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A. Verification of Receipt of Assistance in another State
B. Reviewing Cases Approaching the Time Limit
E. Hardship Exemption Hearings
Beginning January 1, 1997, Work First families in North Carolina that include an adult became subject to a 60-month lifetime limit on the receipt of assistance under the Temporary Assistance for Needy Families (TANF) Block Grant, which includes Work First Family Assistance.
The 60-month time limit is a cumulative total and includes the months TANF assistance was received in other states.
The 60-month time limit applies to any case that includes an adult receiving Work First. In determining the number of months an individual received assistance, do not count months in which the individual received assistance as a minor child, including months they received as a minor parent. If the minor parent is emancipated, she/he is treated as an adult, and the months she/he received Work First count toward the 60-month lifetime limit.
When a request is made for Work First Family Assistance, check the Eligibility Tracking screen in EIS for all the adults in the family to verify the number of months, if any, each adult has on the 60-month time clock. If any adult included in the family has used up his or her time limit, the family is ineligible unless they qualify for a hardship exemption.
Families who have exhausted their 60-month time limit may apply for a hardship exemption that would allow them to receive additional months of assistance.
Hardship exemptions are limited to no more than 20 percent of the average monthly Work First caseload state-wide. The percentage of exemptions will be monitored at the State Level by the Economic and Family Services Section.
If a family received TANF assistance in another State, Commonwealth, Territory, or "Federally Recognized" Tribe with a TANF program and moved to North Carolina on or after October 1, 1996, the caseworker must contact them to determine the number of months the family received assistance under TANF, if any. Only months the family received assistance after a State, Commonwealth, Territory, or "Federally Recognized" Tribe implemented the TANF Block Grant or Tribal TANF grant, count toward the 60-month lifetime limit.
The 60-month time limit only applies to months of assistance that are paid, in full or part, with Federal TANF funds. If a state, commonwealth, territory, or "federally recognized" tribe provides assistance that is funded only by MOE funds, with no TANF funds included, that assistance is not to be counted against the 60 month time clock.
When contacting another State, Commonwealth, Territory or "Federally Recognized" Tribe, always ask how many months of assistance have been counted on the family's 60-month federal time clock.
States, Commonwealths, and Territories implementation dates vary from October 1, 1996, to July 1, 1997. North Carolina’s implementation date was January 1, 1997. (See Figure 105f-1, Schedule of Implementation Dates.) Any months transferred from another State, Commonwealth, Territory, or "Federally Recognized" Tribe, must be entered as "transferred months" on the Eligibility Tracking screen. See the Work First User Manual.
The tracking of the 24 month time limit for North Carolina’s Work First program began August 1996.
Contact the State Office of the state in which the Tribal Program is located for verification of months of assistance received under Tribal TANF.
EXAMPLE: A family received TANF assistance in Virginia from September 1996 until March 1998. Virginia implemented TANF effective February 1, 1997. The maximum number of months they used is 14 of their 60 months of eligibility in Virginia. If they are approved in North Carolina and the caseworker verifies the 14 months are countable, the 14 months from February 1997 through March 1998 must be keyed onto the “ Transfer In” field on the ET screen in EIS.
Special attention must be paid to cases on the 60-month time limit during months 30, 48, and 57 as discussed below.
1. Reviewing Cases
When the caseworker identifies cases with 30 months on the time clock:
See the DSS-5292 as a suggested case summary/review document.
2. Reassessment of Cases Within Twelve Months of Termination
All cases that reach the 48th month must be given a thorough family assessment. The assessment must address family strengths, needs, and barriers to employment. The assessment should include an offer for a voluntary screening for disabilities. The assessment may help identify a disability (for example, when there is a pattern of non participation, behavioral cues, low test scores or poor performance in school or work assignments). If the participant declines the voluntary screening, document the case record.
If the participant has a disability and needs assistance in obtaining the necessary documentation, the caseworker should arrange for the needed assistance and document this in the case record.
The assessment should thoroughly explore all community resources available to assist the family in moving toward self-sufficiency before their time limit expires. For discussion of assessment, see Section 101 and Section 117.
The results of this assessment must be documented in the case record and must include an updated MRA Plan of Action.
Cases in the final twelve months of eligibility should be given priority for employment services.
3. Cases Approaching the 60th Month on the Time Clock
Prior to the mailing of the 58th month check, an automated notice, DSS-8220B, is produced informing the family that their Work First payment will soon terminate and notifying them of their right to appeal or request a hardship exemption. The notice also informs the family of benefits for which they may be eligible after their time limit expires.
During the 60th month, review the case to determine eligibility for Medicaid and transfer the case to the appropriate Medicaid program or terminate the case. If no determination is made by the 60th month, the case automatically transfers to Medicaid.
If the only change affecting eligibility is the expiration of the time limit, key a DSS-8125 to transfer the case to MAF-C for the remainder of the existing payment review period. No separate eligibility determination is required. (See the Family and Children’s Medicaid Manual)
Notify the Food and Nutrition Services caseworker of the family’s Work First termination.
When a family reaches the end of their 60-month time limit, they may request an appeal if they believe that the clock is in error and that they still have months remaining on their time limit. This appeal would be handled through the normal appeal process as described in Section 264, Notice and Hearings Process.
1. A family may request an exemption from the 60-month time limit. This exemption is known as a hardship exemption and can be granted for a period of time not to exceed six months. A hardship exemption may be granted if a Work First family has experienced circumstances that have made leaving WFFA difficult. These circumstances must be beyond the family’s control.
As a reasonable accommodation, individuals with disabilities are entitled to assistance in requesting a hardship exemption. All families should be informed of the rights of individuals with disabilities to receive such assistance.
The following conditions should be met before a family can be granted a hardship exemption.
The agency’s failure to meet the above conditions cannot be the reason that a hardship exemption is denied.
2. The following are examples of situations that might constitute hardship status:
Families may request a hardship exemption within the last three months, at the end of the 60-month time limit or at any time following termination after the 60-month time limit was reached.
A Hardship Exemption may be granted to a family following a review of their case by a committee designated by the county Board of Social Services. Recommended committee members include: Work First case manager, Child Welfare social worker, Vocational Rehabilitation counselor, Food and Nutrition Services caseworker, Child Support agent, and Qualified Professional in Substance Abuse. The committee will hold a hardship hearing to approve or deny hardship status to the case.
If a hardship is verified, an exemption from the time limit may be granted. Exemptions can be granted for any number of months up to six months. All exemptions expire after six months. The family may request another exemption, and this request must be reviewed again by the hardship review committee.
The county must complete the hardship hearing process and issue benefits or send a denial notice within 45 days from the date of the request.
1. Requesting a Hardship Exemption
The family or its representative:
Give or send the family the Notice of Hardship Exemption Hearing, DSS-5293, indicating the date, time, and location of the hearing.
Provide information requested by the family from the case file to assist them in their preparation for the exemption hearing. This does not include confidential third-party information.
Exemption months may be retroactive only to the month the family requested the exemption, provided the family is eligible and has not already received Work First assistance in that month.
There is not a limit on the number of hardship exemptions that can be granted. However, to receive additional benefits, the family must meet all Work First eligibility criteria.
2. Approving a Hardship Exemption
When notified that an exemption was granted:
The notice must:
3. Denying a Hardship Exemption
When the caseworker is notified the exemption has been denied, complete and mail a Notice of Decision on Hardship Status Request , DSS-5294, to the family. This notice must inform the family of the county Board of Social Services or its Designee’s decision and the reason for the decision. The family may request a State-level hearing, as described in Section 264, to appeal this decision.
The DSS-5294 is used in this situation because an appeal of a denial of exemption is heard at the State level, and the deadline for requesting a State-level hearing is 15 days, not the 60 days as stated on the DSS-8109.
Evaluate the family members for any appropriate Medicaid programs.
Work Eligible adults included in cases that are granted exemptions must have an updated MRA Plan of Action that addresses each identified hardship criterion and are expected to work toward resolution of the problems as appropriate.
It is strongly recommended that cases that have been granted hardship exemptions receive group staffing at least monthly.
1. When granting hardship exemptions, take the following actions in EIS:
When a hardship exemption is granted for one or two months and the family is eligible, approve an administrative reapplication as an open/shut case. Evaluate all family members for continuing Medicaid eligibility according to Family and Children’s Medicaid Policy.
When exemptions are granted for three or more months and the family is eligible, approve an administrative reapplication and key a ‘4’ and the month and year the exemption period ends in the SPECIAL REVIEW Field on the DSS-8125. This will cause the case to appear on the Case Management Report one month prior to the end of the exemption period with the message, “Income to end.” At that time, complete and mail a timely notice giving the ending date for the Work First Family Assistance.
2. When the exemption period ends:
A family may request another hardship exemption at this time.
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office. |
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