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| Montana Administrative Register Notice 37-657 | No. 21 11/14/2013 | |
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BEFORE THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES OF THE STATE OF MONTANA
TO: All Concerned Persons
1. On December 4, 2013, at 3:00 p.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, at Helena, Montana, to consider the proposed amendment of the above-stated rules.
2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on November 27, 2013, to advise us of the nature of the accommodation that you need. Please contact Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.
3. The rules as proposed to be amended provide as follows, new matter underlined, deleted matter interlined:
37.70.107 REFERRALS TO THE (a) investigate matters relating to low income energy assistance including, but not limited to, (b) (c) whether the overpayment was due to: (i) a false or misleading statement or a misrepresentation, concealment, or withholding of facts; or (ii) any other action intended to mislead, misrepresent, conceal, or withhold facts. (2)
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
37.70.311 PROCEDURES FOLLOWED IN PROCESSING APPLICATIONS (1) The procedure for determining eligibility for low income energy assistance is: (a) An application is filed by the applicant together with verification for determining financial eligibility and benefit award. After an application is filed, the local contractor may request any additional information or documentation needed to determine the eligibility (i) through (3) remain the same.
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
37.70.401 DEFINITIONS (1) through (8) remain the same. (9) "Incurment" means that portion of a medically needy recipient's income that exceeds the department's medically needy income level for the size of the filing unit. (9) through (12) remain the same, but are renumbered (10) through (13). (14) "Medically needy" means an individual or family otherwise eligible for Montana Medicaid but whose income exceeds medically needy income levels. (13) through (28) remain the same, but are renumbered (15) through (30).
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
37.70.402 GENERAL ELIGIBILITY REQUIREMENTS, ELIGIBILITY REQUIREMENTS FOR CERTAIN TYPES OF INDIVIDUALS, AND HOUSEHOLDS (1) remains the same. (2) Except as provided elsewhere in this rule, households which consist solely of members who are eligible for and receiving supplemental nutritional assistance payments (SNAP), supplemental security income (SSI), TANF-funded cash assistance, or county or tribal general assistance are automatically financially eligible for low income energy assistance benefit awards. (3) Households which consist of members receiving SNAP, SSI, TANF-funded cash assistance, or county or tribal general assistance, and other individuals whose income and resources were not considered in determining eligibility for SNAP, SSI, TANF-funded cash assistance, or general assistance are not automatically eligible for low income energy assistance but must meet the financial requirements set forth in this rule. (4) Individuals living in shelters, including but not limited to, recipients of SNAP, SSI, TANF-funded cash assistance, or county or tribal general assistance, are not eligible for low income energy assistance. Individuals living in licensed group-living situations as defined in ARM 37.70.401 may be eligible if they meet all other requirements for eligibility. Individuals living in licensed group-living situations which are not group-living situations as defined in ARM 37.70.401 are not eligible for low income energy assistance. (5) through (9) remain the same.
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
37.70.406 INCOME STANDARDS (1) Households with one through seven members with annual gross income at or below 60% of the estimated state median income for federal fiscal year (FFY) (2) remains the same. (3) The table of income standards for households of various sizes for the (4) Households at or below 60% of the estimated state median income amount for FFY
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
37.70.407 EXCLUDED INCOME (1) (a) through (z) remain the same. (aa) amounts paid to satisfy an incurment for the medically needy programs.
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
37.70.408 RESOURCES (1) through (3) remain the same. (4) In state fiscal year (5) remains the same.
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
37.70.601 BENEFIT AWARD (1) Except as provided in (2), the benefit matrices in (1)(c) and (1)(d) are used to establish the benefit payable to an eligible household for a full heating season. The benefit varies by household income level, type of primary heating fuel, the type of dwelling (single family unit, multi-family unit, mobile home), the number of bedrooms in the dwelling, and the heating districts in which the household is located, to account for climatic differences across the state. (a) and (b) remain the same. (c) The following table of base benefit levels takes into account the number of bedrooms in a house, the type of dwelling structure, and the type of fuel used as a primary source of heating:
TABLE OF BENEFIT LEVELS
(i) SINGLE FAMILY
(ii) MULTI-FAMILY
(iii) MOBILE HOME
(d) through (2) remain the same.
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
37.70.901 EMERGENCY ASSISTANCE (1) through (4) remain the same. (5) Subject to the provisions of (6), after a household has requested emergency assistance and provided proof that it is financially and otherwise eligible for such assistance, the contractor shall provide some form of assistance to resolve the emergency: (a) remains the same. (b) within 18 hours after the request is made, if the emergency is (6) through (8) remain the same.
AUTH: 53-2-201, MCA IMP: 53-2-201, MCA
4. STATEMENT OF REASONABLE NECESSITY
The Department of Public Health and Human Services (the department) is proposing the amendment of 37.70.107, 37.70.311, 37.70.401, 37.70.402, 37.70.406, 37.70.407, 37.70.408, 37.70.601, and 37.70.901 pertaining to Low Income Energy Assistance Program (LIEAP). LIEAP is a federally funded program to help low-income households pay their home heating costs.
ARM 37.70.107
The department is proposing amendments to this rule to specify its designation of the department's Audit and Compliance Bureau, rather than the Department of Justice (DOJ), as the unit authorized to investigate matters relating to low income energy assistance including the claim for an acceptance of benefits by recipients and the receipt and disbursal of funds by the department or the local contractor. As a means of preventing fraud, waste, and abuse, this designation will allow the Audit and Compliance Bureau to accept fraud referrals and requests for investigation from the LIEAP Program. It is more appropriate for the Audit and Compliance Bureau to investigate possible fraud because they are more knowledgeable about the department's programs and may already be investigating a related incidence of fraud in other programs.
ARM 37.70.311
The proposed amendments to this rule specify the timeline, for applicants to provide additional information or documentation needed to make an eligibility determination, as 45 days from the most recent request for the client to provide the additional information, as opposed to 45 days from the initial application date. This proposed amendment will allow clients additional time to get necessary eligibility information and documentation to the LIEAP agency.
ARM 37.70.401
The department is proposing to add new terms to ARM 37.70.407; therefore, it is necessary to define these terms in this rule.
ARM 37.70.402
This rule is being amended to include eligibility information related to households where all members are receiving supplemental nutritional assistance payments (SNAP). Although the federal regulation allows the LIEAP Program to make energy-assistance payments to households in which one or more individuals are receiving SNAP, this proposed amendment takes a more restrictive approach. The proposed amendments allow LIEAP households, in which all members are currently receiving SNAP benefits, to be determined categorically eligible for LIEAP.
ARM 37.70.406
Because LIEAP is a needs-based assistance program, only households with income and assets below specified limits are eligible to receive LIEAP benefits. This rule contains the maximum income standards used to determine eligibility for LIEAP. These income standards are computed as a specified percentage of the federal poverty guidelines (FPG) issued annually by U.S. Department of Health and Human Services (HHS). The standards currently in this rule are based on the HHS poverty guidelines for 2012. HHS updates the poverty guidelines each year to take into account increases in the cost of living. It has been the long-standing practice of the department to amend this rule annually to provide that the updated version of the poverty guidelines will be used to set the income standards and benefit amounts for the current heating season. If the department did not use the updated guidelines, some households might be ineligible for benefits or receive a smaller benefit due to inflationary increases in the household's income which do not reflect an increase in actual buying power. Thus, this rule is now being amended to provide that the 2013, rather than the 2012, poverty guidelines will be used for the 2013-2014 heating season.
ARM 37.70.407
The proposed amendments to this rule describe unearned income and other deductions which are not included as income for the LIEAP eligibility determination. This rule has been expanded to include amounts paid as incurments for the medically needy program. In medically needy cases, individuals who would not be income-eligible for Medicaid benefits are required to "pay down" their income to the medically needy income level in order for Medicaid to begin paying the medical expenses. Often times, after meeting the incurment the individual is left with a very small amount of income for living expenses, less than would be received by a supplemental security income (SSI) recipient. In most circumstances, the SSI recipient would be categorically eligible to receive LIEAP, but without this rule amendment the medically needy individual may not qualify for fuel assistance, yet is left to live on an amount less than the SSI individual.
ARM 37.70.408
In determining eligibility for LIEAP, the department considers not only income but also assets (known as "resources") the household has that can be used to pay heating costs. This rule specifies the rules relating to resources. Section (4) currently specifies the maximum amount of nonbusiness resources that households of varying sizes can have and still qualify for LIEAP in state fiscal year (SFY) 2014. Section (5) provides that the dollar limits on nonbusiness resources will be revised annually to adjust for inflation, so it is necessary to amend (4) to increase the dollar amounts for SFY 2014. Section (5) specifies that the revised nonbusiness resource limits will be computed by multiplying the current dollar limits by the percentage increase in the national consumer price index (CPI) for the previous calendar year or by 3%, whichever is less. The increase in the CPI for calendar year 2012 was 2.1%, so the dollar amounts in (4) would increase by 2.1% from SFY 2013 to 2014. Therefore, in accordance with the formula provided in (5), (4) must be amended to increase the maximum amounts of nonbusiness resources 2.1% from SFY 2013 to 2014.
ARM 37.70.601
This rule governs the computation of benefits for eligible households. Subsection (1)(a) provides that an eligible household's benefit is computed by multiplying the applicable amount in the table of benefits in (1)(c) by the applicable multiplier from the table of income/climatic adjustment multipliers in (1)(d). The benefit amounts in (1)(c) vary based on the type of heating fuel the household uses and the type and size of the household's dwelling. The benefit amounts also take into consideration available funding and the number of households expected to receive benefits in a given heating season. The department is proposing to amend the benefit amounts in (c). They are being revised based on estimates of the amount of funds available to pay LIEAP benefits for the 2013-2014 heating season as well as fuel-cost projections and an estimate of the number of households that will apply and be found eligible for LIEAP for the 2013-2014 heating season. The revised benefit amounts in (1)(c) for 2013-2014 are based on the department's estimate that 24,000 households will qualify for LIEAP benefits for the current heating season and based on the department's estimates of the federal LIEAP funds it will receive.
ARM 37.70.901
The department is proposing to modify this rule to specify the definition of a "life-threatening" emergency. Federal Low Income Home Energy Assistance Program (LIHEAP) regulations provide timelines in which assistance must be provided to the household who applies for energy crisis benefits, depending whether the crisis is determined to be a life-threatening emergency. A recent review of the LIHEAP program by the federal Department of Health and Human Services (HHS) indicated that the Administrative Rules of Montana (ARM), and the LIEAP policy manual should be clarified to define what constitutes a life-threatening emergency. This clarification will allow workers to more accurately determine the required response time for resolution of the emergency situation.
Fiscal Impact
LIEAP is 100% federally funded. Congress has not yet appropriated funds for LIEAP for the 2013-2014 heating season, but based on the information available at this time the department estimates that Montana will receive LIEAP funds of approximately $18 million for the current heating season. This compares to LIEAP funding of $18 million for the 2012-2013 heating season. Benefit levels for households using all types of heating fuel and for all dwelling types will not change significantly from the 2012-2013 heating season. It is estimated that 21,500 households will qualify for LIEAP benefits this year, which is comparable to last year.
5. The department intends to apply these rules retroactively to October 1, 2013. A retroactive application of the proposed rules does not result in a negative impact to any affected party.
6. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail dphhslegal@mt.gov, and must be received no later than 5:00 p.m., December 12, 2013.
7. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.
8. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.
9. An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register. The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered. In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.
10. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.
11. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rules will not significantly and directly impact small businesses.
/s/ Barbara B. Hoffmann /s/ Richard H. Opper Barbara B. Hoffmann Richard H. Opper, Director Rule Reviewer Public Health and Human Services
Certified to the Secretary of State November 4, 2013.
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A directory of state agencies is available online at http://www.mt.gov/govt/agencylisting.asp.
For questions about the organization of the ARM or this web site, contact sosarm@mt.gov.
