415.29 Undue Hardship SR 18-01, 01/18 (MAM-A)

Applicants and recipients of NF/HCBC/CFI services may apply for a hardship waiver to waive:

• serving a penalty period for transferring assets for less than fair market value, by using DFA Form 791A, NF/HCBC Undue Hardship Application For Asset Transfers; or

• the denial or termination of NF/HCBC services due to having equity in a home that exceeds $572,000, by using DFA Form 791E, NF/HCBC/CFI Undue Hardship Application Due to Home Equity Exceeding the Limit.

Applications for a hardship waiver, and all required documentation of the hardship, must be submitted within 30 calendar days of the date on DFA Form 791AN, Notice of Asset Transfer Penalty, or DFA Form 791EN, Notice of Excessive Equity Penalty.

Submit all hardship waiver application packets received at the District Office to the DFA Asset Transfer Specialist at State Office. State Office:

• makes all hardship waiver application determinations;

• notifies each applicant of the decision on their hardship waiver application using DFA Form 791HD, NF/HCBC Hardship Decision; and

• coordinates any subsequent Administrative Appeals.

Applicants and recipients of NF/HCBC/CFI services may be eligible for a waiver of the penalty period under the following conditions:

• the assets in question were transferred by someone other than the applicant or recipient and the applicant or recipient lacked the mental capacity to comprehend the disqualifying nature of the act;

• a penalty period would deprive the applicant or recipient of care such that the individual’s health or life would be endangered; or

• a penalty period would deprive the applicant or recipient of food, clothing, shelter, heat, hot water, electricity, gas service, cooking fuel, or transportation to medical appointments.

Applicants and recipients of NF/HCBC/CFI services may be eligible for a waiver of the denial or termination of NF/HCBC/CFI services due to having equity in a home that exceeds $572,000, under the following conditions:

• the denial or termination of services would deprive the applicant or recipient of care such that the individual’s health or life would be endangered; or

• the denial or termination of services would deprive the applicant or recipient of food, clothing, shelter, heat, hot water, electricity, gas service, cooking fuel, or transportation to medical appointments.

References: He-W 621-622, He-W 695, RSA 167:4, RSA 167:13-16, 42 USC 1396p