SR 11-33 Dated 08/11

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases revisions to Form NHEP223, Job Search Log, and its associated instructions. This form now includes Participant Instructions Form NHEP223, Participant Instructions for Filling Out Form NHEP223 Job Search Log, and Example Form NHEP223, Job Search Log Example, to be given to the participant.

POLICY

Participants in the New Hampshire Employment Program (NHEP) are required to engage in certain allowable work activities as a condition of eligibility for cash assistance. One of these allowable work activities is to search for a job. The Federal Government mandates that each State put in place a plan for how they will document this job search. NHEP requires the participant to record the amount of time spent during their job search using the Form NHEP223, Job Search Log.

Form NHEP223, Job Search Log, has been revised to be more understandable to the NHEP participant. This was accomplished by enhancing the current form to be clearer and more descriptive. Participant Instructions Form NHEP223 and Example Form NHEP223 have also been created to accompany Form NHEP223, but will only be provided at the NHEP Orientation.

NHEP staff piloted the revised version of Form NHEP223 including Example Form NHEP223 and Participant Instructions Form NHEP223 in several offices for a period of four months. Positive feedback was received.

DESCRIPTION OF REVISIONS MADE TO FORM NHEP223

Form NHEP223, Job Search Log, is a one sheet, double-sided form, which is completed by the NHEP participant to meet NHEP work participation requirements and fulfill federal mandates. This form now includes participant instructions and an example of a completed Form NHEP223, to assist the NHEP participant in completing the Form NHEP223 correctly and timely. The following changes have been made to Form NHEP223:

·   The title of the form was changed from "NHEP Employer Contact Log" to "Job Search Log," to better describe the information collected on this form.

·   There are now additional instructions on the upper right hand corner of the front page of this form explaining how the participant is to enter the time spent on each activity, e.g. .25 = 15 minutes, .50 = 30 minutes.

·   Column titles are more descriptive of the information requested. For example, "Point of Contact: Name of person, Address, Website, Job ID#, or Newspaper" replaced "Person Contacted" to ensure NHEP ECS received the information needed.

·   Instead of continuing to require the NHEP participant to enter text, the "Action Taken" column on the old form has been split into the following two separate columns: "Check Action you Took" and "Check How You Took Action." The choices the NHEP participant may check in these columns include "Application or Resume," "Interview or Research" or "Follow-up" under the "Check Action You Took" column, and "In Person," "Online or Fax," "Mail or Email," and "Telephone" under the "Check How You Took Action" column.

·   A new "Miles Driven" column has been added to further enhance accuracy associated with mileage reimbursement for job search.

·   The days of the week row has been reformatted to provide the NHEP participant with more space to fill in their totals. The word "Row" has been added to the left of the days of the week, and the word "Column" has been added above the daily "Time Spent" column. This further directs the participant to enter the appropriate information in the correct area of the form.

·   The participants have now been provided a space to add up their "Row" totals and compare it with their daily "Column" total to help ensure that information entered is accurate. If these totals do not match, NHEP participants are directed to recheck their figures.

·   An electronic version of Form NHEP223 has been created and contains formulas to calculate the NHEP participant’s hours. The e-version also includes an aqua colored background in the column entitled "Time Spent" and a yellow background in the hours row under the days of the week. The "Row Total" cell and the "Column Total" cell have the corresponding background color to further direct participants to the correct area of the form.

·   To further assist the participant in completing Form NHEP223, a detailed set of instructions and an "Example" Form NHEP223 have also been created. The Example Form NHEP223 provides NHEP participants with a reference for what their finished product should look like. All cells in the Example Form NHEP223 have been filled out with the exception of the NHEP Counselor’s comments and signature. The Example form also discreetly shows participants how long each activity should take. The Participant Instructions Form NHEP223 and the Example Form NHEP223 are only provided to the participant at the NHEP Orientation, during which the correct way to complete the Form NHEP223 can be further explained.

·   Per NHEP, the NHEP participant’s signature and date field on the Form NHEP223 have remained unchanged as well as the NHEP ECS signature and comments field. It has been determined by the NHEP Team that these requirements are federally mandated and cannot be removed from the form.

The instructions for Form NHEP223 have been updated accordingly.

The standing stock of current and older versions of Form NHEP223 stored in the District Offices and DHHS warehouse must be recycled and/or destroyed. State Office will provide an initial supply of the new version of Form NHEP223 to all NHEP Teams at the beginning of September. Once this initial supply has been exhausted, the DHHS Warehouse may be contacted in the usual manner, via the Quarterly Forms Order (QFO), for additional supplies. A Certificate of Destruction has been included at the end of this SR.

An electronic version of this form has also been developed to include Excel formulas to automate calculations for the NHEP participant. At this time the electronic form cannot be accessed via the website, as all website forms must be in PDF only, which automatically removes the excel calculations. As such, NHEP Employment Counselor Specialist (ECS) must manually provide the e-version of Form NHEP223 to those NHEP participants who might be able to use this form, until enhancements can be made to the DHHS website which would allow PDF form fill-in.

POLICY MANUAL REVISIONS

Revised Family Assistance Manual Topics

Section 808.15  Orientation

Section 808.17  Service Determination Appointment (SDA) and Ongoing Assessments

Section 808.39  NHEP Activities: Job Search

IMPLEMENTATION

Begin using the new versions of Form NHEP223 upon receipt of the initial supply from State Office. The new forms, Example Form NHEP223 and Participant Instructions Form NHEP223, will be included in the NHEP Orientation green folders with the release of this SR. Follow normal Form reordering procedures as needed. Destroy old versions of Form NHEP223 and its associated instructions upon receipt of this SR.

CLIENT NOTIFICATION

No special client notification is planned or needed.

TRAINING

No special training is planned or needed.

FORMS MANUAL POSTING INSTRUCTIONS

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the SR has been posted to the On-line manual.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective October 3, 2011. Additionally, this SR will be distributed under separate cover to all internal hard copy holders of the Family Assistance and Forms Manuals.

DFA/LRB:s