*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***

Chapter 16 - Medical Support

Effective:  September 1, 2009

16.15.05 - Initial Good Cause Determinations

Archived:  June 1, 2016 (Previous Versions)

Initial Good Cause Determinations

Caretakers who are referred to medical support may claim good cause for non-cooperation with medical support or establishing paternity. Good cause determinations are made on a case-by-case basis.

Role of the Worker.

When the Claim Is Received.

Determination Process.

Withdrawing Good Cause Claims.

Final Decision.

Related Topics.

Top of Page

Role of the Worker

When a caretaker claims good cause:

l  Check to see if there is an active case for either child support or medical support. The applicant may provide this information on the application or the referral form. If not, most Medical Assistance (MA) and MinnesotaCare agencies have at least one person other than IV-D agency staff who has access to the child support system, PRISM , which also shows active cases.

l  If there is an active child support or medical support case:

n  Explain to the caretaker that the IV-D agency will stop all activity to collect child support and medical support or establish paternity pending the good cause decision, including collection of current child support payments.

Note:  Do not discourage the caretaker from pursuing the claim or deny the claim solely on this basis.

n  If the claim is denied or withdrawn, income withholding will resume.

n  If the claim is approved, IV-D will not resume any enforcement activities.

Example:

Jin receives child support from his ex-wife through income withholding. When he and his son become eligible for MA, he files good cause for medical support.

Action:

IV-D must cease all action to enforce the income withholding order pending the good cause decision.

m The county good cause committee later approves Jin's good cause claim.

m IV-D will not resume enforcement of the income withholding order.

l  Send a copy of the completed Client Statement of Good Cause (DHS-2338) to the IV-D agency so they will cease all child support and medical support enforcement activities.

l  Request documentation from the caretaker to support the good cause claim. See Evidence of Good Cause for more information.

l  Forward a copy of the completed Client Statement of Good Cause (DHS-2338), evidence, and other pertinent information to the agency's good cause committee or designated contact person.

Top of Page

When the Claim Is Received

When the good cause committee receives a good cause claim, they must send the client the notice Important Information About Your Request for a Child Support Good Cause Exemption (DHS-3627) and a Notice of Privacy Practices (DHS-3979). The DHS-3627 tells the client about the good cause claim process, the kind of evidence that is required, and what the next steps will be.

l  The good cause committee must send the notice to the client within five working days of their receipt of the claim.

l  The client then has 20 days to respond to the committee with evidence to support the claim.

Top of Page

Determination Process

The good cause committee will consider the evidence, the person's current situation, and the degree of cooperation that is likely to be required in deciding a good cause claim.

l  If more information is needed, the committee will generally send the Request for Additional Information to Prove Your Child Support Good Cause Exemption (DHS-3632) to the client.

l  If investigating the claim will require contacting the non-custodial parent, the committee will notify the custodial parent or caretaker before making the contact.

Top of Page

Withdrawing Good Cause Claims

A client may withdraw a claim for good cause at any time in the process. Clients should request withdrawals in writing by using the Request to End Child Support Good Cause Exemption (DHS-3631).

l  Forward a copy of the DHS-3631 to the IV-D agency working on the case.

l  The IV-D worker must then take the appropriate action to initiate or enforce the appropriate medical support obligation.

Top of Page

Final Decision

Within 45 days of the date the claim is filed (or a longer period if the committee allows the caretaker more time to provide evidence), the good cause committee will notify the caretaker and the IV-D agency of the final decision. There are two possible determinations:

l  Approval of the claim.

n  The committee will notify the client of the approval with the Notice of Child Support Good Cause Approval (DHS-3629).

n  The IV-D agency may take no action to enforce child support or medical support requirements once a good cause claim is approved.

l  Denial of the claim.

n  The committee will notify the client of the denial with the Notice of Denial of Child Support Good Cause Exemption (DHS-3628).

n  This notice advises the caretaker of the following options:

m To cooperate.

m To choose not to receive health care coverage for the child.

m To withdraw the application or request closure for the caretaker.

Note:  Explain that in this case the IV-D agency may proceed to enforce medical support without the caretaker's cooperation, if possible.

m To appeal the agency's good cause decision.

m To request a conference with the good cause committee.

Top of Page

Related Topics

For more information, see:

Good Cause for Non-Cooperation.

Evidence of Good Cause.

Approved Good Cause Exemptions.

Top of Page