N.J. Admin. Code § 10:78-2.5

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:78-2.5 - Case transfer from one eligibility determination agency to another

(a) When an individual's eligibility transfers from one eligibility determination agency to another, responsibility for the case shall be transferred in a manner so as not to adversely affect the rights of any individual to program entitlement.

1. For individuals for whom, because of an initial screening, it is determined that the eligibility determination agency shall transfer the application to the appropriate agency, the agency of origin has the responsibility to:

i. Transfer, within five working days from the date of the initial screening, a copy of the application form including all verification; and

ii. Send the materials in (a)1i above, with a cover letter specifying that the application is being transferred and requesting written or verbal acknowledgment of receipt.

2. For individuals for whom a determination has been made, it is determined that because of a change in circumstances the eligibility determination agency shall transfer the case, the agency of origin has the responsibility to:

i. Transfer, within five working days from the date of the report of a change in circumstances, a copy of pertinent material to the appropriate agency. Such material shall include, at a minimum, a copy of the first application and most recent application form including all verification;

ii. Send the case material in (a)2i above, with a cover letter specifying that the case is being transferred and requesting written acknowledgment of receipt;

iii. Forward promptly to the receiving agency, copies of any other material mutually identified as necessary for case administration; and

iv. Notify the receiving agency if there will be a delay in providing any of the case material.

3. The receiving agency shall:

i. Communicate promptly with the individual upon receipt of the case material;

ii. Immediately notify the agency of origin, in writing, of the date the initial case material was received;

iii. Review eligibility for the case. If questions regarding case eligibility exist because of information provided by the agency of origin, that agency shall be consulted for resolution of the issues;

iv. Accept responsibility for the case effective with the next month if the initial case material has been received before the 10th of the month;

v. Accept responsibility for the case for the second month after the month of receipt of initial case material when such material is received on or after the 10th of the month;

vi. Update the Eligibility File, as necessary, including entry of a new case number. If the case continues to be eligible for NJ FamilyCare in the receiving agency, there shall be no interruption of entitlement. If the case is determined ineligible for NJ FamilyCare in the receiving agency, eligibility shall be terminated, subject to timely and adequate notice, and the previously eligible person terminated on the Eligibility File;

vii. Notify the agency of origin of the date eligibility for NJ FamilyCare will begin or will be terminated in the receiving agency; and

viii. Issue a NJ FamilyCare identification card with the new number if necessary.

N.J. Admin. Code § 10:78-2.5