SR 02-08 Dated 01/02

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SIGNATURE DATE:	December 21, 2001
FROM:	OFFICE OF THE DIRECTOR Mary Anne Broshek
AT (OFFICE):	Division of Family Assistance
TO:	DFA Supervisors Managers of Administration NHEP Teams
SUBJECT:	Release of New Form CS0019, Reminder of Redetermination Notice, and Release of Revised Forms CS0001, Interview Appointment Notice, and CS0008 Rescheduled Interview Appointment Notice
EFFECTIVE DATE:	January 4, 2002

· This SR releases the following New HEIGHTS-generated forms that are in the Client Scheduling (CS) series:

- new Form CS0019, Reminder of Redetermination Interview;

- revised Form CS0001, Interview Appointment Notice; and

- revised Form CS0008 Rescheduled Interview Appointment Notice.

· The text of each form notifies clients of their upcoming redetermination appointment, and provides a list of acceptable documentation to bring to the appointment. The same verification list appears on each form. The text of each form will appear in standard New HEIGHTS format. For purposes of this SR, the form text is shown on 2 separate pages, with page 1 for the appointment notice and page 2 for the list of acceptable documentation. Since all forms are self-explanatory and generated by New HEIGHTS, no forms instructions are being released with this SR.

· New Form CS0019 is a follow-up reminder to Form CS0001, and was developed to reduce the number of clients who fail to appear for their interview ("no show"). It will be generated for clients in all District Offices except for Berlin, Concord and Laconia, as they are piloting a telephone redetermination reminder project.

Current Policy

Revised Policy

New HEIGHTS generates Form CS0001, Interview Appointment Notice, on the 1st Wednesday of the month for redeterminations due in the following month. The appointment date may be as soon as the 20th of the month prior to the month of redetermination due date or as late as the 19th day of month of the redetermination due date. Form CS0001 is the only redetermination appointment notice generated for the client, unless the appointment is rescheduled.

The time lag between receipt of the redetermination notice and the actual redetermination date may contribute to the high percentage of "no-shows."

Form CS0008, Rescheduled Interview Appointment Notice, is generated when the client’s caseworker reschedules an interview appointment.

New HEIGHTS will still generate Form CS0001, Interview Appointment Notice, on the 1st Wednesday of the month for redeterminations due in the following month. Minor formatting and wording changes have been made to Form CS0001 to improve readability. As a follow-up reminder, New Form CS0019, Reminder of Redetermination Interview, will also be generated 8 days prior to the scheduled interview.

Use of Form CS0019 is expected to reduce the percentage of "no-shows," improve customer service, and increase District Office efficiency.

Form CS0008 will still be used to notify the client of a rescheduled interview. Minor formatting and wording changes have been made to Form CS0008 to improve readability.

BACKGROUND

The current "no-show" rate is 41% statewide and is in part due to the time lag between receipt of the redetermination notice and the actual redetermination date. The high percentage of "no shows" results in a significant amount of rescheduled redeterminations, delays case processing, and affects District Office efficiency. The "no show" rate may also cause overdue redeterminations and negatively impact receipt of client benefits.

Form CS0019, Reminder of Redetermination Interview, was developed to provide clients with a current reminder of their upcoming redetermination appointment and a list of documentation to bring to their interview. It is anticipated that Form CS0019 will reduce the "no show" rate.

NEW FORM CS00019

New Form CS0019, Reminder of Redetermination, provides clients with a current reminder of their upcoming redetermination appointment and advises them of required documentation.

· The appointment reminder text shows the appointment location, date, and time, and advises clients to bring documentation of household circumstances to the redetermination interview. Clients are also advised to notify the District Office as soon as possible if they are unable to keep the interview appointment.

· Additional text provides a list of acceptable documentation that the client should bring to the appointment interview.

REVISED FORMS CS0001, INTERVIEW APPOINTMENT NOTICE, AND CS0008 RESCHEDULED INTERVIEW APPOINTMENT NOTICE

Form CS0001, Interview Appointment Notice, and Form CS0008, Rescheduled Interview Appointment Notice, have been revised and reformatted to enhance readability. Whenever possible, language was simplified. Since these forms have never been released to the Forms Manual, there are no old forms to remove and destroy as noted in the Posting Instructions below.

IMPLEMENTATION

New HEIGHTS will start generating Form CS0019 beginning on January 4, 2002, for all District offices other than Berlin, Concord and Laconia. Revised Forms CS0001 and CS0008 will be generated in all District Offices beginning on January 4th.

CLIENT NOTIFICATION

No client notification is necessary or planned.

TRAINING

No training is planned due to the procedural nature of this SR.

POSTING INSTRUCTIONS

Remove and Destroy

Insert (in front of the Forms Manual)

Forms Manual

None

Form CS0001,

SR 02-08/January 2002,

1 sheet

Form CS0008,

SR 02-08/January 2002,

1 sheet

Form CS0019,

SR 02-08/January 2002,

1 sheet

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised SR has 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.state.nh.us/PMIndex.htm, effective February 4, 2002.

This SR will be distributed under separate cover to all hard copy holders of the Forms Manual.

DFA/SJC:s