Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 11/21/2024
2062
2063 Good Cause for Failure to Cooperate - In rare instances the caretaker may be deemed to have good cause for refusing to cooperate in establishing paternity and securing support payments. Examples of such cases would be those in which it has been determined that pursuing paternity/support is against the best interest of the child or the caretaker. Eligibility Staff have the ultimate responsibility for determining the validity of good cause claims; however, CSS and Protection and Prevention Services (PPS) staff may alert the Eligibility Staff of the need to evaluate for good cause.
The caretaker has the primary responsibility for providing documentary evidence required to substantiate a good cause claim. When necessary, the agency shall assist the client in securing any evidence that the client cannot reasonably obtain.
Good cause for failure to cooperate must relate to one of the following criteria:
2063.01 - The child was conceived as a result of incest or rape;
2063.02 - There are legal proceedings for adoption of the child pending before a court;
2063.03 - The caretaker is currently being assisted by a public or licensed private social agency to resolve the issue of whether to keep the child or relinquish the child for adoption;
2063.04 - The caretaker was a victim of domestic violence whereby compliance with program requirements would increase risk of harm for the individual or any children in the individual's case. Domestic violence includes acts on the part of perpetrators that result in:
(1) - physical acts resulting in, or threatening to result in, physical injury;
(2) - sexual abuse, sexual activity involving dependent children, or threats of or attempts at sexual abuse;
(3) - mental abuse, including threats, intimidation, acts designed to induce terror, or restraints on liberty, or;
(4) - deprivation of medical care, housing, food or other necessities of life.
2063.05 - Good cause claims must be confirmed or substantiated. Uncorroborated statements of the caretaker do not constitute documentary evidence; the mere belief that pursuing paternity or support is not in the client's or the child's best interest is not sufficient evidence. An individual's statement and one corroborating piece of evidence shall meet the burden of proof unless there is an independent reasonable basis to doubt the veracity of the statement. Evidence may include, but is not limited to:
(1) - Police or court records,
(2) - Court documents which indicate that legal proceedings for adoption of the child are pending,
(3) - Protection from abuse (PFA) or Protection from stalking (PFS) orders (filed for and/or obtained),
(4) - Written statement from a public or licensed private social agency substantiating the fact that the client is involved in resolving the issue of whether to keep or relinquish the child for adoption,
(5) - Documentation from a shelter worker, attorney, clergy, medical or other professional from whom the client has sought assistance,
(6) - Other corroborating evidence such as a statement from any other individual with knowledge of the circumstances which provide the basis for the claim, or physical evidence of domestic violence or any other evidence which supports the statement.
Exception: Regardless of the policy in this section regarding uncorroborated statements by caretakers, in extremely rare situations such as when an individual is in hiding and is afraid that there could be information disclosed that could reveal his/her whereabouts and where the Eligibility Staff do not doubt the veracity of the individual's statement, a written statement from the victim signed under penalty of perjury shall meet the burden of proof.
In most instances a good cause determination should be made within 60 days following the receipt of such claim. Exceptions to this would include such situations as when the evidence is extremely difficult to obtain.
The Eligibility Staff are responsible for notifying CSS of good cause determinations. A referral shall not be sent to CSS while a good cause claim is pending. Once a claim of good cause has been substantiated, a referral shall be sent to CSS with the good cause indicated. A good cause claim shall be reviewed as often as necessary and at each pre-populated review.
The Eligibility Staff shall not deny, delay, or discontinue assistance pending a good cause determination as long as the caretaker has complied or is in the process of complying with the requirement of providing evidence or other necessary information. If assistance is granted pending a determination of good cause and it is subsequently determined that the claim is invalid, the assistance granted shall not be considered an overpayment. A referral to CSS will be sent at the time the claim is determined to be invalid.
NOTE: Do not confuse cases that involve good cause with routine cases of noncooperation. A client's claim of good cause does not negate the requirement for the assignment of support rights.