SR 04-26 Dated 10/04

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases the following new services and requirements in the New Hampshire Employment Program (NHEP):

§   NHEP recipients claiming a medical exemption from work requirements or individuals requesting an extension to the TANF 60-month lifetime limit due to the recipient’s or a family member’s medical issue, will now be referred to the Division of Adult Learning and Rehabilitation (DALR) for assessment and case management services. DALR Work Capacity Specialists (WCS) stationed in 4 District Offices will review medical documentation and communicate with the individual’s or the family member’s healthcare provider and/or the family, when necessary, to determine if the individual has the capacity to participate in any NHEP activities. When appropriate, the WCS will help manage the medical situation of individuals who are determined to be totally unable to participate in any NHEP activities, and will assist the individuals or family in exploring and applying for other benefit programs.

§   NHEP recipients with fewer than 39 months on TANF financial assistance and whose youngest child is between the ages of one and two will now be required to attend an NHEP orientation and, following attendance at the orientation, will be referred to the Lifeskills for Employment, Achievement and Purpose (LEAP) program. Attendance at the NHEP orientation and participation in LEAP is mandatory.

§   Additionally:

-   Job Club and the Community Work Experience Program are now approved NHEP activities;

-   the timeframe for submitting a business plan for self-employment has been extended;

-   homeless individuals will not be sanctioned for failure to respond to mailed notification of noncompliance;

-   individuals may "cure" a sanction for not attending an NHEP orientation, by attending the orientation;

-   the NHEP assessment and employment plan formats were enhanced to improve readability, make them more user-friendly, and meet the expected requirements of TANF Reauthorization; and

-   references to the Welfare to Work Program were removed because federal funding ceased for the program on June 30, 2004.

This SR additionally releases automation of fundamental work program functions for both the TANF and Food Stamp Programs:

§   the work referral process to both NHEP and the Food Stamp Job Search Program is now automated;

§   applicants for both the NHEP and Food Stamp Job Search programs will no longer participate in work activities while determination of eligibility is pending. Once determined eligible for TANF or Food Stamp benefits, New HEIGHTS will automatically refer individuals, if not otherwise exempt, to the respective work programs via the automated work referral process; and

§   scheduling and rescheduling for NHEP and Food Stamp work orientations is now automated as well.

As a result of these changes, the following forms or New HEIGHTS-generated client letters were revised or created:

§   Form 220, Notice of Failure to Meet Work Requirements, was revised during the automation of scheduling for NHEP and Food Stamp work program orientations. Although this paper form will continue to be used during the eligibility determination for applicants who voluntary quit a job prior to applying for assistance, it will primarily be used as a paper back-up if New HEIGHTS is inaccessible;

§   Form 221, The New Hampshire Employment Program (NHEP), was revised to incorporate the new work requirements for recipients whose youngest child is between the ages of 1 and 2 and to reference the new DALR services for individuals claiming an exemption due to a medical issue;

§   Form 222, Referral Letter, was revised to reflect the new automated work program referral and scheduling process for both the NHEP and Food Stamp programs. The revised form will only be used as back-up if New HEIGHTS is inaccessible;

§   Form NHEP227, Assessment Form, was revised to reflect the new full family self-sufficiency assessment format. The revised form will only be used as back-up if New HEIGHTS is inaccessible;

§   Form NHEP228, Employment and Family Self-Sufficiency Plan, was revised to reflect the new full family self-sufficiency employment plan format. The revised form will only be used as back-up if New HEIGHTS is inaccessible;

§   Form NHEP240, Partner Agency Participation Form; was revised to update name changes in some of the provider programs offered and to remove the reference to the Welfare to Work Program;

§   Form 261, TANF Interview Checklist, was revised to remove references to applicants and include the new Form 752 process for clients claiming a medical exemption. Minor text adjustments were also made to reflect the automated referral process;

§   Form 752, Physician/Psychologist Statement for Exemption/Limitation From the NHEP Work Requirement, was expanded and revised to obtain more specific information about the medical issue preventing the recipient’s involvement in NHEP and to provide more information about NHEP so that the healthcare provider is better equipped to determine whether the recipient can fully or partially participate in any of the NHEP activities available;

§   Form 752a, Authorization for Release of Protected Health Information, was created to allow the healthcare providers to share information with Department staff, including contract staff;

§   New HEIGHTS-Generated AE0070, DALR Referral Letter, and AE0071, DALR Decision Letter, were both created as a result of the new DALR referral process for individuals claiming a medical exemption from NHEP work requirements; and

§   New HEIGHTS-Generated CS0009, WP General Interview (NHEP), CS0015, WP Reschedule Interview (NHEP), CS0016, WP General Interview (FS), CS0017, WP Reschedule Interview (FS), CS0018, WP Reschedule Interview – Final (FS), and CS0021, WP Reschedule Interview No Good Cause (NHEP), were either created or expanded upon during the automation of scheduling for NHEP and Food Stamp work program orientations.

Due to the policy changes released in this SR, the following forms and one New HEIGHTS-generated client letter are now obsoleted:

§   Form 213, Interagency Referral/Work Registration, and its instructions;

§   Form 214, Return Results Report, and its instructions;

§   Form 221(Sp), Spanish version of the NHEP Pamphlet;

§   Form 226, Initial Employment Appraisal, and its instructions;

§   Form 228, Employability Plan, and its instructions;

§   Form NHEP228P, Employability Plan Preprint, and its instructions;

§   Form NHEP237, NHEP Fact Sheet (Seacoast Version), and its instructions; and

§   New HEIGHTS-Generated AE0069, 3/10 Day Referral Letter for NHEP.

The chart below highlights the major changes effective October 1. Further details of other changes, and procedures for implementing those changes, are contained in the narrative of the SR.

POLICY

Exemption from NHEP Work Participation Requirements Due To A Medical Issue

Individuals claiming an exemption from NHEP work requirements or an extension to the TANF 60-month lifetime limit due to their own or a family member’s medical issue:

§   must complete new Form 752a, Authorization for Release of Protected Health Information, which allows the healthcare provider to share information with Department staff, including contract staff;

§   must have a licensed physician or board certified psychologist complete revised Form 752, Physician/Psychologist Statement for Exemption/Limitation from the NHEP Work Requirement, indicating that the individual is fully able, partially able, or totally unable to participate in NHEP; and

§   may be contacted by a DALR Work Capacity Specialist (WCS), to further discuss the NHEP recipient’s capacity to participate in NHEP.

If the healthcare provider indicates on Form 752 that:

§   the individual is partially or fully able to participate in work or work-related activities, the WCS will enter this information into New HEIGHTS and the individual will be referred to NHEP if the individual is not currently participating in NHEP; or

§   the individual is totally unable to participate in work program activities, the WCS will enter this information into New HEIGHTS and will help the individual explore and apply for programs, if appropriate, that might better serve the individual’s needs, such as Supplemental Security Income, Social Security Disability Income, veteran’s benefits, Aid to the Permanently and Totally Disabled, or Aid to the Needy Blind. If the medical situation is temporary and it is expected that the individual will be able to participate in NHEP in the near future, the WCS will provide case management services while the client is exempt from NHEP participation.

The NHEP exemption claim or the TANF 60-month hardship extension request will be denied, if:

§   the individual fails or refuses to provide or return a completed Form 752a;

§   the healthcare provider fails to return Form 752, even after the WCS attempts to help get the information; or

§   the applicant fails or refuses to cooperate with the WCS.

Applicants

Applicants claiming a medical exemption from NHEP work requirements will be considered exempt until the WCS receives Form 752 and is able to determine the individual’s ability to participate in NHEP.

Recipients

Current mandatory or voluntary participants in NHEP who claim an exemption to work requirements due to their own or a family member’s medical issue will retain their status of mandatory or voluntary during the period of time the WCS is awaiting the return of needed documentation and making a determination on the recipient’s claim for exemption. As such, recipients in mandatory or voluntary status must continue to meet participation requirements during the WCS determination process to be in compliance with NHEP. Failure to comply with NHEP participation requirements during the WCS determination process is cause for progressive sanctioning.

Recipients who are currently exempt from participation requirements due to their own or a family member’s medical issue will be referred to DALR at their next regularly scheduled redetermination and will be responsible for ensuring the completion of the new medical exemption forms, Form 752a and Form 752, at that time. If the recipient is currently participating in NHEP in a limited way based upon information indicated in an existing Form 752, NHEP workers will direct the client to complete the new forms when the information on the currently existing form expires.

New Participation Requirements For Certain NHEP Recipients with Children Between the Ages of 1 and 2

New participation requirements apply to single-parents or caretaker relatives-included who:

§   are responsible for a child between the ages of 1 and 2 years;

§   did not conceive the child while receiving TANF financial assistance; and

§   have been receiving NHEP financial assistance for less than 39 months.

If not already engaged in an approved NHEP activity, single-parents or caretaker relatives-included who meet the above criteria, must:

§   attend an orientation and assessment with NHEP; and

§   after attending the NHEP orientation/assessment, participate in the family and lifeskills training program offered through LEAP.

Participation in the NHEP orientation/assessment process and in LEAP is mandatory. Refusal or failure to participate in either activity is subject to progressive sanctioning. However, following the successful completion of the LEAP program, the parent or caretaker relative-included may decide to volunteer for NHEP or may be exempt until the child turns two.

NOTE: Exemption criteria for single-parents or caretaker relatives-included remain unchanged if the individual is responsible for a child under age 1. Similarly, participation requirements remain unchanged for the following groups provided the individuals do not meet other exemption criteria:

§   two-parent families;

§   single-parents who conceived a child while receiving TANF financial assistance; and

§   individuals who have received TANF financial assistance for 39 or more months.

Referral to Work Activities for Recipients-Only

Individuals who have applied for TANF and Food Stamp benefits will not be referred for an orientation or to work activities while their application is still pending. Although non-exempt Food Stamp applicants are automatically registered for work at application, only individuals determined eligible for TANF and Food Stamp benefits will be referred to NHEP or the Food Stamp Job Search Program, if not otherwise exempt.

NOTE: The only exception involves sanctioned individuals reapplying for TANF assistance. Individuals in sanction status at application must cure the sanction prior to their case being reopened. Consequently, the Family Services Specialist (FSS) will need to make a manual referral to NHEP for sanctioned applicants.

Automation of the Work Referral Process and Scheduling of NHEP and Food Stamp Orientations

At case opening, New HEIGHTS will automatically refer mandatory and voluntary NHEP and Food Stamps recipients to their respective work programs and schedule the recipients for an NHEP or Food Stamp orientation. The new automated process allows FSS and NHEP Team members to enter best times and days for clients to come in for an NHEP or Food Stamp group orientation. New HEIGHTS will refer to this best time/day when initially scheduling the client for the group session. However, best times and days will not be used in the automated rescheduling process if an individual fails to attend their first scheduled orientation. The option of manually scheduling or rescheduling an orientation will always be available to NHEP team members and Food Stamp Interviewers, even once a group orientation has been scheduled.

NHEP and Food Stamp recipients who do not appear for the first scheduled orientation will be automatically rescheduled for a second orientation by New HEIGHTS. Clients will be automatically notified as to the initial scheduled orientation and any reschedules via the following New HEIGHTS-generated client letters:

§   CS0009, WP General Interview (NHEP);

§   CS0015, WP Reschedule Interview (NHEP);

§   CS0016, WP General Interview (FS);

§   CS0017, WP Reschedule Interview (FS);

§   CS0018, WP Reschedule Interview – Final (FS); and

§   CS0021, WP Reschedule Interview No Good Cause (NHEP).

In addition to the orientation scheduling information, the New HEIGHTS-generated client letters include notification of noncompliance for missed appointments, good cause reasons for having missed the appointment, and how the individual can avoid sanction, as failure to appear for rescheduled orientations without good cause will result in sanctioning.

Because of the changes that have been made to the automated work referral and scheduling process, noncompliance information and referral information formerly found on the New HEIGHTS-generated AE0069, 3/10 Day Referral Letter for NHEP, was incorporated into the new CS Group Orientation scheduling letters. As a result, AE0069 has been obsoleted.

New NHEP Activities

Mandatory and voluntary NHEP participants may now be approved for the following activities to meet work participation requirements:

§   Community Work Experience Program (CWEP): CWEP is a client-initiated arrangement with a community agency or non-profit organization, in which the client volunteers for the organization and gains job readiness skills.

§   Job Club: Job Club is a structured group activity that enhances participant’s job search skills and provides participants with motivation to continue with the job search.

Transportation and child care support services are available for the new activities.

Self-Employment Activity

The following clarifications have been made to the self-employment activity in NHEP:

§   For self-employment to count as meeting NHEP work participation requirements, the individual must have net self-employment income.

§   Individuals have 3 months to submit a business plan and are no longer required to have an approved business plan before participation in the activity.

§   Individuals may be approved to participate in a self-employment activity for the period of time remaining on their 60-month lifetime limit, if it is reasonably expected that within that time period their self-employment income will lead to economic independence from financial assistance.

Progressive Sanctioning

The following clarifications have been made to NHEP sanction policy:

§   Individuals may "cure" a sanction for not attending an NHEP orientation by attending a rescheduled orientation instead of completing a minimum period of two weeks’ participation in an approved NHEP activity, as is required when curing other Level 1 sanctioned noncompliances. This means that individuals who have no good cause reason for failure to appear at the first scheduled NHEP orientation will not be sanctioned, as long as they attend the rescheduled appointment.

§   Individuals who indicate that they are homeless at application will not be sanctioned for failure to comply with mailed requirements, unless District Office or NHEP staff are informed by the client or other outside sources that the mailing was received.

§   An individual’s compliance with NHEP work program requirements includes contacting NHEP team members if a scheduling conflict exists and the client is unable to attend orientations, assessments, or other scheduled appointments. Failure to make this contact places the recipient in noncompliance status.

§   An individual may claim good cause for a sanctionable noncompliance by calling, writing or meeting face-to-face with an FSS or District Office Supervisor. If a face-to-face meeting is requested by the individual to explain the reason for the noncompliance, the individual has the right to bring a representative to the meeting.

§   If staff request that the sanctioned individual provide verification to substantiate their good cause reason, the individual has 10 days in which to provide that verification.

New NHEP Assessment and Employment Family Self-Sufficiency Plan Format

The NHEP assessment and employment family self-sufficiency plan formats were enhanced to improve readability and to make them more user-friendly. New tab "Family Self-Sufficiency" was added to the "Employment Plan" screen in anticipation of TANF Reauthorization. This tab will not be used by NHEP workers until Reauthorization occurs.

Elimination of References to the Welfare to Work Program

References to the Federal Department of Labor Welfare to Work program have been removed from the Family Assistance Manual and several forms because federal funding for the program ceased on June 30, 2004.

DISTRICT OFFICE PROCEDURES FOR NEW DALR SERVICES

The DALR WCS will now be:

§   reviewing the information provided by the healthcare providers about the medical issue involved in the claim for an NHEP work program exemption or hardship request; and

§   determining a work program status of "mandatory" or "exempt" from the information provided on the Form 752.

There are four WCS available to review this information. One WCS will be stationed in each of the following District Offices (DO): Laconia, Manchester, Nashua, and Portsmouth. Each of the four WCS will be responsible for reviewing all the information from the following DO and NHEP catchment areas:

Family Service Specialist and NHEP Team Member Procedures

When an individual claims a medical exemption from participation in NHEP activities or requests an extension to the TANF 60-month lifetime limit due to their own or a household member’s medical issue, staff must provide and review the new "DALR packets" with the client. The DALR packets are collated at State Office and sent to each DO and NHEP office. The packets contain:

§   new Form 752a, Authorization for Release of Protected Health Information;

§   revised Form 752, Physician/Psychologist Statement for Exemption/Limitation From the NHEP Work Requirement, which will have a return address in the upper right-hand quadrant of the first page that is specific to the location of the WCS responsible for the DO/NHEP office in that catchment area; and

§   a postage paid envelope with a return address that is specific to the location of the WCS responsible for the DO/NHEP office in that catchment area.

When reviewing Form 752a, explain:

§   the documentation process for a medical exemption from NHEP or a TANF hardship exemption and that release of the individual’s health information is voluntary;

§   what will happen if the individual refuses to sign the authorization, and how the individual can revoke their authorization;

§   that the individual or Authorized Representative must sign the form if the medical exemption is due to the individual’s or a dependent child’s illness or incapacity; and

§   that the respective household member must sign the form if the medical exemption is due to an illness or incapacity of that household member (other than a dependent child).

Tear off the top page of the Form 752a and provide to the individual and then:

§   if the document will be signed by the individual or their authorized representative, indicate where the form must be signed, provide the individual with the white copy for the healthcare provider and the yellow copy for their records. Retain the pink and goldenrod copies; or

§   if the document must be signed by the household member, indicate where the household member must sign the form, and explain that once signed, the white copy of the Form must be provided to the healthcare provider and the pink and goldenrod copies must be returned to the District Office staff person or NHEP worker who provided the individual with the packet.

Retain the goldenrod copy for the DO or NHEP case record and the pink copy must be sent to the WCS in your catchment area.

NOTE: If an Authorized Representative signs and dates form 752a:

§   collect the legal documentation allowing the person to be the client’s AR (e.g., a copy of a completed and signed Form 778, Authorized Representative Declaration);

§   attach this information to Form 752a; and

§   upon verifying the AR’s identity, sign in the space provided on Form 752a.

When reviewing Form 752 explain that the healthcare provider for the individual or household member must return the completed and signed form within 10 days of the individual’s eligibility notice.

Date stamp any Form 752s inadvertently returned to the application office and ensure that they are mailed to the appropriate WCS for the office’s catchment area.

NOTE: A separate DALR packet must be used for each healthcare provider or facility involved in the pertinent medical issue.

Procedures for Recipients Who Have an Active Form 752 Impacting NHEP Participation

Recipients who are currently exempt from NHEP work participation requirements based upon information obtained through the former Form 752 process, retain their exemption status for the time period indicated by the healthcare provider. When the information supporting the exemption expires, or at their next regularly scheduled redetermination, the recipient must follow the new process.

Similarly, if the recipient is currently mandatory for NHEP but participating in a limited way based upon information indicated in an existing Form 752, NHEP workers will direct the client to complete the new forms when the information on the currently existing Form 752 expires.

Procedures for Individuals Requesting an Extension to the 60-month Lifetime Limit

FSS must do the following for individuals requesting an extension to the 60-month lifetime limit who are currently exempt from NHEP participation due to a medical issue:

§   if the information in Form 752 is 4 months old or dated more recently, send the existing medical documentation along with Form 785, Hardship Extension Request, to the Hardship Coordinator – no new DALR packet is necessary; or

§   if the information in Form 752 is more than 4 months old:

-   provide the individual with a new DALR packet;

-   review all the material in the packet as indicated above;

-   mark the hardship box on the front of the Form 752; and

-   send Form 785 to the Hardship Coordinator without waiting for the Form 752 to be returned. The WCS will send the completed Form 752 to the Hardship Coordinator when it is received and a decision is made.

If the individual is closed for TANF but is applying for an extension to the 60-month lifetime limit due to their own or a household member’s medical issue:

§   provide the individual with a new DALR packet;

§   review the material in the packet as indicated above;

§   mark the hardship box on the front of the Form 752;

§   manually refer the individual to DALR; and

§   send Form 785 to the Hardship Coordinator without waiting for the Form 752 to be returned. The WCS will send the completed Form 752 to the Hardship Coordinator when it is received and a decision is made.

Work Capacity Specialist (WCS) Procedures

WCS must:

§   review all Form 752s returned by the healthcare providers;

§   attempt to obtain the completed Form 752 from the healthcare provider if the form has not been returned within 10 days of the client having been determined eligible;

§   verify the individual’s ability to participate in NHEP activities based upon the information provided on the Form 752 and enter this decision into New HEIGHTS;

§   contact the healthcare provider to obtain more information if needed; and

§   if the information on the form indicates that the individual is unable to participate in any NHEP activities, contact the individual to discuss their medical needs and/or explore other benefit programs that may better assist the family.

If the hardship box is checked off on the Form 752, forward the document to the Hardship Coordinator once a determination has been made about the individual’s ability to participate in NHEP and the decision has been entered into New HEIGHTS.

Support Staff Procedures

If the WCS is located in the office in which the support staff works, any Form 752 or Form 752a received in the office must be placed in the mailbox for the WCS. If the WCS is not located in the office in which the support staff works, any Form 752 or Form 752a inadvertently sent to the DO must be date-stamped and immediately sent to the WCS in their home office.

SPECIAL DISTRICT OFFICE PROCEDURES FOR TANF APPLICANTS IN SANCTION STATUS

If an individual with a work program sanction reapplies for TANF financial assistance, the case could either pend or be denied. If the case pends, an automatic referral to NHEP and the scheduling for an Orientation appointment will occur once the individual is determined eligible. However, if the case is denied due to the sanction, the individual cannot be determined eligible until the sanction is cured. In this situation, the referral to NHEP must be done manually as follows:

§   add the following information to Form 808, Proof Needed to Determine Your Assistance: To remove your Work Programs Sanction, please contact the NHEP Team for an appointment at (telephone #) by (enter a date which is 10 days from the date of application); and

§   email the following information to the NHEP Team: (Name of the applicant) has reapplied for TANF financial assistance and has a work program sanction currently in place. (Name of the applicant) will be contacting you for an Orientation appointment to lift the sanction by (enter the same date as was entered on the client’s Form 808 above).

NEW HEIGHTS CHANGES

New DALR Services

Entering a claim of disability into New HEIGHTS remains unchanged; staff will continue to enter the claim of disability for the individual ("self") or the household member ("other household member"), on the "Disability" screen in the "Non-Financial" folder. However if the claim of disability is due to caring for a household member, the worker will now additionally check the newly added box indicating that the individual is caring for an "Adult" or a "Child". Once this information is entered into New HEIGHTS, the case will:

§   no longer pend as "not yet verified" for Food Stamp and TANF cases; but

§   automatically default to a status of "exempt".

NOTE: If the case is for Food Stamp assistance-only (e.g., while a case is pending APTD), and the individual is claiming a medical exemption but has not yet verified it, the case will open as indicated above. However, if the FSS does not enter that the medical claim has been verified within 10 days, the FSS will receive the following alert: "Verification Needed for FS Disability Exemption." If not addressed, in another 10 days the alert will go to the supervisor.

Upon being determined eligible for NHEP, the individual will be immediately referred to the DALR WCS, and New HEIGHTS will generate new client letter AE0070, DALR Referral Letter. If a current NHEP recipient, the referral is made upon staff entering the disability claim, unless the individual has been referred to DALR previously. If the NHEP recipient has had prior referrals to DALR, staff will need to use the "DALR Manual Referral" screen to refer the person to the WCS.

Once the individual’s capacity to participate in NHEP activities has been verified by the WCS, the WCS will enter this information into New HEIGHTS on the new "DALR Referral" screen, and New HEIGHTS will automatically generate new client letter AE0071, DALR Decision Letter, notifying the client of the decision:

§   If the individual fails to verify their medical claim or is determined to be partially or fully able to participate in NHEP activities, the WCS will change the participant’s status to "mandatory" and New HEIGHTS will automatically schedule the individual for an NHEP orientation. The "WP Referral List" screen contains a new indicator to identify NHEP participation restrictions. Additionally, a new button has been added to the "WP Referral List" screen enabling the worker to launch the new "DALR Referral Details" screen. The new "DALR Referral Details" screen specifies the limitations, if any, so that NHEP Team Members can reference the criteria and alter the individual’s participation requirements accordingly.

§   If it is determined that the individual is unable to participate in any NHEP activities, and the individual’s status is not currently exempt, the WCS will change the individual’s status to exempt and continue to manage the case.

Numerous fields have been created on the new "DALR Referral" screen so that FSS and NHEP workers can track the status of the DALR determination process.

New Work Requirements For Certain NHEP Recipients with Children Between the Ages of 1 and 2

FSS will receive a new pop-up message on New HEIGHTS to override the referral status from exempt to mandatory for single-parents or caretaker relatives-included with children between the ages of 1 and 2 who are now required to attend an NHEP orientation and assessment and participate in the LEAP program. Once the individual is switched to "mandatory" status for NHEP:

§   the individual will be automatically scheduled for an NHEP group orientation and assessment unless "needs manual scheduling" is indicated on the "Best Day" screen;

§   the NHEP staff will refer the individual to LEAP using standard referral procedures, once the individual has attended an orientation/assessment; and

§   once the individual has successfully completed the LEAP program, NHEP staff will contact the FSS to change the individual’s status to exempt or voluntary as determined by the individual.

Automation of Work Referral Process and Scheduling of Orientations

In the automation of the work referral and scheduling of NHEP/Food Stamp orientations, the following New HEIGHTS changes were made:

§   fields were added so that FSS could enter best days and times for the individual to attend NHEP/Food Stamp orientations. New HEIGHTS will now use that information to schedule the individual for the initial NHEP and Food Stamp orientation, however this information will not be used in the automated rescheduling process if the client misses the first orientation;

§   individuals will not be automatically scheduled for an orientation if they have attended one in the last six months;

§   the following New HEIGHTS-Generated client notices were either created of expanded upon to notify clients of initial appointments, rescheduled appointments, and provide notification of noncompliance for failing to attend a scheduled appointment: CS0009, WP General Interview (NHEP), CS0015, WP Reschedule Interview (NHEP), CS0016, WP General Interview (FS), CS0017, WP Reschedule Interview (FS), CS0018, WP Reschedule Interview – Final (FS), and CS0021, WP Reschedule Interview No Good Cause (NHEP); and

§   the existing New HEIGHTS-generated referral notice AE0069, 3/10 Day Referral Letter for NHEP, was eliminated because text was incorporated into the new client notices named above.

Assessment

The following New HEIGHTS changes to the NHEP assessment and employment and family self-sufficiency plan format were made in anticipation of TANF Reauthorization:

§   the "Initial Employment Appraisal" form was eliminated from New HEIGHTS. Consequently, the "Print Appraisal Summary" box was removed from all screens where it was previously offered;

§   the tab entitled "Employment Assessment" will now read "Employment Goal" and will capture the employment and/or career goals of the recipient. A new launch button was added so that "Employment" and "Self-Employment" details entered during "Application Entry" can be reviewed. Comments are no longer mandatory;

§   new tab "Employment History" was added to capture previous employment and the "Education and Training Assessment" tabs were merged into one tab. Both tabs reflect the format of paper Form NHEP260, Client Screening Tool, released in SR 04-11. New tab, "Degrees/Certificates" was created to capture additional education and training information;

§   the title of the "Participation Readiness Assessment" tab was changed to "Labor Market Readiness" and now focuses on the recipient’s immediate readiness for the labor market. An indicator was added to this screen for families that have a child under 6 but are unable to access adequate childcare;

§   new tab "Family Health" was added in with the "Barrier Assessment" tab, and the title of the "Barrier Assessment" tab was changed to "Family Barrier Assessment." Five new factors affecting employment were added: Child Health Concern, Child Behavior Concern, Poor School Progress, Child Legal Issues, and Any Other Child Concern;

§   comments are now mandatory for each of the following barriers checked, and will print onto the NHEP Assessment Form: Disability, DV/Safety Issues, SA, No Transportation, No Child Care, Full Time Student Head of Household, License Acquisition, Child Under 1, Housing Problem, Personal/Family Issues, Language Barrier-Limited English Proficiency, IQ Challenged, Legal Issues, Lack of Marketable Skills, and Other;

§   the "Employment Program Assessment" form will now be titled "NHEP Assessment Form"; and

§   the "Employability Screen" is now titled "Employment/Self-Sufficiency Plan" and includes a new "Family Self-Sufficiency" tab. The following fields were added to capture other family support information: Family Supports in Place, Family Supports Needed, and Additional Supports Needed for Employment.

NOTE: NHEP workers will not complete the "Family Self-Sufficiency" tab on the "Employment Plan" screen or provide assessment and family self-sufficiency development services to all families receiving NHEP financial assistance until after TANF has bee reauthorized.

Two New NHEP Activities

As described in the Director’s Memo dated June 28, 2004, subject line "New NHEP Activities," the two new NHEP activities of Job Club and CWEP are available on New HEIGHTS and can be coded as such.

NEW HEIGHTS REPORTS

As a result of the changes released in this SR, the following new reports were developed and will run on a monthly basis beginning at the end of October 2004:

NAE220RA: DALR Monthly Tracking Report

This report is sorted by District Office, DALR Worker, and Statewide and will provide monthly and year-to-date figures and the average length of time that elapsed before a decision was made, if pertinent, for the number of:

§   DALR referrals made;

§   DALR referrals whose decision became "Disabled," "Caring for Disabled Adult," or "Caring for Disabled Child;"

§   DALR referrals whose decision became "Not Disabled" or "Refused to Verify;"

§   DALR referrals with a decision for their referral;

§   DALR referrals without receipt of Form 752 within 20 days;

§   DALR referrals without a decision after 30 days, including the number of:

-   DALR referrals in "752 received" status after 30 days;

-   DALR referrals in "additional verification requested" status after 30 days;

-   DALR referrals in "additional verification received" status after 30 days;

§   referrals to other programs, and the specific programs to which the individual was referred;

§   referrals to other programs that became eligible, and the specific programs for which the individual was eligible;

§   referrals to other programs that were denied, and the specific programs for which the individual was denied; and

§   individuals who became FAP in the report month, whose DALR referral changed from active to inactive in the report month.

NWP141RA: Individuals with Domestic Violence

This report lists the individuals who disclose domestic/family violence and whose information has been entered into the new "Family Health" tab. The report is sorted by District Office and contains the following information: D.O., Client Name, Client RID, Worker Name, if the Client has "Opted" out of participating in the Work Program, if the individual is open for activities, and the referral date. The report will additionally provide a statewide summary of the following information: Number of Individuals With Domestic Violence, Number with Open Activities, and Number with No Open Activities.

NWP142RA: Family Barriers Report

This report lists the individuals who disclose barriers and whose information has been entered into the new "Family Health" tab. The report will sort by DO and provide statewide figures for the following information: Barrier Type, number of individuals in the DO or Statewide claiming the barrier, and the number of individuals to date who have claimed this barrier in the DO or Statewide.

FORMS

New Forms or New HEIGHTS-Generated Letters

Form 752a, Authorization for Release of Protected Health Information, and its instructions, were created to allow the healthcare providers to share information with Department staff, including contract staff.

New HEIGHTS-Generated AE0070, DALR Referral Letter, was created to notify the individual that a referral has been made to the DALR WCS and that the individual is responsible for ensuring that Form 752 is returned within 10 days from the date of the letter. Once a participation status of "Mandatory" or "Exempt" has been determined by the WCS, New HEIGHTS will automatically generate new client letter AE0071, DALR Decision Letter, which notifies the client of the DALR decision and the status of their exemption. The AE0071 provides information about requesting an administrative appeal and includes variable text about the status of the medical claim and reason for the decision.

New HEIGHTS-Generated CS0021, WP Reschedule Interview No Good Cause (NHEP), was created during the automation of the orientation scheduling for NHEP and the Food Stamp Program. This new letter is generated when the client fails to attend the second scheduled NHEP orientation and includes variable text regarding the penalties for failing to attend without a good cause reason for a:

§   mandatory NHEP participant with less than 60-months on assistance;

§   voluntary participant; and

§   participant who is receiving a hardship extension.

Revised Forms or New HEIGHTS-Generated Letters

Form 220, Notice of Failure to Meet Work Requirements, and its instructions were revised to reflect the automated orientation scheduling process for NHEP and the Food Stamp Program. The New HEIGHTS-generated client letters that are generated during the automated scheduling process include text describing the penalties for failing to attend the work program orientations without good cause. This text was incorporated into the Form 220, and its use was additionally expanded to include notification of failure to meet work program requirements for:

§   voluntary participants in NHEP;

§   participants who are receiving a TANF hardship extension; and

§   Food Stamp Job Search Program participants who quit employment before applying for benefits, quit while receiving benefits, failed to attend the orientation to the Job Search program or failed to meet other work program requirements.

Additional changes were made to incorporate the NHEP Full Family Sanction policy released in SR 03-40. Although this form will be primarily used as a paper back-up for New HEIGHTS-generated CS0015, WP Reschedule Interview (NHEP), CS0017, WP Reschedule Interview (FS), CS0018, WP Reschedule Interview – Final (FS), CS0021, WP Reschedule Interview No Good Cause (NHEP), and WP0012, Notice of Not Meeting an NHEP Requirement, it will also continue to be used for notifying individuals of noncompliance with voluntary quit requirements prior to application. Upon receipt of the revised version, destroy all older copies of this form and use the new version, as needed, when New HEIGHTS is inaccessible.

Form 221, The New Hampshire Employment Program (NHEP), was revised to reflect the new DALR policy and the new work requirements for recipients whose youngest child is between the ages of 1 and 2. Usage of this client pamphlet remains unchanged, therefore the instructions were not updated in this release. Current versions of Form 221 must be destroyed and replaced with the new versions dated 10/04. An initial supply was sent to all DOs and NHEP offices.

Form 222, Referral Letter, and its instructions, were revised to reflect the new automated process for scheduling orientations for the NHEP and Food Stamp Job Search Program. This form was additionally expanded to incorporate referrals to other providers, as listed on Form NHEP240. This form will primarily be used as a paper back-up for New HEIGHTS-generated CS0009, WP General Interview (NHEP), CS0016, WP General Interview (FS), and WP0022, Agency Referral Letter. Instructions were revised accordingly. Staff must destroy the paper version of this form upon receipt of the paper back-up supply from State Office.

Form NHEP227, Assessment Form, was revised to reflect the new assessment format and to improve readability, and its usage was revised to reflect that the Food Stamp Job Search program will also use this form with Food Stamp clients. The form is used as a paper back-up only when New HEIGHTS is inaccessible. The instructions were revised accordingly. Staff must destroy the paper version of this form upon receipt of the paper back-up supply from State Office.

Form NHEP228, Employment and Family Self-Sufficiency Plan, was revised to reflect the new employment plan format and will now be used by individuals in the Food Stamp Job Search Program as well. This form is used as a paper back-up only when New HEIGHTS is inaccessible. Instructions were revised accordingly. Staff must destroy the paper version of this form upon receipt of the paper back-up supply from State Office.

Form NHEP240, Partner Agency Participation Form, was revised to remove the reference to the Welfare to Work Program and update the titles of "VR," "Step by Step," and "In-Home Counseling," to "DALR," "Working Futures," and "Family Intervention," respectively. Additionally, the phrases "Determined Eligible On, and "Determined NOT Eligible On" were replaced with the phrases "Accepted," and "Not Accepted," at the request of providers. The use of the form remains unchanged so the instructions have not been re-released. The current version of the form must be exhausted before the revised order is printed.

Form 261, TANF Interview Checklist, was revised to remove references to applicants and include the new Form 752 process for clients claiming a medical exemption. Minor text adjustments were also made to reflect the automated referral process. The use of the form remains unchanged so the instructions have not been re-released. A new supply of the form was provided for the TANF end of interview packets. Destroy all other versions currently in the office.

Form 752, Physician/Psychologist Statement for Exemption/Limitation From the NHEP Work Requirement, and its instructions, were revised to provide more information about the NH employment program so that the healthcare provider would be better equipped to determine whether the recipient could fully or partially participate in any of the NHEP activities available; and

Form 785, Hardship Extension Request, will also be revised to incorporate the changes released in this SR. However, due to other pending changes related to the Hardship Extension Process, the revisions to this form will be released under separate cover.

New HEIGHTS-Generated CS0009, WP General Interview (NHEP), CS0015, WP Reschedule Interview (NHEP), CS0016, WP General Interview (FS), CS0017, WP Reschedule Interview (FS), and CS0018, WP Reschedule Interview-Final (FS), were revised to reflect the new automated process for scheduling and rescheduling NHEP and Food Stamp Job Search orientations. Variable text is used in these New HEIGHTS-generated letters to indicate the status of the participant (Mandatory or Voluntary), the date, time, and location of the scheduled or rescheduled orientation, and whether the orientation is a group or individual orientation. In addition, the notice indicates whether it is an initial orientation or a rescheduled orientation, what the individual must do to avoid a reduction or loss of benefits, the potential sanctions, and what the individual can do if they do not agree with the message of the notice.

All new or revised DFA forms have been attached to this SR for reference.

Obsoleted Forms or New HEIGHTS-Generated Letters

Due to the changes released in this SR, the following forms are no longer needed. Destroy or recycle all copies of the forms listed below upon receipt of this SR:

§   Form 213, Interagency Referral/Work Registration, and its instructions;

§   Form 214, Return Results Report, and its instructions;

§   Form 221(Sp), the Spanish version of the NHEP pamphlet;

§   Form 226, Initial Employment Appraisal, and its instructions;

§   Form 228, Employability Plan, and its instructions;

§   Form NHEP228P, Employability Plan Preprint, and its instructions;

§   Form NHEP237, NHEP Fact Sheet (Seacoast Version), and its instructions; and

§   New HEIGHTS-Generated AE0069, 3/10 Day Referral Letter for NHEP.

POLICY MANUAL REVISIONS

Revised Family Assistance Manual Topics

Section 134.03    Specified Hardship Criteria

PART 803    NOTIFICATIONS AT APPLICATION

Section 808.01    Initial Application

Section 808.03    NHEP Participation

Section 808.05    Exemptions from Participation in NHEP

Section 808.07    Verification of Exemptions

Section 808.09    Referral to NHEP Teams

Section 808.11    72 Hour Requirement

Section 808.13    NHEP 26 Week Component

Section 808.17    Assessment

Section 808.19    Initial 4 Week Job Search Period

Section 808.21    Employment Plan

Section 808.25    Referrals to Other Activities

Section 808.27    Hourly Participation Requirements

Section 808.31    Compliance Requirements

Section 808.33    Conciliation Process

Section 808.35  Sanctions for Voluntary Quit Or Failure/Refusal to Cooperate with NHEP Work Program Participation Requirements

Section 808.37    Participation Requirements for 2 Parent Families

Section 808.39    NHEP Activities

Section 808.39    NHEP Activities: Alternative Work Experience Program (AWEP)

Section 808.39    NHEP Activities: Community Work Experience Placement (CWEP)

Section 808.39    NHEP Activities: Employment

Section 808.39    NHEP Activities: Job Club

Section 808.39    NHEP Activities: Job Search

Section 808.39  NHEP Activities: Lifeskills for Employment, Achievement, and Purpose (LEAP) Program

Section 808.41    Support Services

Section 808.41    Support Services: Transportation Assistance

Section 808.43  Referrals to the Division of Adult Learning and Rehabilitation (DALR)

PART 923    ACTIVELY SEEKING EMPLOYMENT

Glossary   W-words

Revised Food Stamp Manual Topics

PART 809    EXEMPTIONS FROM FOOD STAMP WORK REQUIREMENTS

PART 813    FOOD STAMP WORK REGISTRATION

PART 819    FOOD STAMP JOB SEARCH ACTIVITIES

IMPLEMENTATION

The following policy released in this SR is effective October 15, 2004:

§   the new NHEP work activities, Community Work Experience Placement (CWEP) and Job Club; and

§   the new criteria for the NHEP self-employment activity.

All other policy released in this SR is effective October 1, 2004 for all new applicants and at the next redetermination for all current recipients.

Forms Implementation

Begin using all DFA forms created or revised as a result of the policy changes released in this SR as follows:

§   Form 220, Notice of Failure to Meet Work Requirements, is primarily used as a paper back-up if New HEIGHTS is inaccessible. Continue using the current version until you are supplied with the new version. At that time, destroy all your old versions and use the new version as instructed above.

§   Destroy all versions of Form 221, The New Hampshire Employment Program (NHEP), that do not have a date of 10/04, SR 04-26, and begin using the new versions immediately upon receipt. Logistics has sent all DOs and NHEP offices an initial supply of the new versions of the pamphlets, and the new NHEP folders received will contain the correct version of the pamphlet. The Spanish version of the pamphlet, Form 221(Sp), is obsolete with this SR. When the new version is translated, it will be released under separate cover.

§   Form 222, Referral Letter for the NHEP, Form NHEP227, Assessment Form, and Form NHEP228, Employability Plan, may be destroyed upon receipt of the new versions. Since these forms will only be used as paper back-ups when New HEIGHTS is inaccessible, State Office has sent DOs and NHEP offices a small supply of the latest version to be used when New HEIGHTS is inaccessible. Reorder from State Office, via the Policy Unit, when the office’s paper back-up supply is low.

§   Continue using Form NHEP240, Partner Agency Participation Form, until current supplies are exhausted. The new version of the form will be ordered when current supplies are gone.

§   There should not be a supply of Form 261, TANF Interview Checklist, in any DO because this form is managed by State Office and inserted directly into the TANF end of interview folders. However, if a DO does have a supply of this form and the supply is dated prior to 10/04, SR 04-26, destroy all copies. New copies have already been entered into the TANF end of interview packets.

§   Destroy all versions of Form 752, Physician/Psychologist Statement for Exemption/Limitation From the NHEP Work Requirement, dated earlier than 10/04, SR 04-26. This form, along with new Form 752a, Authorization for Release of Protected Health Information, will now be collected together in the new DALR packets at State Office and mailed to all DOs and NHEP offices as needed. An initial supply of the DALR packets was provided to all DOs and NHEP offices for the October 1 implementation date. Begin using these packets, when needed, immediately upon receipt. Reorder from Mickie Grimes at State Office when the office supply is low.

New HEIGHTS-generated forms will be in production beginning Monday, October 4, 2004.

Forms obsoleted with the release of this SR must be destroyed or recycled immediately upon receipt of this SR.

CLIENT NOTIFICATION

Public hearings for the rules associated with the policy released in this SR were held on November 6, 2000, May 7, 2004, July 9, 2004, and September 10, 2004.

In addition to the New HEIGHTS-generated client letters described in the FORMS REVISIONS section above, additional client letters were mailed September 27 – September 28, 2004 to the following two groups of recipients:

§   a one-time client mailing was generated to NHEP recipients temporarily exempt from NHEP work requirements due to their or a family member’s medical issue on Monday, September 27, 2004; and

§   a one-time client mailing was generated to NHEP recipients exempt from NHEP work requirements due to their youngest child being between the ages of newborn and 2 years old on Tuesday, September 28, 2004.

Letters are attached for reference.

TRAINING

Special training was conducted for all DFA staff as well as NHEP Team Members and Food Stamp Interviewers throughout the month of September. In addition, a remote training for DFA Supervisors and FSS on the topics released in this SR was conducted on September 27, 2004. A recording of this remote training is available on the Centra Website’s Library.

FORMS POSTING INSTRUCTIONS

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at http://www.dhhs.nh.gov/DHHS/DFA/LIBRARY, effective December 6, 2004.

This SR, and printed pages with posting instructions, will be distributed under separate cover to all hard copy holders of the Family Assistance, Food Stamp, and Forms Manuals.

DFA/JBV:s

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CERTIFICATE OF DESTRUCTION

I certify that all copies of the following forms have been recycled or destroyed in accordance with the instructions in the SR:

§   Form 213, dated 10/97, SR 97-37;

§   Form 214, dated 10/97, SR 97-37;

§   Form 220, dated 6/01, SR 01-25;

§   Form 221, dated 12/03, SR 03-40, as well as any earlier versions;

§   Form 221(Sp), dated 7/01, SR 01-03;

§   Form 222, dated 8/97, SR 97-33;

§   Form 226, dated 3/97, SR 97-2;

§   Form NHEP227, dated 8/97, SR 97-33;

§   Form 228, dated 5/96, SR 96-24;

§   Form NHEP228, dated 8/97, SR 97-33;

§   Form NHEP228P, dated 8/97, SR 97-33;

§   Form NHEP237 (Seacoast Version), dated 12/99, SR 99-51;

§   Form NHEP240, dated 12/03, SR 03-40;

§   Form 261, dated 5/04, SR 04-11; and

§   Form 752, dated 3/99, SR 99-08.

Office Manager:    District Office     

Return this certificate to DHHS Stock Control, 6 Hazen Drive, Concord, NH 03301, after the instructions in the SR have been carried out.