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Special Needs Overview
[Eas 44-211]
A special need is a need which is not common to the majority of recipients for certain goods/services and which is necessary for their support. These special needs can be recurring or nonrecurring. The EW is responsible for exploring with each applicant/recipient, any special needs which may be required.
As part of the application or RD process, the EW must carefully review the questions on the appropriate statement of facts which deal specifically with any special needs which the recipient may require. In addition to the application/RD process, the EW should always be alert to situations or changes which might indicate the possibility of a special need. The applicant/recipient should be given a clear explanation of the types of special needs and the procedures for securing payment for these needs. If the client does not provide the required verification, the request for any special need must be denied.
Verification
Before the payment of a special need can be made, verification is required to establish:
- That the appropriate conditions under which the need may be allowed, are met.
- The total cost of the need and payment plan.
- What proportion of the cost should be borne by the recipient, if the need is shared by others in the household.
- The period of time the special need will continue.
In addition to medical verification where applicable, clients must provide receipts indicating the amount paid or owed for a particular expense (e.g., utility bill indicating a spike in use, estimates for any repairs. labor and material, etc.). If the client is unable to obtain proof, the client must be provided examples of the different types of proof that are acceptable and/or assist with obtaining it.
If a release is needed, there are different release of information forms required for different types of information, including but not limited to the following:
- CW 60-Release of Information-Financial Institution
- CW 61-Authorization to Release Medical Information
- CW 2200-last page of the Authorization for Release of Information
If, after all attempts have been made and the county has determined that the client has made a good faith effort to obtain the evidence but was still unsuccessful, a "Sworn Statement" (GEN 853), shall be considered adequate to verify the existence of a special need, with the exception of a Pregnancy Special Need. The GEN 853 must include all the information required to establish the special need in order to be considered adequate.
Reporting
Mid-period report of a special needs request is treated as voluntary. A CalWORKs recipient may report having a special need at any time during the payment period. Recurring special needs that have been requested mid-period and have been verified and approved, will begin the first of the month in which either the need was reported or the verification substantiates that the needs exists, whichever is later, and shall remain in effect until the end of the SAR or AR/CO Payment Period in which the special need is expected to end, with the exception of the Pregnancy Special Need. Refer to Pregnancy Special Needs.
Actual costs must be verified at the processing of the SAR 7 or at annual redetermination for SAR and AR/CO AUs. This information provided together with the submitted evidence must be sufficient for the county to determine eligibility and/or grant amounts. If the special need is time-limited, the special need payment will be allowed to continue until the end of the payment period in which the need expires.
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