C.M.R. 10, 144, ch. 311, IV

Current through 2024-51, December 18, 2024

Chapter IV - PROCEDURAL STEPS

STEP 1: The SAU social worker, DES/WIN interviewer and the client assess the client's situation and jointly agree on the social service plan and vocational plan. The goals, barriers and WIN services needed by the client as identified and requested on MA 5-96.

A. Case not being opened

1. SAU worker submits SWSS-083

2. SAU worker submits SWSS-085

3. Send to terminal operators

4. One copy SWSS-083 and SWSS-085 filed

B. To open case

1. SAU worker opens case on SWSS-083

2. SAU worker submits SWSS-085 to terminal operator

C. One copy SWSS-083 and one copy SWSS-085 is returned to file.

D. Worker records narrative in case record activities which have taken place

STEP 2: If certification is requested:

A. ES submits MA 5-96

B. SAU worker arranges for necessary supportive service and returns one copy of MA 5-96 to WIN. One is retained in client's file.

C. If services cannot be arranged for/provided within 30 days worker return MA 5-96 to WIN as not certified.

D. Worker records activity in case record; if services cannot be provided SAU worker closes service case and so notifies terminal operator.

STEP 3: Provision of services

A. Child care - SAU worker utilizes regional procedures and forms.

1. Billing

a. In-home child care bills are submitted on SWWN-002

b. All child care bills are submitted to Central Office WIN account clerk before being sent to Accounting Services

B. Remedial medical

1. Dental Work and Billing Procedures

a. Primary authorization for diagnosis including prophylaxis and scaling; estimate of recommended work to be sent to SAU

b. SAU will validate cost against State dental fee schedule

c. If estimate less than $150 SAU authorizes according to State dental fee schedule, if any question re: need, however, consult established Dental Consultant

d. If prior approval is needed send with X-rays and diagram to Dental Consultant

e. Dental Consultant will return these to Central-Office Manager, WIN program who will send to SAU Manager in appropriate region

f Regional Manager will assume or delegate responsibility for seeing that work is authorized according to decision of Dental Consultant

g Workers will instruct dentists to return bills (G-49) to local office. Manager will assume responsibility for seeing that final bill submitted is in accord with what was authorized according to Dental Consultant

h Manager will then send validated bill to WIN account clerk

i In cases where prior approval was not needed (under $150) WIN account clerk will validate bill according to Title XIX fee scale.

2. Eye Care

Title XIX guidelines will be followed for eye care and eyeglasses. hills will be submitted to WIN Coordinator for prior approval.

STEP 4: "No Show Policy"

A. In those instances where a WIN mandatory registrant fails to keep an appraisal interview appointment without notification to ES or SAU of his intent:

1. ES will send a certified letter making another appointment, with a copy to SAU/WIN

2. It will then be the responsibility of SAU/WIN to personally contact the registrant within 10 working days to explain the program, the registrant's rights and obligation, and determine if there is "good cause" or reasonable doubt as to why the registrant cannot participate

3. SAU will communicate results of their contact to ES and to IMU if registrant claims exemption. The client will also be advised by SAU to personally contact IMU worker with exemption request.

4. ES will make the final determination as to whether or not to pursue appraisal further for those mandatory registrants who have no valid exemption claim.

B. If the decision is to continue:

1. ES will send a second certified letter offering another appointment

2. If the mandatory registrant again fails to respond, ES will so notify the SAU who will then submit the information to IMU on SWWN-025

3. IMU will then proceed according to policy

4. SAU will "track" these persons and report to ES the action taken by IMU

C. In recognition of the fact that there are those individuals who are not psychologically ready to take the first step from dependency to self sufficiency, it is recommended that, where possible, counseling services he offered by Human Services at 75-25 matching and these persons be returned to the registrant pool for a stated period of time during which the counseling will take place. SAU staff will coordinate the receipt of this service when available.

If the individual refuses counseling IMU will be so notified by SAU. If counseling is accepted and at the end of the counseling period the mandatory registrant still refuses to participate without good cause IMU will he so notified. This is not to be confused With the 60-day counseling period provided to participants who have been certified.

STEP 5: Duration of Supportive Services

A Duration of WIN Supportive Services, DES/WIN Status Change Notice WIN supportive services may be continued as long as the individual is active in the WIN program. The individual is considered active throughout the direct job-entry period which was shortened to 30 days.

If a WIN participant is placed in On The Job Training or Public Service Employment supportive services shall continue for a period of 30 days after the start of subsidized employment and may continue for an additional 60 days at the discretion of the SAU. Such services may continue during this time even after the grant has been discontinued due to income earned from such employment. No supportive services may be provided to the individual when the OJT or PSE enrollment ends and the employment becomes unsubsidized.

If an individual requests a service which he or she feels is necessary in order to participate in the employment plan and the service is denied, the individual shall be advised of his right of appeal under the Department's Fair Hearing procedures. The SAU worker shall offer to assist the individual in filing the appeal. The employment plan will not be implemented until the issue has been ruled on by the Commissioner's office.

B. DES/WIN Status Change Notice

The Welfare Department is officially notified of the individual's entry into participant status in the WIN program on the STATUS CHANGE FORM (MA 5-97). This notice additionally specifies the program component the individual has entered, such as On-The-Job (OJT). Whenever the participant moves from one component, such as OJT, into another such as Job-Entry period, the Status Change Notice is sent. It is sent by the DES/WIN team to the SAU with one copy to IMU.

C.M.R. 10, 144, ch. 311, IV