CASE MANAGEMENT

CS 059-1 IV-A Applicant/Recipient Cooperation Requirements and DWS Non-Participation Assessment

10/87 Revised 04/15/16 Training Completed 04/29/16

R527-039; U.C.A. 62A-11-304.2(1)(h) and 307.2

 

 

Introduction

 

An applicant/recipient applying for IV-A assistance must cooperate with the Office of Recovery Services/Child Support Services (ORS/CSS) in establishing paternity, and in establishing, modifying and enforcing a child support order unless CSS determines that the applicant/recipient is unable to cooperate and is therefore cooperating in good faith, or the Department of Workforce Services (DWS) makes a determination of good cause or other exception to cooperating with CSS.   

 

 

General IV-A Applicant/Recipient Cooperation Requirements

 

Administrative Rule R527-39-3 Cooperation Requirements states:

“1. An applicant/recipient of IV-A or Non-IV-A Medicaid services, with some Medicaid program exceptions, must cooperate with the Office of Recovery Services/Child Support Services (ORS/CSS) in:

a. identifying and locating the parent of a child for whom aid is claimed;

b. establishing the paternity of a child born out of wedlock for whom aid is claimed;

c. establishing an order for child support;

d. obtaining support payments for the recipient and for a child for whom aid is claimed unless a Good Cause determination has been made by the IV-A or Medicaid agency, or the Non-IV-A Medicaid applicant/recipient has declined child support services;

e. obtaining any other payments or property due the recipient or the child; and

f. obtaining and enforcing the provisions of an order for medical support.”

                       

 

Additional IV-A Applicant/Recipient Cooperation Requirements

 

Administrative Rule R527-39-3 Cooperation Requirements states:

“2. The applicant/recipient must cooperate with ORS/CSS with specific actions that are necessary for the achievement of the objectives listed above, as follows:

a. appearing at the ORS/CSS office to provide verbal or written information, or documentary evidence, known to, possessed by, or reasonably obtainable by the recipient;

b. participating at judicial or other hearings or proceedings;

c. providing information;

d. turning over to ORS/CSS any support payments received from the obligor after the Assignment of Collection of Support Payments has been made.

e. complying with a judicial or administrative order for genetic testing.

 

The type of information you request from the applicant/recipient will depend upon what the applicant/recipient can reasonably be expected to obtain or have.  For example, the longer the applicant/recipient and the alleged father or non-custodial parent (NCP) were together, the more information the applicant/recipient should have about the alleged father/NCP.  Depending on the circumstance of the case, you may ask the applicant/recipient to provide some of all of the following additional items/information about the alleged father(s)/NCP: 

 

·                     Social security number (SSN);

·                     Place of birth;

·                     Schools attended;

·                     Telephone number;

·                     Last known home address;

·                     Employer name and/or address;

·                     Occupation;

·                     Bank account or credit card information;

·                     Union or trade association affiliation;

·                     Name and address of the alleged father’s/NCP’s parents;

·                     Name and address of other relatives;

·                     Friends or co-workers;

·                     Make and model or license plate number of the vehicle;

·                     Driver’s license number;

·                     Places of social contact;

·                     Date and place of any arrests;

·                     Date and place of any hospital admissions; and/or,

·                     Any other information likely to assist you in locating the alleged father or NCP.

 

If the applicant/recipient has received direct support payments but has already spent the money, make a retained support referral (see CS 590 Retained Support).

 

Also, refer to the appropriate subsections below for the specific minimum cooperation requirements, depending upon whether the applicant/recipient’s IV-A application is pending or if there is already an existing CSS IV-A case, or if the case is a paternity establishment case or a non-paternity case (e.g., separation or divorce).

 

 

Paternity Cases, Specific Minimum Requirements and Procedures – IV-A Application Pending and No Open CSS IV-A Case

 

When a IV-A application is pending and there is no open CSS case, and paternity needs to be established on the child(ren), the IV-A applicant must meet the general cooperation requirements listed above and, at a minimum, the applicant must provide the real name of the alleged father, or the real names of all possible alleged fathers in a multiple consort situation. 

 

If a IV-A applicant claims that she cannot name the father due to rape, or she became pregnant due to incest, or she believes that cooperating may result in physical or emotional harm to her or her child(ren), inform her of the option to claim “good cause or other exception” to cooperation and refer her to DWS.  If the applicant claims good cause, do not proceed on the case until DWS has made a determination on the claim.  

 

If a IV-A applicant is not claiming good cause with DWS or cooperating in good faith with CSS (see Cooperation in Good Faith section below), take the steps listed below.  

 

1.                   During the initial interview with the IV-A applicant, attempt to verify the existence of the alleged father(s) that the applicant has named.  If you are unable to find any record of the alleged father(s), inform the applicant that she is not meeting the cooperation requirements.

 

2.                   If the IV-A applicant does not provide any additional information which can be used to verify the existence of the alleged father(s) named, initiate non-cooperation procedures.   

 

NOTE:  If the IV-A applicant does not provide the name of the alleged father(s) or does not know how to find out his (or their) name(s), you may suggest ways for the applicant to obtain the information; e.g., contact the alleged father’s friends or family.  However, do not make suggestions that require the applicant to travel, incur other costs, or place the applicant in a potentially dangerous situation.  If the applicant needs to make phone calls to the alleged father’s friends and family, you may offer to let her make the calls from the CSS office.

 

If the IV-A applicant is the mother of the child(ren) and she is certain that the alleged father she has named is the biological father of the child(ren), and you have determined that the alleged father is willing to cooperate with paternity establishment (e.g., voluntarily submitting to genetic testing, and/or signing a paternity stipulation), but the mother will not cooperate, inform her that she is not meeting the cooperation requirements in the paternity establishment process.  Initiate procedures for non-cooperation. 

 

 

Non-Paternity Cases, Specific Minimum Requirements and Procedures – IV-A Application Pending and No Open CSS IV-A Case

 

When a IV-A application is pending and there is no open CSS case and paternity is not an issue (e.g., paternity already legally established; separation or divorce case), the IV-A applicant must meet the general cooperation requirements listed above and s/he must provide, at a minimum, the information below to CSS about the NCP:

 

·                     the NCP’s  name;

·                     the NCP’s date of birth or social security number; and,

·                     the NCP’s last known residential address.

 

If a IV-A applicant claims that s/he cannot cooperate due to rape or incest, or s/he believes that cooperating may result in physical or emotional harm to him/her or to his/her child(ren), inform the applicant of the option to claim “good cause or other exception” to cooperation and refer him/her to DWS.  If the applicant claims good cause, do not proceed on the case until DWS has made a determination on the claim.   

 

If the IV-A applicant is not claiming good cause with DWS or cooperating in good faith with CSS, take the steps listed below.

 

1.                   Attempt to verify the existence of the NCP by using the phone or by accessing the appropriate locate resources.

 

2.                   If you cannot find any record of the NCP, tell the IV-A applicant that s/he is not meeting cooperation requirements.

 

3.                   If the IV-A applicant does not provide additional information that you can use to verify that the NCP actually exists, initiate non-cooperation actions.

 

 

Cooperation in Good Faith

 

CSS may determine that a IV-A applicant/recipient has tried but has been unable to meet the preceding cooperation requirements, and therefore is “cooperating in good faith”.  Before making a cooperation in good faith determination, you must consult with your management chain (Manager, Associate Regional Director, Regional Director, and CSS Director).  Consider the factors listed below.

 

1.                   Paternity cases:  If a IV-A applicant cannot reasonably be expected to provide the required information about the alleged father due to the past and/or present circumstances, CSS may determine that a IV-A applicant is “cooperating in good faith” on a paternity case if at least one of the factors listed below applies.   

a.                   The age and/or mental capacity of the parent or caregiver of the child for whom support is being sought.  You have asked the IV-A applicant to provide the real name of the father but she is unable to do so.  First determine if conception occurred inside or outside the state of Utah, and proceed as follows:  

                                                i.                     inside the state – you may contact her family members, friends and associates to determine if they can help name the alleged father(s). If the alleged father(s) is identified, the mother must sign the “Affidavit of Affiliation” before a paternity action may begin. 

                                              ii.                     outside the state - do not contact family, friends and associates to determine if they know the name of the alleged father.

b.                  Circumstances surrounding the conception of the child (other than artificial insemination, see below).  The IV-A applicant’s statements that she has provided all of the information available to her is believable, and you have been unable to verify the existence of the alleged father(s).  NOTE:  Do NOT obtain a written affidavit from the applicant that states she has provided all the information she has available.

c.                   Artificial insemination.  The IV-A applicant is the mother and she claims to have conceived the child by an unknown donor through artificial insemination.  Have the mother complete the “Paternity Questionnaire” and determine if there are any other possible consorts or if there is a presumptive father.  The mother must also provide a statement from the physician, hospital, or institution that provided the insemination services.  The letter must specify the date that the procedure was performed in order to confirm that the insemination date coincides with the probable date of conception.

 

NOTE:  If the IV-A applicant claims to have conceived the child by an unknown donor through artificial insemination and the specimen was purchased through the internet and introduced at home, the applicant/recipient must provide a receipt of purchase for the specimen.   Determine if the specimen was purchased within a timeframe reasonably close to the date of conception.

 

2.                   Paternity AND Non-paternity Cases:

a.                   The IV-A applicant is a resident alien (resides in the U.S., but not a U.S citizen) from a foreign country, the alleged father(s) or NCP is not living in the U.S., and the IV-A applicant does not know where the father(s) or NCP is living and/or is unable to assist in verifying his identify.

b.                  Time period since last contact.  Several years have passed since the IV-A applicant has had contact with the alleged father or NCP, or his friends or family, and s/he has been unable to initiate contact with these individuals.

c.                   Deception by the alleged father or NCP.  The IV-A applicant or another individual provides evidence of an inability to provide correct information about the alleged father or NCP because of deception on his/her part.  For example, the applicant provides documentation that the alleged father was using a name that was found to be an alias.

 

Once a determination of cooperation in good faith has been made and approved by the team Manager, the IV-A applicant is not required to cooperate further with CSS.  Close the paternity case.  Close the non-paternity case using the appropriate closure code, if possible.  If the non-paternity case does not meet one of the closure criteria, you must continue to work the case until one of the closure criteria are met.   

 

 

Interstate Cases

 

If a IV-A applicant names an alleged father(s) or a NCP that may be living in another state or country, you may need to take more time to verify that the person exists and is in fact living outside of Utah.  Do not take non-cooperation actions until you have determined that the IV-A applicant is in fact not meeting cooperation requirements.

 

 

IV-A Applicant Non-Cooperation Determination

 

If a IV-A applicant fails to cooperate with CSS and you do not believe a determination that the applicant is cooperating in good faith is appropriate, take the steps listed below.

 

1.                   Complete the “Notice of Obligee Non-cooperation Pre-Print.”  Give the IV-A applicant the original and the “Written Request for Review.”

 

2.                   Within five days of your determination of non-cooperation, give the DWS worker a copy of the notice and place a second copy in a “pending” file designated for this purpose.

 

3.                   If DWS later opens a IV-A case with this applicant, file the second copy of the notice in the CSS case and enter the appropriate non-cooperation code on ORSIS.

 

 

Specific Minimum Requirements and Procedures - Newly Opened and Existing CSS IV-A Child Support Cases

 

An applicant or recipient of IV-A assistance on a newly opened or existing CSS case must provide CSS with the all of the required information and cooperate with CSS, as previously described in this section, if s/he has not already done so.

 

If the applicant/recipient fails to cooperate and you have determined that s/he is not “cooperating in good faith,” complete an electronic non-cooperation notice/referral to DWS on ORSIS.  Once the DWS worker receives the notice/referral, s/he should begin the DWS conciliation process to help the applicant/recipient meet the CSS cooperation requirements.

 

 

Applicant/Recipient Options After Non-Cooperation Proceedings Initiated

 

The applicant/recipient has three options after non-cooperation proceedings have been initiated.  S/he may:

 

1.                   call CSS and try to resolve the non-cooperation issue;

2.                   request an administrative review or adjudicative proceeding in writing;

3.                   request a determination of good cause or other exception from DWS; or,

4.                   take the matter to court.

 

NOTE:  Administrative reviews are conducted by the designated Senior Agent on the team, who will talk with the Agent on the case and consult with the Team Manager before making a determination.  If the Senior Agent and the Manager cannot agree, they will consult with the Associate Regional Director.  Adjudicative proceedings are conducted by a Presiding Officer, who will be the designated Quality Assurance (QA) specialist.  The QA will consult with his/her supervisor before issuing a Decision and Order. 

 

DWS Conciliation Process

 

The conciliation process was established by DWS to help the applicant/recipient cooperate with CSS.  It does not require the participation of CSS workers.  When DWS receives either a paper non-cooperation determination notice or an electronic non-cooperation notice/referral from CSS on a IV-A case, the DWS worker is responsible for taking the steps listed below. 

 

1.                   Levels 1 and 2:  The DWS worker will initiate the first two levels of the conciliation process by contacting the applicant/recipient by mail to schedule an appointment in an attempt to help him/her meet the CSS cooperation requirements.  The applicant/recipient is given 10 days to respond before the DWS worker proceeds to Level 3.

 

2.                   Level 3:  If the applicant/recipient still does not cooperate with CSS and s/he has been found eligible for IV-A assistance, the DWS worker will apply level three of the conciliation process by removing the recipient’s amount ($100) from the IV-A grant for two consecutive months. 

 

3.                   IV-A Case Closure:  If, after two months, the applicant/recipient still does not cooperate with CSS, the IV-A financial assistance case will be closed. The IV-A case cannot be reopened until the applicant/recipient satisfactorily resolves the cooperation issue(s) with CSS.

 

NOTE:  Unless the case has been closed due to good cause or other exception, or a determination that an applicant/recipient is cooperating in good faith, the CSS case may not be closed simply because the applicant/recipient is not cooperating with CSS.  Federal closure criteria still apply.  However, once the applicant/ recipient goes off IV-A assistance and you determine that you are unable to proceed with the next step on the CSS case without the CP’s cooperation, you may close the case “Non-IV-A Client Not Cooperating.” 

Additionally, in some cases, civil or criminal action may be brought against the mother for aiding the alleged father or NCP in his failure to support the child (e.g., if the mother provides false information in order to prevent the state from identifying the father, establishing paternity, and collecting support).  If you believe you have a case with this type of situation, carefully research and document all of the evidence in the case narrative.  Then consult with the appropriate attorney about the possibility of taking legal action against the mother.