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PA Bulletin, Doc. No. 02-1773b

[32 Pa.B. 5048]

[Continued from previous Web Page]

28.  Procedures for those with other (not involving disability) employment barriers. (§§ 141.51(a)(2), 141.52)

   Comment: One commentator claimed that the procedures are deficient for persons with other barriers to employment; for example, a barrier not involving disability. For example, the commentator contended that the regulations, read literally, require an individual exempt from WPP with a barrier to employment such as lack of child care for child under age 6 (proposed § 141.51(a)(2)(i)(B)) must cooperate with a WCA under § 141.51(a)(2)(ii). The commentator argued that this does not comport with the Department's alleged statement to the commentator that the Department does not intend to use physicians for such determinations, but the regulations do not state when physicians will and will not be used. The commentator argued that, read literally, the regulations indicate that physicians are to be used in all cases and charged with making all final decisions. Likewise, the commentator claimed that it is unclear whether a physician or psychologist will evaluate multiple barriers to employment and their combined effect. They questioned if MPP will have the resources and regulatory authority to offer remedies that address these needs.

   Response: The procedures set forth in the final-form regulations for persons with other barriers to employment are sufficient. For example, § 141.54(c)(3)(i)(C) specifies that an examination of an individual with good cause will be required only when it is necessary and relevant to the determination of the good cause situation. The MPP team, which may include vocational and behavioral rehabilitation specialists, will consider the results of the WCA in developing the MPP service plan.

   Physicians and psychologists will evaluate multiple barriers to employment and their combined effect. Regarding regulatory authority and funding for MPP, the Department considers MPP a high priority; therefore, the Department has made sufficient provision for anticipated need for MPP in State Fiscal Year 2002--2003. To the extent that funding for MPP is available, the Department expects that MPP will continue to be a high priority. This rulemaking illustrates that MPP is an important component of Extended TANF. Section 141.54 authorizes the MPP team to develop service plans intended to address the needs of MPP participants.

29.  Vocational assessments. (§ 141.52)

   Comment: One commentator suggested that the regulations are unclear regarding vocational assessments for those assigned to WPP. Although the commentator supported the idea of an assessment prior to work assignment, the definitions of assessment and the WPP were criticized as lacking. For example, the commentator said the regulations are silent as to who will perform the assessment and how the recipient's input will be obtained, despite the express command of the Legislature, see section 405.1(a.2)(4) of the code, to involve the recipient in the process of assessment. The commentator also said that assessment is a complex task that should involve measuring literacy or numeracy and other factors for which the regulations do not provide. Further, the commentator submitted that the regulations do not state how any of the factors mentioned will be measured, including mental and physical disabilities, even though the ADA requires consideration of disability. The commentator maintained that even if a person is not fully disabled so as to preclude all employment, the ADA and good public policy require assessment of known disabilities that may affect an individual's ability to perform particular work, health and safety and the need for reasonable accommodation. Finally, the commentator suggested that the assessments be reduced to written form so they can be reviewed, corrected or augmented by recipients.

   Response: The vocational assessment is defined at § 141.52 and addresses the factors enumerated by the commentator. The individual participates in the vocational assessment performed by an employment and training contractor, as specified in § 141.55(b)(1). The Department intends to contract with the Work Force Investment Areas to implement WPP. The contractors will perform vocational assessments based on industry standards. Industry standards include protocols grouped into two broad classifications: testing and workplace assessment. Testing measures literacy and numeracy skills, interests and vocational aptitudes as well as other skills. Workplace assessment consists of observation of the individual in a real-world work environment to address issues like punctuality, adherence to work rules, interaction with supervisors and co-workers, communications skills and others. The results of the vocational assessment are evaluated in light of the needs of the local labor market.

   Section 141.55(b)(4) provides for reasonable accommodations of program rules and requirements to be made in accordance with the ADA. With respect to the commentator's concern that the results of the assessment be reduced to written form, the contractor will review the results of the assessment with the individual and provide written copies of each of the various assessments upon request.

30.  Design of WPP. (§ 141.52)

   Comment: One commentator claimed that the regulations say virtually nothing about the design and operation of WPP; for example, what work sites will be available, how the 30 hours of work and work activity will be structured, the level of participation ultimately selected and whether the recipient selects the activity or is assigned to existing activities or a prepackaged program. The commentator urged the Department to design WPP to address individual barriers in close consultation with recipients so that individual needs and limitations are accommodated and addressed. The commentator contended that nothing in the regulations speaks to choosing the mix of work and work-related activities that will comprise the WPP assignment, nor did the regulation address how a recipient may have input or voice disagreement regarding proposed activities.

   In addition, the commentator suggested that the Department offer existing work opportunity programs such as work experience as part of WPP; the commentator also objected to the Department's unpromulgated policy to limit work experience to 6 months in an individual's lifetime, and argued this policy is inflexible, unwise, legally unauthorized, illegal and relegates all recipients to a costly and ineffectual workfare option.

   Another concern the commentator expressed is that finding and scheduling WPP activities should be done in a way that does not interfere with a recipient's current employment, and this should be the highest priority. The commentator suggested that those with existing employment should be in a separate program, given that their needs and time constraints are so different from those of other recipients. According to the commentator, those recipients need a program to give them the skills and support to continue to make progress, not one to give them an intensive work experience. The commentator also suggested that the Department address the interplay between JRARRE and Extended TANF to avoid confusion and conflicting obligations, especially since the Department generally precludes participation in more than one welfare program at the same time.

   Response: The Department expects that § 141.55 in the final-form rulemaking will satisfy the commentator's concern that the regulations are too vague regarding WPP. Section 141.55 specifies the requirements for mandatory RESET participants and for WPP. For example, individuals employed in unsubsidized employment 30 or more hours per week may receive Extended TANF without any additional work or work-related activity requirements as specified in § 141.55(a)(1). Individuals participating in an employment and training program approved on an AMR while the individual was receiving TANF may continue that program, as specified in § 141.55(a)(2).

   WPP is not limited to one type of work or training; it will offer a range of work, work-related activities and training. WPP is intended to promote self-sufficiency by providing individuals with the combination of work experience and training that most research indicates is most productive. The activities available in WPP may include work experience. However, the Department did not adopt the commentator's suggestion to extend work experience beyond 6 months in the person's lifetime. The Department interprets section 402 of the code as limiting work experience to 6 months in the person's lifetime, unless ADA accommodations are needed. Accordingly, § 165.31(b)(7) and (8) and (c)(3) (relating to RESET participation requirements) reflect this interpretation. The Department's interpretation is neither unwise or illegal, nor does it relegate recipients to workfare. At the end of the 6-month period, other work and work-related activities are available.

   The nature and extent of an individual's work and work-related activities depends on his needs, abilities, limitations and available work sites. Consequently, the Department cannot specify the nature and extent of these varying activities and work sites in these regulations.

   An individual's input regarding the activities in WPP will always be considered but is not dispositive. As specified in § 141.58, an individual may appeal the denial or termination of Extended TANF under Chapter 275.

   In response to the commentator's concern that finding and scheduling WPP activities should be done in a way that does not interfere with a recipient's current employment, the Department agrees. WPP work or work-related activities are scheduled to not interfere with an individual's unsubsidized work hours. Before and after 60 months of TANF, unsubsidized employment is preferred. Individuals who are working 20 to 29 hours, if they can participate in at least 30 hours of work and work-related activities, must maintain employment and participate in a job retention and advancement program, as specified in § 141.55(a)(3). Employed individuals who establish good cause for not participating in at least 30 hours of work and work-related activities, but can comply with RESET, must maintain employment and are referred to WPP to address the good cause situation, as specified in § 141.55(a)(6). Additional provisions for mandatory RESET participants are set forth in § 141.55.

Fiscal Impact

   Commonwealth: The estimated cost in TANF Federal funds for 2002--2003 is $7.577 million.

   Public Sector: No other government entity will incur any costs or realize any savings.

   Private Sector: No private sector entity will incur any costs or realize any savings.

Paperwork Requirements

   The following new forms were created for Extended TANF:

   (WCA 1)--MPP Case Synopsis for Work Capacity Assessment Form--Provides narrative relating to recipient demographics and addresses hidden barriers and will include the MPP worker's observations. Used to compile information from the individual's CAO record and CIS screens and is provided to the WCA contractor as an introduction to the individual's TANF history.

   (WCA 2)--Letter of Explanation and Request for Information Form--CAO letter provided to the individual's treating physician(s) explaining WCA and requesting the individual's medical records to be sent to the WCA contractor. This form also provides the treating physician(s) with the opportunity to become involved in the decision to authorize further diagnostic testing for the individual.

   (WCA 3)--Professional Service Invoice for Photocopy Fees Form--Serves as an invoice for reimbursement for costs incurred with the photocopying of the individual's medical records by the treating physician(s).

   (WCA 4)--Work Capacity Assessment Transmittal Form--Two-part form used to record information about the MPP client from the CAO case record and then provided to the WCA contractor as an introduction of the individual's case information. The WCA contractor uses the form to document information and to capture information that will be data entered in the Automated Information Management System.

   (WCA 5)--Work Capacity Assessment Summary Results Form--Completed by the WCA contractor upon completion of the WCA. The contractor submits to the MPP team the WCA summary results along with supporting documentation received from the individual's physician, results of the medical assessment and any other testing.

   (PA 1724)--MPP Enrollment Form--Completed by the MPP Worker or MPP Case Manager for each individual enrolled in MPP.

   (PA 1718)--MPP Medical and Social History Form--Completed in a private face-to-face interview between the MPP Worker or MPP Case Manager and the individual. Used to help identify possible barriers and is intended to help the MPP worker or MPP case manager, the MPP team and the individual in developing an appropriate Service Plan.

   (PA 1725)--TANF Work Activity Summary Form--Used to help the MPP worker or MPP case manager identify factors that may have contributed to the individual's lack of progress toward self-sufficiency. The information obtained on the TANF Work Activity Summary Form will be combined with the information obtained from the Medical and Social History Form and other documentation to assist the MPP worker or MPP case manager and appropriate team member(s) in developing a plan that will help the individual move closer to self-sufficiency.

   PA/CS 1747--Domestic Violence Verification Form--This form, revised and renamed the ''Domestic Violence Verification Form,'' is used to verify domestic violence when an individual requests a waiver of program requirements (for example, child support, work and time limits) on that basis.

Effective Date

   This final-form rulemaking is effective upon publication in the Pennsylvania Bulletin as final rulemaking.

Sunset Date

   Except for the sunset date specified in Chapter 281, there is no sunset date for the Extended TANF program. TANF regulations are reviewed through the Department's quality control and corrective action review process.

Regulatory Review Act

   Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on August 12, 2002, the Department submitted a copy of this final-form rulemaking to IRRC and to the Chairpersons of the Senate Committee on Public Health and Welfare and the House Committee on Health and Human Services.

   Under section 5(c) of the Regulatory Review Act, the Department provided IRRC and the Committees with copies of the comments received during the public comment period. The Department has also provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Department in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request. In preparing the final-form rulemaking, the Department has considered all comments received from the public, IRRC and the Committees.

   Under section 5.1(d) of the Regulatory Review Act (71 P. S. § 745.5a(d)), on September 3, 2002, this final-form rulemaking was deemed approved by the House Committee on Health and Human Services and the Senate Committee on Public Health and Welfare. Under section 5.1(e) of the Regulatory Review Act, IRRC met on September 12, 2002, and approved the final-form regulations.

Findings

   The Department finds that:

   (1)  Public notice of proposed rulemaking was given under sections 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. §§ 1201 and 1202) and the regulations thereunder in 1 Pa. Code §§ 7.1 and 7.2.

   (2)  A public comment period was provided as required by law and all comments were considered.

   (3)  This final-form rulemaking is necessary and appropriate for the administration of the code.

Order

   The Department, acting under the code, orders that:

   (a)  The regulations of the Department, 55 Pa. Code Chapters 133, 141, 183 and 187, are amended by amending §§ 133.23, 141.21, 141.61, 183.13 and 187.27; and by adding §§ 141.51--141.58 to read as set forth in Annex A, with the ellipses referring to the existing text of the regulations. (Editor's Note: This publication does not include conforming amendments to 55 Pa. Code that were previously published in the Department's final-form rulemaking for the TANF Program which appeared at 32 Pa.B. 4435 (September 14, 2002). Also, the following sections, amended in this document, were not included in the proposal at 32 Pa.B. 431: §§ 141.53--141.58 and 187.27.)

   (b)  The Secretary of the Department has submitted this order and Annex A to the Office of General Counsel and the Office of the Attorney General for review and approval as to legality and form as required by law. The Office of General Counsel and the Office of the Attorney General have approved this order and Annex A as to legality and form.

   (c)  The Secretary of the Department shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.

   (d)  This order shall take effect upon publication in the Pennsylvania Bulletin. Section 141.61(a)(1) is effective March 3, 1997, and § 141.61(c) is effective September 14, 2002.

FEATHER O. HOUSTOUN,   
Secretary

   (Editor's Note: For the text of the order of the Independent Regulatory Review Commission, relating to this document, see 32 Pa.B. 4788 (September 28, 2002).)

   Fiscal Note: Fiscal Note 14-474 remains valid for the final adoption of the subject regulations.

Annex A

TITLE 55.  PUBLIC WELFARE

PART II.  PUBLIC ASSISTANCE MANUAL

Subpart B.  INTAKE AND REDETERMINATION

CHAPTER 133.  REDETERMINING ELIGIBILITY

REDETERMINING ELIGIBILITY PROVISIONS FOR TANF, EXTENDED TANF AND GA

§ 133.23.  Requirements.

*      *      *      *      *

   (b)  Partial redetermination. Partial redetermination procedures are as follows:

   (1)  A partial redetermination is a review that focuses on specific eligibility factors and need and resource items.

   (i)  A partial redetermination is required as frequently as indicated by the budget group circumstances, and is always conducted if previously unreported income is first discovered by a quarterly wage match.

   (ii)  When the partial redetermination focuses on address changes or a change in income or resources, a face-to-face interview is not required if, in the judgment of the worker, the credibility and reliability of the client are such that the client's statements may be accepted. In these instances, the redetermination may be made by telephone or correspondence. If the redetermination is made by telephone or correspondence, verification shall be submitted subsequently by the client.

   (iii)  When the partial redetermination focuses on an eligibility determination for extended TANF, as defined in § 141.52 (relating to definitions), the CAO will update the existing Agreement of Mutual Responsibility (AMR) as defined in § 165.2 (relating to definitions) or complete a new AMR. The redetermination may be conducted by telephone or in a face-to-face interview. If the redetermination is completed by telephone, the CAO will send a copy of the updated or new AMR to the client. The client shall sign and return the AMR to the CAO. The AMR must be received by the CAO within 30 days of the CAO signature on the AMR. If the AMR is not received within 30 days, the client shall be ineligible for extended TANF.

*      *      *      *      *

Subpart C.  ELIGIBILITY REQUIREMENTS

CHAPTER 141.  GENERAL ELIGIBILITY PROVISIONS

ELIGIBILITY PROVISIONS FOR TANF, EXTENDED TANF AND GA

§ 141.21.  Policy.

*      *      *      *      *

   (n)  An applicant or recipient shall cooperate with the CAO in identifying and applying for Federal programs as the primary source of financial assistance, such as, but not limited to, SSI, RSDI, TANF and Extended TANF, in accordance with the following:

   (1)  An applicant for TANF, Extended TANF or GA who fails, without good cause, to cooperate in establishing eligibility for Federal programs is ineligible for cash assistance as follows:

   (i)  For TANF, the applicant is ineligible until the applicant complies.

   (ii)  For GA, the applicant is ineligible for a minimum of 60 days and thereafter, until the applicant complies.

   (iii)  For Extended TANF, the applicant and the applicant's family are ineligible until the applicant complies.

   (iv)  For GA, if the applicant has received 60 months of TANF, the applicant and the applicant's family are ineligible for a minimum of 60 days and thereafter until the applicant complies.

   (2)  A recipient of TANF, Extended TANF or GA who fails, without good cause, to cooperate in establishing eligibility for SSI, RSDI, TANF, Extended TANF or other Federal programs is ineligible for cash assistance until the recipient complies. For Extended TANF and GA, if the recipient has received 60 months of TANF, the recipient's family is also ineligible until the recipient complies.

*      *      *      *      *

ELIGIBILITY PROVISIONS FOR EXTENDED TANF

§ 141.51.  Policy.

   (a)  A family that meets the requirements of Chapter 133, § 141.21 and Chapters 142, 177 and 183 may be eligible for Extended TANF under this chapter.

   (b)  A family otherwise eligible for TANF but for the 60-month time limit on Federally-funded TANF assistance may receive Extended TANF if the eligibility conditions of § 141.53 (relating to eligibility based on domestic violence) are met or the adult head of household or spouse of head of household who received 60 months of TANF meets the requirements of § 141.54, § 141.55 or § 141.56 (relating to maximizing participation project; mandatory RESET participants; and deferred referral).

   (c)  A family may receive extended TANF under more than one section in this chapter. The months during which a family receives Extended TANF need not be sequential.

§ 141.52.  Definitions.

   The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

   Adult--An individual who is 19 years of age or older or who is 18 years of age and not a full-time student in a secondary school or in the equivalent level of vocational or technical training.

   Extended TANF--Federally-funded TANF cash assistance for eligible families in which an adult head of household or spouse of head of household has received 60 cumulative months of TANF assistance.

   MPP--Maximizing Participation Project--As defined in § 281.2 (relating to definitions).

   MPP assessment--An evaluation of medical conditions, functional limitations and good cause situations that may preclude or limit an adult's compliance with RESET.

   MPP service plan--A document developed by the MPP team in consultation with the individual to outline the steps and services necessary to enable the adult to increase self-sufficiency. This may include one or more of the following:

   (i)  Attending English-as-a-Second Language (ESL) classes.

   (ii)  Attending mental health counseling.

   (iii)  Attending general equivalency diploma (GED) classes.

   (iv)  Receiving substance abuse treatment.

   (v)  Compliance with a family service plan or family court recommendations.

   MPP team--A multidisciplinary group consisting of a CAO worker or an agent authorized by the Department and professionals from various disciplines, which may include physicians, psychologists and vocational or behavioral rehabilitation specialists.

   RESET--Road to Economic Self-Sufficiency Through Employment and Training--As defined in § 165.2 (relating to definitions).

   Self-employment--Operating one's own business, trade or profession for profit equal to or greater than the hourly Federal or State minimum wage, whichever is higher.

   Vocational assessment--An evaluation of the factors that impact an individual's ability to perform work, including educational level, employment preferences, work history, skills, abilities and life circumstances.

   WCA--Work capacity assessment--An independent evaluation performed by a contractor, of medical conditions, functional limitations or good cause situations that may preclude or limit an individual's compliance with RESET.

   WPP--Work Plus Program--An employment and training program providing work and work-related activities for at least 30 hours per week for individuals eligible for Extended TANF.

§ 141.53.  Eligibility based on domestic violence.

   (a)  Eligibility. A family may receive Extended TANF if the individual or other family member is or has been a victim of domestic violence, as defined in § 187.22 (relating to definitions) or is at risk of further domestic violence. Eligibility for Extended TANF under this section is subject to the following:

   (1)  Verification of domestic violence not required. No further verification of domestic violence is required if the individual or other family member has met one of the following:

   (i)  A current or past good cause waiver of child support cooperation requirements.

   (ii)  A current or past waiver of RESET requirements under Chapter 165 (relating to Road to Economic Self-Sufficiency Through Employment and Training (RESET)).

   (iii)  Received time-out benefits under Chapter 281 (relating to time-out benefits) based on domestic violence.

   (2)  Verification or self-affirmation of domestic violence required. If the individual is not excused from providing verification of domestic violence under paragraph (1), the individual shall meet one of the following conditions:

   (i)  Provide one of the types of verification specified in § 187.27(b)(1)(iv)--(vi) (relating to waiver of cooperation for good cause).

   (ii)  Affirm in writing that the individual or other family member is at risk of domestic violence and unable to safely obtain other evidence.

   (3)  Completion of form. The CAO and the individual shall complete the Domestic Violence Verification Form under § 187.27(b)(1)(vii), except that the 6-month limitation in § 187.27(b)(1)(vii)(c) does not apply. The perpetrator or alleged perpetrator of the domestic violence is prohibited from completing the Domestic Violence Verification Form.

   (b)  Domestic violence services plan. The individual shall have a domestic violence services plan that meets the requirements of 45 CFR 260.55(c) (relating to what are the additional requirements for Federal recognition of good cause domestic violence waivers).

   (c)  Duration. If otherwise eligible, a family may receive Extended TANF based on domestic violence for as long as necessary.

   (d)  Review of eligibility.

   (1)  Review of eligibility. The CAO will review eligibility for Extended TANF based on domestic violence at least every 6 months.

   (2)  Additional verification. No additional verification of domestic violence is required if circumstances have not changed.

   (e)  Ineligibility. If the individual fails to comply with this section, the family is ineligible for Extended TANF under this section until the individual complies.

   (f)  Other bases for eligibility. A family ineligible for Extended TANF based on domestic violence may be eligible for Extended TANF under § 141.54, § 141.55 or § 141.56 (relating to maximizing participation project; mandatory RESET participants; and deferred referral).

   (g)  Definition. As used in this section, the following word has the following meaning, unless the context clearly indicates otherwise:

   Individual--The adult head of household or spouse of head of household.

§ 141.54.  Maximizing participation project.

   (a)  Eligibility. A family may be eligible for Extended TANF under this section if the individual who has received 60 months of TANF assistance meets the requirements of paragraph (1), (2) or (3). The individual is:

   (1)  Exempt from participation in RESET because the individual is mentally or physically disabled as verified by a physician or licensed psychologist and the disability temporarily or permanently precludes any form of employment or work-related activity.

   (2)  Not exempt from RESET but has good cause for not complying with RESET and referral to MPP, WPP or another employment and training program was deferred under § 141.56(a)(2) (relating to deferred referral).

   (3)  Exempt from participation in RESET because the individual is the parent or specified relative who is providing care for a child under 6 years of age and for whom alternate child care arrangement is unavailable, and referral to MPP, WPP or another employment and training program was deferred under § 141.56(a)(3).

   (b)  Requirements.

   (1)  General. Except as provided in paragraph (2), as a condition of eligibility under this section, the individual shall:

   (i)  Agree on an AMR to enroll in MPP, cooperate in obtaining a WCA, sign and comply with the MPP service plan.

   (ii)  Enroll in MPP, cooperate in obtaining a WCA, sign and comply with the MPP service plan.

   (iii)  Authorize the release of information and cooperate in obtaining information relevant to the WCA, MPP assessment or MPP service plan, whichever applies.

   (2)  Exceptions to WCA requirement.

   (i)  An individual whose current enrollment in MPP began before the individual received 60 months of TANF assistance, or who is grandfathered under this section, as described in subparagraph (ii), may continue in MPP without a WCA if one of the following applies:

   (A)  The individual has received an MPP assessment.

   (B)  The individual has agreed on an AMR to receive an MPP assessment.

   (ii)  An individual is grandfathered under this section if the individual's current enrollment in MPP began before implementation of this section.

   (3)  The WCA.

   (i)  Purpose and scope.

   (A)  The WCA will seek to identify:

   (I)  The nature and extent of medical conditions, functional limitations and good cause situations that preclude or limit the individual from complying with RESET participation requirements.

   (II)  The individual's range of ability to engage in work and work-related activities, with and without appropriate treatment.

   (B)  The WCA will include an evaluation of existing documentation regarding medical conditions and functional limitations. The WCA will also include consideration of previously undiagnosed conditions and limitations.

   (C)  For evaluation of a medical condition or functional limitations, the WCA will require an examination of the individual. For evaluation of a good cause situation, the WCA may require an examination of the individual if necessary and relevant to the determination of the good cause situation.

   (D)  The WCA may include additional testing as needed to facilitate diagnosis and appropriate treatment recommendations.

   (E)  The findings and recommendations of the WCA will be provided to the MPP team.

   (ii)  Standards for review of medical conditions and functional limitations.

   (A)  If the individual has a medical condition or functional limitation that precludes or limits compliance with RESET, the WCA will be conducted based upon accepted medical standards for the evaluation of impairments, using a standard framework and method of analysis.

   (B)  The standard framework and method of analysis used for the evaluation of temporary and permanent impairments will be the most recent edition of the American Medical Association, ''Guides to the Evaluation of Permanent Impairment.''

   (iii)  Evidence of medical conditions and functional limitations.

   (A)  Existing documentation. The individual shall obtain existing documentation regarding medical conditions and functional limitations that may preclude or limit compliance with RESET, including available records of the treating physician and psychologist. If necessary, the Department or its agent will assist the individual in obtaining existing documentation.

   (B)  Treating physician opinions. The WCA will include consideration of available opinions of the treating physician.

   (4)  Results of the WCA or MPP assessment.

   (i)  If the results of the WCA or MPP assessment reveal a medical condition, functional limitation or good cause situation that precludes the individual from complying with RESET, the MPP team will develop an MPP service plan in consultation with the individual.

   (ii)  If the results of the WCA or MPP assessment do not reveal a medical condition, functional limitation or good cause situation that precludes the individual from complying with RESET, the individual will be referred to an appropriate employment and training activity. If the results indicate that there is a medical condition, functional limitation or good cause situation that limits but does not preclude the individual's ability to participate in RESET, the relevant WCA findings and recommendations will be provided with the referral.

   (iii)  An individual who disagrees with the findings or recommendations of the WCA may request a second opinion WCA.

   (c)  Ineligibility. If the individual fails to comply with this section, the family is ineligible for Extended TANF under this section until the individual complies.

   (d)  Definition. As used in this section, the following word has the following meaning, unless the context clearly indicates otherwise:

   Individual--The adult head of household or spouse of head of household.

§ 141.55.  Mandatory RESET participants.

   (a)  General. A family may qualify for Extended TANF under this section if the individual who has received 60 months of TANF meets the requirements of this section, as follows:

   (1)  Employed 30 or more hours per week. If the individual is employed at least 30 hours per week in unsubsidized employment, including self-employment, no additional work or work activity is required. The individual may volunteer for employment and training programs that are designed to increase the individual's earning capacity.

   (2)  Participating in an employment and training program. The individual is continuing participation in an employment and training program approved on an AMR while the individual was receiving TANF.

   (3)  Employed 20--29 hours per week. An individual who is employed 20--29 hours per week in unsubsidized employment, including self-employment, shall maintain employment. Except as specified in paragraph (6), the individual shall also enroll and participate in a job retention and advancement program, funded or approved by the Department, to bring the combined total number of hours to at least 30 hours per week.

   (4)  Employed less than 20 hours per week. An individual who is employed less than 20 hours per week in unsubsidized employment shall maintain employment. Except as specified in paragraph (6), the individual shall also enroll and participate in WPP, to bring the combined total number of hours to at least 30 hours per week.

   (5)  Not employed. Except as specified in paragraph (6), an individual who is not employed in unsubsidized employment shall enroll and participate in WPP for at least 30 hours per week.

   (6)  Special good cause provision. If the individual establishes good cause for not participating in at least 30 hours per week of combined work and work-related activities but is required to comply with RESET, the following rules apply:

   (i)  If the individual is employed 20--29 hours per week in unsubsidized employment, the individual shall maintain employment.

   (ii)  If the individual is employed less than 20 hours per week in unsubsidized employment, the individual shall maintain employment. The individual shall also agree on an AMR to comply with RESET by participating in WPP for a combined total of at least 20 hours per week.

   (iii)  If the individual is not employed in unsubsidized employment, the individual shall agree on an AMR to comply with RESET by participating in WPP for at least 20 hours per week.

   (iv)  The individual who establishes good cause for not participating in at least 30 hours per week of combined work and work-related activities shall also agree on an AMR to address the good cause situation. The AMR will set forth the steps the individual shall undertake to address the good cause situation including cooperation with a WPP contractor.

   (b)  WPP.

   (1)  An individual enrolled in WPP shall cooperate in obtaining a vocational assessment, performed by an employment and training contractor.

   (2)  If the results of the vocational assessment indicate that the individual is not precluded from complying with RESET, the individual shall participate a minimum of 30 hours per week in a combination of work and work-related activities, in accordance with the Fair Labor Standards Act (29 U.S.C.A. §§ 201--219). Work-related activities may include English-as-a-Second Language (ESL) classes. If the individual establishes good cause for not participating in at least 30 hours per week of work and work-related activities, the individual shall comply with RESET in accordance with subsection (a)(6).

   (3)  If the results of the vocational assessment reveal a medical condition, functional limitation or good cause situation that precludes the individual from complying with RESET requirements, the individual shall be referred to MPP.

   (4)  If the results of the vocational assessment indicate that the individual is not precluded from complying with RESET but, because of disability, needs a reasonable accommodation of program rules and requirements, that accommodation shall be made, in accordance with Title II of the Americans With Disabilities Act (42 U.S.C.A. §§ 12131--12165). Findings and recommendations provided with a referral from MPP will be considered in providing accommodation.

   (c)  Sanctions. If the individual fails to comply with § 141.55 (relating to mandatory RESET participants), a compliance review is conducted in accordance with § 165.51 (relating to compliance review). If the individual willfully fails, without good cause, as described in § 165.52 (relating to good cause), to comply with § 141.55, a sanction is imposed on the budget group under § 165.61 (relating to sanctions).

   (d)  Definition. As used in this section, the following word has the following meaning, unless the context clearly indicates otherwise:

   Individual--The adult head of household or spouse of head of household.

§ 141.56.  Deferred referral.

   (a)  General. A family may qualify for Extended TANF if the individual meets one of the eligibility criteria of paragraphs (1)--(4) and complies with an AMR. The individual is:

   (1)  A parent in a one-parent household who is caring for a child who has not attained the age of 12 months and the parent is exempt from RESET under § 165.21(c)(4) (relating to exemptions from RESET participation requirements).

   (2)  Caring for a disabled child or adult for whom appropriate care is unavailable within a reasonable distance from home or otherwise establishes good cause for not complying with RESET under § 165.52 (relating to good cause).

   (3)  The parent or specified relative who is providing care for a child under 6 years of age and for whom alternate child care arrangement is unavailable.

   (4)  In the process of a compliance review under § 165.51 (relating to compliance review) or receiving TANF assistance pending timely appeal under § 275.4(a)(3)(v)(c)(i) (relating to procedures).

   (b)  Redetermination.

   (1)  The CAO will redetermine eligibility under subsection (a)(1) every 6 months or on the date the 12-month limit on the parent's exemption from RESET under § 165.21(c)(4) expires, whichever is sooner.

   (2)  Except for eligibility under subsection (a)(1), the CAO will determine eligibility under this section when circumstances change and no less often than every 90 days.

   (c)  Outcome of redetermination.

   (1)  If circumstances have changed so that the family no longer meets the requirements of subsection (a), the CAO will determine if the family is otherwise eligible for extended TANF under § 141.53, § 141.54 or § 141.55 (relating to eligibility due to domestic violence; maximizing participation project; and mandatory RESET participants).

   (2)  If circumstances have not changed, the CAO will refer the individual to MPP unless the basis for deferred referral is expected to be resolved in less than 90 days from the date of redetermination.

   (d)  Definition. As used in this section, the following word has the meaning, unless the context clearly indicates otherwise:

   Individual--The adult head of household or spouse of head of household.

§ 141.57.  Special allowances.

   (a)  An individual who receives Extended TANF as specified in §§ 141.53--141.55 (relating to eligibility based on domestic violence; maximizing participation project; and mandatory RESET participants) may receive special allowances under § 165.41 (relating to eligibility for special allowances for supportive services).

   (b)  An individual who is eligible for Extended TANF may receive special allowances, including allowances for child care and transportation necessary to enable the individual to participate in programs and activities that are part of the individual's MPP service plan, domestic violence services plan or employment and training activities listed on the AMR.

§ 141.58.  Appeal rights.

   An individual may appeal the denial or termination of Extended TANF under Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings).

ELIGIBILITY PROVISIONS FOR GA

§ 141.61.  Policy.

   (a)  Conditions of eligibility. The following relates to eligibility for GA:

   (1)  A person is eligible for GA under the requirements established in subsection (d) and if the appropriate eligibility conditions in the following chapters are met:

*      *      *      *      *

   (xii)  Furthermore, eligibility for GA requires that the person be ineligible for TANF and Extended TANF because of failure to meet TANF and Extended TANF definitive conditions. An applicant or recipient who does not qualify for TANF or Extended TANF solely because of a refusal or failure, without good cause, to establish eligibility for TANF or Extended TANF is ineligible for GA. A person meeting definitive conditions but ineligible for TANF because of income, resources or participation in a strike is not eligible for GA. A person who refuses without good cause to cooperate in establishing paternity or support as required in the TANF or Extended TANF program is ineligible for GA. A family in which an adult refuses or fails, without good cause, to cooperate in establishing and maintaining eligibility for Extended TANF as provided in §§ 141.53--141.56 is also ineligible for GA.

*      *      *      *      *

   (b)  Social Security number required. A Social Security number is required for each family member for whom assistance is to be granted or is being received. If a Social Security number is needed and no application has been made, it is the responsibility of the CAO to complete and submit the SSA-5 application form.

   (c)  Determining GA categorical eligibility. An applicant for, or recipient of, GA is determined to be eligible in accordance with the following:

*      *      *      *      *

Subpart D.  DETERMINATION OF NEED AND AMOUNT OF ASSISTANCE

CHAPTER 183.  INCOME

INCOME

§ 183.13.  Potential sources.

*      *      *      *      *

   (b)  A recipient of TANF, Extended TANF or GA who fails, without good cause, to cooperate in establishing and maintaining eligibility for SSI, RSDI, TANF, Extended TANF or other Federal programs is ineligible for cash assistance until the recipient complies. For Extended TANF and GA, if the recipient has received 60 months of TANF, the recipient's family is also ineligible until the recipient complies.

   (c)  An applicant for TANF, Extended TANF or GA who fails, without good cause, to cooperate in establishing eligibility for Federal programs is ineligible for cash assistance as follows:

   (1)  For TANF or Extended TANF, the applicant is ineligible until the applicant complies.

   (2)  For GA, the applicant is ineligible for a minimum of 60 days and thereafter, until the applicant complies.

   (3)  For Extended TANF, the applicant and the applicant's family are also ineligible until the applicant complies.

   (4)  For GA, if the applicant has received 60 months of TANF, the applicant and the applicant's family are ineligible for a minimum of 60 days and thereafter until the applicant complies.

   (d)  An individual who is eligible for TANF or Extended TANF and SSI may choose to receive a benefit from one of these programs. The individual may not receive SSI and TANF or Extended TANF simultaneously.

CHAPTER 187.  SUPPORT FROM RELATIVES NOT LIVING WITH THE CLIENT

SUPPORT PROVISIONS FOR CASH ASSISTANCE

§ 187.27.  Waiver of cooperation for good cause.

   (a)  Good cause circumstances. Cooperation requirements may be waived for good cause. Good cause circumstances include the following:

   (1)  The child was conceived as a result of incest or rape.

   (2)  Legal proceedings for the adoption of the child are pending before a court.

   (3)  The applicant or recipient of cash assistance is currently being assisted by a public or licensed private social agency to resolve the issue of whether to keep the child or relinquish the child for adoption and the discussions have not progressed for more than 3 months.

   (4)  Action to establish paternity or obtain child or spousal support would make it more difficult for the individual or family member to escape domestic violence, as defined in § 187.22 (relating to definitions), or unfairly penalize the individual who has been victimized by the violence, or who is at risk of further violence.

   (b)  Proving the good cause claim. The applicant or recipient of cash assistance shall provide relevant verification.

   (1)  A good cause claim may be verified with the following types of evidence:

   (i)  A birth certificate or medical or law enforcement records which indicate that the child was conceived as the result of incest or rape.

   (ii)  Court documents or other records which indicate that legal proceedings for adoption are pending.

   (iii)  A written statement from a public or licensed private social agency that the applicant or recipient is being assisted by the agency to resolve the issue of whether to relinquish the child for adoption.

   (iv)  Medical records which indicate emotional health history and present emotional health status of the applicant or recipient or the child for whom support would be sought; or, written statements from a mental health professional indicating a diagnosis or prognosis concerning the emotional health of the applicant or recipient or the child for whom support would be sought. Supportive evidence submitted from a mental health professional will be defined as statements written by individuals who have obtained licensure or certification, if applicable, or have received a degree in defined areas of mental health including psychiatry, social work, psychology, nursing, occupational therapy or recreational therapy.

   (v)  Court, medical, criminal, child protective services, social services, psychological or law enforcement records which verify domestic violence, as defined in § 187.22.

   (vi)  Statements from individuals other than the applicant or recipient with knowledge of the good cause circumstances, including a domestic violence service provider, a medical, psychological or social service provider, a law enforcement professional, a legal representative, an acquaintance, friend, relative or neighbor of the claimant or other individual.

   (vii)  Domestic Violence Verification Form. The CAO and applicant or recipient will complete this form for all good cause claims based on domestic violence in accordance with one of the following circumstances:

   (A)  To accompany acceptable verification as specified in subparagraph (iv), (v) or (vi) that an applicant or recipient has provided.

   (B)  To grant good cause upon written consent of the applicant or recipient based on verification of the good cause claim provided by a third party on the form.

   (C)  To grant good cause for up to 6 months when an applicant or recipient affirms she is at risk of domestic violence and unable to safely obtain other evidence to verify the claim of domestic violence within the established time frames for providing verification.

   (2)  When the applicant or recipient of cash assistance initiates a claim of good cause, the CAO, court or the DRS may provide assistance with obtaining verification. If requested by the applicant or recipient, the CAO, court or DRS will provide assistance in securing the needed evidence by advising how to obtain specific documents that may be available and by undertaking to obtain specific documents the applicant or recipient is not able to obtain. The CAO may not contact the putative father or noncustodial parent to verify good cause based on a claim of domestic violence.

   (3)  An applicant or recipient shall provide verification of the good cause claim, as specified under paragraph (1)(iv)--(vii)(A) and (B), within 30 days from the date the claim is made, except when the applicant or recipient cannot otherwise provide verification of the good cause claim as specified in paragraph (1)(vii)(C).

   (i)  In the case of an applicant, assistance will be authorized no later than 30 days following application when the applicant is claiming good cause and verification is not readily available or pending from a third party.

   (ii)  In the case of a recipient, the CAO will continue assistance if verification is not provided within 30 days and the delay is due to a third party.

   (c)  Good cause determination. The CAO, court or the DRS will make a determination within 45 days from the day the claim was initiated by the applicant or recipient of cash assistance. The CAO, court or the DRS may approve additional days for the determination to be completed.

   (1)  If the CAO makes a determination on a good cause claim, the CAO will notify the applicant or recipient of cash assistance in writing of the final determination regarding the claim of good cause and the basis therefor and of the right to appeal under Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings). If the good cause claim is denied, neither the Department nor the Bureau of Child Support Enforcement will attempt to establish paternity or obtain support for at least 30 days after the individual has been informed orally and in writing of the denial of the good cause claim.

   (2)  If the court of common pleas or DRS makes a determination on a good cause claim, the DRS will notify the applicant or recipient of cash assistance and the CAO of the final determination and the basis therefor and of the right to appeal under Chapter 275.

   (3)  When the CAO, court of common pleas or the DRS approve a waiver of the cooperation requirement based on a claim of good cause, the DRS will not attempt to establish paternity or obtain support.

   (4)  When good cause is determined to exist, the CAO will review the circumstances upon which the good cause determination is based, at least every 6 months.

   (i)  If the good cause waiver was granted based on verification, no additional verification is required if circumstances have not changed since approval of the initial waiver.

   (ii)  If the good cause waiver was granted based on the recipient's affirmation under subsection (b)(1)(vii)(C), andshe is unable to provide verification as specified in subsection (b)(1)(iv)--(vii)(A) and (B), the CAO will make a determination of good cause based on a current assessment of the recipient's circumstances. This assessment will be completed by an individual with domestic violence training and substantiated by completion of the verification of good cause based on the domestic violence form under subsection (b)(1)(vii).

[Pa.B. Doc. No. 02-1773. Filed for public inspection October 11, 2002, 9:00 a.m.]



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