Oneida Business Committee (2021)
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Oneida Nation
Oneida Business Committee
Legislative Operating Committee
PO Box 365 • Oneida, WI 54155-0365
Oneida-nsn.gov
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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.
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Oneida Nation
Oneida Business Committee
Legislative Operating Committee
PO Box 365 • Oneida, WI 54155-0365
Oneida-nsn.gov
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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
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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
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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.
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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.
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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
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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].
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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:
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•
•
•
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;
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•
•
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:
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•
•
•
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
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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
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▪
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
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•
•
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].
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•
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
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•
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.
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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.
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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.
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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.
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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.
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(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.
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(t) “Income” means a measurement including, but not limited to, a combination of
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salaries, wages, retirement pension, disability income, government benefits, and
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unemployment of all people sharing a particular household/residence.
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(u) “Legal guardian” means a person who has the legal authority to care for the personal
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and property interests of another person granted through a Court order.
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(v) “Legal responsibility” means specific duties imposed upon a person to care or provide
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for another including liability for personal obligations as granted through a Power of
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Attorney or Court order.
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(w) “Major medical surgery” means a surgical procedure that carries a degree of risk to
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the patient’s life, or the potential for severe disability if something goes wrong during
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surgery. It is a surgical procedure that usually requires a patient to be put under general
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anesthesia and given respiratory assistance because he or she cannot breathe independently.
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(x) “Nation” means the Oneida Nation.
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(y) “Public health emergency” means the occurrence or imminent threat of an illness or
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health condition which:
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(1) is a quarantinable disease, or is believed to be caused by bioterrorism or a
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biological agent; and
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(2) poses a high probability of any of the following:
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(A) a large number of deaths or serious or long-term disability among
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humans; or
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(B) widespread exposure to a biological, chemical, or radiological agent
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that creates a significant risk of substantial future harm to a large number
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of people.
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(z) “Non-medical” means necessary intervention to support a patient with an on-going
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medical illness, injury or potential life threatening illness, and requires further testing or
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consultation with a specialist.
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(aa) “Reimbursement” means to make repayment for expense(s) or a loss that incurred.
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(bb) “Routine Exam” means an annual or semi-annual health exam provided by a
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physician, dentist, orthodontist, oral surgeon, or other similar health care specialist.
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(cc) “Security Deposit” means the payment of money held by a landlord in trust to protect
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him/herself from unpaid rent or damage to the living space.
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(dd) “Wages” means taxable income reported to the Internal Revenue Service for
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performing work.
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127 III. SHELTER ASSISTANCE
128 3-1.
Purpose. The purpose of shelter assistance is to assist enrolled members of the Nation with
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financial support for shelter expenses due to experiencing a catastrophic event, illness, or
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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,
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illness, injury or emergency event.
133 3-3.
Eligibility Criteria. In order to be eligible for shelter assistance a person must provide a
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completed Community Support Fund application and the following:
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(a) Proof of enrollment in the Nation;
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(b) Documentation verifying catastrophic event, illness, injury or other emergency event
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within the last thirty (30) days, including but not limited to:
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(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.
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(d) The amount provided for utility assistance shall not exceed three hundred dollars
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($300.00) and shall only be allowed once every two (2) years. Assistance requested under
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this Rule and under Rule 18 shall be counted towards the total number of requests for the
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two (2) year period limit.
187 3-7.
Reporting Changes in the Household. The applicant shall report any changes in the household
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to the case manager within ten (10) business days from the change occurring.
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(a) Changes in the household that shall be reported include, but are not limited to, the
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following: relocation, addition or subtraction of a household member, income changes,
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medical changes, submission of a social security disability application, submission of
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application or receipt of assistance from other agency or program.
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(b) Failure of the applicant to report changes in the household may result in suspension
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of benefits until verification of the change(s) is provided to the case manager, not to exceed
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thirty (30) days.
196 3-8.
Discontinuation of Assistance. The Community Support Fund Manager reserves the right to
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discontinue shelter assistance based on the following:
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(a) A lack of funding availability
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(b) A discovery that fraud or illegal activity has been determined to have caused
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homelessness.
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(c) The case manager shall provide ten (10) day notification to an applicant whose shelter
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assistance will be discontinued.
203 3-9.
Changes in Household Information. An applicant shall be responsible to report to the Fund
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Case Manager any change(s) in the household within ten (10) business days from the change.
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Changes shall include, but are not limited to the following:
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(a) Relocation;
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(b) Household member changes;
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(c) Income;
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(d) Medical changes;
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(e) Submission of Social Security Disability application; and
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(f) Receipt of other agency assistance
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(1) Failure of an applicant to report changes in the household may result in
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suspension of assistance until verification of the change(s) is provided to the
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Fund Case Manager.
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(2) An applicant shall have thirty (30) days to provide the verification once
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notification is received from the Fund Case Manager that verification is
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required.
218 3-10. Lodging Assistance. Lodging Assistance may be provided in the event of extreme situations
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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.
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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.
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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.
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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
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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.
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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.
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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;
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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;
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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
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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
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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
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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.
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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.
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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.
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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
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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.
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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.
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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.
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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'
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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.
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(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.
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(r)(s) “Incapacitation” means a state in which a person is temporarily or permanently
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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;
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153 3-4.
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168 3-5.
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178 3-6.
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(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.
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(1) The Wisconsin Home Energy Assistance Program (WHEAP) serves as an
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example of an alternate program the applicant should apply for before applying for
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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
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230 4-2.
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232 4-3.
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244 4-4.
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259 4-5.
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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.
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301 4-6.
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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.
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(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;
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(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.
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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
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the application for assistance.
427 6-5. Receipt of Required Documentation. Upon receipt of the completed application for dental
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related expenses assistance, the case manager shall determine if all required documentation
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was received from the applicant.
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(a) The applicant shall provide all documentation requested by the case manager.
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(b) The case manager shall notify the applicant in writing of any necessary documentation
432
that was not received and is still needed.
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(c) Upon receipt of a completed application along with all the required documentation, the
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case manager shall have up to ten (10) business days to provide the initial decision in
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writing to the applicant.
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(d) An application for dental related expenses assistance shall be valid for thirty (30)
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days. If the applicant has a determination of award and/or coverage pending
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with another support or assistance resource, the application will be valid for an additional
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fifteen (15) days upon proof of that such determination is pending. If the applicant fails
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to provide all requested documentation, the case manager shall send the applicant an
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expiration notice
for their application.
442 6-6. Upper and lower dentures are limited to a maximum of $two hundred and fifty dollars
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($250.00) each per lifetime.
444 6-7. Financial assistance for dental related services other than dentures is limited to a maximum of
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$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)
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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
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