219.09 Unemployed Parent (UP) (MAM)

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*To be eligible for Parents Caretaker Relative medical assistance (MA), the parent or caretaker relative must verify deprivation of care for the dependent child. Deprivation is the loss of a parent's ability to support or care for a child. The loss can be due to death, continued absence, unemployment of the primary wage earner (PWE), or physical or mental incapacity.

Deprivation of care due to unemployment of the PWE is for two-parent families with dependent children in which the PWE becomes unemployed through no fault of their own. The PWE must meet the unemployment criteria outlined below for eligibility for Parents Caretaker Relative MA.

At the initial application for assistance, the District Office must first determine the PWE in the two-parent household and then must determine if the PWE meets the definition of unemployed.

Use the following criteria to determine the PWE:

. the PWE is the parent who earned the highest income in the 24-month period preceding the month of application for assistance;

. the earnings of each parent for the preceding 24 months must be considered, regardless of when their relationship began;

. if parents had identical income for the 24-month period, the household designates the PWE; and

. once one of the parents has been designated as the PWE, that parent remains the PWE for the purposes of determining whether the PWE meets the definition of unemployed.

Exception: If the family files a new application after a break in eligibility, PWE status must be redetermined.

Definition of Unemployed

The PWE meets the definition of "unemployed" in the UP deprivation of care determination process, when the PWE provides documentation validating:

. work hours of less than 100 hours per month on average;

. that future work hours will be less than 100 hours per month on average, using a "best estimate;" and

. the PWE is not eligible for unemployment compensation benefits.

"Best Estimate" Determination

The "best estimate" is determined as follows:

. if the hours worked by the PWE in the current month are less than 100 hours and are representative of anticipated future hours, the best estimate is the number of hours worked in the current month;

. if the hours worked in the current month are less than 100 hours and are not representative of anticipated future hours, the best estimate is the number of hours per month anticipated to be worked in the future;

. If the number of hours worked in the current month is greater than 100 hours, and documentation indicates the PWE is anticipated to work less than 100 hours in future months, review the number of hours worked in the previous 2 month period when determining the best estimate, subject to the following:

- the average number of hours worked by the PWE in both of the previous 2 months must be less than 100 hours, or the PWE does not meet the definition of unemployed; and

- if the average number of hours worked in the previous 2 months is less than 100 hours, but future hours are anticipated to be more than 100 hours, the best estimate is equal to the number of hours anticipated to be worked in the future.

Exceptions to the two-month averaging:

- if fluctuating hours have been worked less than 2 months, use the actual number of hours worked in the most recent month. If this number is more than 100 hours, the PWE does not meet the definition of unemployed; or

- if earned income in the previous 2 months is higher or lower than current or anticipated earnings and does not reflect a best estimate of current and future hours as determined above, the best estimate is based on the number of anticipated hours to be worked in the future.

Continuing Eligibility: Changes in Employment Status

. If documentation indicates that a currently eligible individual worked more than 100 hours in a month, or anticipates working more than 100 hours in a month in the future, determine a new best estimate to ascertain whether the individual expects to continue working more than 100 hours per month for longer than 1 month. If the individual will work 100 hours or more for longer than one month, the definition of unemployed is no longer being met.

. if earned income in the previous 2 months is higher or lower than current or anticipated earnings and does not reflect a best estimate of current and future hours as determined above, determine a new best estimate for the remainder of the current period of eligibility based on anticipated hours to be worked in the future.

Eligibility by Work and Education History

To qualify for Parents Caretaker Relative MA with UP deprivation of care, a PWE must provide either a work or education history ending within one calendar year prior to application or an unemployment compensation history.

Work history: To be considered unemployed via work history, a PWE must have worked at least 6 calendar quarters in a period of 13 consecutive calendar quarters ending within 1 year prior to application for assistance and earned at least $50 per quarter. In other words, to be eligible for Parents Caretaker Relative MA via UP deprivation of care, at least one calendar quarter used to establish unemployment of the PWE must have occurred within the previous 12 months. Calendar quarters are periods of 3 consecutive months dated as follows:

. January 1 through March 31;

. April 1 through June 30;

. July 1 through September 30; and

. October 1 through December 31.

Credit a PWE (not one who was self-employed) with a calendar quarter of work when they:

. earned at least $50 for the quarter; or

. had at least $50 attributed to them for social security purposes; or

. participated in NHEP work program activities.

Credit a self-employed PWE with up to 4 calendar quarters of work a year according to the following formula:

1.  Determine the PWE's annual countable income for a calendar year.

2.  Divide by $50.

3.  Whole numbers in the answer represent the number of calendar quarters that can be credited for the calendar year, up to a maximum of 4 credits. If the self-employed PWE can be credited with less than 4 quarters in a calendar year, credit the quarters within the calendar year in the way that is most advantageous to the PWE.

Educational history: Substitute educational activities for no more than 4 calendar quarters of work when the activities consist of one of the following:

. full-time elementary or secondary school attendance;

. full-time participation in a vocational or technical training program that is preparatory to employment; or

. participation in a post-secondary education or vocational skills training activity established under the Job Training and Partnership Act.

Eligibility by Unemployment Compensation History

A history of unemployment compensation may be used instead of a history of work or education to establish a PWE's unemployment for Parents Caretaker Relative MA with UP deprivation of care. An unemployment compensation history means that the PWE met one of the following conditions within the year prior to applying for benefits:

. received unemployment compensation (UC) benefits, or

. was (or is) eligible for UC benefits, even if the benefit check was recouped due to overpayment or diverted to the IRS, Office of Child Support Enforcement Services, or another party.

Example 1

A woman is approved for UC benefits this month. However, two years ago she received UC benefits for 22 weeks. At the end of that time it was learned she had received a large severance payment from her previous employer and failed to report it. When she is approved for benefits this month, Employment Security will divert her entire benefit amount to repay the 22 weeks of overpayments plus accrued interest. But because the woman meets work history, income, and other criteria for UC benefits, her unemployment status is established by her UC history, even while her case is open with Employment Security.

. was monetarily eligible to receive UC benefits. For instance, the PWE may have had sufficient earnings to meet unemployment compensation requirements, but did not apply for UC. Or the PWE may have worked for an employer who did not contribute to the UC fund. Farms, for instance, are not required to contribute to the UC fund for their agricultural workers.

Example 2

A man applied for UC benefits. New Hampshire Employment Security's computer wage check found no wages reported by an employer. However, the man provided W-2 statements and pay stubs verifying sufficient quarterly and annual earnings to qualify for UC benefits. Nevertheless, the man is not eligible for UC benefits because his employer was a dairy farm, which is not required by law to participate in UC withholding. Even though the man is not eligible for UC benefits, he meets the work history, income, and other criteria for UC benefits, except for the fact he did not work for a covered employer. His unemployment status is established by UC history, even though Employment Security denied his UC benefits.

NH Employment Security

PWE may substitute a history of UC for a history of work or education if the PWE met one of the following conditions at any time during the calendar year immediately prior to applying for benefits:

. the PWE received UC benefits from NH or another state; or

. the PWE was monetarily eligible for UC benefits, in NH or another state, but was not eligible to actually receive them due to recoupment because of an overpayment, or due to a diversion of the benefit to the IRS, child support services, or another party.

The PWE is considered eligible for UC benefits, although not receiving them due to disqualification by NH, if the PWE is:

. leaving self-employment, such as closing one's business or failing to return to self-employment;

. unavailable for work outside the home, for any reason, for a period of 30 days or less; or

. seeking or receiving unemployment compensation benefits in another state.

Advise a PWE of their right to appeal an NHES disqualification determination.

Refusing an Offer of Employment of Training

Without good cause, the PWE must not have refused a definite offer of employment or a specific training opportunity at a specific location within 30 days prior to receipt of assistance, as long as the offer was, according to NHES, at a wage that is customary for the specific position in the community.

A PWE may refuse an offer of work or training made through NH Employment Security (NHES) or under a program established by the Workforce Investment Act (WIA) of 1998, but the PWE must explain good cause for the refusal. The District Office Supervisor determines if a definite job or training offer was made and if good cause is present to refuse it.

If the PWE refuses an offer of work or training that is made by other than NHES or WIA, the PWE must still provide a statement to explain good cause for the refusal. The District Office Supervisor will determine whether an offer was made and whether the PWE had good cause to refuse it.

Example

A PWE who had been a computer programmer earning $60,000 a year prior to becoming unemployed refused an offer of employment managing a restaurant for $22,000 a year because the salary offered was much lower than he wanted to accept. He then claimed good cause due to the dramatic salary difference between the restaurant manager's position and his prior computer programmer's position. His application for Parents Caretaker Relative MA with UP deprivation would be denied because he does not have good cause to refuse an offer of employment based upon the salary difference between his prior position and the newly offered position. However, the computer programmer may have good cause for refusing that offer if he individually had been offered $22,000 a year to manage the restaurant while other managers of the restaurant in that community are usually offered $42,000 a year. The proffered salary of $22,000 would not be at a wage that is customary for that specific position in that community.

Good Cause Reasons for Refusing an Offer of Employment of Training

Good cause reasons for not accepting an offer of employment or training are as follows:

. The PWE cannot engage in the job or training because of mental or physical health reasons.

. The PWE has no transportation to and from the job or training site.

. The working conditions at the site would be a risk to the PWE's health or safety.

. No Workers' Compensation is available.

. A reason similar to those above is deemed acceptable by the District Office Supervisor.

Ineligibility for UC Benefits

The PWE is not eligible for UC benefits, and therefore not eligible for Parents Caretaker Relative MA with UP deprivation of care, when any of the following occurred. The PWE:

. was discharged for misconduct associated with work involving:

- neglect of duty due to recurring careless or negligent acts; or

- willful misconduct due to a deliberate violation of a company rule designed to protect the legitimate interests of the employer.

. failed to accept or apply for suitable employment without good cause;

. was unavailable for work outside the home for more than 30 days;

. was separated from their last employer due to a disciplinary layoff;

. was separated from their last employer due to participation in a labor dispute as determined by the commissioner of NHES;

. was discharged due to intoxication or use of controlled drugs on the job;

. was discharged due to arson, sabotage, or dishonesty connected with the job;

. voluntarily quit a job through no fault of the employer. However, a PWE's voluntary quit is erased when they secure new employment at comparable wages or hours, then lose the new job through no fault of their own;

. provided a declaration of unemployment, when they were unable to obtain written documentation, and the declaration was inconsistent with:

- other statements made by the individual;

- information provided in current or past requests for assistance; or

- written or verbal information received from other sources.

. failed to provide documentation regarding unemployment, such as work, education, or unemployment history.

Verification of UP Deprivation of Care

The following special verification requirements must be met to determine eligibility for Parents Caretaker Relative MA with UP deprivation of care. For initial eligibility, the applicant must provide verification of the following:

. the earnings of each parent for the preceding 24 months prior to the month of application for assistance. Whatever is not verified electronically, must be verified with paper proof;

. the number of hours the PWE worked-or anticipates working-within the appropriate 30-day period which establishes the PWE as unemployed;

. good cause for the PWE's refusing a true offer of employment or training;

. the work or education history of the PWE, ending within one calendar year prior to the application for assistance;

. the unemployment compensation history of the PWE; and

. a PWE's willingness to apply for and accept unemployment compensation, if eligible.

For continuing eligibility, the individual must provide verification of the following:

. the number of hours the PWE worked in any month for which assistance is requested and the anticipated hours of employment for the following month; and

. a PWE's willingness to apply for and accept unemployment compensation benefits, if newly eligible for those benefits.

When an individual has no way of obtaining written documentation of work or education history, and all avenues for obtaining this information have been exhausted, accept the individual's signed written declaration, unless there is reason to believe the declaration is inaccurate due to inconsistencies in the individual's declaration with:

. other statements made by the individual;

. information provided in current or past requests for assistance; or

. written or verbal information received by the District Office from other sources.

Failure to comply with verification requests results in the denial of Parents Caretaker Relative MA with UP deprivation.

Special Verification of Employment Requirements for Refugees

When a refugee has no way of obtaining written documentation of work or education history, arrange for the New Hampshire Governor's Office of Energy and Community Assistance, Refugee Coordinator, to assist the refugee with a written declaration. A written declaration for a refugee family should include enough information to establish which adult is the PWE and the work history of the PWE. Work with the Refugee Office and the refugee to resolve discrepancies in the declaration.

If the refugee and the Refugee Office have determined a U.S. dollar equivalent for the refugee's earnings in a quarter of at least $50, the work history requirement for that quarter has been met. If earnings of less than $50 are found, apply the following procedures for all types of earnings except self-employment.

1.  Determine the estimated number of hours worked in the quarter.

2.  Multiply the hours by the federal minimum wage for that period of time. The history of the federal minimum wage is charted below:

3.  If the result is less than $50, work with the refugee and the Refugee Office to estimate a comparable New Hampshire wage for the type of work the refugee did. If the estimated wage multiplied by the number of hours worked yields a quarterly wage of at least $50, the work history requirement for that quarter is met. If not, the work history requirement is not met.

For self-employment, use net income to establish earnings. Subtract the cost of doing business from gross income. The result may not be equal to hours worked multiplied by federal minimum wages, since businesses sometimes operate at a loss or with little or no profit. To document self-employment income for refugees, call the DFA Financial Assistance to Needy Families Program Specialist at State Office for determination of employment history.

References: He-W 601.06(p), He-W 601.08(l), He-W 606.22, He-W 628.03, RSA 167:77-e