Department of Health and Human Services
Departmental Appeals Board
AFDC QUALITY CONTROL REVIEW PANEL
SUBJECT: Missouri Department of
Social Services
Docket No. 92-22
DATE:
DECISION
The Missouri Department of Social Services (State)
appealed the
determination of the Regional Administrator
of the Administration for
Children and Families (ACF or
Agency), dated October 9, 1991, that C.C. was
totally
ineligible for AFDC as of the review date, February 1,
1991. 1/ The Agency determined that C.C.'s son, M.C.,
was living in the household; that M.C. was required to be
considered a
member of the assistance unit (AU); and that
his income, $200 in Social
Security benefits, should have
been considered in determining the AU's
eligibility. 2/
For the reasons discussed below, we conclude that the
State correctly
determined that M.C. was not living in
C.C.'s home as of the review
date. Accordingly, we
reverse the Agency's error determination.
Statutes, Regulations, and Agency Interpretations
Section 402(a)(38) of the Social Security Act provides,
in relevant
part:
in making the determination [of eligibility] with
respect to a
dependent child. . . , the State agency
shall . . . include--
(A) any parent of such child, and
(B) any brother or sister of such child, if
such brother or
sister meets the conditions
described in section 406(a) or in section
407(a),
if such parent, brother, or sister is living in the
same home as
the dependent child, and any income of
or available for such parent,
brother, or sister
shall be included in making such determination. . .
The AFDC Quality Control Manual (Manual), issued by the
Agency,
describes the process to be used in verifying the
living arrangements of
children in the AU:
Determine whether the child is actually living with
the specified
relative. . . . If the child has left
the household of record, even if
he/she is living
with another specified relative in another
household,
the child can no longer be considered
part of the original AU. . . .
Manual at V-28. The Manual specifies primary and
secondary evidence
required to document living
arrangements. These provisions will be
discussed more
fully below.
Background
On December 4, 1990, C.C. applied for AFDC on behalf of
herself and her
daughter, A.C. C.C. reported that the
family's only source of income
was $200 in Social
Security benefits paid from the absent parent's Social
Security account for A.C. C.C.'s son, M.C., also
received Social
Security benefits in the amount of $200.
However, the caseworker who
reviewed C.C.'s application
noted that M.C. was not included in the AU and
his Social
Security benefits were not budgeted because M.C. had
moved
out of the home in November of 1990. According to
the application,
C.C. did not retain M.C.'s Social
Security benefits, but gave M.C. his
check. The record
contains a written statement from M.C. verifying
that,
"Mom gave me my $200.00 Social Security check on this
date of
12-3-90." The caseworker noted a December 20,
1990 telephone
conversation with one of the collateral
references listed by C.C. in her
application. The
reference stated that the household consisted of C.C.
and
A.C., as far as he knew.
State quality control review was conducted in March and
April of 1991,
and completed on April 17, 1991. The
review date was February 1,
1991. State QC found a $10
underpayment due to the fact that $210
rather than $200
had been budgeted as A.C.'s Social Security benefit.
In
item 150 of the quality control worksheet, entitled
"Living
Arrangement and Household Composition," State QC
made a "Special
Determination" that M.C. was not living
in C.C.'s home as of the review
date.
The State QC reviewer wrote in the worksheet that there
was conflicting
information as to where M.C. was living
as of the review date.
According to the State reviewer,
C.C. was adamant that M.C. did not live in
the home from
December until mid-February. The reviewer noted that
M.C. did not attend school, so she could not verify his
address from
school records. C.C. furnished a written
statement from M.C. that he
did not return to the home
until February 18, 1991. M.C.'s written
statement, date-
stamped April 5, 1991, states that he was living with
friends, gives the address, and indicates that his
friends would confirm
that he had been living there.
In attempting to verify the members of the household, the
State QC
reviewer contacted several collateral
references. In a letter dated
March 14, 1991, one
collateral reference, C.C.'s landlord, stated that the
members of the household were C.C. and her daughter.
However, in
letters dated March 26 and March 27, 1991,
two other collateral references,
who identified
themselves as friends of C.C., stated that the household
consisted of C.C., M.C., and A.C. The file contains
notes of April
1, 1991 telephone contacts with the two
references who placed M.C. in the
household. According
to the reviewer's notes, both references
confirmed that,
to the best of their knowledge, M.C. was living with his
mother on February 1, 1991.
The State QC supervisor concurred with the special
determination that
M.C. was not living with C.C. as of
the review date. The supervisor's
notes, dated April 17,
1991, report a telephone conversation with M.C.'s
grandmother, in which the grandmother stated that M.C.
had moved into
her home in November, but had moved out
before Christmas. According to
the note, the grandmother
believed that M.C. had returned to his mother's
home.
But the grandmother reported that she did not have much
contact with C.C. and that M.C. could have been "on the
streets."
The supervisor also noted that a Children's Services
social worker had
contacted C.C. while investigating a
child abuse report. According to
the note, as of January
1991, C.C. had told the social worker that M.C. was
not
in the home. The supervisor concluded, "We are reaching
a
likely conclusion that [M.C.] was not in the home until
2/18/91 as shown in
the written statements of [M.C. and
C.C.]. The family is in a state of
flux to the point
that the whereabouts are difficult for non-relatives to
know about."
By letter dated August 27, 1991, the Agency notified the
State that
federal QC review concluded that M.C. was in
the home and that he should be
included in the AU.
Federal QC found the AU totally ineligible, based
on the
addition of M.C.'s Social Security benefits to the AU's
budget. The Agency's letter stated, in pertinent part:
Two collateral statements (both live within a three
mile radius per
the map) were obtained by SQC
stating that [M.C.] was living in the
household.
The landlord (lives approximately 55 miles from
client)
statement did not list [M.C.] in the
household. State Quality Control
made a special
determination based on the statements of [C.C.] that
she
and [A.C] were the only household members as of
the review date.
State Quality Control requested and received a
statement from
[M.C.] as to where he was living
until he allegedly returned home February
18, 1991.
The Federal Reviewer wrote to the names that [M.C.]
gave
to verify where he had been living. The mother
of [M.C.'s] friends
replied that he was there only a
few nights until she asked him to
leave.
The collaterals who [M.C.] stated could prove where
he was did not
confirm his statement. . . .
The friends M.C. named in his written statement refused
to sign a
statement confirming that M.C. lived with them
during the period in
question. The mother of one of the
friends wrote that M.C. spent a few
nights with them and
that she asked M.C. to leave. She wrote that
neither she
nor her daughter remembered the dates M.C. stayed with
them.
By letter dated September 24, 1991, the State requested
that the Agency
reconsider its error determination. With
its request for
reconsideration, the State submitted an
additional statement from M.C.'s
grandmother, dated
September 12, 1991, indicating that M.C.'s brother, J.C.,
had told the grandmother that M.C. was living with him
(J.C.) in
January, 1991. The State obtained a written
statement from J.C., dated
September 10, 1991, confirming
that M.C. was living with him during late
January and
early February, 1991. Finally, the State submitted a
September 10, 1991 written statement from the social
worker mentioned in
the State QC supervisor's April 17,
1991 notation regarding the special
determination. The
social worker stated:
In February, 1991, worker was advised by both [C.C.
and the absent
parent] that [M.C.] was residing in
the home of his brother, [J.C.]. I
met [M.C.] in
the home of [J.C.] during my investigation in early
February. [M.C.] and [J.C.] both advised me that
[M.C.] was living
in [J.C.'s] home at that time.
By letter dated October 9, 1991, the Agency sustained the
federal QC
error finding. The Regional Administrator
summarized the Agency's
position in the following terms:
In evaluating the evidence in this case, I feel that
the greatest
credence must be given to the
collateral statements which placed [M.C.] in
the
client's household. Both statements were made
shortly after
the review date and later verified by
State Quality Control. Both
collaterals live in the
same town as the client and have known the client
and her family for at least 10 years. The evidence
indicating that
[M.C.] lived elsewhere is
contradictory and is provided almost exclusively
by
relatives whose objectivity could be questioned.
Of the social worker's statement, the Regional
Administrator observed,
"The social worker's statement
did not say she observed any evidence that
[M.C.] was
living in the trailer - only that she interviewed him
there." The Regional Administrator also pointed out that
the
evidence suggesting M.C. was living with his brother
conflicted with M.C.'s
written statement that he was
living with his friends.
By letter dated November 8, 1991, the State appealed the
Agency's
decision to sustain the federal QC error
determination to the AFDC QC Review
Panel. In its appeal
request, the State reported additional telephone
contacts
with the family friends who had previously reported that
M.C.
was living in C.C.'s home as of the review date.
The State also
attached written statements of two
additional collateral references
indicating that M.C. was
living with his brother, J.C., as of the review
date.
The appeal request reports that one of the family friends
stated over the
telephone that, as far as he knew, M.C.
was in C.C.'s home at the time he
provided his written
statement (March 27, 1991), but that he did not know
what
was going on in February, 1991. The appeal request also
describes a telephone conversation with the second family
friend, in
which the friend states that his knowledge of
the client's household came
from regular contact with the
absent parent. The friend had no day to
day knowledge of
the client's household. According to the appeal
request,
the absent parent told this friend that M.C. had moved to
his
grandmother's home around Christmas and later told
the friend that M.C. had
moved back into C.C.'s home but
the friend did not remember when. The
appeal request
does not disclose the date of these telephone
conversations or who spoke with these references on the
State's
behalf.
Attachment C to the State's appeal request is a lengthy
written
statement, dated October 19, 1991 and signed by a
reference identified by
the State as a friend of M.C.'s
brother, J.C. This reference states
that M.C. lived with
J.C. and another young man during February,
1991. The
reference states that J.C. rented a house from her
father
in November, 1990, and that M.C. moved in with J.C. about
two
weeks later. She remembers the dates because her
father went into the
hospital a few days after
Thanksgiving in 1990 and remained hospitalized
until
January 22, 1991. The reference reports that J.C. and
M.C. often
watched T.V. at her house in the evening,
because the boys did not own a
T.V. The boys helped her
clean her house in preparation for her
father's return
from the hospital. Her father died on February 1,
1991.
She reports that the night before he died, the boys
watched
T.V. with her family at her home. After her
father's death, she
reports that the boys helped her
remodel her home from the second week of
February until
the middle of April. Although they helped her until
April, she states that they moved out of the house they
had rented at
the end of February because it had been
broken into.
Attachment D to the State's appeal request is a written
statement, dated
October 23, 1991, and signed by the man
who allegedly lived with J.C. and
M.C. during the time in
question. He verifies that M.C. lived with him
and J.C.
from the first of January until "sometime in February or
first
of March."
Discussion
There is no dispute that if M.C. was living in C.C.'s
home as of the
review date, his $200 income would have to
be budgeted and, as a
consequence, the AU would be
totally ineligible for AFDC. On the other
hand, if M.C.
had left the home, the QC Manual states that he could no
longer be considered part of the original AU. In that
case, it
would be proper for the State to have excluded
his income in determining the
AU's eligibility.
In its appeal request, the State essentially argues that
the greater
weight of the evidence establishes that M.C.
was not living with his mother
and sister as of the
review date. Therefore, according to the State,
the
State QC finding of a $10 underpayment should be upheld.
The
Agency did not file a response to the State's appeal
request.
The record before us contains a great deal of
contradictory
evidence. Nevertheless, we conclude that
the most credible evidence
establishes that M.C. was not
living in C.C.'s household as of the review
date. We
note that the evidence upon which we rely would meet the
QC Manual requirements for determining a child's living
arrangement.
Section 3535 of the QC Manual specifies the evidence
required to document
that a child is living in the home
and thus should be considered as part of
the AU. 3/
For school age children the Manual lists two
types of
primary evidence which are acceptable proof of a child's
living
arrangement. The preferred evidence is current
school records.
However, if no school records are
available, the child's living arrangement
may be
documented by "[v]isual observation of the child in the
home
setting . . ., plus at least one piece of
corroborating secondary evidence." The Manual lists
eight
different types of acceptable secondary evidence.
A signed statement
from a non-relative is an acceptable
piece of secondary evidence, according
to the Manual.
The State QC file documents that M.C. did not attend
school, so that his
living situation could not be
established through current school
records. Without
school records, the State could establish M.C.'s
living
arrangement by visual observation corroborated by at
least one
written statement of a non-relative. In its
appeal request, the State
has provided the required
documentation. The State submitted the
statement of the
Children's Services social worker, who observed M.C. in
J.C.'s home. The State also submitted the written
statements of
the boys' neighbor and their roommate.
Neither the neighbor nor the
roommate appear to be
related to the family.
The written statements convincingly support the State's
contention that
M.C. was not living in C.C.'s home as of
the review date. In
particular, the statement of J.C.'s
neighbor provides a fairly detailed
account of the time
period when M.C. was apparently living with his brother
and roommate. We accord significant weight to this
statement
because the hospitalization, release, and
subsequent death of the neighbor's
father provide
landmark dates that she would be unlikely to forget.
The
other written statement is from the boys' roommate, and
his
statement corroborates that of the neighbor. Both
statements
corroborate the report of the Children's
Services social worker that she
observed M.C. in the home
of his brother at about the time in
question. Because of
the additional corroborating evidence provided by
the
State, we conclude that the social worker's statement is
reliable
despite the fact that it does not describe any
extrinsic evidence that M.C.
was living in J.C.'s home.
We note that the statements of J.C. and the boys'
grandmother submitted
by the State with its
reconsideration request also support the conclusion
that
M.C. was living with J.C. during the time in question.
While
the grandmother stated in April that she believed
M.C. had returned to his
mother's home, she also
indicated that she was uncertain that that was the
case
and she later signed a written statement indicating that
J.C. told
her that M.C. had been living with him in
January, 1991. We do not
rely on these statements,
however, because the QC Manual lists only signed
statements of non-relatives as acceptable secondary
evidence of a
child's living arrangement. 4/
In concluding that the State had erred in excluding M.C.
and his income
from the AU, federal QC review and the
Agency's reconsideration
determination relied primarily
on the statements of the two family friends
who placed
M.C. in his mother's home. The Agency found the
statements of the references credible because neither was
related to
C.C., both lived in close proximity to the
family, and both had known the
family for at least 10
years. The Agency discounted the statements of
family
members, reasoning that their impartiality could be
questioned.
The State's appeal request provides information which
tends to cast doubt
upon the statements of the two
references relied upon by the Agency.
The State asserts
that one of the references stated in a telephone
conversation that he believed M.C. was living in C.C.'s
home in March,
when he completed the verification form
for State QC, but that he did not
know where M.C. was
living in February. The other reference apparently
stated in a telephone conversation that he had no day to
day knowledge
of C.C.'s household, that he had been told
by the absent parent that M.C.
had moved back in with
C.C., but that he did not know when.
5/
Thus, when compared with the statements of the boys'
neighbor, their
roommate, and the social worker, the
statements of the family friends appear
to be less
reliable. Therefore, we conclude that the evidence
establishing that M.C. did not live with his mother as of
the review
date is entitled to greater weight.
Conclusion
For the reasons stated, we conclude that the State
correctly determined
that C.C. was underpaid by $10.
Accordingly, we reverse the Agency's
determination.
_____________________________
Thomas
D. Horvath
_____________________________
Carolyn
Reines-Graubard
_____________________________
Leslie
A. Weyn
* * * Footnotes * * *
1. We identify the
recipient and her children
by their initials to protect their privacy.
The State
quality control review number for this case is
48330.
2. The standard
of need for a three-person
household was $292. The addition of M.C.'s
$200 Social
Security benefit to the AU's budget would result in a
total
income of $400, which would exceed the standard of
need and render the AU
ineligible for assistance.
3. By Transmittal No. ACF-AT-91-27, dated
September 9,
1991, former section 3535 of the QC Manual
has been divided into two new
sections: 3536, which
governs household composition, and 3537, which governs
living arrangement. The primary and secondary evidence
required to
establish living arrangement have not been
changed. The revisions are
effective for review months
beginning with October,
1991.
4. For the same
reason, we do not accord any
weight to M.C.'s written statement that he was
living
with friends. In any event, this statement does not
support
the conclusion that M.C. was living in his
mother's
home.
5. We note that
the State did not provide dates
of these telephone conversations or provide
any record of
the conversations other than the narrative statement in
the appeal request. Thus, if this were the only evidence
submitted
by the State, we might not be inclined to
disturb the Agency's
findings.
(..continued)