Conn. Agencies Regs. § 17b-198-11

Current through September 27, 2024

Section 17b-198-11 - Special benefits

(a)Generally. In addition to providing the assistance described in section 17b-198-10 of the Regulations of Connecticut State Agencies, the department shall, as a component of SAGA, provide special benefit payments, as described in this section.

(b)Funeral and burial expenses.

(1) As used in this this subsection:

(A) "Available estate" means the portion of the net value of a decedent's assets, including (i) all liquid assets, (ii) any asset or income to which the decedent was entitled at the time of death, (iii) the face value of any life insurance policy issued on the life of the decedent, (iv) the value of any burial reserve account, revocable or irrevocable funeral fund or prepaid funeral contract, and (v) all real and personal property, such as, but not limited to, the decedent's home and motor vehicle, that remains after subtracting the cost or anticipated cost of administering the decedent's estate.

(B) "Covered funeral and burial expenses" means expenses typically associated with providing funeral and burial services for a decedent, including, but not limited to, the cost of (i) transporting the decedent from the place of death to the funeral home and on to the place of burial, (ii) a wake, (iii) church services, (iv) a burial plot, as defined in subsection (a) of section 17b-198-8 of the Regulations of Connecticut State Agencies, (v) opening and closing a grave, and (vi) other cemetery or cremation charges;

(C) "Eligible decedent" means a deceased person, other than a stillborn child, who was a SAGA recipient at the time of his or her death or who:

(i) Left an available estate of less than one thousand four hundred dollars or the actual cost of his or her funeral and burial, whichever is less;

(ii) Has no legally liable relative who is able to pay for the cost of his or her funeral and burial;

(iii) Was not receiving assistance pursuant to TFA, AABD or RCA at the time of his or her death; and

(iv) Was a resident of Connecticut at the time of his or her death, as determined under the rules described in subsection (b) of section 17b-198-5 of the Regulations of Connecticut State Agencies;

(D) "Legally liable relative" means a decedent's spouse or, if the decedent was under eighteen years of age, unmarried and not emancipated by a court of appropriate jurisdiction at the time of death, parents; and

(E) "Vendor" means a funeral home, cemetery or crematory.

(2) Upon receipt of the death certificate of an eligible decedent, a bill for such eligible decedent's covered funeral and burial expenses and any application required pursuant to this subdivision, the department shall provide payment, in an amount determined pursuant to subdivision (3) of this subsection, for such funeral and burial expenses to the vendor providing funeral and burial services for the eligible decedent. An application for such payment shall be required unless, at the time of his or her death, the eligible decedent was receiving benefits pursuant to SAGA or a Medicaid coverage group limited to individuals below a particular asset level. In no event shall the department issue a payment pursuant to this subsection if a request for payment and any application required pursuant to this subdivision are received more than one year after the date of the eligible decedent's death. Such request and application may be made by the vendor providing funeral and burial services for the eligible decedent, any person who has legal custody of the eligible decedent's remains or a relative, friend or conservator of the eligible decedent.

(3) Any payment provided pursuant to this subsection shall be calculated by subtracting the following amounts from either the actual cost of the eligible decedent's funeral and burial, or one thousand four hundred dollars, whichever is less:

(A) The amount in any revocable or irrevocable funeral fund;

(B) The value of any prepaid funeral contract;

(C) The face value of any life insurance policy owned by the eligible decedent; and

(D) The amount in excess of three thousand two hundred dollars that is contributed towards the eligible decedent's funeral and burial expenses by any other source, with the cost of any item that is purchased and donated or provided in lieu of money, including, but not limited to, a burial plot, as defined in subsection (a) of section 17b-198-8 of the Regulations of Connecticut State Agencies, valued according to its fair market value.

(c)Transportation out of state.

(1) The department shall pay for the cost of transportation for an assistance unit member who is moving to another state or country if:

(A) Such member has neither the income nor the assets to pay for such transportation;

(B) Such member has either (i) relatives who are able or friends who express willingness to aid in such person's support in such other state or country, or (ii) other private means of support in such other state or country; and

(C) The department determines that such move is in the best interest of such member and the state of Connecticut after considering the following factors:

(i) Whether the majority of such member's family and friends live in Connecticut or the state or country to which he or she intends to move;

(ii) Whether such member has employment history, opportunity for employment or other plans for becoming self-sufficient in Connecticut or the state or country to which he or she intends to move;

(iii) Whether such member wishes to maintain residency in Connecticut or establish permanent residency in the state or country to which he or she intends to move; and

(iv) Any other circumstance relevant to determining whether it is in the best interest of such member and Connecticut for such person to move to such other state or country.

(2) Any payment made by the department pursuant to this subsection shall be for the principal mode of transportation used to move a person out of the state and shall not include (A) the cost of any secondary mode of transportation necessary to access such principal mode of transportation, or (B) the cost of moving or storing such person's home furnishings, furniture or other personal property. Such payment shall be in an amount calculated by subtracting from the most economical rate for air or land transportation, whichever is appropriate, any income or assets such person has to pay for such transportation, including any income such person receives upon selling home furnishings or other personal property prior to the move. Any person for whom a payment is made pursuant to this subsection shall, as a condition of such payment being made on his or her behalf, sell any personal property he or she does not intend to transport to such other state or country.

(d)Property repairs.

(1) The department shall pay for the cost of repairs to real property on behalf of a person receiving assistance pursuant to SAGA if:

(A) Such person has an equitable interest in such property;

(B) Such person uses such property as his or her home;

(C) Such person cannot continue to safely live in such property unless the repairs for which payment is sought are completed;

(D) Such person will have to rent alternative housing if the repairs for which payment is sought are not completed and the projected cost of renting such alternative housing over a two-year period exceeds the cost of the pertinent repairs and any other costs attributable to continued occupancy of such property over such two-year period;

(E) The department verifies the need for the repairs for which payment is sought;

(F) Such person obtains and submits to the department no fewer than three bids estimating the cost of the repairs for which payment is sought; and

(G) The department concludes that the winning bid is reasonable.

(2) Any payment made by the department pursuant to this subsection shall be in an amount equal to the lowest bid that the department concludes is reasonable, but in no event shall the department pay for any portion of such bid that is not attributable to repairs necessary for the safe habitation of such property. Any payment made pursuant to this subsection shall be made directly to the contractor providing such repairs after the department verifies such repairs have been satisfactorily completed.

(e)Emergency housing.

(1) The department shall pay for an assistance unit member's emergency housing and not more than three meals per day served by the provider of such emergency housing if such member:

(A) Cannot remain in permanent housing because:

(i) A judgment was entered against such member in a summary process action instituted pursuant to chapter 832 of the Connecticut General Statutes, provided such action was not based on the criminal activity of such member;

(ii) Such member left such permanent housing to escape the threat of domestic violence;

(iii) A judgment was entered against such member in a foreclosure action pursuant to chapter 846 of the Connecticut General Statutes;

(iv) Such member was required to relocate by local health or building officials because (I) a child who is under such member's supervision was found to have a level of lead in the blood equal to or greater than twenty micrograms per deciliter or any other abnormal level of lead, and (II) the local director of health determined that the source of the lead poisoning is such member's permanent housing;

(v) A catastrophic event rendered such permanent housing uninhabitable, as determined by appropriate state or local officials or the department;

(vi) Such member was ordered to vacate such permanent housing by a local building or housing code enforcement official;

(vii) Such permanent housing was a shared living arrangement that such member left because the primary tenant (I) was in the process of being evicted, (II) received a preliminary notice from his or her landlord pursuant to Connecticut General Statutes 47a-15, (III) received a notice to quit due to termination of a rental agreement for lapse of time; or (IV) was engaged in criminal activity; or

(viii) Such member was illegally locked out of such permanent housing by his or her landlord and has filed a complaint with the police concerning such illegal lockout;

(B) Was unable to move into new permanent housing on the day that the previous permanent housing was lost;

(C) Has not received relocation assistance, pursuant to the Connecticut Uniform Relocation Assistance Act, section 8-266 of the Connecticut General Statutes, et seq., in the form of placement by a town welfare agency in temporary or permanent housing despite having made reasonable efforts to obtain such assistance;

(D) Applies for the department to pay for his or her emergency housing not later than forty-five days after the date on which such member's permanent housing was lost;

(E) Agrees to (i) make reasonable efforts to locate new permanent housing, (ii) accept any reasonable alternative permanent housing that is less costly than the previous permanent housing, if requested to do so by the department, and (iii) accept any permanent housing constructed, renovated or rehabilitated with state or federal funding; and

(F) Selects emergency housing that is not a hotel or motel, except that if such member's need for emergency housing was caused by a catastrophic event, as described in subparagraph (A)(v) of this subsection, a hotel or motel may be selected as emergency housing.

(2) Any payment made by the department pursuant to this subsection shall be in an amount equivalent to the actual amount charged for the emergency housing and meals, provided such amount shall not exceed eleven dollars per night for such emergency housing and one dollar per meal served. No assistance unit member shall be eligible for a special benefit payment under this subsection for more than one occurrence during a calendar year or for more than sixty days per occurrence, except that any assistance unit whose need for emergency housing is caused by lead poisoning, as described in subparagraph (A)(iv) of this subsection, may receive such additional assistance for more than one occurrence during a calendar year and for not more than eighty days per calendar year.

(f)Storage charges.

(1) The department shall pay for the cost of storing an assistance unit member's furnishings and appliances in a commercial facility and preparing such furnishings and appliances for such storage if:

(A) The department has agreed to pay for such member's emergency housing under subsection (e) of this section;

(B) There is no other source of payment for the cost of storing such furnishings and appliances commercially; and

(C) Such member submits to the department two estimates for the cost of preparing and storing such furnishings and appliances.

(2) Any payment made by the department pursuant to this subsection shall be provided in an amount equivalent to the lower of the two estimates submitted by the assistance unit. In no event shall an assistance unit member be eligible for a special benefit payment under this subsection for a period longer than such member is eligible for an emergency housing special benefit payment under subsection (e) of this section.

(g)Meals-on-wheels program.

(1) The department shall pay for the cost of an assistance unit's participation in a meals-on-wheels program if:

(A) Such member is unable to prepare meals at home due to physical or mental incapacity or a lack of cooking facilities; and

(B) The department completes a casework assessment recommending such member for participation in a meals-on-wheels program.

(2) Any payment made by the department pursuant to this subsection shall be calculated on a per diem basis at the monthly rate of seventy-three dollars and fifty cents if one meal is delivered each day and one hundred forty-seven dollars if two meals are delivered each day. Such payment shall be provided on a recurring basis, but shall be issued only for days on which such meals are delivered.

(h)Moving expenses.

(1) The department shall pay for the cost of moving an assistance unit's household and personal items during a relocation if such relocation is from one location in the state to another location in the state and is necessary due to:

(A) A need for different living quarters that are more conducive to the health needs and limitations of the assistance unit member due to a chronic illness;

(B) An increase in the cost of shelter, provided the cost of shelter at the new residence does not exceed the cost of shelter at the former residence prior to such increase;

(C) A need for living quarters that are closer to the assistance unit member's place of employment or a new job site;

(D) The occurrence of any event justifying a special benefit payment for emergency housing, as described in subparagraph (A) of subdivision (1) of subsection (e) of this section; or

(E) The assistance unit member living beyond his or her means, provided the cost of the new housing selected is lower than the cost of housing at the previous location.

(2) Any payment made by the department pursuant to this subsection shall be non-recurring and in an amount equivalent to the reasonable cost incurred by the assistance unit member for moving household furnishings and personal belongings and preparing such furnishings and belongings for such move, provided such member submits evidence of such cost to the department. In no event shall such payment exceed an amount that such member's mover would ordinarily charge the general public for similar services or, if such mover does not regularly provide similar services to the general public, an amount that a moving contractor providing similar services to the general public in the assistance unit's area would ordinarily charge.

(i)Repair or replacement of essential household items.

(1) For purposes of this subsection, "essential household item" means any item listed in subdivision (5) of this subsection, in the quantity considered essential under said subdivision.

(2) The department shall pay for the cost of replacing any essential household item owned by an assistance unit member if:

(A) Such item was damaged or destroyed during a catastrophic event;

(B) Such item is not otherwise available to such member in a furnished apartment or shared living arrangement;

(C) The loss of such item is not covered by an insurance policy;

(D) Such member permits the department to conduct a home visit for the purpose of examining such item;

(E) The needs group obtains an estimate of the cost of repair for any such item that (i) was not totally destroyed or damaged beyond repair, and (ii) is assigned a replacement cost in excess of one hundred dollars under subdivision (5) of this subsection; and

(F) The department determines that the cost of repairing such item would exceed the replacement cost assigned for such item under subdivision (5) of this subsection.

(3) The department shall pay for the cost of repairing any essential household item owned by an assistance unit member if:

(A) The requirements of subparagraphs (A) to (E), inclusive, of subdivision (2) of this subsection are met; and

(B) The department determines that the cost of repairing such item would not exceed the replacement cost assigned for such item under subdivision (5) of this subsection.

(4) Any payment made by the department for the replacement of an essential household item shall be non-recurring and in an amount equal to the replacement cost assigned for such item under subdivision (5) of this subsection. Any payment made by the department for the repair of an essential household item shall be in an amount equal to the estimated cost of repairing such item. Whenever an assistance unit member is required to obtain an estimate of the cost of repairing an essential household item, as described in subdivisions (2) and (3) of this subsection, the department shall reimburse such member for any cost incurred in obtaining such estimate.

(5) The department shall utilize the following table for the purposes of determining whether an item constitutes an essential household item and, if so, the replacement cost of such item:

Item	Quantity considered essential	Replacement cost
Bed	One bed space per individual, with a twin bed constituting one bed space and a full bed constituting two bed spaces	Thirty-five dollars per twin or full bed for a frame; Fifty-eight dollars per twin bed and seventy-six dollars per full bed for a box spring; and Fifty-eight dollars per twin bed and seventy-six dollars per full bed for a mattress
Dinette set	One table and one chair per individual	Eighty dollars per table and ten dollars per chair
Chest of drawers	One chest per individual	Sixty dollars per chest
Lamp	One lamp per individual	Twenty dollars per lamp
Living room chair	One per individual	Fifty dollars per living room chair
Sofa	One sofa	One hundred forty-six dollars per sofa
Bathing towels	Two hand towels and two bath towels per individual	Two dollars per hand towel and seven dollars per bath towel
Bedding supplies	One pillow and one pillowcase set per individual; two blankets per bed replaced pursuant to this subsection; two sheet sets per bed replaced pursuant to this subsection; and one mattress pad per bed replaced pursuant to this subsection	Ten dollars per pillow; Eight dollars per pillowcase set; Fifteen dollars per blanket for a twin bed and eighteen dollars per blanket for a full bed; Eleven dollars per sheet set for a twin bed and fifteen dollars per sheet set for a full bed; and Ten dollars per mattress pad per twin bed and fourteen dollars per mattress pad per full bed
Cooking utensils	One set	Thirty dollars per set
Silverware	One set sufficient to serve eight people	Seventeen dollars per set
Dishes	One set sufficient to serve eight people	Twenty-six dollars per set
Dish towels	One set of three dish towels	Four dollars and fifty cents per set
Glassware	One set sufficient to serve eight people	Ten dollars per set
Ironing board	One ironing board	Eighteen dollars per ironing board
Window shades	One window shade per window in the individual's home	Five dollars per window shade
Iron	One iron	Eighteen dollars per iron
Range	One range	One hundred fifty dollars per range
Refrigerator	One refrigerator	One hundred eighty dollars per refrigerator
Washing machine	One washing machine	One hundred sixty dollars per washing machine
Garbage can	One garbage can	Five dollars per garbage can

(j)Replacement of clothing.

(1) The department shall pay for the cost of replacing an assistance unit member's clothing if:

(A) Such clothing was damaged or destroyed during a catastrophic event; and

(B) The loss of such clothing is not covered by an insurance policy.

(2) Any payment made by the department under this subsection shall be non-recurring and shall not exceed the following amount:

(A) Three hundred sixty-two dollars and sixty cents if such member is male and eighteen years of age or younger;

(B) Three hundred seventy-one dollars and forty cents if such member is female and eighteen years of age or younger;

(C) Three hundred ninety-nine dollars and sixty cents if such member is male and nineteen years of age or older; and

(D) Four hundred fifteen dollars and forty cents if such member is female and nineteen years of age or older.

(k)Heating services security deposit.

(1) The department shall pay for the cost of a security deposit that is necessary for an assistance unit member to obtain heating services if such services are provided by (A) a municipal utility company or a private fuel supplier, such as, but not limited to, a propane or bottle gas company, and (B) such security deposit is required for the use of such equipment. In no event shall the department make a payment under this subsection if the assistance unit member obtains heating services from a fuel supplier that is a public service company regulated by the Department of Public Utility Control.

(2) Any payment made by the department under this subsection shall be non-recurring and in an amount equal to that required by the heating services provider as a security deposit, provided that such payment shall not exceed two hundred dollars.

(l)Payment of special benefits. Any special benefit payment authorized pursuant to this section shall be issued as a supplemental payment and, unless another provision of this section provides otherwise, may, at the department's discretion, be paid to the assistance unit member or directly to the vendor, contractor or other person who provides goods or services for such member.

Conn. Agencies Regs. § 17b-198-11

Effective October 11, 2016