117-2           CONTINUED BENEFITS PENDING A FAIR HEARING DECISION

A recipient of ATAP Alaska Temporary Assistance Program, Medicaid, APA Adult Public Assistance, or SNAP Supplemental Nutrition Assistance Program who continues to satisfy all eligibility criteria other than those at issue in the fair hearing request may, upon filing a fair hearing request before the effective date of action (the date the benefits are to be reduced or stopped), have benefits continued pending the hearing decision.

If a fair hearing request is not made before the effective date of action, the fair hearing should still be submitted for action via I-Sight but continued benefits will not be provided and benefits will be reduced or terminated as provided in the notice of adverse action.

The Fair Hearing Request form (GEN 85 Fair Hearing Request form) and the Notice Stock (information on the back of EIS notices) includes a check box for the household to indicate that they do not want to receive continued benefits while they are waiting for a fair hearing decision. If a fair hearing request is received before the date the benefits were lowered or stopped, look to ensure that the household has not checked this box before providing continued benefits.

Note:

For SNAP Supplemental Nutrition Assistance Program, continued benefits can only continue through the current certification period. When a SNAP Supplemental Nutrition Assistance Program certification expires, continued benefits also expire. A new eligibility determination will be made with the receipt of a new Application for Services (GEN 50C).

117-2 A.     CALCULATION OF CONTINUED BENEFITS

A household’s assistance will continue at the benefit amount authorized immediately before the adverse action, unless other factors that were not contested result in a benefit change or a SNAP Supplemental Nutrition Assistance Program certification period expires.  If the client is eligible for continued benefits, the agency is required to take action within five days to continue benefits, unless the client has specifically waived this right.

Continued benefits will be calculated as follows:

1. Determine the issue of the fair hearing

2. Determine the benefits based on all current factors of eligibility including the issue in dispute

117-2 B.     CONTINUED BENEFITS FOR ISSUES RELATING TO MASS CHANGE

If the fair hearing issue is a result of a mass change, the agency will reinstate benefits to the prior level only if:

1. An individual notice of adverse action was not sent to the recipient;

2. The request was received timely; and

3. The eligibility or benefits were improperly computed, the new law is being misapplied, or the federal policy is being misinterpreted.

117-2 C.     TERMINATION OF CONTINUED BENEFITS BEFORE THE FAIR HEARING DECISION

Any case action normally required by agency policy and procedures (such as changes in household composition, address changes, shelter deductions, etc.) will continue to be made after the continuation or reinstatement of benefits has been taken. However, no action that directly relates to the issue of the hearing request can be taken until the final fair hearing decision is made, the issue is resolved in a pre-hearing conference, or the SNAP Supplemental Nutrition Assistance Program certification period expires.  

Benefits may be reduced or terminated prior to the hearing authority’s decision when:

1. The hearing authority makes a preliminary determination, in writing or at the hearing, that the sole issue is one of State or Federal law and the client's claim that the agency improperly computed the benefits, misinterpreted or misapplied such law is invalid;

2. For SNAP Supplemental Nutrition Assistance Program issues, the certification period expires. The client may reapply when the benefits stop, but the level of benefits will be based on the reapplication, not on the level issued prior to the expiration of the certification period;

3. A change affecting the client's eligibility or benefit level, which is not related to the hearing issue, occurs while a hearing decision is pending and the client fails to request a hearing on this new action after the subsequent notice of adverse action; or

4. A mass change affecting the household's eligibility or level of benefits occurs while the hearing decision is pending.

The agency will follow normal adverse action notice procedures if benefits are reduced or terminated for other reasons while the hearing decision is pending.

117-2 D.    TERMINATING CONTINUED BENEFITS FOLLOWING A FINAL FAIR HEARING

When a final hearing decision is received by the agency, the agency must review and determine if the decision is in favor of the agency of client and take the necessary action as described below:

• If the decision is in favor of the agency, terminate continued benefits and send an adequate notice

• If the decision is in the favor of the client, discontinue continued benefits and determine eligibility based on the fair hearing decision

117-2 E.    INELIGIBILITY FOR CONTINUED BENEFITS PENDING A FAIR HEARING DECISION

Clients are not eligible for continued benefits pending the fair hearing decision when:

1. The issue relates to General Relief Assistance or Chronic and Acute Medical Assistance program benefits;

2. The request for the fair hearing was not made timely;

3. The sole issue is one of State or federal law or policy due to mass change and not one of incorrect benefit computation;

4. The issue relates to a denial of an initial application for any assistance program or a denial of a SNAP Supplemental Nutrition Assistance Program recertification; or

5. The issue relates to an action taken on a regularly scheduled SNAP Supplemental Nutrition Assistance Program recertification. The level of benefits will be issued as determined in the recertification.