Oneida Business Committee (2021)

Tribal code

Ask Donna

What actually matters in this document.

Text

1 of 77

Oneida Nation

Oneida Business Committee

Legislative Operating Committee

PO Box 365 • Oneida, WI 54155-0365

Oneida-nsn.gov

~

ONEIDA

LEGISLATIVE OPERATING COMMITTEE MEETING AGENDA

Business Committee Conference Room - 2nd Floor Norbert Hill Center

June 2, 2021

9:00 a.m.

This Legislative Operating Committee meeting will be closed to the public due to the Public Health State

of Emergency. This is a preventative measure as a result of the COVID-19 pandemic. An audio recording

of the meeting will be made available on the Nation’s website.

I.

Call to Order and Approval of the Agenda

II.

Minutes to be Approved

1. May 19, 2021 LOC Meeting Minutes (pg. 2)

III.

Current Business

1. Petition: L. Elm – Real Property Law Eviction and Termination (pg. 4)

IV.

New Submissions

V.

Additions

VI.

Administrative Updates

1. Community Support Fund Law Rule Handbook Amendments (pg. 18)

VII.

Executive Session

VIII. Recess/Adjourn

A good mind. A good heart. A strong fire.

2 of 77

Oneida Nation

Oneida Business Committee

Legislative Operating Committee

PO Box 365 • Oneida, WI 54155-0365

Oneida-nsn.gov

~

ONEIDA

LEGISLATIVE OPERATING COMMITTEE MEETING MINUTES

Oneida Business Committee Conference Room-2nd Floor Norbert Hill Center

May 19, 2021

9:00 a.m.

Present: David P. Jordan, Kirby Metoxen Jennifer Webster, Marie Summers, Daniel Guzman

King

Others Present: Clorissa N. Santiago, Kristen Hooker, Kristal Hill, Brooke Doxtator, Lawrence

Barton, Debbie Melchert (Microsoft Teams), Geraldine Danforth (Microsoft Teams), Justin

Nishimoto (Microsoft Teams), Susan House (Microsoft Teams), Kelly McAndrews (Microsoft

Teams), Matthew Denny (Microsoft Teams), Michelle Myers (Microsoft Teams), Nic Reynolds

(Microsoft Teams), Jo Anne House (Microsoft Teams), Josh Cottrell (Microsoft Teams), Rhiannon

Metoxen (Microsoft Teams).

I.

Call to Order and Approval of the Agenda

David P. Jordan called the May 19, 2021, Legislative Operating Committee meeting to

order at 9:03 a.m.

Motion by Marie Summers to adopt the agenda as is; seconded by Jennifer Webster.

Motion carried unanimously.

II.

Minutes to be Approved

1. May 5, 2021 LOC Meeting Minutes

Motion by Kirby Metoxen to approve the May 5, 2021 LOC meeting minutes and forward

to the Oneida Business Committee; seconded by Jennifer Webster. Motion carried

unanimously.

III.

Current Business

IV.

New Submissions

V.

Additions

VI.

Administrative Items

1. Legislative Operating Committee Fiscal Year 2021 Second Quarter Report

Motion by Marie Summers to approve the Legislative Operating Committee Fiscal Year

2021 Second Quarter Report and forward to the Oneida Business Committee; seconded by

Jennifer Webster. Motion carried unanimously.

2. E-Poll Results: Approval of the Oneida Worker’s Compensation Law Emergency

Amendments Adoption Packet

Motion by Jennifer Webster to enter into the record the results of the May 11, 2021, e-poll

entitled, “Approval of the Oneida Worker’s Compensation Law Emergency Amendments

Adoption Packet;” seconded by Kirby Metoxen. Motion carried unanimously.

A good mind. A good heart. A strong fire.

Legislative Operating Committee Meeting Minutes of May 19, 2021

Page 1 of 2

~

ONEIDA

3 of 77

3. E-Poll Results: Approval of the Early Return to Work Law Emergency

Amendments Adoption Packet

Motion by Jennifer Webster to enter into the record the results of the May 11, 2021, e-poll

entitled, “Approval of the Early Return to Work Law Emergency Amendments Adoption

Packet;” seconded by Daniel Guzman King. Motion carried unanimously.

VII.

Executive Session

VIII. Adjourn

Motion by Marie Summers to adjourn at 9:18 a.m.; seconded by Kirby Metoxen. Motion

carried unanimously.

Legislative Operating Committee Meeting Minutes of May 19, 2021

Page 2 of 2

4 of 77

Oneida Nation

Oneida Business Committee

Legislative Operating Committee

PO Box 365 • Oneida, WI 54155-0365

Oneida-nsn.gov

Legislative Operating Committee

June 2, 2021

Petition: L. Elm – Real Property Law

Eviction and Termination

Submission Date: 4/21/21

LOC Sponsor: Kirby Metoxen

Public Meeting: n/a

Emergency Enacted: n/a

Expires: n/a

Summary: This Petition, submitted by Lori Elm, requests that a: “General Tribal Council

(GTC) meeting be held by virtual or in-person, regarding the Real Property Law, concerning

Eviction and termination including residential leases. With our current pandemic of addiction

in the community, the stipulation of vacating your home in five (5) days, from the time of the

incident is or should be considered and Unconstitutional, furthermore we need a due process

to protect the heads of household leases), from losing their homes, an include procedures in

the case they do. Including timeframes for them to sell their homes; implementation of a chart

of penalties, (Drugs and type, Violence, Sexual abuse or assault, human trafficking and all

unlawful activities) including intent of eviction Notice with timelines, from the date of the

incident as well as date of Notice and including Due Process; Request an advocated board be

created between Oneida Land Commission, Oneida Police Commission, with representatives

from Behavior Health, and Comprehensive Housing Division Area; Request if the head of

household is not the occupant in violation, a compliance agreement be done with them, outline,

behavior or property for a period of time, before termination (eviction) of lessee is

implemented; also requesting occupant of violation must be removed from residence and if a

successful treatment plan and stability review is approved by advocate board, they may be able

to enter into their own lease or reside back at residence; Evaluation of how one can be held

responsible of activities: address on citation, activity at residence, accusations and/or any

other ways; Timeline(s) for getting another lease and how; The reasoning for this petition is

to protect families from their loved one’s addiction, and so they do not lose their home after

all the other family suffering, they already, have consumed over the addiction.”

4/14/21 OBC: Motion by Jennifer Webster to approve the four (4) requested actions [1) To

acknowledge receipt of the petition from Lori Elm regarding Real Property Law

Eviction and Termination; 2) To assign the petition to the next available GTC meeting

agenda for consideration; 3) To direct the BC Direct Report Offices to complete and

submit their administrative impact statements of the petition to the Tribal Secretary

mailbox by Wednesday, May 5, 2021; 4) To direct the Law, Finance, and Legislative

Reference Offices to complete, respectively, the legal review, fiscal impact statement,

and statement of effect with status updates to be submitted for the June 9, 2021, regular

Business Committee meeting agenda and the first BC meeting of the month thereafter

or until the final documents are submitted]; Seconded by Marie Summers. Motion

carried.

Page 1 of 2

5 of 77

4/21/21 LOC: Motion by Marie Summers to add the Petition: L. Elm – Real Property Law Eviction

and Termination to the Active Files List with Kirby Metoxen as the sponsor; Seconded

by Daniel Guzman-King. Motion carried.

Next Steps:

▪

Approve the Petition: L. Elm – Real Property Law Eviction and Termination Statement of

Effect and forward to the Oneida Business Committee for consideration.

Page 2 of 2

6 of 77

Oneida Nation

Oneida Business Committee

Legislative Operating Committee

PO Box 365 • Oneida, WI 54155-0365

Oneida-nsn.gov

Statement of Effect

Petition: L. Elm – Real Property Law Eviction and Termination

Summary

This Petition requests a General Tribal Council (“GTC”) meeting be held, either virtually or inperson, to address certain concerns the Petitioner raises with respect to the Real Property law; more

specifically, the Nation’s process for evicting/terminating residential occupants for activities often

fueled by the AODA epidemic that plagues many families within the community.

Submitted by: Kristen M. Hooker, Staff Attorney, Legislative Reference Office

Date: May 26, 2021

Analysis by the Legislative Reference Office

On April 7, 2021, the Petition: L. Elm – Real Property Law Eviction and Termination (“Petition”)

was submitted to the Business Committee Support Office by Lori Elm (“Petitioner”) and has since

been verified by the Oneida Trust Enrollment Department. On April 14, 2021, the Oneida Business

Committee (“OBC”) acknowledged receipt of the Petition and directed the Law, Finance and

Legislative Reference Offices to complete, respectively, the legal review, fiscal impact statement

and statement of effect (“SOE”) with status updates to be submitted for the June 9, 2021, regular

OBC meeting agenda and the first OBC meeting of the month thereafter or until the final

documents are submitted.

The purpose of this Petition is for a “General Tribal Council (GTC) meeting be held by virtual or

in-person, regarding the Real Property Law, concerning Eviction and termination including

residential leases. With our current pandemic of addiction in the community, the stipulation of

vacating your home in five (5) days, from the time of the incident is or should be considered and

Unconstitutional, furthermore we need a due process to protect the heads of household leases),

from losing their homes, an include procedures in the case they do. Including timeframes for them

to sell their homes; implementation of a chart of penalties, (Drugs and type, Violence, Sexual

abuse or assault, human trafficking and all unlawful activities) including intent of eviction Notice

with timelines, from the date of the incident as well as date of Notice and including Due Process;

Request an advocated board be created between Oneida Land Commission, Oneida Police

Commission, with representatives from Behavior Health, and Comprehensive Housing Division

Area; Request if the head of household is not the occupant in violation, a compliance agreement

be done with them, outline, behavior or property for a period of time, before termination (eviction)

of lessee is implemented; also requesting occupant of violation must be removed from residence

and if a successful treatment plan and stability review is approved by advocate board, they may

be able to enter into their own lease or reside back at residence; Evaluation of how one can be

held responsible of activities: address on citation, activity at residence, accusations and/or any

other ways; Timeline(s) for getting another lease and how; The reasoning for this petition is to

Page 1 of 12

7 of 77

protect families from their loved one’s addiction, and so they do not lose their home after all the

other family suffering, they already, have consumed over the addiction.”

All applicable laws, rules and policies of the Nation were reviewed in developing this statement

of effect, including the Legislative Procedures Act and Administrative Rulemaking law, as well as

the Real Property law, Leasing law, Landlord-Tenant law, Eviction and Termination law and any

relevant rules promulgated thereunder.

Petition Comments and Requested Actions

In her Petition, the Petitioner makes various suggestions regarding the Real Property law, but more

specifically, the process for evicting/terminating occupants of residential leases, entered into under

a housing program of the Nation, for infractions often related to the drug/alcohol epidemic that

plagues many families within the community. For purposes of the SOE, the suggestions have been

broken down as follows:

• That, the stipulation of vacating your home in five (5) days, from the time of the incident

is or should be considered unconstitutional;

• That, there should be due process to protect the heads of household leases from losing their

homes and include procedures in case they do, including timeframes for them to sell their

homes;

• That, there should be implementation of a chart of penalties (i.e. drugs and type, violence,

sexual abuse or assault, human trafficking and all unlawful activities), including intent of

eviction, notice with timelines, from the date of the incident as well as date of notice and

including due process;

• That, when the head of household is not the occupant in violation, an advocate board, made

up of representatives from the Oneida Land Commission, Oneida Police Commission,

Behavioral Health and Comprehensive Housing Division, be created to consider entering

into a compliance agreement that:

o outlines behavior or property for a period of time before termination/eviction of

lessee is implemented; and

o removes the occupant in violation, but provides an opportunity for him or her to

enter into a new lease or reside back at the original residence upon successful

treatment plan and stability review approval by the advocate board; and

• That, there is an evaluation of how one can be held responsible for activities, including

address on citation, activity at residence, accusations and/or any other ways, with timelines

for getting another lease and how.

Real Property Law

The Real Property law was established to provide regulations and procedures for the transfer,

control and management of the territory within the Reservation and all Tribal land; to integrate

these regulations and procedures with the real property laws and practices of other federal and

state sovereigns which may hold jurisdiction within the Reservation; and to establish licensing and

certification requirements for the Nation’s employees dealing with real property transactions. [6

O.C. 601.1-1].

Page 2 of 12

8 of 77

With respect to the leasing of residential property, section 601.9-1 of the law provides that the

Comprehensive Housing Division (“CHD”) shall administer and process all leasing of Tribal land

for residential purposes pursuant to the Nation’s Leasing law. [6 O.C. 601.9-1]. Section 601.12-1

further provides that the CHD shall oversee all residential transactions within the Reservation and

shall process and administer such transactions consistent with the Landlord-Tenant law, Mortgage

and Foreclosure law, Leasing law, Eviction and Termination law, and any rules promulgated in

accordance therewith. [6 O.C. 601.12-1].

The Petitioner’s suggestions do not conflict with any express language and/or provision of the Real

Property law. If, however, the Petitioner is requesting that the Real Property law be amended to

specifically address one or more of the issues raised within her Petition, amendments to the law

would have to be developed in accordance with the Legislative Procedures Act and approved by

the OBC. [6 O.C. 601.2-2].

Because the Real Property law directs the CHD to administer/process residential leases consistent

with the Nation’s Landlord-Tenant law, Mortgage and Foreclosure law, Leasing law, Eviction and

Termination law, as well as any rules promulgated thereunder, a complete analysis of the Petition

requires a review of the aforementioned laws/rules that are relevant to the Petitioner’s suggestions.

Leasing Law

The Leasing law sets forth the Nation’s authority to issue, review, approve, as well as enforce,

leases and was established in accordance with the Helping Expedite and Advance Responsible

Tribal Home Ownership Act of 2021 (HEARTH Act) so that the Nation can approve leases on its

land without having to obtain additional approval from the Secretary of the Interior. [6 O.C. 602.11]. The policy behind the law is to codify the expectations and responsibilities of the lessor and

lessee when leasing Tribal land and to ensure that the leasing of Tribal land results in minimal risk

to the Nation. [6 O.C. 602.1-2].

With respect to evictions/terminations of leases entered into in accordance therewith, the Leasing

law provides, in pertinent part, as follows:

• That, the Division of Land Management or other entity responsible for entering into leases

of Tribal land (“Land Management”) is delegated all powers necessary to enforce the

lease, the law, and any rules developed thereunder, including the power to enter premises,

assess late fees/penalties and cancel leases [6 O.C. 602.11-1];

• That, if a lessee or other party causes or threatens to cause immediate and significant harm

to the premises, or undertakes criminal activity thereon, Land Management or another

interested party may take appropriate emergency action, which may include cancelling the

lease and/or securing judicial relief [6 O.C. 602.11-2]; and

• That, if Land Management determines a lessee is in default, it shall take action to have

lessee cure the default or, if the default is not cured, cancel the lease pursuant to the

Eviction and Termination law [6 O.C. 602.11-4].

And, with respect to the due process rights of lessees who disagree with decisions that Land

Management makes when exercising its delegated authority, including, but not limited to,

canceling leases, the Leasing law provides as follows:

Page 3 of 12

9 of 77

•

•

•

That, the Oneida Judiciary has jurisdiction to hear complaints regarding actions taken

pursuant to the law and/or a lease document [6 O.C. 602.12-1];

That, no administrative hearing body, including a board, committee or commission, is

authorized to hear a complaint regarding actions taken pursuant to the law and/or a lease

document [6 O.C. 602.12-2]; and

That, the lessor is Land Management for purposes of registering grievances authorized

under the law and complaints filed with the Oneida Judiciary shall name Land

Management, as well as the specific lease program at issue [6 O.C. 602.12-3].

The Petitioner’s suggestions do not conflict with any express language and/or provision of the

Leasing law. If, however, the Petitioner is requesting the Leasing law be amended to specifically

address one or more of the issues raised within her Petition, like the Real Property law,

amendments to the Leasing law would have to be developed in accordance with the Legislative

Procedures Act and approved by the OBC. [6 O.C. 602.2-2].

Landlord-Tenant Law

The Landlord-Tenant law was established to “provide mechanisms for protecting the rights of

landlords and tenants of the Nation’s rental programs.” [6 O.C. 611.1-1]. Its underlying policy is

to afford a “fair process to all landlords and tenants of the Nation’s rental programs that preserves

the peace, harmony, safety, health, general welfare and the Nation’s resources.” [6 O.C. 611.1-2].

The Landlord-Tenant law delegates authority to the CHD and Oneida Land Commission (“OLC”)

to develop rules, pursuant to the Administrative Rulemaking law, as well as citation fees and

penalty schedules, for the implementation, interpretation and/or enforcement of the law; provided,

where such rules relate solely to premises administered with federal funding, the CHD has sole

rule-making authority. [6 O.C. 611.3-1(g)].

With respect to the Nation’s rental programs, the Landlord-Tenant law states, in relevant part, that

the CHD shall provide residential rental programs for the Nation’s elder members, low-income

members and members in general. [6 O.C. 611.4-1]. To be eligible to participate in such programs,

the law requires that applicants:

• Have no felony or drug convictions within the past two (2) years from the date of

application, provided that a pardon or forgiveness received pursuant to the Pardon and

Forgiveness law may provide an exception to this condition;

• Meet any other eligibility requirements set by the rental program’s rules, which may not

be less strict than the law, but may be stricter; provided, rules developed for low-income

members and families:

o May not contain eligibility requirements that consider debt owed or evictions from

entities other than the CHD; but

o May contain eligibility requirements that consider debt owed to utility providers if

the debt owed is two hundred dollars ($200) or more. [6 O.C. 611.4-2(b) & (f)].

Like the Leasing law, the Landlord-Tenant law provides a process for grieving decisions made by

the CHD under its delegation of authority. Said process is as follows:

• That, the Oneida Judiciary is granted jurisdiction to hear complaints filed for actions taken

under the law and/or rental agreement;

Page 4 of 12

10 of 77

•

•

That, no administrative hearing body, including a board, committee or commission, is

authorized to hear a complaint regarding actions taken under the law and/or rental

agreement; and

That, the landlord is CHD for purposes of registering grievances authorized under the law

and complaints filed with the Oneida Judiciary shall name the CHD, as well as the specific

program at issue. [6 O.C. 611.10-1 – 611.10-3].

The Landlord-Tenant law does restrict eligibility to participate in CHD’s rental programs when a

previous eviction by CHD or a more recent felony/drug conviction exists; however, an exception

is written into the law for a pardon or forgiveness from the Nation under its Pardon and Forgiveness

law that could lift said restriction. In addition, the Landlord-Tenant law allows the CHD to set

other eligibility requirements by rule so long as they are not less strict than that which is required

under the law.

Although the Landlord-Tenant law does provide a process to overcome eligibility restrictions

related to drug convictions, if the Petitioner is suggesting that the restrictions be lessened or the

exceptions be expanded, it would likely require an amendment to the law, as opposed to any rule

promulgated by the CHD on the issue because the CHD is only allowed to promulgate rules

relating to eligibility that are consistent with or stricter than that which is provided for in the law.

If this is Petitioner’s intent, amendments to the Landlord-Tenant law would have to be developed

in accordance with the Legislative Procedures Act and approved by the OBC or, if applicable, the

GTC. [6 O.C. 611.2-2].

Eviction and Termination Law

The Nation’s Eviction and Termination law was established to provide consistent procedures for

terminating contracts and evicting occupants under the Nation’s rental and/or leasing programs

that include due process and other protections for all parties involved. [6 O.C. 610.1-1]. The law’s

underlying policy is to “provide fair termination and eviction processes that preserves the peace,

harmony, safety, health, general welfare and the Nation’s resources.” [6 O.C. 610.1-2].

According to the Eviction and Termination law, the Nation, as the owner, may terminate a contract

prior to the contract term and evict the occupant, if the occupant:

• Violates the terms of the contract;

• Is alleged to have violated any applicable law or rule; and/or

• Is alleged to have committed one or more nuisance activities. [6 O.C. 610.5-1].

The law defines nuisance as an occupant’s interference with another occupant’s use and enjoyment

of the premises, including, but not limited to, harassment, disorderly conduct, battery, lewd and

lascivious behavior, prostitution, theft, possession of stolen property, arson, illegal drug activity,

gambling, animal violations, trespassing, weapons violations, habitual noise violations, execution

of warrants, alcohol violations, obstruction/resisting and inspection related calls in which a law

enforcement agency responds. [6 O.C. 610.3-1].

With respect to the eviction process, section 610.5-3 of the Eviction and Termination law governs

the form and amount of notice that must be afforded to an occupant, as well as the manner in which

notice must be served, before an eviction/termination may be carried out. For example:

Page 5 of 12

11 of 77

•

•

•

When due to non-payment of rent, the law states “the occupant’s contract is terminated if

the owner gives the occupant notice requiring the tenant to pay rent or vacate on or before

a date at least thirty (30) calendar days after the giving of the notice and if the occupant

fails to pay accordingly.” [6 O.C. 610.5-3(a)].

When due to waste or a non-payment related contract breach, the law states “the occupant’s

tenancy is terminated if the owner gives the occupant a notice requiring the occupant to

remedy the default or vacate the premises on or before a date at least thirty (30) calendar

days after the giving of the notice, and if the occupant fails to comply with such notice….”

[6 O.C. 610.5-3(b)].

When due to a violation of law/rule or nuisance, the law states that the owner must have

received a report of the violation/nuisance from, among other plausible sources, another

occupant, law enforcement agency, or local district attorney’s office and then given the

occupant written notice requiring the occupant to vacate on or before a date at least five (5)

calendar days after the giving of the notice. [6 O.C. 610.5-3(c)(1)(A)-(B)].

When the eviction is based on a violation of law/rule or the creation of a nuisance, the Eviction

and Termination law requires that the notice of eviction contain, at a minimum:

• The violation of law/rule, type of nuisance and/or breach of contract, with citations to the

applicable law, rule and/or contract clause;

• A statement that the occupant may request a hearing with the Oneida Judiciary prior to the

effective date of the termination provided on the notice, and that, if the occupant timely

files for a hearing, there is an automatic stay on the eviction pending the determination of

the Oneida Judiciary; and

• The contact information for CHD staff available to answer questions and/or hear concerns

of the occupant related to the notice. [6 O.C. 610.5-3(d)(1)(A), (D) and (E)].

If the occupant does request a hearing with the Oneida Judiciary as noted within the eviction notice,

the Eviction and Termination law allows the “Oneida Judiciary, in its discretion, to stay an eviction

by honoring any alternative agreement regarding pending actions entered into by the occupant and

a court of competent jurisdiction pending successful completion of the alternative agreement.” [6

O.C. 610.5-3(c)(4)]. This is true even if the owner met the burden of proof to support an eviction.

[Id.].

In addition to the above, the Eviction and Termination law provides further due process relief for

decisions rendered by the CHD under its delegated authority, as follows:

• That, the Oneida Judiciary is granted jurisdiction to hear complaints filed for actions taken

under the law;

• That, no administrative hearing body, including a board, committee or commission, is

authorized to hear a complaint regarding actions taken pursuant to the law and/or a rental

agreement; and

• That, the owner is CHD for purposes of registering grievances authorized under the law

and complaints filed with the Oneida Judiciary shall name CHD, as well as the specific

program at issue. [6 O.C. 610.8-1 – 610.8-3].

The Eviction and Termination law sets the minimal amount of notice required for evictions relating

to violations of laws/rules and/or creations of nuisances at five (5) calendar days. In her Petition,

the Petitioner suggests that this is unconstitutional. Changes to the minimal amount of notice for

Page 6 of 12

~

fflXJCJOO

A good mind. A good heart. A strong fire.

ONEIDA

12 of 77

this type of infraction, as well as any other amendments to the process and/or notice governing

evictions that would contradict any current provision, would have to be approved by the OBC and

developed pursuant to the Legislative Procedures Act to avoid a conflict. [6 O.C. 610.2-2].

Legislative Procedures Act

The Legislative Procedures Act (“LPA”), enacted by the GTC in 2013, sets forth the requisite

process for adopting laws of the Nation. [1 O.C. 109.2-2]. The requirements apply to all legislation

considered by the OBC or forwarded for consideration to the GTC. [1 O.C. 109.1-1(a)].

The LPA established the Legislative Operating Committee (“LOC”), comprised of the five (5)

OBC council members, to develop the Nation’s laws in accordance therewith. [1 O.C. 109.3-1(h)

and 1 O.C. 109.4-2]. It further established the Legislative Reference Office (“LRO”) to support

the LOC with the development of legislation and other items related thereto. [1 O.C. 109.3-1(i)].

Per section 109.5-1 of the LPA, any interested person may submit a request to the LRO for the

development, amendment or repeal of a law. [1 O.C. 109.5-1]. From there, the request would have

to be processed as follows to comply with the law:

• The LRO would place the request for legislation on the agenda of the next duly called LOC

meeting wherein the LOC would decide whether to:

o Accept the request and direct it be developed in accordance with the LPA; or

o So long as the request did not come from a GTC directive by motion or resolution,

deny the request in writing and include the reason therefor. [1 O.C. 109.5-2].

• If accepted, the following would have to occur before the legislation could be introduced

to the OBC or, if applicable, the GTC, for consideration of adoption:

o Fiscal Impact Statement. The agency/agencies selected by the LOC would have to

prepare a fiscal impact statement for the proposed legislation, which is an estimate

of the total fiscal year financial effects associated with the legislation to include

startup costs, personnel, office, documentation costs, as well as an estimate of the

amount of time necessary for an individual or agency to comply with the law after

implementation [1 O.C. 109.6-1 and 109.3-1(c)];

o Legislative Analysis. The LRO would have to prepare a legislative analysis, which

is a plain language analysis, describing the important features of the legislation

being considered and factual information to enable the LOC to make informed

decisions regarding the legislation [1 O.C. 109.7-1 and 1 O.C. 109.3-1(g)];

o Public Review – Public Comment Period. The LOC would have to approve and

provide a public comment period that:

▪ Shall remain open for no less than five (5) business days after the public

meeting is held; and

▪ Shall be noticed in accordance with section 109.8-2 of the LPA and provide

interested persons a reasonable opportunity to submit data, views or

arguments on the legislation. [1 O.C. 109.8-1].

o Public Review – Public Meeting. The LOC would have to hold a public meeting

during the public comment period to solicit oral comments, the meeting of which:

▪ Would have to be presided over by at least one (1) LOC member; and

Page 7 of 12

13 of 77

▪

Would have to register all persons who attend and present oral comments.

[1 O.C. 109.8-3].

o Public Review – Comments and Testimony. The LOC would have to fully consider

all written and oral comments that were received during the public comment period

[1 O.C. 109.8-4];

o Consideration. Contingent upon satisfaction of the public review requirements, the

LOC would have to decide whether to approve the adoption packet, consisting of,

at least, the draft legislation, legislative analysis and fiscal impact, for forwarding

to the OBC for consideration of adoption or, if applicable, forwarding to GTC for

possible adoption [1 O.C. 109.9-1]; and

o Adoption. If approved by the LOC, the OBC would have to decide whether to:

▪ Adopt the legislation, which requires a majority vote of the OBC and an

adopting resolution;

▪ Deny/defer the legislation; or

▪ Forward the legislation to the GTC for consideration of possible adoption

in accordance with the laws governing GTC action. [1 O.C. 109.9-2].

Unless specified otherwise in the resolution or legislation at issue, the law, amendment or repeal

would become effective within ten (10) business days of adoption. [1 O.C. 109.9-3].

But for the five (5) day minimal notice requirement for evictions relating to unlawful activities/

nuisances, the Petitioner’s suggestions regarding the eviction process, including opportunities for

redemption, may be attainable without amendment to the Nation’s laws using some of the due

process protections already set forth therein. However, changes to the five (5) day notice period or

the current processes/relief set forth within the laws that govern the Nation’s rental programs, as

well as evictions therefrom, would have to occur in accordance with the LPA.

Administrative Rulemaking.

The OBC adopted the Administrative Rulemaking law to provide a process for the adoption of and

amendments to the Nation’s administrative rules. [1 O.C. 106.1-1]. Its underlying policy is to

ensure there exists an efficient, effective and democratic process for enacting and revising

administrative rules, and that authorized agencies act in a responsible and consistent manner when

enacting and revising administrative rules. [1 O.C. 106.1-2].

Per the Administrative Rulemaking law, only authorized agencies may promulgate rules. [1 O.C.

106.4-1]. An authorized agency is defined as “any board, committee, commission, department,

program or officer of the Nation that has been granted rulemaking authority.” [1 O.C. 106.3-1(a)].

And, rulemaking authority is defined as “the delegation of authority to authorized agencies found

in the Nation’s laws, other than this law, which allows authorized agencies to implement, interpret

and/or enforce a law of the Nation.” [1 O.C. 106.3-1(i)].

Under the Administrative Rulemaking law, authorized agencies may promulgate rules interpreting

the provisions of any law enforced or administered by it; provided that, it does not exceed the

rulemaking authority granted under the law for which the rule is being promulgated. [1 O.C. 106.43]. When developing rules under the Administrative Rulemaking law, the following applies:

Page 8 of 12

14 of 77

•

•

Rules developed pursuant to the law have the same force and effect as the law which

delegated the authorized agency rulemaking authority and shall be followed by both the

general public and the authorized agency promulgating the rule; and

Rules developed pursuant to the law shall not conflict or supersede a law, policy or rule of

the Nation or a resolution passed by the OBC or the GTC. [1 O.C. 106.4-1(a) and (b)].

In addition, authorized agencies are required to adhere to the following process when promulgating

rules under the Administrative Rulemaking law:

• That, the proposed rule shall be preceded by a public comment period that includes a public

meeting to be held, in pertinent part, as follows:

o Notice. The authorized agency shall set a date for the public meeting and have a

public meeting notice published in the Kalihwisaks and on the Oneida Register not

less than ten (10) business days prior to the meeting.

o Requirements for Public Meeting Notice. The public meeting notice shall include:

▪ The date, time and location of the scheduled public meeting;

▪ Information for electronically accessing the proposed rule and summary

report and a statement that hard copies of the materials will be available

with the authorized agency; and

▪ The name, address, phone number and other appropriate information to

submit written comments on the rule and the time period during which the

authorized agency shall accept written comments.

o The authorized agency shall audio record the public meeting and persons who

provide oral comments shall state their name for the record; and

o The authorized agency shall hold the record open for the submission of written

comments for a minimum of five (5) business days following the public meeting.

[1 O.C. 106.6-1 and 106.6-2].

• That, after the public comment period has expired and the authorized agency has

considered all public comments received, the authorized agency shall submit the proposed

rule and all items contained in the administrative record to the LOC [1 O.C. 106.7-1];

• That, the LOC is then responsible for certifying that the proposed rule meets the following

requirements:

o That promulgation of the rule complies with the procedural requirements contained

in the Administrative Rulemaking law;

o That the administrative record is complete; and

o That the rule does not exceed its rulemaking authority or conflict with any other

law, policy, rule or resolution of the Nation. [1 O.C. 106.7-2].

• That, upon receipt of a complete rule certification submission, the LOC shall take one (1)

of the following actions:

o If it determines the authorized agency complied with the certification requirements,

the LOC shall certify the proposed rule and forward the administrative record to the

OBC; or

o If it determines the authorized agency has not complied with the certification

requirements, the LOC shall not certify the proposed rule and shall return it to the

authorized agency with specific feedback as to which requirements were not met.

[1 O.C. 106.7-3].

Page 9 of 12

~

fflXJCJOO

A good mind. A good heart. A strong fire.

ONEIDA

15 of 77

•

That, the OBC shall review and consider the proposed rule, administrative record, as well

as the LOC’s certification of compliance, and either:

o Adopt the proposed rule through a motion approved by a majority vote of the OBC;

or

o Deny adoption of the proposed rule if the OBC has any concerns and/or requested

revisions to the rule. [1 O.C. 106.8-1 and 106.8-2].

Once an administrative rule is adopted, the authorized agency is required to conduct a review of

the rule at least once every two years following the date of adoption by the OBC. [1 O.C. 106.121]. During said review, the authorized agency may consider, but is not limited to the consideration

of, whether the rule continues to serve its intended purpose and if any amendments to the rule are

necessary. [1 O.C. 106.12-2]. The authorized agency has the authority to decide if amendments to

a rule are necessary to pursue and the OBC shall not compel an authorized agency to amend a rule.

[1 O.C. 106.12-3].

With respect to due process protections, the Administrative Rulemaking law provides:

• Any entity of the Nation hearing an appeal or contest of an action taken pursuant to rules

created under the authority delegated to an authorized agency and the requirements of this

law, upon consideration of the rule and the circumstances regarding the action taken may

take any one (1) of the following actions:

o Uphold the action taken;

o Reverse or modify the action taken; or

o If at the second level of appeal, remand the matter for further consideration. [1 O.C.

106.14-1(a)-(c)].

And, when hearing an appeal or contest of an action taken pursuant to rules created under the

authority delegated to an authorized agency, the hearing body shall recognize that the authorized

agency is accepted by the Nation as the subject matter expert in the given field and shall provide

the authorized agency with deference by upholding the action unless if finds that the action:

• Amounts to a violation of the Nation’s Constitution;

• Was in excess of the authorized agency’s rulemaking authority or is otherwise unlawful;

• Was clearly erroneous in view of the entire administrative and factual records;

• Was arbitrary or capricious; or

• Exhibited a procedural irregularity which would be considered a harmful error that may

have contributed to the final decision and if said irregularity were not present, the decision

would have been different. [1 O.C. 106.14-2(a)-(e)].

Rules Promulgated Under the Administrative Rulemaking Law.

Per the Landlord-Tenant law’s delegation of rule-making authority, the following rules, of possible

relevance to the Petition, were promulgated in accordance with the Administrative Rulemaking

law:

• Title 6. Property and Land – Chapter 611, Landlord-Tenant, Rule # 1 entitled, General

Rental Program Eligibility, Selection and Other Requirements (“Rule No. 1”);

• Title 6. Property and Land – Chapter 611, Landlord-Tenant, Rule # 2 entitled, Income

Based Rental Program Eligibility, Selection and other Requirements (“Rule No. 2”); and

Page 10 of 12

16 of 77

•

Title 6. Property and Land – Chapter 611, Landlord-Tenant, Rule # 4 entitled, Income

Based Rent to Own Program Eligibility, Selection and Other requirements (“Rule No. 4”).

Rule No. 1 was established to provide additional eligibility requirements, selection procedures and

general requirements to govern the CHD’s general rental programs. [Rule No 1, 1.1-1]. It provides,

in part, that applicants who have had a rental agreement with the CHD subject to an eviction and

termination within two (2) years from the date of the application are not eligible to participate in

the general rental program. However, a grant of a pardon or forgiveness pursuant to the Nation’s

Pardon and Forgiveness law may result in an otherwise ineligible tenant becoming eligible. [Rule

No. 1, 1.4-6]. Amendments to the rule may only occur if jointly approved by the CHD and OLC

pursuant to the procedures set forth in the Administrative Rulemaking law. [Rule No. 1, 1.2-2].

Rule No. 2 was established to provide additional eligibility requirements, selection procedures and

general requirements to govern the CHD’s income-based rental programs. [Rule No. 2, 2.1-1].

Like Rule No. 1, Rule No. 2 provides, in pertinent part, as follows with respect to eligibility:

• Applicants that have had a rental agreement with the CHD subject to an eviction and

termination within two (2) years from the date of the application are not eligible to

participate in the income-based rental program. [Rule No. 2, 2.4-5].

• Applicants with any of the following types of convictions are not eligible for participation

in the income-based rental program:

o A drug conviction within three (3) years from the date of application;

o A felony conviction within five (5) years from the date of application; and/or

o A criminal conviction based upon an act of violence within two (2) years from the

date of application. [Rule No. 2, 2.4-6(a)-(c)].

• A grant of a pardon or forgiveness pursuant to the Nation’s Pardon and Forgiveness law

may result in an otherwise ineligible tenant becoming eligible. [Rule No. 2, 2.4-7].

If, following review of a complete application or annual renewal, an applicant is deemed ineligible

to participate in the income-based rental program based on the Landlord-Tenant law and/or rules,

the CHD shall notify the applicant of the cause of the ineligibility and how the applicant may

become eligible in the future. [Rule No. 2, 2.5-3]. At such time, the CHD is also required to inform

the applicant of other housing opportunities offered by the Nation for which the applicant may be

eligible, if applicable. [Rule No. 2, 2.5-3].

Rule No. 4 was established to provide additional eligibility requirements, selection procedures and

general requirements to govern the CHD’s income-based homeownership program. [Rule No. 4,

4.1-1]. Its policy is to afford members of the Nation homeownership opportunities without

requiring credit checks or down payments and to develop, maintain and operate affordable housing

in safe, sanitary and healthy environments within the Reservation. [Id.]. Rule No. 4 contains

eligibility requirements much like Rule Nos. 1 and 2, with a similar exception when a pardon or

forgiveness has been granted by the Nation pursuant to its Pardon and Forgiveness law. [Rule No.

4, 4.4-6 and 4.4-7].

Depending upon how the Petitioner’s suggestions are interpreted or explained by the Petitioner,

amendments to one or more of the rules governing the Nation’s rental/lease programs may be

necessary to avoid a conflict. If amendments are necessary, they would have to be developed in

accordance with the Nation’s Administrative Rulemaking law.

Page 11 of 12

~

fflXJCJOO

A good mind. A good heart. A strong fire.

ONEIDA

17 of 77

Conclusion

After a review of all applicable laws and policies of the Nation, it has been determined that the

adoption of the Petition: L. Elm – Real Property Law Eviction and Termination would not have a

legislative impact; provided, if any of the Petitioner’s suggestions would require changes to any

law of the Nation and/or rule promulgated thereunder, it would have to occur in accordance with

the Legislative Procedures Act and Administrative Rulemaking law, respectively.

Requested Action

Accept the statement of effect for Petition: L. Elm – Real Property Law Eviction and Termination.

Page 12 of 12

~

fflXJCJOO

A good mind. A good heart. A strong fire.

ONEIDA

18 of 77

Oneida Nation

=000000

PO Box 365 • Oneida, WI 54155-0365

ONEIDA

One id a-n sn. gov

TO:

FROM:

DATE:

RE:

,'\.

Oneida Business Committee

Legislative Operating Committee

\ h· ~

Oneida Business Committee

David P. Jordan, Legislative Operating Committee Chaitman ~

June 2, 2021

Certification of the Community Suppo1i Fund Law Rule Handbook Amendments

The Legislative Operating Committee (LOC) has reviewed and ce1iified the proposed amendments

to the Community Support Fund Law Rule Handbook ("Rule Handbook") provided by the

Economic Support Services Depaiiment.

The Community Supp01i Fund law delegates administrative rulemaking authority to the Fund

Operator, which has been identified as the Economic Support Services Depaiiment, to promulgate

rules for the administration of the Community Supp01i Fund. [l 0. C. 124. 4-1 (a), 121.3-1 (i)]. The

Rule Handbook provides guidance on how the Community Supp01i Fund is utilized so that the

Nation can assist the greatest number of members of the Nation who apply for assistance to the

Community Support Fund in times of a catastrophic event, illness, injmy or emergency event when

no other resources for assistance exist. Amendments to the Rule Handbook were sought to bring

the Rule Handbook into compliance with the Community Support Fund law as amended by the

Oneida Business Committee on March 10, 2021, through the adoption of resolution BC-03-10-21C.

The Administrative Rulemaking law requires that the Legislative Operating Committee be

responsible for certifying that a proposed rule meets the following requirements:

• that promulgation of the rule complies with the procedural requirements;

• that the administrative record is complete; and

• that the rule does not exceed its rulemaking authority or conflict with any other law, policy,

rule or resolution of the Nation. [l O.C. 106. 7-2].

The Legislative Operating Committee has determined that the Economic Suppo1i Services

Depaiiment has complied with the ce1iification requirements of the Administrative Rulemaking

law in the promulgation of the amendments to the Rule Handbook. The proposed amendments to

the Rule Handbook are now ready for consideration for adoption by the Oneida Business

Committee.

Requested Action

Consider the adoption of the amendments to the Community Support Fund Law Rule Handbook.

Page 1 of 1

A good mind. A good heart. A strong fire.

19 of 77

MEMORANDUM:

To:

Oneida Nation LRO

From:

Delia Smith, Community Economic Support Director

Date:

May 13, 2021

Subject: Community Support Handbook Amendments

Delia

Smith

Digitally signed by

Delia Smith

Date: 2021.05.19

08:51:56 -05'00'

Economic Support has completed the proper rule amendment process to update the Community

Support Handbook. The amendments were a result of the approved amendment of the

Community Support Law on 3/10/2021. The Handbook is now in align with the law that

includes the following changes:

Rule 4-Allowing for fuel/transportation assistance for applicants with local medical

appointments;

Rule 9-Increasing the amount of assistance for Medical Related Equipment, supplies, or

Furniture;

Rule 13-Increasing amount allowable for shelter assistance;

Rule 14- Removing the requirement for funerals for out of state only, allowing for funeral

assistance for in state as long as the funeral is more than 40 miles from current residence;

Rule 16- Eliminate the restriction of Wisconsin being the only state for assistance, opening to

any state within the United States. Eliminate repayment of program paid Security Deposit

Assistance;

Rule 17- Decrease Rent/Mortgage assistance to 12 months from 24 months.

The following procedural process and timeline was followed for the amendment;

x Public Meeting Notice published in the Kalihwisaks on 4/21/2021,

x Public Meeting via Teams 5/3/2021- No comments

x Waited for written comment until 5/10/2021- No written comments

There is no oral or written public comments and no sign in sheet to submit for review.

Therefore, Economic Support is requesting the proposed Community Support rules and

Handbook changes be approved accordingly.

Attached you will find the signed approved Rules Handbook amendment from the Governmental

Services Director.

20 of 77

Draft of Proposed Amendments

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

Title 1. Government and Finances – Chapter 125

Community Support Fund

Rule Nos. 1 through 18

I. Purpose, Delegation, Adoption, Amendment and Repeal

1-1. Purpose. The purpose of the Community Support Fund rules is to provide guidance on how

the Community Support Fund is utilized so that the Nation can assist the greatest number of

members of the Nation who apply for assistance to the Fund in times of a catastrophic event,

catastrophic illness or injury, or emergency event when no other resources for assistance exist.

1-2. Authority. The Community Support Fund Law, Chapter 125, delegates rulemaking authority

to the Fund Operator pursuant to the Administrative Rulemaking law (Chapter 106 Oneida Code

of Laws).

1-3. These rules were adopted by the Economic Support Department of the Social Services Area

of the Government Services Division in accordance with the procedures of the Administrative

Rulemaking law.

1-4. These rules may be amended or repealed by the Economic Support Department and/or the

Oneida Business Committee pursuant to the procedures set out in the Administrative Rulemaking

Law. For the purpose of future amendments to these rules, each article is a separate rule and may

be amended as such.

1-5. Should a provision of these rules or the application thereof to any person or circumstances be

held as invalid, such invalidity shall not affect other provisions of these rules which are considered

to have legal force without the invalid portions.

1-6. In the event of a conflict between a provision of these rules and a provision of another rule,

internal policy, procedure, or other regulation; the provisions of these rules shall control.

1-7. These rules supersede all prior rules, regulations, internal policies or other requirements

relating to the Community Support Fund.

1-8. This Article applies to each subsequent rule listed herein.

II. Definitions

2-1. This section shall govern the definitions of words and phrases used within this rule. All

words not defined herein shall be used in their ordinary and everyday sense.

(a) “Applicant” means the subject of the application for assistance.

(b) “Business day” means Monday through Friday from 8:00 a.m. to 4:30 p.m., excluding

holidays of the Nation.

(c) “Caregiver” means the person who assists an ill or incapacitated immediate family

member that is in need of twenty-four (24) hour per day, seven (7) days a week care.

(d) “Case manager” means an employee within the Fund operator responsible for

administering Fund benefits.

(e) “Catastrophic event” means a natural or man-made incident, which results in a

substantial damage or loss requiring major financial resources to repair or recover.

Including, but is not limited to, a house fire, tornado, flood, or other disaster.

3.2021

21 of 77

Draft of Proposed Amendments

(f) “Catastrophic illness/injury” means a serious debilitating illness, injury, impairment,

or mental or physical condition that involves:

(1) In-patient care;

(2) A period of continuing treatment due to a chronic serious health condition,

including, but not limited to, chemotherapy, radiation, dialysis, and daily or weekly

therapy resulting from trauma;

(3) A period of illness or injury that is long-term due to a condition for which

treatment may be ineffective including, but not limited to, stroke or terminal disease

or;

(4) Multiple treatments either for restorative surgery after an accident or other

injury, or for a chronic condition, including, but not limited tocancer or kidney

disease.

(g) “COBRA” means the Consolidated Omnibus Budget Reconciliation Act of 1985 also

known as continued group health care coverage costs under an employer’s plan.

(h) “Cosmetic” means any medical service provided with the intent to enhance a person’s

appearance, including, but not limited to, braces, veneers, teeth whitening, implants, or

other plastic surgery.

(i) “Critical Medical” means professionally delivered care or treating a life threatening

illness which requires immediate or regularly scheduled monitored medical care, which

includes, but is not limited to dialysis, chemotherapy, radiation, daily/weekly therapy

resulting from trauma. This does not include routine annual or semi-annual appointments.

(j) “Emergency event” means a situation that poses an immediate risk to health, life,

safety, property or environment. Emergencies require urgent intervention to prevent further

illness, injury, death, or other worsening of the situation.

(k) “Emergency medical travel” means an unexpected serious health situation or

occurrence requiring the immediate presence of immediate family. This includes, but is not

limited to, end of life situations, and/or an immediate family member is placed on life

support.

(l) “Eviction” means the legal notice received from a landlord or mortgage holder that

orders the tenant(s) to vacate the property.

(m) “”FMLA” means the Family Medical Leave Act, a Federal law authorizing temporary

time off from an employment position to provide direct care to a family member, without

losing their employment status.

(n) “Fund” means the Community Support Fund.

(o) “Fund Operator” means the Economic Support Department, or other area within the

Governmnetal Services Division designated authority over the operation of the Fund.

(p) “Garnishment” means a legal action that directs that money owed be seized to satisfy

a debt.

(q) “Household” means all persons who reside together at the same residence.

(r) “Immediate family” means an applicant’s husband, wife, mother, father, son,

daughter, brother, sister, grandparent, grandchild, aunt, uncle, niece, nephew, cousin, and

any of these relations attained through marriage or legal adoption, as well as a person who

has legal responsibility for the applicant, or a person the applicant has legal responsibility

of.

(s) “Incapacitation” means a state in which a person is temporarily or permanently

impaired by mental and/or physical deficiency, disability, illness or injury.

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67

68

69

70

71

72

73

74

75

76

77

78

79

80

81

82

83

84

85

86

87

88

89

90

91

92

3.2021

22 of 77

Draft of Proposed Amendments

93

(t) “Income” means a measurement including, but not limited to, a combination of

94

salaries, wages, retirement pension, disability income, government benefits, and

95

unemployment of all people sharing a particular household/residence.

96

(u) “Legal guardian” means a person who has the legal authority to care for the personal

97

and property interests of another person granted through a Court order.

98

(v) “Legal responsibility” means specific duties imposed upon a person to care or provide

99

for another including liability for personal obligations as granted through a Power of

100

Attorney or Court order.

101

(w) “Major medical surgery” means a surgical procedure that carries a degree of risk to

102

the patient’s life, or the potential for severe disability if something goes wrong during

103

surgery. It is a surgical procedure that usually requires a patient to be put under general

104

anesthesia and given respiratory assistance because he or she cannot breathe independently.

105

(x) “Nation” means the Oneida Nation.

106

(y) “Public health emergency” means the occurrence or imminent threat of an illness or

107

health condition which:

108

(1) is a quarantinable disease, or is believed to be caused by bioterrorism or a

109

biological agent; and

110

(2) poses a high probability of any of the following:

111

(A) a large number of deaths or serious or long-term disability among

112

humans; or

113

(B) widespread exposure to a biological, chemical, or radiological agent

114

that creates a significant risk of substantial future harm to a large number

115

of people.

116

(z) “Non-medical” means necessary intervention to support a patient with an on-going

117

medical illness, injury or potential life threatening illness, and requires further testing or

118

consultation with a specialist.

119

(aa) “Reimbursement” means to make repayment for expense(s) or a loss that incurred.

120

(bb) “Routine Exam” means an annual or semi-annual health exam provided by a

121

physician, dentist, orthodontist, oral surgeon, or other similar health care specialist.

122

(cc) “Security Deposit” means the payment of money held by a landlord in trust to protect

123

him/herself from unpaid rent or damage to the living space.

124

(dd) “Wages” means taxable income reported to the Internal Revenue Service for

125

performing work.

126

127 III. SHELTER ASSISTANCE

128 3-1.

Purpose. The purpose of shelter assistance is to assist enrolled members of the Nation with

129

financial support for shelter expenses due to experiencing a catastrophic event, illness, or

130

injury where no other resources exist.

131 3-2.

Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

132

illness, injury or emergency event.

133 3-3.

Eligibility Criteria. In order to be eligible for shelter assistance a person must provide a

134

completed Community Support Fund application and the following:

135

(a) Proof of enrollment in the Nation;

136

(b) Documentation verifying catastrophic event, illness, injury or other emergency event

137

within the last thirty (30) days, including but not limited to:

3.2021

23 of 77

Draft of Proposed Amendments

138

139

140

141

142

143

144

145

146

147

148

149 3-4.

150

151

152

153

154

155

156

157

158

159

160

161

162

163 3-5.

164

165

166

167

168

169

170

171

172

173 3-6.

174

175

176

177

178

179

180

181

182

(1) Medical verification specifying dates effected by illness or injury;

(2) Verification of short and/or long term disability specifying the dates received

and the amount of the benefit;

(3) Other documentation listing damage or loss.

(c) Landlord Verification Form completed by the landlord of the applicant or a statement

from the applicant’s mortgage holder stating the applicant’s monthly mortgage payment

and current status;

(d) A current utility bill, such as a water, heat, or electricity bill;

(e) Verification of any mortgage disability insurance;

(f) Verification of an applicant’s personal and/or vacation time from employment; and

(g) Any other documentation requested by the Community Support Fund case manager.

Receipt of Required Documentation. Upon receipt of the completed application for shelter

assistance, the case manager shall determine if all required documentation was received from

the applicant.

(a) The applicant shall provide all documentation requested by the case manager.

(b) The case manager shall notify the applicant within five (5) business days in writing of

any necessary documentation that was not received and is still needed.

(c) Upon receipt of a completed application along with all the required documentation,

the case manager shall have up to ten (10) business days to provide the initial decision in

writing to the applicant.

(d) An application for shelter assistance shall be valid for thirty (30) days. If the applicant

has a determination of award and/or coverage pending with another support or assistance

resource, the application will be valid for an additional fifteen (15) days upon proof of that

such determination is pending. If the applicant fails to provide all requested documentation,

the case manager shall send the applicant an expiration notice for their application.

Rent or Mortgage Assistance. An applicant may request assistance for rent or mortgage

payments.

(a) The amount provided for rent or mortgage assistance shall not exceed five hundred

dollars ($500.00) per month. The amount of rent or mortgage assistance shall not exceed a

total of twenty-four (24) months per life-time of the applicant.

(b) Only the applicant’s portion of the rent or mortgage owed shall be considered when

determining the amount of rent or mortgage assistance if the applicant’s household consists

of other adults.

(c) Shelter assistance shall not be used to pay family members or caregivers of the

applicant. Only a valid landlord or mortgage holder shall be paid.

Utility Assistance. An applicant may request assistance for utilities, such as heat, water, and

electricity.

(a) The utility bill shall be in the applicant’s or current household’s member’s name.

(b) Applicants shall provide verification of application to all other available resources and

programs for utility assistance.

(1) The Wisconsin Home Energy Assistance Program (WHEAP) serves as an

example of an alternate program the applicant should apply for before applying for

utility assistance.

(c) Only the applicant’s portion of the utility bill shall be considered when determining

the amount of utility assistance if the applicant’s household consists of other adults.

3.2021

24 of 77

Draft of Proposed Amendments

183

(d) The amount provided for utility assistance shall not exceed three hundred dollars

184

($300.00) and shall only be allowed once every two (2) years. Assistance requested under

185

this Rule and under Rule 18 shall be counted towards the total number of requests for the

186

two (2) year period limit.

187 3-7.

Reporting Changes in the Household. The applicant shall report any changes in the household

188

to the case manager within ten (10) business days from the change occurring.

189

(a) Changes in the household that shall be reported include, but are not limited to, the

190

following: relocation, addition or subtraction of a household member, income changes,

191

medical changes, submission of a social security disability application, submission of

192

application or receipt of assistance from other agency or program.

193

(b) Failure of the applicant to report changes in the household may result in suspension

194

of benefits until verification of the change(s) is provided to the case manager, not to exceed

195

thirty (30) days.

196 3-8.

Discontinuation of Assistance. The Community Support Fund Manager reserves the right to

197

discontinue shelter assistance based on the following:

198

(a) A lack of funding availability

199

(b) A discovery that fraud or illegal activity has been determined to have caused

200

homelessness.

201

(c) The case manager shall provide ten (10) day notification to an applicant whose shelter

202

assistance will be discontinued.

203 3-9.

Changes in Household Information. An applicant shall be responsible to report to the Fund

204

Case Manager any change(s) in the household within ten (10) business days from the change.

205

Changes shall include, but are not limited to the following:

206

(a) Relocation;

207

(b) Household member changes;

208

(c) Income;

209

(d) Medical changes;

210

(e) Submission of Social Security Disability application; and

211

(f) Receipt of other agency assistance

212

(1) Failure of an applicant to report changes in the household may result in

213

suspension of assistance until verification of the change(s) is provided to the

214

Fund Case Manager.

215

(2) An applicant shall have thirty (30) days to provide the verification once

216

notification is received from the Fund Case Manager that verification is

217

required.

218 3-10. Lodging Assistance. Lodging Assistance may be provided in the event of extreme situations

219

as determined by the Fund Case Manager and the Director of Economic Support.

220

221 IV. EMERGENCY/NON-EMERGENCY MEDICAL TRAVEL

222 4-1.

Purpose. The purpose is to assist enrolled members of the Nation with emergency and non223

emergency medical travel expenses. This assistance is limited to immediate family members

224

to assist with travel expenses.

225 4-2.

Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

226

illness, injury or emergency event.

3.2021

25 of 77

Draft of Proposed Amendments

227 4-3.

228

229

230

231

232

233

234

235

236

237 4-4.

238

239

240

241

242

243

244

245

246

247

248

249

250

251

252 4-5.

253

254

255

256

257

258

259

260

261

262

263

264

265

266

267

268

269

270

271

272

Eligibility Criteria. In order to be eligible for emergency/non-emergency medical travel

assistance, a person must provide a completed Community Support Fund application and the

following:

(a) Proof of enrollment in the Nation;

(b) Verifications of medical appointments which include the medical condition, date, time

and location of the appointment;

(c) Verification of the applicants relationship to the patient;

(d) Verification of a valid driver’s license for reimbursement of fuel purchases

(e) Original receipts for hotel, gas, and/or airfare which shall be dated within thirty (30)

days of travel and show total cost paid; and

Receipt of Required Documentation. Upon receipt of the completed application for

emergency/non-emergency medical travel assistance, the case manager shall determine if all

required documentation was received from the applicant.

(a) The applicant shall provide all documentation requested by the case manager.

(b) The case manager shall notify the applicant in writing of any necessary documentation

that was not received and is still needed.

(c) Upon receipt of a completed application along with all the required documentation,

the case manager shall have up to ten (10) business days to provide the initial decision in

writing to the applicant.

(d) An application for emergency/non-emergency medical travel assistance shall be valid

for thirty (30) days. If the applicant has a determination of award and/or coverage pending

with another support or assistance resource, the application will be valid for an additional

fifteen (15) days upon proof of that such determination is pending. If the applicant fails to

provide all requested documentation, the case manager shall send the applicant an

expiration notice for their application.

Non-Emergency Travel. Non-emergency travel is allowed when the applicant or immediate

family member has scheduled medical appointments as shown through medical

documentation.

(a) Documentation of scheduled appointments must be submitted and have prior approval.

(b) Non-emergent medical travel for local members with chronic serious medical needs

may be reimbursed to the applicant with a valid receipt within forty-five (45) days of

appointments. Once the application is approved, applicants within the reservation

boundires may receive assistance direcelty from the program during regular business

hours.

(c) Non-Emergency Travel Less Than Sixty (60) Miles One Way.

(1) Applicants within the reservation boundaries traveling less than sixty (60) miles

one way may be eligiable for public or tribal transportation transit passes for

verified chronic serious medical appointments.

(2) Applicants traveling less than sixty (60) miles one way may receive assistance

or reimbursement not to exceed twenty dollars ($20.00) per week for verified

chronic serious medical appointments.

(d) Non-Emergency Travel At Least Sixty (60) Miles One Way.

(1) Those who travel from sixty (60) miles up to one hundred fifty (150) miles oneway shall receive a thirty dollar ($30.00) fuel assistance. Travel may also be eligible

for reimbursement for up to thirty dollars ($30.00) with original receipts that

coincide with a medical appointment.

3.2021

26 of 77

Draft of Proposed Amendments

273

274

275

276

277

278

279

280

281

282

283

284

285 4-6.

286

287

288

289

290

291

292

293

294

295

296

297

298

299 4-7.

300

301

302

303

304

305

306

307

308

309

310

311

312

313

314

315

316

(2) Those who travel over one hundred and fifty (150) miles one-way shall receive

a forty dollar ($40.00) fuel assistance. Travel may also be eligible for

reimbursement for up to forty dollars ($40.00) with original receipts that coincide

with a medical appointment.

(e) Fuel Assistance will be disbursed the day prior to the appointment if application is

timely and original receipts are due within seven (7) business days. If receipts are not

turned in, future requests for assistance will be denied for six (6) consecutive months

starting when the first new request is made.

(f) Hotel reimbursement shall be a maximum of seventy-five dollars ($75.00) per night for

up to a maximum of three (3) nights, and shall only be considered for approval by the Fund

Case Manager where the appointment is more than one hundred (100) miles one-way from

the residence of the applicant.

Emergency Travel. Emergency travel assistance is allowed when an immediate family

member has a sudden or worsening life-threatening illness or injury, and is provided only on

as a reimbursement of expenses.

(a) Airfare, bus, train, lodging, and vehicle fuel is limited to a combined maximum

reimbursement amount of five hundred dollars ($500.00).

(b) Multiple immediate family members are limited to a reimbursement amount of five

hundred dollars ($500.00) each.

(c) Reimbursement for emergency travel assistance is limited to those persons who must

travel one hundred (100) miles or more one-way.

(d) Hotel reimbursement shall be a maximum of seventy-five dollars ($75.00) per night.

(e) All receipts must coincide with the emergency event that required the applicant to

travel. Applicant is responsible for providing all proper documentation regarding the

illness or injury that required travel and the required receipts in order to be eligible for

reimbursement.

Auto Repairs. Auto repair assistance is allowed when the vehicle is necessary to

obtain/maintain ongoing critical medical care when no other resources exist.

(a) Auto repair assistance is limited to critical medical patients only and will be denied

when an alternate vehicle is owned and available for use;

(b) Auto repair assistance will only cover repairs that are necessary to keep the vehicle in

standard operating condition. No routine maintenance or auto body repairs shall be

eligible for assistance. Routine maintenance or repairs shall include, but is not limited to,

oil changes, brakes, tires, batteries/fuses, lights, tune-ups, exhaust systems, flushes, and

glass replacement;

(c) Auto repair assistance is limited to a maximum amount of five hundred dollars

($500.00) once every twelve (12) months;

(d) Emergency repairs needed to obtain critical medical care which occurs outside of the

program’s business hours, may be considered on a case by case basis, in consultation

with an independent ASE certified auto technician, and for services that occurred within

the previous ten (10) days of the application;

(e) Towing assistance may be considered on a case by case basis for reimbursement up to

maximum of two hundred and fifty dollars ($250.00) once every twelve (12) months when

the vehicle is inoperable and towed to an ASE certified mechanic.

3.2021

27 of 77

Draft of Proposed Amendments

317 4-8.

Items not Covered. The Fund Case Manager is not responsible and will not make any

318

reservations for any form of travel. In addition, the following items, which are not all

319

inclusive, are not a benefit of this assistance program:

320

(a) Auto insurance and deductibles;

321

(b) Car Rentals;

322

(c) Personal expenses, including, but not limited to, meals or personal care items;

323

(d) Auto loans and vehicle registration.

324 4-9.

This program encourages and requests that multiple family members traveling to the same

325

destination carpool and share hotel rooms whenever possible.

326 4-10. CSF reserves the right to discontinue assistance based on funding availability.

327

328 V. MEDICAL BILL ASSISTANCE

329 5-1. Purpose. The purpose of this program is to assist enrolled members of the Nation with

330

financial support for the cost of unpaid medical bills (deductiables and copays not covered)

331

where no other resources exist.

332 5-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

333

illness, injury or emergency event.

334 5-3. Eligibility Criteria. In order to be eligible for Medical Bill assistance, a person must provide

335

a completed Community Support Fund application and the following:

336

(a) Proof of enrollment in the Nation

337

(1) a non-enrolled parent of an enrolled minor child may apply for assistance that

338

directly affects the enrolled minor child;

339

(b) Medical billing statements for the dates of service which are within the last twelve (12)

340

months and be more than fifty dollars ($50.00);

341

(c) Verification that the applicant’s health insurance was utilized within his/her health care

342

network;

343

(d) Explanation of Benefit (EOB) statements received from the health insurance provider

344

showing what portion the health insurance covered;

345

(e) Verification that an Indian Health Service Clinic (IHS) was utilized if applicant is in

346

its service area;

347

(f) Verification that the applicant applied for all of the financial care or assistance programs

348

offered at the medical facility;

349

(g) Statements of denial of assistance or caseworker verification of denial based on

350

eligibility criteria, from an Indian Health Service (IHS) facility or (EOB) from any third

351

party insurance carrier.

352 5-4.

Receipt of Required Documentation. Upon receipt of the completed application for medical

353

bill assistance, the case manager shall determine if all required documentation was received

354

from the applicant.

355

(a) The applicant shall provide all documentation requested by the case manager.

356

(b) The case manager shall notify the applicant in writing of any necessary documentation

357

that was not received and is still needed.

358

(c) Upon receipt of a completed application along with all the required documentation, the

359

case manager shall have up to ten (10) business days to provide the initial decision in

360

writing to the applicant.

361

(d) An application for medical bill assistance shall be valid for thirty (30) days. If the

362

applicant has a determination of award and/or coverage pending with another support or

3.2021

28 of 77

Draft of Proposed Amendments

363

assistance resource, the application will be valid for an additional fifteen (15) days upon

364

proof of that such determination is pending. If the applicant fails to provide all requested

365

documentation, the case manager shall send the applicant an expiration notice for their

366

application.

367 5-5.

Financial assistance will only be available for services already rendered by a Health Care

368

Provider for up to a maximum of five thousand dollars ($5,000.00) within a twelve (12) month

369

period. An extension of this twelve (12) month period can be considered only for chronic

370

medical conditions, but may not exceed an additional five thousand dollars ($5,000.00).

371 5-6.

Medical and/or hospital bills incurred from illegal activity (i.e. operating while intoxicated,

372

injuries due to alcohol or drug use, etc.), or medical conditions that are a direct result from

373

drug use, including the abuse of prescription drugs, are not eligible for assistance, except for

374

Rule 8 which covers Inpatient or Intensive Outpatient treatment.

375 5-7.

Insurance denials resulting from an applicant’s failure to submit information pertinent to

376

processing an insurance claim are not eligible or assistance.

377 5-8.

Medical bills that have aged beyond twelve (12) months, or which have been referred to a

378

collection agency are not eligible for assistance.

379 5-9.

Chiropractic care, holistic treatment, pain clinic treatment/injections, methadone clinic,

380

Saboxon injection and/or nursing home and/or any assisted living facility are not eligible for

381

assistance.

382 5-10. CSF reserves the right to discontinue assistance based on funding availability.

383

384 VI. DENTAL RELATED EXPENSES

385 6-1. Purpose. The purpose of dental related expenses assistance is to assist enrolled members of

386

the Nation with financial support with the cost of dental-related services where no other

387

resources exist.

388 6-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

389

illness, injury or emergency event.

390 6-3. Approval is from the Community Support Fund case manager is required prior to receiving

391

treatment from a dental health care provider.

392 6-4. Eligibility Criteria. In order to be eligible for dental related expenses assistance, a person must

393

provide a completed Community Support Fund application and the following:

394

(a) Proof of enrollment in the Nation;

395

(1) a non-enrolled parent of an enrolled minor child may apply for assistance that

396

directly affects the enrolled minor child;

397

(b) Verification by a dentist, orthodontist, or oral surgeon of the dental procedures to be

398

completed, and that they are a medical need, not cosmetic, and the cost or estimated cost

399

of the dental services, which shall include the name, address, and Federal tax ID number

400

of the dental health care provider;

401

(c) Verification of dental insurance and that the dental health care provider is an in402

network provider;

403

(d) Verification that the applicant is utilizing the Indian Health Service Clinic in his/her

404

service area if available;

405 6-5. Receipt of Required Documentation. Upon receipt of the completed application for dental

406

related expenses assistance, the case manager shall determine if all required documentation

407

was received from the applicant.

408

(a) The applicant shall provide all documentation requested by the case manager.

3.2021

29 of 77

Draft of Proposed Amendments

409

(b) The case manager shall notify the applicant in writing of any necessary documentation

410

that was not received and is still needed.

411

(c) Upon receipt of a completed application along with all the required documentation, the

412

case manager shall have up to ten (10) business days to provide the initial decision in

413

writing to the applicant.

414

(d) An application for dental related expenses assistance shall be valid for thirty (30) days.

415

If the applicant has a determination of award and/or coverage pending with another support

416

or assistance resource, the application will be valid for an additional fifteen (15) days upon

417

proof of that such determination is pending. If the applicant fails to provide all requested

418

documentation, the case manager shall send the applicant an expiration notice for their

419

application.

420 6-6. Upper and lower dentures are limited to a maximum of two hundred and fifty dollars ($250.00)

421

each per lifetime.

422 6-7. Financial assistance for dental related services other than dentures is limited to a maximum of

423

five hundred dollars ($500.00) within a twelve (12) month period.

424 6-8. Dental services requiring surgery or hospital care will be referred to the Medical Bill

425

Assistance Program (Rule 3).

426 6-9. Braces, implants, veneers, teeth whitening, or any other services considered strictly cosmetic

427

are not eligible for assistance.

428 6-10. CSF reserves the right to discontinue assistance based on funding availability.

429

430 VII. OPTICAL RELATED ASSISTANCE

431 7-1. Purpose. The purpose of the Optical related assistance program is to provide enrolled members

432

of the Nation with financial support with the costs associated with optical related services

433

where no other resources exist.

434 7-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

435

illness, injury or emergency event.

436 7-3. Approval from CSF is required prior to treatment or purchase.

437 7-4. Eligibility Criteria. In order to be eligible for Optical Related Equipment assistance, a person

438

must provide a completed Community Support Fund application and the following:

439

(a) Proof of enrollment in the Nation;

440

(1) a non-enrolled parent of an enrolled minor child may apply for assistance that

441

directly affects the enrolled minor child.

442

(b) Cost estimate of optical services this includes the name, address and Federal Tax ID

443

of the provider;

444

(c) Verification of the severe optical illness/injury from an ophthalmologist, optician, or

445

optometrist;

446

(d) Verification of optical insurance and that the ophthalmologist, optician, or optometrist

447

is an in-network provider.

448

the application for assistance.

449 7-5. Applicant must utilize an Indian Health Service Clinic if available, or provided verification

450

that such a clinic is not available.

451 7-6. Receipt of Required Documentation. Upon receipt of the completed application for Optical

452

Related assistance, the case manager shall determine if all required documentation was

453

received from the applicant.

454

(a) The applicant shall provide all documentation requested by the case manager.

3.2021

30 of 77

Draft of Proposed Amendments

455

(b) The case manager shall notify the applicant in writing of any necessary documentation

456

that was not received and is still needed.

457

(c) Upon receipt of a completed application along with all the required documentation, the

458

case manager shall have up to ten (10) business days to provide the initial decision in

459

writing to the applicant.

460

(d) An application for Optical Related assistance shall be valid for thirty (30) days. If the

461

applicant has a determination of award and/or coverage pending with another support or

462

assistance resource, the application will be valid for an additional fifteen (15) days upon

463

proof of that such determination is pending. If the applicant fails to provide all requested

464

documentation, the case manager shall send the applicant an expiration notice for their

465

application.

466 7-7. Eye glass frames and lenses are limited to a maximum of two hundred and fifty dollars

467

($250.00) once per twelve (12) month period, and only the actual frame and lenses are eligible

468

for assistance. Enhancements, including, but not limited to transitional lenses, tinting, or anti469

reflective coatings, are not eligible for assistance.

470 7-8. Optical services requiring surgery or hospital care will be referred to the CSF Critical Medical

471

Bill program.

472 7-9. Transportation costs associated with reporting to a treatment/medical facility will be referred

473

to the CSF Critical Medical Travel Assistance program.

474 7-10. The following are not eligible for assistance: contact lenses, routine eye exams, vision

475

correction surgery (eye laser surgery), or any other services that are considered cosmetic. This

476

list is not exhaustive.

477 7-11. CSF reserves the right to discontinue assistance based on funding availability.

478

479 VIII. INPATIENT OR INTENSIVE OUTPATIENT TREATMENT ASSISTANCE

480 8-1. Purpose. The purpose of the Inpatient or Intensive Outpatient Treatment assistance is to

481

provide enrolled members of the Nation with financial support for inpatient or Intensive

482

Outpatient treatment who have been referred by a licensed or certified counseling agency or

483

program, or who have voluntarily entered into an inpatient or Intensive Outpatient treatment

484

program where no other resources exist.

485 8-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

486

illness, injury or emergency event.

487 8-3. Approval from CSF is required prior to the inpatient stay or intensive outpatient treatment in

488

order to receive assistance.

489 8-4. Eligibility Criteria. In order to be eligible for Inpatient or Intensive Outpatient Treatment

490

assistance, a person must provide a completed Community Support Fund application and the

491

following:

492

(a) Proof of enrollment in the Nation;

493

(b) Cost estimate of the Treatment Center including the name, address and Federal Tax

494

ID number;

495

(c) A referral from a licensed or certified counseling agency or program verifying the

496

catastrophic illness;

497

(d) Verification of health insurance and that the treatment facility is in network. If not in

498

network, verification is to be provided that attempts were made to find a facility in network;

3.2021

31 of 77

Draft of Proposed Amendments

499 8-5. Receipt of Required Documentation. Upon receipt of the completed application for Inpatient

500

Treatment assistance, the case manager shall determine if all required documentation was

501

received from the applicant.

502

(a) The applicant shall provide all documentation requested by the case manager.

503

(b) The case manager shall notify the applicant in writing of any necessary documentation

504

that was not received and is still needed.

505

(c) Upon receipt of a completed application along with all the required documentation, the

506

case manager shall have up to ten (10) business days to provide the initial decision in

507

writing to the applicant.

508

(d) An application for Inpatient Treatment assistance shall be valid for thirty (30) days. If

509

the applicant has a determination of award and/or coverage pending with another support

510

or assistance resource, the application will be valid for an additional fifteen (15) days

511

upon proof of that such determination is pending. If the applicant fails to provide all

512

requested documentation, the case manager shall send the applicant an expiration notice

513

for their application.

514 8-6. Inpatient or intensive outpatient treatment assistance is available up to a maximum of five

515

thousand dollars ($5,000.00) per lifetime.

516 8-7. Inpatient or intensive outpatient treatment assistance will be paid directly to the treatment

517

facility and the treatment facility must be located within the continental United States.

518 8-8. Transportation costs associated with reporting to a treatment facility will be referred to the

519

CSF Emergency/Non-emergency Medical Travel program (Rule 4 section 4-5).

520 8-9. Follow up care expenses in a residential facility, half-way house, or transitional shelter shall

521

not exceed five hundred dollars ($500.00) per month for two (2) months. Follow up care

522

expenses do not apply to intensive outpatient treatment stays.

523 8-10. Shelter Assistance may be considered for intensive outpatient treatment when immediate prior

524

working hours are during the hours of treatment. These hours must be verified through the

525

employer and treatment facility, and shall not exceed five hundred dollars ($500.00) per month

526

for two (2) months.

527 8-11. Costs for incidentals such as food, personal care items, clothing, etc. are not eligible for

528

assistance.

529 8-12. CSF reserves the right to discontinue assistance based on funding availability.

530

531 IX. MEDICAL RELATED EQUIPMENT, SUPPLIES, OR FURNITURE

532 9-1. Purpose. The purpose of the Medical Related Equipment, Supplies, or Furniture assistance

533

program is to provide enrolled members of the Nation with financial assistance with furniture,

534

equipment, or supplies verified by a licensed doctor as being necessary to improve or maintain

535

the quality of life for those applicants who are diagnosed with a life-threatening or chronic

536

medical condition where no other resources exist.

537 9-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

538

illness, injury or emergency event.

539 9-3. Prior approval must be received from the CSF before any purchases are made in order to be

540

eligible for assistance.

541 9-4. Medically related equipment, supplies, or furniture must be rented whenever available.

542 9-5. Eligibility Criteria. In order to be eligible for Medical Related Equipment assistance, a person

543

must provide a completed Community Support Fund application and the following:

544

(a) Proof of enrollment in the Nation;

3.2021

32 of 77

Draft of Proposed Amendments

545

(1) a non-enrolled parent of an enrolled minor child may apply for assistance that

546

directly affects the enrolled minor child.

547

(b) The cost estimate of supplies or equipment prior to purchasing, which shall include

548

the vendor name, address, and Federal Tax ID number;

549

(c) The prescription from a licensed medical physician which must specify the following:

550

(1)

If the need is on a short-term basis (less than six (6) months);

551

(2) The specific life-threatening or chronic medical condition; and

552

(3) That the equipment, supplies or furniture are need to improve or maintain

553

the applicant’s quality of life;

554

(d) Statement of denial of assistance from an Indian Health Service (HIS) facility or EOB

555

from any third party insurance carrier;

556

(e) Proof of home ownership or rental lease agreement; and

557 9-6. Receipt of Required Documentation. Upon receipt of the completed application for Medical

558

Related Equipment, Supplies, or Furniture assistance, the case manager shall determine if all

559

required documentation was received from the applicant.

560

(a) The applicant shall provide all documentation requested by the case manager.

561

(b) The case manager shall notify the applicant in writing of any necessary documentation

562

that was not received and is still needed.

563

(c) Upon receipt of a completed application along with all the required documentation, the

564

case manager shall have up to ten (10) business days to provide the initial decision in

565

writing to the applicant.

566

(d) An application for Medial Related Equipment, Supplies, or Furniture assistance shall

567

be valid for thirty (30) days. If the applicant has a determination of award and/or

568

coverage pending with another support or assistance resource, the application will be

569

valid for an additional fifteen (15) days upon proof of that such determination is pending.

570

If the applicant fails to provide all requested documentation, the case manager shall send

571

the applicant an expiration notice for their application.

572 9-7. Financial assistance for this program is limited to a maximum of two thousand dollars

573

($2,000.00) within a twelve (12) month period.

574 9-8. An additional five hundred dollars ($500.00) may be considered based on medical

575

documentation.

576 9-9. Permanent ramps require the applicant to be the homeowner. Temporary ramps must have the

577

written consent of the property owner.

578 9-10. Home renovations necessary for handicap accessibility are limited to a maximum of two

579

thousand dollars ($2,000) once per twelve (12) month period.

580

(a) Renters are not eligible for home renovations.

581

(b) Home renovations may include, but is not limited to, accommodations to

582

bathrooms, doorways, hallways for wheelchairs, or a walk-in or roll in shower.

583 9-11. The types of equipment, furniture or supplies to be considered for assistance may include, but

584

is not limited to the following: hospital bed, lift chair, wheelchair, scooter, portable or

585

permanent ramps, air conditioners, room air purification systems, hearing aids, artificial limbs,

586

vision aids, wigs, and specialty made undergarments.

587 9-12. CSF reserves the right to discontinue assistance based on funding availability.

588

589

590

3.2021

33 of 77

Draft of Proposed Amendments

591

592 X. PRESCRIPTION REIMBURSEMENT ASSISTANCE.

593 10-1. Purpose. The purpose of Prescription Reimbursement assistance is to assist enrolled members

594

of the Nation with reimbursement of emergency prescribed medications that are needed after

595

regular business hours or not available at Indian Health Service Clinic.

596 10-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

597

illness, injury or emergency event.

598 10-3. Eligibility Criteria. In order to be eligible for Prescription Reimbursement assistance, a person

599

must provide a completed Community Support Fund application and the following:

600

(a) Proof of enrollment in the Nation;

601

(b) Verification of current group health insurance policy that covers prescriptions;

602

(c) Verification of coverage under a spouse/parent if available;

603

(d) Original receipts of prescription medication;

604

(e) Verification that the emergency medical prescription was needed after hours, which

605

shall include the emergency room report or discharge summary;

606

(f) Verification that there is no Indian Health Service Clinic within ninety (90) miles of

607

the applicant;

608 10-4. Receipt of Required Documentation. Upon receipt of the completed application for

609

Prescription Reimbursement assistance, the case manager shall determine if all required

610

documentation was received from the applicant.

611

(a) The applicant shall provide all documentation requested by the case manager.

612

(b) The case manager shall notify the applicant in writing of any necessary documentation

613

that was not received and is still needed.

614

(c) Upon receipt of a completed application along with all the required documentation, the

615

case manager shall have up to ten (10) business days to provide the initial decision in

616

writing to the applicant.

617

(d) An application for Prescription Reimbursement assistance shall be valid for thirty (30)

618

days. If the applicant has a determination of award and/or coverage pending with another

619

support or assistance resource, the application will be valid for an additional fifteen (15)

620

days upon proof of that such determination is pending. If the applicant fails to provide all

621

requested documentation, the case manager shall send the applicant an expiration notice

622

for their application.

623 10-5. Reimbursement for emergency prescriptions is limited to three hundred dollars ($300.00)

624

within a twelve (12) month period.

625 10-6. Prescription reimbursement must be submitted within forty-five (45) days of the original

626

receipt date.

627 10-7. Prescribed medications for chemical dependency (i.e. methadone, suboxon, etc.) are not a

628

covered benefit.

629 10-8. Denials from the IHS clinic resulting from not following preferred purchasing/care team

630

(contract health) will not be covered (i.e. proof of residency not provided, application not

631

updated, no seventy-two (72) hours notice, etc.)

632 10-9. CSF reserves the right to discontinue assistance based on funding availability.

633

634 XI. COBRA INSURANCE PAYMENTS

3.2021

34 of 77

Draft of Proposed Amendments

635 11-1. Purpose. The purpose of COBRA insurance payments assistance is to assist enrolled members

636

of the Nation with payment of COBRA insurance premiums when they experience an

637

interruption of employment.

638 11-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

639

illness, injury or emergency event.

640 11-3. Eligibility Criteria. In order to be eligible for COBRA insurance assistance, a person must

641

provide a completed Community Support Fund application and the following:

642

(a) Proof of enrollment in the Nation;

643

(b) Verification of current group health insurance policy;

644

(c) Verification of coverage under a spouse/parent if available;

645

(d) Verification of all state and public benefits applied for if eligible;

646

(e) Written estimate of employer’s group health care coverage plan premium for COBRA

647

coverage;

648

(f) Verification of medical diagnosis, prognosis, and approximate length of employment

649

interruption;

650

(g) Verification of the approved medical leave from employer;

651

(h) Verification of all household employment within the last thirty (30) days of

652

submission of the application for assistance.

653 11-4. Receipt of Required Documentation. Upon receipt of the completed application for COBRA

654

insurance payments, the case manager shall determine if all required documentation was

655

received from the applicant.

656

(a) The applicant shall provide all documentation requested by the case manager.

657

(b) The case manager shall notify the applicant in writing of any necessary documentation

658

that was not received and is still needed.

659

(c) Upon receipt of a completed application along with all the required documentation, the

660

case manager shall have up to ten (10) business days to provide the initial decision in

661

writing to the applicant.

662

(d) An application for COBRA insurance payments shall be valid for thirty (30) days. If

663

the applicant has a determination of award and/or coverage pending with another support

664

or assistance resource, the application will be valid for an additional fifteen (15) days upon

665

proof of that such determination is pending. If the applicant fails to provide all requested

666

documentation, the case manager shall send the applicant an expiration notice for their

667

application.

668 11-5. COBRA insurance premium payments are limited to a maximum of five hundred dollars

669

($500.00) per month for a total period of three (3) months. An additional three (3) months of

670

COBRA Insurance premiums may be requested with additional supporting documentation

671

from a medical professional which indicates the applicant’s return to employment is

672

established and with documentation from the employer approving the extended leave time.

673 11-6. Upon notification of employment termination, a referral to state or public assistance will be

674

made.

675 11-7. CSF reserves the right to discontinue assistance based on funding availability.

676

677 XII. FAMILY MEDICAL LEAVE ACT WAGE REPLACEMENT

678 12-1. Purpose. The purpose of the Family Medical Leave Act (FMLA) Wage Replacement

679

assistance program is to assist enrolled members of the Nation with wage replacement when

3.2021

35 of 77

Draft of Proposed Amendments

680

wages are interrupted due to the need to care for an immediate family member as approved

681

under the Family Medical Leave Act.

682 12-2. FMLA wage replacement assistance is available only to employed immediate family members

683

utilizing the FMLA or approved medical leave by the caregiver’s employer.

684 12-3. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

685

illness, injury or emergency event.

686 12-4. Eligibility Criteria. In order to be eligible for FMLA Wage Replacement assistance, a person

687

must provide a completed Community Support Fund application and the following:

688

(a) Proof of enrollment in the Nation;

689

(b) Verification that the caregiver has been employed with their company for at least

690

twelve (12) months, and must have worked for at least one thousand two hundred and fifty

691

(1250) hours in the last twelve (12) months;

692

(c) Verification of approved FMLA or equivalent leave from the caregiver’s employer;

693

(d) Verification of the medical need requiring full-time care of the immediate family

694

member, which indicates that continuous care is needed twenty four (24) hours per day, for

695

seven (7) days a week. Said verification must also specify the approximate length of time

696

this direct care is needed.

697

(e) Verification of all household income within the last thirty (30) days of submission of

698

the application for assistance.

699 12-5. Receipt of Required Documentation. Upon receipt of the completed application for FMLA

700

Wage Replacement assistance, the case manager shall determine if all required documentation

701

was received from the applicant.

702

(a) The applicant shall provide all documentation requested by the case manager.

703

(b) The case manager shall notify the applicant in writing of any necessary documentation

704

that was not received and is still needed.

705

(c) Upon receipt of a completed application along with all the required documentation, the

706

case manager shall have up to ten (10) business days to provide the initial decision in

707

writing to the applicant.

708

(d) An application for FMLA Wage Replacement assistance shall be valid for thirty (30)

709

days. If the applicant has a determination of award and/or coverage pending with another

710

support or assistance resource, the application will be valid for an additional fifteen (15)

711

days upon proof of that such determination is pending. If the applicant fails to provide all

712

requested documentation, the case manager shall send the applicant an expiration notice

713

for their application.

714 12-6. FMLA wage replacement shall be for a maximum of three hundred and fifty dollars ($350.00)

715

per week for up to twelve (12) weeks. However, wages that are less than three hundred and

716

fifty dollars ($350.00) per week will be paid at the actual wage rate appearing on the

717

caregiver’s pay stubs.

718 12-7. An extension of an additional twelve (12) weeks of wage replacement may be considered on a

719

case by case basis, and updated verification must be provided showing additional approved

720

FMLA leave from the caregiver’s employer.

721 12-8. FMLA wage replacement will not be available to caregivers who are unemployed, receiving

722

social security benefits, retirement benefits, or any other source of income.

723 12-9. A W-2 tax statement will be issued to the caregiver from the Oneida Nation Central Accounting

724

Department. This will be a separate W-2 tax statement from regular earnings if the caregiver

725

is an employee of the Oneida Nation.

3.2021

36 of 77

Draft of Proposed Amendments

726 12-10.The applicant must notify the case manager ten (10) business days prior to the end of the

727

approved FMLA.

728 12-11.The wage replacement will end seven (7) days after the immediate family member being cared

729

for is institutionalized or passes away.

730 12-12.Failure of the applicant to report changes in the household will result in the termination of

731

benefits.

732 12-13.Applicants are not eligible for shelter, utilities, or any other supportive service during the time

733

of receiving wage replacement.

734 12-14.The applicant must be directly caring for an immediate family member, and not oneself.

735 12-15.CSF reserves the right to discontinue assistance based on funding availability.

736

737 XIII. FIRE/NATURAL DISASTER ASSISTANCE

738 13-1. Purpose. The purpose of the Fire/Natural Disaster Assistance program is to assist enrolled

739

members of the Nation with financial support for fire or natural disaster shelter expenses where

740

no other resources exist.

741 13-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

742

illness, injury or emergency event.

743 13-3. Eligibility Criteria. In order to be eligible for Fire/Natural Disaster assistance, a person must

744

provide a completed Community Support Fund application and the following:

745

(a) Proof of enrollment in the Nation;

746

(b) A police and/or fire department report specifying the fire/natural disaster and

747

confirming that the home is uninhabitable;

748

(c) Verification of claim submitted to homeowner’s or renter’s insurance if insured;

749

(d) Verification of assistance provided or applied for from disaster relief organizations

750

such as Red Cross, FEMA, etc.;

751

(e) Verification of all household members at the time of the fire/natural disaster;

752

(f) Verification of lease or mortagage lender information.

753 13-4. Receipt of Required Documentation. Upon receipt of the completed application for

754

Fire/Natural Disaster assistance, the case manager shall determine if all required

755

documentation was received from the applicant.

756

(a) The applicant shall provide all documentation requested by the case manager.

757

(b) The case manager shall notify the applicant in writing of any necessary documentation

758

that was not received and is still needed.

759

(c) Upon receipt of a completed application along with all the required documentation, the

760

case manager shall have up to ten (10) business days to provide the initial decision in

761

writing to the applicant.

762

(d) An application for Fire/Natural Disaster assistance shall be valid for thirty (45) days.

763

If the applicant has a determination of award and/or coverage pending with another support

764

or assistance resource such as Red Cross, the application will be valid for an additional

765

fifteen (15) days upon proof of that such determination is pending. If the applicant fails to

766

provide all requested documentation, the case manager shall send the applicant an

767

expiration notice for their application.

768 13-5. Temporary shelter assistance will be given for up to a maximum of fifteen (15) days with the

769

limit of seventy-five dollars ($75.00) per day for a grand total of one thousand and one hundred

770

and twenty-five dollars ($1,125.00) if shelter expenses have not been paid by other resources.

3.2021

37 of 77

Draft of Proposed Amendments

771 13-6. Temporary shelter may be extended for up to an additional five (5) days upon verification from

772

a licensed contractor that repairs are not able to be completed within the original fifteen (15)

773

day time period, and alternate shelter is verified as not being available.

774 13-7. Immediate shelter arrangements may be made by the case manager for a hotel/motel, making

775

an effort to obtain a room with appliances for storing and preparing meals.

776 13-8. Security deposit and first month’s rent shall not exceed one thousand dollars ($1,000.00) if the

777

current home is uninhabitable and is in need of major repair beyond thirty (30) days. The

778

following additional information must be provided:

779

(a) Landlord verification form which shall include the amount of security deposit and

780

monthly rent;

781

(b) Copy of a new rental lease agreement;

782

(c) Verification that the household income can support the monthly rent expense.

783 13-10.Applicant is responsible to report to the Case Manager any changes in the current catastrophic

784

situation, such as assistance from other agencies, or long-term housing arrangements.

785 13-11.Direct vendor payment may be made up to one hundred dollars ($100.00) per family member

786

for clothing and basic household item needs.

787 13-12.Any claim of items stored in a household by persons other than residents of the household will

788

not be considered for assistance (i.e. stored items in basement, garage, etc.)

789 13-13.Some services are not eligible for assistance, including, but not limited to auto replacement,

790

transportation, food, storage fees, furnishings, smoke or water damage cleaning fees, and

791

rebuilding costs.

792 13-14.The CSF will not pay family members or caregivers, rather payment will be made to a valid

793

landlord or mortgage holder.

794 13-15.The CSF reserves the right to discontinue assistance in cases where fraud or illegal activity has

795

been determined to have caused the catastrophic event, illness, injury or emergency event

796

resulting in the need for shelter.

797 13-16.The CSF reserves the right to discontinue assistance based on funding availability.

798

799 XIV. FUNERAL TRAVEL REIMBURSEMENT

800 14-1. Purpose. The purpose of the Funeral travel reimbursement program is to provide a consistent

801

process of reimbursing enrolled members of the Nation with expenses associated with funeral

802

travel when there are no other resources that exist.

803 14-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

804

illness, injury or emergency event.

805 14-3. Eligibility Criteria. In order to be eligible for Funeral travel reimbursement, a person must

806

provide a completed Community Support Fund application and the following:

807

(a) Proof of enrollment in the Nation;

808

(b) A copy of the obituary that lists the immediate family member;

809

(c) A copy of the applicant’s valid driver’s license if requesting fuel reimbursement;

810

(d) Original receipts that show payment for hotel, gas, and/or airfare turned in for

811

reimbursement within thirty (45) days of the date of the funeral;

812 14-4. Receipt of Required Documentation. Upon receipt of the completed application for Funeral

813

Travel Reimbursement assistance, the case manager shall determine if all required

814

documentation was received from the applicant.

815

(a) The applicant shall provide all documentation requested by the case manager.

3.2021

38 of 77

Draft of Proposed Amendments

816

(b) The case manager shall notify the applicant in writing of any necessary documentation

817

that was not received and is still needed.

818

(c) Upon receipt of a completed application along with all the required documentation, the

819

case manager shall have up to ten (10) business days to provide the initial decision in

820

writing to the applicant.

821

(d) An application for Funeral Travel Reimbursement assistance shall be valid for thirty

822

(30) days. If the applicant has a determination of award and/or coverage pending with

823

another support or assistance resource, the application will be valid for an additional

824

fifteen (15) days upon proof of that such determination is pending. If the applicant fails

825

to provide all requested documentation, the case manager shall send the applicant an

826

expiration notice for their application.

827 14-5. Airfare, train, bus, lodging and vehicle fuel is limited to a combined maximum reimbursement

828

amount of five hundred dollars ($500.00).

829

(a)

Multiple immediate family members are limited to reimbursement of five hundred

830

dollars ($500.00) each.

831

(b)

Hotel lodging is limited to a maximum of seventy-five dollars ($75.00) per night

832

and up to two (2) nights of stay and is only for those who reside in excess of sixty (60)

833

miles one-way from the location of the funeral.

834

(c)

All receipts must coincide with the initial funeral date.

835

(d)

Payments will not be made for “celebrations of life” or similiar gatherings after the

836

family members death.

837 14-6. Purchases not eligible for reimbursement include, but are not limited to, rental car, car repair,

838

food, clothing, flowers, and actual funeral costs.

839 14-7. Vehicle fuel reimbursement is limited to those persons who must travel forty (40) or more

840

miles one-way to attend a funeral service.

841 14-8. Reimbursement of travel expenses will not be considered when travel was completed more

842

than forty-five (45) days after the verified date of the funeral.

843 14-9. CSF will not make any reservations for any form of travel. This assistance is by reimbursement

844

only.

845 14-10.This program encourages multiple family members traveling to the same destination to

846

carpool, and/or share hotel rooms whenever possible.

847 14-11.CSF reserves the right to discontinue assistance based on funding availability.

848

849 XV. APPLIANCE REPAIR AND REPLACEMENT: FURNACE AND WATER HEATER

850 15-1. Purpose. The purpose of Appliance Repair and Replacement assistance is to assist enrolled

851

members of the Nation with an emergency repair or replacement of a furnace or water heater

852

where no other resources exist.

853 15-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

854

illness, injury or emergency event.

855 15-3. This assistance is limited to furnaces and water heaters, and shall not include any other kind of

856

appliances.

857 15-4. Eligibility Criteria. In order to be eligible for Appliance Repair and Replacement assistance,

858

a person must provide a completed Community Support Fund application and the following:

859

(a) Proof of enrollment in the Nation;

860

(b) Two (2) cost estimates for repair of a water heater or furnace from a licensed/certified

861

repair professional, one (1) estimate is acceptable when weather is extremely cold and/or

3.2021

39 of 77

Draft of Proposed Amendments

862

during a National emergency, to include the name, address, phone number, and Federal

863

Tax Identification number of the professional;

864

(c) Verification that the applicant applied for Energy Assistance with the county agency

865

in which the applicant resides, along with proof assistance was denied; and

866

(d) Verification that the applicant is the owner of the home.

867 15-5. Receipt of Required Documentation. Upon receipt of the completed application for appliance

868

repair and/or replacement assistance, the case manager shall determine if all required

869

documentation was received from the applicant.

870

(a) The applicant shall provide all documentation requested by the case manager.

871

(b) The case manager shall notify the applicant in writing of any necessary documentation

872

that was not received and is still needed.

873

(c) Upon receipt of a completed application along with all the required documentation, the

874

case manager shall have up to ten (10) business days to provide the initial decision in

875

writing to the applicant.

876

(d) An application for appliance repair and/or replacement assistance shall be valid for

877

thirty (30) days. If the applicant has a determination of award and/or coverage pending

878

with another support or assistance resource, the application will be valid for an additional

879

fifteen (15) days upon proof of that such determination is pending. If the applicant fails

880

to provide all requested documentation, the case manager shall send the applicant an

881

expiration notice for their application.

882 15-6. When a cost estimate indicates that the repair costs will exceed the value of the appliance,

883

replacement will be considered and approved on a case by case basis.

884 15-7. The repair and/or replacement of a water heater shall be at least one hundred dollars ($100.00)

885

and not exceed six hundred dollars ($600.00) once every ten (10) years.

886 15-8. The repair and/or replacement of a furnace shall not exceed two thousand and five hundred

887

dollars ($2,500.00) once per lifetime.

888 15-9. The CSF reserves the right to discontinue assistance based on funding availability.

889

890 XVI. SECURITY DEPOSIT ASSISTANCE

891 16-1. Purpose. The purpose of the Security Deposit assistance program is to provide enrolled

892

members of the Nation residing in the State of Wisconsin with financial support to ensure

893

quality of life when shelter expenses are threatened with eviction.

894 16-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

895

illness, injury or emergency event.

896 16-3. Eligibility Criteria. In order to be eligible for Security Deposit assistance, a person must

897

provide a completed Community Support Fund application and the following:

898

(a) Proof of enrollment in the Nation;

899

(b) A landlord verification form completed by the potential landlord or a current

900

rental/lease agreement showing the amount of the security deposit;

901

(c) Verification of a current emergency situation, which shall include, but is not limited

902

to, a pending eviction;

903

(d) Eviction cannot be due to illegal activity with charges against the applicant see (125.7904

2);

905

(e) The applicant shall demonstrate the ability to fulfill the terms of the rental lease. The

906

operators of the Fund shall not co-sign any lease.

3.2021

40 of 77

Draft of Proposed Amendments

907 16-4. Receipt of Required Documentation. Upon receipt of the completed application for Security

908

Deposit assistance, the case manager shall determine if all required documentation was

909

received from the applicant.

910

(a) The applicant shall provide all documentation requested by the case manager.

911

(b) The case manager shall notify the applicant in writing of any necessary documentation

912

that was not received and is still needed.

913

(c) Upon receipt of a completed application along with all the required documentation, the

914

case manager shall have up to ten (10) business days to provide the initial decision in

915

writing to the applicant.

916

(d) An application for Security Deposit assistance shall be valid for thirty (30) days. If

917

the applicant has a determination of award and/or coverage pending with another support

918

or assistance resource, the application will be valid for an additional fifteen (15) days

919

upon proof of that such determination is pending. If the applicant fails to provide all

920

requested documentation, the case manager shall send the applicant an expiration notice

921

for their application.

922 16-5. Security Deposit assistance shall not exceed the amount of five hundred dollars ($500.00) and

923

approved once per lifetime

924 16-6. Security Deposit assistance is limited to one (1) person per household.

925 16-7. CSF will not pay family members or caregivers a security deposit; it must be a valid landlord.

926 16-8. CSF reserves the right to discontinue assistance based on funding availability.

927

928 XVII. SOCIAL SECURITY DISABILITY DETERMINATION SHELTER ASSISTANCE

929 17-1. Purpose. The purpose of the Social Security Disability Determination Shelter assistance

930

program is to assist enrolled members of the Nation with financial support for shelter expenses

931

for those waiting an eligibility determination for the Social Security Administration for a

932

disability finding.

933 17-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

934

illness, injury or emergency event.

935 17-3. Eligibility Criteria. In order to be eligible for Social Security Disability Determination Shelter

936

assistance, a person must provide a completed Community Support Fund application and the

937

following:

938

(a) Proof of enrollment in the Nation;

939

(b) Verification of a pending Social Security Disability Application;

940

(c) A Landlord verification form completed by a landlord or other statement from the

941

mortgage holder that show the monthly rent and the applicant’s current status;

942

(d) Verification of the applicant’s current utility bills for water, heat, and electricity,

943

however energy assistance must be applied for before any utility bills will be considered

944

for payment;

945

(e) Verification of mortgage disability insurance, if applicable;

946

(f) Verification of all household income within the last thirty (30) days of submission of

947

the application for assistance.

948 17-4. Receipt of Required Documentation. Upon receipt of the completed application for Social

949

Security Disability Determination Shelter assistance, the case manager shall determine if all

950

required documentation was received from the applicant.

951

(a) The applicant shall provide all documentation requested by the case manager.

3.2021

41 of 77

Draft of Proposed Amendments

952

(b) The case manager shall notify the applicant in writing of any necessary documentation

953

that was not received and is still needed.

954

(c) Upon receipt of a completed application along with all the required documentation, the

955

case manager shall have up to ten (10) business days to provide the initial decision in

956

writing to the applicant.

957

(d) An application for Social Security Disability Determination Shelter assistance shall

958

be valid for thirty (30) days. If the applicant has a determination of award and/or

959

coverage pending with another support or assistance resource, the application will be

960

valid for an additional fifteen (15) days upon proof of that such determination is pending.

961

If the applicant fails to provide all requested documentation, the case manager shall send

962

the applicant an expiration notice for their application.

963 17-5. Rent/mortgage assistance shall not exceed the amount of five hundred dollars ($500.00) per

964

month, not to exceed twelve (12) months.

965

(a) Only the applicant’s portion will be considered when the household consists of other

966

adults.

967

(b) Rent/mortgage assistance will be terminated if the household fails to meet their

968

timely portion of the scheduled payments.

969

(c) Retro-payment for back rent/mortgage assistance is not eligible for assistance.

970 17-6. Upon receipt of the verification that all other resources have been applied for, utility assistance

971

will be considered for water, heat, and electricity.

972

(a) Only the applicant’s portion of the utility bill will be considered when the household

973

consists of other adults.

974

(b) The utility bill must be in the applicant or current household member’s name.

975

(c) Payment for past due amounts owed for utilities are not eligible for assistance.

976 17-7. The applicant is responsible to report to the Case Manager any change(s) in the household

977

within ten (10) business day from the change occurring.

978

(a) Examples of household change shall include, but is not limited to the following:

979

relocation, household members, income, medical changes, submitted social security

980

disability application, or application for or receipt of other agency assistance such as

981

housing allowance, etc.

982

(b) Failure of the applicant to report changes in the household may result in suspension

983

of benefits until verification of the change(s) is provided to the Case Manager, but

984

shall not exceed thirty (30) days.

985 17-8. CSF will not pay family members or caregivers; the assistance is paid only to a valid landlord

986

or mortgage holder.

987 17-9. CSF reserves the right to discontinue this assistance based on funding availability.

988 17-10.CSF reserves the right to discontinue this assistance in cases where fraud or illegal activity has

989

been determined to have caused the eviction.

990 17-11.The Case Manager will provide ten (10) day written notification to an applicant whose

991

assistance under this program is being discontinued.

992

993 XVIII. UTILITY DISCONNECTION ASSISTANCE

994 18-1. Purpose. The purpose of the Utility Disconnection assistance program is to assist enrolled

995

members of the Nation with emergency financial support to ensure quality of life when home

996

heating and electric services are threatened with disconnection.

3.2021

42 of 77

Draft of Proposed Amendments

997 18-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

998

illness, injury or emergency event.

999 18-3. Eligibility Criteria. In order to be eligible for Utility Disconnection assistance, a person must

1000

provide a completed Community Support Fund application and the following:

1001

(a) Proof of enrollment in the Nation;

1002

(b) A copy of the current disconnection notice received from the utility company for the

1003

household in which the applicant is residing;

1004

(c) Verification of address;

1005

(d) Verification of application for Energy Assistance and crisis assistance with the county

1006

agency in which the applicant resides;

1007

(e) Verification of payments made in each of the three (3) previous months of at least

1008

twenty-five follars ($25.00) per month.

1009 18-4. Receipt of Required Documentation. Upon receipt of the completed application for Utility

1010

Disconnection assistance, the case manager shall determine if all required documentation was

1011

received from the applicant.

1012

(a) The applicant shall provide all documentation requested by the case manager.

1013

(b) The case manager shall notify the applicant in writing of any necessary documentation

1014

that was not received and is still needed.

1015

(c) Upon receipt of a completed application along with all the required documentation, the

1016

case manager shall have up to ten (10) business days to provide the initial decision in

1017

writing to the applicant.

1018

(d) An application for Utility Disconnection assistance shall be valid for thirty (30)

1019

days. If the applicant has a determination of award and/or coverage pending with another

1020

support or assistance resource, the application will be valid for an additional fifteen (15)

1021

days upon proof of that such determination is pending. If the applicant fails to provide all

1022

requested documentation, the case manager shall send the applicant an expiration notice

1023

for their application.

1024 18-5. Requests for assistance for the payment of utilities shall only be allowed once every two (2)

1025

years by the responsible payee. Assistance requested under this Rule and under Rule 3 shall

1026

be counted towards the total number of requests for the two (2) year period limit.

1027 18-6. Utility assistance shall not exceed the amount of three hundred dollars ($300.00).

1028 18-7. CSF reserves the right to discontinue assistance based on funding availability.

1029

1030

End.

1031

1032

Adopted in whole 01-24-2018 – Effective 01-25-2018 – LOC Certified 01-17-2018

1033

Amended __-__-____ - Effective __-__-____ - LOC Certified __-__-____

Digitally signed by Tina Jorgensen, MS, RDN

Date: 2021.05.14 09:12:17 -05'00'

3.2021

43 of 77

Draft of Proposed Amendments (Redline to Current)

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

1

2

3

4

5

6

7

8

Title 1. Government and Finances – Chapter 125

Community Support Fund

Rule Nos. 1 through 18

I. Purpose, Delegation, Adoption, Amendment and Repeal

1-1. Purpose. The purpose of the Community Support Fund rules is to provide guidance on how

the Community Support Fund is utilized so that the Nation can assist the greatest number of

members of the Nation who apply for assistance to the Fund in times of a catastrophic event,

catastrophic illness, or injury, or emergency event when no other resources for assistance exist.

1-2. Authority. The Community Support Fund Law, Chapter 125, delegates rulemaking authority

to the Social Services Area of the Government Services DivisionFund Operator pursuant to the

Administrative Rulemaking law (Chapter 17106 Oneida Code of Laws).

1-3. These rules were adopted by the Economic Support Department of the Social Services Area

of the Government Services Division in accordance with the procedures of the Administrative

Rulemaking law.

1-4. These rules may be amended or repealed by the Economic Support Department and/or the

Oneida Business Committee pursuant to the procedures set out in the Administrative Rulemaking

Law. For the purpose of future amendments to these rules, each article is a separate rule and may

be amended as such.

1-5. Should a provision of these rules or the application thereof to any person or circumstances be

held as invalid, such invalidity shall not affect other provisions of these rules which are considered

to have legal force without the invalid portions.

1-6. In the event of a conflict between a provision of these rules and a provision of another rule,

internal policy, procedure, or other regulation; the provisions of these rules shall control.

1-7. These rules supersede all prior rules, regulations, internal policies or other requirements

relating to the Community Support Fund.

1-8. This Article applies to each subsequent rule listed herein.

II. Definitions

2-1. This section shall govern the definitions of words and phrases used within this rule. All

words not defined herein shall be used in their ordinary and everyday sense.

(a) “Applicant” means the subject of the application for assistance.

(b) “Business day” means Monday through Friday from 8:00 a.m. to 4:30 p.m., excluding

holidays of the Nation.

(c) “Caregiver” means the person who assists an ill or incapacitated immediate family

member that is in need of twenty-four (24) hour per day, seven (7) days a week care.

(d) “Case manager” means an employee within the Fund operator responsible for

administering Community Support Fund benefits.

(e) “Catastrophic event” means a natural or man-made incident, which results in a

substantial damage or loss requiring major financial resources to repair or recover. This

includes Including, but is not limited to, a house fire, tornado, flood, or other disaster.

3.2021

Community Support Rules1through 18

Page 1 of 25

44 of 77

Draft of Proposed Amendments (Redline to Current)

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67

68

69

70

71

72

73

74

75

76

77

78

79

80

81

82

83

84

85

86

87

88

89

90

91

92

(f) “Catastrophic illness/injury” means a serious debilitating illness, injury, impairment,

or mental or physical condition that involves:

(1) In-patient care;

(2) A period of continuing treatment due to a chronic serious health condition,

including, but not limited to, chemotherapy, radiation, dialysis, and daily/ or weekly

therapy resulting from trauma;

(3) A period of illness or injury that is long-term due to a condition for which

treatment may be ineffective including, but not limited to, stroke or terminal disease

or;

(4) Multiple treatments either for restorative surgery after an accident or other

injury, or for a chronic condition, including, but not limited to, cancertocancer or

kidney disease.

(g) “COBRA” means the Consolidated Omnibus Budget Reconciliation Act of 1985 also

known as continued group health care coverage costs under an employer’s plan.

(h) “Cosmetic” means any medical service provided with the intent to enhance a person’s

appearance, including, but not limited to, braces, veneers, teeth whitening, implants, or

other plastic surgery.

(i) “Critical Medical” means professionally delivered care or treating a life threatening

illness which requires immediate or regularly scheduled monitored medical care, which

includes, but is not limited to dialysis, chemotherapy, radiation, daily/weekly therapy

resulting from trauma. This does not include routine annual or semi-annual appointments.

(j) “Emergency event” means a situation that poses an immediate risk to health, life,

safety, property or environment. Emergencies require urgent intervention to prevent further

illness, injury, death, or other worsening of the situation.

(k) “Emergency medical travel” means an unexpected serious health situation or

occurrence requiring the immediate presence of immediate family. This includes, but is not

limited to, end of life situations, and situations in which/or an immediate family member

is placed on life support.

(l) “Eviction” means the legal notice received from a landlord or mortgage holder that

orders the tenant(s) to vacate the property.

(m) “”FMLA” means the Family Medical Leave Act, a Federal law authorizing temporary

time off from an employment position to provide direct care to a family member, without

losing their employment status.

(n) “Fund” means the Community Support Fund.

(o) “Fund Operator” means the Economic Support Department, or other area within the

Governmnetal Services Division designated authority over the operation of the Fund.

(o)(p) “Garnishment” means a legal action that directs that money owed be seized to

satisfy a debt.

(p)(q) “Household” means all persons who reside together at the same residence.

(q)(r) “Immediate family” means an individual’sapplicant’s husband, wife, mother,

father, step mother, step father, son, daughter, step son, step daughter, brother, sister, step

brother, step sister, grandparent, grandchild, mother-in-law, father-in-law, daughter-inlaw, son-in-law, brother-in-law or sister-in-lawaunt, uncle, niece, nephew, cousin, and any

of the these relations attained through marriage or legal adoption, and/oras well as a person

who is legally responsible or otherwise named the has legal guardianresponsibility for the

applicant., or a person the applicant has legal responsibility of.

3.2021

Community Support Rules1through 18

Page 2 of 25

45 of 77

Draft of Proposed Amendments (Redline to Current)

93

(r)(s) “Incapacitation” means a state in which a person is temporarily or permanently

94

impaired by mental and/or physical deficiency, disability, illness or injury.

95

(s)(t) “Income” means a measurement including, but not limited to, a combination of

96

salaries, wages, retirement pension, disability income, government benefits, and

97

unemployment of all people sharing a particular household/residence.

98

(t)(u) “Legal guardian” means a person who has the legal authority to care for the

99

personal and property interests of another person granted through a Court order.

100

(u)(v) “Legal responsibility” means specific duties imposed upon a person to care or

101

provide for another including liability for personal obligations as granted through a Power

102

of Attorney or Court order.

103

(v)(w) “Major medical surgery” means a surgical procedure that carries a degree of risk to

104

the patient’s life, or the potential for severe disability if something goes wrong during

105

surgery. It is a surgical procedure that usually requires a patient to be put under general

106

anesthesia and given respiratory assistance because he or she cannot breathe independently.

107

(w)(x) “Nation” means the Oneida Nation.

108

(y) “Public health emergency” means the occurrence or imminent threat of an illness or

109

health condition which:

110

(1) is a quarantinable disease, or is believed to be caused by bioterrorism or a

111

biological agent; and

112

(2) poses a high probability of any of the following:

113

(A) a large number of deaths or serious or long-term disability among

114

humans; or

115

(B) widespread exposure to a biological, chemical, or radiological agent

116

that creates a significant risk of substantial future harm to a large number

117

of people.

118

(x)(z) “Non-medical” means necessary intervention to support a patient with an on-going

119

medical illness, injury or potential life threatening illness, and requires further testing or

120

consultation with a specialist.

121

(y)(aa) “Reimbursement” means to make repayment for expense(s) or a loss that incurred.

122

(z)(bb) “Routine Exam” means an annual or semi-annual health exam provided by a

123

physician, dentist, orthodontist, oral surgeon, or other similar health care specialist.

124

(aa)(cc)

“Security Deposit” means the payment of money held by a landlord in trust

125

to protect him/herself from unpaid rent or damage to the living space.

126

(bb)(dd)

“Wages” means taxable income reported to the Internal Revenue Service

127

for performing work.

128

129 III. SHELTER ASSISTANCE

130 3-1.

Purpose. The purpose of shelter assistance is to assist enrolled members of the Nation with

131

financial support for shelter expenses due to experiencing a catastrophic event, illness, or

132

injury where no other resources exist.

133 3-2.

Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

134

illness, injury or emergency event.

135 3-3.

Eligibility Criteria. In order to be eligible for shelter assistance a person must provide a

136

completed Community Support Fund application and the following:

137

(a) Proof of enrollment in the Nation;

3.2021

Community Support Rules1through 18

Page 3 of 25

46 of 77

Draft of Proposed Amendments (Redline to Current)

138

139

140

141

142

143

144

145

146

147

148

149

150

151

152

153 3-4.

154

155

156

157

158

159

160

161

162

163

164

165

166

167

168 3-5.

169

170

171

172

173

174

175

176

177

178 3-6.

179

180

181

182

(b) Documentation verifying catastrophic event, illness, injury or other emergency event

within the last thirty (30) days, including but not limited to:

(1) Medical verification specifying dates effected by illness or injury;

(2) Verification of short and/or long term disability specifying the dates received

and the amount of the benefit;

(3) Other documentation listing damage or loss.

(c) Landlord Verification Form completed by the landlord of the applicant or a statement

from the applicant’s mortgage holder stating the applicant’s monthly mortgage payment

and current status;

(d) A current utility bill, such as a water, heat, or electricity bill;

(e) Verification of all household income for the last thirty (30) days;

(f)(e) Verification of any mortgage disability insurance;

(g)(f) Verification of an applicant’s personal and/or vacation time from employment; and

(h)(g) Any other documentation requested by the Community Support Fund case

manager.

Receipt of Required Documentation. Upon receipt of the completed application for shelter

assistance, the case manager shall determine if all required documentation was received from

the applicant.

(a) The applicant shall provide all documentation requested by the case manager.

(b) The case manager shall notify the applicant within five (5) business days in writing of

any necessary documentation that was not received and is still needed.

(c) Upon receipt of a completed application along with all the required documentation,

the case manager shall have up to ten (10) business days to provide the initial decision in

writing to the applicant.

(d) An application for shelter assistance shall be valid for thirty (30) days. If the applicant

has a determination of award and/or coverage pending with another support or assistance

resource, the application will be valid for an additional fifteen (15) days upon proof of that

such determination is pending. If the applicant fails to provide all requested

documentation, the case manager shall send the applicant an expiration notice for their

application.

Rent or Mortgage Assistance. An applicant may request assistance for rent or mortgage

payments.

(a) The amount provided for rent or mortgage assistance shall not exceed $five hundred

dollars ($500.00) per month. The amount of rent or mortgage assistance shall not exceed a

total of twenty-four (24) months per life-time of the applicant.

(b) Only the applicant’s portion of the rent or mortgage owed shall be considered when

determining the amount of rent or mortgage assistance if the applicant’s household consists

of other adults.

(c) Shelter assistance shall not be used to pay family members or caregivers of the

applicant. Only a valid landlord or mortgage holder shall be paid.

Utility Assistance. An applicant may request assistance for utilities, such as heat, water, and

electricity.

(a) The utility bill shall be in the applicant’s or current household’s member’s name.

(b) Applicants shall provide verification of application to all other available resources and

programs for utility assistance.

3.2021

Community Support Rules1through 18

Page 4 of 25

47 of 77

Draft of Proposed Amendments (Redline to Current)

183

(1) The Wisconsin Home Energy Assistance Program (WHEAP) serves as an

184

example of an alternate program the applicant should apply for before applying for

185

shelterutility assistance.

186

(c) Only the applicant’s portion of the utility bill shall be considered when determining

187

the amount of utility assistance if the applicant’s household consists of other adults.

188

(d) The amount provided for utility assistance shall not exceed $three hundred dollars

189

($300.00) and shall only be allowed once every two (2) years. Assistance requested under

190

this Rule and under Rule 18 shall be counted towards the total number of requests for the

191

two (2) year period limit.

192 3-7.

Reporting Changes in the Household. The applicant shall report any changes in the household

193

to the case manager within ten (10) business days from the change occurring.

194

(a) Changes in the household that shall be reported include, but are not limited to, the

195

following: relocation, addition or subtraction of a household member, income changes,

196

medical changes, submission of a social security disability application, submission of

197

application or receipt of assistance from other agency or program.

198

(b) Failure of the applicant to report changes in the household may result in suspension

199

of benefits until verification of the change(s) is provided to the case manager, not to exceed

200

thirty (30) days.

201 3-8.

Discontinuation of Assistance. The Community Support Fund Manager reserves the right to

202

discontinue shelter assistance based on the following:

203

(a) A lack of funding availability

204

(b) A discovery that fraud or illegal activity has been determined to have caused

205

homelessness.

206

(c) The case manager shall provide ten (10) day notification to an applicant whose shelter

207

assistance will be discontinued.

208 3-9.

Changes in Household Information. An applicant shall be responsible to report to the Fund

209

Case Manager any change(s) in the household within ten (10) business days from the change.

210

Changes shall include, but are not limited to the following:

211

(a) Relocation;

212

(b) Household member changes;

213

(c) Income;

214

(d) Medical changes;

215

(e) Submission of Social Security Disability application; and

216

(f) Receipt of other agency assistance

217

(1) Failure of an applicant to report changes in the household may result in

218

suspension of assistance until verification of the change(s) is provided to the

219

Fund Case Manager.

220

(2) An applicant shall have thirty (30) days to provide the verification once

221

notification is received from the Fund Case Manager that verification is

222

required.

223 3-10. HotelLodging Assistance. HotelLodging Assistance may be provided in the event of extreme

224

situations as determined by the Fund Case Manager and the Director of Economic Support.

225

226 IV. EMERGENCY/NON-EMERGENCY MEDICAL TRAVEL

3.2021

Community Support Rules1through 18

Page 5 of 25

48 of 77

Draft of Proposed Amendments (Redline to Current)

227 4-1.

228

229

230 4-2.

231

232 4-3.

233

234

235

236

237

238

239

240

241

242

243

244 4-4.

245

246

247

248

249

250

251

252

253

254

255

256

257

258

259 4-5.

260

261

262

263

264

265

266

267

268

269

270

271

Purpose. The purpose is to assist enrolled members of the Nation with emergency and nonemergency medical travel expenses. This assistance is limited to immediate family members

to assist with travel expenses.

Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

illness, injury or emergency event.

Eligibility Criteria. In order to be eligible for emergency/non-emergency medical travel

assistance, a person must provide a completed Community Support Fund application and the

following:

(a) Proof of enrollment in the Nation;

(b) Verifications of medical appointments which include the medical condition, date, time

and location of the appointment;

(b)(c) Verification of the applicants relationship to the patient;

(c)(d) Verification of a valid driver’s license for reimbursement of fuel purchases

(de) Original receipts for hotel, gas, and/or airfare which shall be dated within thirty (30)

days of travel and show total cost paid; and

(e) Verification of all household income within the last thirty (30) days of submission of

the application for assistance.

Receipt of Required Documentation. Upon receipt of the completed application for

emergency/non-emergency medical travel assistance, the case manager shall determine if all

required documentation was received from the applicant.

(a) The applicant shall provide all documentation requested by the case manager.

(b) The case manager shall notify the applicant in writing of any necessary documentation

that was not received and is still needed.

(c) Upon receipt of a completed application along with all the required documentation,

the case manager shall have up to ten (10) business days to provide the initial decision in

writing to the applicant.

(d) An application for emergency/non-emergency medical travel assistance shall be valid

for thirty (30) days. If the applicant has a determination of award and/or coverage pending

with another support or assistance resource, the application will be valid for an additional

fifteen (15) days upon proof of that such determination is pending. If the applicant fails to

provide all requested documentation, the case manager shall send the applicant an

expiration notice for their application.

Non-Emergency Travel. Non-emergency travel is allowed when anthe applicant or

immediate family member has scheduled medical appointments as shown through medical

documentation.

(a) (a) Documentation of scheduled appointments must be submitted and have prior

approval.

(b) The medical appointment must be more than sixty (60) miles one way from the

residence of the applicant.

(b) (c) Gas cardsNon-emergent medical travel for local members with chronic serious

medical needs may be reimbursed to the applicant with a valid receipt within fortyfive (45) days of appointments. Once the application is approved, applicants within

the reservation boundires may receive assistance direcelty from the program during

regular business hours.

(c) Non-Emergency Travel Less Than Sixty (60) Miles One Way.

3.2021

Community Support Rules1through 18

Page 6 of 25

49 of 77

Draft of Proposed Amendments (Redline to Current)

272

273

274

275

276

277

278

279

280

281

282

283

284

285

286

287

288

289

290

291

292

293

294

295

296

297

298

299

300

301 4-6.

302

303

304

305

306

307

308

309

310

311

312

313

314

315 4-7.

316

(1) Applicants within the reservation boundaries traveling less than sixty (60) miles

one way may be eligiable for public or tribal transportation transit passes for

verified chronic serious medical appointments.

(2) Applicants traveling less than sixty (60) miles one way may receive assistance

or reimbursement not to exceed twenty dollars ($20.00) per week for verified

chronic serious medical appointments.

(d) Non-Emergency Travel At Least Sixty (60) Miles One Way.

(1) Those who travel from sixty (60) miles up to one hundred fifty (150) miles oneway shall receive a thirty dollar ($30.00) fuel assistance. Travel may also be eligible

for reimbursement for up to thirty dollars ($30.00) with original receipts that

coincide with a medical appointment.

(2) Those who travel over one hundred and fifty (150) miles one-way shall receive

a forty dollar ($40.00) fuel assistance. Travel may also be eligible for

reimbursement for up to forty dollars ($40.00) with original receipts that coincide

with a medical appointment.

(e) Fuel Assistance will be disbursed the day prior to the appointment if application is

timely and original receipts are due within seven (7) business days. If receipts are not

turned in, future requests for assistance will be denied for six (6) consecutive months

starting when the first new request is made.

(1) Those who travel from sixty (60) miles up to one hundred fifty (150) miles oneway shall receive a $30.00 gas card. Travel may also be eligible for reimbursement

for up to $30.00 with original receipts that coincide with an appointment.

(2) Those who travel over one hundred fifty (150) miles one-way shall receive a

$40.00 gas card. Travel may also be eligible for reimbursement for up to $40.00

with original receipts that coincide with an appointment.

(df) Hotel reimbursement shall be a maximum of $seventy-five dollars ($75.00) per night

for up to a maximum of three (3) nights, and shall only be considered for approval by the

Fund Case Manager where the appointment is more than one hundred (100) miles one-way

from the residence of the applicant.

Emergency Travel. Emergency travel assistance is allowed when an immediate family

member has a sudden or worsening life-threatening illness or injury, and is provided only on

as a reimbursement of expenses.

(a) Airfare, bus, train, lodging, and vehicle fuel is limited to a combined maximum

reimbursement amount of $five hundred dollars ($500.00.).

(b) Multiple immediate family members are limited to a reimbursement amount of $five

hundred dollars ($500.00) each.

(c) Reimbursement for emergency travel assistance is limited to those persons who must

travel one hundred (100) miles or more one-way.

(d) Hotel reimbursement shall be a maximum of $seventy-five dollars ($75.00) per night.

(e) All receipts must coincide with the emergency event that required the applicant to

travel. Applicant is responsible for providing all proper documentation regarding the

illness or injury that required travel and the required receipts in order to be eligible for

reimbursement.

Auto Repairs. Auto repair assistance is allowed when the vehicle is necessary to

obtain/maintain ongoing critical medical care when no other resources exist.

3.2021

Community Support Rules1through 18

Page 7 of 25

50 of 77

Draft of Proposed Amendments (Redline to Current)

317

(a) Auto repair assistance is limited to critical medical patients only and will be denied

318

when an alternate vehicle is owned and available for use;

319

(b) Auto repair assistance will only cover repairs that are necessary to keep the vehicle in

320

standard operating condition. No routine maintenance or auto body repairs shall be

321

eligible for assistance. Routine maintenance or repairs shall include, but is not limited to,

322

oil changes, brakes, tires, batteries/fuses, lights, tune-ups, exhaust systems, flushes, and

323

glass replacement;

324

(c) Auto repair assistance is limited to a maximum amount of $five hundred

325

dollars ($500.00) once every twelve (12) months;

326

(d) Emergency repairs needed to obtain critical medical care which occurs outside of the

327

program’s business hours, may be considered on a case by case basis, in consultation

328

with an independent ASE certified auto technician, and for services that occurred within

329

the previous ten (10) days of the application;

330

(e) Towing assistance may be considered on a case by case basis for

331

reimbursement up

to a maximum of $two hundred and fifty dollars ($250.00) once

332

every twelve (12) months when the vehicle is inoperable and towed to an ASE certified

333

mechanic.

334 4-8.

Items not Covered. The Fund Case Manager is not responsible and will not make any

335

reservations for any form of travel. In addition, the following items, which are not all

336

inclusive, are not a benefit of this assistance program:

337

(a) Auto insurance and deductibles;

338

(b) Car Rentals;

339

(c) Personal expenses, including, but not limited to, meals or personal care items;

340

(d) Auto loans and vehicle registration.

341 4-9.

This program encourages and requests that multiple family members traveling to the same

342

destination carpool and share hotel rooms whenever possible.

343 4-10. CSF reserves the right to discontinue assistance based on funding availability.

344

345 V. MEDICAL BILL ASSISTANCE

346 5-1. Purpose. The purpose of this program is to assist enrolled members of the Nation with

347

financial support for the cost of unpaid medical bills (deductiables and copays not covered)

348

where no other resources exist.

349 5-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

350

illness, injury or emergency event.

351 5-3. Eligibility Criteria. In order to be eligible for Medical Bill assistance, a person must provide

352

a completed Community Support Fund application and the following:

353

(a) Proof of enrollment in the Nation

354

(1) a non-enrolled parent of an enrolled minor child may apply for assistance that

355

directly affects the enrolled minor child;

356

(b) Medical billing statements for the dates of service which are within the last twelve (12)

357

months; and be more than fifty dollars ($50.00);

358

(c) Verification that the applicant’s health insurance was utilized within his/her health care

359

network;

360

(d) Explanation of Benefit (EOB) statements received from the health insurance provider

361

showing what portion the health insurance covered;

3.2021

Community Support Rules1through 18

Page 8 of 25

51 of 77

Draft of Proposed Amendments (Redline to Current)

362

(e) Verification that an Indian Health Service Clinic (IHS) was utilized if applicant is in

363

its service area;

364

(f) Verification that the applicant applied for all of the financial care or assistance programs

365

offered at the medical facility;

366

(g) Verification of all household income within the last thirty (30) days of submission of

367

the application for assistance.

368

(h) (g) Statements of denial of assistance or caseworker verification of denial based on

369

eligibility criteria, from an Indian Health Service (IHS) facility or (EOB) from any third

370

party insurance carrier.

371 5-4.

Receipt of Required Documentation. Upon receipt of the completed application for medical

372

bill assistance, the case manager shall determine if all required documentation was received

373

from the applicant.

374

(a) The applicant shall provide all documentation requested by the case manager.

375

(b) The case manager shall notify the applicant in writing of any necessary documentation

376

that was not received and is still needed.

377

(c) Upon receipt of a completed application along with all the required documentation, the

378

case manager shall have up to ten (10 ) business days to provide the initial decision in

379

writing to the applicant.

380

(d) An application for medical bill assistance shall be valid for thirty (30) days. If the

381

applicant has a determination of award and/or coverage pending with another support or

382

assistance resource, the application will be valid for an additional fifteen (15) days upon

383

proof of that such determination is pending. If the applicant fails to provide all requested

384

documentation, the case manager shall send the applicant an expiration notice for their

385

application.

386 5-5.

Financial assistance will only be available for services already rendered by a Health Care

387

Provider for up to a maximum of $five thousand dollars ($5,000.00) within a twelve (12)

388

month period. An extension of this twelve (12) month period can be considered only for

389

chronic medical conditions, but may not exceed an additional $five thousand dollars

390

($5,000.00.).

391 5-6.

Medical and/or hospital bills incurred from illegal activity (i.e. operating while intoxicated,

392

injuries due to alcohol or drug use, etc.), or medical conditions that are a direct result from

393

drug use, including the abuse of prescription drugs, are not eligible for assistance, except for

394

Rule 8 which covers Inpatient or Intensive Outpatient treatment.

395 5-7.

Insurance denials resulting from an applicant’s failure to submit information pertinent to

396

processing an insurance claim are not eligible or assistance.

397 5-8.

Medical bills that have aged beyond twelve (12) months, or which have been referred to a

398

collection agency are not eligible for assistance.

399 5-9.

Chiropractic care, holistic treatment, pain clinic treatment/injections, methadone clinic,

400

SaboxinSaboxon injection and/or nursing home and/or any assisted living facility are not

401

eligible for assistance.

402 5-10. CSF reserves the right to discontinue assistance based on funding availability.

403

404 VI. DENTAL RELATED EXPENSES

405 6-1. Purpose. The purpose of dental related expenses assistance is to assist enrolled members of

406

the Nation with financial support with the cost of dental-related services where no other

407

resources exist.

3.2021

Community Support Rules1through 18

Page 9 of 25

52 of 77

Draft of Proposed Amendments (Redline to Current)

408 6-2. Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

409

illness, injury or emergency event.

410 6-3. Approval is from the Community Support Fund case manager is required prior to receiving

411

treatment from a dental health care provider.

412 6-4. Eligibility Criteria. In order to be eligible for dental related expenses assistance, a person must

413

provide a completed Community Support Fund application and the following:

414

(a) Proof of enrollment in the Nation;

415

(1) a non-enrolled parent of an enrolled minor child may apply for assistance that

416

directly affects the enrolled minor child;

417

(b) Verification by a dentist, orthodontist, or oral surgeon of the dental procedures to be

418

completed, and that they are a medical need, not cosmetic, and the cost or estimated cost

419

of the dental services, which shall include the name, address, and Federal tax ID number

420

of the dental health care provider;

421

(c) Verification of dental insurance and that the dental health care provider is an in422

network provider;

423

(d) Verification that the applicant is utilizing the Indian Health Service Clinic in his/her

424

service area if available;

425

(e) Verification of all household income within the last thirty (30) days of submission of

426

the application for assistance.

427 6-5. Receipt of Required Documentation. Upon receipt of the completed application for dental

428

related expenses assistance, the case manager shall determine if all required documentation

429

was received from the applicant.

430

(a) The applicant shall provide all documentation requested by the case manager.

431

(b) The case manager shall notify the applicant in writing of any necessary documentation

432

that was not received and is still needed.

433

(c) Upon receipt of a completed application along with all the required documentation, the

434

case manager shall have up to ten (10) business days to provide the initial decision in

435

writing to the applicant.

436

(d) An application for dental related expenses assistance shall be valid for thirty (30)

437

days. If the applicant has a determination of award and/or coverage pending

438

with another support or assistance resource, the application will be valid for an additional

439

fifteen (15) days upon proof of that such determination is pending. If the applicant fails

440

to provide all requested documentation, the case manager shall send the applicant an

441

expiration notice

for their application.

442 6-6. Upper and lower dentures are limited to a maximum of $two hundred and fifty dollars

443

($250.00) each per lifetime.

444 6-7. Financial assistance for dental related services other than dentures is limited to a maximum of

445

$five hundred dollars ($500.00) within a twelve (12) month period.

446 6-8. Dental services requiring surgery or hospital care will be referred to the Medical Bill

447

Assistance Program (Rule 3).

448 6-9. Braces, implants, veneers, teeth whitening, or any other services considered strictly cosmetic

449

are not eligible for assistance.

450 6-10. CSF reserves the right to discontinue assistance based on funding availability.

451

452 VII. OPTICAL RELATED ASSISTANCE

3.2021

Community Support Rules1through 18

Page 10 of 25

53 of 77

Draft of Proposed Amendments (Redline to Current)

453 7-1.

454

455

456 7-2.

457

458 7-3.

459 7-4.

460

461

462

463

464

465

466

467

468

469

470

471

472 7-5.

473

474 7-6.

475

476

477

478

479

480

481

482

483

484

485

486

487

488

489 7-7.

490

491

492

493 7-8.

494

495 7-9.

496

Purpose. The purpose of the Optical related assistance program is to provide enrolled members

of the Nation with financial support with the costs associated with optical related services

where no other resources exist.

Requests for assistance from the Fund shall be tied to or be a result of a catastrophic event,

illness, injury or emergency event.

Approval from CSF is required prior to treatment or purchase.

Eligibility Criteria. In order to be eligible for Optical Related Equipment assistance, a person

must provide a completed Community Support Fund application and the following:

(a) Proof of enrollment in the Nation;

(1) a non-enrolled parent of an enrolled minor child may apply for assistance that

directly affects the enrolled minor child.

(b) Cost estimate of optical services this includes the name, address and Federal Tax ID

of the provider;

(c) Verification of the severe optical illness/injury from an ophthalmologist, optician, or

optometrist;

(d) Verification of optical insurance and that the ophthalmologist, optician, or optometrist

is an in-network provider.

(e) Verification of all household income within the last thirty (30) days of submission of

the application for assistance.

Applicant must utilize an Indian Health Service Clinic if available, or provided verification

that such a clinic is not available.

Receipt of Required Documentation. Upon receipt of the completed application for Optical

Related assistance, the case manager shall determine if all required documentation was

received from the applicant.

(a) The applicant shall provide all documentation requested by the case manager.

(b) The case mana

This text is long and has been trimmed here. Open the source document for the complete record.

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

A word about cookies

We need a few to keep you signed in and the library working. The rest help us see which pages people use and where they get stuck. They stay off unless you say yes.

Oneida Business Committee (2021) | Frix