Section 144-607-14 - SUPPORT SERVICE BENEFITS AND PAYMENT PROVISIONSSummary: This section describes support service benefits provided to enable participants to complete the Family Contract Amendment and provisions for payment by ASPIRE-TANF.
I.GENERAL PROVISIONSA. Support service benefits such as child care, transportation and other services directly related to education, training, job search, work component activities and employment services are necessary for participants to complete the Family Contract Amendment and obtain employment.B. ASPIRE-TANF will provide funding for support services which are necessary to complete the Family Contract Amendment, including any assessments, only when funding for such services is not available from other sources, and only as long as ASPIRE-TANF funding is available for needed services.C. ASPIRE-TANF will provide support service benefits for the least expensive service providing that service is of acceptable quality as determined by ASPIRE-TANF.D. The participant will be responsible and accountable for the appropriate use of service benefits as outlined in the Family Contract Amendment. Any documented and substantiated misuse of service benefits, purchased goods and/or services by a participant will be grounds for the termination of a current Family Contract Amendment, and repayment or other suitable recovery procedure will be instituted unless there is Good Cause. (Refer to Section 4, VII. for Overpayment Procedures).E. The amount for support service benefits will be limited. Specific caps on support services are included in their descriptions in Section 14. II.F. The term "period of enrollment" used in this chapter is defined as that period beginning with the opening of activity with the ASPIRE-TANF program, until participation with ASPIRE-TANF is ended (unless closure is due to a sanction).G. When payment is made directly to a participant for a support service, a paid receipt must be provided to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established (Refer to Section 4, VII. for Overpayment Procedures.). Mileage reimbursement is excluded from this requirement. II.SUPPORT SERVICE BENEFITS, PAYMENT PROVISIONS AND PROCEDURESA.Childcar.ASPIRE-TANF will provide a (TANF) benefit for childcare (exception: see number 6 below) for children who are included on the TANF grant and who are under the age of thirteen (13); or physically or mentally incapable of caring for themselves (as certified by a physician or licensed psychologist); or under court supervision; or who would be dependent except for the receipt of Supplemental Security Income or because they are in foster care. A (TANF) benefit for childcare may be provided for a participant to complete the Assessment or to complete the requirements of a Family Contract Amendment. ASPIRE-TANF, in situations that are not included above but are recognized to exist and are authorized by regional ASPIRE-TANF management, will provide a (TANF) benefit for childcare when it is required for a participant to complete the requirements of a Family Contract Amendment.
No participant will be required to engage in ASPIRE-TANF activities unless that person has suitable child care. ASPIRE-TANF will expect the participant to choose the children's care arrangements, but will help participants who need assistance in securing child care. ASPIRE-TANF must approve child care providers who are not licensed or registered by the State prior to making payment. All adults living in or frequenting the location the child care is to be provided must be approved. Such approval will consist, at a minimum, of a check for prior or present involvement with child protective services, and other approval processes (such as a home visit or Department of Motor Vehicle and State Bureau of Identification checks) as may be deemed necessary on a case-by-case basis. Other provisions pertaining to child care are as follows:
1. ASPIRE-TANF will provide a (TANF) benefit for child care at a rate equal to the actual cost or child care Market Rate cap, set by the Department's Office of Child and Family Services, Early Childhood Division, whichever is less.2. Market Rate Cap charts are available through OFI offices.3. ASPIRE-TANF will provide a benefit for child care in excess of the Market Rate Cap for special needs children on a case-by-case basis.4. ASPIRE-TANF will not provide a quality stipend for children enrolled in centers or homes participating in the Maine Child Care Quality Rating System.5. ASPIRE-TANF will not provide child care benefits to providers who are living in the participant's household. (Exceptions may be made with supervisory approval when it is determined this service is necessary for a participant to comply with his or her Family Contract Amendment.)6. ASPIRE-TANF will not provide a child care benefit to a participant who is receiving a child care deduction in the determination of the TANF grant amount. ASPIRE-TANF will discuss with the participant the options, to determine the best course of action, as to whether ASPIRE-TANF will provide a child care benefit or the participant will use the child care disregard in the computation of the participant's TANF benefit. ASPIRE-TANF can pay the cost of child care that exceeds the TANF child care disregard, if this is in the best interests of the participant and the ASPIRE-TANF program.B.Transportation - ASPIRE-TANF will pay for the reasonable cost of transportation necessary for the participant to engage in scheduled activities prescribed in the Family Contract Amendment. Transportation reimbursement is limited to forty-five cents per mile ($.45) and a weekly cap of one hundred and forty dollars ($140). (Exception: ASPIRE participants who are disabled and who operate their own personal wheelchair lift or other specially-equipped vehicle during the course of participating in activities outlined in the Family Contract Amendment may receive a mileage reimbursement rate of fifty-five cents per mile ($.55). The following provisions apply:
1. ASPIRE-TANF will pay for the least expensive mode of transportation that will effectively enable the participant to engage in activities required for ASPIRE-TANF engagement or prescribed in the Family Contract Amendment. ASPIRE-TANF will make the final determination regarding mode of transportation after considering such factors as scheduling of Family Contract Amendment activities. The selected transportation mode(s) will be defined in the Family Contract Amendment.2. Payment for public transportation services, where reasonably available, will be provided via ASPIRE-TANF ticket purchases.3. Car pool drivers will be reimbursed for the most direct route, including stops at child care providers, at the rate of $.45 cents per mile plus $2.00 per day per ASPIRE-TANF participant transported (excluding the driver).4. Taxi fare will be paid, but only as a temporary measure while more permanent and less expensive transportation modes are secured, unless it proves to be the least expensive mode of transportation.5. ASPIRE-TANF will reimburse a properly licensed participant using a properly registered private vehicle at the rate of $.45 cents per mile for the most direct routes to and from activities required for ASPIRE-TANF engagement or are prescribed in the Family Contract Amendment including trips to a child-care provider. Other provisions regarding use of a private vehicle are as follows: The $.45 cents per mile shall be used to cover all costs of maintaining the vehicle including gasoline, maintenance and repairs, license and registration fees, insurance, tows and parking fees.
C.Auto Repairs - In addition to reimbursing $.45 cents per mile, ASPIRE-TANF will pay a maximum of $1,000 per participantper calendar year on the vehicle used by the participant while engaged in activities as specified in the current Family Contract Amendment. Under no circumstances will any part of the $1,000 carry-over from one calendar year to another - any unused portion will lapse at the end of each calendar year. The vehicle's value, overall mechanical condition and other pertinent factors will be used by the case manager to determine whether payment for vehicle repairs is warranted.1. ASPIRE-TANF will only pay repairs on a vehicle that is registered to either the participant, the participant's spouse, or a TANF parent or specified relative who resides in the home and would be included in the TANF grant if otherwise eligible who has a valid license to operate a motor vehicle in Maine.2. Repair costs shall be approved in advance of the actual service except in the case of an emergency which may be approved by ASPIRE-TANF following the emergency. The participant will be required to provide to ASPIRE-TANF an estimate and evidence of the need for the repair signed by a licensed inspection mechanic. The actual repair may be performed by a qualified person of the participant's choice.3. In an emergency when a repair and/or tow is needed in order to make the vehicle functional, and ASPIRE-TANF cannot be reached for approval, the participant may have such repairs performed and request approval from ASPIRE-TANF within one week.4. Payment of approved repair costs to a vendor will be made only following submission of an itemized, original bill. When payment is made to a participant, a paid receipt must be returned to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established. (Refer to Section 4, VII. for Overpayment Procedures.)D.Auto Liability Insurance - ASPIRE-TANF will pay the cost of the minimum liability insurance required by Maine law up to a maximum of $600 per calendar year, commencing with paid mileage necessary to complete the Family Contract Amendment, for a vehicle registered to and solely operated by the participant. The participant must have a valid license to operate a motor vehicle in Maine. In instances where a vehicle used by the participant is co-registered with another person or used by another person, ASPIRE-TANF will only pay that portion of the premium which is attributable to the participant. ASPIRE-TANF will pay premiums in the most cost-effective manner possible, but will not pay premiums for extended periods when the participant is not actively engaged in prescribed Family Contract Amendment activities. When payment is made to a participant for auto liability insurance, a paid receipt must be provided to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established. (Refer to Section 4, VII. for Overpayment Procedures.)E.Eye Care - With prior approval, ASPIRE-TANF will pay the cost of eye care which is not covered by MaineCare or other sources and which is necessary for the participant to complete the Family Contract Amendment. Payment for eye care appliances will be for the least expensive quality option to correct the deficiency and will not exceed $200 per calendar year. If a participant has a special vision condition requiring special lenses this rate may be exceeded to cover the least expensive quality option necessary to correct the condition upon verification of the need and cost in writing from an optometrist or ophthalmologist. When payment is made to a participant for eye care, a paid receipt must be provided to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established. (Refer to Section 4, VII. for Overpayment Procedures.)F.Dental Care - ASPIRE-TANF will pay the cost of dental care that is not covered by MaineCare and that is necessary to alleviate pain, or for the participant to be able to obtain employment. These payments will conform to MaineCare rates where such a rate is scheduled. If there is not a scheduled MaineCare rate, ASPIRE-TANF will pay for the least expensive quality dental service necessary to correct the condition upon receipt of verification of cost and need in writing from a dentist. ASPIRE-TANF will not pay for orthodontics. Dental care reimbursement is limited to $2,000 per participant for the period of enrollment. Dental Care shall be paid directly to the vendor providing dental services. (Refer to Section 4, VII. for Overpayment Procedures.)G.Education and Training Expenses - ASPIRE-TANF will not provide funding for tuition and mandatory fees at a post-secondary institution unless: 1. The participant is unable to secure other educational funding needed to complete the participant's Family Contract Amendment due to: a. Poor credit as determined by the educational funding source; or b. The consideration by the educational funding source of resources from past years that are not actually available to the participant; or2. In the determination of the case manager, failure to pay the tuition or fees would result in higher ASPIRE-TANF Program costs to achieve the participant's approved goal; or3. In the determination of the ASPIRE-TANF Program Manager, failure to pay tuition or fees would otherwise be a substantial barrier to the participant obtaining his or her employment goal.4. When ASPIRE-TANF pays for these items a limit of up to $3,500 per academic year for tuition and mandatory fees is in effect.5. Education and training expenses shall be paid directly to the vendor providing education and training services.H.Books and Supplies - ASPIRE-TANF will provide up to $1000 per academic year for required books and supplies, to the extent that the student does not have non-repayable financial aid (scholarships; grants) which, after paying tuition and fees, would be available to pay for books and supplies. Required books and supplies are books and supplies mandatory for everyone in the class. When payment is made to a participant for required books and supplies, a paid receipt must be provided to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established. (Refer to Section 4, VII. for Overpayment Procedures.) I.Clothing and Uniform. - ASPIRE-TANF will pay for clothing and uniforms in accordance with the following conditions providing prior approval is given and items have not already been purchased as part of training and financial aid funds: 1. Clothing required for performance of an occupation and/or to train for that occupation including uniforms, special work shoes or boots, gloves, etc.2. Clothing not specifically required for the occupation, but necessary for maintaining appropriate appearance in order to seek or maintain employment. ASPIRE will determine appropriate clothing to seek or maintain employment based on the participant's employment goals and Family Contract Amendment activities. 3. Emergency clothing necessary to meet the participant's immediate needs such as a winter coat.4. Clothing and uniform reimbursement are limited to $300 per calendar year.5. When payment is made to a participant for clothing and uniforms, a paid receipt must be provided to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established. (Refer to Section 4, VII. for Overpayment Procedures.)J.Occupational Expenses - ASPIRE-TANF will pay for tools and equipment necessary for the participant to perform an occupation (when the employer requires all employees to have such equipment and the employer does not purchase such equipment for any of these employees), or for material and equipment for a participant with an ASPIRE-TANF approved self-employment plan or occupational-related expenses such as licensing and certification fees, examination fees, etc. Occupational expenses are limited to $500 per period of enrollment. When payment is made to a participant for occupational expenses, a paid receipt must be provided to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established. (Refer to Section 4, VII. for Overpayment Procedures.)K.Relocation Costs - When it is necessary for the participant to relocate in order to participate in education or training or take employment which is part of the Family Contract Amendment but is not available in the area in which the participant resides, and the commutation to the education or training program or employment would be impractical due to excessive distance or other transportation difficulties, ASPIRE-TANF will pay costs of relocation up to a maximum of $500 per period of enrollment. Included in this amount may be travel at the rate of $.4 5 per mile, cost of transporting household goods, and any portion of the first month's rent which exceeds the monthly rent or mortgage the participant has been paying in her most recent housing arrangement, and any portion of a security deposit which exceeds the deposit returned from the most recent rent. When payment is made to a participant for relocation costs, a paid receipt must be provided to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established. (Refer to Section 4, VII. for Overpayment Procedures.) L.Job Development - ASPIRE-TANF may pay for job development services (on a fee-for-service basis) not to exceed $800 per period of enrollment. See Section 12. II.D.1. for further information. This service cap does not apply to payments included in a statewide ASPIRE contract that provides job development services. M.Job Placement and Retention - ASPIRE-TANF will pay (on a fee-for-service basis) up to $500 per period of enrollment for job placement and retention services. See Section 12. II.D.2. for further information on this. This service cap does not apply when a statewide contracted operator is providing job development services statewide to ASPIRE participants. N.Vocational Evaluation and Related Services - ASPIRE-TANF will pay (on a fee-for-service basis) up to $2500 per calendar year per participant for a comprehensive vocational evaluation and services (such as an evaluation of physical/mental health issues that impact on employability) required as a result of the evaluation, in order to assist participants in becoming self-supporting. This is targeted to those participants who have been determined to have, or are suspected of having, multiple barriers to becoming employed, but can apply to any participant or group of participants in need of services unavailable through the Department of Health and Human Services or its designated contractor or agent. The hourly rate paid for these services should correspond as much as possible to rates paid by other State agencies for similar services, but it is not to exceed $75 per hour.O.Other - If ASPIRE-TANF determines that the participant has other support service needs which are not otherwise specifically mentioned in this Section, but are necessary for the participant to complete the Family Contract Amendment, it may pay for the least expensive quality service necessary to meet the need, if the service cost cannot be paid from another source. "Other" support services are limited to $500 per calendar year. When payment is made to a participant for other necessary expenses, a paid receipt must be provided to ASPIRE within two calendar weeks of the receipt of the benefit. If no receipt is provided or the amount on the receipt is less than the support service benefit, an overpayment will be established. (Refer to Section 4, VII. for Overpayment Procedures.) P.Return of Purchased Goods - A participant who does not complete an education or training program, or who does not take employment for which books, tools or other materials or equipment have been purchased by ASPIRE-TANF must return those items to ASPIRE-TANF, if they can be used by other participants. Personal items such as dentures, eye glasses and clothing need not be returned.III.EMPLOYMENT SUPPORT SERVICES Support Services may be available anytime a Family Contract Amendment is active. Once a participant is determined to be ineligible for TANF due to income from employment, transitional services may be utilized in place of child care and transportation support services, as soon as they become available to the participant.
IV.PROMPTNESS OF PAYMENT OF SUPPORT SERVICES Participants should be paid or reimbursed promptly by ASPIRE-TANF in order that the Family Contract Amendment is not unnecessarily interrupted. However, bills submitted more than 30 days after the service was provided will not have as high a priority, and may take longer to get paid, than those submitted within 30 days of the date of service. ASPIRE-TANF will assure promptness of payment as follows:
Participants submitting bills to ASPIRE-TANF for payment will be issued payment no later than fifteen (15) working days following the receipt of the bill at the ASPIRE-TANF office. This time limit applies to bills which do not contain errors. Payment for bills containing errors will be issued no later than fifteen (15) working days from the date the corrected bill is received by the regional ASPIRE-TANF office.
The Department of Health and Human Services, Office for Family Independence (OFI) will ensure that entities with which it contracts issue payments in accordance with time frames described in this section, and comply with all other provisions of this section as may be appropriate to fulfill its intent. OFI will monitor compliance and will enforce compliance when necessary.
Emergency. The Department shall maintain a system for providing emergency payments to ASPIRE participants and/or providers for supportive services which meets the following requirements:
a. An emergency shall be defined as those circumstances in which "services are immediately necessary to enable the participant to participate in an approved education, training or employment plan," 22 MRSA §3788(5), or circumstances in which the participant has not received payment in accordance with the 15 day promptness standard. Emergency circumstances shall not be limited to unforeseen circumstances.b. The invoice or bill in question must have been submitted correctly, as described above. c. Any participant or provider facing emergency circumstances who brings to the Department's attention the fact that they have an outstanding ASPIRE invoice shall receive relief within three working days in cases of emergency. Payment may be made by check, bank transfer, or any other reasonable method, at the discretion of the Department. If a physical check is to be issued, it must be generated within three days, and the recipient must be notified of the opportunity to collect it in person. 1. No emergency procedures under this section need to be taken if support service payments have been approved at the time of the emergency request and if the payment will issue within following work week after the request.d. If a check has been issued but not yet received within three days of mailing, the Department may choose to issue a duplicate check, make an electronic deposit, or employ any other reasonable method of payment, at the Department's discretion. Any duplicate payment received must be returned or refunded, or be subject to offset.e. Any decision by Department staff not to issue an emergency payment under this section is subject to immediate review by the unit supervisor or Central Office.10-144 C.M.R. ch. 607, § 14