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Good Cause Determinations Overview

When a custodian applies for SoonerCare (Medicaid), she agrees to cooperate with OCSS to establish and enforce child support and/or medical support. If the custodian fails to cooperate and his/her cooperation is necessary for the next action on the case, OCSS reports to the Oklahoma Health Care Authority (OHCA) the custodian is not cooperating.

However, in some situations the custodian may apply for “Good Cause for Failure to Cooperate.” When a family is receiving Temporary Assistance for Needy Families (TANF), the determination of whether a custodian has “Good Cause” is made by the Adult & Family Services (AFS). When a family is receiving non-TANF Medicaid, the “Good Cause” determination is made by OCSS and reported to OHCA.

Pursuant to OAC 340:10-10-6. Good cause, OKDHS determines that the client has good cause for refusing to cooperate only if:

    1. there is possible physical or emotional harm to the child;
    2. there is possible physical or emotional harm to the parent or caretaker relative-payee;
    3. the child was conceived as a result of incest or forcible rape;
    4. legal proceedings for adoption of the child are pending before a court; or
    5. the client is currently being assisted by a public or licensed private social agency to resolve the issue of whether to keep the child or relinquish the child for adoption.

For additional information about good cause, you may review other articles — What Happens when a “Good Cause” Claim is Denied, Process for Good Cause, and Making Good Cause Determination Checklist.