New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 102 - CASH ASSISTANCE PROGRAMS › Part 620 - DESCRIPTION OF PROGRAM BENEFITS - BENEFIT DETERMINATION/GENERAL › Section 8.102.620.11 - NON - REPORTING SANCTIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				General: The eligibility determination and payment calculation process relies
				upon applicants and participants to provide accurate and timely reports of
				information affecting their eligibility and payment. Payment sanctions for
				non-reporting shall be established to encourage timely and accurate reporting
				and to offset benefits resulting from the reporting of inaccurate or misleading
				information, the untimely reporting of changes, or the failure to report any
				required information.
B.
				Non-reporting sanctions:
(1) Length of
				sanction: Each non-reporting sanction shall run for a period of four months
				beginning with the first month in which failure to report occurred. An
				additional month shall be added for each additional month of non-reporting
				until the payment is corrected.
(2)
				Definition of an occurrence of non-reporting: An occurrence of non-reporting
				exists when an applicant or participant who fails to report information or
				reports incorrect information which results in an overpayment of cash
				assistance benefits for which the participant is at fault.
(3) Amount of sanction:
(a) Reporting sanctions shall be calculated
				at twenty-five percent of standard of need for the size of the benefit group
				being sanctioned.
(b) Reporting
				sanctions are not progressive. If there is another occurrence of non-reporting
				prior to the end of a non-reporting sanction period, the next and any
				subsequent non-reporting sanctions shall be consecutive and at the twenty-five
				percent level.
(c) Reporting
				sanctions, child support sanctions and work program sanctions shall be
				integrated into a single calculation to determine the final sanction
				amount.
(d) If a case closes during
				a reporting sanction period for reasons other than sanctions, the non-reporting
				sanction shall be suspended and resumed at the same duration the next time the
				case is opened.
(4)
				Procedures: The following steps shall be taken in implementing a payment
				sanction.
(a) The caseworker shall document
				and establish an overpayment claim using the HCA overpayment claims procedures.
				The caseworker shall also determine whether the participant was at fault for
				the overpayment.
(b) The county
				director or a designated supervisor shall review the overpayment and determine
				the accuracy of the overpayment determination and appropriateness of the
				determination the participant was at fault for the overpayment. Upon
				determining that a non-reporting sanction is appropriate, the county director,
				or designated supervisor shall issue a notice of intent to sanction to be
				issued to the participant. Failure by the participant to contact the person
				issuing the notice within 10 working days allowed shall constitute waiver of
				conciliation rights.
(c) If the
				participant requests conciliation within the 10 working days of issuance of the
				notice, the county director or designated supervisor shall schedule a
				conciliation conference.
(d) The
				conciliation conference is conducted by the county director or designated
				supervisor.
(i) The caseworker shall describe
				the reporting error, how the amount of the overpayment is determined and the
				reasons for finding the participant at fault for the overpayment.
(ii) The participant shall have the
				opportunity to discuss the overpayment determination, the finding of fault and
				to show good cause why the sanction should not be imposed.
(iii) Based upon this determination, the
				county director or designated supervisor shall determine whether a sanction
				should be imposed.
(iv) The
				participant may represent himself or be represented by someone else. If the
				participant wishes to be represented by another individual, the participant
				must designate that individual in writing.
(e) Following the conference, the county
				director shall issue written notice stating whether or not the sanction is to
				be imposed, and the worker shall affect the sanction causing issuance of a
				notice of adverse action. The payment reduction takes effect in the month
				following expiration of the notice of adverse action.
(f) Participants who disagree with the
				sanction determination shall have fair hearing rights and access to legal
				adjudication through the fair hearing process.