GN BOS00605.660 Representative Payees for the Onsite Institutions - Connecticut Department of Administrative Services, Department of Developmental Services and Department of Mental Health and Administrative Services (TN 2-89, 7/2003)

A. Introduction

Effective July 1, 2003, the State of Connecticut reorganized the representative payee structure for those agencies serving as representative payee for beneficiaries in onsite institutions. The State of Connecticut's Department of Administrative Services (DAS) serves as a central collection agency for the Department of Developmental Services (DDS) and the Department of Mental Health and Administrative Services (DMHAS). Each of these Departments (or organizations within the Departments) serves as representative payee for RSDHI and/or SSI benefits.

DDS has four organizations which serve as representative payee for RSDHI and SSI benefits. These organizations are the DDS North, South and West Regional Offices and the Southbury Training School.

DMHAS has one organization, the Connecticut Valley Hospital, which serves as representative payee for RSDHI and SSI benefits.

DAS provides administrative services to DDS and DMHAS and serves as representative payee for some DDS and DMHAS clients.

When deciding which agency should be the representative payee consider which agency has jurisdiction of the client, the type of benefit received, and where the beneficiary resides. Follow the instructions in GN BOS00605.660B - C when appointing a representative payee for clients under the jurisdiction of DDS or DMHAS.

B. Policy

When selecting a payee, follow the list of preferred payees found in GN 00502.105. Our primary concern must be that the payee we choose will serve the best interests of the beneficiary.

When the DAS, DDS or DMHAS files to become representative payee, ask the agency to disclose all known information about the existence of parents and relatives who show concern. Use this information to locate potential payees and to determine entitlement to any additional benefits.

C. Representative Payee Structure

Use the following guidelines to determine which organization should file as representative payee when there is no other individual who is higher on the list of preferred payees.

1. DDS Regional Office

Each DDS Regional Office serves as representative payee for the clients described below who reside in its specific geographic area. The DDS Website (http://www.dmr.state.ct.us) provides a listing of the towns each of the three DDS Regional Offices serve. The DDS Regional Offices serve as representative payee for:

  • Title XVI recipients who reside in a medical (Title XIX) facility where Medicaid pays more than 50 percent of the cost of care (except those who reside in the Southbury Training School),

  • Title II and/or Title XVI beneficiaries who are in the Supported Living Program, and

  • Title II and/or TXVI beneficiaries who are in the Residential Subsidy Community Living Arrangement.

The DDS Regional Offices mailing and location addresses in RPS are the same. Both addresses are:

DDS North Region
155 Founders Plaza
255 Pitkin Street
East Hartford, CT 06108
DDS South Region
104 S Turnpike Rd
Wallingford, CT 06492
DDS West Region
250 Freight Street
Waterbury, CT 06702

2. DDS Southbury Training School

The Southbury Training School which is under the jurisdiction of the DDS West Region serves as representative payee for the DDS clients who reside in the Southbury Training School and are:
      Title XVI recipients who reside in a medical (Title XIX) facility where Medicaid pays more than 50 percent of the cost of care.

The RPS entry for the Southbury Training School location address is:

Southbury Training School
Rte 172
Southbury, CT 06488

The RPS entry for the Southbury Training School mailing address is:

Southbury Training School
PO Box 872
Southbury, CT 06488

3. DMHAS Connecticut Valley Hospital

The Connecticut Valley Hospital which is under the jurisdiction of the DMHAS serves as representative payee for clients who reside in the Connecticut Valley Hospital and are:
      Title XVI beneficiaries who reside in a medical (Title XIX) facility where Medicaid pays more than 50 percent of the cost of care and who are under age 22 or who are age 65 or older.

The Connecticut Valley Hospital mailing and location addresses in RPS are the same. Both addresses are:

Connecticut Valley Hospital
Box 351
Silver Street
Middletown, CT 06457

4. DAS

The DAS will serve as representative payee for all other Title II beneficiaries and Title XVI recipients.

The DAS mailing and location addresses in RPS area the same. Both addresses are:

CT Dept of Admin Svcs
165 Capitol Ave.
5 West
Hartford, CT 06106

D. Procedure

For an individual under the jurisdiction of the DDS or the DMHAS his/her case worker will provide the information needed to file an application for benefits or a representative payee application. The case worker will provide the information regardless of whether the DDS/DMHAS or the DAS will be the representative payee.

The field office parallel to the DDS Regional Office, the Southbury Training School, or the Connecticut Valley Hospital is responsible for processing new applications for benefits, new representative payee applications, redeterminations, and continuing disability reviews (CDRs).

The field office parallel to these organizations will contact the DDS or the DMHAS case worker to obtain information and completed applications/forms with proper signatures.

If the DAS is filing to be representative payee or is the payee, an appropriate DAS official will sign the applications and redetermination forms. This signature requirement does not change the FO processing jurisdiction specified above. When a DDS Regional Office, the Southbury Training School or the Connecticut Valley Hospital is the representative payee the case worker will sign the applications and redetermination forms.

All CDR forms will be signed by the legal guardian. All DDS clients have a court appointed legal guardian. The legal guardian may be the DDS Regional Office or a relative.

If the Connecticut organization serving as representative payee changes to a different Connecticut organization (e.g., the payee changes from the DDS Regional Office to DAS or from one DDS Regional Office to another DDS Regional Office) obtain a representative payee application from the new payee.

E. RPS Procedures

1. How to Select the Correct Representative Payee in RPS

Before initiating a representative payee application determine the type of benefit received (or applied for) and whether the individual is a resident of a medical (Title XIX) facility where Medicaid pays more than 50 percent of the cost of care, a participant in the Supported Living Program, or a participant in the Residential Subsidy Community Living Arrangement. Choose the appropriate representative payee based on the criteria in GN BOS00605.660C above.

All organizational representative payees are retrieved by the physical location zip code in RPS. To select the correct agency in RPS choose the physical location zip codes for the DDS Regional Offices, Southbury Training School, the Connecticut Valley Hospital, or DAS from the list below:

  • DDS North Region                 06108

  • DDS South Region                  06492

  • DDS West Region                   06702

  • Southbury Training School        06488

  • Connecticut Valley Hospital        06457

  • DAS                                        06106

2. Record the Individual's Residence Address in RPS

Always record the individual's residence address in RPS. If the representative payee has physical custody of the individual (e.g., Southbury Training School is filing for a resident of the school), answer “YES” to the question “Do you have physical custody?” on the RELA screen. This will establish the individual's residential address.

If the representative payee does not have physical custody of the individual (e.g., DAS is filing for a resident of the Southbury Training School), answer “NO.” This will place the CSCD screen in the application path. On the CSCD screen select 12 INSTITUTION and enter the individual's residential zip code. The ZIPL screen will appear. If the individual lives in an institution that is already on the ZIPL screen (in this example, Southbury Training School), select the proper entry. If the individual lives in a residence not listed on the ZIPL screen press enter and complete the BCIA screen.

3. Direct Deposit

When you appoint one of these agencies as representative payee you must input the direct deposit information into RPS. RPS propagates direct deposit information to the MBR and/or SSR only if you input it on the RPDA screen.

The DAS, DDS North Region and DDS South Region direct deposit routing and transit numbers and the depositor account numbers are annotated on their respective RPST screens.

The DDS West Region use more than one account for direct deposit. The DDS case worker will provide the correct routing and transit number and the depositor account number for this payee.

The Connecticut Valley Hospital and the Southbury Training School do not have direct deposit.

Enter the direct deposit information in RPS. On the Relationship Information (RELA) screen answer “Y” to the question, “Have you established a bank account for receipt of these payments?” This will bring the Direct Deposit Application (RPDA) screen into the application path.

F. Due Process

When appointing any of the above entities as representative payee, you must provide advance notice of the appointment to those listed in GN 00503.100.

G. Onsite Review Indicator

DAS, the DDS Regional Offices, the DDS Southbury Training School and the DMHAS Connecticut Valley Hospital are under the onsite review program. State mental institutions participating in the onsite review program should not receive individual representative payee accounting reports.

RPS contains an onsite indicator which prevents the mailing of representative payee accounting reports. Only Central Office can apply this indicator to RPS and make changes to the organizational information. The field office must not establish RPS entries for onsite representative payees. Any entry established by the field office will not contain the onsite indicator and cause the organization to receive representative payee accounting forms. If an organization reports receiving an individual representative payee accounting form clear the diary and tell the organization to discard the form. Determine the reason the accounting was issued and take corrective action. Contact the Program Policy and Systems Team of the Regional Office if any changes must be made to RPS for any onsite organization.


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