441—7.7 (17A) Notice of intent to approve, deny, terminate, reduce, or suspend assistance or deny reinstatement of assistance.
	 7.7(1) Notification.
	  a.   	 Whenever the department proposes to cancel or reduce assistance or services or to revoke a license, certification, approval, registration, or accreditation, it shall give timely and adequate notice of the pending action, except:
	 (1) 	 When a service is deleted from the state’s comprehensive annual service plan in the social services block grant program at the onset of a new program year, or
	 (2) 	 As provided in subrule 7.7(2).
	  b.   	 For the purpose of this subrule, “assistance” includes food assistance, medical assistance, the family investment program, refugee cash assistance, child care assistance, emergency assistance, family or community self-sufficiency grant, PROMISE JOBS, state supplementary assistance, healthy and well kids in Iowa (HAWK-I) program, foster care, adoption, aftercare services, or other programs or services provided by the department.
	  c.   	 The department shall give adequate notice of the approval or denial of assistance or services; the approval or denial of a license, certification, approval, registration, or accreditation; and pending action for a state or federal tax or debtor offset.
	  d.   	 “Timely” means that the notice is mailed at least ten calendar days before the date the action would become effective. The timely notice period shall begin on the day after the notice is mailed.
	  e.   	 “Adequate” means a written notice that includes:
	 (1) 	 A statement of what action is being taken,
	 (2) 	 The reasons for the intended action,
	 (3) 	 The manual chapter number and subheading supporting the action and the corresponding rule reference,
	 (4) 	 An explanation of the appellant’s right to appeal, and
	 (5) 	 The circumstances under which assistance is continued when an appeal is filed.
	 7.7(2) Dispensing with timely notice. Timely notice may be dispensed with, but adequate notice shall be sent no later than the date benefits would have been issued when:
	  a.   	 There is factual information confirming the death of a recipient or of the family investment program payee when there is no relative available to serve as a new payee.
	  b.   	 The recipient provides a clear written, signed statement that the recipient no longer wishes assistance, or gives information which requires termination or reduction of assistance, and the recipient has indicated, in writing, that the recipient understands this must be the consequence of supplying the information.
	  c.   	 The recipient has been admitted or committed to an institution which does not qualify for payment under an assistance program.
	  d.   	 The recipient has been placed in skilled nursing care, intermediate care, or long-term hospitalization.
	  e.   	 The recipient’s whereabouts are unknown and mail directed to the recipient has been returned by the post office indicating no known forwarding address. When the recipient’s whereabouts become known during the payment period covered by the returned warrant, the warrant shall be made available to the recipient.
	  f.   	 The agency establishes that the recipient has been accepted for assistance in another state.
	  g.   	 Cash assistance or food assistance is changed because a child is removed from the home as a result of a judicial determination or is voluntarily placed in foster care.
	  h.   	 A change in the level of medical care is prescribed by the recipient’s physician.
	  i.   	 A special allowance or service granted for a specific period is terminated and the recipient has been informed in writing at the time of initiation that the allowance or service shall terminate at the end of the specified period.
	  j.   	 Rescinded, effective 2/1/84.
	  k.   	 The department terminates or reduces benefits or makes changes based on a completed Form 470-2881, 470-2881(S), 470-2881(M), or 470-4083(MS), Review/Recertification Eligibility Document, as described at 441—paragraph 40.27(1)“b”or rule 441—75.52(249A).
	  l.   	 The agency terminates benefits for failure to return a completed report form, as described in paragraph “k.”
	  m.   	 The agency approves or denies an application for assistance.
	  n.   	 The agency implements a mass change based on law or rule changes that affect a group of recipients.
	 7.7(3) Action due to probable fraud. When the agency obtains facts indicating that assistance should be canceled, suspended, or reduced because of the probable fraud of the recipient, and, where possible, the facts have been verified through collateral sources, notice of the action shall be timely when mailed at least five calendar days before the action would become effective. The notice shall be sent by certified mail, return receipt requested.
	 7.7(4) Conference during the timely notice period. During the timely notice period, the appellant may have a conference to discuss the situation and the agency shall provide a full explanation of the reasons for the pending action and give the recipient an opportunity to offer facts to support the contention that the pending action is not warranted. The appellant may be accompanied by a representative, legal counsel, friend or other person and this person may represent the appellant when the appellant is not able to be present unless otherwise specified by statute or federal regulation.
	 7.7(5) Notification not required. Notification is not required in the following instances:
	  a.   	 When services in the social service block grant preexpenditure report are changed from one plan year to the next, or when the plan is amended because funds are no longer available.
	  b.   	 When service has been time-limited in the social service block grant preexpenditure report, and as a result the service is no longer available.
	  c.   	 When the placement of a person(s) in foster care is changed.
	  d.   	 When payment has been in accordance with the Medicaid payment schedule for the service billed because there is no adverse action.
	  e.   	 When services of the community self-sufficiency grant project are available to all PROMISE JOBS participants as specified in subrule 441—47.46(1).
	 7.7(6) Reinstatement.
	  a.   	 Whenever the department determines that a previously canceled case must remain canceled for a reason other than that covered by the original notice, timely and adequate notice shall be sent except as specified in subrule 7.7(2).
	  b.   	 Whenever the department determines that a previously canceled case is eligible for reinstatement at a lower level of benefits, for a reason other than that covered by the original notice, timely and adequate notice shall be sent except as specified in subrule 7.7(2).
	  c.   	 Food assistance cases are eligible for reinstatement only in circumstances found in rule 441—65.44(234). FIP cases are eligible for reinstatement only in circumstances found in 441—subrule 40.22(5).
[ARC 8003B, IAB 7/29/09, effective 9/2/09]