SECTION 730.1204. Notice Requirement--Proposed Termination or Reduction of Assistance

(a) The Texas Department of Protective and Regulatory Services (PRS) must give clients timely and/or adequate notice if a review of the client's situation shows that the grant is to be lowered or denied or services reduced or terminated; PRS decides to make or continue a protective, vendor, or two-party payment; or PRS decides to continue a protective payment in AFDC mismanagement cases.

(1) PRS mails a timely notice at least 10 days before the date of action. The 10-day period begins the day the notice is mailed and ends 10 calendar days later, unless the 10th day is a nonworkday. In this case, the period ends on the next workday.

(2) PRS continues assistance if a request for a fair hearing is postmarked on or before the 10th day. Payment may not be changed to a protective, vendor, or two-party payment pending the appeal. PRS allows two full calendar days mailing time for receiving the appeal notice before taking action to terminate or reduce assistance or services.

(3) An adequate notice includes a statement of the proposed action; the reasons for the action; the specific regulations supporting the action; an explanation of the client's right to a hearing, if any; and the circumstances under which assistance or services are continued if the client requests a hearing.

(4) PRS must give adequate notice to every client for across-the-board reductions necessarily made in good faith, such as denials or reductions made because of raises in Social Security; reductions required because of changes in PRS policies of general applicability; termination of the grant when a client reaches the maximum eligibility age, such as an AFDC child reaching 18 years old or 19 years old if attending school; or reduction because a member of the dependent group received a new grant, and the total of the two grants is equal to or larger than the original grant.

(b) PRS may withhold assistance or services without the timely 10-day notice and continued benefits pending appeal, but it must send adequate notice not later than the effective date of the action if:

(1) PRS has facts confirming the death of a client or of an AFDC payee when no relative is available to serve as the new payee;

(2) the client sends a clear written and signed statement that he no longer wishes assistance or services. The statement gives information that requires PRS to terminate or reduce assistance or services. The client must indicate that he understands the consequence of supplying this information;

(3) the client has been admitted or committed to an institution, and further payments to the client do not qualify for federal financial participation under the state plan;

(4) the client has been placed in skilled nursing care, intermediate care, or long-term hospitalization;

(5) the client's whereabouts are unknown, and the postal service returns mail PRS sent indicating no known forwarding address. If the client is located during the payment period covered by the returned check, PRS must make the check available to him;

(6) a client is accepted for assistance in a new jurisdiction (either certified in another state or for SSI), and this has been established by the new jurisdiction;

(7) an AFDC child is removed from the home as a result of a judicial determination or voluntarily placed in foster care by the legal guardian;

(8) the client fails to submit a correctly completed status report, and the household admits it did not submit the form;

(9) the client's attending physician prescribes a lower level of care or concurs with the Texas Department of Health's long-term care unit's change in level-of-care determination; and

(10) a protective or family self-support service is provided for a specific, time-limited period, and the recipient was informed in writing when it was initiated that the allowance or service terminates at the end of the specified period.

(c) PRS may terminate services without advance notice to a person receiving nonprotective purchased community care for aged and disabled services who threatens his own health or safety or that of others in the facility.

Source Note: The provisions of this §730.1204 adopted to be effective April 3, 1987, 12 TexReg 954; duplicated effective September 1, 1992, as published in the Texas Register September 11, 1992, 17 TexReg 6279.