SR 15-28 Dated 10/15

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases new Form NHEP207, Additional Communication Preferences, its associated instructions, NHEP207(i), and its Spanish translation, Form NHEP207(Sp). This form is completed by New Hampshire Employment Program (NHEP) participants during the NHEP Orientation and provides the participant with the options of being contacted by NHEP staff via text message and/or email message, if the NHEP participant so chooses, in addition to phone and/or mail as is current procedure.

POLICY

Provide Form NHEP207, Additional Communication Preferences, to all NHEP participants attending the NHEP Orientation. The current process of contacting NHEP participants via mail and phone to relay information will continue regardless of whether the participant completes or fails to complete Form NHEP207. It is the NHEP participant’s choice whether he or she would like NHEP staff to contact him or her via text or email:

·      If the NHEP participant opts to being contacted by text message and/or email in addition to phone and/or mail, use the information provided on NHEP207 to contact the NHEP participant as he or she has indicated on the form, as long as texting or emailing in the circumstance is deemed appropriate according to NHEP case management protocols.

·      By signing Form NHEP207, the NHEP participant gives NHEP staff permission to use text and/or email as additional modes of communication with that participant. This permission remains in effect for as long as the individual is an NHEP participant or until the individual indicates to NHEP staff in writing to stop using text or email to communicate with him or her.

·      If the NHEP participant does not check ‘Yes’ to receiving text or email messages from NHEP, or if the NHEP participant fails to sign Form NHEP207, do not send text or email messages to the NHEP participant.

NEW HEIGHTS SYSTEMS PROCEDURES AND IMPLEMENTATION

There are no New HEIGHTS changes required to implement Form NHEP207, nor is there a New HEIGHTS version of this form. However, prior to using text or email to contact an NHEP participant, NHEP staff must review the “Assessments” category under the “NHEP Additional Communications Preference” type in the client’s New HEIGHTS e-folder to ensure permission has been granted to contact the participant using these additional communication methods.

DESCRIPTION OF REVISIONS MADE TO FORMS

New Form NHEP207, Additional Communication Preferences, is a one-page, single-sided paper form completed by NHEP participants during the NHEP Orientation. This form is used to:

·      offer the participant the options of being contacted by text message and/or email message;

·      collect the participant’s current contact information (including cell phone number, cell phone provider, and email address);

·      collect the participant’s preferred additional method of communication;

·      collect the participant’s best time to be contacted during business hours;

·      collect the participant’s best time to have meetings scheduled;

·      inform the participant of their rights and responsibilities regarding any incurred fees resulting from NHEP contact and privacy setting liability; and

·      inform the participant that he or she may opt-out of receiving text messages and/or email messages from NHEP staff by contacting their Employment Counselor Specialist (ECS) and indicating his or her decision to opt-out in writing.

The ECS uses the information provided on NHEP207 to determine the best way to contact the NHEP participant.

Instructions for this new form were created accordingly and the form has been translated into Spanish. An initial supply of Form NHEP207 has been printed and sent to all offices for use in the Orientations immediately upon receipt. However, as a Service Bureau Project under Workplace Success staff supervision, clients will be inserting this new form into the NHEP Orientation folders. This form is available in the DHHS Warehouse and may be ordered using current forms reordering procedures, via the Quarterly Forms Order (QFO). The forms are also available electronically, for Department staff only, on the Lotus Notes Family Services Database. The Spanish translation of the form may be printed from the Lotus Notes Family Services Database when needed, or, if a larger supply is required, contact the Supervisor of the Policy Development Unit.

POLICY MANUAL REVISIONS

Revised Family Assistance Manual Topics

Section 808.15  Orientation

IMPLEMENTATION

An initial supply of Form NHEP207 has been printed and sent to all offices for use in the NHEP Orientations immediately upon receipt. Begin using the new form upon receipt. However, as a Service Bureau Project under Workplace Success staff supervision, clients will be inserting this new form into the NHEP Orientation folders beginning in October. This form is available in the DHHS Warehouse and can be ordered using current forms reordering procedures, via the QFO. The forms are also available electronically, for Department staff only, on the Lotus Notes Family Services Database. The Spanish translation of the form may be printed from the Lotus Notes Family Services Database when needed, or, if a larger supply is required, contact the Supervisor of the Policy Development Unit.

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 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 www.dhhs.nh.gov/DFA/publications.htm, effective November 2, 2015. Additionally, this SR, and printed pages with posting instructions, will be distributed under separate cover to all internal hard copy holders of the Family Assistance and Forms Manuals.

DFA/JBV:s