APPENDIX E: Notice Text for Change From WSC to TANF

Reason Code 070

Option A: Time Limit Expired

Eligibility for Cash Assistance in the Work Support Component (WSC) Program for you and your family ends on the date indicated above. Participation in the WSC is limited to 120 days in a 12-month period. Our records indicate that you received benefits in this category from: (date to date), (date to date), (date to date), (date to date). Temporary Assistance for Needy Families (TANF) Cash Assistance for you and your family begins and your TANF “clock” starts effective ___________. You will receive a separate notice if there is any change to your Cash Assistance benefit amount or if there is any change to your Medical benefits or to your food stamp benefits if you currently receive food stamps.

Regulations: 55 Pa. Code §§125.1(i) and (j) and §141.41(d) and 45 CFR §260.31

Reason Code 070

Option B: Individual Add

Eligibility for Cash Assistance in the Work Support Component (WSC) Program for you and your family ends on the date indicated above. Participation in the WSC is limited to 120 days in a 12-month period. _________________________ moved into your household and is required to be included in your Cash Assistance grant. Our records indicate that he/she received 120 days of Cash Assistance in this category from: (date to date), (date to date), (date to date), (date to date). Temporary Assistance for Needy Families (TANF) Cash Assistance for you and your family begins and your TANF “clock” starts effective ___________. You will receive a separate notice if there is any change to your Cash Assistance benefit amount or if there is any change to your Medical benefits or to your food stamp benefits if you currently receive food stamps.

Regulations: 55 Pa. Code §§125.1(i) and (j), §141.41(d) and §171.21(a)(1) and 45 CFR §260.31

Reason Code 070

Option C: Individual No Longer Mandatory for Work Participation (Determined Exempt or with Good Cause)

Eligibility for Cash Assistance in the Work Support Component (WSC) Program for you and your family ends on the date indicated above. The WSC is limited to helping employable individuals find work. You are unable to comply with the 30-hour weekly-work requirement of the WSC program at this time. Temporary Assistance for Needy Families (TANF) Cash Assistance for you and your family begins and your TANF “clock” starts effective ___________. You will receive a separate notice if there is any change to your Cash Assistance benefit amount or if there is any change to your Medical benefits or to your food stamp benefits if you currently receive food stamps.

Regulations: 55 Pa. Code §§125.1(i) and (j), §141.41(d) and §165.21(c) and 45 CFR §260.31

Reason Code 070

Option D: Individual Not Job-Ready and/or Referred for Additional Skills Training

Eligibility for Cash Assistance in the Work Support Component (WSC) Program for you and your family ends on the date indicated above. The WSC Program is limited to helping employable individuals find work. The WSC contractor determined that you are unable to meet the work requirement for the WSC program at this time and that additional skills training or work-related activities may help you prepare for work. Temporary Assistance for Needy Families (TANF) Cash Assistance for you and your family begins and your TANF “clock” starts effective ___________. You will receive a separate notice if there is any change to your Cash Assistance benefit amount or if there is any change to your Medical benefits or to your food stamp benefits if you currently receive food stamps.

Regulations: 55 Pa. Code §§125.1(i) and (j) and §141.41(d) and 45 CFR §260.31

Reason Code 070

Option E: Individual Gets Employment

Eligibility for Cash Assistance in the Work Support Component (WSC) Program for you and your family ends on the date indicated above. The WSC is limited to helping employable individuals find work. You have been successful in getting a job. Temporary Assistance for Needy Families (TANF) Cash Assistance for you and your family begins and your TANF “clock” starts effective ___________. You will receive a separate notice if there is any change to your Cash Assistance benefit amount or if there is any change to your Medical benefits or to your food stamp benefits if you currently receive food stamps.

Regulations: 55 Pa. Code §§125.1(i) and (j) and §141.41(d) and 45 CFR §260.31

Reason Code 070

Option F: Other

Eligibility for Cash Assistance in the Work Support Component (WSC) Program for you and your family ends on the date indicated above because:

_______________________________________________

_______________________________________________

_______________________________________________

Temporary Assistance for Needy Families (TANF) Cash Assistance for you and your family begins and your TANF "clock" starts effective *B01.

You will receive a separate notice if there is any change to your Cash Assistance benefit amount or if there is any change to your Medical benefits or to your food stamp benefits if you currently receive food stamps.

Regulation: 55 PA Code 125.1(i) and (j) and 141.41(d) and 45 CFR260.31

NOTE:  Insert the following language in Option F to change budgets from WSC to TANF pending the outcome of a timely appeal filed for a WSC budget:

Regulation: 62 P.S 403(b) and 45 CFR260.31

You have filed a timely appeal. The Agreement of Mutual Responsibility that you signed on ___________ stated that if you file a timely appeal the Cash Assistance you receive during the appeal period will be in the Temporary Assistance for Needy Families (TANF) category.

Reason Code 070

Option G: TANF Work Support Non-Compliance

You and your family are no longer eligible for Cash Assistance effective the date indicated above. We received a report from the employment and training contractor named in your most recent Agreement of Mutual Responsibility (AMR) that you did not appear for your appointment with this contractor on the date specified in this AMR. You also did not contact the contractor or the County Assistance Office (CAO) to explain why you did not keep this appointment. When you signed the AMR, you agreed to keep this appointment. Completing and complying with the AMR is a condition of eligibility for Cash Assistance. You can regain eligibility by contacting your CAO to, at a minimum, revise your AMR.

You will receive a separate notice if there is any change to your Medicaid or food stamp benefits, if you currently receive food stamp benefits.

Regulation: 55 Pa. Code 125.1(h)(3) and (j)

Reason Code 070

Option H: TANF-Ineligible Failure to complete WSC AMR

You and your family are ineligible for Cash Assistance because you did not complete the Work Support Component (WSC) Agreement of Mutual Responsibility (AMR) dated *A01. Regulations require that each applicant who is required to complete and sign the application must complete and sign an appropriate AMR. You and your family are ineligible for Cash Assistance until you sign the WSC AMR indicating that you agree to comply with the obligations and responsibilities listed on this AMR.

Regulation: 62 P.S. 401 and 405.3(a)

Reason Code 070

Option J: Individual Completes the WSC Program within the Allotted Time Frame

Eligibility for Cash Assistance in the Work Support Component (WSC) Program for you and your family ends on the date indicated above because you completed the requirements of the WSC. Temporary Assistance for Needy Families (TANF) cash assistance for you and your family begins and your TANF “clock” starts effective ___________. You will receive a separate notice if there is any change to your Cash Assistance benefit amount or if there is any change to your Medical benefits or to your food stamp benefits if you currently receive food stamps.

Regulations: 55 Pa. Code §§125.1(i) and (j) and 141.41(d) and 45 CFR 260.31

Reissued:  January 31, 2012 replacing December 16, 2008