TN 8 (11-06)

A. Policy

An organization is responsible for submitting a completed and signed SSA-445, along with all other evidence requested proving that it meets the required qualifications to become a Fee for Service organization. The principal officer or his/her designee (an individual who is authorized to enter into agreements on its behalf) must sign the form SSA-445, Application to Collect a Fee for Payee Services, on behalf of the organization.

NOTE: The FO must establish a paper precedent file for each organizational payee. This file should contain copies of the FFS application, the entire bond and/or insurance contract, licensing agreement (provided that licensing is available in the State), a copy of the authorization letter from SSA, a eRPS list of beneficiaries served, the completed site review forms, and copies of the Fee For Service screens (MS INTRANTERPS 014.008 and 015.004).

B. Procedure

Applications for fee for service status should be referred to the SSA reviewing official in the servicing FO along with all pertinent documentation. The SSA official will make a decision within 30 calendar days of receipt by the servicing FO.

NOTE: Applications received in a non-servicing FO should be mailed to the servicing FO for a decision. The non-servicing FO should notify the organization that the application was transferred. The reviewing official will determine if all qualification factors are met based on the information received.

1. SSA Reviewing Official

The form SSA-445, Application to Collect a Fee for Payee Services, will be reviewed in the servicing FO by a member of management (OS, MSS or above). The reviewing official will:

• Decide if the organization submitted all information required to make a determination (refer to GN 00506.010B.1. and GN 00506.010B.2. for a list of all the documentation required);

• Request CO to obtain a credit report, only if the organization is on eRPS and currently serving five or more beneficiaries (refer to GN 00506.600);

• Perform a follow-up (if needed) to obtain additional information and clarify any pending issues with the organizational applicant, including an explanation of the FFS rules and responsibilities (in addition of fulfilling the regular payee duties); and,

• Determine whether the organization will be approved or denied to collect a fee, mail the appropriate notices, and enter appropriate data on RFEE screen.

2. Timeframe for Decisions

The income generated from fees for payee services may be important to the overall economic stability of the nonprofit organization and may determine the extent of its services. Once the servicing FO receives form SSA-445, it is SSA policy that a decision be made on an organization’s application and proper notice be issued within 30 calendar days.

a. Required Documents Not Received After Initial Request

If the organization fails to send a copy of any required document (e.g., IRS letter, bonding agreement, etc.) which must accompany the request, proceed as follows:

• Contact the applicant or its designee in writing, indicating that this is the second request and remind them of the additional documentation needed.

• Give a 15-day deadline (including mailing time) from the date of the second request. This 15-day deadline counts towards the 30 calendar days.

• Document the contact on the eRPS Report of Contact Details screen and control the document’s return in eRPS by using the Add New Issue screen. Enter “ORGCON” in the issue field.

• Deny the request if the information is not received by the specified date on the basis that the qualification factor has not been established due to the lack of evidence (GN 00506.100B.). Issue the appropriate denial notice per NL 00703.944.

b. Documents Received

Upon receipt of a completed and signed SSA-445, along with all other evidence proving that the organization meets the required qualifications to become a Fee for Service organization:

• Process the FFS application as soon as possible not to exceed the 30 calendar days from receipt of the application.

• Issue the appropriate notice (i.e., approval or denial notice) and file the documentation in the paper precedent file to be kept in the FO. Send copies of the approval notice to your RO and to Central Office at the address listed in GN 00506.170B.

• Complete the Fee For Service screens (MS INTRANTERPS 014.008 and 015.004) (if applicable) and clear the issue on the Add New Issue screen in eRPS.

• Notify the beneficiaries (if applicable) using the notice found in NL 00703.770 Representative Payee — Authorized Fee Notice to Beneficiary or Person Standing in Place of Beneficiary

3. Improper Signature

The only person authorized to sign a form SSA-445, Application to Collect a Fee for Payee Services, is the principal operating officer or its designee. If the signature is not that of the authorized official, follow this procedure:

• contact the head of the organization if the application does not indicate that the applicant has the authority to enter into an agreement.

• Ascertain if the person submitting the request can act on behalf of the organization.

• ask that the proper individual in the organization to submit an application, if the person submitting the original application cannot act on behalf of the organization.

• if the authorized individual does not sign the form SSA-445, Application to Collect a Fee for Payee Services, or you are unable to obtain proper signature within the specified 30 calendar days, deny the request and document the eRPS Fee For Service screen. Issue the appropriate denial letter per NL 00703.944.

4. Questionable Bonding or Licensing

a. Unable to determine proper bonding or licensing

If it cannot be determined that a non-governmental organization is bonded and licensed in the state in which it serves as payee:

• Contact a representative of the organization or State agency which issued the agreement or license to obtain further explanation; and/or

• Obtain the necessary information, such as the protection given under a bonding agreement or the purpose of a license, and document the eRPS Fee For Service screen with the information obtained.

• Document the contact on an SSA-5002 and photocopy the proofs for the FO paper precedent file.

b. Documentation provided is not acceptable

If it is determined that the evidence submitted by a non-governmental organization is inappropriate:

• Deny the request if the applicant organization does not present an acceptable license or the bonding/insurance agreement does not provide for adequate protection against losses caused by the organization.

• See GN 00506.105C. for bonding/licensing characteristics.

• Document the eRPS Fee For Service screens (MS INTRANTERPS 014.008 and 015.004) accordingly. Send denial letter per NL 00703.944.

5. Questionable Government Agency

If it cannot be determined that an organization is a government agency:

• contact the person who applied and determine whether the organization was created as a part of state or local government for the benefit of the public at large.

• determine if there is a parent agency and/or a subsidiary that is not questionable. Contact that office for verification of the questionable agency’s status.

• document the eRPS Fee for Service screen (MS INTRANTERPS 015.004) with the information obtained and input your determination.

C. References

GN 00506.150 - Requests for Review Fee for Service Decisions

GN 00506.105 - Bonding and Licensing Guidelines for Non-Governmental Fee or Service (FFS) Organizations

GN 00506.600 - Credit Reporting for New Fee for Service Applicants