5016-4        FAILURE TO COOPERATE WITH CSSD

5016-4 A.   WHAT IS NONCOOPERATION

Noncooperation occurs when:

• The caretaker refuses, or fails within 10 days, to complete and sign a “Child Support Information” form (CSSD 1603a) for the noncustodial parent of a dependent child included in the household;
   

• The caretaker fails or refuses to provide information about medical support covered by the assignment of rights; or
   

• CSSD informs the caseworker that the caretaker has failed to cooperate.

5016-4 B.   GOOD CAUSE FOR NON-COOPERATION

A caretaker cannot be required to cooperate with CSSD activities if the caretaker claims and establishes good cause.  If at any time a caretaker indicates they have good cause for noncooperation, they must be given the opportunity to complete the Child Support Cooperation Statement, GEN 80 or EIS notice M060.  Once a good cause claim is made, the caseworker must decide whether to allow the claim or not.  If the good cause claim is allowed, the caretaker is excused from cooperation.

A caretaker may have good cause for not cooperating with CSSD if:

• Cooperation may result in physical or emotional harm to the child or to the adult, or affect the adult’s ability to care for the child adequately; or
   

• Proceedings to establish paternity or secure support will be detrimental to the child because:
   

  • The child was conceived as a result of incest or rape;
     

  • Legal proceedings for adoption of the child are pending before a court; or
     

  • The adult is currently being assisted by a public or licensed private social agency to resolve the issue of whether to keep the child or relinquish him or her for adoption.

The caretaker’s statement may be accepted to establish that good cause exists, if the claim is not questionable.  Administrative Procedures Manual Section 105-1 provides policy on when information is considered questionable.

If the claim for good cause is questionable, the household will be asked to submit documents, such as police or court records, medical records, or statements from mental health or social service agencies that establish the existence of good cause.  The household may also submit written or oral statements from other individuals who have personal knowledge of the family's circumstances, such as a minister, attorney, social worker, or relatives of the caretaker.

In many cases, such as domestic violence situations, documents may not be available to support the good cause claim.  If the claim is questionable and additional documents are not available, the caseworker will consider the information and use their prudent judgment to make a decision on the claim.

5016-4 C.   FAILURE TO COMPLETE A CHILD SUPPORT INFORMATION FORM (CSSD Child Support Services Division 1603A)

A completed CSSD 1603a form means a response is entered for each question and the form is signed by the applicant or recipient.

Completion of the form is required even if the applicant is reapplying for benefits after a recent closure of their Medicaid case or if the applicant or recipient has already provided similar information for other children included in the household.

If the CSSD 1603a form is not completed for the noncustodial parent of a child, and the caretaker does not have good cause for not cooperating, the child will still be included or added to the case as of the required effective date.  The caseworker will take appropriate action to impose a penalty following the rules for noncooperation. See Section E below.

Applicants:  An applicant in a DPA office is given a CSSD 1603a form to complete with their application form.  If they refuse or fail to complete the CSSD form, the caseworker must give them the opportunity to claim good cause by providing them with a Child Support Cooperation Statement, GEN 80 or EIS notice M060.  When applications are received without an accompanying CSSD 1603a, the form must be provided to the applicant with the GEN 80 or M060 notice, and 10 days allowed for the completed form or request to claim good cause to be returned.

Note:

If the household is ineligible for some other reason, no further action is taken on the cooperation requirement.  The application is denied on the other grounds.

Recipients:  When a recipient’s household composition changes, such as when a child is added to an ongoing case or a parent leaves the home, the caseworker may need to provide the recipient with a CSSD 1603a form for completion.  If the recipient refuses or fails to complete the CSSD form, the caseworker must give them the opportunity to claim good cause by providing them with a Child Support Cooperation Statement, GEN 80 or EIS notice M060.  The Statement may be provided to the recipient with the CSSD 1603a form, and 10 days allowed for the completed form or request to claim good cause to be returned.

1. Good Cause Claim

If the caretaker claims good cause for not completing the CSSD 1603a form, the caseworker must decide whether to allow the claim or not.  While the good cause decision is pending, the caretaker is not required to cooperate with CSSD.  The caseworker must complete the eligibility determination without entering any noncustodial parent information on EIS so that benefits can be issued, and code the Coop Field “PD” on the CSEA screen to show that a good cause claim is being reviewed.

A good cause claim must be acted upon within 30 days from the date the signed claim for good cause is received in the DPA office.   The caretaker must be informed of the decision in writing.

If good cause is allowed, the M061 notice is sent and EIS is coded appropriately.  When the good cause decision is made after the eligibility determination has been completed and benefits approved, the caseworker must also notify CSSD of the good cause decision by sending an email to cssdgoodcause@revenue.state.ak.us.  This is necessary:

1. To prevent CSSD activities as appropriate to each case; and
    

2. To allow CSSD to review the caseworker’s decision on the good cause claim.  If CSSD has reason to question that decision, they may correspond with the caseworker and ask for reconsideration.  However, the good cause decision is ultimately the responsibility of the DPA caseworker.

If the caseworker determines that good cause does not exist, the caseworker must send the M062 notice and impose a penalty as described in Section E.  If the caretaker is not included in the household, a penalty cannot be imposed, but CSSD will still pursue medical support for the child.

2. No Claim for Good Cause

If the caretaker refuses to complete the CSSD 1603a and does not claim good cause, or fails to respond within 10 days to the request to complete the CSSD 1603a form or claim good cause, the caseworker must impose a penalty following the policy in Section E.  If the caretaker is not included in the household, a penalty cannot be imposed, but CSSD will still pursue medical support for the child.

5016-4 D.   CSSD Child Support Services Division NOTICE OF NONCOOPERATION

CSSD will notify the caseworker through an EIS alert whenever they determine a caretaker has refused or failed to cooperate with requested activities.   If this occurs, the caseworker must send a timely notice of adverse action and impose a noncooperation penalty if the caretaker is included in the household according to the penalty provisions described in Section E. below.

The notice informs the caretaker that CSSD has notified DPA of their noncooperation.  It also instructs the caretaker to take one of the following actions within 10 days:

• Cooperate by contacting CSSD and completing the requested activity; or
   

• Claim good cause for not cooperating, and provide evidence to support the claim.

If the caretaker claims good cause for not completing the requested activity, the caseworker must decide whether to allow the claim or not.   A good cause claim must be acted upon within 30 days from the date the signed claim for good cause is received in the DPA office.

If good cause is allowed, the caseworker sends the M061 notice to the caretaker, codes EIS appropriately, ends the penalty and restores benefits.   When the good cause decision is made after the eligibility determination has been completed and benefits approved, the caseworker must also notify CSSD of the good cause decision by sending an email to cssdgoodcause@revenue.state.ak.us.

If good cause is not allowed the caseworker sends the M062 to the household and the penalty remains in place.  If the caretaker is not included in the household, a penalty cannot be imposed, but CSSD will still pursue medical support for the child.

If CSSD notifies the caseworker that the caretaker has cooperated, the penalty is ended and benefits restored.

5016-4 E.   PENALTY FOR FAILURE TO COOPERATE

A caretaker who is required to cooperate with CSSD for a child living in the household, but who fails to do so without good cause, is ineligible for Medicaid.  Should that caretaker want Medicaid benefits in the future, cooperation is required.

Only the caretaker may incur a loss of Medicaid benefits for refusal to cooperate with CSSD.  To assure that a child is not made ineligible because of the parent’s noncooperation, the following rules apply toward determining household size and need standard.

Denali KidCare:  The needs of the noncooperating caretaker continue to be included in determining the household size for Denali KidCare.

Family Medicaid:  The needs of the noncooperating caretaker who is a mandatory member of the household continue to be included in determining the household size for Family Medicaid and their income still counts, but the caretaker’s Medicaid eligibility ends.  A caretaker who is an optional member of the household and who is required to cooperate, but fails to do so, must have their needs, income, and resources removed from the household.

Under 21 Medicaid:  A 19 or 20 year old who is applying for medical assistance only for themselves, regardless of the individual’s living arrangement, is not required to cooperate with CSSD.

A 19 or 20 year old who fails to cooperate with CSSD in establishing the paternity of his or her own child is ineligible for Under 21 Medicaid.