findigs of the

ext1æ. A recipien of aid to the blid mider the proVisions of ths chapter shalsi.ìt to a re"exåmIition as to his eyesight when rèquired fo do so hy the stare,de-

paent. He alo shal fush any inormtion req\.red by the state depaent.

Social Service Bordat Nort DakQta

Transmitted""by'Manual Letter #847

" ,No'vembr. 1971

305~ 5

#

..Socia Work MaualChapter 305

AID TO AGED. BUN.OR DISABLED PROGRAM

SOURCE: Nort DaotaCentury Code

50.24-09. Sup~lementli' servces u When provided. -- On the basis of thefindis of the exmiation made by the ophthlmologist, or physician skilled in thediseases of the eye, supplementary ,services may be provided by the state departentto any applicant or recipient of assistace under th age of sixty-five who 1sm needof treatment either to prevent blidness or to restore lúe eyesight whethr or not he isblid as defied in subsection Sa of Section 50-24-03, if he otherwse is qualified for

assistance under ths chapter. The supplementary servces may include necessary

travelig and other expenses to receive treatment from a høsp,ital or clic designtedby the state departent.

50-24-10. Denil or withdrawal of assistace when tratment refused. -- As-sistace to the blind or totally and pennanently disabled may be d1ed to, or havingbeen granted, may be withdrawn fÎom any persoT'. who refuses medical, surgical, or

other tratment when such person. or We eyesight, may be restored partally orwholly by such treatment, and a certcate in wrti to tht effect is made by ~ ex-

amg ophthlmologist or physician, as th case may be. Any person who is deniedassistace or whose assistace is withdrawn upon ths groun may appeal to th statedepartent in the manner provided in sections 50-24-18 and 50-24-19.

50-24-11. Findings of county agency on investigation. -- The county agency,upon completion of the investigation of an application for assistace to the aged, bli.

or disabled shall determe in accordce with its fidigs whether or not the

applicant is eligible for assistace and shall make a wrttn order. in duplicate, to theeffect tht the application be allowd or rejected. A copy of the fidigs and order ofth,e county agency shall be transmitted fortwith to the state departent. If the county

agency finds that th application should be allowed, it shall, on applications except

those for medical assistance for the aged, attch to its order a certficate of eligiility

set:g fort the amount of monthly assistace which it finds the applicant is entitledto receive and the date upon which assistace is to begin.

50-24-12. Amoun of aid -- Detenntion. -- The amount of assistace towlùch any person sha be entitled under th provisions of ths chapter sha bedetermned with due regard to th follow

1. The resources of the individual, includig any income and propert tht

he may have and any support he may receive from other sources;

2. The necessary expendtures of the invidual; and

3. The rules, regutions, and directions which the state departent may

fid necessary to prescri.

November. 1971 Transmitted by

Maual Letter #847Socal Servce Board

of Nort Dakota305..6

....~,;-,-"r "

--.Social Work ManualChapter 305

AID TO AGED. BLI,OR DISABLED PROGRAM

SOURCE: Nort DakotaCentury Code

Such amowi shall be sllcient. when added to all other income and resources of the

recipient. to provide suc person with a reasonale subsistence compatile withdecency and health.

50,24-13. Owership of Prop~- Trafer in Trust. u Th owrship ofreal or personal propert by an applicant for assistace to the aged. blid. or

disabled, or by the spouse of such applicant. eithr individually or jointly, or ofinsurance on the ile of the applicant. shall not prec~ude the grtig of such '

assistace if the applicant is wlthout fuds for.hs support. Howver, as a conditionto the grant of old age assistace, aid to the blid. or aid to the pennently andtotally disabled, the applicant shall be required to tranfer such propert in trt by

approprite instruent as securty for assistance payments the applicant may

thereafter receive, uness the propert consists of the followg:

1. A homestead;

2. A life inurance policy having a cash surrender value of less th the

hundred dollrs; or

3. Personal propert of a value less thn the hundrd dollrs, not .includig household gos, wearing apparel and persona effcts, such

as money. or

4. Propert selected by the applicant having a value of less th three

hundrd dollrs;

5. Real or personal propert held in trust for the applicat by the federalgovernent;

6. Rea or persona propert on wmch th taki of securty may be prohi-ited throug legislation enacted by the Congress of the UlÙted States.(S. L. 1911, ch. 470, §.2.)

Social Service Bordof Nort Dakota

Transmitted by

Maual lAttr #847

Novembr, 1971

305-7

""

...

Social Work ManualChapter 305

AID TO AGED, BUN,OR DISABLED PROORAM

SOURCE: Nort DakotaCentury Code

50-24 -14. Life insurafce policy.. Agrement for payment of premiums.--If an applicant for old age assistace, aid to the blid, or aid to the permanently and

totally disabled, under the provisiol)sof ths chapter, has a policy of insurance or a

fraternl beneficiary cenuicate on his lue and ü such policy or beneficiary certicate

has a surrender value less th that stated or has no cash surrndr value at all, th

county agency may recommend and the state departent may authorie premiumsupon such insurance policy or beneficiary certicate to be paid out of assistace

payments. Such agencies may enter into such arrangemen.ts with the insurd as shaLl.protect the interests of the insured and the interests of the state and assure repay-ment to the state, upon the death of the insured, of not less th the premium~..payments so made afer funeral expenses of not to exceed ~ hundred and fidollrs have been paid. (d'i / f. f, ¿!, .;.. .i)

...

50- 24- 15. Homestead of applicant for assistace not encumred. u Anapplicant for assistace to the aged, blid, or disabled under th provisions of ths

chapter in no case shall be required to transfer a homestead occupied by hi assuch uness he or she desires to do so. A recipient of old age assistace, aid tothe blid, or aid to the permanently and totaly disabled sha nol be permtted toencwnr or convey such homestead without the approval in wrtig of the statedepartent. Whn an application for old age assistace, aid to th blid. or aidto th permanently and totay disabled is granted and it appears tht the applicantoccupies a homestead, which he ows, th state departent sha caus to be

recorded. in the offce of the register of deeds of the county in whch such home-stead is located. a statement in wrting to th effect tht the owner of such

homestead is receiving or is about to receive assistace payments. Such wrttenstatement shall be signed by the executve director of th state departent.

Afr the recordg of such statement, any instrent of conveyance or

enci.rance exei.¡,-ted by such applicant for assistace without th approval ofthe state departent shall be nul and void. No fee shall be charged by the register

of deeds for recording such statement. Ths section shall not apply to an applicantor recipient of assistace to th aged, blid. or disabled who ows a homestead

which is held in trt for hi by the federal governent. (S.1. 1971, ch. 470. S. 3.)

50-24-16. Rejection of appllcationuNotice of--Contents.-- If the countyagency upon investigation of an application for assistace to the aged, blind. or

disabled. finds that the application should be rejected, it forthwith shall noti the

applicant in writing of its decision. The notice to the applicant also shall statethat he may appeal from the findings of the county agency to the state departentwitln thirt days from the receipt by the applicant of such written notice and that

such appeal may be taken by filing a written notice of appeal with the county agency01' state departent.

l\ovembr, 1971 Transmitted by

Manual Lettr #847Social Service Board

of Nort Dakota305- 8

r

.. .- ..-4. . Social Work Maua

Chpter 305AID TO AGEDt BUN,

OR DISABLED PROORASOURCE: Nort Daota

Century Cod

50- 24-17. Powe& of state departent to change determtion of county

agency. -- The state deparnent shall have the fOllowg powers in regad to thereconsideraton of the chage in the amount of assistace to th aged. blid. or dis-

abled tht has been granted iider th provision of ths chapter:

1. To approve. mod, or reverse th findi of the county agecy;2. To return the application for assistae to the county agency for such

furter action or proceedigs as th s~te deparent may direci.3. To conduct a hearing or make or cause a furer investigation to be made;

4. To make such fial disposition of an application for assistace as in itsjudgment the ends of justice require;

5. On its ow motion, to reconsider any or al assistae grants made;6. To consider aI application upon which a decision has not been made by

the county agency with a reasonale time;7. To grant assistace where it has been refused or to chage the amount of

assistace, if afer furtr investigation it determes tht the ends of

justice so require; an8. To withdraw assistace if it is found tht th recip.intts circumstaes

have altered sufciently to wan-ant such action.

Whenever assistace is withdrawn, revoked. suspended, or in an way chad, t;

recipient sha be notied in wrting and thereupon sha have th right of a fa beargbefore the state departent in the same manner as a hearg is aforded upon anappeal from the decision of the county agency rejectig an application for assistace.

50-24-18. Appeal to state departent--When taen. u An applicant forassistace to the aged, blid, or disabled under th provisions of th chapter mayappeal to the state departent if:

1. An application Is not acted upon by the county agency with a reasonable

tie afer it is filed;2. Th applicaton Is denied; or3. Th applicat dems the alowance insufcient.

The appeal sha be tan by fig a wrttn notice with the county agency or sttedepartent

305-9

Socia Servce Boardof Nort Dakota

Transmittd byMaual Letter #847

Novembr. 1971

0#

..4

Social Work ManuaChapter 305

AID TO AGED, BLI,OR DISABLED PROGRAM

SOURCE: Nort DakotaCentury Code

50-24-19. Appeal-- H~w heard. -- Where an appeal is taen under thprovisions of Section 50-24-16, th state departent shall give the applicant anopportunty for a fair hearig. The state departent may designte some personto act as referee and take and certif evidence to the state departent. When anappeal is heard before a memr or membrs of the state departent, or a refereedesignated by such departent, such person or persons shall make findings in writig

and shall state the reason why the application should not be granted or rejected orchanged in amount, as the case may be, and report such fidings to the state depart-ment, together with all the evidence upon which the saie is based. The statedepartent may accept and approve such findings or reverse or modi the same orhear the matter anew or make such disposition of the appeal as the faCtS and the lawwarrant. If th decision of the deplrtent results in a denial of assistace or in adenial of the claim of th applicant in whole or in part, such appellt upon writtndemand shall be aforded a fair hearin before th departent. The decision of the

state departent shall be finl, and binding upon the county agency.

50-24-20. County share of assistace. -- Each county in ths state shallreimburse the state departent for amoWlts expended for assistace to the aged, bli,

or disabled in such county in excess of the amount provided by the federal governent,in the following percentages:

1. Aid to the pennanently and totally disabled u fifteen percent;2. Old age assistace -- ten percent;

3. Medical assistace for the aged -- ten percent;4. Aid to the blid -- none.

(

50-24-21. How county's share paid. -- The state departent shall keep recordsand accounts in relation to the expenditures for each program listed in Section50.24-20 in each COWlty in Nort Dakota. Clais for reimbursements shall be

presented by the state departent to the board of county commissioners at the end

of each calendar month. Th executive director of the state departent sha certto each county the total amount paid for each program to or on, behalf of persons intht county, and the countyt s share of such payments. The amount so certied shallbe paid to the treasurr of the state departent from the county trasur upon the auditand approval of the county auditor and the channan for the board of countycommissioners.

November, 1971 Transmitted by

Manual Letter #847

Social Servce Bordof Nort Dakota

305-10fI

d~

.,"".., ...

"

Social Work MauaChaeter 305

AID TO AGED, BUN,OR DISABLED PROGRA

SOURCE: Nort DakotaCentury Code

50-24-22. COl1appropriation. -- The board of county commissioners ineach county in ths state shall appropriate anually such sum as, in its judgment,may be needed to carry out the provisions of ths chapter. including expenses ofadministration based upon a budget prepared by the county welfare board, alr tag

into account state aid. and shall include in the ta levy for such coun the sum orsums appropriated for tht purpose. Should the sum SO appropriated, however. be

expended or exhusted durng the year and for the purpose for which it wasappropriated, additional sums shall be appropriated ,by the board of county Coms-sioners.

50- 24- 23. When county's share of fund furnshed by state. -- U th ficial

condition of any county is such that it canot make an appropriation or levy a ta forassistace to the aged, blid, or disabled, or canot legaly issue warrants in an

amount suficient tp provide the necessary fuds to comply Vnth the provisions of thschapter. the board of county commissioners shall report such fact to the statedepartent. The state departent shal mak, or cause to be made~ a cómplete

investigation of the fiancial condition of such county. U such investigation showsthat the COWlty canot appropriate funds or legay issue warrants or levy a ta in an

amount sufficient to provide the county's shar of fuds needed for the purses of thschapter in that county. the state departent may provide either as a grant or a8 .loan that county's share of fuds for the puroses of ths chapter or so muc thereofas may be necessary, from state funds appropriated to th state departent for th

puroses of ths chapter.

50~24-25. Indians --When state fuds used. -- Any county in which an Indian

reservation is located may apply to the state deparent for payment. out of statefunds. of the entire amount of aid paid towrd Indians residing in the county and on

the Indian reservation. The state departent sha make, or cause to be mae, acomplete investigation of the fincial condition of any county so applying, and if the

investigation shows tht the finial condition of the county is such that it woul be

inequitale to ask the county to contrute its sha or th amount necessar toprovide aid to such Indis the state departent may use funs approprited to thepublic welfare fu for aid to aged, bli, or disabled persons to pay such pa of

the costs of aid to such war Indian as is not pad by th federal goernent.

50-2..26. Welfs~c1al fud. -- All moneys received by the state depart-ment from any source for th purpose of carrg out the provisions of ths chaptersha be depoited in the state treasur to the credit of the welfare specia fund anshall be disbursed in th maer provided in section 50-06-14. (S.1- 1965, ch. 181,§. 22.)

Social Servce Bordof Nort Dakota

Transmitted by

Mauall£tter #:847

Novembr J 1971

305-11

..

-4

Social Work ManuaChapter 305

AID TO AGED, BUlU,OR DISABLED PROGRA

SOURCE: Nort DakotaCentury Code

50-24-2.. Disbursemetts for assistance to the aged. blid. or disabled uDisbursements for assistance under the provisions of ths chapter shall be made onlyfor the purposes of this chapter which shall include:

1. Payments to or on behalf of recipients of assistace;

2. Expnses of admistration of the assistace to the aged, blid. ordisabled pla in this state.

All disbursements for expenses of admistration sha be made in the manerprescrid by section 50-06-14. (S.1. 1965, ch. 181, I. 2..)

50-24-28. Person handli~oney to tUsh bond. -- The treasurer of thestate deparoent and al persons having any control over or who hadle any of themoneys for the purposes of ths chapter shall be bonded in such sum as the st&.tedepartent by resolution shall require. '

50-24-29. Recovery of assistance to the aged. blid. or disabled fromperson liable for support. -- If, at any tie during the contiuace of any allowancegranted under the provisions of ths chapter. it is ascertained that anyone who isliable for support and care of a recipient of assistance to the aged, blid. ordisabled is able to aford the necessary support or care of such recipient but faisand refuses to do so, there shall exist a cause of action for such assistance agatsuch person. The action shall be brought by the state's attorny of the county in thename of the county in which such assistace was granted and aganst the personliable for the support or care of the recipient of the assistance. The action shall bebrought for the recovery of the amoWlt of money with interest thereon paid to such:rcipient, together with the costs and di.sbursements of the action.

(

50-24-30. Authority to compromise and sette. -- The state departent shalhave the autority to enter the appearance of th state in any proceeding aiectingpropert upon which the state may, bye a cla for old-age assistace, aid to thblid, or aid to the pennently and totay disabled to prosecute and defend in any

such proceedigs. to institute probate proeedings as a creditor to deceased persons,and either in the course of or in the absence of and apar from any action orproceeding enter into any stipultion. compromise. settement or other agrementor arangement in respect to such cla as may seem wise, and to execute any such

stiultion, modifcation, quit clas, releases, paral releases, discharges.

exnsions. agrments. satisfactions. pa satisfations or subordintion orothr contracts or stipultion or agrement which th interest of the parts or thecircumstaces of the case may make advisable.

November, 1971 Transmitted by

Manual Lettr #847

Social Service Board

of Nort Dakota

305-12..

.. ....-.,t!

. Social Work MauaChapter 305

AI TO AGED, BUN,OR DLCABLBD PROGRA

SOURCE: Nort DataCentu Code

50-24-31. Coiúntial character of records -- Penaty. -- All applications.inormation. and records concerning any applicant or recipient of assistace to aged,blid, or diabled under the provisions of tms chapter shal be confdenti and shalnot be disclosed nor used for any purose not directly connctèd with the adminstra-tion of assistace to the aged, blid, or disabled; except tht upon the personawritten request of any elected public offcial the records of the naes. addresses.and amounts of assistance shall be open for his inspection by the state or countywelfare board. Such inormation shall not be used for any political or comm('rcialpurpose or made public in any maier. Any Rerson using any application, inormation.or records concerning any applicant or recipient beyond hi official capacity or forpurposes not directly connected with the adminstration of assistace to the aged,

blid, or disabled is gulty of a misdemeanor.

.'50..24-32~ Recipient to notif the state deparen of receipt of propert or

income -- Assistace altered or canceled. -- If. at an tle durg the contiuationof assistace to the aged, blid. or disabled under the provisions of ths chpter, th

recipient becomes the ower of any proprt or income in excess of the amount stted

in the application provided in section 5Q.24-05, he immediately shall noti th countyagency of the receipt of possess;on of such propert o- inome and the comity agency,afer investigation, eithr may cancel the assistance or alter the amount threof in

accordance with the circumstaces. Any assistance paid afr the recipient hascome into possession of such propert or income, an in excess of lûs needs, ah

be recoverable by the state from the estate of the recipient.

50-24-.33. Recovery from estate of recipient of assistace to the aged, blid,or disabled. -- On the death of any recipient of assistace to the aged, blid. or

disabled under the provisions of ths chapter the tota amount of assistace paid underths chapter shall be allowd as a preferred clai against the estate of such person

in favor of the state, afr fueral expenses for recipient and his or her spouse, not

to exceed in each individua case thee hundred and fift dollrs, and such expenses

of the last iless of recipient and spouse as are authorizd or paid by th county

agency, have been paid, and afr th expenses of adnisteri the estate,

including the attornyl s fees approved by the cour, have ben paid. No cla shallbe enforced against th followig:

1. Real estate of a recipient for the support. mantenace or comfort of

th survi spouse or a dependent;

2. Personal propert necessar for the support, maintenance or comfort

of the survvig spouse or a dependent;

3. Persona effects, ornents, or keep'saks of the deceased, not exceed-

ing in value two hundred dollrs;

Social Servce Bordof Nort Dakota

Transmitted by

Manual Letter #847Novembr, 1971

305-13

.-

Social Work MaualChapter 305

...AID TO AGED, BLl"D,

OR DISABLED PROORASOURCE: Nort Dakota

Century Cod

4. Any real or personal propert of a recipient which is held in trust fort!.

him by the federal government.(Am'd. S. L. 1969, S. B. No. 151.)

50-24-34. Division of moneys recovered. -- Any amounts recovered under the

provisions of sections 50-24-27 or 50-24-29 for assistace to the aged, blid, or

disabled paid under the provisions of ths chapter sha be deposited promptly in theappropriate fund and credited respectively to the federal governent, th state, andthe county in proporton to the amounts in which the assistace payments representedfunds contributed by the federal governent, state, and county.

50-24-35. Guardian aptlointed--Payments to gurdian. -- Whenever a gurdishall have been appointed for any ~ecipient by a coun or competent jurisdiction, the

paym~nt of aid shall be made to such lega gudian. The lega gurdian shall file a

report at the end of each calendar year with the county agency, showg thedisbursement of the money received by him for the benefit of such recipient.

50-24-36. Aid not assignle--Cashig checks afer death of payee. -- Aidgranted under ths chapter sha not be tranferrable or assignle in law,or equity,and the money paid or payable under ths chapter sha not be subject to executon,

attchment, garnshment, or other lega process or to the operation of anybanuptcy or insolvency law. Aid checks delivered to a recipient before his deathbut not endorsed by such recipient may be endorsed and paid, upon approval of thecounty agency under rues and procedurs adopted by the state departent.

. 50-24-37. No fees to be charged. -- No person shall mak any charge norreceive any fee from the applicant, recipient. or any other person for representingan applicant or recipient in any proceedigs under the provisions of ths chapter,or with respect to any application for aid. '

50-24-38. Statute of limitations sha not ru. -- The statute of litationsL

shall not run against claims of the state of Nort Dakota for repayment of assistanceto the aged, blind, or disabled.

50-24-39. Fraudulent acts--Penalty. -- Whoever knowingly obtans, or at-tempts to obtan, or aids or abts anothr, by means of a wUuly false statement orrepresentation, or by impersonation, or by other fraudulent device, assistace to theaged, blind, or disabled to wlûch he is not entitled. or assistance grater than tht to

which he is justly entitled. is gulty of a misdemeanor and shal be punshed by a fieof not more than five hundred dollrs, or by imprisonment in the county jail for notmore than twelve months, or by both such fine and imprisonment;. In assessing thepenalty. the court sha tae into consideration, along with other factors. the amountof money fraudulently received.

Novembr, 1971 Tranmitted byManual Letter #847

Social Servce Boardof Nort Dakota

305- 14

..

... - ..r Social Work Maua

Chapter 305AI TO AGEDt BUN,

OR DISABLED PROGRASOURCE: Nort Daot

Cent Code

50-24-40. Urniitíons of chapter. n Al assistace to the aged, bli. ordisabled granted under ths chapter shall be deemed to be granted and to be held subjectto the provisions of any amending or repeal act that hereafer may' be passed. Norecipient sha have any cla for compensation or otherwse because his assistace is

afected in any way by any amending or repealing act.

50-24-41. Suspension of cha¡:ter. -- In the evant tht any provision orprovisions of this chapter shall be in conct with TItl XV - Grants to States forAid to 'te Aged, Blind, or Disabled or for sucb aid ánd medical assistance for th

aged being amendments of Title I of the Social Security Act, being Pulic Law 87-543,87th Congrss, H. R. l0606t dated July 25, 1962, providig for a state plan for theaged,blid, and disabled; under which, if ths chapter were not in conct, th state

would be entitled to receive ' contriutions from the United States for the combined

state plan for the aged, blind, and disabled, such provision or provisions of thschapter so in confct with such law of the Unted States sha be considered assuspended and noneffective unti fi days afr conveni th legislative assembly

in the year 1965 so as to enable th state to quali and partcipate in such

contrutions for the aged, blid, and disabled from the Unted States.

Social Servce Boardof Nort Dakota

Transmitted by

Maual Lettr #84 7

Novembr, 1971

305..15

..-.

Social Work ManualChnRter 306

AID TO THE AGED,BLI:''O, OR DISABLED

CHAPTER CONTE NT'

ChapterContents

-.Page

SECTION 1. ELIGIBILITY Aì\'D RELATED FAGTORS TO ALL COMPONENTSOF AABD ..Par. 1 - General Statement . . . . . . . . . . 306-1Par. 2 - Common Eligibilty Requirements. . . . . . . . 306. iPar. S - Citizenship of Durational Residence ,in United States Not

Required . . . . . . . . . . . . . . 306.2Par. 4 - Concurrent Receipt of Assistace Through More Than One

Progrm Prohibited. . ' . . . . . . . 306-2Par. S - Confidentiality ot.-Records . . . 306-2Par. 6 . Rìght to Fair Hearing. . . . 306-2

SECTION 2. SPECIAL FACTORS IN OLD AGE ASSISTANCE

Par. I - Age. . . . . . . . . . .Par. 2 - Verification of Age Not Normally Required.

. . .' 306-3306.3

SECTION 3. SPECIAL FACTORS IN AID TO THE BUN

Par. I - General Statement . . . . 306.4'2 - Definition of "Blindness"

. .306-4Par. . . . . . . . .

Par. 3 - Determination of Blindness . . . . . . . . . . . . 306 - 4

Par. 4 - Cost of Eye Examination . . . . 306-4Par. S - PXocedure for Estalishig Eligiilty . . . 306-4Par. 6 - Emergency Eye Treatment . . . . . . . . 306-5Par. 7 - Redetermination of Blindness . . . . . . . . 306-5Par. 8 - Refusal to Accept Treatment . . . . . . . . 306- 5

Par. 9 - Services to the Blind . . . . . . 306-6

SECTION 4. SPECIAL FACTORS IN AI TO THE DISABLED

Par. I - .General Statem~nt . . . . . . . . 306-7Par. 2 - Eligiilty. . . . . . . . . . . . . . 306- 7

3 -II ' ,-

306-7Par. Definition of Terms . . . . . .

Par. .4 - Coun Welfare Board's Funtion in Detennining Eligibility 306- 10

Par. S - State Review Team's Function in Determinig Eligibility . 306-10Par. 6 - Acceptance of Medical Treatment . . . . . . . . . 306-11lPar. 7 - Acceptance of Vocattonal Training or Employment aftr

Training . . . . . . . . . . 306- 11

Par. S - Continuig Eligiility . . . . . . . . . . . . . . . . 30ó- 12

Social Service Board

of North Dakota

Transmitted by

Manual letter #854

Decembr, 1971

306-i

.. -Social Work t\lanualCI~aptel 306

AID TO THE AGED,BLIJ\D, OR DISABLED

Chapte r

Contents

SECTION 5. RESIDE~CE..

Par. 1 ~

Par. 2 -Par. 3 -Par. 4 -Par. S -Par. 6 -

Par. 7 -Par. S -

Par. 9 -Par. 10 -

Par. 11 -

State Residence. .County Residence .Detennination of County Residence

State Department Opinion Offered as Service .

Court AC,tion to Determine County Residence .Social Service Board Responsibilty for Determinng StateResidence.How State Residence Is Lost . .County Residence for Persons Uving in Homes for Aged orNursing Homes. . ..- ... .Applicants or Recipient's Living Out of State .Re-evaluation of Need for Recipients Living Temporarily Out-Of-State, .. ..Recipients in Foreign Countries

306- 13

306-13306-14306- 14

306-14

306-14306-14

306-15306-15

306-15306-15

SECTION 6. RESPONSIBLE RELATIVES

Par.Par.Par.Par.Par.Par.Par.Par.Par.

1 - General Statement .2 - Method for Detenninig Relatives' Ability to Contribute3 - Support Must Be Available .

4 - Contributions Other Than Monetary May Be Meaningful

5 - "In- Laws" Not Considered Responsible Relatives6 - Frequency of Contact.

7 - Inonnation to Be Recorded .

8 - Procedure when Relative Refuses or Neglects to Contribute .

9 - Legal Action.

306-16306-16306-18306-18306-18306-18306-19306-19306-19

, .1P

December, 1971

306- ii

Transmitted by

Manual Letter #854Social Service Doard

of North Dakota

..~-Social Work ManualCliopter 306

AID TO THE AGED,I3U~'D, OR DISAI3LED

Se,,'tion 1

For:". 1- 2

.,,SECTION 1. ELlGIßILITY At\TI RELATED FACTORS COMMON TO ALL co~iro-

NENTS OF A.¡\J3D

Par. 1. General Statement -- The Aid to the Aged, Blind, and Disabled (.-ABD)

Program was established by the 1963 Legislative Assembly to combine the three adultassistance programs, known individually as Old Age Assistance, Aid to the Blind, andAid to the Disabled. The purpose of combining the programs was to simplifyadministration, provide greater unifonnity of eligibility requirements, and increasefederal financial participation. .

While most of the conditions of el1gìbility are common to all three components ofAABD, some, specifically age, blindness, and disability. are peculiar to only onecomponent. For this reason, the fonner program designations (OAA, AB, and AD)

are used throughout this chapter and the special factors applicable only to onecomponent are examined in detail in subsequent sections.

Par. 2. Common Eligibility Requirements u To qualify for assistace throughany of the three components of AABD. an iidividual must:

a) Be a resident of North Dakota (see Section 5 of this chapter);

b) Have insufficient income and resources to maintain a standard of economicsecurity as defined by the Social Service Board of North Dakota (seeChapter 318);

c) Have no adult clúld(ren) able to provide support at a stadard of economicsecurity as defined by the Social Service Board of Nort Dakota except thatassistance cannot be denied or witheld because of such child's refusal orneglect to contribute (see Section 6 of this chapter for additional

considerations relating to responsible relatives);

d) Not have transferrd propert or resources for th purpose of becoming

eligile for assistance (see Chapter 314 for policies relative to disqualifying

transfers); and

e) Not be an inmate or patient in any public institution maintained and operateduner federal, state, county, or municipal auspices with the exceptio:is of

th Grand Forks County Home. Larimore. and the Cass County Hospital.Fargo (payments not subject to federal matching).

Social Service Board

of North DakotaTransmitted by

Manual Letter 1t854Decem~l, 1971

306- 1

... '"Social Work ManualChapter 306

AID TO nm AGED.BUND. OR DISAI3LED

Section 1

Pars. 3.6

(Par. 3. Citizenship o:t'Durationnl Residencein United States ;\Ot Reauired --

In an opinion dated June 14. 1971, the United States Supreme Court ruled that financialor medical assistance could not be conditioned upon (a) the applicant's possessionof United States citizenship, or (b) if the applicant is an alien, upon his having residedin the United States for a specifed number of years. Such requirements were held bythe court and subsequently by the North Dakota Attorney General to be in violation ofthe equal protection clause of the 14th Amendment to the United States Constitution.

Thus. neither citizenship nor duratlonal residence iri the United States is a pre-requisite for receiving MBD.

Par. 4. Concurrent Recetpt of Assistance Through More Than One ProgTam

Prohibited .. No person receiving assistance through one component of AABD may forthe same period receIve assistace thi'ough another component of AABD or through

Aid to Familes with Dependent Children. This provision does not, however. precluderecipients from the same household from receiving different fonns of assistance nordoes it preclude a recipient of AABD from being the payee for an AFDC grant as longas his needs are not also included in the latter.

Par. 5. Confdentiality of Records u Federal and state law prohiit the dis-closure of infonnation from the case records of AABD recipients for any purpose not

directly related to the adminstration of the program. Provision is made. however.for registers of names, addresses, and amounts of assistance to be opened for

inspection by any elected public official upon his personal written request (usualythrough the use of Form 508).

For a more definitive statement of policies relating to the safegurding of information!see Chapter 362.

Par. 6. Right to Fair Hearing u If an applicant for or recipient of AABD isdissatisfied with any decision relating to his eligibility or receipt of assistace, hemay request a fair hearing with 30 days of being notifed in writig of that decision(see Chapter 361, "Complaints and Appeals").

December, 1971 Transmitted by

Manual Letter:# 854

.

Social Service Doard

of North Dakota306-2

.. ..Social Work ManualChapter 300

AI D TO THE AGED,OLI NO, OR Dl SABLED

Section 2

Pars. 1-2

...SECTIOi\ 2. SPECIAL FACTORS IN OLD AGE ASSISTANCE

Par. 1. Age u I n addition to meeting the conditions of eligibility describedin Section i of this chaptert state law requires that a recipient of Old Age

Assistance be at least 65 years of age. Application may .b made by an individual

prior to the date he .bcomes 65 and certifcation made for payment effective forthe month during which he reaches that age. Howevert the grant for the monthhe reaches 65 may not be delivered to him until he 'has actually reached the dateof his 65th birthday. .

Par. 2. Verifcation of A~ Not Nonnally Required .- In accordance with

the provisions of the simpl.ed method for deteminlng eligibilty (Chapter 335), itis not necessary to verify the age of an OAA applicant unless the eligbiHty worker,

under the "prudent person" principle, häs reason to question the reliability of thelionnation given by the applicant. In the event documentation is needed, a birt

certificate is the best and usually the most accessible source of verification. Ifthe applicant does not have one, a marriage certUicate, miUtary records, licenses,et cetera, which may be in the person's possession will usually serve the necessarypurpose. The county welfare board can often obtan proof of age from th Divisionof Vital Statistics, which is accomplished by completing and forwarding Form 130 tothe State Department of Health, Capitol Building, Bismarck. North Dakota 585OL.(See Chapter 392-5 and 7.)

"

Social Service Board

of North DakotaTransmitted by

Manual Letter #854December, 1971

306.3

-..Social Work ManualChaRter 306

AID TO THE AGED.BLIl\'D. OR DISABLED

Section 3

Pars. 1-5

SECTION 3. SPECIAL FACTOrtS IN AID TO THE BLIND

Par. 1. General Statement -- In addition to meeting the conditions of eligibiltydescribed in Section 1 of this chapter; a recipient of Aid to the Blind must have eitherno vision or vision so detective with correcting glasses as to prevent the performanceof ordinary activities for which eyesight is essentiaL.

There is no age restríction in the Aid to the Blind Program.'.

Par. 2. Definition of "Blindness" -- Blindness. for purposes of this chapter,

is defined as (a) central visual acuity of 20/200 or less in the better eye with correc-ting glasses; or (b) a field defect in which the peripheral field has contracted to suchan extent that the widest diameter ~f visual field subtends at an angular distance of

.. no greater than 20 degrees.

Par. 3. Determination of Blindness u Eligibility with respect to blindness isdetermined by the State Supervising Ophthalmologist on the basis of a report of an eyeexamination by a qualified ophthalmologist or optometrist of the applicant's choice.

Par. 4. Cost of Eye Examination u Inasmuch as the Social Servce Board

require s an eye examination to determine an individual's eligibility for Aid to theBlind, the expense of such examination is assumed by the departent.

Par. 5. Procedure for Establishing Eligibilty h The county welfare board is

responsible for receiving and processing applications for Aid to the Blind. Uponfinding that an individual meets all technical (except for degree of blindness) andfinancial requirements of the program, the county welfare board certifies his eligiil-ity to the Social Service Board. Form 409. "Physician's Report on Eye Examination, Itor Form 464, "Optometrist's Report on Visual Examination, " and an authorizationwith which to pay for the examination are forwarded to the county welfare hoard. Thecounty welfare board shall insert the nae of the physician or optometrist of theapplicant's choice on the forms and deliver them to the applicant who should then

arrange for the examination as soon as possible. The practitioner's report of hisfindings is to be returned to the Social Servce Board which in turn forwards it to theState Supervising Ophthalmologist for his review. The fial decision on the individual's

eligiility for Aid to the Blind rests with the State Supervising Ophthalmologist. Thecounty welfare bord shall be advised in aU instaces of his decision.

As an aid to the Division of Vocational Rehabiltation to whom all applicants for Aidto the Blind are referred. the county welfare board is also required to completeForm 443, "Social Report. ..

, l

December. 1971 Transmitted by

Manual Letter #857SOCial Service Bo~ ld

of North Dakota306 - 4

l

~-4

Social Work ManualChapter 306

AID TO THE AGEDl13UND, OR DISABLED

Section 3

Pars. 6.8..

Par. 6. Emerg€ncy Eve Treatment -- On occasion. a physician may encoun.ter an eye condition so acute, that immediate treatment is necessary to prevent rapiddeterioration or irreparable damage to the eye. When such a condition is reponed

to the county welfare board because of the patient's indigencel the physician should beauthorized to proceed with necessary arrangements for treatment with the under-standing that a determination of eligiility for assistance, including a review by the

State Supervising Ophthalmologist, wil be made as promptly as possible. The countywelfare board may need to give the attending physician assurance that payment for theemergency treatment wil ultimately be made from county funds in the event thateligibilty for Aid to the Blind (or Aid to the BHnd- Remedial Care) should later bedetermined not to exist. If the patient is being referred to an out-of-state facilityfor treaonent, the county w~lfare board will likely need to issue medical authoriza~tions for delivery at the time of his admittnce.

Eye conditions requiringemergency treatment should be promptly reported bytelephone to the state deparonent for the purpose of receiving suggestions on procedureand, in some instances, consultation from the State Supervsing Ophthlmologist.

Conditions of the eye which require emergency treatment are most frequently associ-ated with acute glaucoma. acute iritis, detached retina. and accidents.

"

Par. 7. Redetermination of Blindness u The State Superivsing Ophthalmologist

may request re-examinations of the degree of blindness at periodic intervals. Whensuch is requested. the county welfre board shall assist the recipient in arranging forthe examination by a qualified practitioner with the resulting report being forwardedto the Social 5e rvice Board for review.

If the county welfare board observes activities or behavior on the part of a blindrecipient which raises doubt abut his disability, all pertent inonnation shal bereported promptly to th state deparment so tht another examination can be

requested.

Par. 8. Refusal to Accept Treatment _. If an applicant/recipient refuses toaccept recommended medical treatment, his reasons for objecting to the treatmentshall be reported to the Social Service Board. The state deparoent, withappropriate consultation from the State Supervising Ophthlmologist, will make ajudgment as to whether or not the recommended treatment represents risks which a"reasonably prudent person" would not undertke. such as endangering the

individual's remaining capacity.

Social Service' Boardof North Dakota

Transmitted by

l"lanual Letter #854December. 1971

306.5

." .,

Social Work ManualChapter 306

AID TO THB AGED,BLIl\ro, OR DIS~\BLED

Section 3

Par. 9

Par. 9. Services to thê'Blind -- mind a.nd \'isually handicapped persons.

whether self-supporting or recipients of assistance. are often in need of serviceswhich the county welfare board or the area social service center is either Doble toprovide or assist in obta.ining.

All applicants of Aid to the Blind not already known to the Division of VocationalRehabilitation are routinely referred to that agency by the Social Service Board

for evaluation for vocational training or for a variety of specialized services whichmay help to make their lives more meaningful and pròductive. In addition to theseservices, the Division of Vocational Rehabiltation is the lending agency for talkig

book machines for the adult blind. The Division also distributes a limited numrof braile watches to persons needj.g thm.

Special travel conC'essions are sometimes available to the blind. Certin railroads

and bus lines will permit a blind person to be accompanied by an attndant for thecost of one reguar fare.

The American Foundation for the Blind. 15 West 16th Street, New York. New York,10011. offerb d. catalogue. free upon request. entitled "Aids and Appliances. " whichlists various special devices particularly useful to blind and visually handicapped

persons in "performing skills in everyday living, communication, and travel. "

December. i 971 Transmitted by

Manual Letter #854Social Service Board

of North Dakota

306 - 6

-..Social Work ManualChapter 306

AID TO THE AGED,BLI0.1). OR DISABLED

Sec~ion 4

Pa r s . 1 - 3

..SECTIO¡" 4. SPECIA L FACTORS r¡. AID TO THE DISABLED

Par. 1. General Statement -- The purpose of the Aid to the Permanently and

Totally Disabled Program is to pro"ide needed assistance to persons who have

physical or mental conditions which are so disabling as to make substantial employ-ment or the perfonnance of homemaking functions impossible or impractical. The

Joint Conference Committee Report on the Social Security Administration Amcidmentsof 1950, which authorized this program, contaiped tlie following statement of intent:

"Although assistance would be confined to those who are permanently andtotally disabled, it is recognized that with proper traing. some of theindividuals aided possibly could be returned to a condition of self- support. ..

TIie reference of the Conference Committee Report to the possibilty of trainig and

rehabilitation suggests that it was not the intent of Congress to confine the programto cases of invalidity; that is, cases of complete helplessness. Rather, it was theintent that state and local agencies were to work closely with vocational rehabilitationagencies to ensure that every individual for whom vocational rehabilitation is feasibleactually receives the necessary opportunities to become rehailitated.

In keeping with Congress' intent to emphasize a disabled person's remainig capacityand potential rather than the permanence and totality of his disabilty, the programwill hereinafter be referred to as Aid to the Disabled.

Par. 2. Eligibility d In addition to fulfillg the conditions of eligibility

described in Section 1 of this chapter and havig a major physical or mentaimpainnent or disease. a recipient of Aid ,to the Disabled must have attined theage of at least 18 years.

Par. 3. Definition of Teiis -- In general. "permanently and totally disabled"

means that an individual has some permanent physical or mental impainnent,disease. or loss that substantially precludes him from engagin in useful occupationswithin his competence, such as holding a job or homemakng. The impairment may bephysical or mental, orgaic or functional, and of such a degree as to interfere withthe individua's faculties, such as senses, reasoning, mobility, et cetera. Theimpairment may exist from birt, be acquired during th lUetime of the individual,'or result fr accident. The impairment may be obvious, as in the instance of the

loss' of a limb, or it may be such that it can be revealed only by medical examination,and it may exist singly or in combination.

Social Service. ßoardof North Dakota

Transmitted by

Manua1.l.tter #857

Decembèr, 19i1

306- i

."-.,

Social Work ManualChapter 306

AID TO THE AGED,BLIND. OR DISABLED

Section 4

Par. 3

..The concept of "permanently and totally disabled" must be understood if the programis to avoid the implication that it is merely assistance to individuals who can donothing for themselves and who are looked upon, or tend to look on themselves. asno longer effective members of sociea.'\ As a means of shedding further light onthis concept, the various components of the above definition are describd separatelyas follows:

a) PERMANENTLY. The tenn "permanently",refers to a physiological.anatomical, or emotional lmpainnent which is verìfable by medical findings.A physician must provide the county welfare board with the inormationwhich bears on this aspect of eligibility.

..The impairment must be of major importnce and must be a condition notlikely to improve or which will continue throughout the lifetime of theindividuaL. Any condition which is not likely to respond to any knowntherapeutic procedure shall be deemed to be permanent; furthermore. anycondition which is considered Hkely to remain static, or to become worse,shall be deemed to be "permanent" if tratment is unavailable, inadvisable,or if the individual justifably refuses treatment.

"Permanence" does not rule out the possibility of vocational rehabilitationor even recovery from the impairment. Individuals wil sometimes respond

favorably to treatment after an unfavorable prognosis or the condition maybecome arrested. The discovery of new drugs or other medical advancesmay also change the prognosis on a previously. regarded pemanent condi-tion. Thus, the term "permanently" canot be defined in an absolute sensebut rather must be defined relatively in the sense of continuing indefinitely,as .distinct from "temporary'. or "transient. ..

("

b) TOTALLY. Like "permanently, " the tenn "totally" is not absolute since itmust be considered in reference to th ability of the person, as revealed bythe facts in his case, to perform those activities necessary to carry outcertin responsibilities, such as those necessary to employment or homew

making. In addition to medical findings, "totally" involves such otherconsiderations as age, traig, skills, and work experience, and the

probable fuctionig of the person in his particular situation in light of hisimpalnnnt. The county welfare board carries the major responsibilityfor providing th State Review Team with the information which bears on

ths part of eligiilty. In many instances, no decision as to "total" disw

ability can be made without social inormtion which describes the individ-uall s education and work history, the act! vities required by him in hishome, living and workig conditions, interests, native capactities, andextent to which he has adjusted to the loss he has sustained. The socialdata must therefore provide a sufficient base to make it possible to relatethe medical findings to the types of activity the individual is competent to

, perform. .1

December, i 971 Transmitted by

Manual Letter #854

Social Service Boardof North Dakota

306.8

-..

Social Work ManualChapter 306

AID TO THE AGED,BUt\TQ. OR DISABLED

Section 4

P,ll. 3

..c) SUBTANTILLY PRECLUDES - TIie term "substantially precludes" has

reference to the degree to which an individual's permanent impairment hasleft him able to pai:ticipate in those activities which are essential to holdinga job or homemaking. If an individual is able to perform such activitieswell enough and with sufficient regularity to receive reguar payments forhis efforts or to carry homemåking responsibilities on a reasonalycontiuing basis. he cannot be found to be permanently and totally à..sabled.

d) USEFUL OCCUPATION - A "useful occupation" generally means productiveactivity which adds to the economic wealth or produces goods or servicesto which the public attaches a monetary value and which demands the timeand attention of tle person for the ultimate benefit of others. Hobbies.activities which do not provide bona fide job opportunties. occupationaltherapy. and training progTams designed for seriously disabled personsare not ordinarily regarded as "useful occupations. 11

e) HOMEMAKING - This term involves the abilty to carry home-managementand decision-makng responsibilities. and also includes the extent ofcapacity to provide essential services with the home for at least oneperson in addition to one's self as distinguished from the maid or house-keeper who is hired to perform domestic duties for wages in a homemaintained by others.

The following activities are importnt to successful performance of theoccupation of homemakng -- shopping for food and supplies; planng andpreparing meals; washing dishes; cleaning house (sweeping, moppin,dusting. et cetera); makng beds; washig and ironing cloths. In certin

settgs havig primitive facilities. carrying water and fuel and buiding

fires may also constitute importt factors in the ability to successfulyperform homemakg duties.

.

Social Service,ßoardof North Dakota

Transmitted by

Manual Letter #854December. 1971

306- 9

.. .. '*

Social Work ManualChapter 306

Al D TO THE AGED.ßU KD. OR DIS:\ßLED

Section 4

P;.rs. 4.5

.,.Par. 4. County Wel fare Board's Function in Determi'niiig Eliglbì1i:\' u

The county wel fare board is responsible for determining all eli'gibility factorsexcept for the disabilty. the decision for which is made by the State Review Team.

Since the review team does not see the person. it must depend on the examining

physician's current medical fîndings to document the physical or menta impair-ment. The county welfare board arranges for the physician to make his reportwhich is usually accomplished through the use of Form 444. 1/ In addition. theteam must rely on the caseworker's report. whicn is bâsed on his observation and

knowledge of the individual. of the social factors about the person in his totalenvironment. This report helps the team to determine whether, in the light of hisimpairment, the person is able to engage in any useful occupation (includinghomemaking) that is within his ..emaining capacity. The social information whichis reported on Form 443 (Social Report) is forwarded along with the Form 444(Medical Report) to the Social Service Board for its evaluation and decision.

..,

The importance of the caseworker's responsibility to report relevant inforationconcerning the individual's social situation cannot be over~emphasized. The case-worker has knowledge which contributes to the understariding of the whole person.He may have the kind of information which will substantially modify or complementthe opinions of the physician or psychologìst. Pertinent information about theperson's past employment or homemaking adjusonents. type of housing, method ofheating ile home. the availabilty or lack of modern conveniences in the home, abiltyto manage personal needs and affairs, attitudes and behavior. motivation andrehabilitation potential, et cetera, is invaluable to the review team and wil help toreduce injustices and incorrect decisions.

Thus, the caseworker becomes the eyes and ears of the State Review Team. Theteam's decision wil depend in grat measure on the quality of the information madeavailable by the caseworker.

Par. ,5. State Review Team's Function in Determining Eligibîlity -- Th

State Review Team, consisting of a physician, a professional social worker, andconsulting specialists from related fields as needed, carefully reviews all medicaland social inormation an renders a finding as to the permanent and total disabiltyof the individuaL. This decision will be made on the basis of the team's professionaljudgment as to whether or not the person's permanent impairment wil permit Wmto perform usefu employment or carry on essential homemaking duties.

The county welfare board wiU be promptly advised of the review team's decision.

l/ The county welfare board must arrange for the exense of the initial medicalexamination.

.

December, 1971 Transmitted by

Manual Letter #854Social Service Board

of North DJkota306~ 10

....Social Work ManualChapt~r 306

AID TO THE AGED,BLIND, OR DISAI3LED

Section 5

Pars. S- 11

Par. 8. COW'ty Residence for Persons UVing in Homes for Aged or f\ursingHomes -- A person who has legal residence in a county in this state does not lose hisresidence in that county when, residing in a licensed home for the aged or nursinghome in another county. The time spent in such licensed homes shall not be includedin computiig the time necessary to establish legal residence. County residence wilbegin, however, when the person leaves the licensed home to live some place otherthan in a licensed home in the same county or in another county in the state.

~ar. 9. Applicants or Recipients Livig Out of State -- A resident of Nonh

Dakota who is living out of state for a temporary purpose has the right to apply for orreceive assistance from tls state on th same basis as if he were here physically.

However, prompt steps mus.t be taken by the county welfare board to transfer arecipient who moves from North Dakota w,ith th intent to reside in another state formore than a temporary purpose. The tränsfer can be accomplished by advising therecipient of the necessity of applying for assistace in th state to which he will moveand by forwarding pertinent information to th appropriate out-at-state agency.

These efforts should be carefully coordinaed with the other state in order to preventeither lapses or duplication in assist:'1ce payments.

Par. 10. Re-evaluation of Need for Recipients Living Temporarily Out-of-

State -- When a recipient leaves the state for a temporary purpose, except for ltefvisits, the county welfare board should promptly request that an investigation be madein the other state to determine his current needs and circumstances.

Par. 11. Recipients in Foreign Countries u Assistance payments may be

continued to recipients living in foreign countires for a temporary purpose providedthat costs of transporttion to distat points are not paid through the grant and

provided also the satisfactory arrangements ca be made for th completion of threquired periodic review of eligibility.

Recipients moving to foreign countries with the intent to remai pennanently losetheir residence in Nort Dakota for assistance purpses.,

Social Servce Bord, of Nort Dakota

Transmitte byManual Letter #854

December. 1971

306-15

--lI-'.L"

~

(

Social Work l.'bnualChapter 306

AID TO THE AGED,BLIND, OR DISABLED

Section 6

Pars. 1-2..

SECTION 6. RESPONSIDLE RE LA TIVES

Par. 1. General Statement -- TIie detennination of the capacity of all legallyresponsible relatives to provide support to an applicant for or recipient of assistanceis a requirement of the AABD Program. Ii a relative is already contributig at thtie an individual applies for assistance. it is normally expected that the contribution

will continue. Eligibility for AABD should not be an indication to relatives that

contributions can be discontinued or reduced although either is permissible if such

contriutions are creatig undue hardship on the relatives or their families. Generaly,

however. public assistace is to be considered a supplement to, not a replacement

for, othèr sources of income, including support from responsible relatives.."

Responsible relatives are defined by AABD law as including adult children for theirindigent parents, parents for theirindigent children, and spouse for spouse. if theyare of sufcient financial means to provide needed support.

Par. 2. Method For Determining Relatives' Abilty to Contribute d The"Relatives' Income Scale" is to be used by the county welfare board as the basis fordetermining whether or not a relative's income is suficient to warrant expectationtht he can cohtribute to the support of an applicant or recipient of AABD afer hisresponsibilities to himself and to his immediate dependents have been discharged.The income scale relates various levels of income to the number of personsdependent upon that income. The levels of income are expressed in terms of grss

income, and are designed to provide an acceptable stadard of living for therelative and his dependents.

The use of the income scale, shown below, simplifies adminstration inasmuch as

it eliminates fruit! ess and routine contacts of relatives who are obviously in noposition to finacially assist applicants or recipients of public assistace.

RELATI VES' I NCOME SCALE

Numr of Persons Dependent Estiated Gross IncomeUpon I ncome Anual Monthly1 $4,00 $333. 332 5,200 433.333 6,200 516.67.. 7. 200600. 005 8,200 683.336 9.200 766.677 10,200 850.00

Add $800 to estimated income for each additional dependent over 7.

;¡'l,

,-December, 1971 ' Transmitted by

Manual Letter #854Social Service Board

of Nort Dakota

306-16

..-l

Social Work Ma.nuul

CI1.piCr 306AID TO THE AGL:D,

BLIì-D, OR DISABLEDSection 6

Par. 2

..Under ordinary circumstances it should be unnecessary to contact relatives directlyin order to determine whether or not contributions from them are feasible. Thecounty welfare board can usually make a reasonable estimate of their income froma review of Forms 1 or 2 or from discussion with the applicant/recipient. TIielatter's statements concerning each of his responsible relative's ty of employment.number of dependents, and other pertinent information, will often sufice as a methodfor estimating their incomes. Thus, a relative's income. as estimated in thirmanner, shall be measured against the income ,scale 'and will generally serve as thebasis for the county welfare board's decision to contact that relative for a contribution.However, if the information received from the applicant/recipient is either limitedor is inconclusive, the county welfare board may find it necessary to seek substanti.ating information from the relative himself. Relatives who are engaged in business

operations will more often need to be contacted by the county welfare board becauseof the grater difficulty in estimating thir incomes without first hand inormation.

No i-equest will be made by the county welfare board for contriutions from relatives

whose gross income appears to fall below the appropriate income level unss theapplicant/recipient is the spouse of such relative. 1/ However, any regular andsignficant contribution actually made by a relative whose income falls below the inomelevel must be taken into consideration in determning eligibility.

Any relative whose estimated income appears to exceed the appropriate income levelwill be contacted to determine his willngness to contribute to his needy relative.Whenever possible. contacts with relatives should be made through personalinterviews since these are much more effective in interpretig th economic andsocial needs of th applicant/recipient, and also in assessing relatives' capacity and

readiness to involve themselves meanngfully in th person's lie. If personal

interviews with relatives are not possible, contacts may be made throughcorrespondence.

letters should be friendly an courteous in tone, reflect th county welfre board'sinterest in the applicant or recipient. and should exlore th relatives' wilngness tocontribute. Since these particulars can more readily be tranmitted thrugh apersonal lettr. this meth is advised. 'T use of fonn lettrs is stroglydiscourage~ beause they oftn suggst indifference towards th indigent person rather

than warmt& än interest.

1/ A distinction 1s made throughout this section between contacts made with relativesfor the purpose of requesting contributions an contacts which are directed towardachievig a desired casework objective. It Is emphasized tht th restrction agaist

requesting support from relatives whose inome Is insufcient to pennt contriutions

in no way precludes contacts by the county welfa boad of thse same relatives for

the purpose of enlistlngtheir aid in helpin an elderly, bUnd, or disabled person withsome otter espect of his functioning.

Social Service .Board

of Nonh DakotaTransmitted by

Manual Letter #854December, 1971

306-17

--4

Social Work ManualChaeter 306

AID TO THE AGED,BLIND, OR DISABLED

Section 6

Pars. 2-6

( ...Whether contacts with relatives are made through personal interviews or throughcorrespondence. an approach which is cordial is more apt to bring about the desiredresult than is a legalistic approach. For this reason, responsible i'elatives shouldnot be required to complete affidavits. .

Relatives who are able and wiling to contribute to an applicant for or recipient ofassistance should be counseled as to the importance of regular and predictablecontributions. .Contacts with relatives will be made with the knowledge and consent of the individua.

Par. 3. Support Must Be Ave.lale u The apparent ability of a legallyresponsible relative to support the applicant or recipient does not of itself affect hiseligiility for assistance. Contributions must be in an appreciable amount, regular,

and actually available to the person before being taken into consideration indetennining the amount of his need.

Par. 4. Contributions Other Than Monetary May Be Meaningful.-

Contributions from relatives may be made in some tangle fonn as cash or asincome-in-kind, including such items as room, board, clothing, housekeeping servces,

et cetera. However, the importace of non- monetary contributions in time, attention,personal services, and other expressions of affection'should never be underestiatedas a means of enriching the lives of aged, blid, or disabled persons. Suchintangile services provided by relatives have great value, and the county welfare

board shall endeavor to preserve and strengten relatives' interest in their indigentkin even when monetary contriutions are not possible.

Par. 5. ''In. Laws" Not Considered Responsible Relatives -- An "in.1aw",

defined as the spouse of a legally responsible relative. is not to be considered liablefor the support of an applicant or recipient cl AABD. Only th~ iu(:ome of the legalyresponsible relative will be assessed. To illustrate, a married daughter wil not becontacted for the object of requestiig support uness it is deteimlned that she hasincome in her own right, and the amount of her income appears to exceed theappropriate level of income on the scale. Her husband would not be required to

contribute from his earngs although any reguar contribution he made voluntarily

would need to be caidered in detennining th amount of need.

Par. 6. Frequency of Contct n All responsible relatives whose incomes have

ben estimated to be in excess of the income scale shall be contacted during the courseof the initial detennination of eligibility. Thy shal be contacted as frequently asnecessary thereafter, but not exceedig intervals of three years. Relatives whose

incomes fell below the income scale at the tie of original application, and thus were

not contacted, shoul have their incomes assessed periodcally to detennlne whethrchges in their status make a currnt contact ~ecessary.

:1..

December, 1971 Transmitted by

Manual Letter #857Social Servk:e Bord

of North Dakota

306..18

-.-..Soda! Work !\lanualCha¡:ter 306

Al D TO THE AGED,BLl ND, OR DJ SABLED

Section 6

Pnrs. 6.9

1 f contacts with rclaÜ..s are made by letter and no reply is received within

approximately t\'.' weeks, a second letter shall be sent. However. urgently needed

assistance shall not be dela~'ed because of relatives' failure or delay in responding

to the county we Ifare board's inquiries about support.

Par. 7. Information to Be Recorded u I nformation concerning allresponsibl e relatives, including their names. addresses, dependents. estimatedincome. amount and regularity of contributions, et -cetera, should be contained inthe case fie. When relatives whose incomes' exceed the income scale do not

actually contribute, the case file should also Indicate the attempts which have been

made to obtain contributions.

Par. 8. Procedure .;'hen Relative Refuses or Neglects to Contriute ~- When

a relative believed to be capable of contributing fails to respond to inquiries, or'refuses or neglects to provide support, the individual's grant shall be certied in

the amount of full need. The county welfare board must then determine whether

further efforts to obtain support from the legally liable relative are warranted. Ifsuch relative lives in the vicinity. and a personal contact with hi.m has not alradybeen made. this procedure may bring results. If the relative lives in another ceutywithin the state. the county welfare board in the county in which the relative llw.smay be requested to personally interview the relative as a method of furter assessingthis potential source of income. Public agencies in other states. however. will

normally not provide ths servce.

Par. 9. Legal Action u In most instances, relatives wil be willing tocooperate with the county welfare board in planig for the care and support of theapplicant or recipient. Nevertheless. relatives whose incomes suggest th potenticapacity for contributing will sometimes decline to do so for a variety of justiiablereasons.

There will be occasions, however. when a relative who is clearly in a position tosupport without undue àdjusonent in his own standard of livîng, refuses to make anycontribution. Unless there are over.riding social reasons. the county welfare board

is obligated in thse instaces to notify such relative either personally or by registeredmail that unss a meanigful contribution is fortcoming, the mattr will be broughtto the at"..otion or th state's attorney. If the relative ignores the notification and/orcontin~es to refuse to dischrgt his legal responsibility to contribute, the state'sattorney shall be so advised. The referral to th state's attorney can be accomplished

either through personal consuJtation or by lettr. Regardless of th method. th

referral should outline in detail all :dormation pertnent to the situation. Once threferral is madet th county weUare bord wil be governed by the state's atto:rney'srecommendation as to what legal action, if any, is indicated and whethr or not suchaction should attempt to recover assistance previously extended in addition to '

obtaining suppon for currnt need.

Social Service Doard

of t\olth Da kOla

Transmitted by

Manual Letter #854December, 1971

306- 19

-4 -Soial Work ManualChapter 314

PROPERTY FACTORS FORAID TO AGED, BUND, AND DISABLED

Cb pterContents

,., CHAPTER CONTENTS Page

SECTION 1. INTRODUCTION

Par, 1

Par. 2

Par, 3

Par. 4

Par. S

- Property Provisions Appear in Law and Pulic WelfareBord Policy, , . . , , , , . . , .

- Initial and Continuing Eligibility Afected , .- Property Rules Should Be Carefuy Interpreted .

- Provisions Concerning Real and Personal 'Property andHomesteads . . . , , , . , , . .

- Forms Must Be Received Before Checks Ca Be Issued ForOAA, AB, AFID . . .

314-1314-1314-1

314-2

314-2..-

SECTION 2. DISQUALIFYlNG TRANSFERS

Par, 1 - Disqualifyng Transfers Applicable to OAA, AB, and APro .

Par. 2 - Intent is Basis for Determining Eligibility. ....,Par. 3 - Applicants To Be Assisted In Obtainig Evidence , . . .

Par. 4 - Purpseful Motive Should -Be Established On Part of Applicant

Par. S - Effect of Lapse of 1i me Following The Transfer ,

Par. 6 - How to Regard Deed Given to Save Foreclosure. ,

Par. 7 - Re-transfer Terminates Efect of Disqualifyng Transfer

Par. 8 - Trust Mortgage From Spouse to Correct DisqulifyngTransfer. . , , .Par. 9 - Life Lease to Correct Disqualifying Transfer

Par, 10 - Disqualification Not Permanent

314-3314-3314-3314-3314 -4

314-4314-4

314-4314-5314-5

SECTION 3. REAL PROPERTY

Par, 1 - Homestead Exempt From OM, AD, an AP TransferRequrements, . , . . . .

Par. 2 - Recipient May Not Encumber or Convey Without Consent of

Pulïc; Welfre Bord.Par. 3 - Definition of "Homested" . .Par. 4 . Who May Clim a Homestead .Par. 5 * Efect of Temporary Absence or Home Not Occupied

Par. 6 - Climants Select Property To Be Treated As Their

Homestead. . . , .,Par. 7 - Need Not Be Absolute Owner

Par. 8 - Should File Declaration If Not UV' On the HomesteadPar. 9 - Must Transfer If Not "Homested" ... ..Par. 10 - Homestead in Name of Spouse. ...

Par, 11 * When Recipient Requests County To Take A Deed ,

Par, 12 - Real and Personal Property of An Indian

314-6

314-6314-6314-'314 -,

314-8314-8314-8314-8314-8314-9314-9

Public Welfare Boarqof North Dakota

(Continued)Transmitted by

h.w.nual Letter #410April. 1963

2h~ i

~

...

Social Work ManualChapter 314

PROPER TY FACTORS FORAI TO AGED, BLIND, A~in DISAB~ED

ChapterContents

.

SECTION 3, REAL PROPERty (continued)

Par. 13 ~ Homestead Acquired After Mariage. . . . . . . . , . .Par. 14 - When Homestead Is Abandoned. . . . . . . . . . . . .Par. 15 ~ When Buildigs, Trailer Houses, or Home are Persona PropertPar. 16 - Transfer of Home Covered By Homestad Statement. . . . .

l!314-9314-9314-9314-9

\

SECTION 4. REAL PROPERTY OTHER THA HOMESTEkD

Par. 1 - All Real Property Except Homestead and Property Held in Trust

Transferred in OAA, Aß, and APD. . . . . .Par. 2 - Maxmum Value of Real Property. . . . . .Par. 3 - Transfer of Real or Per~onal Propert Covered by

Trust Mortgage. . . . . . . . . . . .

314-10314-10

314- 1 1

SECTION 5. PERSONAL PROPERTY

Par. 1 - General Statement. . . . . . . . . . . . . .Par. 2 - Personal Property Limitations. . . . . . . . . .Par. 3 - Effect of Receipt of Fire Insurance Proceeds on Eligiility

Par. 4 - Assignment of Life Insurance . . . . . . .Par. 5 - Special Assignents. . . . . . . . . . . .

314-12314-12314-13314-13314-14

SECTION 6. PROPERTY ADMIf\iSTRATION

Par. 1 - Treatment Divided Into Three Topics: Services, Settement,

and Probate . . . . . . . . . . . . . . . .Par. 2 - Whom to Consult - Distict Representative or Field Auditor

314-15314-15

SECTION 7. PROPERTY SERVICES

Par. 1 - Rights of Those Whose Taxs Axe Deliquent. . . . . . . .Par. Z - Recipients of Assistace Should Be Advised On Property Matters

314-16314-16

SECTION 8. SETTLEMENT AN RELEASE

Par. 1 - Policies Regardig Settlement and Release of Liens. . .

Par. 2 - Circumstaces Under Which Releases May Be Granted .

Par. 3 - Full Repayment Defied. . . . . . . . . . .

314-17314..17314-17

/i

Mach, 1970(Continued)

Transmitted by

Manual Letter =746

Pulic Welfare Board

of ~orth Dakota

l 314-ii.,

/....

Soial Work ManualChpter 314

-.PROPERTY FACTORS FOR

AID TO AGED. BLIND. AND DISABLEDChpter

Contents

.--f . ~

. SECTION 8. SETTLEMENT AND RELEASE (Continued)...

Par. 4 - Form in Whch Remittnce To Be Submitted. . . .Par. 5 - Crting of Remittces . . . . . . . . . .Par. 6 - Request for Release of Trust Mortgge an Homested

Page

. 314-17

. 314-18. . -,

Par. 7 -

Par. a -

Par. 9 -

Par. 10 -

Par. 11 -

Par. 12 -Par. 13 -Par. 14 -Par. 15 -Par. 16 -

Statements to be Sent to Division of Accounts an Auditsif Accompaed by Ful Repayment. . . . . . , . . . .Forms To Be Used in Requesting and Efecting Relea!!es. . . .

Unsatisfactory Reasons for Requesting Release. . . .

Normal Procedure for Approving a Compromise Settement.Procedure When Field Auditor Dos Not AgeWith County Welfare Bord Recommendtion. . . .Procedure When F~eld Auditor Reviews Before CountyWelfare Bord Action Taken . . . . . . . . . 314-20Procedure When Considering Release Without Repayment . . ,.' 314-20

Soial Aspets To Be Considered. . . . . . . . . . . . 314-20Realization of Ufe Insurance Benefits. . : . . . .. 314-20Trst Chttl Mortgges Must Be Renewed . . . .. . 314-21Subordination of !.ens for OM. AS. an AP Propert. . . . 314-21

314-18314- 18

314- 19

314-19

. . 314-19

SECTION 9. PROM TE

Par. 1 - Preparation and Filng of Claims. . . . . . . . .. 314-22Par. 2 Preferred and General Claims, When Filed and Allowed. . . . 3i4-2~Par. 3 - Definition of "Last nines5" . . . . . . . . . 314-23Par. 4 - County Welfre Board to Initiate Probate Proceedings. .. 314-23Par. 5 - Employment of An Attorny . . . . . . . . . . . . . 314-23Par. 6 .. Notice to Credtors and Fillng of Clai . . .'. . . . . . 314-24Par. 7 .. Filng of Objections Pror to Hearing od Claims. . . . . . . 314-24

Par. 8 - Hearing on Claims and Appel From Orer of Court. .. 314-24Par. 9 - Hering On Fina Acount aml Appe Prom Deree . .. 314-25Par. 10 - Remittnce and Release Same As For Oter Settements. . 314..25Par. 11 - Sumar Administrtion orEatates. . . . . . . . . . . 314-25Par. 12 - Probate of Trt Propert of IOOla11 . . . . . .. . 314-25

SECTON 10. ACTON TAKBN WHBN RECIENT OF ASSSTANCB ACQtnRBSPROPBRTY

Pa. i, .. Reover of OM, AS. "O. AP Fro Repients. . . . . . ~ 314..26

Public Welfre Bordof Nort Daota:

Transmitt byMaua Lettr #410

Apr. 1963

~"'..Soial Work ManuaChap~r 314

PROPERTY FACTORS FORAIDTO AGED, BLIND, A~"D DISABLED

Section 1

Pars. 1-3

,SECTION 1. INTRoot1cnoN

Par. 1.' Property Provisions Appear in Law and Pulic Welfare Bord Policy uIn order to estalish eligibilty for Aid to the Aged, Blind, and Disabled on th part of

appcants who own,property, it must be shown tht there is compliance with certainprovisions of th state law concernng property, as well as with the policies on prop-

. erty which the Public W elf are Board has promulgated in carrng out such provision. and in.implementing other eligibilty factors such as need.

Par. ,2. liùtial and Continuin~ Eligibilty Afecte? -- Th ownership and dis-position of property afects not only initial elgibility, but also continuing eligibiltyfor assistance. Thus, in ~ case of property acquired subsequent to approva ,'.of as-sistae' or 1n the case oi' property ownership not ascertaned prior to approval for

assistace, the provisions of law and poU¿y must be carried out with respect to such

property in the same maner as if the recipient had not yet been approved for assist-ance. Faiure to comply in such cases withn as'Short',a time as is reasonay possi-ble renders the recipient inelgible for furter assistace unti he does comply withthe requirements. .

Par. 3. Property Rues Should Be Carefuy Interpreted n The propert provi-'

sions of the AAD law should be carefuy interpreted to applicants for assistace inorder tht fears over loss of home and property may be dispelled. It should be

pointed out to them that, according to law, no claim will be enforced against any realestate of a recipient whie it is occupied by the survving spouse or a dependent, antht no claim may be enforced against any persona property necessary for the support,maintenance. or comfort of th survving spouse or a dependent. The heirs may clear

the propert of a claim by the repayment of the assistance granted. Since the law

provides for the fi of a claim for only the amount of Old Age Assistace actuygranted on and aftr May 1, 1937, or for Aid to th Permanently and Totay Disabledgranted on or úter Janry 1, 1~51, or for Aid to th Bld on or afr JulY 1. 1963,or for Medca Aid for the Aged on or afr JulY 1, 1961, plus interest at the legarate beginnng sùc months after the death of the recipient, the applicant an his heirsca have the assurane tht thy will not lose the propert unless, in probati theestate, there is no eqty left for the heirs afr fueral expnses not to exeed $250for th appcat an spose, last illness expenses, cost of admstration, an theamount of OA, A... MA, or AB granted, have been pad.

Pulic Welfare Bordof Nort Daota

Transmi ned by

lvnual Lettr #410

ApriL, 1963

3 ~ i.~ 114 -. ..

..

-.Social Work ManualChapter 314

PROPERTY FACTORS FORAID TO AGED, BLIND, AND DISABLED

'Section 1

Pars~ 4-5

Par. 4. Provisions ConcéI'ng Real andPersona Property and Homesteads u , ~.1e law regarding OM, AB, and APID states tht the ownrship of property sha not

preclude the granting of assistae if the appliCant is "Without fuds for his support,"

provided tht certain transter-tn-trstprovisionsare carried out with respect to prop-

erty other th a homestead; they also provide for the recordig of a document by whicha homested may -:;,~oL:be ; transferred by the recipient Without the writtn consent ofthe state department. These provisions are treated separatey in later sections deaWith (1) homesteds, (2) rea propert other thn a homested, an (3) persona property.

An applicat is deemed to be "without fus for his support" if he lacks cash, or assetsconvertible into cash, in an apount sufcient to meet current needs. Such "convertible'~

assets" comprise al property, real.or persona, wlûch it is deemed proper to dispose

of thoug sale after consideri the vaue of the proceeds obtainle though sale as

compared with the benefit to the applicat of retainng the propert, with due considera-

tion bein given to psychologica and rehailtati:ve values oftn inerent in property

ownrship. Consideration of the convertibity of propert, as thus defied, is a part ofthe determtion of resources and income avalable to me~t need, an, as such istreate in the chapter coveri tht subject. \.,.. , ,',. ,"'~' y..'.. ,Uncer the MA proVision of the law the rea propert of a sine recipient or recipient'and spouse is lited to the recpient's home and other rea property of a current net

,,~V'lLue of not more th $2,500.,

~ .:rson property under MA is l1keWise limited to $2,500 of current net value.

Par. 5. Forms Must Be Received Before Checks Ca Be Issued For OAA, AB.

or AP .. Al forms requred to be completed as a pre-requsite to elgibility, an for..-:...~.:"which the origi or a copy Is requred to be sent to the state department, must be re-ceived in the state department, shoWi recording an fig inormation, et cetera, before .iy checks are released from the state departent to th recipient.

(

Apri, 1963 Transmi tted by41ual Lettr #410

Pulic Welfare Bordof North Daota

. "314..2

....Soial Work MaualChpter 314

PROPERTY FACTORS FORAID TO AGED. BLIND. AN DISABLED

Setlon 2

Pars. 1-4

I ' SECTIO~ 2. DISQU.AIFYIG TRASFERS

Par. 1. Oisqufy~ Transfers, Applicable to Old Age Assistance, Aid to the

Blind, and Aid to the Permently an Totay Disabled - - The section of the law onOM, AB, and AP. and MA render ineligible any person who. before or afrmaking application. gives an assignent or makes a tranfer of propert for the pur-

pose of renderig himself eligible for assistae; ths inludes person who tranferproperty to avoid the enumbrane or recovery features of the OM, AR, A.TD, anMA statutes, except tht the transfer of a home or other real. property valued atless th $2,500 is not disqufy uner the MA program.

. Par. 2. Intent is Basis for Determining Eligibility -- The approach to the

question of eligibilty on ths basis must be entirely with reference to th intent of theperson who made the transfer or gave the assigent. Determintion of what the in-tention was at the time of the transfer will deped upon the answer to qustions suchas the fOllOWing: (1) was the consideration adequte?: (2) was the applicat's state

purpose reasonable in view of his circumstaces at the time of the tranfer'?; (3) didit apper, at the time of the trsfer, tht he would be in need of assistae sooner

th if the transfer had not been made?: (4) were there benefits obtaine by th ap-plicat :rom the trferee tht were contingnt upon tranfer of the propert; (5)did the tranferee have a lega and/or equtae interest in the property trfe.rred

to him?; et cetera.

Par. 3, Applicant To Be Assisted in Obtain Evdence u The couty welreboard should determine whether or not there is any vald reason for assum bt atranfer or assignent is disqufyng an secure as much information an evidenceas is readily available on the point. If it is believed tht suh a ''vald reason" doesexst, after considering th answers to questions such as those in the precedi para.graph, t.l-e applicat shoud be given every opportty to refute any presumption ofineligibilty resulting therefrom, an should be assiste in the obtaining of th evi-dene tht he may Wish to present if such assistae is need.

Par. 4. Purpsef Motive Should Be Estashe on Part of Applcat n Anapplicant may be requred to state his motives for mak a trsfer; ths statement

i

wi then be considered as evidence. the valdity or weight of which will depe to alarge ext upo the reasonae an apparent purpsefuess of the avowed motive.

The lesi purpsef or the less personay necessitous or advantageous the motive,

the more persuasive must be the addtiona evdence presented to prove tht theavowed motive was th actu one, rather th a desire to gain elgibility for assist.ance or to avoid enumbrane or recovery. The evidence thus presente by the ap-plicant to establish his motive as bein other th to qu for assistae wouldthen be weighed agst whatever indications exste for presuming the transfer to

be disquifyng. and a decision made in accorde with th best judgent of the

county welfre bord on the question of the intet in th case.

Public Welfare Bordof North Dakota

Transmitt byMaua Letter #427

Deember, 1963

314-3

.,

..Soial Work MaualChapter 314

PROPERTY FACTORS FORAID TO AGED, BLIND, AND DISALED

Setion 2

Pars, 5-8

Par. 5. Effect of Lase.of TIme Followin~ The Transfer -- There is no arbi-

.ry lapse of time folowi which a transfer could no longr be considered disqul-iiy. In some cases, tranfers may be necessary and entirely acceptable as far as

eligibilty is concerned even thgh made only a very short time prior to, or at thetime of, the application for assista. On th other ba, consideration of eligibi-ity on ths score might cover a transfer tht is qute old. The more recent trsfer,however, the more pertnt would be any question as to elgity.

Par. 6. How to Regard Deed Given to Save ForeclosUre u Dein of prop-

erty to a mortgge holder at the time of the imminency of foreclosures. proceeingusuay would not be disqulifg. Ony if such a traier were made With widisregard of the usua bargainng position of the mortggor which would entitle himto a consideration equvalent to the ÍJcome he would have derived during the year of

redemption, or of advantageous redemption possibilties, could the transfer be con-sidered disqufyng.

Par. 7. Re-transfer Termnates Efect of Disqug Trnsfer -- Th ef-fect of a (li8qufyng transfer or assignent is termte, as far as elgibility isconcerned, if an unconditiona re-transfer to the applicant is made, so tht the ap-plicat's fu lega and equtable interest in the property is restored; or if someother settement. satisfactory to the county welre bord an approved by the statedepartent, is arrived at wluch nulfies th efect of th trfer so far as th effect

,"In the Ileed and eligibility of the applicat is concern. It must be kept in min, how-er, tht the termination of the disqulifyng effect of a tranfer by are-transfer

..ces not necessarily mea tht the applicant is eligible for assistance, as the prop-erty re-transferred may be a resource by means of which, temporariy at least, in-come is available to meet requrements.

Par, 8. Trust Mortgge From Spuse to Correct Disqufyng Transfer uThe effect of a disqualifyng transfer of a homestead or other property to a spousemay be terminte by the spouse's exeuting a trst mortge on the propert as se-curity for assistance rendered to the applicant: tls method of correcting a disqu-tyng transfer in such cases is au option alterntive to re-trerring the propertyto the applicant.

April. 1963 Transmittd by

Maual Lettr #410Public Welfare Bord

of North Daota314-4 ,.

Soial Work ManualChapter 314

"'"'

PROPERTY FACTORS FORAID TO AGED, BLIND, AND DISABLED

Section 2

Pars. 9-10

1--, Par. 9. Life Lease to Correct Disqualifying Transfer -- As already indicated,

the consideration receted by the applicant as a result of his transfer of property toanother person is often important in determining what his intention was at the time ofthe transfer, since any transfer made for an adequate consideration coud usuay beshown to have been made for a reason other th to qulif for assistance.' Often-

times,in connection with property which has been the home of the applicant, part orall of the consideration rendered by the transferee consists of the furnshing of a Ufe .lease to the applicant in the home property. The evaluation of the life lease part ofthe consideration in such cases should not faU to tae into account th life exptacyof the applicant, the likelihood of his 'actual use of the property as a home during theremainder of his life, et cetera. In some cases in which a home has been transferred

for a consideration. but in which the consideration is inaequate. the disqualifyuigeffect of the transfer may be corrected by the givi of a lie lease. If the life lease,

is to be approved as a method of thus, correcting a disqung transfer, or if it is

deemed desirable and proper in any other circumstaces, it is executed on Form f! "

379 and recorded in the offce of the Register of Deeds in the county in which theproperty is locte.

Par. 10. Disqualification Not Permanent - - If it is foun tht a transfer basbeen made for the purpse of estalishng eligibity or avoiding encumbrance or re-

covery and the recipient is therefore disquifed, the disqufication isa.ot nes-

sariy permanent. The county welfre bord should detene the amount reeelvedor tht should have been received by the recipient as consideration for the trnsfer.

It may then determine the amout of monthy payment tht would be pad the recipientif he were not disqued. By dividing the tota amount the recipient receive or

should have received as cousideration for th trnsfer by th amount of his monthy.

grant. the county welfre bord may ascerta for how many month th appcat l. 'disqued. The assumption is tht during tht period of tlme th money recvefrom the sae or trfer of th propert woud be used for his iupport.

PubUc Welre Boof,Nort Daota

Transmitt byMaual Lettr *410 ' ~ J ~ ,

.' Apr. 1963

314..5.

,.

Soial Work Manual

Chpter 314

-4PROPERTY FACTORS FOR

A1 TO AGED. BLIND, AND DISABLEDSection 3

Pars. 1-3,

\SEC110N 3. REAL PROPERTY ,-"/

.. \.Par. i. Homestead Exempt From OM. AB. and APTD Transfer Requirements

u The "homestead" is exempted from tht provision of the state law regarding OAA,AB, and APTD acts which require that real property be transferred in trst as security

for assistace given.' If, how Er/er, the value of the homestead is in excess of $25,00it canot be classed as a homestead and the applicant is ineligible.

..',- ....Par, 2. Recipient May Not Encumber or Convey Without Censent of Public

Welfare Board h The basis for the homestead exemption is the desire by th legisla-ture to protect the use of the homestead for the survving spouse and dependents. Oncean application for OAA, ÁB. or AP is approved, the applicant is not permtted to en-cumber or convey his homestead wltbout the approval in writing of the state depart-ment. The means by which ths recirement of the law is fulflled is the "HomesteadStatement." When the owner of a homestead 1s granted assistance, the state depart-ment causes to be recorded in the offce of the Register of Deeds of the county in .which such homestead is locted, the Homested Statement. which is a statement inwriti to the efect tht the owner of such homested is receivi, or 1s about to re-

ceive OAA, AB. or AP payments. The statement is signed by the Executive Direc-tor of the Pulic Welfare Board. . The law provides tht, after the recording of theHomested Statement, any instrent of conveyance or encumbrance execute by thè '

applicant without the approval of the state department shall be null and void.

"e Homested Statement, since it is based on a special provision of the North Daota~tute, would not be valid in another state. A homeste in another state must be

trnsferred in trst by use of "Trst Mortgge" form and recorded in the county in

which th property is located.

(7

Par. 3. Definition of "Homestead" n The "homestead" is tht portion of therea property of a head of a famiy occupied or selected by him or her as a home, ex-cept tht It sha not exceed the follOWing limitations as to area or value:. c..,l.S"""'\

a) If it is withn a town plat, it shal not exceed two,pcres of land upon which

the homested claimant resides, and the improvements thereon, and notexceedng $25, see in vaue over and above liens an encumbrances.t I.ø 000 . .l' g ("l'""~' tl.

b) If it is not With a town plat, it sha not exceed 160 acres, together Withthe dwellng house situte thereon in which the homested claimant re-

side.. with al ita apprtnance., and al othr Improvementa on the lai

regardlelS of the vaue.

..-:--'"-'.¡"i

l:":':,,;:-.

,..V"-

April, 196S

314-6

Transmitted by

Manua Letter l410Public Welfare Bord

of North Dakota !,

.,

~~....

Social Work ManualChapter 314

....PROPERTY FAc-RS FOR

AID TO AGED. BUND. AND DISABLEDSection 3

Pan. 4-5

l Par. 4. Who May Claim A Homestead? ~~ While the homestead is originallyestablished only in reation to a person who is the head of a family, as explained

aboe, his (or her) homestead right in the particular home under consideration con-

tiues even after he (or she) no longer continues to be the head of a family. Ukewise,the right descends to the survVing spouse and/or dependents after his (or her) death.The phrase "head of a family" in th above definition of the homestead means:

a) The husbad or wife when the homestead claimant is a married person, butin no case are both husband and wife eah entitled to a homestead.

b) Every person who has resided on the premises with him and under his careand maintenance, eithr: (1) his child or the child of his deceased spouse,whether by birth or adoption: (2) minor brother or sister, or the minor

child of a decbsed brother or sister: (3) a fathr, mothr, grandather, orgrandmother: (4) the father or mother or grndather or grndmother of adeceased husband or wife: and (5) an unmarred sister or any other of therelatiTe8 mentioned in ths paragrph who have attined th age of majority

and are unale to take care of or supprt themselves.

,.-

Par. 5. Efect of Temporary Absence or Home Not Occulied u 'Te term"reside" as used in th abve detinition of "homeste.. refers to the fact of livi an

maJdng a home on the la; an the fat of whether or not a homeste claimant is en-

titled to a homested exemption is deteined in much th same way inwhic:h residencin a county or state 1s determd. JudiC::iai interpretation in various cases involVithe, homestead exempton act would seem to estalish the fact tht a person and Wi

famiy may'be considered to be "residing" in a home for th purpses of hmestedexempton:

a) Evn though thy are temporarty absent, provided there is no intention toabandon the,home. an there 1s an actu and continuing intention to even-tully return to and agan ocpy it as a homeste; and

b) If th prospetive home property bas beei p.rchased aÌi improved in pur-

. sunce of a go-fath intetlon to bu th fay dwel tireon. and toreside thre. even d: áctu ocpa bai not yet begu; providetht IU fay sha not coutl to be ccmdered &s "resid1n" threonif actu ocpauc bas not start With a resonable time afr comple-tlOI of th dwel.

PubUc Welfre Bordof Nort Dakota

Trumitt byManual Lettr l4 10

Apr, 1963

314~7

..

Soial Work Manual

Chapter 314

PROPER TV FACTORS FOR ..AID TO AGED, BLIND, AND DISABLED

Setion 3

Pars. 6- 10

Par. 6. Claimants Select Property To Be Treated As Their Homestead u Them -"selected by" as used in theo.aboe definition of i 'home stead " refers to the right

homestead claimants themselves to select tht portion of their property which.subJect.to the limitations heretofore describe, shall be claimed as a homestead. Thewordng of the law on selection of hom'ested exemption 1s as follows:

r/\

If a homestead claimant is marrie,d. th homestead may be selected fromthe separate property of the husband, or with th consent of th wife.from her separate property. When the homested claimant i8 not marriedbut is the head of a family. . . . the homested may be selecte from hisproperty .

Par. 7. Nee Not Be Absolute Owner -- The phrase "re property of a fam Mîly, " as used in the above definition tif "homested, tt does not imply tht a person needbe the absolute owner of land in order to be entitled to clam it as a homestead. Anyinterest in land, coupled with the requisite occupancy, is suffcicient to support a

homested exemption,"',

Par. 8, Should File Declaration If Not Uvhig On the Homestead H Propertywhich is not being presently occupied by the applicant but wluch i8 claimed a8 the home-stead may be treated as such only if the applicant and spouse make a Declaration ofHomestead, 1/ afer which a Homested Statement woud be recorded. A Delaration()f Homestead must also be made in every instance in which th vaue of the property

which the home is locte is in excss of th limitation speified In Par. 3 of thi

ction,and it is necessary for the appUcant to select and speify tht porton of suchproperty as he chooses to call his homestead. .

r

Par. 9. Must Transfer If Not "Homested" -. Every applicant for OM, AB, orAP who is Dot entitled to homestead rights, ai explained in Paragrph 5 of ths Se-tion, is required to transfer his or her home In trst.

Par. 10. Homestead In Name of Spuse - - A Homested Statement Ii not usedwhen the homested 1s In th nae of an tneU¡ble spouse under th age of 65 yean.When such a spose beomes elgie for OM, AD, or Al. the tlltrent wU berecorded alter appUcadon .. appft for such a'81sta.

1/ The contentJ of a Delaration of Homestead are describe in the North Dakota

,~ntiry Code; th &ssts1Bnc of an attrny is recommened for ltJ prepaation.t¿,"'-..";:-:-i_'--,,,,,, .¡¡

'"

April, 1963 Trnsmitt byManual Letter H 10

Pul1c Welfre Bordof Nort Daota

314-8 ..

..-lSocial Work ManualChapter 314

PROPER TV FACTORS FORAID TO AGED, BLIND, AN DISABLED

Section 3

Pars. 11-16

Par. 11. WbeniRecipient Requests County To Take A Deed n There are occa-

sional instances in which the applicant voluntarily requests the county to take a deedto the home, other real property or persona property, and, if the applicant's reasonsfor making the transfer to the county are valid, such a deed may be taken. The deedmust be to the county, however, and not to the county welfare board, since me countywelfre board is not a legal entity and is not legally entitled to own or tranfer reaestate. In the case of OAA, AB, and APm, deeds taken by the county are as trsteefor the federal, state, and county governents. In no case is the giving of a deed tobe suggested or solicited. .

Par. 12. Homestead of an Inian -- A Homestead Statement is recorded on

the homestead of an Indian uness held in trst by the Federal Governent. lnorma-tion as to whether the homt:stead is under trst may be obtained from the IndianAgency governing the area where the property is located.

Par. 13. Homestead Acquired Mter Marrage n In cases in which a trstmortgge has been executed against a home by reason of the recipient not having ahomestead right, and th recipient subsequently marries and uses the propert as a

home, or declares it to be such, a Homeste Statement will be recorde. Th trst

mortgge, howe7er, is retained as the property continues to serve as security tor thamount of OAA, AB~ or A. extended prior to the time tht the property bee ahomestead.

Par. 14, When Homested is Abndoned -- If a recipient abdons a homesteadagainst which a homestead statement has been recorded, or declares anothr piece of

property to be the homestead, a trst mortgge should be promptly execute on theabadoned homested.

Par. 15. When Buildins, Trailer Houses, or Home are Persona Property u

Buildings which are not a pat of the land on which they are locted are persona prop-erty, and subject to a trst chattl mortgge, even though used as a home. If the ap-plicant acquires the la, or moves the building to land which he own, the property

would thereby become rea estate. and subject to a homestead statement or trst

mortge, whichever is appropriate.

Pa. 16. Transfer of Home Covered Bi Homestead Statement - - Since the

transfer of a homested on which a Homeste Statement has been recorded is nuland void by law, an attmpt on the part of the recipient to effect such a transfer bygiving an recording of an instrent of conveyane or encumbrane caot disqualhim for assistace. The recordin of such an instrment does, however, add to pro-

bate costs beuse of the fonnalities required to establish tht it is nul and void; anattmpt should be made. therefore. to have the recipient obtain an record an intr-

ment re-transferrng the property or property-interest to him.

\Public Welfare Boardof North Daota

Transmittd byMaua Letter #485

March, 1965

314-9

--

-4Soial Work ManualChapter 314

PROPERTy FACTORS FORAID TO AGED. BUND. AND DISALED

Sec.:tion 4Pan, 1-2

'EcnON 4. REAL PROPERTY.OTIER THAN HOMESTEAD i

\,

Par. 1. Al Rel Property Except Homestead an Property Held in Trst

Trasferred in OM, Ant and AP u The OAA, AB, and AFTD section of the lawprovides tht all real property, with the exception of a homestead or ref.l property

held in trst by the Federal Governent, shall, as a condition precedent to the a,p-proval of assistace, be transferred in trst as security for OM, AB, and APIDpayments. The Trst Mortgge is used to meet this requir~ment of the law. Thisinstrment is executed even though the property has a sec\,red or unsecured mortggeor mortgages already recorded against it, is in the proccess of i'o'(;c!osure, or is thesubject of an unrecorded deed delivered to some other person.

If the county welfar¡; board has rea(on to believe that there is an unrecorded deed, anattmpt should be made to have it surrendered and destroyed. If such unrecordeddeed is not surrendered or destroyed and does not become recorded, and the county

welfare bord knows of its existence, cognizance should be taken of the fact tht suchdeed would take precedence, and should be recognized as a transfer of property, If

such transfer does not disqualify the applicant, and the outstading unrecorded deeddoes not become recorded, the trst mortgage should be recorded in order tht theproperty provisions wil be carried out in th event tht the unrecorded deed does notturn out to be an actua.! transfer of property. If the county welfare bord does notknow of the existence of an unrecorded deed, such deed does not take precedence over'"he Trst MortgagE: or Homestead Statement. /"

Par. 2. Mamum Value of Real Property - - TI.e maxmum veJUE of real prop-ert other thn a homestead tht an applicant Eind his sPOUSt; may own to be eligible for

OAA, AB, and AFTD, is established at $8,000 over and above lìens and encumbrances.Ony as the oVvLlershíp of such property withn such limit af~cts need, such as by its

cap&city to produce income, or its availability for advantageous sale, does it have aneffect on eligibihty for assistace.

The advisabilty of requiring tht such property be offered for sale sha be weighedagainst the current income which the property produces a.r.d can be made to produceby careful maintenace and management, In all insta..es, the income received mustw&.rrõnt the E:xpensé of continuil'.g the ownership of, or equty in. the property. If the

property does not produce sufcient income to provide a resource to the applicant,the applicant. as a condition of eligibility, will be required to convert such propert10.to available cash. The applicant may be deemed eligit-le. if in need, pending theconverting of the property for a reasonable ome, but if the applicant fails to convertthe property within a reasonable time because he does not wish to cooperate, he willhe ineligible for public assistanc.e, A reasonable time shan be constred to mea aperiod of 81: months or less, When such property is sold, the cash proc.eeds mustbe considered as income available to meet the needs of the applicart.

r~,TTc1nsmined by

Ma!"u.:l Lettei #485Putlic Welfã.H Foard

of North Oã.kota

I!

IMarch, 1965

314- 10 ",

..-4 ,;

..

Soial Work ManualChapter 314

PROPERTY FACTORS FORAID TO AGED. BLIND, AND DISABLED

Section 4

Pars. 2.3

-,In instaes where such property is to be offered for sale, the county welfare bordwill appraise the property to determine its current value. The appraisal value shandetermine the resource which is availale to the applicant.

Par. 3. Transfer of Real or Personl Pro~rt: Covered by Trust Mortge --There is no legal restriction. against the transfer of real or personal property agatutwhich a Trust Mortgage has been recorded. Any such conveyance would be sllbject tothe Trust Mortgage. and would in no way invalidate it. Such transfer would result indiscontinuance of assistance only if the proceeds were suffcient to enle the recip-

ient to provide for his own requirements, and only for such time as such proceedswere suffcient to so provide. A person taing title in such a case would take it sub-ject to the Trust Mortgage l\nd would be liable for the repayment of aU assistance re-cei ved.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #410Aprl, 1963

314-11

\

..-l

PW 199(Rev. 11- 70)

/( ..

NOTICE OF WITlIRAWAL OF APPEAL

To the Public Welfare Board of Nortlf Dakota

Bismarck, North Dakota 58501

1, , of

County, North Dakota, having on the day of . 19..

filed a Notice of Appeal for a fair hearing, do hereby withdraw my request for the

following reasons:

Dated this day of . 19

(Appellant)

. North Dakota

"auv North Dakota Products" 361.17

.-Form 135 (Rev 11-71) ..

BEFORE THE NORTH DAKOTA SOCIAL SERVICE BOARD

;"

( fi,BlS~~RCK, NORTH DAKOTA

State of North Dakota Legal Residence

(COU;1ty)55County of Burleigh

Case No.Physical Residence

(County)

NOTICE OF APPEAL

To the North Dakota Social Service Board. Bismarck, North Dakota:

Notice is hereby given that the undersigned... (Name of Appellant)

of reques ts the Social Service Board to conduct a(Address)

fair hearing.

APPELLANT'S REQUEST IS FOR A FAIR HEARI~G ON THE ACTION TAKN ON

BY:

19,

(date)

/ / 1. County Welfare Board

OR

\.l / II. Social Service Board Medical-Social Review Team

LJ i. Denying appe11an t ' s application forOR

LJ 2. Suspending appellant's grant forOR

L7 3. Closing appellant's case forOR.c 4. Decreasing appellant' 5 grant forOR

LJ 5. Other: (Specify) ,

Reasons appellant disagrees ~ith the above action of the county welfare board or Social

Service Board Medical-Social Review Team:

Dated j 19_ at\.

(Appellant)

*Original to Ei-ecutive Director. Social Service Board l Bismarck (By Register~d :'1all).One copy to county welfare board.One coov to hl" r;;r-::dnl"n hv """.;.""11,...t

..-.f

Social Work ManualChapter 361 COMPLAINTS ANU ~PPEALS

Section 7

Pars, 1-3

SECTION 7. CONCLUSION ...

Par. 1. Report Studiedby State Department Staff ~vfembers -~ The report of thedecision on the appeal is studied by staie stafJ members responsible for theadminis-tration or public assistance, medical assistance, or servìces, ror the purpose of re-evaluating the state department's policies, standards, and practices; and by state staffmembers responsible for field supervsion in order to evaluate the county agency'sinterpretation of the assistance program and the efficacy of their own work with thecounty agency. Since the hearing often brings out the (tounty agency's problems ofadministration and personal relationships as well as of interpretation, the report of ahearing is also studied by state staff members for the purpose of obtaining a betterunderstanding of the county agendes.

..Par. 2. Report of Decision Used in Evaluation Process -- The county agency

uses the report of the decision to evaluate its own work; and as a basis for interpreta-tion of the program and for conferences with the program supervisor. Both the 'statedepartment and the county agencies use the results of a hearing as a supervisory toolfor the fu:;t'hr development of the assistance program.

Par. 3. Appeal Procedure Has Nation-Wide Application - - The appeal procedureis nation~wide in its application to public assistance, medical assistance, or services,and a county welfare board is not justified in viewing the procedure as aimed at anyspecific or peculiar conditions in this state or in any particular county. A fair hearingecision different from that originally made by the county welfare board does not usu-

ally indicate an error in judgment or lack of sincerity on the part of the county welfare

board inasmuch as additional facts are often produced tht were not in evidence at thetime the county welfare board made its decision, The entire appeal procedure requires

the whole-hearted cooperation of the county agency and the state department in the inter~est of obtaining justice for the individual.

..~Æ:~;-,: :-"",

r '.'1..

February t 1970 Transmitted by

Manual Letter #740

Public Welfare Boardof North Dakota

361-14

..-4

Social Work l",lii11ualChapter 361 COMPLArNTS AND ¡\PPEALS

Section b

Pars. 8"~lO'

-,Par. 8. Payments to Effectuate Decisions are Fcderall)t l\'1atche~ u A rayme

made to carry out a decision on an appeal will be federally matched as a current paymeut for all or any part of the period in which the appeal wa s pending in addition to the

month of filing, and the two preceding months. provided that the amounts paid wereshown to have been improperly denied or withheld in such monils by administrativeaction.

Par. 9~ Record, Testimony, and Evidence of Hearings Available in CountyOffce -- A copy of the transcnpt of all testimony and all evidence submitted as ex-hiits at a fair hearing, or the summary of the testimony and evidence as agreed to by

the parties, will be sent to the county agency and wil be available to the appellant andinterested parties at any i-asonable time. The appellant is notified in the l'otice ofDecision as to the availabilty of this material.

Par. 10, Prompt Administrative Action and Judicial Renew Notification --Prompt, definitive, and final administrative action will be taken within 60 days fromthe date of the request for a fair hea.ring. The appellant will be notified of the decision,in writing, in the name of the Public\Velfare Board of North Dakota and of his right tojudicial review.

..,....

\

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter ':740February. 19'70

361-13

..--Social Work ManualChapter 361 COMPLAINTS Al\U APPEALS

Section 6

Pars, 5-7

Par. 5. Appeal Decisioq.,is Final - Local Agency Informed -- The decision of

Public Welfare Board is final and shall be put into effect by the county agency im-iediately in accordance with the terms of thePublíc Welfare Board decision. This

decision does not preclude the county abrency from modifying the grant thereafter tomeet changed conditions. After such modification the recipient would again have theright to appeal if dissatisfied.

)

Decisions of the Public Welfare Board will be binding on the state and local agencies,The appropriate division of the Public Welfare Board ìa charged with the responsibilityof determining that the decision of the Public Welfare Board on all appeals has been putinto effect, The Public Welfare Board through the Appeals Referee will inform in sum-

may form all local a'gencies, which are the county welfare boards in the state of NorthDakota, of all of its fair hearing decisions.

A copy of the decision by letter from the executive director of the Public Welfare Boardto the county welfare board shall be kept in the appellant's fie by the county welfareboard having jurisdiction of the case and this copy of the decision shall be accessible tothe appellants, claimants, their representatives, and the public subject to the provisions

relating to safeguarding public assistance information.

Par. 6. County Agency to Notify When Decision Carried Out -- Upon receipt of

a copy of the decision on an appeal, it shall be the duty of the county agency to notify thedirector of the appropriate division of the Pulic Welfare Board as soon as necessary"'teps have been taken to put the decision into effect. This notification should include a,tatement as to the specific steps taen, the amounts, dates, periods, et cetera, of

assistance approved, and any other information pertinent to specific points in thedecision. This notification is necessary as the means by which the state department

may assure itself that the decision on the hearing has been carried into effect. A re-view of the case situation in the COWlty offce by the program supervisor within areasonable period of time following the decision on th appeal will also be a pat of ths

procedure. The appropriate division of the Public Welfare Board is charged with theresponsibility of having ths paragraph put into effect without delay after the PublicWelfare Board decision is made in an appeaL.

Par. 7. Reopening for Rehearing After Decision Made - - Consideration ofapplications to reopen the case for rehearing after a decision has been announced is

discretionar with the Public Welfare Board to be based on new evidence indicating that

an unjust or invalid determination has been made.

/L 't

February l 1970 Transmitted by

Manual L.etter #740Public Welfare Board

of North Dakota361-12

..-4

Social Work ManualChapler 361 COMPLAINTS A?\'D APPEALS

Section 6

Pars. 1.4

.( SECTION n. FINDlNGS AND DECISION

Par. 1. ~~feree Submits Report to Pubhc Welfare Bo~rd -- After the hcarin(.the Appeals Referee w111 promptly subinit a wrnten synopsis of the testimony and his

recommendation for a decision uporl the appeal to the Public WeUare Board. In additionto the report of the Referee, the record of the hearing that is submitted to the Board

includes the verbatim transcript of the hearing and all papers and documents that wereput in evidence.

. Par. 2. Action by Public Welfare Board ~~ In arriving at its decision, the PublicWelfare Board will consider the Referee's report and the other material submitted, andwill not consider any other material except this, The Referee will always be consulted,

since he is in a peculiarly."advantageous position to evaluine the evidence. The Boardmay adopt a.rd confirm the findings and recommendations of the person conducting thehearing, or may reject these recommendations and reach independent conclusions on

the basis of the evidence, or may again refer the matter for further hearing.

Par. 3, May Submit Evidence After Close of Hearing -~ Both the appellant andthe county agency have the nght to submìt eVidence after a hearing is closed. Copies

of such new evidence, however, must be sent to the other paty, together with an ex~planation as to his right to explain or refute the new evidenc.e. The disposition:o~ suchnew evidence wil depend upon the time of its receipt. If It 15 received propr to thetime that the report is submitted to the Public Welfare Board. It may. if considered tobe evidence of consequence as affecung the decision in the case. be the basis uponwhich the Appeals Referee may reopen the hearing. If it is received subsequent to tl.time that the report is submitted to the Board or, if received prior to that time, but the

Referee has not reopened the hearing as a result, then it should be considered by theBoard only as a basis upon which to order a reopening of the hearingj if it is not con~sidered pertinent enough to warrant a reopening of the hearing, it is not to be takeninto consideration in arriving at the decision in the case.

Par. 4. Contents of Report of Public Welfare Board - - The report of the PublicWelfare Board sets forth 1ts findings and decision. The Publïc, Welfare Board will also

designate the date, present, future, or retroactive, upon wlùch the decision becomes

effective. A copy of the decision is sent to the appellant, the county agency. and the

appropriate division director of the Public Welfare Board.

Public Welfare Boardof North Dakota

Transmincd by

Manual Letter "740February, 19'ì'w

361-11

..-4

Social Work Manual., Chapter '361 COMPLAir-trs kND APPEALS

. Section 5

Pars. 9.13 '.. .' .

D. bLOSINGS AND ADJOURNlvNTS)

Par. 9. When May Hearing Be Closed -- The hearing may be closed when the

person conducting the hearing is satisfied that all pertinent information bearing upon theappeal has been introduced and examined. The appellant is advised at the close of thehearing that he wil be informed by letter of the findings and decision on his appeaL.

Par, 10. Adjournment at Discretion of Appeals Referee -. The hearing may L~

adjourned from day to day or to a designated day, at the discretion of the AppealsReferee, and upon reasonable notice to the appellant and other interested parties; thehearing must be so adjourned when reasonably necessar to afford full opportunity tothe parties to obtain and present all evidence. .' .

..Par. 11. Mal Adjourn to Enable County Welfare Board to Act on New Informa-

tion -- If new evidence is presented at the hearing which was not previously in thepossession of the county agency, and the new evidence is of such a nature as probablyto cause the county agency to revise its decision, the Appeals Referee has authority tocontinue the hearing. If. in the light of the new evidence, the county agency is able tosatisfy the appellant, the appellant will be asked to withdraw his appeal.

Par. 12. Procedure When Ap¡:llant Fails to Appear -- When the appellant failsto appear or to be otherwise represented within a reasonable time after the scheduled

time of the hearing, the person conductig the hearing shall write to him asking that he"dvise the state department of the reason why he failed to appear at the hearing. If the

.ppellant does not respond or wish to have a hearing at a later date, and does not with-draw his appeal, the Appeals Referee will proceed to make his fidings and recommen-dations.

Par. 13. Hearings Closed if Appellant Fails to Appear Second Time - - If,after having failed to appear or to be otherwise represented at an originally scheduledhearing, the appellant faUs to appear or to be otherwise represented at a secondhearing that he has agreed to attend or be represented at, the Appeals Referee willproceed to make his fidings and recommendations, unless it appears to him tht thereis good cause for futher adjournment.

r"f .lFebruary, 1970 Transmitted by

Maual Letter #740Public Welfare Board

of North Dakota361-10

..-4

'. Social Work :-lanualCha pter 361

.CO?\1PLA1NTS AND APPEALS.. ._.__-;_...._w...... _ ~ ; Ji

Section 5

Pars, 5 S.. -, '

,

Par. 5. ~peaT~efe~e Has ß!EllÈ .'\ul12.0rity - - The Appeals Referee has br(:?\authority to conduct the hearing 11 such a way as to bnng out all the pertinent facts:

an orderly manner, He may exclude extraneous evidence, ask for addìtional evident..ask that additional documents be brç.ught in. ask for additional witnesses. questlon

witnesses as to their competency, dismiss witnesses from the room for good and suffi-clent reason, compel the attendance of witnesses by subpoena, administer oaths. anddismiss from the hearing room all persons not concerned with the fair hearing aswitnesses,

· Par. 6. Acceptable Evidence or Test; many - - In riceiving testimony and other

evidence, the Appeals Referee may permit any oral testimony or receive any documentsor other evidence which in his judgment appear to be reasonaly related to the issueinvolved and to have value.-in determining the facts in issue.

When the hearing involves medical issues, a medical assessment other than that of theperson or persons involved in making the original decision wil be obtained and made apat of the record if the Appeals Referee or the appellant considers it necessary.

" ~ ".'

Par. 7. Technical Rules of Evidence Do Not Apply u Technical rules of evi~dence do not apply, so that, in developing the facts relevant to the points at issue, theperson conducting the hearing need nDt reject testimony or proofs on certain groundsupon which a court of law would reject them, such, for example, as the fact that theyare not the best proof, or that the person responsible for the statement is not presentor that documents have not been authenticated. Affdavits of persons not present ane'

who cannot be questioned should rarely be used. Care should be taken to insure the

accuracy of all copies of papers and extracts from records, and reasonable effortsshould be made to obtain the most credible evidence of any fact, where it exists,

C. RECORDING

Par. 8. Complete Stenogra:phic Record Is Taken -- A complete record of the

proceedings at the hearing is made by a recording device. Where it is impossible tohave a record made, a summary of the testimony 8Jd other evidence is set down inwriting upon conclusion of the hearing, and this should be agreed to and si gned by theinterested parties as a fair statement of the proceedings,

Public Welfare Boardof North Dakota

Transmuted by

Manual Letter ;:740February, 19ïO

361.9

.--l

Social Work ManualChariter 361, COMPLAINt's AND APPEALS '

...

. Section 5. .Pars, 1~4

~CTrON 5. CONDUCT OF THE HEARING

A. A TTEl\TDANCE

Par. 1. Conducted by Appeals Referee ~~ The hearing is conducted by the

Appeals Referee, who is an official of the state department designated by the executivedirector to hold such hearings.

Par. 2. 'Who May Attend the Hearing -- The hearing is attended by the appellantand any witnesses whom he may request to have present who are able to give relevanttestimony concerning the facts in ql!estion, and by representatives of the county agencyand the state department who may have been concerned with the case. If the appellantis not able to be present at the hearing, he may be represented by someone else, pref-erably a relative or friend to act in his behalf. He may be similarly represented if heis present at the hearing, The appellant has the right to be represented by an attorney

if he so desires. Section 50-24-37 of the North Dakota Century Code provides that no

fee may be charged by an attorney for representing an appellant in a fair hearing inAAD cases. The county agency may properly bring members of the county welfareboard and any witnesses who are able to give relevant testimony concerning the facts inquestion. The hearing shall not be open to the publíc.

'R. PROCEDURE

Par. 3. Three Steps Essential in Every Hearing- -- The following procedure is

essential in every hearing:

1. A statement of the problem and the points at issue, made by the Appeals

Referee at the openig of the hearing;

2. Opportunity given to the appellant, representative of the county agency, orothers interested in the hearing, for correction or modification of the state*

ment of the problem; and

3. Development of the facts relevant to the point or points at issue.

Par. 4. Hearings Are as Informal as Possible u In practice, the hearing is asinformal as possible and provides an opportunity for all persons who have pertinentinformation to be beard promptly. The appellant and county agency are given theoppòrtunity to examine all evidence, to offer testimony and rebuttaL, and to questionopposing witnesses.

.February, 1970 Transmitted by

Manual Letter #740

Publìc Welfare Boardof North Dakota

361-8

..-i

Social Work ManualChapter 3'61 COMPLAINTS' AND .APPEALS

$e.: lÌon 4,Pars. 6.11

. \ . f',Par. 6. Appeals Referee May Request Additional Information -- If'the trans..

cript from the county agency clearly shows that lffponant information is lackin~. thAppeáis Referee may request the county agency to make, a supplementary in\'esri~o1i.or otherwise obtain the needed information; or may request the area social service

i center to visit the county in an attempt to assist in obtaining the desired facts.

Par. 7. Services of the Area Social Service Center ~- When an appeal is fied.

the services of the area social service center are åvailable to both the county agency

and the appellant in advising them as to the adequacy of the information at hand,~ the

desirabilty of securing additional information, the proper interpretation of the perti~'nent statutes and regulations, and the desirabilty and methods of reconsidering actibnsor decisions leading to or ponstituting the appeal.

Par. 8. Information from Case File Available to Appellant -- Information con-tained in the case fie may be helpful to the appellant in preparing his case for t.1¡e

appeaL. If the appellant asks to see certain documents or other papers. they should beremoved from the fie for his inspection. He may also want to refresh his memory onspecific facts or dates recorded in the narrative or chronological record; upon request.such information should be imparted to him by the worker. If the request for informa-

tion is received by mail, the request should be answered by sending copies of the perti~

nent records or otherwise supplying the factual information requested.

\._"Par. 9. Time of Heari~ -- In setting the date for the hearing. the Appeals

Referee will be governed by the objective of having prompt, definitive and final admi:istrative action taen within 60 days from the date of receipt by the state department

of the request for a fair hearing.

Par. 10. Place of Hearing u In setting the place for the hearing, the AppealsReferee will select a place convenient to the appellant, usually in the offce of the county

agency of the county in which he resides. In case the appellant is outside the state, thestate (iepartment will attempt to arrange for a hearing to be held by officials oI the statein which the appellant resides, unless the appellant prefers to return to North Dakota~ . .. .for the hearing.

Par. 11. Hearing Canceled Upon Signed Withdrawal -- If the appellant of hisown volition, either as a result of a better understanding as to the conditions of eliø-bilty or as a result of a satisfactory adjustment of the questions at issue, decides to

withdraw his appeal, the Appeals Referee should be notified promptly so that the hear-ing may be canceled. The appellanls acknowledgment of withdrawal or satisfactoryadjustment should be in writing over his signture, giving reasons, and should be

mailed to the state department, The form PW 199, "Notice of Withdrawal of .-\ppeal, ..could be used for this purpose.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #792

ì\ovember, 19iO

""..SOcial Work ManuflChapter 361 ' COMPLAINTS AND APPEALS

.

Section 4

Pars, i-5 . ." #...,

SECTION 4, PROCEDURE PRE:i'IMINAR Y TO THE FAIR HEARING

Par. 1. Form to be Used in 'filng ApReal u An appeal is initiated by the client,with the county a&rency or the state department, of his request in writing over his

signature or mark, or at rus request the signâture of someone on his behaf, for the

review of his case by the state department. This should be done on Form PW 135,"Notice of AppeaL." If the appeal results from dissatisfaction over a decision, and isnot an appeal from delay in decision, the appeal must be fied within 30 days of the

receipt of written notice of such decision.

Par. 2. To Assist AEpellant in Preparing Form - - It is the duty of the countyagency to assist the appellant in the preparation of ths form if requested by him to doso. If so requested, the information which the appellant desires to have reported on

the form as the grounds for his appeal should be reported thereon as be desires to have

it reported. The line underscored "Appellant" should contain the signture of Jie appel-

lant, or the person he requests to sign on his behalf if for any reason he cannot sign the

Notice of AppeaL.

Par. 3. Number of Copies and Routing -- Upon the appellant's request for theform on which he may make an appeal, he should be furnished with thee copies ofPW 135. The appellant retains one copy, and files the original and one copy with eitherthe county welfare board Or the Public Welfare Board, whichever he desires. Thecounty agency, upon receipt of the original and one copy of the form from the appellant,

ill send the original to the state department; likewise, the state depatment will send..1e duplicate to the county agency upon receipt of the form in duplicate in the statedepartment.

Par. 4. State Department Sends Prompt Acknowledgment to Appellant -- Upon

receipt of the request for fair hearing in the state department, either directly from theclient or from the county agency, an immediate acknowledgment is sent to the appellant,and he is advised of the date, place, and hour set for the hearing, or is informed that

he will be so advised within a few days. In the notice of the hearing, the appellant isencouraged to advise the state department or the county agency if the arrangement isnot convenient for him and to suggst a more suitable time and/or place for the hearing,

Par. 5. County Agency to Furnish Transcript of Information - - The county

agency is promptly notified of the receipt of an appeal and requested to furnish theAppeals Referee with a transcript of pertinent information from the client's case fie.This will usually consist of complete information as to the basis for the county agency's

action, a summar of the case reCord, a copy of the "Budget Schedule, " Form PW 286,and a description of the pertinent documents considered in reaching the decision. Thetranscript should be transmitted promptly to the state department by mail, five daysbeing the maXmum time allowable for preparation and mailing.

(~ If

February, 1970 Transmitted by

Manual Letter #740

Public Welfare Boardof North Dakota

361-6

..-.Social Work Ì\lanual

- Chap~er.\361 ,CO;\IPLAJNTS AND APPEA-LSSection 3

Pars. 4-5 '.'

Par. 4, ~lust !hform Applicantof His Right to a Fair Hearing -- The manda'.....

provisions begin with the responsibility of the stale department and the county agcn'

see that the applicant or recipient shall have been properly informed of all his rights ulrelation to fair hearings. The state_-department attempts to meet this responsibility by

having printed on rhe Notice of Decision (Form PW 600) a statement fully informing theapplicant of hisrìght to appeal and the steps to be taen by him to avail himself of thisright. The county agency attempts to meet its responsibilty in this connection by theproper use and interpretation of the forms and other written material supplied, and by

explaining the right to a fair hearing to the applicant at the time of the application inter~1 view and later whenever there seems to be need for further interpretation.

Par. 5. Rules and Regulations Available for Reference and Distribution -- The

rules and regulations govêrning appeals and fair hearings included in this Chapter shallbe available in the county office for reference to interested persons.

...-.

Public Welfare Boardof l'orth Dakota

Transmitted by

Manual Letter #740

February, 1970

361-5

..""

Social Work ManualChapter 361 COMPLAINTS AND APPEALS

~~."A~ '. , .. .aCTION 3.' It\TTRODUCTION T"ó APPEALS AND FAIR HEARINGS

Section 3

Pars. 1-31I

"

Par. 1. Objectives of the Appeal Procedure -- The objectives of the appeal and

fair hearing procedure are:

a) To safeguard the interests of the individual by affording him a practicalmeans by which he is protected against county agency actions which arecontrary to state policy;

b) To protect the county agency from unwarranted pressure; and

c) To assist in the developnient of policies and procedures by bringig to theattention of the state departtnent information indicating the need for clarifi-cation or revision of county and state department policies and procedures.

Par. 2. Grounds for Appeal and Fair Hearings -- A fair hearing may be demanded

in relation to any decision of the county agency or state department with respect to publicassistace, medical assistance; tir services for the individual, and in relation to anyfailure to act on the part of the county agency.

An applicant or recipient is entitled to a fair hearing under any of the following circum-stances:

a) If opportunity to make application or reapplication has been denied;

b) If his application has been rejected, or has not been acted upon witln areasonable period of time;

c) If the grant is inadequate or inequitable in relation to the state's stadardsof assistance;

d) If the grant has been modified, suspended, or canceled; or;

e) If reconsideration is refused or delayed.

Par. 3. Fai Hearings Provisions Mandatory -- The basic principles of fair

hearings and the stadads adopted by the state department for carrying them intoeffect are mandatory, since they are basic requirements of federal and state statutes,

.'February, 1970 Transmitted by

Manual Letter #740Public Welfare Board

of North Dakota361-4

..

Social Work Ì\lanualChapter 361

-.Section 2

Par. 5COMPLAINTS AND APPEALS...' . . .Par. 5. , Procedure When COll.plaìnt,ls I\lade to State Depar.iment -- When com-

plainants come in pers~n to the state department, reports of the interviews are senuthe county agency, and the county agency is asked to inform the state department of.

facts in cOlmection with the situation that it would be well to have on file in the statedepartment if the matter should come up agaln. When written complaints are receivedin the state department, the county agency is sent a copy of the complaint and requestedto furnish the state department with such information as wil make it possible for thestate department to formulate an informational and helpful reply to the complainant. Ineither case, the complainant is referred to the county agency for any further contact he

may wish to make with regard to his situatioii, and is advised of his right to appeal.The state department reserves the right to handle special situations on a case-by-casebasis.

..

. . .,....., '.

Public We Hare Boardof North Dakota

Transmitted by

Manual Letter #740

February. 19,_

361-3

.....,

Social Work ManualChal?ter 361

.COMPLAINTS Al\D APPEALS

Section 2

Pars, 1~4

.~ISECTION 2, COMPLAlt\1TS IN "ENERAL

Par. 1. Cause and Siæiificance of Complaints -- Complaints from applicants

for or recipients of public assistance, medic~_l assistance, or services, or from personsinterested in their behalf, arise from many causes. The number and type of complaintsmay indicate the problems that the county agency is facing as well as the tye of servicethat is provided by the county agency. They may be an indication of the need for moreadequate interpretation of the function of the agency at the time an application is madefor assistace. They may ìndicate more staff development training sessions are needed.

Par. 2. Standards of A~ncy Indicated by Way Complaints Are Met -- The fact

tht complaints are made should not in itself be disturbing. The way in which the com~

plaints are met, however, does indrêate the standads of the agency, Every complainanthas the right to expect a sincere attempt on the part of the agency to meet his problem,to explain why he is not considered to be eligible for assistance, or the reason for the

,board or staff action complained about.

Par.~. When Does a Complaint Become an Appeal -- Ordiarily the dissatisfiedapplicant or recipient wil make his complaint to the county agency, either in person or

by letter. On the other hand, a complaint may originate as, or develop into, a specific

request on the part of the applicant or recipient for a review of the decision of the county

agency by the state department. Such a complaint, when fied on the form specified forthe purpose, is recognized as an "appeal" and is followed by a special procedure for fair

~arings as described in the Sections to follow.

Par. 4. Procedure When Complaint Is Made to County Agency - - When the com-

plaint is made to the county agency l provision should be made by the county agency for

the careful consideration of the complait. The county agency should review the situation

and take action suitable to the circumstances. This action may consist of an explanationand interpretation of the program either by letter or by interview. remedial action, orthe institution of the, appeal procedure.

In every complaint situatiorí attention should be given not only to the question as to'whether the treatment of the applicant or recipient was in accord with established policy.but also to a review of the policy itself to determine its fairness and adequacy, In manyinstances complaints have helped to claify policies and at times to change them.

/,ø:~:..,f¡

. February, 1970 Transmitted by

Manual Letter #740

Public \Veltare Boardof North Dakota

361~2

.A-.

.Social Work Manual

. Chapter 361 COi\:PLAH\ífS AND APPEALSSection 1Pars. 1-5

( ....SECTION 1. DEFIÌ'nTION OF TERMS

.

Par. 1. Definition of "Complaint" -- A complaint is any expression of dtssatli:-faction by or in behalf of an applicant for or recipient of public assistance. medicalassistance, or services concerning any action or nonaction on his case by the county

agency, whether such expression be formal or informal, and whether it be made to thecounty agency or the state department or both.

,

Par. 2. Definition of "Appeal" u An appeal is a specialized type of complaint

in which the dissatisfíed applicant or recipient makes a. specific request for a reviewby the state department of a decision or delay in a decision of the county agency con-cerning his case. ..

Par. 3, .Definition of "Fair Hearing" -- A fair hearing is a proceeding at which

the state department undertakes, upon receipt of an appeaL. to examine the circumstancesof an applicant or recipient who believes that proper action has not been taken by the

county agency relative to his situation, and to arrive at a finding of facts and a decision

on the appeaL.

Par. 4. Definition of "Appeal s Referee" -- The Appeals Referee is the officialdesignated by the Executlve Director of the state department to set the time and placefor the fair hearing on an appeal, to conduct such hearing at the time and place desig-nated, and to submit a report of findings to the Pulic Welfare Board for final decisiorThe Appeals Referee shall be a person who has not taken part in the particular actioifrom which the appeal is taken.

Par. 5. State Department Determinations Included -- Since the state department

may, on its ow.. motion, review individual cases and make determinations which arebinding upon the county agency, an applicant or recipient aggrieved by such determinationshall upon request be afforded the opportunity for a fair hearing. All references in this

Chapter to appeals from decisions of county agencies shall, therefore, be understood toinclude appeals taken from determtnatioI:s made by the state departmellt as describedabove.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter # 740February, 1970

361 ~l

....Social Work ManualChapter 361

,SECTION 5. CONDUCT 0 F THi, HEARING

COMPLAINTS AND APPEALSw

ChapterContents

~ . ,l

. ATT~NDANC5 i1 - Conducted by Appeals Referee,

Par. 2 - Who May 'Attend the HearingB. PROCEDUREPar. 3 ~ Three Steps Essential in Every Hearing

Par. 4 - Hearings Axe as Informal as Possible

Par. 5 - Appeals Referee Has Broad Authority . ',' .

Par. 6 - Acceptable Evidence or Testimony ,

Par. 7 - Technical Rules of Evidence Do Not Apply. "

C. RECORDING 'Par. 8 - Complete Stenographic Record Is Taken.

D. CLOSINGS Al\TJ ADJOURNìvIEI\'TSPar. 9 - '''hen May Healing be Closed . . . :Par. 10 - Adjournment at Discretion of Appeals Referee

Par. 11 - May Adjourn to Enable County Welfare Board to Act on

New InformationPar. 12 - Procedure When Appellant Fails to Appear, ....Par. 13 - Hearings Closed if Appellant Fails to Appear Second Time .

. .. ,

361-8361-8

361-8361-£

.. 361-9

361-9361-9

361-9

361-10361-10

361-10361-10361-10

SECTION 6. FINDINGS AND DECISION

"ar. 1 - Referee Submits Report to Public Welfare Board,

ar. 2 - Action by Public Welfare Board,

Par. 3 - May Submit Evidence After Close of Hearing. .

Par. 4 - Contents of Report of Public Welfare Board

Par,S - Appeal Decision is Final -- Local Agency Informed.PaL 6 - County Agency to Nottfy \¥hen Decision Carried OutPar. 7 - Reopening for Rehearing After Decision Made " .

Par. 8 - Payments to Effectuate Decisions are Federaly Matched.

Par. 9 - Record, Testimony, and Evidence of Hearings Available

in County Office., ' . . ' ..,. r" , ", '" . . . . . .Par. 10 - Prompt Administrative Action and Judicial Review Notification .

361-11361-11361-11361-11361-12361-12361-12361-13

'361-13 . -;1 '361-13

~ECTION 7. CONCJ.USJON ...... -

Par. 1 - Report Studied by State Depatment Staff Membrs . .Par. 2 l - Report of Decision Used in Evaluation ProcessPar. 3 - Appeal Procedure Has Nation - Wide Application

. .361-14361-14361-14

.

FORM PW 135 - Notice of Appeal. . . .

FORM'PW 199 - Notice of Withdrawal of Appeal.. 4' .. 361-15

361- 17. . . . il ..

.(f?"""¡ ..I

,..ebruary, 1970 Transmitted by

Manual Letter #740

Public Welfare Boardof North Dakota

361-ii

J...

Social Work ~lanualChapter 361 CO~lPLAINTS AÌ'1)APPEALS.~

Chapter~, Contents

;.. CHAPTER CONTEl\'TS ~, .

SECTION 1. DEFINITION OF TERMS

..

Par.Par.Par..Par.Par.

.1 - Cause and Significance of Complaints.

2 - Standards of Agency Indicated by Way Complaints Are Met.

3', - When'Does,a.Cornpla.int Become an Appeal . . . .. ..4 - Proeedure When Complaint Is Made to County Agency

5 - Procedure When Complaint Is Made to State Department.

l 361-1. .

361 ~ 1

361-1361-1361-1

.. 361-2

361-2. 361-2 ,

361-2. 361-3

Par. 1 - De finhion of "Complaint" .

Par. 2 - Definition of "Appeal" . . .Par. 3 - Definition of "Fair Hearing" .

Par. 4 - De finition of "Appeals Referee" .

Par. 5 - State Department Determinations Included

SECTION 2. COMPLAi~fTS IN GENERAL

SECTIOì" 3. l~lRODUCTION TO APPEALS AND FAI HEARINGS..,.

Par. 1 - Objectives of the Appeal Procedur~

Par. 2 - Grounds for Appeal and Fair Hearings

Par. 3 - Fair Hearings Provisions Mandatory .

Par. 4 - Must Inform Applicant of His Right to a Fair Hearing

Par. 5 - Rules and Regulations Available for Reference and Distribution ., '.

. 361-4361-4

. 361-4

. 361-~

. 361-5

SECTION 4. PROCEDURE PRELIMINARY TO THE FAIR HEARING

. -'Par. 1 - Form to be '~ed in Filing Appeal .

Par. 2 - To Assist Appellant in Preparing Form

Par. 3 - Ì'umber of Copies and Routing .

Par. 4 - State Department Sends Prompt Acknowledgment to Appellant.

Par. -5 - County Agency to Furnish Transcript of Information ." .'

Par. 6 - Appeals Referee May Request Additional Information.Par. 7 - Services of the Area Social Service Center.

Par. 8 - lnfori:tion from Case File Available to Appellant

Par. 9 - Time of Hearing.

Par. 10 - Place of Hearing.Par. 11 - Hearing Canceled Upon Signed Withdrawal .

. 361-6

. 361-6

. 361-6361-6 .361-6

. 361-7

361-7361-7361-7 ·

. 361-7

. 361-7

. '

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #740February. i 970

361-i

..'::.

..

, ,."'.,..

. --"'

RilLES. ..!.

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. '\, ,.~ ~..,..

..-.OPINION

STATE OF NORTH DAKOTA TU,ii,.HONI224'2210

..,HELGI JOHANNESON DORIS KRElN

CHARLOTTE L.OGANARDYTH HANSON

siiCIUTAllllUi

.'AUL. M. SAND/llflST AssieTANT ATTORNEY GENERAL

JOHN E, ADAMSGERALD W. VANDEWALLEL.YNN E, ERICKSONROBERT p, BRADy

AtlSIST,IN'tS

,~SUSAN AL.BERS

CLl!lIkBISMARCK. NORTH DAKOTA 5850\JOHN R. ERICKSON

AUDIToli

October 16, 1972

Mr. T. N. TangedahlActing ExecutLve DirectorDepartment of Social ServicesState CapitolBismarck, North Dakota 58501

Dear Mr. Tangedahl:

We have examined the proposed Rules and Regulations ofthe Social Service Board of North Dakota, numberedR 50-24-01 to and including number R 50-24-13, Aid tothe Aged, Blind and Disabled, to be promulgated andadopted pursuant to Chapter SO - 24 0 f the North DakotaCentury Code, as amended.

From such examination it is our opinion that when saidrules and regul ations have been duly adopted, promulgatedand fi led in accordance wi th Chapter 28- 3 Z of the NorthDakota Century Code, they wi i 1 be legal, val id, and bindingregulations which will have the force and effect of law.

Sinc~rely yo\), ~t 1J i t t-(f--c. ' / /t /i

Helgi Jot'an~sonAttorney General

~

HJ : ah

..--

.,,

RULS AN REGUTIONS

for

AID TO THE AG, BLIN, AN DISABLE."

SOCIA SERVICE BOAl OF NORTH DAA

STATE CAITOL

BISMCK

NORTH DAKatA

Rule

R 50-24-01

R 50-24-02

R 50-24-03

R 50-24-04

R 50-24-05

R 50- 24-06

R 50-24-07

R 50-24-08

R 50-24-09

R 50-24-10

R 50-24-11

R 50-24-12

R 50-24-13

..-4

...

TABLE OF CONTS

PaaePUROSE 1SPECIA FACTORS IN OLD 'AGE ASSISTANCE 1

SPECIA FActORS IN AID TO TH BLIN 1

SPECIA FACTORS IN AID TO TH DISABLE 2COUN SHA OF ASS 1STANCE COST 3CITIZENSHIP OR DURTIONAL RESIDENCE 4CONCU RECEIPT OF ASSISTANCE THOUGH MORE THONE PROGRA PROHIBITED 4RIGHT TO FAIR HEAING '+RESPONS IBLE RELATIVES SPROPERTY PROVISIONS 5ASSISTANCE UNIT 8NEED 8REDETERHATION OF NEED 12

APPENIX

Chapter 50-24

North Dakota Century Code

Aid to the Aged. Blind. and Disabled

..-4

RULES AN REULTIONSFOR

.. SOCIAL SERVICE BOAR OF NORTH DAKOTAFOR

AID TO THE AGED, BLIND, AN DISABLED

R 50-24-01 PURPOSE.

A. General Purpose.

1. The Aid to the Aged. Blind. andDisabled (AAD) program was establishad by the 1963 Legislative Assemblyto combine the three adult assistanceprogram. known individ~lly as OldAge Assistance, Aid to the Blind. andAid to the Disabled. The purpose ofcombining the progra1' was tosimplify admnistration. providegreater uniformty of eligibilityreauirements. and increase federalfinancial participation.

While most of the conditions ofeligibility are commn to all threecomponents of AAD, some, specifical-ly age, blindness. and disability,are peculiar to only one component.For this reason. the former programdesignations (OAA. AB, and AD) areused throughout this chapter and thespecial factors applicable only toone component are examined indetail in subseauent sections.

R 50-24-02 SPEClA FACTORS IN OLDAGE ASSiStANCE.

A. Age.

1. An applicant for Old Age Assistancenust be at least 65 years of age.This means he lIst have reached his65th birthday before he can makeapplication.

2. The grant for Old Age Assis tance.when approved, becomes effective onthe 65th birthday when the appli-cation is made on that date. Allapplications made subsequent to the65th birthday. when approved, becomeeffectiVe as of the date of

application.

R 50-24-93 SP EelA FACTORS IN AID TOTl BL 1N .

A. Age.

1. There is no age restriction in theAid to the Blind program.

B. . Qualifying Vision.

1. Definition of Blindness. Blindness.fot' purposes of eligibility in the Aidto the Blind program, is (8) centralvisual acuity of 20/200 or les8 in thebetter eye with correcting glasses. or

(b) a field defect in which the peri-pheral field has contracted to such anextent that the widest diameter ofvisual field subtends at an angulardistance no greater than 20 degrees.

2. Determination of Blindness. Eligibilitywith respect to blindness 1s determnedby the State Supervising Ophthalmlogiston the basis of a report of an eyeexamination by a qualified ophthalmlogistor optometrist of the applicant's choice.

3. Cost of Eye Examination. The exeiueof the eye examination required by theSocial Service Board to determine anindividual i s eligibility for Aid tothe Blind is paid by the Social ServceBoard.

4. The county welfare board is responsiblefor receiving and processing applicationsfor Aid to the Blind. The StateSupervising Ophthalmlogist shall notifythe county welfare board of his decision.

C. Emergency Eye Treatment.

1. A physician may encounter an eyecondition so acute that immdiate

-1-

..

treatment is necessary to preventrapid deterioration or irreparabledamge to the eye. When such acondition is reported to the countywelfare board because of the patient iindigence. the physician ahould beauthorized to proceed with necessaryarrangements for treatment with theunderstanding that a determination ofeligibility for assistance. includinga revie'- by the State Supervising

Ophthalmlogist. will be made aspromtly as possible.

..2. The county welfare board shall give

the attending physician assurance thatpayment for the emergency treatmentwill ultimately be made from countyfunds in the event that eligibilityfor Aid to the ~lind or Aid to theBlind-Remedial Care should later bedetermined not to exist.

D. Refusal to Accept Treatment.

1. When an applicat or a recipient of anAid to the Blind grant refuses toaccept recommended medical treatment,his reasons for obj ecting to thetreatment shall he reported to theSoeial Servce Board. The SocialSerVice Board upon consultation withthe ~tate Supervising Ophthalmologist,will make a j udgcent as to whether ornot the recommended treatment re-presents risks which a "reasonablyprudent persontl would not undertake.such as endangering the individual'sremaining vision capaci ty ,

2. Assistance to the blind as definedin these rules. may be denied orhaving been granted, may be with-drawn from any person who refusesmedical. surgical. or other treatmentwhen his eyesight may be restoredpartially or wholly by such treatmentand a certificate in writing to thateffect is made by the examiningoph thalmologist.

..4

cR 50-24-04 SPECIAL FACTORS IN AID TO

TH DISABLE.

A. Purpose.

1. The Aid to the Pennnently and TotallyDisabled program shall hereinafter bereferr~d .to as the Aid to the Disabledprogram and its purpose 18 to provideneeded assistance to persons who havephysical or mental conditions which areso disabling as to make substantial

emloyment or the performnce of hom-maldng functions impossible orimpractical.

B. Agè.

i. An applicant for Aid to the Disabledmust have attained the age of at least18 years. Application may be made onor after the 18th birthday.

C. Definition of Terms.

1. PERMENTLY. The term "permnentlytlrefers to a physiological, anatomical, c=or emotional impairment which 1sverifiable by medical findings. Aphysician must provide the county welfareboard with the information which bearson this aspect of eligibility.

a. The impairment must be of majorimportance and must be a conditionnot likely to improve or which willcontinue throughout the lifetime ofthe individual. Any condition whichis not likely to respond to anyknown therapeutic procedure shall bedeemed to be permanent ¡ furthermore,any condition which is consideredlikely to remain static, or tobecome worse. shall be deemed to be"permanent 11 if treatment isunavailable, inadvisable, or if theindividual justifiably refusestreatment.

..

-2-

(

.,,

b. "Permence II does not rule out

the possibility of v~cationalrehabilitation or even recoveryfrom the impairment. ThUl theterm "permnently" cannot bedefined in an absolute sense butrather must be defined relativelyin the sense of continuingindefinitely as distinct from"temporary" or "transient."

2. TOTALLY. The term "totally" is notabsolute since it mut be consideredin reference to the ab~ity of theperson, 8S revealed by the facts inhis case, to perform those activitiesnecessary to carry out certainresponsibili ties, such as thosenecessary to emloymnt or homeking.

"'"".

a. Hobbies, activities which do notprovide bona fide job opportunities,occupa tional therapy t and traininprogram designed for seriouslydisabled persons are not ordinat'ilyregarded as "useful occupations."

5 . HOMING. This term in\ J 1 ves theability to carry home-nagemnt anddeCiSion-making responsibilities. andalso includes the extent of capacityto provide essential services withinthe home for at least one person inadd! tion to one i s self.

R .50-24-05 COUNY SHA OF ASSISTANCECOST.

a. In addition to medical findings lt1totallyll involves such otherconsiderations as Age, training,skills. and work experience, Andthe probable functioning of theperson in his particularsituation in light of hisimpairmnt.

3. SUBSTANTIALY PRECLUDES. The termllsubstantially precludes" ha.s

reference to the degree to which anindividual's permnent impairment hasleft him able to perform suchactivities well enough and withsufficient regularity to receiveregular payments for his efforts or tocarry hommaking responsibilities on areasonaly continuing basis. hecannot be found to be permnently andtotally d1sab1ed.

USEFU OCCUATION. A "usefuloecupat'1on" generally lleaDS productiveactivity which adds to the economicwealth or produces goods or servicesto which the public attaches Bmoetary value and which demands thetime and attention of the person forthe ultimate benefit of others.

A. For purposes of apportioning the county 1 sshare of assistance costs to the AAD programthe following principles shall govern~

4.

1. The county's portion of the esiitaneecosts of a person who resides in thestate but who is not a legal i-esideotof a particular county is generally borneby the county in whieh Buch peraoubecomes in need. An exception to thisrule exists if the person 18 commttedto a state institution before establish-ing legal residence in a county and thensubsequently is returned to a community.In this instance, he becomes the financieresponsibility of the county from whichhe was committed, provided he is eligibltfor assistance.

2. Determnation of County Share ofAssistance. In the event responsibilityfor county share of assistance is notacknowledged by any county, neededassistance shall be granted promptly bythe county in which the applicant 18physically present at the time ofapplication. The county welfare boardw111 certify "under protestll and thecounty's share of assistance given willbe charged to the proper county after adetermination thereof is made. Whenthere is disagreement of this responsi-bility between two or mot'e counties. thecount welfare boards involved should

-3-

"",

present pertinent informtion to their A.resp~cti ve state's attorneys in ane.ffort to obtain an ackowledgementor adjudication of the county ofresponsibility for the county shareof 88sistance.

3. State Department Opinion Offeredas Servce. If the procedure des-cribed in the preteding paragraph doesnot bring about a determnation of thecounty of legal responsibility, thestate departmet, through the servicesof its legal cOoPsel. will offer".~itten opinion. on the question uponreceipt of a stipulation of the factsin the case agreed upon by the etate '6attorneys involved. This service isde.igned solely to be of assistance tostate's attorneys and county welfareboards and is not intended to put thestate department in the position ofattempting to settle disputes betweencounties.

4. Court Action. If the proceduresdescribed in the preceding paragraphsdo not bring about a determination ofcounty of responsibility for countysharc of assistance cost.

5. County Responsibility for PersonsLivinii in Homes for Aged or NursingHomes. A person who has legalresidence in a county in this statedoes not lose his residence in thatcounty when 'Ceaiding in a licensedhome f~r the aged or nursing home inanother county. The time spent insuch licensed homes shall not beincluded in computing the timenecessary to establish legal residenceCounty residence will begin, however,when the person leaves the licensedhome to live some place other than ina licensed hoae in the sam county orin another county in the state.

It 50-24-06 CITIZENSHIP OR DURATIONALRESIDENCE.

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(Neither citizenship in the United Statesor durational residence in the State is aprerequisite for eligibility for AAD.

1. There is no durational state residencerequired fOT eligibility for an AADgrant. nor citizenhip in the UnitedStates. .'

z. No penon who is otheNae eligiblemay be denied ass:ltance under theAAD program if he resides in the statewi thin the meaning of the followingdefinition: tlA resident of the state. isone who i8 living in the state ,voluntarilyand not for a temorary purpose; that is *with no intention of presen1.ly removingtherefrom. A child is tlresiding in thestate" 1£ he is makig his home in thestate. Temporar absence from the state,with subsequent returns or intent toreturn when the purposes of the absence.have been accomplished, shall notinterrupt continuity of residence. i;

3. Residence as defined herein foreligibility purposes for an AAD grantdoes not depend upon the reasön forwhich the individual entered the stateexcept insofar as it may bear uponwhether he is here for a t1temporarypurpose. "

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R 50-24-07 CONCUNt RECEIPT OFASS ISTANCE THUGH MORETH ONE PROGRA PROHIlITED.

No person receiving assistance through onecomponent of AAD may for the same period receiveassistance through another component of AAD orthrough Aid to Families with Dependent Children.This provision does not, however, precluderecipients from the same household from receivingdifferent form of assistance nor does it precludea recipient of AAD from being the payee for anArDC grant as long as his needs are not alsoincluded in the latter.

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R 50-24-08 RIGHT TO FAIR HEING.

If an ápplicant for or recipient of AAD isdissatisfied with any decision relating to his

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eligibility for receipt of 'assistance, he mayrequest a fair bearing before the SocialService Board of North Dakota within 30 d1ysof being notified in writing of that decision.

R 50-24-09 RESPONSULE RETins.

A. General Statemnt.

l. The determination of the capacity ofall legally responsible relatives toprovide support to an applicant for orrecipient of assistance. is a require-ment of the AAD progråm. Publicassistance i8 considered a supplementto and not a replacement for othersources of income including supportfrom responsible relatives.

2. Responsible relatives for AADpurposes include children for theirindigent parents. parents for their C.indigent children, and spouse forspouse if they are of sufficientfinancial means to prOVide neededsupport.

3. the apparent ability of a legallyresponsible relative to support theapplicant or recipient does not ofitself affect his eligibility forassistance.

R 50-24-10 PROPERTY PROVISIONS.

A. Owership of Property.

1. The fo;Lowng are the rules and D.regulations relative to owership ofcash reserves. per.onal aDd realproperty. and life insurance byappliecu for and reCipients of AAD.

B. Cash Reserv.

1. The 'cuh reaerve for each AADrecipient may not exceed $350 andis defined 8S, but not limited to.liquid assets such as cash. stocks andbonds, Individual Indian Monies (IIM),and other negotiable instruments butexcluding the c.uh surrender value of

....

life insurance.

2. The cash reserve may be clai1d onlyonce during a continuous stretch ofeUgibility.

3. In those instances when there 18'insufficient cash reserve uaets onhand at the time of application, thecash reserve cannot be claimed.

1;. The cash reaerve shall be allowed inthe event the family should subsequentlyreceive a lum sum payment from anysource.

5. Current benefits from any source muRtbe used to meet current need and maynot becom a part of the cash reeerveexemp t ion.

Life Insurance.

1. Thtlre is no lilltatio on tli' uount oflife insurance which may be owed by anapplicant or a recipient of AAD.

2. All life insurance policies of anapplicant for or recipient of AADhaving a cash surrender value of $30or more iiust be assigned to the countywelfare board.

3. No assiinmnt is required for lifeinsurance policies carried by anineligible spouse.

Personal Property.

1. The. county welfare board shall disregardin its consideration of the resources ,ofthe applicant or recipient of AAD amobile hoiie if used aa living quarters.

2. The applicant or recipient of an AAgrant is limited to the owership of .personal property other tha the aboveexclusions to a net value of $1.000.The applicant or recipient is in.llgiblefor an AAD grant when his owership ofproperty other than thé aboe naedexcluaion exeeeds $1.000. '

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3. The county velfare board may vaivethi6 limitation of $1.000 on theamunt of owership of personalproperty if the property in questionis essential to the rehabilitationof the famly and if the plan isspecifically approved by theAdmnistrator of Public Assistanceof the Social Service Board.

E. Effect of Receipt of Fire InsuranceProceeds on Eligibility.

1. Eligibility for AAD is not afl~ctedif the proceeds are used to repairor replace the home or essentialpersonal property or to apply asreimbursement against assis tancereceived.

2. If the proceeds of the fire insurancepolicy are not utili~ed in this vay tthe proceeds must be consideredincome available to the recipient forsubsistence needs.

)pecial Assignnts.

1. An applicant for AAD may owpersonal property exceeding thel~tations above set forth butwhich cannot be properly disposed ofbecause there is no current market.Urgently needed assistance shouldnot ,be denied to such a person ifhe is willing to transfer theproperty determined to be in excessof the limitations until such time asthe market permits other disposition.The transfer shall be in trust to thecounty welfare board.

G. Real Property.

l. The maimum value of real propertyother than a homestead that anapplican t and his spouse may ow tobe eligible for AAD is establishedat $8.000 over and above liens andencu1Jrances. As a condition ofeligibility for AAD. the propertyowed by the applicant must produce

..*

(sufficient income to provide a resourceto the applicant or he will be requiredto convert such property into availablecash.

a. The applicant may be deemed eligibleif in need pending the converting ofthe, property for a reasonable timebut if the applicant fails to con-vert the property 'Wthin a reasonabletime because he does not wish tocooperate. he will be ineligible forAAD. A reasonable time shall beconstrued to mean a périod of sixmonths or less. When such propertyis sold. the cash proceeds must beconsidered as income available tomeet the needs of the applicant.

b. All real and personal property notdisregarded as therein provided mutbe transferred in trust to thecounty providing assistance under theprovisions of Section 50-24-13 NDCC.

B. Disqualifying Transfers.

(1. Every person who before or aftermaking application for AAD givesan assignment or makes a transferof his property for the purpose ofrendering himaelf eligible for AADassistance is thereby rendered ineligible.

2. The intent of the person making sucha transfer is the basis for determiningeligibility for AADi Determnation ofwhat the intention was at the time oftransfer will depend upont but notlimited to. ans\oers to questions suchas the following:

a. Was the consideration adequate?

b. Was the applicant i s stated purposereasonable in view of his circumstanees at the time of transfer?

c. Did it appear at the time of thetransfer that he vould be in needof assistance sooner than if thetransfer had not been made?

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d. Were there bem:fits obtainableby the applicant from thetransferee that were contingentupon transfer of the property?

e. Did the transferee have a legalor equitable interest in theproperty transferred to him?

3. The applicant should be given everyopportunity to refute any pre-sumtion of ineligibility resultingtherefrom and should b, assisted inobtainig evidence that he may wishto present 1f such assistance iineeded.

4. The applicant shall be given anopportunity to present to the countywelfare board any statement hewishes to make which shows hispurpose for maing such a transfer.

5. The more recent a transfer; the morepertinent would be the question as todigibility.

6. The effect of a disqualifying trans-fer or assignment of property by anapplicant or recipient of AAD istermnated as far as eligibility isconcerned if an unconditionalretranBfer to the appli~ant orrecipient is made 80 that applicantor recipient's full legal and

equitable interest in the property1& restored.

7. When a home has been transferred bythe applicant for inadquateconsideration or for no considerationthe disqualifying affect of thetransfer may be corrected by thegiving of a life lease by thetransferee to the applicant.

I. Bostead.

1. For AAD -purposu; a h-OMstead rightmay be claim by the head of afaiy or the husband or wife \/enthe homstead claimant ia A aarried

-- --

persOl but in no cae are both hU$bandand wife each entitled to a homestead.

2. A person need not be the absoluteower of land in order to beentitled to claim it as a homsteadfor AAD exemption pUrpO$~9. Any'interest in land coupled with therequisite occupancy is sufficient tosupport a homestead exemtion.

3. When the ower of a homestead isgranted AAD assistance. the SocialService Board of North Dakota shallcause to be recorded in the Officeof the Register of Deeds in thecounty in which such homestead islocated a Homestead Statemet; which i8a statement in writing to the effectthat the ower of such homestead isreceiving or is about to receive AADpayments. The statement 1s siinedby the Executive Director olthe SocialService ßoard of North Dakota. Section50-24-15 NOCe provides that after therecording of such Homestead Statemet;any instrument cf conveyance orencumrance executed by such applicantfor assistance without the approvalof the State Department shall be nulland void.

4. A Homestead Statement is not usedwhen the homes tead is in the naeof an ineligible spouse under theage 65 years. When such a spousebecomes eligible for.AAD. thisinstrument viII be recorded afterapplication and approval for suchassistance.

5. A Homestead Statement is recorded onthe homestead of an Indian when theproperty is not held in trust by thefederal governent.

6. Since the transfer of a homesteadon which a homestead statement hasbeen recorded is null and void by law.an attempt on the part of the. recipientto affect such a transfer by giving andrecording of an 1n6t~nt o~ coveyance

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or encumrance canot disqualify himfor assie tance.

J. A Trust Mortgage May Be Released When:

1. Reimursement is made in an 8lountrepresenting the state's equity inthe true and fair value of theproperty.

2. The county welfare board is satisfiedthat the collection of the amountpaid in AAD grants ~~ll not bej eopardbed. .'

3. Release in whole or in part isnecessary for the maintenance orsupport of the recipient's gpouse.minor. or incapacitated children.

K. Full Repayment Defined.

1. The full repayment of an MBD grantwill consist of remittance to theSocial Service Board of North Dakotaof an aiount equal to all MBDpayments received by the recipientaccompanied in the case of a deceasedrecipient by simple interest at thelegal rate commencing six monthsafter the date of recipient's death.No interest will be charged on theamount of AAD grant repaid by arecipient while he is living.

L. Release of a homestead statement or trustmortgage will not be approved when thereason for requesting such release isthat the recipient has moved permanentlyto another state or that a relative orother person volunteers to assume supportin return f or release of the property.

It 50-24-11 ASSISTANCE UNIT.

À. Definition.

i. A single applicant or recipient.

2. An individual and his spouse livingtogether regardless of whether one orboth are applicants or recipients ofassistance.

...

3. Parents and their dependent childrenif Ii ving together and eligible toreceive assistance whether throughone or more program categories.

(

4. The grant entitlement for eachassistance unit shall be computedindependently and without referen~e toanr other assistance unt.

R 50-24-12 NEED.

A. Budget.

1. A person's need 1s determined by abudget. Available net income and re-sources are collated with basic main-tenance reauirecents. If net incomeand resources exceed maintenance re-quiremnts. no need or eligibilityexists. If income is insuffiCient. theresulting budgetary deficiency is theamount of the assistance grant.

B. Definition of IlNeed. li

1. Attached hereto and on the next pageis form 286 entitled, "StandardRequirements and Budget Plan. (

2. The combined requirements as show onform 286 represent the minimum amountsof income necessary to maintain astandard of living compatible withdecency and health by size ofassistance units. They represent 100percent need for an AAD a.ssistancegrant.

3. The Social Service Board of NorthDAkota niy curtail the payment ofbenefits by a system of ratablereductions whereby all recipientswithin one or more of the categoricalassistance programs will receive afixed percentage of the standard ofneed. Said system of ratable reductionsshall be implemented by the SocialService Board of North Dakota toaccommdate budgetary realities and toequi tably apportion those funds allocatedby the legislature for public assistance

TO ram.

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"Ofl' 286 (~. 7.11) IT ANDAR! REQUIRMENTS AND BUDGET PUN "Buy Norh D.iiO( Produc"

Cue Name Ca. Number

Sehedule 1. L tvINC II 1lSINC mat Circle nwier of eraQIU in u.ii tllce uitA. 1 2

-3 4 5 6 9 10 nil' 1\

- - _._ _ ø - - ..--_.._-- 7 II

I. 1..1e Jtqu1r_tl~ - - - - - - $125 $190 $245 $300 $340 $375 $400 $420 $435 $450 1

C, Spie1a1 1I1td 11 - -------D. Total .._---- - - ----- ,

E. L... Total Net IncOl (Line 4C)

F. Net Need and Grant - - - - - -

AAD (. . . . .) - - -- ..

AAn ( : . . .) - - - -

AI ( . . . . .) - - .. -

Schedule 2. LIVIN IN UST 1l, POSTtl CA. OR BOAN RO A.EKEM

A. Monthly late - - - - - - - - - $~. Clotb1ni aAd huoiil ¡¡..di- -C. Sped..1 )l...c - - - - - - - - -D. Total- - - - - - - - - - .. - -E. i.a. Total Net Ine08.. - - - -F. Het Need and Grant - - - -

Schedule 3. LIVING IN NURSING Il

(Rate pir Koath )A. Cloth1ni _ad Per.ooal Ne.dI - - $I, Special Mea - - - - - - - - -C. Total - - - - - - - - - - - - -D. i... Total Met IncOM - - - - -E. Het Keid aad Grant- - - - - - -

Schedule 4. OOHPUTAnON 01 NET IK(X!(A. E.ED INea:

i. Toul ero" Earnid InCO- - - - - - - - - - -l-ru

2. Deduct Appropriate tarnid Income Exemption -

3. Deduct Earned IncOl Elq.. ;.. Suii WorklTt& A.a_ - - - - - - - -b. Wìihholdin Tuel (8M Em. Tax Oiiic) - - - - -

Ç. SOi.L Seriy DeiidÎOIU (Se Em. Tu Oiitdl --4. Total Earned tncOl Dedu.tiona (Lla.. 2 + 3a + 3b + 3e)

S. Net Í!uned Inco.. (1. all1\1 A4)- .. - - . - - - - - -i. OTER INaii

1. OASDI Ben.flu - - - - - - - - - - - - - - -

2.

3.

4.

S. Add: Total Other hlci- - - - - - - - - - - - - - - - -

C. TOAL NET DlCO (AS + IS)- - - - - - - - - - - - - - - - - -

Dati Workr'. S1sot~~!l Add U 0 pC IKflon 0\'' 10,Y "SlKc4l NH" portWi (It s...u1. 1 1(1 ti. -. OAy un4 e(l~~ ptl-M4 I.. s.lo i Q( ~ 31..

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C. Initial Grant.

1. The county welfare board may notinclude need which 16 for a periodprior to the moth for which the firstpayment is authori~ed.

a. An exception to this policy can bemade when payments for precedingmonths must be made to correctprevious admnistrative action H.such as for examle to carry outthe decision of a fair hearin"..

D. Recipients Living Outside of State.

1. Assistance recipients residing tem-porarily outside the State of NorthDakota are to be budgeted inaccordance with the same standardsas are applicable for recipien ts incomparable living arrangements withinthe state.

E. Converting Weekly Figures to Monthly'~-~gures .

When income is reported in weeklyfigures, the amounts shall beconverted to monthly figures bymultiplying them by 4 1/3.

F. Security Assistance in miole Dollars.

1. Assistance payments are to be made inthe amount of the nearest wholedollar. In establishing the grant,needs and incomeR will be computedin their exact amounts with therounding off process to be done atthe end.

G. OVerpayments.

1. Current assistance grants will not be

reduced because of prior overpaymentsunless the recipient has fundscurrently available in the amount bywhich the county welfare boardproposes to reduce payment exceptwhere in the judgmnt of the county

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(welfare board and the program 'supervisor. the recipient withheld orfalsified informtion which pro~tedthe overpayment. In this instance.the county welfare board may elect toreduce the Amount of current or futurepayments not exceeding a two monthtsduration until all or the portion ofoverpayment has been reconciled.

Standard Requirements of Budget.

1. Form 286 attached to this Rule andincorporated herein by reference heretospecifies the total basic requirementsincluding shelter and most special needsby the numer of persons in the assistanceunit. This form serves as the basisfor budgeting need and is to be usedin determining initial and continuingeligibility for AAD. The basicrequirements are preprinted on the form286. These appear On form 286 inSchedule 1, A and B.

2. Schedules l, 2. and 3 are the threemajor types of living arrangements.The eligibility worker must select theappropriate living arrangement forbudget accordingly.

c

I. Special I tems of Need.

1. In form 286 in Schedule 1, line C;Schedule 2. line C; Schedule 3. lineB are provisions for special needs.These items are as follows:

a. Essential Services. The cost ofservices which are essential tothe ~ell-being of the recipientshall be provided for in his grantas needed. These mus t be specificservices which the individual orfamily. because of aget infirmity,or temporary illness, cannotperform,

b. Work/Training Expenses. Anindividual involved in vocationaltraining, other than under theManpower Development and Training

(

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Act, the standard eiploymentallowance and speciál allowancefor transportation. uniform~ etcauthorized by county welfareboard on a hardship basis will beset forth under Line 1 C of form286.

c. Catastrophic Events. In theevent of a disaster involvingan AAD or Are recipient, thecounty welfare board, afterexploring the availability ofproperty insurancQ"and communityresourcee. ~liall authorize thereplacement of food. clothing.furni ture. household equipment.and other needed supplies at alevel comarable to thatmaintained by the recipient atthe t1m~ of the fire. flood.tornado, or other naturaldisaster.

d. Establishment of Guardianship.The cost of establishing a legalguardianship for a recipientincluding the expense oforiginal appointment and anannual report to the court ifrequested by the county judgemay be incorporated in hisgrant as a special allovance.The inclusion of funds with whichto compensate the guardian formaaging the reCipient t sfinancial affairs is allowableup to 5% of the recipient' 5total monthly requirements ifnecessary to obtain guardianshipservices.

e. Meical Insurance Premium. Thecounty welfare board may author-ize the cost of prelluUl forprivate medical and hospitalinsurance if at least one ofthe followng conditions ismet:

1.

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insurance and he or membersof his family have a chronic,pre-existing condition whichwould ma it difficult orimOSSible to re-aequire coverag,if the policy were to bedropped, particuJ 'r1y if'eligibility for public assistanciis expected to be of shortduration; or

2. The individual Or familyalready carries privateinsurance and the past andanticipated future utilizationof medical benefiu 18 suehthat continued 'coverage appearswarranted. 'Hover, countywelfare boards are requutednot to inquire of an insurancecomany about an individual t l!past utilization of aedicalbenefits because such a requestentails an extensive timeconsuming search of its r~eord8.

J. Income and Resources.

1. All income and resources of anindividual applying for or receivingassistance must be taken into con-sideration except as is required bylaw to be disregarded. Only incomewhich is actually available to theindividual or famly uiy be taken intoconsideration in determining theatount of the grant.'

2. The county welfare board must re-investigate eligibility as promptlyas possible but not exceeding 30 day.after receiving informtion aboutChanges in need. income, or resources.

3. All income earned by an eligible AADrecipient must be accounted for inthe assistance plan except exemptionsand employmnt expenses whieh federallaw and. regulations may from tim totim require to be disregarded.

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.. ."Social Work ManualChapter 306

AID TO THE AGED,BLIND, OR DIS.-\BLED

Section 5

Pars. 3.7

..Par. 3. Determination of County Residence.. In the event county residence

is not acknowledged by any county, needed assistance shall be granted promptly bythe county in which the applicant has physical residence at the time of application.The county welfare board will certify "under protest" and the county's share ofassistance given will be charged to the proper county after a detenninatIon of

residence has been made. When there is disagreement on legal residence betweentwo or more counties. the county welfare boards involved should present pertinentinformation to their respective state's attorneys in an effort to obtain an acknowledge-

ment or adjud~catìon of county residence. .

Par. 4. State Departent Opinion Offered as Service u If the procedure

described in the preceding paragzaph does not bring abut a determation of the county

of legal residence. the state department. through the services of its legal counsel.will offer a written opinon on the question upon receipt of a stipultion of the facts inthe case agreed upon by the state's attorneys involved. Ths service is desigedsolely to be of assistance to state's attorneys and county welfare boards and is notintended to put the state departent in the position of attempting to settle residencedisputes between counties.

Par. 5. Court Action to Determine County Residence -- If the procedures

describd in the preceding paragraphs do not bring about a determination of county

residence. a District Court determination may be sought under the provisions of

Section 50.02-08 of the Nonh Dakota Century Code (Manual Chapter 300).

Par. 6. Social Service Board Resf)onsibility for Determining State Residence

-- The Social Service Board has responsibilty for the uniorm administration of thassistance programs. Under this responsibilty. questions of state residence, if theycannot be determined by the county welfare board and state's attorney, are to bereferred to the Social Service Bord for a determination of state residence. Thedecision of the Social Service Board that an applicant has or does not have stateresidence is binding upon the county welfare board. The county welfare board, aferapproving assistance. may ta action to estalish county residence if it does notacknowledge such.

Par. 7. How State Residence Is Lost -- For assistance puroses. the residence

of a person is lost upon his mOVg to another state with the intent of living in suchother state for more th a temporary purpose. A judgment of whether or not an ab-

sence from the state is temporary must be based on the purpose of the absence and

the intent of the person with respect to his return rathr thn on the lengt of absence.

December, 1971 Transmitted by

Manual 1.tter #854

Social Service Board

of North Dakota

306-14

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l-I

Social Work ManualChapter 306

AID TO THE AGED,ßLH\D, OR DIS:\BLED

Section 5

Pal's. 1.2

..SECTION 5. RESIDENCE

Par. 1. State Residence -- As the i"esult of a U. S. Supreme Court ruling

issued April 21. 1969. there is no durational resIùence requirement in AABD. Noperson who is otherwise eligible may be denied assistance if he resides in the statewithin the meaning of the following definition:

"A resident of the state is one who is living in the state volwuarily and notfor a temporary purpose. that is, with no intention of presently removìng

therefrom. Temporary absence from the state, with subsequent returnsor intent to return when the purposes of the absence have been accomplished,shall not ìnterrupt coiitinuity of residence. "

ReEidence as defined for eligibility purposes does not depend upon the reason forwhich the individual entered the state. except insofar as it may bear upon whether heis here for a "temporary purpose. II

Persons coming tó North Dakota for the purpose of obtaining education or specialiedtraining or services such as provided at colleges. the Wahpeton School of Science.

Crippled Children's School. Vocational Training Center. Medical Center RehabiltationUnit. et cetera. are nonnally to be regarded as residing in the state for a temporarypurpose and are therefore not eligile for public assistance. Ukewise. however,residents of North Dakota who leave the state temporarily to pursue educational orother specialized training or servces do not lose their residence in this state forassistance purposes.

Par. 2. County Residence -- The U. S~ Supreme Court ruling which

invalidated state residence laws has no direct bearing on legal residence provisions

between counties. An individual gains county residence in the manner outlned inSection 50-02-04 of the Nort Dakota Century Code (Manual Chapter 300).

The county's porton of the assistance costs of a person who resides in the state butwho 1s not a legal resident of a particular county is generally borne by the county in

which such person becomes in need. An exception to this rue exists if the person iscommitted. to- a state institution before establishing legal residence in a county andthen subsequently is retued to a commwiity. In this instance. he becomes thefinacial responsibility of the county from which he was committed. provided he is

eligible for assistance.

Socinl Service -Baldof North Dakota

Transmitted by

Manual llmcr #854

December. 1971

306-13

..-4

Social Work ~lanualChaptc r 306

AID TO THE AGED,BLIND, OR DISABLED

Section 4

Pars. 7-8

fUkewise. an applicant or red"pient of Aid to the Disabled who has received vocationaltraining which prepared him for employment is expected to accept an appropriate jobavailable in his community or in a community to which he can reasonably be expectedto move. If he refuses without good cause, assistance will ordinarily be denied ordiscontinued.

Problems of employment due to lack of employment opportunities. geographiclimitations, and poor education and work backgrounds by and large do not constitutea basis for eligibilty. '

Par. 8. Continuing Eligibilty - - The responsibility for determining whether

periodic re-examinations are needed to re-establish a person's eligibilty rests withthe State Review Team. Some co;ditions are almost certain to remain withoutsubstantial change throughout the lifetime of the individual or become progressivelyworse. When recovery is obviously not possible, as in the instance of profound mentalretardation, dismemberment. et cetera, re-examination of the disabling conditionmay be waived by the team or made contingent upon the observation of change by thecounty welfare board.

It will be necessary in many instances. however, to re-establish the existence ofdisability by yirtue of the concept that "pennanently and totally disabled" does notnecessarily preclude improvement or recovery. In all cases in which improvement

in the physical or mental condition seems possible. periodic medical examiationsand reviews of pertinent social factors wil be requested by the review team. Thecounty weUare board shall promptly arrange for such re-examination. 1/

The county welfare board must promptly report to the State Review Team anysignficant changes observed in the recipient's disabling condition or his adjustmentto it so that appropriate arrangements can be made for re-evaluation.

1/ The expens~ relating to the medical re-examinat10ns may be paid thou$th theMedical Assistance Program.

December, 19i1 Transmitted by

Manual Letter #854Social Service Board

of North Dakota306-12

.. -Social Work ManualChupter 306

AID TO THE AGED,ßU1\1J, OR DIS..\BLED

Section 4

Pars. 5~ i( ...While it is not the intent to limit tiie Aid to the Disabled Program to persons who are

complete invalids, as noted previously, neither is it ïntended to include persons 'with

emergency or acute illnesses- of short duration or who are merely unemployed. In itsevaluation of the disability, the State Review Team will in some instances decide thateligibilltyfor Aid to the Disabled will depend on the individual's willingness to follow

through on recommended medical treatment and/or to accept training which willprepare him for a vocation he can perform or to accept appropriate employment once

such trainng has been completed. These considerations are outlined in greaterdetail in Pars. 6 and 7 of tlùs section. .

'"

Par. 6. Acceptance of Medical Treatmentu The applicant with a physical ormental impairment which is..dsabling but which is considered to be amenable tosome generally accepted and available therapeutic measure will be expected to followthugh with such treatment as a condition of eligibility. Those who decline treatmentwill normally be denied assistance unless it can be shown that their reiusal is basedon risks that a "reasonably prudent person" would not undertake. The matter ofwhether restorative treatment must be pursued as a condition of eligibility for Aid toth Disabled should therefore be considered from the standpoint of whether the person

is unreasonable in his refusal or whether his life or remainig capacity is actuayendangered.

Par. 7. Acceptace of Vocational Training or Employment after Training --The inabilty to contiue in a certain type of employment or industry does not. in

intself, constitute permanent and total disability within the meaning of thsprogram. Nor does the fact that a person may have to change Dccupations or work

locations to be re-employed with the limitations of his remaing capacity. If

a person is determined to be capable of light work such as operating an elevator.answering the telephone, or perlonning as a watchman, and work of this natureexists in his community or in a community to which he can reasonably be expectedto move, such person will be considered unemployed rather th pennanently andtotally disabled.

Eligibility will in some instaces hinge on the individual's willigness to accepttraiing which will prepare him for a vocation his disability will tolerate. Personswith potenti for retraing but who refuse without good cause can ordnarily expect

to have thir assistace denied or tenninated. The county welfare board should

therefore be alert in identiying persons with potential for vocatinal trainig so that

appropriate referrals can be made promptly to the Division of VocationalRehabilitation, Manower Development and Training, or some other manpowertraining program.

Social Service Bordof North Dakota

Transmitted by

Manual Letter #854December. 1971

306~ 11

..

Social Work ManualChapter 314

PROPERTY FACTORS FORAI TO AGED, BLIND, AND DISABLED

Section 5

Pars. 1.2

\\

--,l

_.SECTION 5. PERSONAL PROPERTY.. \.

Par. 1. General Statement ... The ownership of personal property by an appli.

cant or recipient of AAD or by the spouse of such person, either individually orjoi.ntly, does not prohibit the granting of assistace to an individual without adequatefuds for his support.

For purposes of this section, personal property includes liqUid assets such as cash,bonds, stocks, savigs accounts, notes, mortgages, and prepaid burials; life insurance:and goods and equipment such as automobiles, farm machinery, tools, and livestock.

Par. 2. Personal Property.Limitations u State law and th Pulic Welfare

Board have established the following regulations relative to ownership of cash reserves,life insurance, and other personal property by applicants for and recipients of AAD:

a) CASH RESERVE - The term "cash reserve, lt which may not exceed $350 foreach individual receiving AAD in his own right, 1s defied as liquid assetssuch as cash, stocks and bonds, lndividuallndian Moines (11M), prepaid

burials, and other negotiable instruments but excludig the cash surrendervalue of life insurance. The cash reserve, to be claimed only once duringa continuous stretch of eligiilty, is exempt from assignment. If theexemption canot be claimed at the time of application, it shall be allowedin the event the recipient should subsequently receive a lump sum paymentfrom an inheritance, OASDI, railroad retirement, sale of property, etcetera. Current benefits from such sources, however, must be used to

meet current need and thus may not be disregaded for the purpose ofaccumulating to the amount of the cash reserve exemption.

"The cash reserve exemption, if claimed. should be entered on the propertycard as a permanent par of the record to preclude the possibility of itsbeing allowed more than once. y

'¡¡InasmUCh as the flat grant provides for all basic maintenance needs (except forcertain special needs identified in Chapter 318. Section 3), it is incumbnt uponthe recipient to protect a portion of his monthly grant to enable his meeting suchobligations as real estate taxes, repairs, or replacement of household furnishings

when the need arises. The county welfare board must therefore exercise carefuljudgment in differentiating between the "cash reserve" and other funds which mayrepresent savings from the recipient's grant with which to discharge a futureobligation.

( ...

May, 1971 Transmitted by

Maual Letter #823Pulic Welfare Board

of North Dakotai

L314~12

..

.. .. '. - 1l.."

Social Work MaualChapter 314

PROPER TY FACTORS FORAID TO AGED, BLIt\U, AND DISABLED

Section 5

Pars. 2~3

b) LIFE INSURA'tCE - There is no spcified limitation on the amount of lifeinsurance which may be owned by an applicant/recipi.ent of AAD. Statelaw, however, requires the execution of an assignment of any life insurancepolicy having a cash surrender value of $300 or more or of a policy onwhich premium payments are being allowed in the grant, regadless of thecash surrender value. No assignment is required for life insurancepolicies carried by an ineligible spuse.

See Chapter 393, Section 2, for instructions in securing assignments.

..

c) OTHER PERSONAL PROPERTY ~ Excludig the cash reserve exemption,cash surrender or loan value of life insurance policies, household goods,

furnitue, clothidg, personal effects, and a mobile home if used as livig

quarters - is limited to a net value of $1,000 for a single applicant/recip-

ient or an applicant/recipient and his spouse, regardless of whether oneor both receive assistance. Of this amount, the applicant/recipient m.ay

select property of a value less than $300 which is exempt from transferin trust. That portion of "other personal property" which is valued in ex~

cess of $300 is requiredby law to be transferred 1.n trust by means of.trust chattel mortgage as outlined in Chapter 393.

The $1,000 limitation in "other personal property" may be waived if theproperty in question is essential to the rehailtation of the individual

and/or his spouse and if the plan is spcifically approved by the admins-trator of public assistace.

Personal property owned by the ineligile spouse is not subject to transferin trust unless the property consists of a car, in which instace a transferis required. Any transfer in ownership of personal property to an ineligile

spouse which shows evidence of havig been made for the pirpse of avoid.

ing the stipulations of the law shall be evaluated in terms of disqualfication(see Section 2 of ths chapter).

Par. 3. Effect of Receipt of Fire Insurance Proceeds on Eligiilty ~ - If thepremiums for fie insuance are to be allowed though the AAD grant, the policy mustcarry a 10s8 payable clause to assure payment of any proceeds to the county welfaeboard as t:øte for dispsition. A loss payable clause may be secured tróm the insur-

ance agent. Contiued eligiilty for assistance upon receipt of fire insurance proceeds

by the recipient whose property has suffered fie daage depends upon the intended use

of the proceeds. Eligiility hi'not affected it the proceeds are used to repai or replacethe home or essetial persona,l property or to apply as reimbursement against assis-tace received. If not utilized in either of these ways, the proceeds must be consid-

ered income available to the recipient for subsistence needs.

Public Welfare Boardof North Dakota

Transmitted by

Maual Letter #823May, 1971

314-13

..

...

Social Work ManualChapter 314

PROPERTY FACTORS FORAID TO AGED, BLIND, AND DISABLED

Section 5

Pars. 4-5

Par. 4. Assignment of Life Insurance -- As stated in Par. 2, life insurancepolicies which have a cash surender value of $300 or more or on which premiums areto be paid with AAD funds are required to be assigned to the county welfare board assecurity for assistance received. The assignent of an insurance policy is defined asthe transfer of control of the pollcy from the owner to the county welfare board, Uponthe death of the insured, no payment can be made to the beneficiar until the interestsof the assignee (county welfare board) have been satisfied.

'\,

To execute an assignment of life insurance, form PW 22 must be properly completed,signed, and transmitted in the manner described in Chapter 393-5. In the instance ofownership of life insurance with a fraternal society, the county though which AAD isreceived must be designted as the. beneficiar. The forms needed to obtain a chage

in beneficiary as well as instructiöns for their completion ca. usually be obtained froma local representative of the fraternal Bociety. If there is no local chapter, the formsand necessar procedural instructions are to be requested from the society's homeoffice.

In determinng whether or not an applicant or recipient of AAD is actually the ownerof the life insurance, the following criteria will be used. If he origilly contractedfor the life insurance and is shown on the policy as the purchaser, he will normally beconsidered the owner of the life insurance even 'though a relative or friend may haveassumed some responsibility for payig premium costs. Such payments will usuallybe considered a contribution to the applicant/recipient, However, s. exception to thisgeneral rule may be made if there is evidence that a relative or friend has paid a lageshare of the total premium cost and if, in the judgment of the county welfare board,the execution of an assignment of the policy would constitute an unreasonable courseof action.

\.

Par. 5. SpeCial Assi~ents -- In rare instaces, an applicant for AAD mayown personal property exceedig the specified limitation but which canot be properlydisposed of because there is no current market. Urgently-needed assistace shouldnot be denied to such a person if he is wiling to transfer the property determined tobe in excess of the limitation until such time as the market permits other dispositton.If the trust chattel mortgage is not an appropriate instrument for executing such anassignment, the cou.ty,welfare board should collaborate with the states attorney forthe purpose of designing an assignment form which will accomplish this purpose. Thestate department will then determine if this special assignment meets the legalrequirements of transfer in trust.

( .May, 1971 Transmined by

Manual Letter #823

Public Welfare Boardof North Dakota

314.14.,

Soial Work MaualChpter 314

"'PROPERTY F AC'0RS FOR

AID TO AGEQ, BUND, AND DISALEDSection 6

Pars. i - 2

,

I. ''"i

SECTON 6. PROPERTY AD~NISTRA nON..

Par. 1. Treatment Divided Into Thee Topic~: Servces. Settlement. andProbate u Treatment of property owned by applicats or recipients, o~r th as it

is involved in considerations of eligibilty, is diVided for convenience .into the topic.,

each of which is exained sufiently in ths setion to provide an overall View of th

extet and nature of county weìtre bo resposibties in property adstration'

Tbe three remait sections contain th speifc rues, pocies, an othr lnorm-Uon tht the state department deemed importt to p.lh in carr out t.ese re- '

~posibities. The three topic. are: ' '". .

a) Property servce.; , ...

b) Settement amfrelease; and

c) Probate.

-')

Par. 2. Whom to Consut- Distrct Representative or Field Audtor u 'T "tol1owlg has been adopte as a guidi pocy in th ¡i,¡stent of primary respo~'

Ì;ty for contative servces: th distrct reprsentative shd be consute on i,problems involvi propert servces an th field audtor on mattrs iiolvl settòj,

aient an probte.' Bese of th inter.-re1tionhip of soda! an fiu.1ialcoUder-.;¡~t101, bowever,th ab ii not lnteed to be .. hard aD faIt rue, but mery a i'~SUd1 pocy, a. state'

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I:

¡t,

';

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.:¡

Puc Wele Bordof Nort Data

Tramitt byManu Lettr ..10

Apr,1963

31.-15

..

Soial Work Manual

Chpter 314PROPERTY FACTORS FOR...

AID TO AGED. BLIND. AND DISABLEDSection 7

Pars. 1-2

SECTION 7. PROPERTY SERVICES//~ . .. I~

Par, 1. Rights of Th~se Whose Taes Are Delinquent u The worker should

acquaint himself with the essential provisions of the law with regard to disposition ofproperty on which ta paymen~ are delinquent. He should, for exmple, be aware of

the right of an individual to redeem ta certificates on his property purchased by someother person. by payment of the taes plus interest. H property has goe to ta deei

th right of the owner to redeem at any time prior to sae of the propert by the coutyshould be recognzed, and advtage shoud be taken of an agreement which may be

possible to make with the County Commissioners for maki such redemption, such asby a monthy alowance in the assistace grnt or by payment in a lump~eum amout.When the county holds a ta title, it is requred by law to alow at least a fullyea for

redemption beore offering the ta deed for sale.4'

Par. 2. Reciptents of Assistance Should Be Advised on Pro~rt Mattrs u':,'The county welfare bord should be on the alert for opprtu ties of providing adviceto recipients of such a nature as to ward off injudicious exercise of th discretioDaryprivieges which they retaln with respt to thir prope. Por example. if forecloi-

ure of rea property is imminent. the recipient should be caution against givi a

deed without approval of the couty welfare bord. The couty welre lxrd ordr~fly Wi not recommen the givi of a deed to foresta foreclosu unless the mort-gagee W1 pay an amout equ to the average annual inome from ti property, anJhe cost of foreclosure. in the case of forecosure against person propert, the

'.ty welfre bord should provide al help possible in savaging the largest possible, .Jrtion of the vaue of the property for the recipient. If the holder of a real estatemortgge attmpts to persuade the recipient to apply any of his persona property on'the debt, the recipient shoud be adiied tht it is not neenary to do ths. nmelyadvce may in some instances ward off a trsfer of prrt which coud disquth recipient for continued assistace uner the dilqu trfer section of ,thstatute.

/,

(

Apr, 1963

3 i. ~ 16

Trmi tt byMaual Lettr "10

Pulic Welfre Bordof North Daota

..

...,T ..

Section 8

Pars. 1.-~

Soial Work ManwiChp,ter 314

-4PROPERTY FACTORS FOR

AID TO AGED. BUND. AN otSALEO

SECTION 8. SETTLEMENT AND RELEASEfl.

Par. 1. Pol1cies Regarding Settement and Release of Uens - - PolicIes on Set..tlement of claims pertain chiefly to the exercise of the discretionary power of thstate an county departments to release OAA, AB. an AP liens and homestestatements with respet to al or part of the re or persona property of a recipient; ,it Is assumed. of course, tht it 1s always in order to release mortgges and home,,sted statements to correct errors or when grts of OM. AB. or AP have been 'repaid in fu. Use of ths discretionary authority' inudes proper consideration of . ,the right of the pulic Welfare Bord to accept compromise settements uner a legaprovision whereby the depatment can. in the exrcise of good business Judgment.

. compromise its claim against the property or estate of an QA, AB. or AP recip..tent for less th the 4mQlt of such blalm.

Par. 2. CircuInt!taces Under Whch Releases May Be Grate -- The de" "

iion as to whetber or not to recmmend tht a Trst Mortgge be released oft 're~.':qures the utmost of goOd judgment and discretion on th part of th coanty welfe '

l:rd.. In order tht the mortgge sha not work haship or tnequty l?on th In.~t of th trfer.tn.trst provisiou. certa circumstas are defi ~r,neh a release may be grante for go cause sho Thse ar:

a) When settement 1s made in an amout representi the state', eqty in th

tre and far vaue of the property;

b) When th county welfe bord 18 satisfied tht th collection of th amout

paid in OM. AB. or AP wU not be Jeopardzed¡ or

c) When release in whole or in part is necessar "for th maintenace or sup.port of th reclp1ent.s spose or mior or incapacitate chUd;en.

Par. 3. Ful Repayment Defi n Ful repayment of anOA' AD. or APclm wU consist of remtt'to th .state depaent of an amount equ to al OM.AD. or AP reeived. acompaed. in th case of a deied reipient. by simpleinterest at th lega rate commenin IlX month afr th date of th replentideath. No tnterelt wt be charge on th amount of OA, AD. or APT repad by a.rep1ent whUe bel. UVi. '

Pa. 4. For tn.Whch Remitt To Be Suitt n. Remtts to th~Itate depaent in fu or pati settement of any c1 must be in 1h form of acouty treasurer'. cbk.~ bl dr. eetted ch, ot inon ordr ~ peyaeto th Puc Wel Bord of North Dakota an autt with a lettr of extionto the Dh1.inon of Actl an Auta. i ~

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Pulic Welre Boof Nort Daota

Trltt byMaua Lettr.l4'lO

Ap. 1963

314.17

~ \

Soial Work MaualChpter 314

-.PROPERTY FACTORS FOR

AID TO AGED, BLIND, AND DISABLEDSection 8

Pars. 5-7

. Par. 5. Crediting ot:'Remittces -- Remittnces received in payment of

fms filed against estates are eredited to the OAA, AB, or" APTD account for which_-e claim is filed. In th case of living married recipients, however, remittnces are

credited to the. account of the recipient who does not have title to the property, so tht

as much of the OAA, AB. or APTD claim as possible wtil be retained in the accountfor which the state will have a preferred claim. Those making payments in fu orpartial settlement should be informed of tls plan for crediting proceeds. If it is be-lieved tht ex~eption to this plan shoud be allowed in unusua cases, the remittceshould be accompanied by a request for such exception wi th reasons in detaiL.

/",\"

Par. 6. Reguests for Release of Trst Mort~s and Homestead StatementsTo Be Set to Division of Accouts and Audits if Accompaed by Ful Repayment --Requests for releases of trst mortges and homested statements are made to thecouty welfare bord. If the request is accompaed or preceded by fu repayment ofany OU. AD, ,or AP claims. it is suitt along With th remitte directly tothe Division of Accounts and Audits. If a compromise settlement or release withtrepayment is bein considered. review and decision by the field auditor 1i obtained.' ·

Par. 7. Forms To Be Used in Reguesting and Efectii: Releases u The fol-

low forms are to be used in requesting and effectt releases:

a) FOR RELEASE OF A TRUST MORTGAGB for OAA, AD, and APTD - "Re~quest by County Welfare Bord for Discharge of Trst Mortgge" is sub-mitt to the Division of Pulic Assistae by th county welfre bord.The forms necessary to efect release of propert of OAA, A., and AP'cases are as folows:(1) Request by Pulic Welfr~ Bord for Discharge of Trs. Mortgge; and

I'~

(2) Satisfaction of Trst Mortgge (Partial Satisfaction of Trst Mortge).

Forms liste in indentures (1) and (2) abve wi be forwarded to the coutyauditor. Mtr the forms liite in (2) above are sign by the Chrman ofthe Bord of County CòInissiQners, they wi be delivered by the county

welfre bord to th person entitled to receive them.

b) FOR RELEASE OF A HOMESTED STATEMENT. A lettr requesti suchrelease.w1tb reasons. 18 ient to the state departent., The state departentwi thn forwa~ to the couty welre bo the form necessary to'efecta release of the homested statement on property of OM, AS. or APcasei for record an delivery to th part conerned.

("April, 1963 Transmitt by

Manal Lettr ..10Public Welfare Bord

of Nort Daota31..18 ~

..Soial Work ManuaChptr 31..

..PROPERTY FACTORS FOR

AID TO AGED., DUNn, AND DlSABLEDSection 8

Pars. 8- 10

Par. 8. Unal1,!fa~,tonr Reasons for Reteesting Release -- Release of home-

sted statements or t rust mortges is not approved whe the following reasons are '

given for the request:

a) Recipient bas moved permanently to anothr state; or

b) A relative or othr personrvolunteers to assue supprt in return for re-lease of ~operty. Ageements with relatives or other persons for supportare not bindin, an, even though intentions are the best, conditions may

arlse wluch make it necessary for the recipient to again receive assistance.,The 8tat-É department will, however,' consider approval of a wrttn agree-ment to th efect tht release will be grte at th death of the reipient

provded it is qemo.trte tht be did supprt the reipient an providefor the expees of last U1ss and bu.. Factors' to betaen into considl",' .'~eration in recommenng such an arnment ar: lie expetacy' of th..recipient;. vaue of th~' proprt l amowt of &s8istancreceiyed. et ~tera. .

Par. 9. Normal Procedure for Appovi'. Copromise Settement .-Whn acompromise settement ie propsed or requeste, th director of th couty welfebord prepare i in trplicate a ,detailed statement of th proposed settem~. glvl. the vaue ,of the propety involved. tbe method of evaluation, and other pertt inor-

Q1aUon which wi aid in arrv. at 11 de81on 1b proposal is th sut: tobcounty welfare bord for itsco8ideration and recommention. After couty welarebord action, the field audtor reviews th proposa an recmmendat1cmand makesadecision in beha of the state department. If h18 decision 1s to appove th, prpow.an if tls 1a 1n line With the county welfre bord's recomendtion" h! forwars orbas.forwarded th origina and duplicate of th proposa to the OJvtsion nf Publc As-

sistance with a sign notation of his decision and the formal request for release.

'le state departent Wi thn forwa.rd the nessary forms to efect release.

, Par. 10. '.Procure Wh Pield Auditor Dos Not Agee With Couty Welfre

Bord Reommention .. -in,tt event tht th fiel audtordos not ag reC with thaction take by th couty wele bord on th propsa, either for appov or re-Jection. be Wi glve tb coutylwe1e bo su cou and advice.. need ort:!!t¡ute. and aut a reponÓn th propo to th Dlvløtou ofPuic\Aølrat~ th Puc We1f Bord alon With th origi an duplcate of th wrtt state-ment of di prposa. In givi couel and advice to the county welre l)rd 1n sucheases he åb prre a revied proposa. or assist th couty welfare~f? in 80doi, if he beeves a settement tis in order on terms dierent from the acte uponby th couty wel bo ,.1bs rfNøed propsa woud be presente'to th pesonseekng th reease,' an. If satiaftOry to bl, wou be acte upon by th Bo 1rtb ..me maun a. th or prpo-l.

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Puc Wele Boqt Nort Dlta

Tritt by ;Manua Lettr 1410

Apr. 1964

314-19

""

Soial Work Manual

Chpter 314

-IIPROPERTY FACTORS FOR

AID TO AGED, BUND, AND DISABLEDSetion 8

Pars. 11-14

. Par. 11. Procedure When Field Auditor Reviews Before County Welfare Bord

tion Taken - - In some instances the most convenient time for the field audtor to ".,..cure a review of a proposa is before the county welfre bord has had an opport-ity to act on it. In such cases the field auditor will submit his written recommenda"tion to the state department an may make a copy availble to th county welfarebord. When the county welfare bord has taken action on the proposal. a report oftls action. together with the origina and duplicate of the proposal. and th formalrequest for release, should be sent directly to. the Divtl!ion of Public Assistace fordecision.

Par. 12. Procedure When Considering Release Without Repayment d When a

release is being considered uner condtions under which no repayment of OM. AB.or AP is involved, and if it is for..reason othr th the correction of an error in

lega description, the method of obtaining a decl8ion on such a reea"e wU be thesame as tht just describe for compromise settements, exept tht 1n the place of aproposal for settement there will be a request for release without repayment.. ,ni.

should be carefuly prepared with reasons in deta. and acte upo in the sae ma-ner a8 in th case of a propsal for settement.

Par. 13. Soial As~ts To Be Considered -- When Uvi recipients or neeysurvVing dependents of deceased recipients are involved in property settements. 'both the couty welfre bord an the Public Welfre Bord wi at.tempt to make ,thtty of settement which, with legallmlts, wi have th best inuence on th so-al aspects of th case. In ths area the servces of th distrct representative are

vailable to th county welfre bord and the field auditor.~,

Par. 14. Reaization of Ufe Insue Benefits n Upon the death of a reclp- 'tent with life insurance, proper steps should be taen promptly to reaze such benè-fi ts and proceds as have been arr for though an assignent, order, oragreement in efect. Old line compaes requre only notication of death for paymentof fu procees to th couty holdi th assi.t. F~)l; frtern societies, thecounty welre bo must eut to th compi proo of deth of th lnsu~ lL ,make request for payment of inuran a8 beciary. For belent insurabe so-cieties, th couty welare bord ehd prpare a itateentior tb';beneflctary Uit-1n th coata of last Ule81 an bu an the amoutof OA, AB. or AP reel'9.

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April. 1963

314..20

Trnsmtt byMaual Lettr l410

PuUc Welfre Boof Nort Daota

..

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Soial Work Manual

Chapter 314

..PROPERTI FAd-RS FOR

AID TO AGED. BLIND, AND DISABLEDSetloa 8

Pars. 15-16

l

\"Par. 15. Trust Chttel Mortgages Must Be Renewed .. The county welfare

bord's duties under1le provisions on property settement include the servcing of

transfer-tn-trst forms to keep them in a valid condition so tht eventu settementmay be assured as intended, On Trst Chttl Mortgages ths means tht a renewal

must be secured withn 90 days prior to the expiration of three years from th dateof execution. If renewed, the Trust Chttl Mortge beomes 'Void at the exprationof six years. If it is not renewed withn tht period of time, it 1s necessary to exe-cute a new Trust Chttel Mortgge.

Par. 16. Subordnation of Uens for OAA, AB. andAPTD Prope~ .- Subord-nation of liens are generally requred by oU, gas, and mierallease purchasers whenthere is a homestead statementor trst mortgage .on the property.

It 1s the policy of the Pu'ÍiC Welfre Bord to cooperate in th development of re-sources of the state by permittng the execution of a subordination of lien on propert ,upon which there is a homestead statement or trst mortgge filed.

The "Surdination Ageement" cannot. however, include a clause trnsf~rr oUt

gas. ,or mineral rights. Uner a le.e. th property owner receives on-eghth ofihe income from the sale of oUt gai, or mierals recovere. U mineral rigbta are "

t:ferred. th propert ownr haii ¡no futhr equty in ib rigbtl tr~ferre'.':

". 'l' procedure for obtang a "SUbordintion Agment" 1s:

a) Al requestl for subrdnation ageementl shoud be subitt to th Pu-. '

,lic Welare Bord by th lessee. Ths reest 1s Informal,tbrefore. no ':speial form 1s need.

b) Subordination Agreement-Trst Mortge 18 used when a Trst Mortgeis on file.

Surdination Ageement-Homested Sttement is used when a HomestedStatement 18 on fUe. '

One of the ab formi, whchever appes. wi be completed by th Pub-lic Welre Bord an will be signed by the person or firm requiting theaurd nation.

c) Th Surdnation Ageement wi be returned to the couty welre bord.If th prpert 1s covered by a Trst Mortge, a Surdtion Ageeent-Trst Mortgge must be signed by th couty commlea1oners, but if thproperty ii cO'ered by a Homeste Stteent. . SUrdnation Agement-Homelied'Stateent wU be l1ed by th Extive Dtretor of th PucWelfre Bord."

d) Th couty were bord wU return th proply 8l Surdtlo:Ageement to the purcaer of th lease. :

Puc Welfre Boof Nort Oaota

Tn.smlt' byManual Lettr "'10

April, 1963

314-21

#

Soial Work Manual

Chpter 314

PROPERTY FACTORS FOR M.AID TO AGED. BLIND, AND DISALED

Section 9

Pars. 1.2

SECTION 9. PROBATE. ..

(i.

Par. 1. Preparation and Ftling of Claims'" The county weUare bord has theuuty of preparing and fiing claims against the estates of deceased recipients of Gen.era1 Assistance, and of cooperating with the state department in the filing of claimsagainst the estates of deceased recipients of OAA, AB, MA. and APID. A claimshould be prepared and filedin evf:ry estate. irrespetive of the prospect of recovery

and irrespetive of whether or not there 1s a will, since a Wi only determines thedistrbution of the estate after al debts have been satisfed. .

Par. 2. Preferred and General Claims - When Filed and Alowed n In OM.AB, MA, and APTD the claim filed will be a preferred claim if it Is for assistacerendered to the person whose estate is being probated. If the non.title owner receivedassistae, the amount of such assiS'nce received pror to the death of the titleowner is filed as a general claim against th estate of the title owner. Assistance re" ,celved by the survving slXuSe subsequent to the death of the title owner becomes apreferred claim against any estate he or she might have. OU, AB. MA, and APclaims are not enforced against rea or persona property necessary for the support,maintenace. or comfort of the survving spouse or a dependent, or against personaeffects. ornments or keepsakes of the deceased not exceeding $200 in value. A pre- '

ferred claim for OAA, AB. MA, or APTD is requred by law to be alowed after ex-peses of administration, fueral expnses not exceedin $250, an last Ulness ex-penses authorized and paid by the county welfre bord. Clms in favor of the county"'lr General Assistance exnded for such person and bis lega depedents have pref-

ence in the order of payment over claims for any of the AAD programs. Th stat-úte of litations sha not ru agat claims of the state of Nort Dakota for repiy-

ment of OA, AB, MA, AP¡, w. General Ass1atacë ~t:ded by tl~. couty.

(

(r'-'.'t

'tismi tt byManual Lettr #4 10

PuUc Welfre Bordof Nort f)ot

APril, i 963

314-22..

.. "-;,Soial Work ManuaChapter 314

..PROPERTY FACTORS FOR

AID TO AGED, BUNO, AN DISABLEDSection 9

Pars. 9- 12

,,f f Par. 9. Hean.~ On Final Account and Appe From Decree u When the

county court entertins an application for the fina settement of the account of an ad-

ministrator or gurdian. a citation is issued to intereste persons to show cause. ifany. why, the fina report and account :should not be allowei and distrbution of the

residue made to the heirs, deVisees. or legtees. A representative of the county we-fare bord should appear at such hearings if it appers tht a claim for assistace

rendered has su~ered as a result of action tak.en by the' administrtor. Afær thcourt bas made an order alowing the fina account folow such hearing, tne state

department may. withn 30 daya, appeal to the district court. If it is believed tht anappeal is in order. a copy of the decree or order and fu information beeved to ren-der the ordèr' or decree improper should be submitt immediately to th state de-partment.

.-Par. 10. Remittnce and Release Same as for Oter Settlements -- After re~

mittnce is received in the s,tate offce in settement of claims agat estates. an no', appe is to be filed, release of liens and homested statements is effecte a.r sub-

mission of formal requests as in the case of any other settement. In every case inwhich the claim for OAA, AB, MA, or AFro is not fuy paid, ii copy of the adm.istrator's repor.t shoWi receipts and disbursements must be sent to th ltate de-partment by th county welfre bord;

Par. 11. Suary Administration of Estates u If the value of an estate doesnot exceed $2,500. the court may, after filing of a petition for summary administrationby any heir, legatee, deVisee or creditor, make a decree assignng the whole estateto the survving spose, or to the minor children if thre is no survving spouse. Thestate Is thus assigned subject to whatever mortgages, liens, or encumbrances werein effect at the time of th decedent's death, and to the payment of adminstration.fueral, and last iless exses. It is advisable in many instances for th countywelfre bord to consider the advisability of intiati a summary adminstration of asmal estate. When propert is thereby assigned to a survi spouse, tas. re-

pairs, and upkeep ca be just1ably provided in th assistace grant and sti preservefu equty for the survvi spouse inste of th one-thrd interest remaln wheth reguar probate procure is used.

Pa. 12. Probte of Trst Property of Indan u Upn the death of an Inianownng trst propert. includig nM accounts, th state department prepares a Proo

of Clai, RDng th orgina "and one copy to th eXlr ofinberitance of the De-

partment. of Interior an copies to the county welfre bord and th superintendent ofthe Inn Agnc. It 1s not neessary' for th county welare bord to ~ coernwith th probati of trst property of Inia. exept to be certa iæstadepat-ment is in possession of iDonnation as to trst property so owned and to noti th

state depatment of th deth Of Inians ow trst propert. If an Indan recipientowns uou*t:t propert. probate proc~l:np ihoud be unrt as in any 0t1rC8øe.

Pulic Welfae Boof Nort Daota

Trnsmi tt byManua Lettr #410

Aprt, 1963

314-25

..

-4Soial Work Manual

Chapter 314

PROPERTY FACTORS FORAID TO AGED, BLIND, AND DISABLED

section 10

Par. 1

~r1"110N 10. ACTION TAKEN WHEN RECIPIENT OF ASSISTANCE ACQUIRES PROP-"'.' . .'Y

'T

Par. 1. Recovery of OM. An, 'or AP From Recipients -- A recipient orformer recipient of OAA, AB. or MID will be requeste to repay the amount tht hereceived through these programs if he acquires property of a value wlnch 1s deter~mined by the county welfare board to be suffcient to provide his needs, if properly ,

used. during the balance of his Ufe and to repay the amount of assistance be ha re-

ceived.

--..p"'~ -'~'... -

U repayment is refused. there sha exst a cause for action for such assistace 'agast the person. Ths action sha be brought by the state', attrney of th county'in the nae of th county in wluch &sskt.e was grante.

..,/- ,

;'

/~~"..."

" ' , '.

. ., I

~.r ., .:

. '""

..,

Apri. 1963

314-26r""

Trnsmi tt byMaual Letter #410

Public Welfare Bordof Nort Daota

..

..-li

..

DETERMINATION OF NEED

CHAPTER CONTENTS

ChapterContents

Social Work ManualChapter 318

Page

SECTION 1. GENERAL PRINCIPLES OF BUDGETING

Par. 1 . General Statement 318-1Par.2 - Definition of Need , . . -, , , . 318-1Par. 3 - Budgeting Process. . . . , . . , 318+1Par. 4 - Initial Grant to Include Curent Need 318-1Par. S - Budgeting For Household Receivg Assiance From One Program. 318-2Par. 6 - Budgeting for Households Receiving Assistance From Morc Than 9ne

Program or Grant. , . . , , . , . , . . . . . 318-2Par,7 . Budgeting in Behalf of Recipients Living Ou t of State, 318.3Par. 8 - Convening Weekly Figures to Monthly Figes. . 318.3Par.9 . Security Assista1le in Whole Dolls. , . . 318-3Par. 10. Budgeting in Relation to Overpayments . . 31 &-3

SEClION 2. STANDARD BASIC REQUIREMENTS

'Par. 1 - General Statement. , . . . . . . , . , , . . .

Par. 2 - Standard Requirements and Budget Pla, Form PW 286

Par. 3 . Budgeting Procedures . . , , . , , , . , . . .

Par. 4 - Shelter. . . . . . . . . . , , , . . . . , ,

318-4318+5318.9318-10

SEClION 3. BUDGETING PROCEDURES IN SPECIFIED CIRCUMSTANCES

Par. i - General Statement. , . , , . . . . . . . . . . . .

Par. 2 - Recipients Not Subject to Plat Grant Method of Budgeting. . . , . .

Par, 3 - Special Items of Need . . . . , . . . . . . . . . . , . . ,

Par. 4 - Budgeting During Periods of Hospitiization. , . , , . . . . . . .

Par. 5 - Buy-In With Socia Security Administration and Blue Cross-Blue Shield

Par.6 - Medical-Health Seices. . . . , . . . . . . . . . . . . . .

. . 318.11

318-11318-16318.17318-18318-19

Socia Service Boardof North Dakota

Transmitted byMaual Letter 828

JulY, 1971

318.i

-"Social Work ManualChapter 318 DETE1lMlNATION OF NEED

ChapterContents

'f. CHAPTR CONTENTS Page

.:CTION 4. INCOME AND RESOURCES

Par.Par.Par.Par.Par.Par.Par.Par.Par.Par.Par.Par.

Par.Par.Par.Par.Par.Par...~r..lr.

Par.Par.Par.Par.

1 - Income and Resources Must Be Considered ,2 - Definition of Earned Income.3 - Earned Income (AABD)4 - Earned Income (AFDC) . .5 - Earned Income of Children .6 - Conservation of Children's Earnings for Future Identifiable Need

7 - Income from Real and Personal Property8 - Income from Home Not Used by Recipient .9 - Old Age Survvors and Disabilty Insurance

10 - North Dakota Old Age and Survvors Insurance System.11 - Railroad Benefits

12 - Income from Compensation (Workmen's, Unemployment,and Veterans') .

13 - Relatives' Contributions .14 - Court-Ordered Support Payments

15 - Income from Earned Rights.16 - Income in Kind .17 - Income from Other Sources .18 - School Lunch Program19 - Urban Renewal-Relocation Adjustment Payments,20 - Highway Relocation Payments .21 - Payments from Board and Room Arrangement.22 - Home Produce23 - Lons .24 - Food Servces

. 318-23

. 318-24

. 318-24

318-26318-28

. 318-28

. 318-29

318-29. 318-S0

318-33. 318-33

. .. .

. . 318-34. 318-34

318 - 34318-35318-35318-35

. 318-36

318-36. 318-37

318-37318-37

. . 318-38318-38

l,

(-- .. ...ne, 1970

318-ii

~. '

(Transmitted by

Manual Letter #767

Public Welfare Boardof North Dakota

".

JI-lSocial Work ManualChapter 318 DETERl\UNA nON OF NEED Pars. 1-4

SECTION 1. GENERAL.'pRINCIPLES OF BUDGETING

Par. 1. General Statement u The purpose of as"sistance payments under TitlesIV -A and XVI of the Social Security Act is to provide fiancial assistance to eligile

families and individuals when their incomes and resources are inadequate to meet theSocial Service Board's defined standard of economic security. Under the provisionsof the Act, the Social Service Board has the responsibilty for determining that assis-

tace payments are made in such amounts and in such a maner as to make it pos-sible for eligible indiviudals to function as responsible members of the community.

In order to qualify for assistance, an individùal must meet all technical requirementsof a grant program and must, in addition, have insufficient income to meet thestandard of economic security as defined by the Social Servce Board. The conditionof need must be found to exist with respct to each individual. Policy does.

however. permit consideration of the fact that the presence in the homE: of needymembers of the applicant1s family and other needy persons with whom hè lives maybe essential to his well-being, and m~y affect his need. (See Section 3 of this Chapter).

Par. 2. Definition of "Need" -- The combined requirements. as shown on form

F'V 286 (Chapter 318-7), represent the minimum amounts of income necessary tomatain a standard of livig compatible with decency and health, by size of assistceunits. These requirement levels are based on extensive sureys conducted by the

Social Service Board, Department of Agriculture. Offce of Economic Opportuity, andthe Consumer Price Index, as published by the Bureau of Labor Statistics. Theyrepresent 100% need as curently defined by the Social Service Board of North Dakota.

Par. 3. Budgeting Process u The process by which a person's need is deter-mined is known as the budgeting process. It is a procedure by which available netincome and resources are collated with basic maintenance requirements. If net in-come and resources exceed maintenance requirements, no need or eligiilty exists.If income is insufficient, the resultig budgeta deficiency is the amount of the

assistance grant.

Par '4. Intial Grant to Include Curent Need u The intial grant mayprovide for "curent need" only. defied as that portion of an individual's orfamily's requirements which are incurred duing the month for which payment is

made. Hence. the county welfare board may not include need which is for a periodprior to the month for which the first payment is authorized. An exceptíon to this

pOlicy can be made when p.ayments for preceding months must be made to correctprevious administrative action such as. for exaple, to ca out the decision of a

fai hearing.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #823

May, 1971

318-1

-#

Social Work ManualChapter 318 DETERMINATION OF !\EED

Section 1

Pars. 4-6

./

,

A person receiving medical aseistance only will on occasion become eligible forinancial assistance during the course of a month because of a change in his circum~

stances, as in the instace of his e~try into a rest home or a board and room arrange-ment, If for some reason he canot be immeditely transferred to a grant program,the county welfare board may provide for the unmet portion of hiB need for the monthfor a; period not to exceed the current month and two precedig months in order toprotect the sheltered living arrangement considered necessar for him,

Par. 5, Budgeting for Households Receiving Assistance from One Program --

'When all members of a household are eligible for one program, assistance 1s pro-vided through a single grant. An AAD recipient i s ineligile spouse, if living in thehousehold, is to be considered needy for such time as the grantee remais eligile

for assistace, The ineligile spoüse's maintenance needs wil be recognzed in

computing the amount of the grant though any net income which the ineligible spousemay have at lùs disposal wil be taen into consideration. If, however, a person

receivig assistace as the ineligile spouse from one program becomes eligile in

his own right for assistance from the Bame or another program, he will' be expectedto apply for assistance from the category established fDr persons in like circum-staces.

Similarly, the parents of children receiving AFDC, if living in the home, are to beconsidered needy as long as the children remain eligile for assistance. The parents'

matenance needs will be computed in accordace with assistace stadads with any'let income to be deducted in determining the amount of the family's grant entitlement. \

When 'some members of a family are eligible to receive assistance and other membersor non~members of the family are living in the home but are ineligile for assistace,only the needs of those meeting the technical requirements of the program may beincluded in the grant (except when essential servces are required. Chapter 318,Section 3, Par. 3 a) ).

Par. 6. Budgeting for Households Receiving-Assistance from More Than One

Program or Grant ~- In some instances, more tha one member of a household receiveassistance grants in their own right, either through one or more program categories.When this occurs, the budget will be computed on the basis of the combined need of

all of the eligible recipients in the household with the exception of any recipient (s) whoare budgeted on a board an room basis (Section 3, Par. 2 c), d), and e)). Any

available income is then deducted to determine the net need of the combined assistaceunits. The county welfae board shall apportion the various money payments in

accordace with the convenience and wishes of the members of the household.

. ¡:.,I; (

May, 1971 Transmitted by

'Manual Letter #823

Pulic Welfare Board

of North Dakota318-2

..

..-4

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 1

Pars. 7-10

Par. 7. Budget:g in Behalf of ReciI?ients Living Out of State - - Assistancerecipients residing temporarily outside the state of North Dakota are to be budgeted in

the same maner and in accordace with the same standads and procedures as areapplicable for recipients in comparable living arangements within the state.

Par. 8. Converting Weekly Figures to Monthly Figures -- When income is re-

ported in weekly figues, the amounts shall be converted to montlùy figures by

multiplying them by four and one-thid,

Par. 9. Security Assistance in v.'hole Dollars -- Assistance payments are to be

made in the amount of the nearest whole dollar. In establishing the grant, needs andincomes wil be computed in their exact amounts with the roundig-off process to bedone at the end. .'

Par. 10. Budgeting in Relation to Overpayments -- Current assistace grantswill not be reduced because of prior overpayments unless the recipient has fudscurrently avàilable in the amount by which the county welfare board proposes to re-duce payment except where, in the judgment of the county welfare board and theprogram superviosr, the recipient withheld or falsified information which promptedthe overpayment. In tros instace, the county weifare board may elect to reduce

the amount of current or future payments (not to exceed two months in duration) untilall or a reasonable portion of the overpayment has been reconciled. If it appearsthat the overpayment resulted from a deliberate attempt by the individual to obtainassistance to which he was not entitled, the matter shall be referred to the statesattorney in the manner outlined in Chapter 364, Section 3.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #823

May. 1971

318-3

"'4

Social Work MaualChapter 318 DETERMINATION 0 F NEED

Section 2

Par. 1

...aCTION 2. STANDARD BASIC REQUIEMENTS (

Par. 1. General Statement .:- The Social Service Board of North Dakota, as of

July I, 1971, adopted a simplified method for determining need in public assistanceprograms. The method, commonly called the flat grant, combines cost standads forall basic requirements, with limited exceptions, by size of the assistance unit. Con-sideration of special needs is eliminted with the exception of child care and other

expenses related to employment and vocational trainig, catastrophies, and house-

keeping (essential) serVÍces necessar to maintain a home. These exceptions areare descríbed in detail in Section 3 of this chapter. The cost stadads apply state-wide and tor all grant programs.

.'The flat grant method is designed to be more equitale and uniform, simplify ex-plantion to recipients and to the public, and to simplify the adminstrative processby reducing budgeting errors, minimizing the time necessar to compute budgets,

reducing the number of monthly grant adjustents, et cetera. In addition, the flatgrant is intended to help assistance recipients develop or maintain their self-relianceby mang it unnecessary to rely on the county welfare board whenever a specialneed arises,

The revised budgeting method represents an attempt to identify the quatity of incomenecessary to support an average indiVÍdualor family of a given size at a minimum'evel consistent with standads of living prevailing in the state. The standard require- (,

"Dents therefore represent amounts of funds which, if budgeted carefully, wil provide

an acceptable level of consumption. However, since it is geared to average need, theflt grant may fall somewhat short of expctation in instaces of unusual need.

It is also recognized that some recipients, because of age, infimities, or other de-ficiencies in their capacity to manage on limited incomes, wil have difficulty withthe flat grant method. Eligiility and social service persolUel are thus provided with

both the opportuity and challenge to make available appropriate services directedtowards improvig money management and helping recipients explore other availableresources which may help to alleviate fiancial stress. Such other resources mayinclude but are not limited to portective payments or legal guardianship, food stampsor surplus commodities, public housing, employment (earngs from which can bepartially disregaded), home-grown food, and ,in selected instaces, emergencyassistance from the Bureau of Indian Affairs or General Assistance.

cMay, 1971 Transmitted by

Manual Letter #823Public Welfare Board

of North Dakota318-4

iD,~),~

..-tlSocial Work ManualChapter S18

Par. 2. Standag,Requirements and Budget Plan, Form P\V 286 -- Form PW 286

specifies the total basic requirements, including shelter and most spcial needs, by thenumber of persons in the assistance unit. The form serves as the basis for budgetingneed and is to be used in determining initial and continuing eligibilty in AAD andAFDC. The basic requirements are pre-printed on the form to faciltate th budgetigprocess and to eliminate the necessity of transferring figures.

DETERlilINATION OF NEEDSection 2

Pa.~ 2

Individuals and families generally reside in one of three major typs of livig 'trrange-

ments. These include living in a (1) housing unit, (2) resthome, foster home, or boardand room arrangement, and (3) nursing home. In most instances, the eligiility workerneeds only to select the appropriate living arangement and budget accordigly.Occasionally, however, budgeting will have to be done on the basis of more than oneliving plan, as in the instai of an individual living in his home but whose spouseresides in a nursing home.

Specific instructions for completing form PW 286 are provided in Par. 3 ,of this Section.However, several general features of the budgeting process shoùld be noted, including:

a) Schedules 1,2, and 3 represent the most common Hving arangements,only one of which wil ordinaríly apply.

b) Schedule 1 C, "Special Need", may be used or4y under the limited con-ditions prescribed in Section 3 of this chapter,

The cost of child care, if associated with the WIN program, must be paid'through the vendor method (Chapter 324, Par. 8) and will not, therefore,appear in the budget plan, Child care costs not related to VolIN may be met

through the vendor payment method or included in the recipient's grant. Ifthe county welfare board elects the latter option, the cost of child care shallbe entered as a special item of need rather than as an icome~related expensein Schedule 4.

c) A reasonable allowance for transportation, and/or uniforms, if authorizedin behalf of employed persons on a hadship basis (Chapter 318, Section 4,Pars. 3 and 4), shall be entered as a spcial item of need (Line 1 C) rather

tha as an income-related expense in Schedule 4.

\ Pulic Welfare Board

of North Dakc:aTransmitted by

Manual Letter #823

May, 1971

318.5

-II

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 2

Par. 2

d) Although individuals i'n vocational training are eligible for a standad em- (ployment allowance, this need canot easily be shown in Schedule 5 A since

this section is designed specifically for persons with earned income. There-fore, when computig the budget for persons in vocational training, thestandard employment allowance and any special allowance for transportationand/or uniforms, which the county welfare board may have authorized on a

hardship basis (Chapter 318, Section 4, Pars. 3 & 4), should be shown as

special items of need on Line 1 C. An exception to this rule exists if anAFDC recipient receives vocational trainng under the Manpower Develop-ment and Trainìng Act since MDTA allowances are considered earedincome in AFDC.

.'e) If the calculation in Schedule 4 A 5, Net Earned Income, yields a negative

numbr or zero, the recipient is entitled to the entire earnings without agrant reduction. No subsidization shall be made for negative amounts.

/....'.l¡ (

May, 1971 Transmitted by

Manual Letter ~823Publíc Welfare Board

of North Dakota318-6

~3I' " ..

.. ,--:~-\T,

-ø

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 2

Par, 3

Par, 3. Budgetil\g Procedures -- Detailed instructions for determining the

amount of an individual's or famíly's assistance grant are given in relation to thevarious living arrangements appearing below:

a) SCHEDULE 1. LIVING IN-HOUSING UNIT - Circle the figure designatingthe number of persons in the assistance unit (Line A). Enter the amountfor special needs, if any, on Line C to arrive at the total requirements onLine D. Compute the total net income in space provided in Schedule 4.Enter total net income on Line E. Subtract from total requirements onLine D to obtain the net need and amount of grant (Line F).

To obtain the total basic requirements for assistance units in excess of 10persons, the foUowing procedure shall be used: Show the number of persons

in excess of 10 in the parenthesis in the "over 10" column and add $10 foreach such person to the printed amount in the "10" column, and enter totalin "over 10" column.

For children who do not live with parents and whose caretaker is ineligible.budgeting will be done on a board and room basis, the rate for which willbe negotiated.

b) SCHEDULE 2. LIVING IN REST HOME, FOSTER CARE, OR BOARD ANDROOM ARRANGEMENT - The monthly rate for care in a rest home, fostercare. or board and room situation is to be entered on Line A. Enter theamounts for clothing and personal needs ($13) and special need, if any, onLines B and C, respectively, to arrive at the total requirements on Line D.Enter total net income on Line E, Subtract total net income on Line E fromtotal requirements on Line D to arrive at the amount of net need and grant

on Line F.

c) SCHEDULE 3. LIVING IN NURSING HOME - The nursing home rate shouldbe given in the space provided. The allowance for clothing and personalneeds ($8) iato be listed on Line A. Special need, if any, shall be enteredon Line B and added to amount on Line A to determine the total require~menta on Line C. Enter total net income on Line D. Subtract total netincome (Line D) from total requirements on Line C to arrive at the amountof net need and grant on Line E.

LPublic Welfare Boardof t\orth Dakota

Transmitted by

Manual Letter #823

May, 1971

318-9

-4 \Social Work ManualChapter 318 DETERMINATION OF NEED

Section 2

Pars. 3-4

d) SCHEDULE 4. COMPtlTATION OF NET INCOME - Schedule 4 is to be usedin computing net income, both eared and unearned, to be deducted from theindividual's or family's need. This schedule is designed so that net earnedincome can be calculated in the same sequence as outlined in Chapter 318,Section 4. Pars. 3 and 4.

(

Space is provided at the right hand side of Schedule 4 for calculations. re-marks, or explanations and for enumerating any special items of needwhich may have been entered on Line 1 C.

Par. 4. Shelter -- The flat grnt includes a standad for housing based on the

size of the assistance unit. The standad is intended to cover average housing costs

includig such expnse of ownershii(as real estate tas, upkeep, and insurance.

The flat grant method introduces a degree of inflexiility into the area of fiancinghousing for public assistance recipients. Ths does not mean, however, that thecounty welfare board is to be unconcerned about the adequacy of recipients' livig

arangements. On the contrar, eligiilty and social service personel can oftenprovide an invaluable servce to recipients, particularly those who are aged, infirm.or overextended fiancially, by helping them to explore and select from a variety

of housing alternatives which would adequately serve their needs and at a manageablecost. Pulic housing is but one such alternative which is becoming increasingly

"aUable in more communities, (\"

r-'-If (

May, 1971 Transmîtted by

Manual Letter #823

Public Vlelfare Boardof North Dakota

318-10..

..-4

Social Work ManualChapter 318 DETERMINATION 0 F NEED

Section 3

Pars. 1.2

SECTION 3. BUDGETIri PROCEDURES IN SPECIFIED CIRCUMSTANCES

Par. 1. General Statement -. l1iis section concerns itself with budgetingprocedures which are applicable only in certain specific circumstances.

Par. 2, Recipients Not Subject to Flat Grant Method of Budgeting u Certain

recipients of assistance, because of the nature of their living arrangements, are notto be budgeted in accordance with the flat grant methpd outlined in Section 2 01 thischapter. They are identifed as follows:

a) RECIPIENTS IN HOMES FOR THE AGED - Aged. blind, or disabled personssometimes prefer living in homes offering group care to any other type ofliving arrangemeñt. Homes for the aged or rest homes, as they are fre-quently called, are non-medical facilities and offer a typ of care primarilydesigned to assist the individual in meeting his basic needs of daily living.A person desiring this kind of living arrangement shall have freedom(within grant limitations) to select the licensed home of his choice. Heshall also have the freedom to move from one home to another or into someother type of living arrangement if and when he chooses.

There exists a wide variation in the quality of care and services in resthomes as well as in the charges made by homes for residential care, Thecounty welfare board, after appraising the quality nf care offered, shallnegotiate with the administrator of the home a reasonable and equitable ratefor basic rest home care on behalf of public assistance recipients. 1/"Basic rest home care" is defined as including board, room, and laündry,preparation of simple special diets, supervision and control of medications

which do not require the continuing attention of traìned medical personnel,observation, supervision, and assistance, as needed, with walìng, gettingin and out of bed, bathing, dressing, feeding, and the use of the toilet.Basic rest home care also includes the provision of routine transportationneeds which canot be met by the recipient's family, relatives, friends, orby volunteers, and which do not require ambulance service.

1/ The. county welfare board in the county in which a home is located is responsiblefor negotiating rates for all public assistance recipients regadless of their countyof legal residence, Rates determined in this maner are binding on counties of le-gal residence,

Pulic Welfare Board

of North DakotaTransmitted by.

Manual Letter ff823Mày, 1971

318-11

...

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 3

Par. 2

.,The Social Service Board has established a maxmum rate of $150 per monthfor basic rest home care. The county welfare board is therefore.! autho:-

rized to negotiate a basic care rate in excess of that amoWlt. Payment inexcess of the basic care rate may be allowed only when it has been deter- .mined through a case-by-case evaluation by the Group Care Screening andUtilization ReView Team (Chapter 331) that an individual requires more thabasic rest home care, and when the CDunty welfare board is satisfied thatthe rest home in question is capable of funishing the additional care. Thecounty welfar board, in all instances in which payment greater tlu the

estalished basic rate is being certified, is required to indicate in Section X

of form P\V 600, "Change of Status, " that the individual's needs wereevaluated by the screeniIl' team.

Prior to granting fial approval to a request for an increase in a rest home'srate for basic care on behalf of public assistace recipients, the countywelfare board shall consult with the administrator of public assistance forcounsel and recommendations.

In addítion to the rate al1()wed for rest home care, recipients shall beallowed $8.00 per month for clothing and $5.00 for personal needs.

Some individuals lìving in homes for the aged will be temporarily out of thehome from time to time, Charges for guests who are temporarily out of thehome are as follows:

a) For absences of one or two weeks, no reduction il rate or returnof part of the monthly payment is made;

b) For absences of approximately one month. a reduction or return of50% to 60% is made; and

c) For absences exceeding one month, most of the homes wil not

reserve the guest's room.

Vl1ien a guest leaves a home or dies and payment for care has been made inadvance, the home is 1;0 return the Wlused part of the advance payment minusany exta expenses that might be incured at the time the individual dies orleaves the home. This is usually done on a day-rate basis.

i¡

May, 1971 Transmitted by

Manual Letter #823

Publlc Welfare Boardof North Dakota

3l8~ 12

..

(

"-

(

..-4

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 3

Par, 2

b) RECIPIENTS lN NURSI NG HOMES~ The costs of skiled nursing services inbehalf of recipients living in nursing homes will be met through the vendorpayment method (Chapter 331). The county welfare board wil providenursing home residents with an $8,00 per month clothing and personal needs

allowance. Those having régular income wil retain $8.00 each month and

apply the remaining income towards their medical care.

c) ADULT RECIPIENTS IN LICENSED FOSTER CARE HOMES - Not infre-quently, aged or disabled adults prefer the homelike atmosphere of a familyfoster home to the somewhat more impersonal group living arrangement inan institutional setting. Foster care for adults is designed to provide

elderly or infirm persons with needed personal and household services. and,to the extent possible. with a satisfactory substitute for their own homeswhich they can no longer maintain. Such an arrangement should be usedonly when desired by the individual and with his active pariicipation in theselection of the home in which he wHl live. A foster home may not beappropriate for persons with severe physical or mental disailities.

The county welfare board shall negotiate a reasonale and equitable rate forsuch care with the foster parents. In addition. each recipient shall beallowed $8, 00 per month for clothing and $5, 00 for personal needs.

Foster care homes for adults must be licensed in accordance with thestandards and procedures prescribed in Chapter 327.

d) ADULT RECIPIENTS It\ BOARD At\D ROOM ARRANGEMENT - Recipientssometimes arrange for board and room with a family. Such a plan issomewhat similar to that in a foster home, the primary distinction beingthat the board and room arrangement is not licensed, This may be theresult of the home not meeting licensing stadards despite its serVÌng a

particular person's needs well, or the boarder-roomer may be capable ofindependent liVÌng without receiving "care, " a condiuon necessary beforethe licensing statute must be invcked. Persons offering board, room, andcare to relatives are specifically exempt by law from the licensingrequirement.

As with recipients living in licensed foster homes, the county welfare boardis expected to negotiate a reasonable and equitable rate with families pro-viding board and room service. In addition. each recipient shall be allowed$8, 00 per month for clothing and $5.00 for personal needs.

(Pulic Welfare Board

of North DakotaTransmitted by,

Ì\lanual Letter #823May, 197f

318-13

--Social Work ManualCh~l)ter 318 DETERMINATION OF NEED

Section 3

Par. 2

e) CHILD RECIPIENTS I~ BOARD AI'1D ROOM ARRANGEMENTS - An AFDCchild placed in the home of a relatíve whose needs are not to be included inthe grant (ineligile caretaer) shall be cared for at an equitable rate to be

negotiated between the cowity welfae board and the relative. The negotiated

rate should be established on the basis of the specific needs of the child andshould take into consideration his board, room, care, clothing, laundry,personal needs, et cetera.

1-\

Homes of non-relatives which provide foster care for children must belicensed in accordance with standards and procedures outlined in Chapter 422.

f) UNWED PREGNANT GIRLS OR MOTHER AND CHILD(REl"l IN BOARD ANDROOM ARRANGEMENT -..unmarried mothers-to-be sometimes live withtheir parents pending and/or following the delivery of their children. Simi-larity, married children, particularly daughters, sometimes return withtheir offspring to their parental homes following marital disruptions. .Inthese instances, the county welfare board shall negotiate a reasonable and

equitable rate based on the needs of the unwed mother-to-be or the motherand her child (ren) and should take into consideration their board, clothing,

laundry, personal needs, et cetera. While the negotiated rate may also

include an allowance for housing, this item is frequently contributed with-

out charge by the mother's paents. However, if the mother f s parents arethemselves receiving public assistance, the budget should be computed by

means of the flat grant method on the basis of the combined need of alleligile recipients in the household (see Section 1, Par, 6 of this chapter)

rather than on a negotiated board and room rate basis.

,I\.

g) STEPCHILDREN - As a result of an interpretation of the 1968 U. S. SupremeCourt decision in the case of King vs. Smith, stepchildren canot bearbitrarily denied assistance through AFDC on the assumption the income ofthe stepfather is avai1able to meet their needs. The only relevant questionwhen determining program eligiility is whether the stepfather, as"substitute father, " is actually supporting or is able and willing to supportthe children.

To determine whether adequate support from the stepfather is actuallyavailable to the children, it is generally necessary to schedule a conferencewith the stepfather and the mother for the purpose of ascertaining thestepfather's ability and willingness to provide for all or a portìon of the

children's needs. If the stepfather is willing and able to assume full re-sponsibility for the support of his stepchildren, eligibility for AFDC doesnot exist. If he cannot or wil not assume full responsibilìty for thestepchildren, AFDC eligibility exists for the unmet portion of thelT needs,

t""

_..ay, 1971c.

Transmitted by

Manual Letter #823

Public Welfare Boardof North Dakota

318-14

~,-

....Social Work lvIanualChapter 318 DETERMINATION OF NEED

Section 3

Par. 2

( The determination of eligibilty for stepchildren thus differs from thatnatural children in that there is not the strict adherence per se to personalproperty limitatio~s, income, staiidard employment allowances, and otherconventional program regulations. Rather, eligibility is determined on thebasis of a mutual agreement between the stepfather and the county welfareboard as to the respective responsibility of each party. 1:/

Except in instances of death, continued absence, or incapacity of eL~er theparent or stepparent (in which case conventional AFDC polícies and the flatgrant method for budgeting apply), only the unmer needs of the stepchildrencan be included in the AFDC grant. Once a stepchìld's eligibility for assls~tance is established, the county welfare board shall negotiate an equitablerate for their car with the stepfather. However, in no instance shall the

negotiated rate exceed $55.00 for one stepchild, $95.00 for two stepchildren,$135.00 for three stepchildren, and $35.00 for each additional stepchild.

If income specifically earmarked for the stepchildren, as in the instance ofRacial security or child support payments arising from the death or sepa-ration of the natural father, is received in an amount sufficient to meet the

stepchildren's needs according to Social Servce Board standards,eligibility for AFDC does not exist. Similarly, H.tne stepfather makes acontribution to the support of his stepchildren in addition to housing and

utilities, such contribution shall be reflected ìn the negotiated rate for their care.

The natural parent, who is usually but not always the mother, is legallyresponsible for the support of her children born prior to her current mar-riage. However, her responsibilty for them is no greater or lesser thanher responsibility for her husband, herself, and any children born during

her present mariage. Therefore, the county welfare board caiot requirethat income to which she may have access, whether eared or unearned,be first applied against the needs of her offspring born preViOUSlY (unless

specifically earmarked for them) if, by doing so, other members of thefamily are deprived of the basic necessities of life. Thus, the question of

AFDC eligibility for her children when she, the natural mother, has incomein her own right, can be determined only aftr a thorough evaluation of the

needs and income of the total famUy.

Y Insofar as support is concerned, a stepmother's relationship to her stepchildren isidentical to that of the stepfather in relation to his stepchildren. Thus, as with thestepfather, it must be determined that she is able and willing to contribute to thesupport of her stepchildren before it can be assumed that she is actually doing so.

Püblic Welfare Boardof North Dakota

Transmitted by,Manual Letter #823

May, 1971

318-15

M4

Social Work ManualChapter 318 DETER~llNA TION 0 F NEED

Section 3

Pars. 2-3

The eligibilty and/or..ant entitlement of stepchildren is subject to adjust-

ment if the family's circumstances chage.

'Par. 3. Special Items of Need -- The flat grant method for budgeting public

assistance grants eliminates all consideration of special needs except as follows:

a) ESSENTIAL SERVICES - The cost of services which are essential to thewell-being of the recipient shall be provided for in his grant as needed.

These must be specific services which the individual or family, because ofage, infirmity, or temporary illness, canot perform and include nursing

or custodial care, housekeeping duties, and attendant services necessary

for a person to remain in his own home or to keep a family intact. Anineligible spouse, howevi.r, if livig with the recipient, is consideredessential to the well-being of the recipient by virtue of the fact that he orshe is the spou se.

If the essential services are being provided by the ineligible spouse, thecost of such services must be met by including the spouse's needs in thegrant rather than on a wage basis, y If the services are provided by arelative other than a spouse, the cost may be met by either includig theessential person's needs in the grant or negotiati.ng a wage, depending onthe county welfae board's judgment as to which method is the mostequitable. If a non-relative provides the essential services, the payment

of wages is ordiarily the preferred procedure.

b) CHILD CARE NOT ASSOCIATED WITH WIN ~ Reasonable child care costsincurred as the result of employment or vocational training but not associ~ated with the WIN program may, subject to the judgment of the countywelfare board, be met through either the vendor payment method or in-clusion in the recipient's assistance grant. However, if the latter methodis utilized, the cost must be identified as a special item of need andentered on Line 1 C of form PW 286 rather than shown as an employment~re-lated expense in Schedule 4.

Child care costs which are related to the WIN program must be dischargedthrough the vendor method and wil not, therefore, appear on form PW 286,

,Y An ineligible spouse whose need is being met through the assi.stance grant is re-quired to apply for Old Age Assistance upon becoming 65 years of age.

Transmitted by

Manual Letter #8231971 Pulic \Velfare Boarèi

of North Dakota318-16

~

(

(

/0'L..~

.,-l

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 3

Par. 3

c) VOCATIONAL --RAINING EXPENSES - Schedule 4 of Form 286 "Standard Re-quirements and Budget Plan," is designed specifically far persons with eared income,Thus. when individùals in vocational training are involved, the standard employmentallowance as well as any special allowance for transportation, uniforms, et cetera.

which may have been authorized by the coumy welfar board on a hardship basis(see Chapter 318, Section 4, Pars. 3 and 4) must be identified as special items ofneed on Line 1 C. This rule does not apply if an AFDC recipient receives VU'cational training under 1\IDT A (Manpower Development and Training Act) sincefederal law treats MOTA allowances as eared income in AFDC, subject to theearned income exemption. In this instance, Schedule 4 of Form 286 shal be used.

The cost of transportation, uniforms, et cetera, when authorized by the countywelfare board in behalf of an employed recipient on a hardship basis. shal alsobe shown as a specia.item of need (Line 1 C of Form 286) rather than as an income-related expense in Schedule 4.

d) CATASTROPHIC EVENTS - In the event of a disaster involving an AABD or AFDCrecipient, the county welfare board, after exploring the availability of propertinsurance and community resources, shal authorize the replacement of food,clothing, furniture, household equipment, and other needed supplies at a levelcomparable to that maintained by the recipient at the time of the fire, flood,tornado, or other natural disaster. Red Cross services, contributìons from fraternal

organizations, and private donadons sometimes become available at times of ad~versity, and community resources such as these should be explored and utilized.

e) ESTABLISHMENT OF GUARDIANSHIp. The cost of estblishing a legalguardianship for a recipient, including the expense of orignal appointment andan annual report to the court if requested by the county judge, may be incorporatedin his grant as a special alowance, However, the inclusion of funds with whichto compensate the guardian for managing the recipient's financial affairs is not withinthe scope of the state plan.

f) MEDICAL INSURANCE PREMIUMS. The county welfare board may authorize thecost of premiums for private medical andhospita insurance if at least one of thefollowin conditions is met:

(1) The individual or family alady caries priate insurance and he or memberof his family have a chronic, pre-existing condition which would make itdifficult or impossible tore-acquire coverage if the policy were to be dropped,paricularly if eligibilty for public assistance is expected to be of shortduration i or

(2) The individual or family already carries private insurance and the past andanticipated future utilization of medical benefits is such that continuedcoverage appear waranted However, county welfare boards are requestednot to inquire of an insurance company about an individual's past utilzationof medical benefits because such a request entails an extensive time-consumingsearch of its records.

SocialServìce Boardof Nort Dakota

Transmitted byManual Letter 828

July, 1971

318-17

\,

..~

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 3

Pars..4-5.

Par. 4. Budgeting durin!' Ptriods, of Hospitalization. - Budgeting in behalf of an assis-tance recipient who is hospited shal be done in accordance with the following principles:

a) A re-duction in the grt wil ordinarily not be made for the first 30 days of

hosp italization;

b) If the recipient is hospitaized for more than 30 days, a clothing and personal needsalowance of $8.00 per month shall be provided for beyond that period. In addition,it may be necessary to protect the hospitalized patient's normal livjng arangement.Thus, the county welfare board may authoriz,e,paymem of suffici¿nt funds to affordthis protection for a reasonable period of time, The policy for protecting an individ-uai~s living arangement in a home for the aged during periods of hospitaization isoutlined in Section 3, Par. 2 a) of this chapter¡

.4c) The hospitaized recipient's grant may also provide for an essential person whose

needs had previously been included in the grant,

Par, S. Bu -In with Social Securi ' Administation and Biue-Cross-Blue Shield. . Eachmoney payment recipient 65 years of age or over is automatic y enrolled with the Social Secu-rity Administration for Pan B (physicians' services) of Medicare and insured with Blue Cross-

Blue Shield to cover the deductibles and co.insurance of Pars A and B of Medicare. In bothinstances, monthly premium payments are made directly by the Social Service Board,

Aged recipients who receive only medical assistance are requìred to pay their insurance premi-ums tliemselves since they are not included in the Social Service Board's "buy-in" arangement,Failure to make premium paymen ts will result in costy lapses in their insurance coverage. Theinsured status of a grant recipient with some income iiihis own right wil be placed in jeopardyif he is hospitalized for indefinite or lengty periods of time unless the county welfare boardcan help him:to keep his coverage intact. As provided for in Section 3, Par, 4 a) of thischapter, grants wi ordinarily not be reduced or terminated during the initial 30 days ofhospiwization, This assures the individual's "buy-in" coverage for that period of time. Ifthe person is to be hospitalied beyond 30 d~ys and he has no income in his own right, thecounty welfare board shall reduce the grant to the amount needed for essential maintenanceincluding $8,00 per month for clothing and personal needs. If such individual has income ofhis own, he will retain the funds necessary to cover his essential maintenance needs, includinga clothing and personal needs alowances, and apply any remaining income towards his medicalcosts. Howevr, in the latter instance, the county welfare board will provide a valuable serviceby placing the individual's grant in suspension for a reasonable period of time after the initial30 day period rather than immediately transferring him to medical assistance. Since the SocialSen,ice Board can continue to pay premium costs for reasonable periods of suspension, thisprocedure wil make certain that his insurace coverage remains intact.

\,

cJulY, 1971

3 i 8. i 8

Transmitted byManual Letter 828

Social Service Boardof North Dakota

..

..-4

Social Work MaualChaeter318 DETERMINATION OF NEED

Section 3

Pars. 5*6

Aged grant recipients 'Wth income of their own who enter nur sing homes will be ex¥

pected to enroll in Part B of Medicare and insure themselves against the deductiblesand co-insurance with a private health insurance company of their choice. (See Chap-

ter 330, Sec. 3). A portion' of their income can be diverted to pay the cost of this

medical insurance. After thus insurng themselves, aged persons wil reta the

amount of their clothing and personal needs allowances from their income and theircases will be transferred to medical assistance only. Any remaining income wil beapplied towards their medical costs.

Par. 6. Medical-Health Services -- Provision must be made for assistace

recipients' medical-health needs according to policlesprescribed in Chapters 330 and

331..'

Pulic Welfare Board

of North DakotaTransmitted by

Maual Letter #823May, 1971

318-19

..-4

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 3

Par. 8

î) LIFE INSUllCE PREl\UMS - Provision may be made for the cost of lifeinsurance premiums on insurance owned by the recipient prior to receivíngassistance, and may be made for both life insurance policies and fraternalbeneficiary certificates. AAD applícants must be wiling to give an assign-

ment on their life insurance, or make the county welfare board the benefi-

ciary of fraternal certificates. Either procedure wil protect th interestsof the insured and wil assure the repayment of such payments to the stteafter burial and last illness expenses ha~e been paid.

Insurance resources established prior to application for assistance may beused prior to the receipt of public assistance by conversion of the insured's

equity into cash to be used for living needs, In some instances where thepremiums are htgh, this procedure may be best. However, if the Ufe ex-pectacy is relatively short, the insurance should be converted into ex-tended paid up insurance or the amount of the insurance decreased with aresultig decrease in the amount of the premiums. No uneasonable sac-rifice in material values should be permitted or required.

Provision for the cost of insurance premiums may be made to protect onlylimited values and may not be made to:

(1) Pay premiums on insurance acquired after receipt of assistace;

(2) Pay premiums on insurance in excess of $1,000;

(3) Pay premiums which are excessively hìgh. An adjustment is to bemade to lower the premiums consistent with the circumstaces of theapplicant; or

(4) Pay premiums on insurance on the life of a person other than theassistance recipient.

j) REAL ESTATE TAXES - An allowance for real estate taes is to be alowedin a single grant anually and in time to obtain any available discount.

State law provides exemption from taxtion any part of fires, building and

improvements upon non.fam lad up to an assessed valuation of $6,000which is owned and occupied by a legaly blind person. Aid to the Blind recip- .ients are by defition legally blind.

Public Welfare Boardof 2\orth Dakota

Transmitted by

Manual Letter #767June, 1970

318-21

-4Social Work ManualChapter 318 DETERMINATION OF NEED

Section 3

Par. 8

Any person 65 years-, of age or over with an aruual income of $3,000 or less

from all sources, including the income of any per son dependent upon him and

includig any form of public assistance. social security or other retirementbenefits, shall receive a'50% reduction in the assessment up to a maxmumreduction of $1,000 of assessed valuation on his home. In the instance of ahusband and wife living together, only one is entitled to this credìt. Thisprovision does not reduce the liability for special assessments levied againstsuch property. An indìvidual must apply for the reduction by completingForm RE - EX. 3, "Application for Assessmentof Homestead Credit, "available from the county auditor.

r

k) INSURANCE PREMIUMS ON REAL PROPERTY - The cost of a comprehen-sive propert insuranc(¡.premium may be allowed in the grant when in thecounty welfare board's judgment the value of the property warrants the ex-pense. The insurance policy shall carry a loss payable clause to the countywelfae board.

1) HOME REPAIS - Home repairs, including electrical wiring, may be allowedas necessar to prevent or arest deterioration of livig quarters and tosafeguard the health of the occupants. Repais shall be considered by thecounty welfare board upon the estimate of cost by a reputable carpenter orcontractor. It is frequently prudent to request cost estimates from morethan one such craftsman.

/m) CHILD CARE - An allowance to provide for adequate child care arrange-

ments is to be made when appropriate to enable a parent to maintain employ-ment, to receive vocational traiing, or for other acceptable reasons.

n) DRIVER EDUCATION - As a result of legìslation enacted in 1969, highschool students, as a condition to graduation, must have received a minimumamount of classroom instruction in driver instruction. The cost of class-room instruction is absorbed by the school district and no additional chargeis made to the student. Although behind-the-wheel instruction is not a re-quirement for graduation, youth 14 to 16 years of age must show proof ofhaving successfully completed the minimum classroom instruction in drivereducation and a mimum of six hours of behind-the-wheel instruction beforethe State llghway Patrol will administer drivers' examinations. If thebehind-the-wheel portìon of the driver education is part of a school's normalcurriculum, no additional charge is made to the student. However, if such

portion of the traing is conducted at other than normal school ho~rs, such

as in the evening or during the summer, a charge covering the costs of theprogram can be made. This expnse, which normally wil not exceed atotal of $25 to $35 per student, may be"allowed in the assistance grant, asincurred.

ft~"'Jr

une, 1970 Transmitted by

Manual Letter #767

(Public Welfare Board

of North Dakota318~22

".

.....

Social Work ManualChapter 318 DETERMINATiON OF NEED

Section 4

Par. 1

SECTION 4, INCOME ~ND RESOURCES

Par. 1. Income and ,Resources Must Be Considered u The Social Security Act

requires that all income and resoure:ts of an individual applying for or receivigassistance be taken into consideration, except as is required to be disregaded. TIiisnecessitates a survey with the individual of the kinds and amoWlts of income and re-sources he has or believes he can secure for himself. In arriving at the amount of

assistance to whiCh the individual is entitled, the county welfare board Will nt:ed tocompdIe all net income and resources found to be available to the individual in meetingcurrent needs with the money amount determied through the application of the stdadrequirements (see Section 2 of ths chapter). However, only income which is actualyavailable to the individual or family may be taen into consideration in determining theamoun~ ot the srant. ..

The county welfare board has responsibility for assisting an indiVidua) in developingpotential sources of income to a state of availaility. However, plans for vocationaltraining and for initiating or maintaining business enterprises as means of developingincome shall bt carefully evaluated by the county welfare board in terms of their feasi-bility and likelihood for future self-support. Subsidization of business enterprises isnormally outside the scope of the public assistance programs unlss such plans areclearly rehabil:,ative in nature. as in the instance of joint planning with the Division of

Vocational Rehabiltation. County welfare boards are therefore expcted to be particu-larly prudent in their evaluations of business ventues. Personnel from area socialservice centers are available for consultation and assistance with such evaluations.

Needy indi,'iduals are not required to be completely destitute in order to be eligible forassistance. For the definitions and amounts of real property, cash reserves and other

personal property which can be retained wh\.le assistance is received on a continuingbasis, see Chapter 314, Sections 3 and 5, and Chapter 321. Setion 1, Par. 3.

Seasonal income and lage amounts of income should not be prorated on a monthlydeduction basis, When a deduction continues to be made several months after the

income has been acquired, there frequently is no mcome acwaly availale to theindividual. The preferable method is to suspnd the case tf the income is expcted tolast thee months or less. or to close the case if such income is expcted to last morethan thee months.

Couty welfare boards must re-investigate eligiility as promptly as possible but notexceeding 30 days after receivig information abut changes in need, income, orresources.

Public Welfare Boardof North Dakpta

Transmitted by

Manual Letter #767June, 1970

318-23

-II

Social Work l.,1anualChapter 318 DETERMINATION OF NEED

Section 4

Pars. 2-3

Par. 2. Definition of Eat'ed Income -- Earned income is defined as income in

3h or kind currently earned through the receipt of wages, salaries, or profit from

activities in which the individual is engaged as an employee or a self-employed person.Income, to be considered "earned, " must involve an appreciable amount of personaleffort on the part of the recipient.

(

Income accruing as the result of past service, such as unemployment compensation,OASDI, veterans', railroad, and other retirement benefits, i.s excluded from thedefinition of earned income since it is not currently earned. Also, because the defini-tion requires active participatíon on the part of the individual, rentals, dividends, andinterest are generally excluded from earned income. Income from room rentals,however, may be considered earned income if the recipient is actively engaged in theventure; i. e., is responsible for måking the bed, chaging the linens, cleaning the

room, et cetera.

Sick leave pay received during periods of illness is considered earned income.

Earned income in kid must be assigned a cash value not to exceed the standard budgetallowance for that particular requirement. A reasonable cash value must be assignedby the caseworker to such earned income in kid if no corresponding cost standarden st s.

Par. 3. Earned Income (AAD) -- All earned ìncome must be accounted for in; assistance plan. However, the appropriate earned income exemptions and expenses

..'hich are reasonably attributable to the earning of the income shall be taken into con~sideration in determining the net income to be deducted from the individual's need.

An AABD recipient who is employed or in vocational tri;dning on at least a half-timebasis is entitled to a standard employment allowance of $20 per month to cover theexpnse of holding a job or participating in a training program. In addition, employedpersons shall have the actual cost of their withholding taxs and social security deduc-tions deleted in ,determinig their grant entitlement. While the standard allowance isnormally expected to defray the costs of transportation and all other items frequentlyassociated with job-related activity, a special allowance may be authorized to accom-modate these expnses when undue hardship would otherwse result, y

,Y For less than half-time employment or vocational training. the standard employ-ment allowance is $10.

p,,"...li

January. 1 971

c_Transmitted by

Manual Letter #803

Public 'Welfare Boardof North Dakota

318-24r

""..-

Social Work ManualChapter 318 DETERMINA TlON 0 F NEED

Section 4

Par. 3

Net earned income, to lJe applied against the assistance budget, is the amount remain-ing after all appropriate earned income exemptions and employment expnses are de-ducted in the following sequence:

a) Deduct earned income exemption (fist $20 of EIoss earned income plus one-half of the balance up to $60 in Old Age Assistance and Aid to the Disabledand first $85 of ~ earned income plus one-half of the remainder in Aid to

the Blind);

b) Deduct standad employment expense ($20 for recipients employed one-halftime or more and $10 for those employed less than one-half time);

c) Deduct the amot!t of witlùolding taxes and social security deductions;

d) Remaining amount is considered net earned income to be applied against theassistace budget.

The AAD recipient's ineligile spouse, if employed, is entitled to the standad employ-ment allowance and other actual job-related expnses. The ineligile spouse, however,is not entitled to an eared income exemption. If both husband and wife are eligile forand receiving AAD and both are employed, each is entitled to the appropriate earedincome ,exemption and the standard employment alowance, as well as other work-

related. expenses actually incurred.

An AAD recipient receiving vocational training through the Manpower Development andTraining Act (MOTA) will receive a training incentive payment from MOTA not to exceed$20 per week. In addition, each such person will receive from MOTA an expense allow-ance not to exceed $10 per week to help defray expnses related to training. Neither the

training incentive payment nor the expnse allowance is to be considered as income indetermining the amount of assistance needed. However, the county welfare board shouldascertain that the assistance grant does not include an allowance for traing costs

which the MDTA expnse allowance is intended to defray.

MOTA also provides for some on-the-job traiing. Although this contains a trainingcomponent, persons thus engaged are considered to hold regular jobs. As such, their

earnings, after application of the appropriate eared lUcome exemption and considera-tion of work-related expnses, will be show as deductible income in determining the

amount of grant entitlement.

In accordace with the agreement between the Division of Vocational Rehabilitation(Chapter 379), traing allowances received from the Division of Vocational Rehailta-tion will be disregaded in determinig the amount of an individual's grant.

Pulic Welfare Board

of North DakotaTransmitted by.

1\1aual Letter #767

June, 1970

318-25

..~

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 4

Par. 4

Par. 4. Earned Income.(AFDC) -- All income earned by an eligile AFDC

~.retaker and/or by a child 16 to 18 years of age who is a non-student and living in theJme must be accounted for in the assistance plan. However, appropriate earned

income exemptions and expnses which are reasonably attibutable to the earning of theincome shall be taken into consideration in determining the net income to be deductedfrom the family's need,

The county welfare board shall disregad the first $30 plus one-third of the balance of~ income earned for a month by an eligible AFDC caretaker and/or an eligile child16 to 18 years of age who is not a student. If two or more such persons in the samefamily are employed, their incomes shall be totaled and the exemption formula appliedaganst the total gross earned income rather than against each separate income, .!/ InAFDC, training incentive payments and work allowances under the Manpower Develop-ment and Training Act (MDTA), påÝments under the Economic Opportunity Act of 1964,and earnings under Title I of the Elementary and Secondary Education Act are also con-sidered to be "earned" income and, as such, are subject to the $30 plus one-:hird ex-emption.

Earned income, however, does not include the $30 per month training incentive pay-ments resulting from participation in Institutional and Work Training (Priority II underthe Work Incentive Program. These payments are to be disregaded in their entirety,Also, by agreement with the Division of Vocational Rehabilitation (Chapter 379), trainingallowances received from that agency are to be disregarded when determining thefamily'.s grant.

'he earned income exemption in AFDC does not apply in determining if a family iseligile at the time of initial application or for a transfer from Medical Assistance to agrant unless the family is determined to be eligile without regad to any of the pro-visions for earned income exemptions, including those for children 14 years of age andover. In determíning eligibílít:y, hùwever, the county welfare board shall deduct from

the family's gross earnings the standard employment allowance plus withholding taxes,

social security deductions, and the costs of child care. A preliminary step must,therefore, be undertaen to determine whether eligiility exists without applying theearned income exemption provision. The 1967 Amendments, however, provide that afamily whose AFDC grant has been interrupted by either termination or suspension mayhave its grant re-instated v..ithout loss of the earned income exemption if the stoppageoccurred not more than four months prior to the resumption of payments, Thus, afamily may reapply for assistance and receive the benefit of the earnings exemptionwhile elìgibility is being redetermined if the four-month provision is met.

1/ If earned income accumutates in an amount exceeding the $350 cash reserve limita-tion (Chapter 321, Section 1, Par. 3 a), the family become s ineligile for AFDC. Ac-cumulated earnings of children. however, can be protected for an approved futureidentifiable need by placing them in a joint account. (See Par. 6 of this section.)

1971 Transmitted by

Manual Letter ~803

Pulic Welfare Board

of North Dakota318-26

..

(-ì,

1\

c,

.. t;:

..Social W or k ManualChapter 318 DETERMINATION OF NEED

Section 4

Par. 4

The county welfare bawd shall not disregad any portion of eared income for a monthof any person otherwise entitled to the $30 plus one-thd exemption if he or she, with~out good cause, either terminated employment or refused a bona fide offer of employ-ment or reduced his earned income without god cause during the period of 30 dayspreceding that month.

An eligible AFDC caretaker (and/or a child 16 to 18 years of age who is not in schooland is livìng in the home) who is employed or in vocational training on at lev ~t a half-time basis is entitled to a standard employment allowance of $20 per month to coverthe expense of holding a job or participating in a training program. In addition, em-ployed persons shall have the actual amount of their withholding taxes and soctal secu-rity deductions deleted in determining their grant entitlement. The cost of child care,if incurred, must also be.taken into consideration. Such expense, unless WIN related,

is to be entered on form PW 286 as a special item of need rather than as ai income-related expnse. (See Chapter 318, Section 2, Par. 2.) While the standad allowance

is normally expected to defray the costs of transportation and all other items frequent-ly associated with job-related activity, a special allowance may be authorized toaccommodate these expenses when undue hadship would otherwise result. y

Neither the earned income exemption nor the standad employment expense applies tocaretakers in AFDC involvig stepparents (except when eligiility is based on thedeath, continued absence, or incapacity of a parent or stepparent) since the caretaersin these inStances are considered ineligile; that is, their needs are not included in the

grant. Furthermore, eligiility for stepclùldren is determined without strict adher-ence to conventional program regulations (See Chapter 318, Section 3, Par. 7.).

However, eligile stepclùldren do qualify for whatever earnings ex.emptions are

appropriate on a basis similar to children in other AFDC familes.

The method and sequence for computing the amount of net earned income to be appliedagainst the assistance budget is as follows:

a) Deduct earned income exemption (first $30 of .8 earned income plus one-third 0 f the balance);

b) Deduct standad employment expnse ($20 for recipients employed one-halftime or more and $10 for those employed less tha one-half time);

c) Deduct the amount of withholding taxes and social security deductions;

d) Remainig amount is considered net earned income to be applied against theassistance unit.

Y For less than half~t1me employment or vocational training, the standad employ-ment allowance is $10.

Pulic Welfare Board

of North DakotaTransmitted by

Manual Letter #767June, 1970

318-27

... \Social Work ManualChapter 318 DETERMINATION OF NEED

Section 4

Pars. 5~6

Par. 5. Earned Income of Children -- Children in AFDC families should be (.;-ncouraged to obtaìn work exprience in suitable employment as a means of increasìng.ieir sense of responsibility for themselves and their famìlies, However, employment

which interferes with their attendace or performance in school or which is in conflct\vith child labor laws should be emphatically discouraged.

No inquiry will be made into th amount of income from earnings of a child under 14years of age. The earnigs of such children are almost certain to be casual and in-consequentiaL

Al income earned by an eligile AFDC child, age 14 to 21 years, is to be disregadedif such child is a full-time student or a part-time student but not a full-time employee.

.'A student is one who attends an elementa or seconda school or a course of voca-tional or techncal training designed to fit him for gainful employment or is participa-ting in the Job Corps program under the Economic Opportuity Act of 1964. A full-time student must have a school schedule that is equal to a full curriculum. A part-time student must have a school schedule that is equal to at least one-half of a fullcurriculum.

The county welfare board shall exercise judgment in deciding whether an employedchild should remain in the grant during the summer months when school is normally notin session, Generaly, however, a child retains his full-time student status during thec¡ummer, and therefore is entitled to remain in the AFDC grant and to the earings:xemption, if he lives at home, intends to return to school in the fall, the amount ofhis carned income is modest, and his use of the income is withn acceptable bounds,

,r'--

An eligible employed child who is not a student or who is a part-time student workingfull time is entitled to have the first $30 plus one-third of the remaining gross earnedincome disregaded in the maner outlined in Par. 4 of tils section.

Par. 6, Conservation of Children's Earnings for Future Identifiable Need -- Ifa cilld' s earned income accumulates in an amount exceedig the $350 cash reservelimitation (Chapter 321, Section 1, Par. 3 a)), his family becomes ineligìle for AFDCunless the fuds are set aside for an approved futue identifiable need such as an edu-

cational or vocational training plan. Thus, a child may elect to place all or any portionof his earnings into a joint account with the county welfae board as a means of con-serving his accumulated earnigs for a future need without jeopardizing his family'seligiility for assistance.

The future plan for the accumulated funds must be approved and recorded in the casefile by the caseworker. Such plan should be orieIlred towards exploiting the child f smaxmum potential as an independently-functioning indh1duaL.

l--,I\ /"Jne, i 970 Transmitted by

Manual Letter #767

Publìc Welfare Boardof North Dakota

(\"

318-28

..j¡,

.. "..~'!..~

...Social Work MaualChapter 318 DETERMINATION OF NEED

Section 4

Pars. 6-8

/ Children should be allq)yed a voice in any decision and planing relative to their earn-

ings though the joint account is usually an arrangement between the parents and thecounty welfare board.

Savigs may be released to the child1om the joint account for any of the followingreasons:

a) For payment of expenses for the child f S training or education beyond highschool; .b) For payment of appropriate activities and items such as summer camps,

debate, band, athetics, class rings, graduation pictures, et cetera;."

c) Upon the child's attaining the age of 21;

d) When the family is no longer certified for public assistance and/or it is theconsensus of the county welfare board and the family that the joint accountno longer represents good social planing; or

e) For any of a variety of other purposes acceptable to the county welfaeboard,

Par. 7. Income from Real and Personal Property -- All cash returns from thesale or rental of real estate or personal property must be considered as availableincome. Such income may be handled iii either of the following two ways, dependingupon the best plan arrived at by the recipient and the county welfare board:

a) He may use the income to repay his assistace account and he wil continueto be eligile for assistance if no funds remain.

b) He may use the proceeds for current subsistence needs. In this case therecipient would be ineligile for assistance.

Par. 8. Income from Home Not Used by Recipient h Recipients of assistancewho fid it necessary to move from their own home into other quarters, such as aboardig home, nursing home, or horne for the aged, have a potential source of incomeavaiable from the renta or sale of their horne. The net income from rent aftr theexpenses of ownership of the property have been deducted will be an income to be usedby the recipient to meet his needs.

Each recipient should attend to the rental of the property. payment of bills, taxes, etcetera, whenever possible. If the recipient is unable to assume this responsibilty, hemay appoint some other person to attend to his affairs or t in some situations, it maybe necessa for a guardian to be appointed.

Pulic Welfare Board

of ~orth Dakota

Transmitted by

Maual Letter #767June, 1970

318~29

-4

Social \Vork ManualChapter 318 DETERMINATION OF NEED

Section 4

Pars, 8- 9

If. a.fter it becomes apparent th¡,t the recipient has permanently moved from his home ,/'id that he does not desire to rent the home. his decision not to do so may lead to the \.

Jnclusion that he does not wish to avail himself of a source of income and will raise aquestion as to his eligiilty. "Permanently," for purposes of evaluation of availabilty

of property for rental, shall be construed as being the time the recipient recognizes

that he can no longer live in the home, or the date upon which he has been absent fromthe home for six months and his return later canot be anticipated.

Property which is available but not utilzed must be assigned, a fair rental value afterit is positively determined that it can be rented. The rental value wil be that amountgenerally obtained for similar quarters in the community. The necessary expnses ofproperty ownership will be deducted from the assigned rental value and the net amountof potential income will be considered avaìlable and deducted from the maintenanceneeds of the recipient. ..

Par. 9. Old Age Survivors and Disability Insurance u A potential source of

income for many persons is Old Age, Survivors. and Disability Insurance (OASDI),

which is administered by the Social Security Administration through its district offices.The purpose of this program is to provide workers and/or their faml1es with partialreplacement for loss of income due to old age. disability. or death of the insured, andto protect aged persons against the expense of costly ìllnesses. Uninsured or under-insured persons age 72 or over are also eligible for a special cash payment in someinstances. The replacement of income is attained though the provision of monthlybenefits to workers and/or thei.r famìles who have reached retirement age, are de-

/"---~eased or disabled. and who have fied applications for benefits. In addition. a lump,urn death benefit can be paid to the surviving spouse, or if none, to whomever assum-

ed the cost of the buriaL.

,/\

Because of the program's broad coverage. the eX"Ploration of social security benefitsis mandatory in connection with all applications for Ali.BD. In AFDC, an explorationof benefits must also be made whenever the employment history or other pertinentdata suggest the possibilty of entitlement. Potential entitlement may be explored

through the use of form PW 352 or by having the individual file an official applicationwith the nearest district office of the Social Security Administration.

A system, sometimes referred to as the Beneficiary Data Exchange (BENDEX), has

been designed to provide county welfare boards with prompt and accurate social

security benefit entitlement information from the Social Security Administration.Tls system presently provides entitlement information for public assistance recip-ients who are 65 years of age and over. It will eventually be expanded to yield similarinformation for recipients of lesser age. The Bendex system therefore eliminates the

necessity of consulting the Social Security Administration for information concerningthe receipt of or change in benefits for individuals 65 years of age and over. Until thesystem is expanded, however, similar information about persons of lesser age, whenneeded, should be obtained from the Social Securit)r Administration through the use ofform PW 352 (Chapter 392, Section 4).

(-'"r'ebruary, 19i1

l1"-

Transmitted by

Manual Letter tl808Public Welfare Board

of North Dakota318-30

~ti..~(,

'f.....

Social Work MaualChapter 318 DETERMINATION OF NEED

Section 4

Par. 9

The Social Security AQ,inistration is an arm of the Department of Health, Education,

and Welfare. Therefore, the routine use of the Bendex system as a means of obtainingcurrent and accurate benefit information is neither a breach of confidentiality nor aviolatìon of the principles governing the simplified method for determining eligiilty

(Chapter 335). In addition to providing current data about benefit entitlement, theBendex system can be instrumental in identifying persons who are not currently re-ceiving social security payments, but who may qualify for them. The county welfareboard is responsible for referring such persons to the Social Security Admir; stration

for the purpose of making application. .

For more detailed information concerning the use of Bendex, see Chapter 716.

The fOllOWing persons are.-eligile to receive OASDI benefits:

a) A retired insured person age 62 or over with limited earned income;

b) The wife (including a divorced wife in some cases) of a retired or disaled

worker entitled to benefits if she is:

(1) Age 62 or over, or

(2) Caring for the worker's clûd who is under age 18 or disabled and en-titled to social security benefits;

c) The dependent husband of a retied or disabled woman entitled to benefits ifhe is age 62 or over;

d) A disabled insured worker; y

e) The dependent, unmaried child of a retired or disabled worker entitled tobenefits, or of a deceased insured worker if the child is:

(1) Under age 18, or

(2) Age 18 or over but under a disabilty which bega before age 18, or

(3) Age 18 or over but under age 22 and attending school full time:

Y "Disability" is defied as the inability to engage in any substatial ga1nful activityby reason of any medically determiable physical or mental impairment which can be

expcted to result in death or wlùch has lasted or can be expcted to last for a conti-uous period of not less tha 12 months.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #767June. 1970

318-31

...Section 4

Par. 9

Social Work ManualChapter 318 DETERMINATION OF NEED

f) The widow (including a surviving divorced wife in some cases) of a deceasedinsured worker if tbl. widow is age 60 or over; f

i

g) The widow (includig a surviving divorced wife in some cases) of a deceasedinsured worker if the widow is age 50 or over and became disabled betweenages 50 and 60;

h) The widow (includig a surviving clvorced wife in some cases) of a deceasedinsured worker; regadless of her age, if she is caring for a child of thedeceased under age 18 or disabled who is entitleq to benefits;

i) The dependent widower of a deceased insured worker at age 62 or over;

j) The dependent parents of a deceased insured worker at age 62 or over;

k) An uninsured or under-il'sured person age 72 or over in certain instances; Y

1) A person age 65 or over who elects to receive hospital and physician ser~vices (Medicare);

m) A miner disabled by pneumoconiosis (black lung disease) or the widow of aminer who was disabled or died from that disease.

Any applicant for or recipient of public assistance who is potentially eligile for OASDIbenefits, but who persists in his refusal to make application for such, will be deniedassistance on the basis of his refusal to explore a resource which may be available toWm. TWs principle also applies to any person who refuses to accept reduced social'gecurìty benefits for which he is entitled. (

li Under the provisions of legislation enacted in 1966 (Prouty Amendment), it is some-times possible for persons 72 years of age and over to receive a Special Age ~ 72 socialsecurity benefit with fewer quarters of covered employment than .:e ordiarily requir-

ed. Such monthly benefit for a single individual has been established at $46 and for ahusband and wife both having entitlement the total award is $69. However; with theexception of Workmen' s Compensation and V A compensation from service -connecteddisabilty or death, these awards are reduced by the amount of any retirement benefitor pension received through a federal, state, or local government pension plan. AfterJanuary 1, 1972, the roll for new Special Age ~ 72 beneficiaries will be closed andindividuals will subsequently be required to have regular employment coverage.

Federal law prohibits the receipt by one person of the Special Age ~ 72 benefit and apublic assistance money grant during the same month. The decision as to whether thespecial benefit or a public assistance grant is most benefícial to the individual wìll bemade on the basis of the amount of his need for that month. If the special award ex-ceeds the amount of his need; the assistance grant should be terminated. Conversely,the special award should be forfeited whenever Ws need is in excess of the amount towhich he would be entitled in order to permit the larger public assistance payment.Careful coordiation of efforts between the counrywelfare board and the dístrict officeof the Social Security Administration is therefore essential to prevent the concurrentreceipt of both public assistance and the Special Age ~ 72 benefit.

me, 1970(

Transmitted by

Manual Letter #767

Public Welfare Boardof North Dakota

318-32

..

..~..

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 4

Pars. 10-11

Par. 10. Norta.Dakota Old Age and Survivors Insurance System n The Old Age

and Survivors Insurance System (OASIS) was established by the state of North Dakotaand was operative from July 1, 1947 to April 23, 1957. Participation in this retirementplan was compulsory for all persons employed during that time by the state or by anycounty or municipality. The State Uìiemployment Compensation Division, Bismarck,

North Dakota, adminsters the program on behalf of those persons who have coverageand are therefore entitled to benefits,

To qualify for OASIS, a governmental employee must have retired from service prior

to April 24, 195 i; other s not retiring by that date were refunded the amount of theirfinancial contributions, thereby canceling any later claim to benefits. Consequently,

the roll for new beneficiaries is now closed with the exception of a limited numbr ofwidows who have reached cr will reach retirement age themselves (65) and whose

huabands had established claims by retiring prior to April 24, 1957. Any widow ap-pearing to qualify for benefits should be urged to have her eligiility status evaluatedby writing to the Unemployment Compensation Division givig full name and address,her husband's social security number, and the name and address of the governmentalagency by whom the husband was employed.

The county welfare board may ascertaín the receipt of OASIS benefits by requesting theadministrator of Public Assistance to obta this information from the UnemploymentCompensation Division.

Par. 11. Railroad Benefits -- Under the provisions of the Railroad Retirement

Act, a number of benefits, includig sickness and accident, dependents' and survivors',

Unemployment Compensation, retirement, and fueral, are available to current orformer employees of railroads. In order to attain a fully-insured status and thereforebe eligile for all such benefits, an individual must have had a minimum of 120 monthsof railroad employment with 40 full quarters of coverage (10 years). However, insofaras retirement benefits are concerned, persons with less than 10 years tenure withrailroads will generally qualify, when retirement age is reached, for a combinedbenefi.t from Railroad Retirement and social security.

Applicants for and recipients of public assistce with backgrounds in railroad employ-ment must, whenever appropriate, be referred to the Railroad Retirement Board for anexploratiOn of possible benefis. The Railroad Retiement Board is locateò in Room314, Black Building, Fargo, North Dakota, 58102. The filing of an application is usuallyfacilitated if the indiVìdual can appear personally at that offce; however, if this is notpractical, application may be made on the forms provided, upon request, by the Rail~road Retirement Board.

Information relative to railroad retirement benefits, when this is necessary, may be. obtaed by forwarding a completed and signed Form G-l54, Authorization to FurishInformation, to the Railroad Retirement Board, 844 Rush Street, Chicago, Illinois,60611. Form G-154 may be obtaed from the Railroad Retiement Board in Fargo.

Publiç Welfare Boardof North Dakota

Transmitted by

Manual Letter #767June. 1970

318-33

~.Social Work MaualChapter 318 DETERMINATION OF NEED

Section 4

Pars. 12-14

Par, 12, Income from Compensation (Workmen's, Unemployment, and Veterans')

H Workmen'8 Compensation, linemployment compensation, and veterans' benefits, C

utlined in Chapters 374, 375, and 376 respectively, are common sources of incomeand must be considered, when actually available, in determining need. Questions con-cerning eligiilty for servicemen' s or veterans' benefits should be referred to the

County Veterans Service Officer. lnquìries about eligiility for or amount of unem~

ployment or workmen's compensation should be sent to the administrator of PublicAssistance.

Par. 13. Relatives' Contributions H Cash contributions from legally respon-

sible relatives and others must be taen into consideration, when actually available, indetermining the amount of grant. Income-in-kind contributions will be treated in themaer described in Par. 16 of th~ section, Policies and procedures relating to legal-ly responsible relatives are found.in Chapter 312, Section 5.

Par. 14. Court-Ordered Support Payments -- Court-ordered payments by ab-

sent parents must be taen into account when they are in fact available to the fámily.Exprience has shown tht most support payments to AFDC familes are irregular.Since interruptions or fluctuations in payments to families whose income is aleadylimited can result in severe hardship, county welfae boards should make every con-ceivable effort to ensure that support payments are received regulaly,

The method of handling court-ordered support payments is at the discretion of eachcourt and the procedure may vary within the state. However. stene law gíves the court (

he option of providing in its decree that support pa)Tments be made to the clerk ofcourt who wil maintain a current record of all information nece ssary for the properadmstration of the decree. Any failure to make paymems as requìred will result inthe court's notification, by registered or certified mail, of the person responsible forthe support oralímony payments. Failure to bring delinquent pa)'ments np..j.o-datewithn 10 days will result, at the discretion of the district judge, in the issuance of acitation for contempt of court.

Under the provisions of the law, county welfare boards are required to notify the clerkof court of the court makg the support decree whenever an application is made forpublic assistace by a person entitled to but not receiving support pa)rments. Theperson entitled to child support may also notify the cleik of court if payments whichhave been ordered are not forthcoming. The clerk of court upon such notification shallintiate the procedure outlined above.

l"tl""''"".'~'.I

.ie, 1970 Transmitted by

Manual Letter :f767Public Welfare Board

of Nortli Dakota

(

318-34

..

"'..4/

Social Work MaualChapter 318 DETERMINATION OF NEED

Section 4

Pars. 14-17

In some instances in which irregular receipt of support payments constitutes hardship

for the family, the counÌ)r welfare board may, with the approval of the court, makearrangements whereby the family can receive assistance payments regularly in the fullamount of unmet need, and arrange for the intermittent support payments to comedirectly to the county welfare board trom the absent parent. The support payments canthen be remitted to the Public Welfare Board as a reimbursement for the assistancepaid. Such a procedure may in some instances be helpful in removing much of the un-certainty which accompanies iregular income.

Par. 15. Income from Earned Rights n A resource consisting principally ofcare for the aged, having been acquired by virtue of membership in a lodge, must beconsidered in determining need if the individual actually avails himself of his right tolive in the home provided. ¡he Eastern Star Home at Fe ssenden is a facility offeringthis ty of care. Persons who make use of such a resource shall be considered to

have income in the amount of the value of the service furnished. However, the avail-

ability of such a resource shall not deprive a person of his right to liv(; elsewhere ifhe wishes. 'Par. 16. Income in Kind -- Income in kid which is regularly received and is

of appreciable value which can be computed shall be considered available income.Contributions from relatives and friends of shelter, fuel and utilities. clothig, board.

et cetera. are illustrations of income in kind. An allowance for the amount of the

maintenance need will be inserted in the budget and a like amount shown as income, asdefied in Section 2 of this chapter. If less than the total maintenance item is received,

the amount of the income in kind for that item will not be considered,

Irregular gifts of small value to a recipient are expressions of affection and are not to

be considered income, nor is a contribution of food since this is regaded as a supple~ment to a miimum diet.

Par. 17. Income from Other Sources u Other potential sources of incomewhich must be explored whenever pertinent are governmental, industrial, and privateanuities, as well as other tys of pension plas. These resources, whenever found

to exist, must be taken into consideration in determing whether an individual iseligile for assistance.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #767June, 1970

\318-35

-4,

Social Work ManualChapter 318 DETERMINATION OF NEED

Section 4

Pars. 18-19

Par. 18. School Lunchflrogram -- All schools sponsoring a school lunch pro-ram must agree, as a condition of financial participation by the U. S. Department of

Agriculture, to provide lunches either free of charge or at a reduced rate for childrenfrom low income familes, Children whose only means of support is public assistance,general assistance, food stamps or surplus commodity programs are by defintionconsidered to be from "low income" families. Children whose parents have sources ofincome in addition to some form of public assistance must meet a gross income scalemeans test, a determìnation of which is made by school autporities, The decision on

whether meals wil be served free of charge or at a reduced rate also rests withschool offcials. A price is not considered to have been reduced unless the reduction

is at least ten cents off the established price. However, in no instance shall the costto children from low income familes exceed twenty cents per meaL,

..Parents who believe that their children qualify for free or reduced-price lunches maybe asked by school offcials to sign a simple application. A supply of these application

forms is in the hands of school authorities. In some instances, school officials wil

request county welfare boards to provide supplementary or clarifying informationabout the financial circumstances of families who request meals at less than the fullprice for their children, County welfare boards are urged to cooperate with schools

making these requests and may do so without fear of violating rules of confidentiality.Famlies who are dissatisfied with decisions made on their applications have the rightto appeal to a person designated by the school authorities.

The school lunch program represents a significant resource to school children fromfamiles with limited means, County welfare boards should take whatever action is

appropriate to assure that such children have the opportunity to avail themselves ofthis resource. Their participation in this program shall in no way affect their eligî-bility for any public assistance or food distribution program.

r!"" .

Par. 19. Urban Renewal - Relocation Adjustment Pa~'ments -- The Housing Act

of 1964 authorizes local public agencies engaged in urban renewal projects and localhousing authorities constructing new public housing to make payments to low incomefamilies and elderly individuals (62 years of age or over) who must be relocated.These payments consist of 1) reasonable and necessary moving expenses not to exceed$200, and 2) relocation adjustment payments, not to exceed $500, to assist individualsand families in locating adequate housing elsewhere and to compensate for the incon-venience and indirect addítonal costs involved in moving. The responsibility for deter-mining who qualifies for and the amount of relocation payments rests with local housingau thori tie s.

r-'.f ", (

November, 1970 Transmitted by

Manual Letter #791Public Welfare Board

of North Dakota

/318-36

..

.-...

Social Work MaualChapter 318 DETERMINATION OF NEED

Section 4

Pars. 19-22

In accordace with thefintent of Congress, relocation adjustment payments are to beregaded as a supplement to rather than a substitute for public assistance grants sincesuch payments are for a different purpose than public assistance granted under thevarious titles of the Social Security Act. Thus, relocation adjustment payments arenot to be considered as income or rêsources in determig eligiility or the amount of

grant entitlement, provided such relocation payments cover goods and services notalready included in the standad assistance requirements. No duplication should existin assistance granted by public assistance program~ and the payments made by localhousing authorities. Therefore, transportation of family and household goods, de~

posits for utilities, fees for intiating service, and other expnses related to movingwould not be allowed in the public assistace grants as spcial items of need inasmuchas payments made by the housing authorities are expected to underwrite these costs.

~.

Par. 20. Highway Relocation Payments -- Under the provisions of the Federal-Aid Highway Act of 1968, persons displaced because of a federally-fianced highway

project may qualify for payments with which to underwite the costs of moving, tempo~rary housing, monetay loss of condemned property, et cetera. Highway relocation

assistance paid under this Act shall be disregaded for the purpose of determingeligiility or the extent of eligiilty.

Par. 21. Payments from Board and Room Arrangement u On occasion, arecipient of public assistance may provide foster home care or a board and roomarrangement for a child or an adult for a negotiated rate of payment. Or, an older,employed child who is not eligile to be included in the assistance unit may contiue tomake his home with his family whom he compensates for his board and room. Sincethe payment in such instances is largely offset by the actual expnse of providig thsservice, the remuneration received is to be disregaded in determining the amount of

the reCipient' s grant entitlement,

Par. 22. Home Produce ~- Food produced for home consumption from gadens,raising chickens, keeping a cow, et cetera, will not be considered as a resource in thedetermination of need. Home produce for family consumption is instead to be considwered an incentive to recipients toward self-help, Furthermore, the cost of producingthe food often equals or exceeds the value of the food.

Home produce which is raised for the purpose of selling or exchangig, however, is tobe considered as a business operation and treated in accordace with policy stated inPar. 2, 3, and 4 of ths section.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #767June, 1970

318~37

Social Work ManualChapter 318

-4Section 4:

Pars. 23-24DETERMINATION OF NEED

. Par. 23, Loans -- Loans made to applicants or recipients are not to be regad-

,,d as income when the natue ~f the loan is such that the principal is not available for (

ilrrent maintenance, When the loan constitutes a debt, and the property purchasedwith the proceeds canot be converted for current living needs, it does not represent aresource to be considered in determiing property reserves.

Typical of such loans are those made under conditions specified by the creditors as topurchases that may be made, purposes to be fulfilled, or other controls which precludethe individual from using the fuds to meet current maintenance costs. Loans made nythe Farmer's Home Administration, U. S. Department of Agriculture, under Title ITrof the Economic Opportlity Act, come withi the above classification.

Par. 24. Food Services --.In determining eligiiUty or the amDunt of grant

entitlement, county welfare boards shall disregad the increased purchasing power offood stamps and the value of surplus commodities of persons and families who par-ticipate in the food service programs of the U. S. Deparment of Agriculture,

c

, 1970 Transmitted by

Manual Letter ~767

Public \Velfare Boardof North Dakota

(

318-38

..

. .... /,;..1

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Clotr.i~~ end Pe;tc ~:1 ~eeds-Silccul ::aed .. - - - .. - .. - ..

tot¿l- - .. .. - .. - ~'.. .. .. .. -WS 'Lc ~.¡l ~et Ir. ~: ,.;l!- .;' .. - ..

-: /_. ~ tnd Gra;,~_

CAR£.. OR BOAi.

Schedule 3. U\lU:C IN hìJRSii.¡; ir~i.

(tate Fer t":t'thl, Ciot~in~ end l~r8on~1,t., S;ie::1d ~;¡:c:S - - - -

C. Tot~.. - - - - - - -D. ì.ss 1'0 td l:o~ Inct'::~ .;E. i:e: K~cè e:-J Crant- ..

)i::iedlJ s

_~ 1"~

--.. -. Qj¡.:rU¡ATlO:i OF la:7 I'''-'-i+'i.._

w."t.D n:co'i:1. Total Cross tci~cd Income-" - - - - - - - -.. - - --

Re:;.::: ".$,.2. Deduct Appropriate Earned tnc~~ Exemption

3. Deduct Earned Income txpenses:a, Standerd ~ploymftnt Allo~ance

b. ~ithholding Taxes- - .. .. - - - ..c. Soc1alSecurlty Deductions - .. ..

4. Total Earned Income Deductions (Lines 2 + 3a + 3b + Je)"

S. Net Earned Income (lJiiinus 1.)- -orER INcc:1. OASDI Benefits ",- - - .. - - - - -

2.'Ì

SSA.-BSS\

3.AU ~ iSi4

4.

S. Add: Total Other Income - - -." - - - - - - - .. - .. - .. D.ver Rèil,on~ l. ' .., .ro!. l¡"£T ItiCOl (1i + 2S)- - - -

. . ,,' ,

~orkerls S~:~tc~\

per perso~ aoer 10.Need" ponion of Schedule i to be uaed only under CC::lt1C"_i!l prescribed in Sectio 3 of this chap-tHo

318-7

.... ..-4

Social Work MaualChapter 335

APPLICATION ANDDETERMINATION OF ELIGIBILITY

ChapterContents

..' C HAlTER CONTENTS ~SECTION 1. APPLICA nON

Par. 1 - Definition of Terms .Par. 2 - Effective Date of Application.

. 335-1. . 335-1

SECTION 2. BASIC PRINCIPLES

Par. 1 - General Statement . . . . . . .Par. 2 - Certain Practices Prohibited , ......Par, 3 - Opportuity to Apply for Assistance A Legal Right. .

Par. 4 - Application to Reèei ve Prompt Attention . . . . .

Par. 5 - Applicant/Recipient to Be Notified of Decision-'";'.. .

Par. 6 - Right to Appeal and Fair Hearing ......Par. 7 - Right to Review Maual Policies. . . . . . . .Par. 8 - Right to Non-Discrimination . . . . . .

. . 335-2

. . 335-2335-2335-2335-3

. 335-3335-3335-3

SECTION 3. SIMPLIFIED METHOD FOR DETERMINING ELIGIBILITY

Par. 1 - General Statement . . . . . . . . . . . . . . .Par. 2 - Method for Determining Eligiilty. . . . . . . . . .Par. 3 - Redetermination of Eligiilty and Frequency of Review

Par. 4 - Other Considerations Associated with Simplified Method.

Par. 5 - Reporting of Changing CircumstacesPar. 6 - Suspected Fraud. . . .Par. 7 - Eligiility Control Review.

. 335-4, 335-4

335-6. . 335-8

335-9, 335-10. 335-10

SECTION 4. SEPARTION OF ASSISTANCE AND SERVICES

Par. 1 - Statement of Philosophy and PuposePa. 2 - Role of Agency Workers ...Par. 3 - Federal Fincial Paricipation. .

Par. 4 - Staff Orientation and Development ." . .. . .. II

. 335-11. . . . . 335- i i

. 335-15. . . . . 335-16

Pulic Welfare Board

of Nort DakotaTransmitted by

Manual Letter #788

October, 1970

335-1

"S...Social Work ManualChapter 335

APPLICATION ANDDETERMINATION OF ELIGIILITY

Section 2

Pars. 5~8

Par. 5. Appl1dmt/Reclpient to Be Notified of Decision u The county welfaeboard shall promptly notify the applicant/recipient on form PW 600 (See Chapter 394,

Section 2. ) of any decision toncerning an application for or a grant of pulic assis-

tance. A decision of denial of assistace is to be accompanied by an .adeuate expla~

nation to the individual of the reason; In instaces in which assistance is to be dis-continued or reduced, the recipient is to receive timely advance notice so that he mayhave the opportunity to discuss his situation with the county welfare board staff beforethe proposed action becomes final (see Chapter -338, ~..LiVH a)..

. i 3 'J~ p... aiPar. 6. Right to Appeal and Fair Hearing u Any person who is dissatisfied as

the result of an action taen or not takn by a county welfae board or the state depar-ment With respect to his application or his grant is legally entitled to appeal for animpartial review of his c1tcumstances through the fair hearing procedure (see Chapter361 for detP.ils).

Par. 7. Right to Review Maual Policies -- State and county welfae agenciesare required to maitain program manuals and policies and to make them available forexaination by the public upon request. The right of the public to such a review eX-tends LO rules and regulati-ons governing eligiilty t need and amount of aSblste.

recipient rights and responsibilities, and types of servces offered. Agencies have thri ght to insist tht exaination of policies be resticted to regular hours durg normalwork days.

Pulic welfare agencies are required to reproduce without charge specific policy

materials requested by an applicant/recipient to help him decide whether to appeal for

a fair hearing or with his prepaation for a far hearing. Agencies must also bewilling to reproduce policies. without charge or at a charge related to actual cost. forother individuals or orgaizations appearing to have a legitiate interest in thm.

Par. 8. Right to Non~Discrimintion . - It is the intent of the Pulic WelfaeBoard of North Dakota tht all public Welfare pro.grams be administered without

di scrimination by reason of race t color t or natióna origi.' (See Chapter 360.)

Public Welfare Boardof Korth Dakota

Transmitted byMaual Letter #788

October, 1970

335~3

..\-4

Social Work MaualChapter 335

APPLICATION ANDDETERMINATION OF ELIGIBILITY

Section 3

Pars, 1.2

SECTION 3. SIMPLIFIED MET~D FOR DETERMINING ELIGIBILITY

Par. 1. General Statement -- Regulations issued by the Secreta of the

Department of Health. Education. and Welfare and published in the Federal Registeron Novembr 20, 1968, required tht all states adopt a simplified method for deter-mining eligiility for financial and medical assistance, based largely on the acceptaceof the applicant's or recipient's statement of fact.

, ' The simplified method represents an effort to humanize the administration of thepublic assistance programs by more adequately safeguardig the individual's personaldignity and constitutional rights, Also, by simplifyng the eligiilty process and byshifting to the applicant/recipient the primary responsibility for providig the accurateinformation needed to determine hiS-eligiility, the task of equating th informationreceived agast the program requirements can be assigned to an eligiilty worker(see page 662-125). This permits the exclusive assignment of caseworkers and socialworkers in the area of social servces in the mamer described in Section 4, of thischapter. And fily, the simplified method maximizes efficiency of adminstration by

makng it possible to deliver needed assistance more promptly while at the same timeminimizing the costs of determining eligiility by eliminating much paper work androutie. time -consumig investigations.

The simplitied method and its underlyig principles and related considerations areoutlined in subsequent paragraphs. r

Par. 2. Method for Determing Eligiility -- The simplified method is defiedas an orgazed technque by which the county welfare board, to the fullest extentpossible, accepts the statements of the individual, or of someone acting responsibly inhis behalf, as the basis for determig his initial or continuing cligiilty and/or theamount of assistance to which he is entitled. This method is based on the principle

that the applicant/recipient is the primary source of information about his own situa-tion. The individual's sttements about his circumstaces are entered on either theapplication or redetermination of eligiilty form, both of which have been designed to

be completed by the individual himself, Questions have been devised in non-technical

langua~ so that in most instances the information needed to determine eligibility wilbe elicited, The forms must be signed by the applicant/recipient and countersigned

by any person assistig in their completion.

October. 1970 Transmitted by

Manual Letter #788

Public Welfare Boardof North Dakota

335-4..

.. ..~.. "'

-lSocial Work MaualChapter 335

AlPLICA TI ON ANDDETERMINA TI ON 0 FELl Gl 81 LI TY

Section 1

Pars. 1-2

SEcn O:- 1. AlPLlClTION

Par. 1. Definition of Terms h The following are definitions of the termsfrequently used in relation to ile application process:

a) APPL1 CANT - A person who has. directly or through someone acting re-sponsibly for him, requested assistance and whose request has not been re-solved, withdrawn, or otherwise terminated. The relative wiil whom a childis living or wil live is the applicant in the chìlds behalf in AFDC.

b) APPLlCA nON - An action by which an individual makes known to the countywelfare board his wish to receive fiancial or medical assistace. The re-que st may be mâCi orally or in writing. If made orally, however. it wil

normally be formalized by reducing it to writing, a procedure which isaccomplished by the applicant when he completes and signs form PW I,"Assistance Application" (see Chapter 391, Section 1). If th applicant.

because of impaired health or other extenuatig circumstaces, is unable toperform tls fuction himself, a lega guardian, spouse, relative, or otherinterested person may do so. In the event no interested party is availeto act for him, an oral or written notifcation of his circumstances by aphysician, hospital official, et cetera, without subsequent completion of

form PW I, constitutes a valid application.

c) INQUIRY - A request for information about eligiility requirements forassistace that is not a formal application although an application may

follow.

d) APPLICATION PROCESS - All activity related to the exploration and dispo-sition of an application for assistace. It begis when ile request for assis-tance (writtn or oral) is received by the county welfare board and termin-

ates when the individual's application has been approved, denied, or disposedof otherwise. with appropriate notification and explanation of the action taenforwarded to the person.

Par. 2. Effective Date of Application -~ Ai application shall be considered as

"received" at the t1me a request (not an inquir) is made oraly or in writig by an

individual in his ow behalf or by someone authorized to act for him. If such oral orwritten request precedes the receipt of the completed and signed form PW 1, the date

of request is the date of application.

Pulic Welfare Board

of Nort h DakotaTransmitted by

Maual Letter #788October, 1970

335- i

..

\..Social Work ManualChapter 335

APPLICATION ANDDETERMINATION OF ELI GIBILITY

Section 2

Pars. 1-4

SECTION 2, BASIC PRINCI PLEŠ'

Par. L General Statement - - ,Certai methods and procedures are considered

essential for the proper and efficient operation ôf public assistance programs in NorthDakota. These methods and procedures, which are enumerated and describd though-

out ths chapter, reflect basic principles concerning the rights and responsibilities of

individuals and of governmental agencies in a democracy. They are necessa to in-sue that an individual's basic rights are respcted an protected during the process of

determining elígiilty for public assistace. A public àgency's consistent adherence

to these principles also tends to inspl.e pubUc confidence which in turn promotes awider use of the agency' s services by persons in need of them,

Par. 2. Certa Practices Pr.¿hibited u The determination of a perG:r:s initialor continued eligiilty for public assistace shal be conducted in a maner consistent

with his rights under the United States Constitution, the Social Security Act, an(À Title

VI of the Civil Rights Act of 1964. Thus, any practice which violates an individual'sprivacy or personal dignity, or subjects hi to any form of harassment, or whichviolates his constitutional rights, is forbidden.

By way of illustration, county welfare boards must guard against such violations asentering a home by force. or without permission. or under false pL'ctenses. The

search of rooms, closets, drawers, or papers, for the purpose of Wlcovering clues to

possile deception or fraud is not permitted. Except for emergencies, home visitsshould not be made outside of normal working hours unless aranged for by appoint.ment. Whenever practical, an individual should, as a matter of coul'tesy, receiveprior notice of a planed visit, includig those made duing working hours. Surprisevisits to homes during normal sleeping hours (night raids) are prohibited.

Par. 3. Opportuity to Apply for Assistance A Lega Right -- Persons wishig

to apply for any form of public assistace have a lega right to do so, includig thosewho may be clearly ineligile. The county welfae board is expcted to provide in-formation about the eligiility requirements of the program which appears applicable,explain rights and obligations under the program, assist individuals as necessary incompleting their applications, and to accept their applications without delay.

Par. 4, Application to Receive Prompt Attention - - Applications are to beprocessed without undue delay. Except in unusual circumstaces, no more th 30days should elapse betyeen th date of application and the date of receiving the initialassistace grant or the notice of denial of assistance. In many instances. this processca be completed in less time. Once eligi1Uty is estaHshed. assistance is to con-tinue regularly until such time as eligiility no longer exists.

October, 1970 Transmitted by

Maual Letter #788Public Welfae Board

of North Dakota335 - 2

.. ..

..-4

Social Work MaualChapter 335

APlLICA TlON ANDDETER:MNATlON OF ELIGIBILITY

Section 3

Par. 2

In keeping with an indhildual's legal right to apply for assistance, application formsmust be readily accessible to persons wishing to avail themselves of this right. Ai

application form may be obtained at the office of the county welfare board and, in somecou.nties, at other strategic locations, or mailed to the individual upon request. Theperson may complete the form in tht office although it is often advantageous for Moo todo it in the privacy of his own home where he has various documents and records uponwhich he can draw for more complete and accurate information. Regadless of the

me thod, it is expected that he will provide facnia1 information about his circumstaceswhich is within his knowledge and competence,. .! . He may request the assistance of a

county welfare board staff member in completing the form, do it himself, or secure

the aid of his spouse, relative, friend, or other person. In any event, the county

welfae board should make certai tht a well-inormed staff member is available toanswer questions by telepaone or in person tht applicants or recipients may raise

abut items on the form. The individual may personally deliver the completed and

signed form to the county welfae board or retur it by mail.

Upon receivig the form, the eligiility worker will carefully review it for complete-ness, clarity, consistency, and questionable or contradictory statements. In the

absence of any reason to, doubt the facts set forth, the eligiility worker, without delay

or futher exploration, will recommend to her diector or supervisor tht intial or

contiued payment be approved if eligiilty exists, or denied or discontiued 1f ~Ugi-bility does not exist. If any uncertainty as to eligiility arises, the individual must be

given the first opportuity to provide additional or clarifyg information. Ths isusually accomplished by returnìng the form to hi with an explanation of th specific

information needed and why it is needed. If the person is unable by himself or with

the help of the eligiilty worker to clarify the matter and/or circumstances suggstto a prudent person 2/ that futher inquir 1s necessa, the eligiility worke, with

the concurrence of her diector or supevisor, is required to conduct additional ex-ploration and secure appropriate verification. Such verification will be obtaed fromthe individual whenever possible. When this is not possible, the eligibility worker.with the individual's knowledge and consent, will seek the necessary documentig in-formation from outside collateral sources.

1/ The acceptance of the applicants/recipients statements does not apply to eligiil-ity factors for which federal law or policies require procedures beyond obtag anindividual's sttement. ilustrations of tls include the requirements for a profession-

al examin0n and evaluation to determine the degree of blindness, incapacity, ordisa111ty, for a determintion of whether vocationa trainig or employment is appro-

priate, or whether work or traig was refused for good cause.

2/ A "prudent person" insofa as ths chapter is concerned is defied as one who isittntive, cautious, perceptive, and circumspet, and who 1s governed by generallysound Judgment. As applied to the simplified method for determinig eli gii.ty , sucha person in addition to having a thorough knowledge of program requirements mu.st becapable of reviewing and carefully weighg all sttements made by the applicant/re-cipient and quicldy and accurately decidig whether further inquir into his circum-staces is indicated.

Pulic Welfare Board

of North DakotaTransmitted by

Manual Letter #788

October, i 970

335-5

....

Social Work: ManualChapter 335

APLICATION ANDETERMINATION OF ELIGIBILITY

Section 3

Pars. 2-3

The County welfae board must b. discriminating in seekig additional substantiation (of the information provided by the applicant/recipient. There must be a valid reason

for obtaining addtiona verification. Items to be verified are to be selected on thebasis of question or uncertaity around a spcific eligiilty factor rather than on the

basis of a sample of cases or of all the cases ii a parcular area or program. Somefactually unresolved doubt about a certain eligiility factor or factors must exist before

futher investigation is made, Verification is to be made only on the issue or issuesabout which there is uncertaty, not on all eligiility requirements.

In instces in which the "prudent person" principle die'tates tht addtiona information

or documentation be obtaied, the individual must be consulted and his permissionsecured. Ths is usually accomplished though the use of form PW 134. the procedure

for which is describd on page 392-4. Ths means tht the county welfae board should

tae no steps in the exploration of eligiilty to wlùch the person does not agree, When-ever information is sought from collateral sources, the applicant/recipient should

receive a clear interpretation of the information needed, why it is needed, and how it

will be used. Requiring the person's consent for outside contacts recognizes the prin-

ciple that he retas the right to make decisions which affct him and his faily,

Occasionally, the person may be reluctat or unwillig to give his consent to have anoutsi.de source contacted for i.formation, Further discussion will usually result inagreement on the collateral sources to be used. In rare instances, however, the issuemay be such that the applicant/recipient must ultimately decide whether to permit thecounty welfare board to seek essential information, to withdraw his application. or to (

have his application denied or his assistace termi.ated on the basis that his eligibili.tycanot be established.

Par. 3. Redetermintion of Eligiility and Frequency of Review -- When re-

viewig contiuing eligiility, the county of lega residence generally mails the Re-

determination of Eligiilty form (PW 2) directly to the recipient for compleÙón, !/

1/ If the recipient is a patient at the State Hospita. the Redetermination of EligiilityfOrm should ~ be øent to the recipient. In tlùs instce, the Stutsman County Welfae

Board will conduct the review of eligiilty on behalf of the individual, normally without

being reminded of the review date. If, however. the recipient was receivig Old AgeAssistace prior to his entrance into the State Hospita and was merely transferred to

th Medical Assistace program, the Stutsman County Welfare Board, tn order to learnof the individual's hospitaization, should receive a copy of the form PW 60 makg thetransfer. In addition, the county of legal residence should inform the Sttsman CountyWelfae Board as to the date of the next eligiility review so the person's name ca beentered on the register and the reviw appropriately scheduled.

October, 1970 Transmitted by

Manual Letter #788

Public Welfare Boardof North Dakota

335-6

s,:,fI

.... ~'''

-4

Social Work l..la.ualChapter 335

APLICA nON ANDETERrvfiNATION OF ELIGIBILITY

Section 3

Par. 3

If the recipient lives i.~other county, the county of physical residence will not need

to be involved in the redetermination of eligiilty process unless some aspct of hiseUgiilty canot be resolved by mail or the person needs assistace in properly com-

pletig his periodc review form. lt such instces, the county of physical residence

may be requested to contact the recipient. However. whether or not the county ofphysical residence is personally acquaited with a particular recipient, it must be keptinformed of the eligiility status, grant adjustments, et cetera, of all recipients from

other counties livig within its boundaies. Also, since consideration of cosuy spcialallowances ordinarily requires an assessment of the need by the servce worker as apart of casework plang, the county of lega residence should request th couty ofphysical residence to visit the recipient for the purpose of evaluating the need forsuch allowances.

..Space is provided in the upper right hand corner of form PW 2 for the eligiilty worker

to îndicate the date the form is sent to the recipient and the date by wNcb the completedform i.s expcted to be returned. In the event the completed form is not retued by thdate specified, a follow-up letter urgig prompt attention is ordiarily sent although the

eligiility worker may wish to contact the recipient by telephone or persona viSit. pa-

ticularly if the person, because of age or infimity, may need help in fushinft in-

formation, When reasonable attempts to review eligiility are unsuccessfu bec:se of

a recipient's falure to cooperate, the county welfae board may ultimately nee$oeither suspnd his grant or have it sent to the a~ncy until eligiUity can be re-estllsbedHowever, such action should be used advisedly and only after other methods of resolvig

the matter have been explored.

A medical recipient, whose continued eligiilty is uncert because of his failure to

cooperate with the county welfare board, should be advised in writing tht furter pay-

ment for medical services will not be made until his eligiility has been estlished.

The procedure for reViewig and processing a Redetermination of EligiiUty form, onceit is received by the county welfare board, is identical as for processing new applica-tions. describd in Setion 3. Par. 2.

Redetermition of eligiility must be made as often as necessay, but sha not exceecert spcified intervals, accordig to program:

AI TO AGED, BLIND, OR DISALED - 12 months

AI TO FAMLIES WITH DEPENDENT ClfLDREN - Six months

MEDICAL ASSISTANCE - Six months for persons receiVig cae on an inter-mittent basts. and 12 months for those wh arechrOnically il or receivig medical care reguly

Pulic Welfare Board

of North DakotaTransmitted by

Manual Letter #788

Octobèr, 1970

335-7

.#

-.Social W or k M:ualChapter 335

APLICATION ANDDETERMINATION OF ELIGlILITY

Section 3

Pars. 3-4

Al programs require that el1giiUty be redetermined whenever there is an indicationof a chage in circumstces which may either increase or decrease the amowit of

assistance to which an individual is entitled or which may make him ineligile. Thecounty welfare board is therefore expcted to redetermine eligibility as promptly aspossible but not exceeding 30 days after receivig information suggesting a possible

chage in status.

/'

Par, 4 Other Considerations Associated with Simplined Method u Certaother considerations relating to the simplified method for determing eligiility are

set forth in subparagraphs below for special emphasis:

a) ELIGIBILITY TO BE ESTABLISHED FOR EACH PERSON - Eligiilty must

.be,-.stablished indiViduallY-for each recipient of fiancial or medical assis-

tance payments made under the Social Security Act. The simplified methodin no way relieves the county welfae board of the responsibility for properlyevaluatig the information supplied by the applicant/recipient. recognzingwhen additional data is needed, and determining that each individual meetsall conditions of eligiility for assistace.

b) INCOMPLETE FORMS - Occasionally, applications and redetermination ofeligiility forms will be presented incomplete to the county welfae board.

particularly by elderly or infim persons. The problem can sometimes beresolved by returing the incomplete form to the person with spcific in-stuctions as to wha is needed. If the form again comes in incomplete,

however, the eligiility worker should be prepared to contact the individualpersonally to insure the form's proper completion, In the interest of pro-cessing an application or redetermination of eligiility more promptly y the

eligiility worker may on occasion decide to obtain the needed information

by telephone or other means and enter the data on the form herself. Whenthis technque is used, however. the entr should be made in red in and/orinitialed by the eligiility worker so that it is clearly distiguishale fromthe information ente;red by the applicant or recipient.

,,'

c) PERSON TO BE ADVISED OF PROGRA OF ELIGIBILITY - Under the sim-plified method, an indiVidua applies for assistace rather than for a specificcategory of assistace. It is therefore of the utmoSt importance that the

county welfa board recognze its respnsibility to determine the specificprogram, if any. for which he qualfies and to advise him accordingly. Toillustrate. a person may request assistace with payment of medical ex-penses. If in the process of evaluating his eligibilty. the county welfareboard determines the applicant to be eligile for a grant in addtion tomedical servces, he must be so advised':

October, 1970 Transmitted by

Manual Letter #788

Public Welfare Boardof North Dakota

335-8,

i;

....- ,~

..Social Work ManualChapter 335

APPLICATION ANDDETERML'JA TION OF ELIGIBILITY

Section 3

Pars, 4-5

..d) PERSONAL INTERVIEWS - The determintion of initial or continuing eligi-

bility mayor may not require a personal interview with the individuaL.dependig upon the program involved, the capacity of the applicant/recipientto properly complete eligiility forms, and other factors peculiar to a given

situation. At least one such interview, however, is nece ssar in processingapplications for Aid to the Blind, Aid to the Disaled, and Aid to Familieswith Dependent Children based on incapacity because of the requirement inthese programs for a professional ,evaluation of social factors.

County welfare boards are encouraged to have at least one personal contactwith all new applicants, at least within a short time followig the certifica-

tion of grant enttlement, for the purpose of explaining their rights and

responsibilties, the procedure for obtaing medical services. the fairhearing, and the tys of social services which are offered. To ensure tht

each individual makes his decision regading his need and wish for servceson the basis of complete and accurate knowledge, at least one face-to-faceinterview with him is beneficiaL

e) RECORDING - In many instances, the information contaned on form PW 1 orPW 2 represents the only justification needed for the expnditure of pulicfuds without futher explantion of the individual's circumstaces in the casenarrative, Exceptions to this may arise when there is diffculty in determin-

ing eligiilty or when there is some other atypical condition present. Whensocial services are provided, includig evaluations of social factors as acondition of eligiility in some programs, appropriate identifyng and evalu-ative information is required to be entered in the narative section of the

case record. County welfae boards are required to record in the naativethe specific reason(s) for either denyig or terminating assistace.

Par. S. Reporting of Changig Circumstaces -- The applicants/recipientsresponsibility for promptly and accurately reportig any chage in circumstaceswhich' may affect either his eligiility for assistce or the amount of his entitlement

is emphasized on the application and redetermintion of eligiilty forms and in the

instuctionl brochue. The county welfar board should tae additional steps to

assure it_if tht ths respnsibility is clearly understood For exaple, any oralinstructiOl given to the individual or informational releases for pulic consumptionshould inc:de a reminde of the importace of prompt reportig of changes. As re-

lated to chages in income, however. the instuctions should be suffciently spcificas to elimiate unecessa reportig such as tht of an occasional gift or smallamounts of iregular and undependale income.

Pulic Welfare Board

of North DakotaTransmitted by

Manual Letter #788

October. 1970

335-9

..

-4Social Work ManualChapter 335

APPLICATION ANDDETERMINATION OF ELIGIBILITY

Section 3

Pars. 6- 7

. Par. 6. Suspected Frauc:;-- In instances in which there Is evidence that a per-

son has committed fraud for the purpose of obtaîning assistace to which he is notentitled, the county welfae board is obligated to refer the matter to the appropriatelaw enforcement offiCial; namely, the 'states attorney. However, the county welfare

board in its investigation and assessment of possible fraudulent actions must respectthe legal and human rights of the individual by such means as givig the person noticeof the unesolved questions, offering him the opportunity to reply, advising him of hisright of appeal and fair hearing, and of the need to refer the matter to the states

attorney. Referrals to the states attorney shall be made in töe maer outlined inChapter 364, Section 3, '

Par. 7. Eligibility Control Review H The systm of Eligiilty Control (for-merly known as Quality Control) is a. administrative device for determining the extentto which persons receivig fina¡ì.cidl.or medical assistace are (1) eligile for assis-

tace, and (2) receiving payments in the amounts to which they are properly entitled.Administered by the Pulic Welfare Board, the Eligibilty Control's prim purposeis to maintai a contiuous and systematic control over the incidence of ineligiblerecipients and incorrect payments in the public assistace caseload. For purposes ofths system, errors in eligiilty include ineligiilty of assistace recipients as well

as erroneous denials of assistance to applicants and recipients, Similarly, errors in

amount of payment include both overpayments and underpayments.

The focus of Eligiility Contol is on locating tys of errors that occur with such

frequency as to cause error levels in excess of acceptale tolerance limits (3% on I'case ineligiilty and 5% on incorrect payments). Thus, the system has the responsi-

bility of holding the incidence of en'on. below the pre~established tolerance levels. Itaccomplishes this by (1) continuous review of statistically reliable, statewide samplesof cases; (2) periodic assembly and analysis of case fidigs to determie the incidenceof errors; and (3) appropriate corrective action on matters of policy or procedure

when tolerance limits are found to be exceeded.

A statewide sample of active cases rec.eivig assistce and a sample of negative case

actions (denials, closings, and those disposed of otherwise) are selected randomly eachmonth by Research and Statistics. Th lists of selected cases are forwarded to theEligiHity Control reviewers, at least one of whom is headquartered in each area social

service center. The reviewers conduct a "full field investigation, tt defledas the pro-cess by which all elements affectig eligiility and payment are indepedently studiedand documented by an imparal reviewer. It is accomplished by means of review of thecase record and other offcial documents, intervews with applicants/recipients andwith collateral sources of information, correspondence, telephone conversations, com.putation of budgets by established stdards of assistace, and any other activity which

may be pertinent to the review of a case. Documentation from collateral sources ismade only with the individual's knowledge and con~nt.

The findings are forwarded to the Eligiility Control Coordiator for purpses of tau-1ation' analyses, review of adeuacy of current policies and procedures. and reporting.

October, 1970 Transmitted by

Manual Letter #788

Public Welfare Boardof North Dakota

335-10..

.. ~Social Work ManualChapter 335

..APPLICATION AND

DETERMINATION OF ELIGIBILITYSection 4-Pars. 1-2

/ SECTION 4. SEPA.¡¡ON OF ASSISTANCE AN SERVICES

Par. 1. Statement of Philosophy and Purpose - - The concept of sepaation

means that the fuction of assistace or 1ncome malntenance ,(determining initial and

continuing eligiility, comput1ng the-mount of entitlement, and arangig for moneygrants and medical care payments) is caried out by highly skilled personnel otherthan staff responsible for provld1ng social services.

The principle underlying the separation concept is that the execution of both fuctionsis improved in the process. The two roles may be inherently contradictory since it isdiffcult for one person to do an effective job as an investigator of eligiilty on one

hand and a helping person on the other. The dual role tends to create conflct for bothrecipient and caseworker..- Furthrmore, the fuctions of making a proper determin-tion of eligiilty and of delivering high quality servces are both extremely demandigand specialized activities. Attempts to perform both fuctions simultaeously deprivethe caseworker of the time, concentration, and singleness of purpose 'lhich are neededto properly carry out either fuction.

As methods for determing eligiilty are simplified, the qualifications of those ex-pected to perform such activities are affected. The use of more higly qualfied per-sOMel tha actually requied for an activity is costy. ineffcient, and damagil tomorale which often leads to staff turover. Otherwise stted, the use of profeúionalpersonnel, who are in limited supply, for activities which could be performed as wellor better by less qualified stff reduces the availability of th professionals for activ-

ities actually requiring their special abilities.

Par. 2. Role of Agency Workers u Limitig the social servce worker's in-terviews exclusively to social problems is sometimes difficult. May social serviceaeti vit1es are closely related to ficial conditions. Frequently. information whichmay affE~.ct the individual's elígiil1ty wil be discovered during the social servce in- ~

terview. Servce workers must then decide how t1us information is to be used. If theinformation will have an affect on tle individual'. eligiilty or the amout of his grant,

the social service inteew becomes. tram the recipient's point of view. an extensionof the assistce fuction. however untentionally th inormation ii discovere. andthe objective underlyig the simpl1fied method is somewhat depreciated. If the infor-mation is no use. th eervce worker may not be safegudig the public trust.

When this diemma is encountered, the social servce worker should urge th appli-cant/recipient to prompty report the informaton to th eHgiUity worker for properconsideration. However, th service worker may pass th information on to the ell-gibility worker in th event the individu fals to report the matter as advised, isunable for some reason to do so 1umself. or for some other extnuatig circumstace.

Pulic Welfare Board

of North DakotaTransmitted by

Maal Letter #788October. 1970

335 -11

-4Social Work MaualChapter 335

APPLICATION ANDDETERMINATION OF ELIGIILITY

Section 4

Par. 2

In oräer to insure a more effect:e delivery of services, clientele should understadthe differential roles of county welfare board personnel and the purpose of the variouscontacts and activities between the county welfare board and themselves. They mustalso understand tht the service workers are not investigatig their statements con-

cerning eligiility in the maner chaacteristic of the old system. If the expressedgoals of enhanced personal dignity, improved delivery of social services, and moreefficient and prompt determi.nation of eligiilty and granting of needed assistace areto be achieved, it is essential that persons served have a clear understandig of thesimplified method. .The following is intended to serve as a guide to county welfare boards in their classi-'fication of activities between income maintenance, social service, combined incomemaitenance and service, and intae-fuctions.

A. INCOME MANTENANCE

The nucleus of income maintenance is the administration of the basic money and medicalpayment segments of the public assistace prograffs, Included is the full range ofactivitieR from the point of inquiry to the determination that all eligiilty conditions

have been satisfied, computation of the amount of entitlement, subsequent redetermi-ations of eligiility, and assistace with arangig for a fair hearing which an individual

may request. The income maintenance function also includes those administrativeactivities diected towards assistig applicants/recipients obtain other financial re- ('

sources to which they may be entitled.

Specific exaples of activities associated with the income maintenance function are set

forth below:

a) Answering inquiries from the public or from potential applicants abut eli-giility requirements j

b) Distributig application, redetermiation of eligiility, and related assis'"tanee forms and assistig those who caot complete the forms themselves

or with the help of other responsible personsi

c) Assisting with arangements for medical examinations and reports whendisabilty, incapacity, or blindness is a prerequisite to eligiility;

d) Reviewing application and redetermination of eligiilty forms for com-

pleteness, accuracy, and consistency, and determining whether or not

eligibilty requirements are met, including those in the Food Stamp and

Surplus Commodity programs.

October, 1970 Transmitted by

Manual Letter #788

Public Welfare Boardof North Dakota

335-12..

.......

Socia Work MaualChapter 335

APPLICATION ANDETERMINA TiON OF ELIGIBILITY

Section 4:Par. 2

e) Comparing the applicants/recipients net income and resources against histota need, in accordace with estalished standads, and determining the

extent of unet need;

f) Evaluating factors of persònal and real propert with reference to worth. dis-qualifying transfers, required encumbrances, releases of instruments, pro-bate, et cetera;

g) Assisting individuals in developing-potential sources of income to a state ofavaHability;

h) Contacting responsible relatives who appear to be able to contribute towardsthe support of ttie applicant/recipient; and

i) Identifying applicants and recipients in need of social services and makgprompt referrals to service persomiel.

B. SERVICES

Social services, in contrast to income maitenance, include activities diected to-wards improvig an individual's capacity to deal with his own problems, assistg himand/or membrs of his family to attain economic independence, strengtenig familylife, and fostering child development. For exaple, assistg an individual to increasehis employability by evaluating his potential for education or vocational traig and byreferring him to the appropriate manpower agency is clearly a service fuction. Ser-

vices also include assistg appropriate aged. blind, or disaled persons to att or

retan their maxmum level of self-care. Thus, the social servce fuction embracesall activities which raise the educational or vocational level or otherwse enrch thelife of a recipient, or in any way cary out the basic objectives of the social servceprogram.

Specific examples of activities associated with the social service fuction are set forth

below:

a) Referring persons for appropriate servces to agencies within the community;

b) Developing. mataiing, and implementing a service plan for each family

ud child;

c) Providig self-support services, includig the determination of persons

appropriate for referral to the Work Incentive program, Vocational Reha-biltation, or other manpower programs;

d) Aranging child care servces;

Public Welfare Boardof North Dakota

Transmitted by

Maual Letter #788October. 1970

335 -13

--Social Work MaualChapter 335

APPLICATION ANDDETERl\NA nON 0 F ELIGIILITY

Section 4

Par. 2

e) Providig family pla.g services;

o Providig services aimed at preventing or reducing births out of wedlock;

g) Providig services to and on behalf of chidren;

h) Aranging foster care for children;

i) Arangig for homemaker services;

j) Providing protective services to adults, includig an evaluation of the need

for rest home. foster care, or nursing home care;..

k) Providig special services for blind or other disabled persons (e, g., trai-

ing in mobility and sklls of daily livig); and

1) Evaluating social factors and completing required report (form PW 443) when

disability, incapacity. or blindness is a prerequisite to eligii-íiry.

c. ACTIVTIES INVOLVING BOTH INCOME MANTENANCE AND SOIAL SERVICEPERSONNEL

Certain activities do not reaclly lend themselves to a clear and absolute designation as .~either an income maitenance or social service fuction. Whle perhaps tendig to beassociated with income maintenance, these activities, because of their sensitive nature,may also require the special evaluative abilties of social service personneL Thus, insome instces, elements of both assistace and service functions may be involved.necessitatig close cooperation and collaration of effort by stff persons from both

areas. The diector of the county welfare board should therefore exercise judgment in

assigning responsibility for carryng out these activities, based on the specific task tobe performed and on the capabilities of his staff membrs,

Examples of activities that may require a coordiated, teamwork approach are listedbelow:

a) Locating and interviewing absent parents;

b) Determining the feasibilty of obtaining support from a non-contributingabsent father, particularly if personal interviews with the parent are con~

templated;

c) Estalishig paternity and obtainng support, includig cooperative arrange-

ments with courts and law enforcement officials for these purposes;

October, 1970 Transmitted by

Manual Letter #788

Public Welfare Boardof North Dakota

335 -14

.,

. .... ..

..Social W or k MaualChapter 335

APFLICA TION ANDDETERMlNA nON OF ELIGIILITY

Section "Pars. 2~3

d) Determ.g-whether an applicant/recipient should receive a protective orvendor payment (includig consideratìon of the need for a lega guardian);

e) Determing whether a recipient has refused or quit employment or traig

for "god cause;" and ,---

f) Evaluating the need for spcial allowances, paricularly for relatively ex-pensive items. Ths normally involves a social servce worker w::o cangive invaluable assistance in assessing the need for such items as par ofover-al casework planing with the individual or family.

D. INTAKE4.

It is-difficult tó break down the intae fwiction in terms of spcific area of assignment,By the very nature of intae, a combination of income maitenance and services isinvolved. If a full time service worker interviews an applicant duing.hs intial or

other early visit to the office for the purpose of explaiing the vaious provisions ofthe public assistce programs, his basic rights and respnsibilities, the seces(fiancial, medical, and/or socia) which are availe, and of makg an intialassessment of the individual's level of functioning and need for soial servces, 'such

intervew is regaded as a service activity.

Par. 3, Federal Financial Participation u For purposes of federal reimburse-

ment, there must be divorcement of activity between income maintenace and socialservice persoruel. For staff fully engaged in service activity, the rate of reimbrse-ment is 75%.. Persoruel involved exclusively with the income maintenance fwction orin combined service and income maintenance ãctivities are reimbursed at a 50% rate.

Intae activities performed by a service worker, as describd in Par. 2 D of thissection. are reimbursed at 75% whlle those carried out by an income matenancestaff member or by a combintion income maintenance and service worker are re-imbursed at the 50% leveL.

Pulic Welfare Board

of North DakotaTransmitted by

M:ual Letter #788October, 1970

335-15

..

-4Social Work MaualChapter 335

APPLICATION ANDDETERMINATION OF ELIGIBILITY

Section -4Par. 4

Par. 4. Staff Orientation.and Development ~ ~ The separation of the assistance

and service functions requires a clearly.defined pla for the differential use of staff.Orientation of personnel assigned to the eligiilty fuction necessitates a concentra-

tion on determining eligiility for fiancial and medical assistace and processingcorrect payments with objectivity and huma understanding even though a personalcontact with the indivídual may not always be necessar. Eligiility workers must

also be thoroughy acquainted with such basic concepts as the right to apply, courtesyand respect, fair and equal treatment of clientele, individualization, self-determin-tion, confidentiality, unrestricted money payments, anç the right to a fair hearing. Inaddition, eligiil1ty personnel need assistace, though supervisory conferences andopportunities for staff development, in identifying social service needs so tht properreferrals can be made to the service personnl. To carry out these important activi-ties effectively, eligiilty workers..il generally require close supervision.

Personnel responsible for providing social services need to be competent and/orlaowledgeable in interviewing skills, mapower training programs and other rehabil-itative techniques as well as in the entire range of supportive, environmental, inform-ational, and referral services. Under the separation concept, caseworkers must

.bcome adept in offering these services without the traditional eligiility and relatedforms and activities as the entree. In order to effectively provide services with apublic welfare agency setting, however, caseworke:is must be thoroughly grounded inthe various programs for which the county welfare board is responsible.

The task of orgaizing a county welfare board's staff must .b approached from thepoint of view that each employee is a member of the team. All activity should be re-lated to agency goals and fuctions and each employee 8,S a mp.mber of the team should

have sufficient exposure to the philosophy, purpose and function of social welfare pro-grams to appreciate the importace of his own role within the overall framework ofhis agency's responsibilities. Ths can be achieved through supervisory conferences,

professional reading, attendace at appropriate staff training institutes, and joint staffmeetings.

r

r

October, 1970 Transmitted by

Maual Letter ::788Public Welfare Board

of North Dakota335-16

..

."

K. Other ,Income to be Considered inDetermination of AAD Need and Exloredby the County Welfare Board include,but are not Limted to:

1. Income from Workmn' s Compenation,Unemployment Compenation, andVeteran' s Benefits.

2. Contributions of cash from relatives.

3. Court ordered support payments..'

L. Loans.

1. Loans made to applicants or recipi-ents are not to be regarded asincome when the nature of the loanis such that the principal is notavailable for current maintenance.

a. When the loan constitutes adebt and the property purchasedwith the proceeds cannot beconverted for current livingneeds. it does not representa resource to be consideredin determining propertyreserves.

R 50-24-13 REETERMNATION OF NEED.

A. A redetermination of eligibility forAAD will be made whenever thesituation warrants but at least everytwelve months.

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-12-

..

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.. 1:"

..."

SOURCE: Nort DakotaCentur Cod

...AI TO AGED, BLI, OR DISABLED PROGRAM

(Headig of Code Chpter 50-24)

50-24-01. Defitions.--ln ths chapter, uness th context or subject mattrotherwse requires:

1. "State departent" sha mean the Public Welfre Board of Nort 02\:ota;

2. "County agecy" shall mean the county welfare board of each of thseveral counties of the state;

3. lIApplicane' shallmean a person who has applied for assistace unr ths

chapter;

4. "Recipient" shall mean a person who has received assistance under theterms of ths chapter;

5. "Assistace" shall mean money payrPl1ts to or go or servces providedfor recipients under the terms of tls chapter;

6. "Assistace to the aged, blid, or disabled" shall mean money payments to

or in behalf of persons eligile under the provisions of ths chapter and theservices that will improve thir well-being and aid them in increasing thircapability for self-care, sell-support, and sell-reliance; the term "assistaceto aged, blid, or disabled" shall be understoo and interpreted as a

general tenn referring to "old age assistance", "aid to the blind", and "aidto the permanently and totally disabled"; (5.1. 1971, ch, 470, 8.1.)

7. "Old Age Assistance" shall mean money payments to or goo and servcesprovided to or in behalf of needy aged persons;

8. .'Aid to the Blind" shall mean money payments to or gos and servces toor in behalf of needy blid;

9. "Aid to the Pennanently and Totally Disabled" shall mean money paymentsto OJ: goos and servces provided to or in behalf of needy persons deter-mined to be permanently and totally disabled;

Social Servce Boardof Nort Dakot

Novembr, 1971

i

-4.

.50-24-02. Duties of state departent. -- The state departent shal:...

1. Take such action and make such rues and reguations as may becomenecessary to entitle the state to receive aid from the federal governentfor assistance for the agedt blid, an disabled in Nort Dakota;

(

2. Supervse th adminstration of the assistance for the agedt blid. ordisabled thughout ths state;

3. Take such action, give such directions. andpromulgte such rules and

regulations as may be necessary or desirable to carr out the provisions

of this chaptert includig the adoption and application of suitale stand-

ards and procedures to i.sure unform and equitable treatment of all.applicants;

4. Cooperate with the federal governent in matters of mutual concernpertining to assistance for the aged. blid or disabled. includg theadoption of such methods of administration as are found by the federal

government to be necessary for the efficient operation of the progrm;

5. Provide such qualified employees and representatives as may be

necessary;

6. Prescrib th form of and print for and supply to the county agencies

blanks for applications. reports. and such other forms as it may deemnecessary and advisable;

c

7. Have authority to establish and maintain personnel standards on a merit

basis for personnel employed by the state and county public assistanceagencies not covered by a state'NidC' merit system;

8. Make such reports in such

federal government. from time to time, may require;

9. 'Comply with such provisions. rules and regulatíons as the federalgovernent. from tíme to time. may find it necessary to require;

10. Publish a biennal repoit and such interim reports as may be deemed

necessary; and

11. Administer all funds appropriated or made availale to it for the purposeof carrying out the provisions of this ch,~pter.

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".'k

. "I.-l-"

50~24-03,' Eli~ility. -- Assistace shall be granted under tls chapter to any

person who shall meet e followig requirements:

1. Has resided ten years in the United States, or is a citizen of the UnitedStates.

2. Has not sufcient income or other resources to provide a reasonable

subsistence compatile with decency and health.

3. Has no child or other relative of sufficient fiancial ab1lty to support

him who is responsible W1der the law for his support, provided, however.tht if such child or other relative refused or neglects to provide

necessary assi~tace. such refual or neglect shall not make such ap-

plicant ineligif:le for assistance to the aged, blind or disabled.

4. Has not at any time before or afer makig application for assistae to

the aged, blind or disabled made an assignent or transfer of propert

for the purpose of rendering himseU eligile for assistance under ths

pla.

5. Is not a patient in any medical institution as a result of a diagnosis of

tubrculosis or psychosis with respect to any period after the recipienthas been a patient in a medical institution as a result of such dignosisfor forty-two days.

6. Is not an inmate of. nor being maintained by any municipal. state or

national institution at the time of receiving assistance; provided,however. that the state department shall have authority to make pay-ments as provided in this chapter to residents of such public intituons

as are approved by the state departent.

7. Applicants for old age assistance shall in addition have attind the

age of sixty-five years. A county in which an applicant has residence

for poor relief purposes will be finacially responsible for the cOtmty's

share of any assistance provided under this chapter. (S. L. 1971, ch.471, l. 1.)

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8. Or applicants for aid to the blid sha in addition have;

.,. (a. No vision or viion with correctig glasses is so defective as to pre-

vent the performce of ordinary activities for which eyesight isessential.

9. Or applicans for aid to the permanently and totally disabled shall inaddition have:

&. Attd the age of eighteen years.

b. Been determed in the maner prescribd in federal reguon tobe permanently and totally disabled.

.'c. A county in which an applicant has residence for poor relief purposes

will be finncially responsible for the COWlty'S share of any assistace

provided under ths chapter. (S. L. 1971. ch. 471, 6.2.)

50-24-03.1. How residence in state lost. .- If any person not receivig publicassistace but having legal residence in ths state for poor relief purposes voluntariymoves from ths state. his residence for public assistace purposes is lost. destroyedor defeated in the same maner and upon like conditions as the residence of a personin that state vOlW1tarily moved to this state would be lost, destroyed or defeated.

'F1 resident of this state receivig public assistance who voluntarily moves fromstate continues to be eligile for public assistance on a residence basis from

ths state'until he becomes eligible in the state to which he moves, unless the otherstate does not have a public assistace program for which he is eligile. In ths

event. eligiility continues for one year after he moves from thii:, state. A personnot a legal resident receivig public assistace from this state loses eligiility forpublic assistace upon voluntarily moving from this state.

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50~24.05. Application for assistance. ~- An application for assistace to theaged, blid, or disabled under the provisions of this chapter shall be made to the

county agency of the CDunty in which the applicant resides. It shall be in writing or

reduced to wrting in the manner and upon the form prescribd by the state depan-ment and shall be verified by the oath of the applicant. The application shall contain:

1. A statement of the amount of propert. both personal and real, whch

the applicant O'WS or in which he has an interest;

2. A statement of all the income which the applicant has at the time of the

filing of the appUcatio'ns; and

3. Such other information as may be prescribd by the state departent.

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R',,-,~,-;~ ..

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50-24-06. Inve~tigations of al?plications. -- Whenever a county agency receivesan application for assistace to the aged, blid. 01" disabled, an investigation of the

circumstaces of the applicant shall be made to ascert:

1. Th facts supportng thê application; and

2. Such other inormation as may be required by the state departent,

If the county agency believes that assistace ha become necessar byreason of the action of an person contrary to law. the agency shaadvise the state's attorney of th fact and shall give to hi the nae ornames of the offending person or persons together with their last mowaddress. .'

50-24-07. Power of state and county agencies on investigation. -- The countyagency and state deparnent and the offcers and authorized employees threof autor-ized to make investigations under the provisions of this chapter shall have th powrto:

1. Conduct examintions;

2. Require the attendance of witnesses and the production of books. record,

and papers; and

3. Make application to the district court of the county to compel the atten..dance of witnesses and the production of books. records. and papers.The officers and employees designted by the county agency and the statedepartent also may administer oaths and affinnations.

50-24-08. Blind aid--Exmination. -- No application for aid to the blid imderthe provisions of ths chapter shall be approved until the applicant has been exedby an ophthalmologist. physician skilled in th diseases of the eye. or optometrist

designted or approved by the state department to make examinations. The exain-ing ophthalmologist, physician skilled in the diseases of the eye. or optometrist shacertif in writing, upon forms provided by the state departent, the findigs of the

exintion A recipient of aid to the blind under the provisions of this chapter shasubit to a re-exåmiÌltion as to his eyesight when rèquiÌl'd to do so by tht- fltate,de-partent. He also shall fursh any information required by the state departent.

5

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'50-24-09. Sul?plementary ~rvces -- When provided. -- On the basis of the:gs of the examintion made by the ophthlmologist, or physician skilled in the

0._ ~d.ses of the eye_ supplementary services may be provided by the state departentto any applicant or recipient of assistace under the age of sixty-five who is in need

of treatment either to prevent blindness or to restore ils eyesight whethr or not he is

blid as defined in subsection 8a of Section 50-24-03, if he otherwse is qualified for

assistance under ths chapter. The supplementary servces may inlud necessarytravelig and other expenses to receive treannent from a hospital or clic designtedby the state departent. .

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50-24-10. Denial or withdrawal of assistace when treatment refused. -- As-sistace to the blind or totally and permanently disabled may be diDied to, or having

been granted. may be withdrawn from.ay person who refuses medical, surgical, orother treatment when such person, or ros eyesight, may be restored partally or

wholly by such treatment, and a certficate in writig to tht effect is made by the ex-

amig ophthlmologist or physician, as the case may be. Any person who is deniedassistace or whose assistance is withdrawn upon ths groWld may appeal to the statedepartent in the manner provided in sections 50- 24-18 and 50- 24- i 9.

50-24-11. Findigs of COWlty agency on investigation. -- The county agency.

upon completion of the investigation of an application for assistance to the aged. blind,, or disabled shall determne in accordance with its findings whether or not the

.~nlicant is eligible for assistance and shall make a written order, in duplicate. to the~ tht the application be allowed or rejected. A copy of the findings and order of

t._ .;ounty agency shall be transmitted forthwith to the state department. If the countyagency finds that the application should be allowed, it shall. on applications exceptthose for medical assistance for the aged, attach to its order a certficate of eligibilitysettng fort the amoWlt of monthly assistance which it finds the applicant ic entitledto receive and the date upon which assistance is to begin.

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50-24-12. Amount of aid -- Determination. -- The amoWlt of assistance towhich any person shall be entitled under the provisions of this chapter shall bedetermined with due regard to the following:

1. The resources of the individual, including any income and propert thathe may have and any support he may receive from other sources;

2. The necessary expenditures of the individual; and

3. The rules, regulations, and directions which the state departent may

find necessary to prescrib.

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..M4

Such amount shall be sufcient. when added to all othr income and resources of th

recipient. to provide such person with a reasonale subsistence compatile withdecency and health.

50-24- is. Owership of Propert- Trasfer in Trust. -- The owrship ofreal or personal propert by an applicant for assistace to the aged, blid, or

disabled, or by the spouse of such applicant, either individUally or jointly, or ofinsurance on the lle of the applicant, shall not preclude the grantig of suchassistace if the applicant is without funds for ,his sùpport. However, as a conditionto the grant of old age assistance, aid to the blind, or aid to the permanently andtotally disabled, the applicant shall be required to transfer such proprt in trust by

appropriate instrument as security for assistance payments the applicant may

thereafter receive, uness -ce propert consists of the following:

1. A homestead;

2. A life insurance policy havig a cash surrender value of less th three

hundrd dollrs; or

3. Personal property of a value less than three hundrd dol1ara, not

includig household goods, wearing apparel and personal effects, s\lb

as money; or

4. Propert selected by the applicant having a value of less th the

hundred dollars;

5. Real or personal propert held in trust for the applicant by the federalgovernment;

6. Real or personal propert on wluch the taking of security may be prohi

ited through legislation enacted by the Congress of the United States.(S. L. 1971, ch. 470, §.2.)

7

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. 50~24 ~ 14. Life insuran~ policy n Agrement for payment of premiums. -- c_'U applicant tor old age assistace, aid to the blid. or aid to th permanently and

illy disabled, under the provisions of ths chapter, has a policy of insurance or afraternl beneficiary certicate on his lie and if such policy or beneficiary certicate

has a surrnder value less th tht stated or has no cash surrnder value at all. the

county agency may recommend and the state departent may authorie premiums

upon such insurance policy or beneficiary certcate to be paid out of assistancepayments. Such agencies may enter into such arrangements with the insurd as sha

protect the interests of the insured and the interests of th ståte and assure repay-ment to the state, upon the death of the insured. of not less th the premiumpayments so made after £uer,.i expenses. of not to exceed~bundred and fidollars have been paidJ.l ;r i' v I( J!/. ;).: 3)

..50~24-15. Homestead of applicant for assistace not encumbered. -- An

applicant for assistace to the aged, blid, or disabled under the provisions of ths

chapter in no case shall be required to transfer a homestead occupied by hi assuch uness he or she desires to do so. A recipient of old age assistace, aid tothe blid, or aid to the permanently and totally disabled shall not be permitted to

encumr or convey such homestead without the approval in writing of the statedepartent. When an application for old age assistace, aid to the blind, or aidto the permanently and totally disabled is granted and it appears that the applicantoccupies a homestead, which he owns, the state departent shall cause to berecorded, in the offce of the register of deeds of the county in which such home.

~ad is located, a statement in writing to the effect tht the owner of such:lestead is receiving or is about to receive assistance payments. Such written

statement shall be signed by the executive director of the state department.Afer the recording of such statement, any instrument of conveyance or

encumrance executed by such applicant for assistance without the approval ofthe state depanment shall be null and void. No fee shall be charged by the registerof deeds for recording such statement. This section shall not apply to an applicantor recipient of assistance to the aged, blind, or disabled who owns a homesteadwhich is held in trust for him by the federal government. (S. L. 1971, ch. 470, i.S.)

(

50-24-16. Rejection of application-- Notice ofuContents.-- If the countyagency upon investigation of an application for assistance to the aged. blind, or

disabled, finds that the application should be rejected. it forthwith shall noUty the

applicant in writing of its decision. The notice to the applicant also shall statethat he may appeal from the findings of the county agency to the state departmentwithn thirt days from the receipt by the applicant of such written notice and thatsuch appeal may be taken by filing a writtn notice of appeal with the county agency

or state departent.

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50- 24-17. Powet"of state departent to change determtion of countyagency. -. The state departent sha have the followig powers in regad to thereconsideration of the chage, in the amount of assistace to the aged. bli. or dis-

abled tht has been granted under th Erovision of tls chapter:

1. To approve. modif. or reverse the findings of the coimty agency;2. To retur the application for assistace to the county agency for such

furter action or proceedings as the state departent may direct;3. To conduct a hearig or make or cause a furer investigation to be made;

4. To mak such finl disposition of an application for assistace as in itsjudgment the ends of justice require;

5. On its ow motion. to reconsider any or al assistace grants made;6. To consider any' application upon which a decision has not been made by

the county agency witln a reasonable time;

7. To grant assistance where it has been refused or to chage the amount of

assistace, if after furter investigation it determines tht the ends of

justice so require; and

8. To withdraw assistace if it is found that the recipients circumstaceshave altered suficiently to warrant such action.

Whenever assistace is withdrawn, revoked, suspended, or in any way chaged, threcipient shall be notified in writing and threupon shall have the right of a fai hearigbefore the state departent in the same manner as a hearing is aiforded upon an

appeal from the decision of the county agency rejecting an application for assistace.

50-24-18. Appeal to state departent-- When taken u An applicant forassistace to the aged, blind. or disabled under the provisions of ths chapter mayappeal to the state departent if:

1. An application is not acted upon by the county agency with a reasonale

time afer it is filed;2. The application is denied; or

3. The applicant deems the allowance insufficient.

The appeal shall be taken by filing a written notice with the county agency or statedepartent.

9

...,

.. . - .50-24-19. Appeal u How heard. u Where an appeal is tan under theovisions of Section 50~24- 16, th state departent shall give the applicant an

opportunty for a fair hearig. The state departent may desigte Borne person

to act as referee and take and certif evidence to th state departnt. When anappeal is heard before a membr or membrs of the state departent, or a refereedesignated by such departent, such person or persons shall make fidings in wrtigand shall state the reason why the application should not be granted or rejected or

chaged in amoWlt, as the case may be, and report such fidigs to the state depart-ment, together with all the evidence upon whìch the same is based. The state

departent may accept and approve such findings or reverse or modify the same orbear the matter anew or make such disposition of the appeal as the facts and the lawwarrant. If the decision of th depaient results in a denial of assistace or in adenial of the claim of the applicant in whole or in part, such appellt upon writtndemand shall be afforded a fair hearing before th departent. The decision of the

state departent shall be finl, and binding upon the COWlty agency.

50-24~20. County share of assistace. n Each COtmty in ths state shallreimurse the state departent for amounts expended for assistace to the aged, blid,

or disabled in such county in excess of the amount provided by the federal governent,in the followig percentages:

1. Aid to the permanently and totally disabled -- fifteen percent;2. Old age assistace -- ten percent;

3. Medical assistance for the aged -- ten percent;~. Aid to the blind - - none.

50-24-21. How county's share paid. u The state departent shall keep recordsand accounts in relation to the expenditures for each program listed in Section50-24-20 in each county in North Dakota. Claims for reimbursements shall bepresented by the state departent to the board of county commissioners at the end

of each calendar month. The executive director of the state department shall certifto each county the total amount paid for each program to or on behalf of persons intht county. and the county's share of such payments. The amount so certified shallbe paid to the treasurer of the state deparoent from the county treasury upon the auditand approval of the county auditor and the chainnan for the board of countycommissioners.

10..

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"" 'V

-iSocial Work ManualChapter 305

AID TO AGED, BLI,OR DISABLED PROGRA

SOURCE: Nort DaotaCentury Code

50M24-22. Co'lty appropriation. -- The board of county commissioners ineach county in ths state shall appropriate annuay such sum as, in its judgment,may be needed to carry out the provisions of ths chapter. including expenses ofadministration based upon a budget f.repared by the county welfare bord. afer tag

into account state aid, and shall include in the ta levy for such coun the sum orsins appropriated for that pllose. Should the sin so appropriated, however, be

expended or exhausted during the year and for the purose for which it was

appropriated, additional sums shall be appropriated by th board of county conus-sioners.

50-24-23. When county's share of fund furnshed by state. -- If the ficial

condition of any county is such tht it cannot make an appropriation or levy a ta for

assistace to the aged, bl1hd, or disabled, or canot legally issue warrants in anamount sufficient to provide the necessary funds to comply with the próvls10ns of thischapter, the board of county commissioners shall report such fact to the statedepartent. The state departent shall make, or cause to be made, a Càmplete

investigation of the ficial condition of such county. If such investigation shows

that the county carmot appropriate funds or legally issue warrants or levy a ta in an

amount sufficient to provide the county's share of foods needed for the purpses of.tle

chapter in that county, the state departent may provide either as a grant or as aloan that county's share of funds for the puroses of ths chapter or so much thereofas may be necessary, from state funds appropriated to the state departent for thepurposes of this chapter.

50-24-25. Indians -- When state funds used. -- Any county in which an Indiareservation is located may apply to the state departent for payment, out of statefunds. of the entire amount of aid paid toward Indians residing in the county and on

the Indian reservation. The state department shall make, or cause to be made. acomplete investigation of the financial condition of any ¿ounty so applying, and if theinvestigation shows that the financial condition of the county is such that it would beinequitale to ask the county to contribute its share or the amount necessary toprovide aid to such Indians the state departent may use funds approptited to thepublic welfare fund for aid to aged. blind. or disabled persons to pay such part ofthe costs of aid to such ward Indians as is not paid by the federal governent.

50-24-26. Welfare special fund. -- All moneys :rceived by the state depart-ment from any source for the purpose of carrying out the provisions of ths chaptershall be deposited in the state treasury to the credit of the welfare special fund and

shall be disbursed in the manner provided in section 50-06-14. (S. L. 1965. ch. 181.ø. 22.)

11

K.,

Social Work ManualChapter 305

AID TO AGED, BLI,OR DISAB LED PROGRA

SOURCE: Nort DakotaCentury Code

c~ .50-24-27. Disbursements for assistace to the aged, blid, or disabled --

ùisbursements for assistace under the provisions of ths chapter shall be made onlyfor the purposes of ths chapter which shall include:

1. Payments to or on behal of recipients of assistace;

2. Expnses of administration of the assistace to the aged, blid, ordisabled pla in this state. .

Al disbursements for expenses of administration shal be made in the manerprescrid by section 50-06-14. (S. 1. 1965, ch. 181, §. 23.)

.'50-24-28. Person handlng money to furnsh bond. -- The treasurer of the

state departent and all persons having any control over or who handle any of the

moneys for the puroses of this chapter shall be bonded in such swn as the statedepartent by resolution shall reqUire.

50-24-29. Recovery of assistance to the aged, blínd. or disabled froml)rson liable for sUPl0rt. -- If, at any time during the continuance of any allowance

granted under the provisions of ths chapter. it is ascertained that anyone who islile for support and care of a recipient of assistance to the aged, blind, or

disabled is able to afford the necessary support or care of such recipient but failsa.nd refuses to do so, there shall exist a cause of action for such assistance against

such person. The action shall be brought by the state's attorney of the county in thename, of the county in which such assistance was granted and against the personliable for the support or care of the recipient of the assistance. 111c action shall be

brought for the recovery of the amowìt of money with interest thereon paid to suchrecipient, together with the costs and disbursements of the action.

(

50-24-30. Authority to compromise and settle. -~ The state department shallhave the authority to enter the appearance of the state in any proceeding affectingproperty upon which the state may have a claim for old-age assistance. aid to theblind, or aid to the permanently and totally disabled to prosecute and defend in anysuch proceedings. to institute probate proceedings as a creditor to deceased persons,and either in the course of or in the absence of and apart from any action orproceeding enter into any stipulation, compromise, settlement or other agreementor arrangement in respect to such claim as may seem wise. and to execute any such

stipultion, modWcation. quit claims, releases, partal releases, discharges,extensions. agreements, satisfactions. partal satisfactions or subordination orother contracts or stipulation or agrement which the interest of the 'panies or thecircumstances of the case may make advisable. __

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12 ..

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50-24-31. Confdential character of records -- Penaty. -- Al applications,inormation, and reco:tB concering any applicant or recipient of assistace to aged,blid, or disabled under the provisions of tls chpter shall be confdential and shanot be disclosed nor used for any purose not directly connected with the adminstr-tion of assistace to the aged, blid, or disabled; except tht upon the persona

writtn reuest of any elected publiê- official the records of the naes, addresses,and amounts of assistace shall be open for his inpection by th stte or cotm

welfare board. Such infoiiuation shall not be used for any political or commerciapurpose or made public in any maner. Any persop. using any application, Llonnation,or records concerng any applicant or recipient beyond his offcial capacity or forpuroses not directly connected with the adminstration of assistance to the agd,blid, or disabled is guilty of a misdemeanor.

50..24-32, Recipieht to notif th state departent of receipt of ~ropeI' or

income -- Assistace altered or canceled. -- If, at any time during the contiuationof assistace to the aged, blid, or disabled under the provisions of this chapter, th

recipient becomes the owner of any propert or income in excess of the amount statedin the application provided in section 50-24-05, he immediately shall notif th countyagency of the receipt of possession of such propert Ol income and the county agency.

afer investigation. either may cancel the assistance or alter th amount thereof in

accordance with the circumstaces. Any assistace paid afr th recipient ha

come into possession of such propert or income, and in excess of his needs, shbe recoverale by the state from the estate of the recipient.

50.2.4..33. Recovery from estate of recipient of assistace to the a~d, blid,

or disabled. -- On the death of any recipient of assistance to the aged, blind, or

disabled under the provisions of this chapter the total amount of assistace paid underthis chapter shall be allowed as a preferred claim against the estate of such personin favor of the state. after funeral expenses for recipient and his or her spouse, notto exceed in each individual case three hundred and fifty dollars. and such expensesof the last illness of recipient and spouse as are authorized or paid by th countyagency, have been paid, and after the expenses of administering the estate,including the attorney's fees approved by the court, have been paid. No clam shabe enforced against the following:

1. Real estate of a recipient for the support, maintenace or comfon of

the surivig spouse or a dependent;

2. Personal propert necessary for the support, maintenance or comfort

of the surviving spouse or a dependent;

3. Personal effects, ornments, or keepsakes of the deceased, not exceed-

ing in value two hundred dollrs;

13

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4. Any real or persona propert of a recipient which ,is held in trt for

him by the federa' government.(Amtd. S. L. 1969, S. B. No. 15l) c

50-24-34. Division of moneys recovered. u Any amounts recovered under the

provisions of sections 50-24-27 or 50-24-29 for assistance to the aged, blid, or

disabled paid under the provisions of ths chapter shall be deposited promptly in thappropriate fund and credited respectively to the federal goernent, th state, andthe county in proporton to the amounts in which the assistace payments representee.funds contributed by the federal governent, state, and county.

50-24-35. Guardian appointed--Payments to gurdia. -- Whenever a gurdia

shall have been appointed for any recipient by a cour or competent jurisdiction, the

payment of aid shall be made to sú'h legal gurdian. The legal gurdian shall file a

report at the end of each calendar year with the county agency, showg thedisbursement of the money received by him for the benefit of such recipient.

50-24-36. Aid not assignle--Cashing checks afr death of payee. -- Aidgranted under ths chapter shall not be transferrale or assigle in law or equity,and the money paid or payable under ths chapter shall not be subject to execution,attchment, garnshment, or other legal process or to the operation of anybanptcy or insolvency law. Aid checks delivered to a recipient before his deathbut not endorsed by such recipient may be endorsed and paid, upon approval of theCOWlty agency under rules and procedures adopted by the state departent. (

50-24-37. No fees to be charged. -- No person shall make any charge nor

receive any fee from the applicant, recipient, or any other person for representingan applicant or recipient in any proceedings under the provisions of this chapter,or with respect to any application for aid.

50-24-38. Statute of limitations shall not ru. -- The statute of limtationsshall not rlU against claims of the state of Nort Dakota for repayment of assistaceto the aged, blind, or disabled.

50-24-39. Fraudulent acts--Penalty. -- Whoever knowingly obtains, or at-

tempts to obtain, or aids or abts another J by means of a willfully false statement or

representation, or by impersonationJ or by other fraudulent device, assistace to theaged, blind, or disabled to which he is not entitled, or assistance grater than that towhich he is justly entitled, is guilty of a misdemeanor and shall be punshed by a fineof not more than five hundred dollrs, or by imprisonment in the county jail for notmore than twelve months; or by both such fine and imprisDnment~ In ,assessing thepenalty, the court shall take into consideration, along with other factors, the amountof money fraudulently received.

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50-24-40. lJrwtations of chapter. -- All assistace to th aged, bllnd,ordisabled granted under ths chapter shall be deemed to be granted and to be held subjectto the provisions of any amending or repealig act tht hereafr may' be passed. Norecipient shall have any clam for compensation or otherwse because his assistace isafected in any way by any amending..or repealing act.

50-24-41. Suspension of chapter. -- In the event tht any provision orprovisions of this chapter shall be in confct with TItle XV - Grants to States forAid to the Agd. Blind, or Disabled or for such aid" and medical assistace for the

aged being amendments of Title I of the SociaI Security Act, being Pulic ÙlW 87-543.87th Congress. H. R. 10606, dated JulY 25, 1962, providing for a state plan for th

aged, blid, and disabled; under which, if ths chapter were not in confct, the state

would be entitled to receive contributions from the United States for the combind.state plan for the aged, blid, and disabled, such provision or provisions of thschapter so in conflict with such law of the United States sha be considered assuspended an noneffective until fif days afer convenig th legislative assembly

in the year 1965 so as to enable the state to quafy and partcipate in suchcontrutions for the aged, blid. and disabled from the United States.

is

"'-4

Social Work ManualChapter 391 CASE ACTI00J FORi\IS

ChapterContents

lto, CHAPTER CONTE~TS ~

SECTION 1. "ASSISTANCE APPLICATION," FORM PW 1

,," ..Par. 1 - Purpose of Form. . . . . . . . . . . . .Par. 2 - Instructions in the Use of Form PW 1 . . . . . . . .

Par. 3 - Effective Date of Application. . . . . . . . . .

. 391-1

. 391-2

. 391-2

FORM PW 1 - Assistance Application . 391-3

SECTION 2. "REDETERMINATION OF ELIGIBILITY," FORM PW 2

.'Par. 1 - Purpose of Form. . . . . . . . . .Par. 2 - Instructions in the Use of Form PW 2 .

. . . . 391:.5. . . . . . 391-6

FORM PW 2 - Redetermination of Eligiility. . . 391-7

SECTION 3. OPTONAL USE OF FORMS 8M 1, 2, 3, 4, and 5

Par. 1 - General Statement . . . " of .. 1I 391-9

FORM SM 1FORM SM 2FORM 8M 3FORM SM 4FORM 8M 5

....-......... 391-11. . . 391,-13'. . . 391-15" . . 391-17

. 391-19

........................"............,.,.....,..........,......SECTION 4.

SECTION 5. -"PHYSICIAN'S REPORT ON EYE EXAMINATION, H FORM. "PW 409 AND "OPTOMETRIST'S REPORT ON VISUALEXAMINA TION," FORM PW 464

Par. 1 - Purpose of Forms . . . . . .Par. 2 - Routing of Forms. . , . . . ,Par. 3 - Forms Must Be in Case File .

.. .. . .. ... . . . . . 391-23, . . . . . 391-23. . .. 391-23

FORM PW 409 - Physician's Report on Eye Examination. . . . . , , , 391-25FORM PW,464 - Optometrist's Report on Visual Examination . . ( . . . 391.27

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #827

Ma~r, 197.

391:'i

..-.Social Work ManualChapter 391 CASE ACTION FORMS

ChapterContents

SECTION 6. "SOCIAL REPOR'tt" FORM PW 443

Par. 1 - Purpose and Use of Form .Par. 2 - How to Prepare . . . . . . ~ . . . . . .

. 391.29

. 391-29

FORM PW 443 - Social Report ............ . 391-35

SECTION 7. "MEDICAL REPORT." FORM PW 444

Par. 1 - Purpose and Use of Form . . . . . . . . . . . 391-41

FORM PW 444 - Medical Report. ... . . . 391-43

SECTION 8. "STATE REVIEW TEAM REPORT. " FORM PW 445

Par. 1 - Purpose and Use of Form . . . . . . . ' 391-45

PORM PW 445 - State Review Team Report . . . . . . 391-47

,SECTION 9. REFERRAL TO WORK INCENTIVE PROGRAM - FORMS PW 136,

"REFERRAL A~'D ENROLLMENT FORM, t1 Ai\TD PW 137."EMPLOYABILITY RE FERRAL FORM"

Par. 1 - Purpose of Forms . . . . . . . . . .Par. 2 - "Referral and Enrollment Form, .. Form PW 136Pa. 3 - "Employability Referral Form. .. Form PW 137 .

. .. 391-49. 391-49. 391-50

FORM PW 136 - Referral and Enrollment FormFORM PW 137 - Employabilty Referral Form. . . .

. . . 391-55. . . . . 391-58

. .

May, 1971 Transmitted by

Manual Letter #827

Public Welfare Boardof North Dakota

391-ii

..-4

Social Work ManualChapter 391 CASE ACTION FORMS

Section 1

Par, 1

SECTION i. "A_~SIST.\~CE ~PPLJCA TION," FORM PW 1

Par. 1. Purpose of Form - - Form PW i, "Assistance Application, It when prop-erly completed and signed, generally provides the basis for which a determination ofan individual's initial eligibiliry for public assistance is made, The form is specif-ically designed to be completed b)' the applicant or by someone actíng responsibly inhis behalf. Quesnons are expressed ín simple language in response to which the indi-vidual can normally set forth all of the facts required to determine his eligibilty.

Form PW 1 is to be used when an individual wishes to apply for Aid to the Aged, Blind,or Disabled, Aid to Famìles with Dependent Children, Medical Assistance, Aid to theBlind Remedial, or Foster Care Payment, and may also be used for the General Assis-tance program. The form.must be completed and signed whenever an individualinitially applies for assistance or reapplies following a denial, withdrawal, or closing.A new application is also required in certain instances in which a recipient of oneprogram becomes eligible for assistance through another program. To illustrate, arecipient of General Assistance who wishes to have a determination made of his eligi-bility for AAD, AFDC, MA, ABR, or FCP will need to file a new application. Like-wise, any recipient of .AD who may become eligile for AFDC, or vice versa, shallbe required to complete a new Form PW 1.

Form PW 1 has, however, been designed to eliminate some of the need for processinga new application each time a recipient of one assistance program becomes eligiblefor assistance through another program, For example, a recipient of Medical Assis-tance may be transferred to a categorically-related grant, if eligiility exists, withouthis having to formally apply for the grant program. Conversely. a grant recipientwho becomes eligile for medical care only may be transferred to the related categoryof Medical Assistance without filing a new application. It is likewise unnecessary fora recipient of one phase of AAD to reapply in order to receive assistance thoughanother phase of AAD. These procedures can be accomplished through transfers bynotifying the Public Welfare Board of the appropriate change in case numbers on FormPW 600.

Public Welfare Boardof North Dakota

Transmited byManual Letter #725

December, 1969

39 i - i

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Social Work ManualChapter 391 CASE ACTION FORMS

Section 1

Pars, 2-3

Par, 2. Instructions in 11ic Use of Form PW 1 -- An application form may beobtained at the offce of the county welfare board. and in some counties, from otherstrategically-located offces, or mailed to an individual upon request. The formshould be accompanied by an instructional brpchure. a Question and Answer pamphletfor the program to which he wishes to apply. and other related materials which willassist him in fiing his application.

,

Space is provided in the upper right hand corner of Form PW 1 for the eligibiltyworker to indicate the date the request for assistance was made (See Par. 3 of thissection for effective date of application). Since the form is designed so that theapplicant can normally complete it himself. the items contained therein need nofurther explanation.

. .

The application form must be dated and signed by the applicant. If a husband and wife

are both applying for assistance in their own right though the same program .:rdìfferent programs. the signature of each must appear. Thus, the single applicationform wil serve both applicants. If an applicant because of physical or mental inca-pacity is unable to si¡;.i the form himself and he has no legal guardian to represent him,a spouse, relative, or other interested person who is able to act responsibly for him

may do so. In this instance, such person would sign the applicant's name followed

with the name of the signer, as "By John Doe." When the basis of the applicant's in-abilty to sign his name is iliteracy. a mark of "X" or a thumb print constitutes a

valid signature provided it is countersigned by two witnesses.

If another person assists the applicant in completing the items on the form, the nameand address of that person are expected to be listed.

Par, 3. Effective Date of Application -- An application shall be considered as

"received" at the time a request (not an inquiry) is made orally or in writing by an

individual in his own behalf or by someone authorized to act for him. If such oral or

written request precedes the receipt of the completed and signed Form PW 1. the dateof request is the date of appl1cation.

December, 1969 Transmitted by

Manual Letter #725

Public Welíare Boardof North Dakota

391-2

.. c","~

..PW.L (1/69)

ASS~Sïr AI:~ C~ A~t'ltCA ¡¡LON'"611 No,ih Dal1ø "0.1",1,"

P.l1f Of r.tdl,~n rOA ASSISTAI-~(

F~ . 'SE. r-.lZJ.O C.cr:~FU!.I.Y: I HEREBY APPLY FOR FINANCIAL ASSISTANCE AND/OR MEDICAL CARE, AND UNDEr;i' ,\LTY OF PERJURY, CERTIFY THAT fJHE lNFOi~rI1ATION I AM ABOUT TO GIVE IS A TRUE AND COMPLETE STATE-

/ ",QF FACTS. I UNDERSTAND THAT I AM TO LET THE V/ELFARE OF¡:lCE l(NOW PRO:.'lPTLY OF ANY CHANGES, '(((CCUR IN MY INCOME OR NEEDS. IF I FAil TO DO THIS, I VlilL BE RECEIVING ASSlSTANCE ILLeGAllY AND

ytlLi..dE SUBJECT TO PROSECUTION UNDER THS LAWS OF NO~TH DAKOTA.PÌ!;!ase read th~ information pamphlct before completing this form.

1. Your Mailing Address-Street, Box No. or RFD No. 2. Town or City-Zip Code

. 3. Directions for reaching your home if it is, in the country I, 4. Telephone Number

; I WISH TO APPLY FOR ASSISTANCE FOR THE PERSONS LIVING IN MY HOUSEHOLD, LISTED BELOW, FOR WHOM IAM RESPONSlBLE. (IF THE ASSISTANCE FOR WHICH YOU ARE APPL Y!f":G IS FOR YOURSELF AND YOUR DEPEND.ENTS ONLY, YOUR NAME GOES ON LINE llF A MAN AND LINE 2 ¡r: A WOMAN. IF YOU ARE COMPLETING THIS F.ORMIN BEHALF OF SOMEONE ELSE, DO NOT lNCLUDE YOUR NAME, IN THIS CASE, ANSWER ALL QUESTIONS AS THEY

~APPLY TO THE PERSON(S) FOR WHOM YOU ARE REQUESTING ASSISTANCE.) .. 4

RACE Soelo I S.~v'¡1y No. ((oe"lAT FIItT INITIAl iinATlON'1 B1P,TH su INDIAN fu", liy memb., mu.1 hQY.5. SHIP DATE WHITE o So~¡ol Sfv'lly No.)

OTlER

Man Male(1

Woman Female(2)(3)(4)(5)''')

..' ",

- ,'.

~

(l,)

(11)(12)

(List below children 18-21 years of age who are living at home and attending school) ,

I i I I I.INDICATE THE SCHOOL AND TYPE 0' COURSE lIlNG T"I(£N BY CHllOREN LISTED ON lIMES 11 AND 12

ADDITIONAL IDENTIFYING INFORMATION

6. Have you or your sp'ouse ever been employed by the Railroad? Yes 0 No 0If yes, please give your Rallroad Retirement No.

7. If applicant has a legal guardian, give his name and address:

NAM Of GUAltPIAl'8. Are you or your spouse a veteran? Yes 0 No 0

If yes, give claim number and serial number:

9. If you are 65 years of age, you must have a medIcare number.List your number here: List your spousels number here:

10, Are you a c1tizen of the United States? Yes 0 No 0If your answer is noi how many years have you Jived fñ the United States?

AWItW Of GUARCIAN

CLAM NO. SERIAL NO.

YEA itS

DURING THE PAST 24 MONTHS I HAVE LlVED IN THE FOLLOWING PLACES:ADDUSS fROM I TO..Address:

Check belów to indicate where you !lve and ~-~f-;h~lter cos't you ~ etch month. If no rent is paid, please indicate.

12. 0 No Shelter CostsMONTLY aA1' MONTLY AA1'

fo In a Rest Home . - _. - $

In a Nursing Home - - - $ ...

In Home of Relative. - . $

Ü Other. . - . . . . $o I own or am buying a house or trailer home:. . . - . -

o I rent a house, apartment, room, or trailer home:. .In addition to rent do you pay for any of th~ following:

Heating - . - - - - - - - Yes 0 No 0Lights. - . - . . - . . - Yes 0 No 0

In addition, do you pay for any of the following:Telephone Yes 0 No 0Laundromat Yes 0 No 0Health Insurance Yes 0 No 0

o Board and Room -

o State Hospital

Name of Relative

Explain

- $

- ,$

--_.__....$$

Please check each item "yes" or "no"Cooking Fuel - - - - . - - - - Yp.s 0 No 0Water, Sewer, and Garbage - . - . Yes 0 No 0

Amount

Amount of premium

Transporttion Yes 0

Housekeeper Yes (Jper month.

No 0 Amount

No 0 Amount

Name of Company

Address

Fire Insurance Yes 0 No (J Amount of premium

Name of Company

Life Insurance Yes 0 No 0 Amount of premium

Policy No

Date Due

Policy No

. Name of Company

. ~dress

ou eat meals in a cafe every day, circle the number of meals eaten. (Not lunches). 1 2 3

We make, the following monthly payments. (State to whom made and amount paid monthly)

00 you have cooking facilities (stove and dishes)? Yes 0 No 0

CHECK BELOW TO INDICATE THE HELP YOU RECEIVE FROM YOUR ADULT CHILDREN

.3. 1. I have no adult children. 02. The following adult children give me money regularly. (Give name and address of each one, and amount of contribu-tion.) '.' . "

HAME NAME

ADDRES AlOREM

Amount $

The following adult children are unable to help me. (Give name and address of each one.)

Amount $

NA/E ADDRESS HAE ÄDDRßS

NAME ADDRES HAE AnDRESS

AOOllESS N~f ADDRESS

~, y~u or the per!;::i for whom you are reCluestinrr ilssistônce is undcr 65 years of ¡¡~e and blind or dis:ibledexplain the miture of the disability and th.? nzme of tl~e doctnr in the spnt,~ below: '

Nature of disabiltyName of doctor

..-l/

Social Work Manualfliapter 391 CASE ACT�0i:£9R!\-s____

Section 2

Par, 1

"SECTION 2. "REDET~MiNA-rIOl' OF ELI~~8JL_ITY ~Q!,M PW..

Par. 1. Purpose of Form -- The purpose of Form PW 2, "Redetermination of

Eligibiliry, " is to proVide current infgrmation about a recipient's fina.ncial and relateddrcumstances. It is to be completed by the recipient or by someone acting respon-sibly in his behalf at the time of each redetermination of eHgibilty. Questions on theform are expressed in simple language in response to which the individual can normal-ly set forth all of the facts required to determine if continued eligibility exists.

Form PW 2 is to be used in redetermining eligiilty for Aid to the Aged, Blind, orDisabled, Aid to Families with Dependent Children, Medical Assistance, Aid to theBlind Remedial, and, if the county welfare board chooses, for Foster Care Payment.It may also be used in the ~neral Assistance program.

(' .,

Public Wel fare Boardof North Dakota

Transmited byManual Letter t; 725

December t 1969

391.5

.--4

Social Work ManualChapter 391 CASE ACTION FOR~1S

Section 2

Par. 2

-,Par. 2. Instructions in the Use of Form PW 2 -~ The Redetermination of

Eligibility form is generally mailed to recipients, including those living out of county.

In the latter instance, the county of physical residence shall be kept informed of the

individual's eligibility status, grant adjustments, et cetera. The county of physicalresidence does, however, carry responsibility for obtaining information needed to re-establish blindness, disability, or incapacity as well as for providing needed social

services. As in the original application process, the recipient, who may request

assistance of others in completing the form, is respollsible "for accurately reportingall of the pertinent facts of his situation.

~

Space is provided in the upper right had corner of Form PW 2 for the eligiiltyworker to indicate the date the form is sent to the recipient and the date by whlch thecompleted form is expected to be returned. Since the form is desiened so that therecipient can normally complete it himself, the items contained therein need no furtherexplanation.

The Redetermination of Eligibility form must be dated and signed by the recipient. Ifa husband and wife are both receiving assistace in their own right through the same

program or different programs, the signature of each must appear. Thus, the sameredetermination form wil serve both recipients. If a recipient because of physical ormental incapacity is una~le to sign the form hlmself and he has no legal guardian torepresent him, a spouse, relative, or other interested person who is able to act re-sponsibly for him may do so. In this instance, such person would sign the recipient'sname followed with the name of the signer, as "By John Doe." When the basis for therecipient's inability to sign his name is illiteracy, a mak of "X" or a thumb printconsti.tutes a valíd signature provided it is countersigned by two witnesses.

If another person assists the recipient in completing the items on the form, the nameand address of that per son are expected to be listed.

,

December t 1969 Transmitted by

Manual Letter #725

Public Welfare Boardof North Dakota

391-6

..THIS ':7.CTIOi! L:SìS YOU~ HOLD!NCS, GIVE THE TOTA:. \/r,LUE'" F TH:: (E\~(S) fiND LIST AN'( M.iOUNT YOUc:rt.. (I'! TH: i¡1Q?r.;\lY. IF YOU O\\'i~ NOt':E, CHECK "NC~~E" AiW GJ c:.~ TO THE NEXT IrE¡.1.

14. 0 NoneI, my spouse or dependent children have the following:

cr _.' - - - - $ J?avings at Home - - $Account - $ U. S. Bonds - - . - $Account. - $ Indlan Account - - $

spouse or dependent children own the following personal propert.o None 0 YesAutomobile(s) - Value Amount OwedMachinery - Value Amount OwedLivestock - - Value Amount OwedTools - . - - Value Amount OwedTrailer Home . Value Amount Ç)wedOther - - . Value Amount Owed

i, my spouse or dependent children own the following real propert.o None 0 Yes

Home valueLega I description

Land valueLegal description

(legal description may be copied from your tax statement.IF YOU ARE RECEIViNG ASSISTANCE IN BEHALF OF CHILDREN YOU MUST C01V1PLETE THE FOLLOWING SECTION,TO INDICATE THE REASON FOR THE ABSENCE OF THE PARENT(S), IF THERE ARE NO CHILDREN IN YOUR HOME'fT THE PRESENT TIME YOU !'i/P.Y SKIP THIS SECTION,.

15, (1) Death . -

Stocks and Bonds . $C. Os.. . - . . . $Other - - - . . . $

(If you own none, check "None")

Monthly PaymentsMonthly PaymentsMonthly Payments

Monthly PaymentsMonthly PaymentsMonthly Payments

(If you own none, check IlNone.")

Amount Owed~.

..mount Owed

NAME DA TE OF DEA TH SOIAL SECURITY No.

(2) DesertionNAME

(1) Service in Armed Forces. NAMEDATE PUENT lEFT tlOME ADDRESS, IF kNOWN AND SOC. SEC. No.

DATE Of tNPUCTIOt- SUIAl OR SOCIAt SECUIUTY Nt).

Divorce - . .NAME AND ADDRESS OF AII$ENT PARENT OAT! OF DIVORCE AND PLACE SOIAL neURITY No.

. LENGTH Of SENTENCE DATE SENTENCE IEGAN

DATE OF HOSPITALIZATION N.AAE Of HOSPITAL ORTREATMENT fACIliTY

(7) Separation(a') Legal (by court order)

(b) B A NA.E ANP ADDRESS If I(NOWNY greement(without court order)NAME OF PÂ1lNT DATE 0' SEPÂRATION

If divorced or separated, has there been an order to secure support? Yes 0 No 0Have you taken any steps to secure support from the childs or children's father(s)? Yes 0 No 0

I would like to talk to a caseworker about my needs or problems. (See the information booklet) Yes 0 No 0Signature or mark of applicant, guardian or Interested person. (If you sign your name with a mark or X, you musthave two witnesses slgn their names too.) If you can write your name, it is not necessary to have the witnesses sign.

PAn 0' UPAUTION SOC1ÂL SECURITY No,

AtPRts, IF kNOWN

DAn YOUR NAM! OR MARK

DAnWitness to Mark: 1.

2.Signature of person, if any, who helped applicant complete this form:Name Address

SIGNATURE Of spouse

DateDate

,r 1FFICE U~E amy..

£'.'0"0'\tinued eligible 0 Amount $,,' '1it Change 0 from $

Šuspended 0 Reaso,n:Closed 0 Reason:

Effective Dateto $ Effective Date

~ .,,.l;I;.'W-- ,~,..iii :":1'4'; SIGNATURE OF COUNTY OIRECTOil OR SUPERVISOR

-PLEASE ANSWER THE QUESTIONS BELOW ABOt;' YOUR MARITAL STATUS

o Married, Ilvng with spouse 0 Divorcedo Separated 0 Widowed

SHOVI IF YOU HAVE ~~SPOSED OF P~O?ERTY Il'l THE PAST T\'0 YEARS

.1. ... the past two years have you, or your spouse (i any) given away! sold or deeded any items of value, sd'smoney, land, houses, shares of stock or bonds?Yes 0 No 0 If no¡ go on to next Item. If yes, describe the items.

o. 0 Never married

-~

Value of items: $ How much did you receive In return?

What did you do with what you received?

Date of transfer'

,

SHOV¡ YOUR TOTAL GROSS INCOME FROM ALL SOURCES (Income before deductions)Check either box "yesll or "no" and show how much you rec9ive aacii month.

L2. Workmen's Compensation.____...._____. Ye~ 0 No 0..

Social Security Yes 0 No 0

State Social Security (OA5IS)______ Yes 0 No 0

Railroad Retirement .Yes 0 No 0

_Yes 0 No 0

,Yes 0 No 0

Yes 0 No 0

Veteran's Benefits

Civil Service Benefits~-

'arders or Roomers

Jpport Payments for Children___...Yes 0 No 0

Cash from Relatives

Unemployment Benefits

Manpower Training

Work i ncentive Program

Yes 0 No 0

..__ Yes 0 No 0

,Yes 0 No 0

Yes 0 No 0

Yes 0 No 0

Yes 0 'No 0

Yes 0 No 0

Yes 0 No 0

Neighborhood Youth Corps

Rental of Land

Lease Land

Other Income (Specify)

$

$ ,

$

$

$

$

$

$

$

$

$

$

$

$

$

$

MINE MY $louse

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

DEHNDENT CHilDREN

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$Earnings from Employment before deductionsIf you have no income, check 0If you are not paid by the month, are your paid 0 weekly 0 tNice a month 0 hourly 0 annually

o every other week 0 other Explain

Fill IN SECTION BELC\V ONLY IF you LISTED EAl1NINGS

$

you checked earnings from employment. show payroll deductions and cost of child care, if any.\,_ MINE MY SPOUSE DEPENDENT Cl", '~'lIncome Tax Deductions . . . . - - -

Social Secudty and Retirerpent Deductions

Child Care (Baby Siling) - - - . * - -

._*-$

. - T ota 1 $.._--$$

$

$

$

$

$

..-~

(

Social Work i..fanualChapter 391 CASE ACTION FOR;-..1S

Section 3

rar. 1

fl.SECTION 3, OPTIONAL USE OF FORMS $\1 1, 2, 3, 4, and 5

Par. 1. General Statement -- Several forms have been designed to facilitatethe county welfare board's determination of inWal and continuing eligibility for publicassistance. These forms ~ SM 1, 2, 3, 4, and 5 - are largely self~explanatory andtheir use is optional. A brief explanation of the purpose of each of the forms is as

follows:

a) 8M 1 - The primary purpose of thi~ form is to serve as a cover letter whenthe application and related forms are mailed to an individual who has

indicated by telephone or mail the wish to apply for assistance. it contains

general instructlons for the proper completion of the application form. Ifthe eligìílìty worker wishes, this form may also be attached to theapplication materials when the individual comes to the office to expresshis intention of applying for assistance.

b) SM 2 - This form may be used in instances in which an application has beensent or given to a would-be applicant but the completed form has not bet:nreceived by the county welfare board.

c) SM 3 - This form may be usedby the eligibility worker whenever she findsit necessary to return Form PW 1 or PW 2 to the individual because one ormore items have not been completed. This procedure wil be expedited by

checking with a red pencil the item or items needing further attention.

d) SM 4 - This form is mailed with the Redetermination of Eligiilty form

prior to the date eligibilty is to be re-established. 8M 4 containsinstructions for properly completing the redetermination form and specifiesthat the form is to be completed and returned within seven days.

, e) SM 5 -This form may be used by the eligibility worker when the recipienthas neglected to retur the Redetermination of Eligibility form to thecounty welfare board.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #827

i\lay, 19ï1

391.1.

J-.

.,.

Dear

Your re.quest for public assistance has been received in this offce. In order to deter-

mine whether you are eligible for assistance, the enclosed form wil serve as a com-bination application and declaration of your need for assistance. The form should befiled in and returned to US.AS soon as possible, but not later than 7 days.

Please answer all the questions on the form and fi1 in the exact dollar and cents amountswhere money value is requested. Papers you have on hand, such as rent receipts, lifeinsurance policies, deeds, et cetera, will help you give the correct information, If you

do not fill in the form completely, it may be necessary for us to return it to you. Whena question does not apply to your own situation, write in the word "None. ll (If you needhelp in completing this form, it is all right to ask a friend or relative to help you, orsomeone from the welfare office may also be of help. )

\. .

It is necessary that you include the social security number on the application form op-posite the name of each person for whom you are applying for assistance. It win not

be possible for us to process your application unless a social security number is in-cluded for each member of the family. If you do not have these numbe'rs, we sugg~sttht you contact your local post office or social security office in order to obtain theforms needed to get the numbers.

May we repet, we wil be unable to process your application unless you include thesocial security numbers on the assistance application.

Each time a child is born, or a minor child who has been absent from the home returns,it will be necessary for you to obtain a social security number for the child and reportthe number and the child's name to the county welfare board.

After you have answered an the questions, please be sure to sign the form on the lastpage. If someone helpe you complete the form, please have that person sign the formalso in the space provided. However, if there is noboy to help you, let me know so

that we can make arrangements to assist you.

Sincerely

Ene. EligibiUty Worker(12/69)

SM 1 391-11

....4

1l,

4'

Dear

Recently we sent a form to you which must be completed as your application of need inorder to determine'financial eligiUity for assistance. This form has not been received

in ths offce yet.

If you have already mailed the form, please ignore this letter. If, by chance, you did

not receive this form, or it has been mislaid, please let us know immediately.

It is important for us to know what you have decided about continuing with the application.

If help is needed in fillng in the form, and no one is available to help, please let usknow. If it has been decided to withdraw the request for assistance, please let us knowthis also; otherwise, if we do not hear from you in 10 days we will assume that you areno longer interested in applying for assistance.

Sincerely

Eligibilty Worker

(12/69)

SM 2 391-13

""-4

...

..

,.. Dear

Thnk you for cooperating with us and returning your application and/or redetermina-tion to us so promptly.

\...

You have, however, missed one or two important questions which we have checked inRED. You must answer all questions or write in the word "NONE" if there is no othe:answer.

As soon as you fil in the space(s) checked, please return the form immediately in the

enclosed, self-addressed envelope so tht we can determine your eligibilty for assis.tance as soon as possible.

Sincerely,

Eligibilty Worker

"

(12/69)

SM 3 391-15

..-ll

.,,

Dear

Periodically the county welfare board requires certain information to determine if youcontinue to be eligible for ptblic assistance and to see how your social worker may beof help to you. We secure this information by mail through the enclosed Redeterìna~tion of Eligibilty form which we are requesting that you complete.

Please answer an questions on the form, Be very careful to fill in the exact dollar andcents amounts where mon~y value is requested. Papers you may have, such as rent

receipts, life insurance policies, deeds, et cetera, wil help you to give correct infor~

mati on.

After you have answered all questions, please sign the form. (If you need help in com-

pleting this form, it is aU right to ask a friend or relative to help you.) If someoneelse helped you with the form, have that person sign in the space provided. The formshould be returned in the enclosed envelope within the next 7 days.

If you need help in completing the form and no one is available to help you, please letus know. If any questions are not answered completely, it may be necessary to returnthe form to you.

Be sure to include the social security number for each member of your family livingat home. If any children have been born recently, it is necessary tht a social securitynumber be assigned to them as soon as possible.

If you need additional services or would like to have an intervew with your social worker,please feel free to contact ths office.

Sincerely,

Ene. Eligibilty Worker

. (12/69)

SM4 391- 17

....

..

. .

Dear

Recently we sent a form to you which must be completed in order toredetermine your eligibility for assistance. This form has not beenreturned to this office at this time.

If you have already mailed this form, please ignore this letter. Ifyou did not receive this form or if it has been mislaid, please letus know immediately.

\,

If you need help in completing the form, please let us know. If yoursituation has changed and you no longer need assistance, please letus know this also.

If we do not hear from you in 10 days, we will aSSume you no longerneed help with living expenses or medical expenses and it will benecessary to close your case.

Sincerely,

Eligibility Worker

(5/71)

SM 5 391-19

....,.

Social :-¡ork Hanuo.

Cho:pter "391 CASE ACl¡! OJ! FOn;:SSection );SPars. 1-3

."

S7'C"', "'tTT -i.S 1I'O-;-ïSIC-""S ':~PO"" 0": "''Y'- -\,'¡"Ti""'!O:T11 i:,--,:: =i 40g A"': flo:ori.iot~.; i.J.v...!: .40-# J..:ui .A .: 1. L .. L..u..'.. t..~.i ... , ..V...... J:l _ ..,J. 'J ..l'.i$~S r...'oæ 01: VISU.¿.L Z,X....l-!¡lAIO:¡II. FOri: P',í 46t',

Par. 1. Purose of Forms": Fore P'.: 409, "ib:rsicia.:i's Report on :iyeExe.oine.tion n, is the for~ to be used by the exro~ining ophthaioolo~ical physi-cian or Form PW 464, "Optonetristls Report on Visual Exaninationfl to be usedby the optometrist to indicate his findinGs a.s to existence and/or degree ofblindress of an applicari t for Aid to the 131indt and to cake recoi:endations asto eligibility for assistance. .

Par. 2. Routinr, of Forms Ei ther Form PW 409 or Form PW 464 is sentin dulicate to the county agency after receipt of the other certificationforos from the county agêhcy, or, upon instruction from the county aeeney, tothe ophthaL.'!ologist or optometrist of the applicttnt i s choice. l:he ophthal.01-ogist or optonetrist cO""letes the forns and returns both copies to the Divi-sion of Public Assistance. ~he originnl is then se~t to the Supervising Op~tnaLcologist. ~he original copy of the for. containing e designation of theSupervising Ophthalmologist' s a~~roval or disappr~¡ni, is retcined in thestate office and the duplicate with the ophthaologist i s ap?r~vai or disapproval is retured by the state departnent to the county agency.

Par. 3. Forms ¡-,Just :Be in Case rile - It is the responsibility of thecounty e~ency to ~eep copies of these forns pe~~en tly in the case file.

Pub1ie ~elfnre ~onrdof ~jorth Dakota

---Dece4.ber 1951~rnnsi:i tted by

).anua1 Letter *_,ai-2i;

R-#

l'W .~i)l-i(;~

(

l)UßUC WELFAltl ßO¡"i.HOOf" NORTH DAl(OTA

PHYSICIAN'S.. REPORT ON EYE EXA~llNATION

Application No. .....,....._,.._......_...___. .....

Applicant's name .~.. .... ...-~.~.. ~...o.~. ..... .....~ u.... a. ....... .0............. ........... ........... ...... .. .......... ...... .u. ............................. Sex..............,..._ ,_n. Race.....,.............. ,_._.__...

Addres .....,.. .........',.. .......,... ......... ,......... ...,...., .... m. ..........,.... ..... M._..~........,.. .,... ...,. _...,.._,....._.,........_____....._.._.........._.____18tricl and IllOmli. I IUunll',.II)') (CCWilr) (JltAl4)pale of ßirth .........................................,... ................. Ate at onst or bÜlHlnCSs': flght ej'e_....,...__.._...._.. left eye.._.___.._ n'". -"DIAGNOSIS: (ll primary ~)'e conditión or etiological I¡ctor Ullot Uie sae lor both eyes, divide space and indicate each J(patey,)

Eye condition priiarily responsible fo'r blindness ........ ..... ~.._.._,._......_......... ........._.._..___......_..,................ .........._.._..__....__.. ._._"'................_...................~........... tl...... .... .................t.......~..... ......................... ..........................".._.......... ......................... ..... ........... ............~........_................. ..... ........ ...................._.......... .._.................._...............""......_....__......

S~onda conditions if any ......,....... ,... ._......... ,......... ...,........ .., __. .._.................. ..... .....,....._.... ...............,_..,.,......,............ .....__....__.....__.....

....._................._.. .._..... ........ .... ~ ........ ........... _... ..-.. .... .................... ............ ...... ...."'...... .............,.... ............ ......... ....._..._......... ......... ......... ..........u ......................__....................._.""........................._..._..._....__.._.. .._.._

Etiological fac lor responsible for pr liar eyé condition.,... ......_............ .... ._............_.... ... ................ .._..................."......._......_.,... __........

If the.i:a is a history of eye injutJ. state t~,pe and date................,......___.._.........................................____......__._..............._.......__..__.....

Desribe the appearance of eyes, includig fundi._.... ..... ...,....,. ..... ....... ...........,........... ...m ..........._,..............._.........____,............_,....

. .......... ...... .........................ø......... ..... ..a .....".~........ ..... ...... ...... ,... .a..................... "................. ..........." ..................... ..... ................................... ........."...................... ....... ... "'........................_..........'!_.."'...

... ........ ........... ......... ...................... "....... ........ .....................,... .... h..~........... H..... .a..ø..a-_.... ........ ...... ....... ......... ...., ........... ................. ............. ............................_........"'.................. ..........".._......_.....__...

........--'!..................._._.....ø.......ø........................ ......... .a.. .a......a........." .............a................................a..................................................,..................a................._................._............_............_,.._...__........__

CEJ~RAL VlSUAL ACUITY: Vi'lOU'l ciL.3E1D\lUl (20 fut) Near 04 lii..) W1TH Ot.DIn,, (~ fhl) NUl (11 ~)Use SneIJen notations in :rècordng visions

as 20/200, HI/ZOO, etc. Use AMA l'eadlgcad in determinng DeaI viion.

Right 'e)'e ,.............._..........

I.ft eye .."......._....._...._. .........._......_...,._ _...,......._.,........ ,..,.,__.._.....PERJlIlEUAL VISION: (To be rclC'rded where accepted as a factor in blindnes on persM who$e centrl vision is SO enat as to

render them ineligible for aid to the blind in the St3te and who by rough ~ show a makto field deJec)'10 be done on amndard perieter with a Is there any litation in the fieldradlus of 13 lnche$ and II wrote test ob. " ? Ri h~ 6mm In cletel'. The tet object of \115IOn __n................._,................ g t Ese ......_.......... Left eye ..._..___ n."should he of such site tht it subùmds What is widest diameter in åegreesan angle of approximately one åelPee, of remaling visual field?.".., ""~ Right ei'e ,......_~....., Left eye __._._. .__

Prognosis (Is there any likelihoo tht visn could be resti- by operation or matment?) .....,......___~_....._........._________

+....+~+-.......~......¡+........... .................. ........" ....." ............................u'O ....... ........... ......... .............. ............. .... .......... ..a.. ..... ..... u ..... .............. ..... ........ ....._.....__................."......"'...... .._........-..._,._.._..._

Reominedn tiom- PrinJ'Y ej'C condi tion....... ......_ .... .... ...... ....__,. '.. '......, ,........_. .......................... ,.. ...... .............. ...... _........................__,.._

.............. ........... ............ ....... .......... ....... ......... .............. ........... ..... ....'..... ,-.,.. u... ....................... ..............._...._........"......".....I..............¡............... ................. ..............._..... ..............................._._.._.._....__.___.

\Uiicn dn lions-Etiological condition .. "n..... ..,... ....... '.......... ......,..........,............... ._........___..._...._._....__............. ..........,.... "'-;;".""'.':"

r~......:rks (Give dote when rtN~xaminntion should ~ made) ._.....:................................._;h........_ If none needed, so sttel

""......... ....a,..~... ..,. ....... ..,.... 0"" .'fø.~.. ....11 ..........'..., .. . ø............. ,... ..,........... ...... ........ ........ ........... .......................................""...4+. .... .......... ....... ...................._......... ................ ..........."'...................... ..,. ..............

"ate of eXBnimntlon'... ..............,..., ..-K äi;;~¡;;;"~T~';;" p;;y;i;~-i ï'...'. ...,.... .....,. on ,_....,

.,-I

PW ~,~ puei I C weirARE BOARD

or NORTH DAKOTA

OI'TO¡'ETR 1ST'S RE:lOiH ON Vi SUA\. EXANINAT ION

...APPLICATION NO.

APP!.I CANT'S NAI4£;

AOOR£SS

SEX RACE,

STREE. AND -ÑuTJ.a1ri-"

..COUNTYIl,UNlcllAL.ITY.

PAlE OF BIRtH _ AGE: AT ONSET OF BL.INDNESS: RIG.HT EV~

B. HISTORY or BL.INDNESS: WAS ONSET or BL.INDNESS SUDDEN OR GRADUAL?

STATE

LEFT EYE

IS APPL ICANT IN

PAIN OR DISCOMFORT?h:s OR NO-- -'

HlstORV or BL.INDNESS IN THE FAMILV:

C. PESCklÐE THE APPEARANCE or EVES: ARE EYES REO OR INlLAMEO?YES OJ' No

. DOES THE EYE OR SURROUNDING

. ARE PUPILS OILATEO?

. RtACTlON TO LIGHT?

AREA fEEL HARD TO THE TOUCH7.n .'

TOUCH? ___' ANY OTHER___' Is THE EYE OR SURROUNDING AREA TENDER TO THE:

FACTORS. INCl.UOINQ FUNOI:

D. CENTRAL VISUAL ACUITY:

USE SNELL.EN NOTATIONS IiR~ORO'NG VISIONS AS 20 200,10 200, ETC., USE AMA READ-IG CARD W OETERI., I N I NO: NEARVISlOlL

W l THOUT GLASSES WI TH GLASSESDISTANCE ~20 FT.) NEAR (1l¡ IN.) DISTANCE (20 FT.) NtAR (1~ IN.)

RIGHT EVE

LEFT EYE

C. PtRIPH£RA~ VISION: (TO 8E RECORDED WHERt ACCEPTED A$ A FACTOR IN BLINDNESS ON PERSOS ~~OSECENTRAL VISION Is SO GREAT AS TO RENDER THEM INE~IGie~E fOR AlO TO THEBL 1 NO I N THE S TATE AND WHO BY ROUGH T EST SHOW A MARKED fIELD DEFEe T. )

TO BE DONE ON A STANDARD PERI- IS THERE ANY Lll~/TATIONMETER WITH A RADIUS or B WCHES IN THE fIeLD Of VISION? . . RIGHT EYE LEFT EYEAND ;i \,'HI Tt lEsr OBJI:CT br;11 INDIIl14ETER. THE TEST OBJECT SHOULO WHAT IS WIDEST DIAMETeR INaE Of SUCH Sl2E THAT IT sueTENDS O£GREtS OF REMAINli~ VIS-AN ANGLE OF APPROXIMATELY ONE UAL FIELD? . . . . . . . . RIGHT EYE LEFT EYEDEGREE.

r. WHAT IS THE REFRACTION tRROR?

G. WH.L NEW GLASSES IMPROVE Vi SIOU?

H. ARt ANY CORRECTIVE l-\tASUR£S /HOtCATEtl?

I . RECOfo.MENOATIONSl__ .

J. GHOULO PATIENT BE REFERREO TO AN OPHTHALMOUOQlsT?

K. REMARKS: CIVE DATE WHEN ~~EXAMINATION SHOULD BE MAOE . i r NONE NEEOtQ, SO STATE.

DATE or £XAM1NATIONSIGNATURE of OPTOMEtRisT

()TE or REPORTADDRESS

JUNe 1'51

.....

Social Work ManualChapter 39 i CASE ACTION FOfUS

Secti on t'

Pars. 1-2

SECTION'S.C, "SOCIAL ItEPORT", FORM PW 443

Par. 1. Purpose and Use of Form - - Form PW 443 (Social Report) is to beused by the county welfare board in reporting the social conditions concerning each

applicant and family applying for Aid to the Permanently and Totaly Disabled, Aid tothe Blind, and for Aid to Dependent Children when one or both of the parents are phys-ically or mentally incapacitated, The form will also be used when a review of cases

of the medical and/or social aspects of these persons and families is requested by thePublic ~elfare Board or is desired by the county welfare board.

In order that as complete information as is possible be available to the county welfareboard in providing services .and assistance to these familes, each portion of the re-

port must be answered as completely as possible. This information is also essentialfor the Public Welfare Board in determining the extent of incapacity and eligibility forthe particular category of assistance for which application is being made.

Form PW 443 (Social Report) is to be completed in duplicate, with the copy retainedin the county welfare board's case record and the origil1a1 sent to the Public WelfareBoard with the certification for assistance or upon request by the state departent.

Par. 2. How to Prepare -- Following are instructions for the completion ofForm PW 443:

SECTION 1. Inormation in ths section identifies the assistace group in which theapplicant lives: '

Item A - Enter the name of the person applying for assistance,

Item B - Enter the case number which includes the county number, family

number; and program number.

Item C - Enter name of assistance program under which application for aid isbein made.

Item D - Enter all other tyes of assistance or servces being provided to

membrs of the family.

Item E - Enter name of any member of the family who has served in the U. S.Ared Forces.

Public Welfare' Boardof North Dakota

Transmitted by

Manual Letter #279

April, 1959

......

Social Work ManualChapter 391 CASE ACTION FORr-,1S

Section 1¡"

Par, 2

11.

ECTtON n. The information in this section concerns only the person whose physicalmental incapacity is the basis of eligibility for assistance,

)

Some of the items in this section are self explanatory whereas other items requirecareful reading of instructions in order to correctly classify and supply the infonna-tion requested.

The information requested is necessary to the county welfare board in approving as-sistance as well as providing servces, and to the Public Wel:are Bord in determiningeligibility on a physical or mental basis and providing consultation to the county wel-fare board regarding the situation.

.'

Items A, B, and C - Self explanatory.

Item D. Race-

1. White - Check Wapplicant or recipient is white. A person of Mexicanbirth or ancestry is to be reported as white unless he is regarded inthe community as an Indian or as a member of some other nonwhiterace.

2. Indian - Check if applicant or recipient is Indian or of mixed white andIndian ancestry, if enrolled on an Indian agency or reservation rolL. If

not so enrolled, he should be reportea as Indian if his ancestry is one-fourth or more Indian, or if he is regarded in the community as an In-dian.

3. Other - Check if applicant or case is neither white or Indian, as de-fined above, and enter race.

Items E, F, and G - Self explanatory.

Items H. Health Situation -

1. and 2 - Self explantory.

3. Mobility - The appropriate mobility condition to be checked should bebased on tnfonnation in medical records. or on careful observation oftLe applicant or recipient. or if that is not possible, on informationfurnshed by persons with whom the applicant is U ving, or a' combina-tion of these sources. The entry selected should reflect the habitu orcustomary mobilty pattern of the person,

JApril, 1959 Transmitted by

Manual Letter #279

Public Welfare Boardof North Dakota

391-30

..-.

Social Work ManualChapter 391

StCASE ACTION FORMS

il.

a. Housebound - Check the appropriate space if the applicant orlent is ordinarily confined to his place of residence because C'

chronic illness or disability. Do not classify applicant as ho',

bound if he is confined to his house or room because of a tem~.condition.

1) Bedridden - Check if applicant o.r recipient is customarì::.fined to bed because of his condition.

2) Chairfast - Check if applicant or recipient is customarilyto a chair because of his condition.

. .

3) Requires help of device or of another person to walk.

4) Walks without help.

If the applicant or recipient is customarily confined to his rof residence because of his condition put is neither bedridè:chairfast. check 3) if he requires help to walk. or 4) if he ':without help.

\.,'

b. Not housebound - Capable of activity outside of home or usualdence. (The term "home or usual residence" includes a roorrinstitution if the applicant is living in an institution,) Check tpropriate number if applicant or recipient is accustomed to 112:

his place of residence for any tye of activity outside; such a~

ing, riding. and visiting. Do not check if the applicant or ree:is occasionay taken to a doctor's office or a clinic for perio~cheek-up or treatment, or to the home of a friend or relative'visit. but is otherwise confed to his residence.

5) With help of another person - Check if the applicant or ree.needs the assistance of another person in getting about out~lus usual residence. irrespective of whether he needs a di;'

6) With help of a device - Check if applicant or recipient doefneed the help of another person to get about outside his us\:idence. but uses a device such as crutches. braces. cane,

wheelchr.

7) By self ~ Check if applicant or recipient needs no personalsistace or device in gettng about outside his usual resid..'

Public Welfare Bordof North Dakota

Transmitted by

Manual Letter #279

Apri:

-4

Social Work ManualChapter 391 CASE ACTIO;' FORMS

Section UPar. 2

fl.4, Personal services needed in essential activities of daily living - Check

one or more of the services, depending upon the number of essential

activities for which the applicant requires the assistance of anotherperson. The personal services checked should be based on medical

records, or on carefcl observations of the applicant, or on information

furnished by persons with whom the applicant is living. or on a combi-nation of these sources.

"

j

Entries shocld not be made by inference from the tye of impairmentpresent, For example, the worker might infer from the fact that anapplicant has had both hands amputated that assistance would be neededfor all functions - usually involving the use of the hands. yet personswithout hands can learn to perfonn by themselves many complicatedfunctions.

Personal services checked shocld be based on those services custom-arily required by the applicant but not those required because of a tem-porary condition.

a. In eating '- Check if applicant or recipient ordinarily needs the helpof another person in conveying food from the plate to the mouth. Donot check this item if the personal service required in relation tomeals is essentially assistance in the ambulatory function. For ex-ample, an applicant confined to bed or chair and to whom mealsmust be brought but who can use knfe, fork, spoon, and other eating

utensils, shocld be classified, with respect to service, under "In am.bulating" rather than under "In eating, ...

b, In dressing - Check if applicant or recipient needs any assistance in

dressing, or needs help with such details as b'.ttons, shoelaces, orneckties.

c. In taking care of toilet needs - Check if applicant or recipient is in-continent or otherwise needs help in the elimination functions. Donot check if applicant needs help in gettng to bathroom, but needsno help in passing urine or stool; such assistance, with respect to

ths service, should be classified under "In ambulating. "

JApril, 1959 Transmitted by

Manual Letter #279

Public Welfare Boardof North Dakota

391.32

....;f

Social Work ManualChapter 391 CASE ACTION FORMS

Section f\'Par. 2

..d. In ambulating ~ Check if applìcant or recipient needs personal as-

sistance in walking, operating a wheelchair, or other means ofmotion, Do not check if applicant uses such devices without helpfrom otherpersons;' Do not check here for applicants who are bed-ridden and sometimes require being carried from bed.

e. In activities affecting personal safety - Check îf applicant or recip-ient needs close personal supervision in assuming his perst"nalsafety because his movements in whole or in part are involuntaryor because he lacks judgment.

f. In none of above activities - Check if the applicant or recipient doesnot requii;e personal assistance or supervsion in any of the aboveactivities.

Item 1. Living Arrangements ~ Classification of the applicant's or recipient'sliving arrangement should be made on the basis of the person's usualplace of living without regard to temporary absence for visits to rela-tives or friends, :01' hospital care,

In own home - Own home should be defined as a house. apartment,room, or other dwelling unit with separate cooking facilities. The ap~plicant or recipient should be considered to be living in own home if inthe opinion of the worker he is in charge of the establishment or share.~

ths responsibilty with spouse or other persons.

In hospital-Check if applicant or recipient is a patient on a continuingbasis in a medical institution other than a nursing or convalescenthome. An institution to be classified as a hospita must meet two cn-teria: (1) it was established to proVìde medica care. other than nurs-ing or convalescent care only. and has the necessary professional per-sonneL, equipment, and facHities to manage the medical needs of pa-tients on a continuing basis in accordance with accepted standards; and(2) it is staffed by professional medical or professional nursing per-sonnel who have clear and definite responsibility to the institution inthe provision of medical services to patients, The term "staffed by"does not mean that the institution has to have resident medical or nurs-ing staff, but staff must be assigned and available to give necessarycare. Applicants and recipients in hospital on a montly rate basis

are to be included.

Public Welfarè Boardof North Dakota

Transmi tted byManual Letter #279

April, 1959

391 -33

......

Social Work ManualChapte r 39 i

.CASE ACTION FORMS

Section ¡"

Par. 2...

Ln licensed Nursing Home - A nursing home is a private home or an in~,

stitution, other than a hospitaL. licensed by the State Health Depart-ment, which undertakes to giye nursing services to persons il with di-sease, or who are crippled, infirm, or otherwise afflicted. (See CR-

1. )

~

In licensed Home for the Aged and Inrm - A home for the aged and in-firm is a home licensed by the Public Welfare Board of North Dakota

and operated by any person, institution, organization, or private orpublic corporation, in which three or more adults who are aged or in-firm and not related by blood or marriage to the owner or manager ofsaid place, are reCeived. kept and provided with food, shelter and

care for hire or compensation,

In other (specify) - An applicant or recipient living in any other arrange-ment not indicated above,

Items J and K - Self explana tory.

SECTION in. This section of the report concerns the entire family group with whomthe incap~citated person lives.

SECTION iv. This section of the report covers a minimum of information on the so-cial and health conditions of the entire family which is necessary to the county welfareboard in determining the effect of the incapacitated member's condition on the othermembers of the family, as well as the relationship of the other members to each

, other and to the incapacitated person;

SECTION V. Self explanatory.

r' CROSS REF ERENCES: CR-I Par. 7~ _Page 33 i .15a .:

~~

April, 1959 Transmitted by

Manual Letter #279

Public Welfare Bordof North Dakota

....PW 443 (Rev. 3/59)

SOCIAL REPORT

( FAMILY INFORMATION:",

A. Name of applicant

C. Type of assistace for which application is being made

D. Other public assistance or servce provided to members of the family:OAA_ AB _ AD APD CCS CW GA _ None

B. Case No.

E. Has any member of the family served in the.U. S. Anned Forces?

Name Serial No.

n. INFORMATION REGARDING P.ERSON WHOSE INCAPACIT IS THE BASIS FOR ELIGffILITFOR SECURITY ASSISTANCE:

A. NAME

C. SEX: 1. Mae_D. RACE: 1. White_

B. BIRTHDA TE

2. Female_(2. Indian_ 3. Oter (specify)

E. MARIAL STATUS: 1. Single.. 2. Married _ 3. Widowed

4. Divorced 5. SeparatedF. EDUCATION: Circle highest grade completed. 1 2 3 4 5 6 7 8 9 10 11

Other tyes of training or education:

G. RESOURCES:1. Has application been made for:

a. OASDI disability freeze?_b. OASDI cash benefits?

c. OASDI dependent's allowance'?

d. Workmen's Compensation'?_e. Unemployment Compensation?_f. VA benefits?

g. Oter benefi ts (specify)

2. Results of any applications måde.

H. HEALTH SITATION:1. Describe fuly the physical or menta health problems as observed by the caseworker.

2. Has any' psychological or psychiatric study or treatment been provided?

U so, a~ch copy of report unless ths is already on fie in the state office. 391-35

....4

PW 443 Page 2.

3. Mobilty:a. Housebound ~- fl._1) Bedridden_2) Chairfast_3) Required help of device or

of another person to walk_4) Walks without help

b, Not housebound ¥ capable of activitiesoutside home or usual residence --

5) With help of another person6) With help of device7) By self

4. Personal servces needed in essential activities of daily livig:a. In eating . _ d. In ambulatingb. In dressing e, In activities affectig personac. In tang care of toilet needs safety

_ f. in none of these activities.'

I. LIVING ARRANGEMENT:

in own home In hospitalfor the Aged and lninn

In licensed Nursing HomeIn other (specify)

In licensed Home

J, EM..LOYMENT (hstory and potential):1. List tyes of employment person has engaged in and specify dates of each tye of

employment.

2. Give reason for leaving last tye of employment.

3. Describe fuy how tls person's health impairment limits his work ability at the presenttime. Also. describe remaining capab1lties. If the applicant's occupation is housewife.describe her abilty to perform homemakig duties.

4, What tye of work does the person feel capable of undertking at the present time?In the near future?

5. Wht tye of work does caseworker believe person may be able to underte?

391.36

.- £,-~,;

..

PW 443..

Page ~~"

~

6. Wht help can the CVlB,provide in ths area?

...

,.-

:f ,/.,/

,K. REFERRAL FOR SERVICES OR ASSISTANCE:

11s a referral been made td any other public or private agency or institution for servcesor assistace?

Name of agency:,:-f

Purpose of referral:

Results: . '

lIT. FAMLY SITATION: .

A. Give nam":, age. and relationslup of all membrs of the famiy.

~B. Describe general living arrangements and condition of the home.

C. Describe any signicant factors of harmony or disharmony between or among members of

the family?

"

., i" . ""..

, ... -4 ..

. .'W 443 Page 4,'). Describe health problems (pk-ysical and mental) of all members of the family with the ex-

ception of those described under Schedule II.

E. Describe any signficant social problems.

..'

,. What services are needed by the famlly1

Are there any aspects of the case about wluch you have a question at ths time'?

Date Signture of Caseworker ,

. "'. . .. .Social Work ManualChapter 391 CASE ACTION FORMS

?Section lt

Par. 1

SECTION fl1"ME'ICAt REPORT, " FORM PW 444

Par. 1. Purpose and Use of Form -- Form PW 444 (Medical Report) is usedby the qualified physician of the applÜ;.ant s choice in reporting on the physical ormenta exmination of an applicant for or recipient of assistance. (See CR- 1.)

. The specific medical information desired by the county welfre bord is to be so in-

dicated in Section II,

.'

CROSS REFERENCES: CR-1 Par. 1 _ _ Page 315-4 _ ~

Public Welfare Boardòf North Dakota

Transmitted by

Maual Letter #310May, 1960

'.t', A'

....

P",' 444 (-l,l60)MEDICAL REPC RT

Case ~o.1. IDE0:1IFICATION: 'f.

Last Name First Name Middle ~ame Address

Age Sex

II. INSTRUCTIOi'S TO THE PHYSICIAN: It is necessary that this form be completed as indicatedbelow for the county welfare board. A letter can be inç.luded as part of the information. Inmental illness, obvious and known data should be described by the examining physician. Be

specific in the diagnosis and conform to medical nomenclature. Authorization to reveal thisinformatíon is signed by all applicants for assistance.

.nl.- MEDICAL INFORMATION ~UESTED:

A. Please complete the reverse side of form in giving:

Complete medical report

Progress report from(Date)

B. The reverse side need not be completed unless you believe it necessary for:

Recommendation of need for hospitalization or nursing home care

Recommendation of need for physical therapy

Report on drugs required (include daily dosage)

(Other)

iv, HISTORY OR REPORT: - - '. ....... ..~. ,. ..,.~..,.. I..... I.' ,.,.., ..~U..~'.ri.. 'u.'."...,.'......'~....,l...'...~~,... .."................._..,'.-.-........ "_"_'" ..._....,_......~..._...._,., ...__....._." ......... .._................. .... .... .,... ......, .....' ....~.~.~.... 'n'~'" .." .~... ,.., .,..... .....,..." _.-- .._-

-....~.....~...~...... ~ ....-.. ..~....".~.. .... .... ~.. ........ .... ....... ....~ ~........... ..........., u. ~.~ ..........~.... ..~.._...... ... ........~.. ~...._.. .... ......~ .n.. .......... ..... .. _... . ...__............. .~.. ................ ... ......u.'.. .... ~.. '."~"'''' ........ ........ ~.. . _.. _. ._. _..... ,..

I...'.. "'" ..,~,..,."" ",....... n. 'n,. ,....,". .....,~'.. ...¥..._" ........~,... ...-n..~.~....N.".......n........,........ ..............,............_..__~. ..............__._._..__..._... ......"... ........ ,.....,"'.. ..".....~.. ,.. ..~.... ,.............~.~.........~..._.~...j.. .._......

..~"..~. '''n"'",,,,, .~.... .....,,...._.,....... ... n..., .~.........__.... .H.... ......... ...............~h..... ......._._..~._.... .,_. ............, ........ "'.' ..... ....~. .........,.. .",,,.... ...,.. It.., ,..n. .~..'" ....,_. '_"~""'''''''''''''_'''_'''' .._..... .._...._.....~... ......" oW.

~.. .,.-u..."'~...........,..H.. ....."'......................r.....~.............. ............ ,..~"..... ..........~............ ........,........~.....'r......._..~........~..~.......... .~.._. ...__....._...~_.d...~_....... ........., ........... ......' ,'_'F"'_'" .., .".....".'.'.'." ....". .._..' ,

_.'...~..._....,_...~..~.... ..._....._................_..........~..."...........¡...._.._...~~..._...__...¡._..._..._,.. ........,~...._............... ",.0".,.,_ '.M.....'.......,..uu~..a..'''.....,...... ,................_....___....-..........._..... ...... ...... ,....... ..", i."., ... .... ...

..............,..._...................,......_.....................n.......~..............._............ .........;..............,............ ;........,........,............,........". ,u........,.....~.'n....'........',.................--.....--.........,................'.' ..,.....-..............""....-:....

.... ,~......... ,....... ............,,, ....,.................. ...,. I. u, '''UHu.. ,... ,.u ...... ...11 ,...., ...".,... ....",.,~,.,.......--.... u.' .....i'.~U.............,--..,........,. ...........~.._......h....~._.... ..., ......." H' r.....1......i.....~..........~...~......H........ ..... ", ."...

'... ............ .u.,"'., ...., .. ... "",_," ""~'" _,.. I. ,~, ..,.. ,... ..~... '~"""'." ,.,... ..... ,. ,.....................,.......,...........~......;..~....,.............................~...._u_...,...,.. ..............~..a..__...........u... ......."..., ... .,................ ......~...... ....

_...... ... .... .......~.._... H...._ ,.,.,~.~,...".... ,....,".,.""..., ,.. .......... ......,..., . '...~,........."..-. '.."...H...........",..........,........................a'.........._..._............ ....., ...,.,.".. ........n.....~._.._.............,_._.,' ."., ,- "" ,,,.. ,.,..... .

..,..... ..... ........,......... ...... ..." ...... ...... .... ,u.. ..... ....."... ...... .......in.....' ,............. ......,. ...................................... ...'_........................~..__....... ,..._..........,...., ...,.... ,.~. ....' ............-.-........- uh. .... ........ ,..... ¡

....... ,.......".. ,., ...... .,.., ....." ..., '''H' ..,... ,.,.... ................... ......~..,.,." 'I'ti ............. ...........-.._~...u".._...............,..,......-i............... ............~....U .,'"".................... ._. ......._.......h...............H ...~...~..,. . '1., .........--...-. -. _......,,'

.......~u.. ...~...............~.. ....... ..._.. .... ...., .U.........~.............~h....._. ............U.......... ,.............................. .................... ....,...~.~......... ".. ".........._.- .u...~.... ....d....... .....'....~'....b'... .~....,.. .......... n' ,~"" -.............. ..

...,......,....,..,,,..'.....IC'....'..'l'.'....,,,,,.t..,...,.........-n'............,..""..."..,.......,...,.......,..............._..,..............,........._...........,...,".".....,.,.-...,..',.....................,....,.,.,..."..-"..,..".,

.. ....~,......., ....._...~. .... ..... ...._. .... .~._. ._U.................... ._. .... ...................... ........... ..... ..... ............ ........ ..hI....."..... n' ........ ."........"..., -, ..... ....-.-.... .....,.".. -,..., ,."",,,,, "'.'''p' -,., .. ...... ........ .,...,.., .

.., -4

V, PHYSICAL EXAMINATION: (Complete those of the following items which have diagnosrksignificance for this person.)

a, Height '.Veight fl,

b, General Examinatìon: (Abbreviate Negative N, Positive.€.)

Eyes Ears Nose ThroatAdenopathy_ Abdomen_ Pelvis_

Blood Pressure

Neck

Rectal

Heart Lungs

SkinExtremities

Vision: With glasses (if worn)

Is refractíon indicated?

Rt, Lt.

Note positve findings: (General appearance, N, B. in arthritis especially describe de~formities, limitations.) ..

. VI. LABORATORY TESTS AS INDICATED:

VII. OTHER DIAGNOSTIC PROCEDURE:

VIII. CONCLUSIONS:

a. Diagnosis: (1) Primary Disability

(2) Secondary Diseases

b. Adequacy of recent treatment

c. Type of work recommended: Present

Future

d. Recommendation for treattent or rehabilitation:

\ùate) M...(Signature of Physician)

Address:

.,....,

Social Work ManualChapter 391 CASE ACTION FOrU\'1S

Section 8

Par, 1

SECTIO~ 8. "STATE ItEVlEW TEAM REPORT," FORM PW 445

Par. 1. Purpose and Use of Form -- Form PW 445. "State Review Team Report, ..is used by the State Review Team in :teporting its findings concerning incapacity in Aidto Families with Dependent Children and disability in Aid to the Disabled. These findingsare based upon the team's consideration of social information transmitted by the county

welfare board on form PW 443, "Social Report;' and medical information contained inform PW 444, "Medical Report. "

Form PW 445 is also used to indicate an individual's primary and secondary diagnosis,the basis for the State Review Team's finding, whether or not a future review of theincapacity or disability is ~teded, and if so, the date of such review.

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #763

May, 1970

391-45

..-4

PW 445 (Rev. 3/70)

STATE REVIEW TEAM REPORT..'

Social Security No.

Name of Applicant Case No.

Address

Do the medical and social facts indicate disability (AD) or incapacity (AFDC)?Yes or No

Pr.imary diagnosis code

."Secondary diagnosis code

Basis for team decision:

Medical-social review needed?Yes or No

If needed, date for medica1-$ocial review:Mo. Day Yr.

Signed: M.

Medical Reviewer

Social WorkerDate:Mo :-Oay

..-4

Social Work ManualChapter 391 CASE ACTrON FORMS

Section 9

Pars. 1.2fl,

SECTION 9, REFERRAL TO WORK IN'CENT1VE PROGRAtv1 - FOR~lS PW 136."REFERRAL Aì'1) ENROLLME0rT FORl\lt, PO AND PW 137. "E;-1PÏ.OY-ABIUTY REFERRAL fORM"

Par. 1. Purpose of Forms -- The purpose of these forms is to facilitate thereferral to the employment service of AFDC recipients who are considered by thecounty welfare board to be appropriate for employm,ent or vocational training which

will lead to employment, The two sets of forms, in order to constítute a formalreferral to the WIN program, should be forwarded together to the employment service,

The manner in which the forms are to be completed and the routing are outlined in thefollowing paragraphs. .'

Par. 2. "Referral and Enrollment Form, .. Form PW 136 -- This form is to be

prepared in quadruplicate. The first, second. and fourth copies are identicaL. The

third copy differs from the others in that the bottom portion contains information ad-dressed to the applicant or recipient.

The form is divided into four sections. Section 1. to be completed by the county welfare

board, certifies the referral of the individual to the WIN program. Section II, to becompleted by the employment service, contains the statement of consent or refusál ofthe individual to enroll in the WIN program. Section II is to be completed by the em-ployment service only if agreement is reached with the county welfare board that areferral should be canceled before enrollment takes place. This section describes the

. giving of particulars relative to an applicant's or recipient's refusal to participate inthe WIN program or to take available employment.

After the county welfare board completes Section I of the form, the first and secondcopies are mailed by the county welfare board, along with an "Employabilty ReferralForm,l1 form PW 137. to the employment service. Copy number three is to be givento the individuaL. It wil (1) constitute written notifcation of his referral, (2) inform

him of the right to a fair hearing. and (3) advise him that the employment service wílschedule a date for his interview. Copy number four is to be detached and held by thecounty welfare board pending a report of action by the employment service.

When the applicant reports for his appointment with the employment service. that agencywill complete Section II in duplicate. Space is provided for the applicant's signature, If,

he refuses to participate and will not sign. an indication is made of that fact. Copynumber one shall remain with the employment service and copy number two wil bemailed back to the county welfare board,

Public Welfare Boardof North Dakota

Transmitted by

Manual Letter #754

April, 1970

391-49

J-l

Sodal Work Ì\1anualChapter 391 CASE ACTION FORÌ\rS

Section 9

Pars, 2~3

..If the employment service learns of additional information about the individual \\híchcasts doubt on the appropriateness of the referral and if the county welfare board upon

consultation agrees that the referral is not appropriate at this timet the employmentservice wil fil out Section III and return copy number two to the county welfare board,

This referral is then canceled by the county welfare board.

.

If the applicant refuses to be enrolled in the WIN program, details wil be given by theemployment service about this refusal in Section iV. If a jòb assignment has beenrefused, details are provided about the kind of job involved, its location, duties, wages,et cetera, and why the individual refused it.

Par. 3. "Employability Referral Form. " Form PW 137 -- The "EmployabiltyReferral Form" provides basic information about the AFDC recipient who has been

determined by the county welfare board to be appropriate for referral to the WIN pro-

gram, It is to be completed in duplicate with the original being forwarded, along withthe first and second copies of form PW 136, to the employment service. The copy ofform PW 137 is to be added to the individual's case record, All documents. should bearthe same date of referraL.

In Item At check one box only to indicate if the referral is for Ù1e Work Incentive Pro-

gram or for services provided by the employment service. In the space provided fordate of referraL. Item E, enter the date the form is completed and transmitted to theemployment service. In Item C, give the name and address of the county welfareboard as well as the name and telephone number of the contact person at the countywelfare board. This may be the name of the caseworker; if the agency chooses tochannel all contacts through one person, give the name of the coiirdinator. Enter the

name and address of the employment service in Item D. When the name and telephone

number of the contact person at the employment service becomes known, it can be!:a..dwritten in Item D for future use.

Applicant Information

1. Name, address: and telephone number of applicant: Ènter the applicant's lastname, first name, and middle initiaL. Also, enter the complete house number,street, city, state, county, and zip code of the applicant's place of residence. and

the telephone number, if any, though which he can be reached. Check the appro-priate box to indicate if this is the applicant' s telephone or that of a contact,

2. Case Number: Enter the applicant's (family) AFDC case number.

3. Social Security Number: Enter the applicant's nine-digit social security numbr.

4. Sex: Check the appropriate box.

April, 1970 Transmitted by

Manual Letter #754

Public Welfare Boardof North Dakota

391- 50

..~,"

//

Social Work ManualChapter 391 CASE ACTION FORivIS

Section 9

Par. 310.

5. Date of birth: Enter the month, day, and year of birth.

6, Language(s) spoken: Check the ~ppropriate boxes to indicate the language(s) spokenby the applicant. If "Other" is indicated, specify,

7. Resides in public housing: Check the appropriate box.. Public housing refers to

individual dwelling units usually within a complex operated as a public housingarea by a local housing authority.

8. Type of applicant: Check the appropriate box to indicate the type of applicant."Unemployed fat!-er" and "AFDC mother" are selt-explanatory. "Youth" includes

those 16 through 20 ye1lrs of age who are not married, not head of a household, notin school or in training, and for whom there are no educational plans under consid-eration for implementation within the next three mor~ths, "Other" includes allother caretaker relatives and essential persons not included in the first threecategories.

9. Applicant only AFDC referral: Check appropriate box to indicate if applicant is theonly member of the AFDC household referred to the WIN program.

10. Amount of AFDC money payment for month prior to referral: Self-explanatory.

11. Lengt of time on AFDC: In the boxes provided, enter the total number of con-secutive whole years and months the applicant has been on AFDC since the mostrecent opening of the case. Also, enter the total numbr of years and months onAFDC during the last 5 years.

12. Dependents: A dependent is defined as a person in the household whose needs andresources are taken into consideration in determining the amount of the assistancepayment. In the appropriate boxes, enter the total number of dependents and thebreakdown of the number of child and adult dependents of the applicant; that is, thenumber of dependents under 6 years of age, the number from age 6 through 15, 16though 20, et cetera.

13. Persons in household for whom care must be arranged: In the boxes provided,enter the total number and the breakdown of the number of children and/or adultsin the household for whom care must be arranged (either by the applicant or thecounty welfare board) in order for the applicant to participate in the WIN program.This would cover child care, nursing care, homemaker service, et cetera.

Public Welfare ßoardof North Dakota

Transmitted by

Manual Letter #754

April, 1970

391-51

..-4

Social Work ManualChapter 391 CASE ACTrO~ FORMS

Section 9

Par. 3

..14. Conditions relatin;: weare for dependents whích may have a bearing on work ex-

perience and training activities or employment: For instance. the planned childcare may have no flexibility of hours. and the employment activities must beplanned within those hours. There may "be older children or adults with special

needs, arising perhaps from such conditions as mental retardation. physicaldisabìlitíes. et cetera, which affect the availability of the applicant.

)

15. Employabilty services already provided the applìcant: ' This information wil beavailable i.ii the applicant's case record. Check each box that applies, More thanone box may be checked. The first two items are self-explanatory. "Other welfareprograms" means education and/or training provided under the service amendments."Vocational Rehabilitation" meas services provided through the Division of Voca-tional Rehabilitation. "MOTA and other Manpower programs" means participationin MOTA, Job Corps, Neighorhood Youth Corps, et cetera,

16. Description of employability services already provided: Give information about

each of the items checked in Item 15 as fOWld in the case record for the applicant,Give, as available, beginning and ending dates of involvement in the program(s)

and a description of what was provided in it (them), such as basic adult education(first and last grade), high school equivalency work (first and last grade), kind(s)of work experience, kind(s) of vocational training, et cetera. This information is

intended to inform the employment service of work experience and training pro-grams in which the applicant has already participated in order to avoid duplicationof effort and furnish a basis for building on these activities for the further improve-ment of the applicant's employabilty.

17. Date of medical examination: Give date of medical examination. If the examinationis scheduled but not given before referral for a good reason, indicate reason anddate when scheduled.

18. Limitations, if any, on employment and/or traiing activities arising from physicalor mental conditions: Ths information will be available from the examining

physician's report on this question or from other health reports in the applicant'sfile. Such information which bears on the individual's employability is necessary

to help the employment service make a proper training or employment placementin the interests of the individual's welfare and his capacity to perform satisfactorily.Health information other than that relative to employability should not be given.

19. Characteristics of the apI'licant which have a relationshiI' to employability: Suchinformation will come from the agency's knowledge from working with the applicant,Very confidential information should be taken up personally with the employmentservice counselor when meeting to work out a plan for the applicant.

)April, 1970 Transmitted by

Manual Letter #754

~Public Welfare ßoard

of North Dakota391-52

..-#

Social Work ManualChapter 391 CASE ACTION FOR1\'IS

Section 9

Par. 3

..20. Interests or the applicant relating to emplo)iabilitr'. Describe the interests of the

applicant as expressed in everyday living, recrea:ion, et cetera, Jobs held by the

kinds of persons he admires, any vocational aspiration he may have articulated,et cetera. Such observations wi1 be helpful to the employment sen.ice in planning

a vocational goal with the applicant,

. 21. Other factors affecting employment and/or trainin~ This might include, for example,details of a factor like probation which sets geographic limitations on the applicant.reporting requirements, et cetera. Give these and other facts about the conditions

of probation so that employment and/or trainig can be worked out around the con-ditions. Information in this section may also give some indication of suitable areas

of occupation and have"a bearing on whether or not the applicant is bondable.

22. AppHcant volunteer: Self-explanatory.

'1..

Public Welfare Boardof North Dakota

Transmitted by

i..1anual Letter #754April, 19ïO

391.53

..-4

PW 136(Re~. 4/70)

Copies 1, 2, and 4

1".

REFERRA AJW ENROLL.'1NT FORMWork Incentive Program

SECTION I. FOR COUN WELFARE BOAR USE - REFERR

(Name of Applicant - Preface with Mr., Mrs., or Miss)

Pub 11eAssistanceCase No.

..

(Address of Applicant - street name and no., town, state, zip code)

CERTIFICATION: I certify the referral of this individual to the Work IncentiveProgram. The Employability Referral Form is attached.

(Name of county welfare board) (Da te)

(Address of county welfare board)

(Name of Person Certifying Referral) (Telephone No.)

SECTION II. FOR EMLOYMNT SERVICE USE - ENROLUiENT OR REFUSAL

The Work Incentive Program has been explained to me by the Fmployment Ser'l1ice and

o I agree to participate c= I refuse to participate

This applicant

(Signature of Applicant)

o has been enrolled 0 refuses to be enrolled.(Date)

\.

(Name of Employment Service) (Dà.te)

(Signature of Employment Service Official)

..~

'f,

)

SECTION !Ii. FOR EMPLOYMENT SERVICE USE - REFER..L RECALLED bY COmiTY HEU'ARE BOARD

Descri~e circumstances.

..

SECTION iV. FOR EMPLOYMENT SERVICE USE - RESON FOR REFUSAL TO PARTICIPATE

If the applicant refuses to be enrolled, give details. If the refusal is to take ajob, describe job, its location, wages, et cetera, and why the applicant refused it.

.l

"Buy North Dakota Products"

391 -56

..-4

PW iSï p,.ig~ 2

"~ ::. Persons in household for ,,'hom care (child care, nursing, etc.) must ÌJc r.n'am;~cd.

Ages shown are inclusive. Give numbers. .

Total :\one Under 6 ears 6-1~ ears i 6- 20 e:ir s 21-64 ears 65 anù over

14. Describe any conditions of planned child or other cure which may have a bearing on

work experiënce and trainìng activities or employment.

o'

15. Applicant has participated in the following. Check box(es).

o Community Work and Training Program o Vocational Reìiahilitation

o 'Title V, Work Experience andTraining Program

o MDTA and other lvnpowerprograms

o Other welfare programs

16. If any of the items were checked in 15, describe the work, education and/or training

received in the checked program(s), giving the dates of involvement, and other servicesprovided :,'')' the welfare agency relating to employability.

,-,.'

17. Date of medical examination

391-60

..PW' 137 -.

page 3

18. Describe the limitations, if any, on employment and/or training activities arisingfrom physical or mcntalo,conditions.

. ."19. Describe characteristics of the applicant which have à relati0!1ship tQ employabilty

such as unusually shy or aggressive, slo_w pr quick to comprehend, articulate orinarticulate; requires constant encouragement; et cetera.

...., -

. "

20. Describe interests of the applicant which have relationship to employability.

.... ., .

21. Describe other factors afecting employment and/or training such as court orders,garnishment of wages; et cetera.

22. Did the applicant volunteer for participation in the Work .Incentive Progam?

DYes D No

"Buy North Dakota Products"

391~61

r" ,,-.

Social Work ManualChapter 321

ELIGIBILITY FACTORS OF AID TOFAMILIES WITH DEPENDENT CHILDREN

Section 4

Par, 1

SECTION 4, AID TO 1'AMILlES WITH DEPENDENT CHILDREN - FOSTER CARE.

p~i,., ~. Él,igibiUtf -- TJ;e 1967 Amendments to the Social Security Actauthoriz,ed féderal. participation in the financing of foster care for children throughAFDC under c.ertain conditions. Consequently, federally-matched AFDC Foster

C,are, payments, 6,lla,li be provided in behalf of any otherwise eligible child who,after April30i i~61, was x'emoved from the home of a relative by CI"11rt action

because of conditions contrary to his welfare and placed in licensed \ ,1' appJ:ovedfoster care. and either:

,',,.

a) Was a'l'ecipient of AFDC during the month court action to remove the

child was initiated or during any of the six months preceding the"cô.Ürt 'action; 01'.-

~), 'Wotild.'havê beElÍi eligible for AFDC~ùuring the month court pction wasfnítiâtedordnring any of the preceding six months if application forassistance. had been made; and".' . -, ,

c) Whgse fQster home placement. care, and supervision are the responsibility" of the county welfare ,'noard, the Pepartment of Social Servces. or the

,'.' \'. gover_nrn~mtal '\-pit having jurisdi6tion. '

A copy of the court's order to remove the child from his home must be on file.

In addition, any child whose foster care is to be financed through AFDC must besafeguarded by a service plan which insures that:

a) His placement with a foster family or a child care institution is in accord-ance with his needs;

b) His need for and the appropriateness of his care and services in such

placement will be reviewed not less frequently than every six months; and

c) Services will be provided to improve the conditions in the home from whichhe was removed to facilitate his return or to make possible his placementin the home of another relative if such planning is preferable to the fosterhome arrangement.

Eligibility and other factors relative to foster care which is not matched withfederal funds are described in Chapter 423.

'\'-

TransmItted byManual Letter #938

,JUlY" 1973, ',l. "'~,.

Social Service Boardof North Dakota

321-25

. . ...."

Social Work Manual ELIGIBILITY FACTORS OF AID TO Section 4Chapter 321 FAMILIES WITH DEPENDENT CHILDREN .. ',I Pars. 2-6The amount of the mont~y foster care payment fs determined by sùbtracting a.y

deductible inoome available to a child from his total neeq. Fçister, parents may,'I . ~- . .sometimes wish to contribute their servioes fre-e of charge or-at a lesser rate~ihanthe established standard. The coun~ welfare board shaii.c0n.ye~t aJY suoh in-kindcontribution to a monetary value in tfiemanner~described irfÇhapte-r,3,J,8-35. ,Par. 16 and deduct it as income. .~~~ t, :, " "~',

-,' ".: .'r ..: ':~ ....., ~; . :. ~ '.. . .Foster parents who move from North Dakota to another state w~ththeir .fdstèrchildwill continue to be reimbursed on thf same basli)as for those, 'liVirtgwithirl the'state. "", ,'., ', '. ,. ,

Par. 3. Rate for Handicapped Child -- A family foster care rate may benegotiated in excess of the standard :rate when tIe 'chUg in qnestion bas a handicapwhich significantly affects ,lis adjustment or,.the cosJ 9f,,h,saar~.,, Such a handicap,however. must involve a substantial physical, ' emotinns.l.' ol.behaviQ,ral problem.The special rate must be approved by the state department onthebásis-:üf thecounty welfare board\s written 'report(lf the pertiß~nt fapta: surz:ounping the requestfor increased compensation. The'l'port.sbpuld be. rOtw:~'d~q.'l)s,'~W,1i~t~chinent toForm 423-1, nFosterCareStatus." , if., ,!;d-i~:~'!~,:;"r/' ,

Par. 4. S~ecial Clothing Allowance -- A child entering foster care with aninadequate wardrobe may l1áve his initi~l 'cÍothirig;inciHíding ã:'layétte. suppliedthrough a special allowance. Likewise,' a specia.l" allowance may be authorized:

to replace clothing lost in a fire. 'nood~ or',otber disaster. or because of a child'ssudden and unusual growth.

Age

o - i year1 - 4 years5 - 12 years13 years and over

,Maximum Initial Allowance

$ 50SO

100160

Par. :;. Application and Certification -- Application for AFDC-FC payment maybe made by the person(s) legally responsible for the support of a child. the fostercare parent(s). or the director or other authorized representative of the county

welfare board. The superintendent of the State Industrial School may make theapplication in behalf of any child who is being placed in foster care from thatinstitution.Form la. "Application for Assistance in Behalf of Others, n is to be completedaccording to instructions outlined in Chapter 391, Section la.

Upon establiShing that technical and financial eligibility exists for a child. thecounty of legal residence shall certify such eligibility to the Administrator ofAccounts and Audits on Form 423-1. "Foster Care Status. t1

Par. 6. Residence -- A child's residence. state and county, is determined

according to the principles described in Section 1 of this chapter.

:::" ....S~cÌ:al Service Board-,. "; ótNórth Dakota

Transmitted byManual Letter #980

May, 1974

(;t.".; ~~~321-27

. , . 'o"'

-4Social Work ManualChapter ,,?,fi 1

ELIGlBILllY FACTORS OF AID TOFAMILIES l\lI'n llEflENDENT CHILDREN..;----~..._"'..._-""

Section 4

Pars. 12-13

PSl". 12. Medicaii:":rvices -- Prúvisio\1 for' a chilrr s necess&J'Y medical

servi(~cs, inc1uò.ing m~dicallY-l'elated transportation, shall he ilride in accordanci

with policies 8.nd p~oceduX'es deSúï'ib(:d in Cht\pters 330 and 331,

PUT'. 13. Differential Roles of~~~aff' -- The AFnC- FC Program requires certain_.c._..--,. .,.',__,___,.joìntly"r;lanlíed an.d coo:rdhiate(l s.ütiviti(;~; betw6~n tlis~ income mßinterltlnCe andsocisl sl.;r,vicoß staffs, De:c:i,it~ tlH,!h: iu1.er)'"eJah;driem). however, tll0re is aclesdy"defined üÜJtÜ:iction in their' l'olt's. activití€~~, and responi:,dhUities.

.

Ii!00me maintenance personnel's responsibilities are restricted to (1) determining

ü, chn(~' f1 tf.ê!lmicaJ and financial eUgibilty. Gu esta.blishing the s.ppropriate rateof payment and f,rl'imging for its timely delivery, and (3) reviewing' continuingeligibiJHy, M: røquirt'd. ...

Sor'i,ih..l.'~ st£lff f,1,,-,;tJvity will be directed towanIs (1) assi.sting l as ~'equired by theconrt, in detÐKmining a chiUi.s need for foster care. (2) finding. investigating.

anó líeansinc fuster homes. (3) arranging for and supervising 8 child's placement

in ae~Gròan.;e íf.ith his individualized needs, (4) periodicaly reviewing hiscontinue6 need for care in a substitute home. and (5) working with the child'sparents or other relative towards his eventual return home, if appropriate.

"July, 1973Social Service Board

of North Dako.ta

Tr~nsmitted by::\'Ianual LeHer #938

321- 29