An individual may be exempt from participation in RESET if he or she is:
An individual with a verified physical or mental disability, which temporarily or permanently prevents employment or participation in a work activity.
A single custodial parent, in a one-parent household, caring for a child under the age of 12 months. The months do not need to be consecutive and the child is not required to be on TANF. This exemption is limited to a maximum of 12 months during the parent’s lifetime.
An individual under 18 years of age and pursuing a high school diploma or GED, unless the individual is married or is the single head of household.
A TANF parent who cares for a disabled family member living in the home.
The need for the disabled family member to have a care giver must be verified on the Caregiver Review Form (PA 1820). The family member must be living in the home.
An individual is required to cooperate in providing needed information and verification regarding exempt status.
The CAO will:
Assist an individual in obtaining verification when help is needed.
Not require verification of information that has already been verified and is not subject to change.
This exemption continues unless medical documentation supports a change from exempt to mandatory status. See Section 135.312 When to Review Medical Exemption. 55 Pa. Code § 165.21(c)
Individuals with 12 continuous months of medical exemption will be referred to the Disability Advocacy Program (DAP) for assistance in pursuing Social Security Administration (SSA) or Supplemental Security Income (SSI) benefits. Individuals who are cooperating with the Social Security Administration and the eligibility process are considered exempt until the final eligibility determination for Retirement, Survivors, Disability Insurance (RSDI) or Supplemental Security Income (SSI) is made.
A physician, psychologist, physician assistant or certified registered nurse practitioner must verify a physical or mental disability and employment and training status using the PA 635, Medical Assessment Form, must be used for TANF. 55 Pa. Code § 165.22
See Section 129.31, Verification of Incapacity for TANF.
NOTE: The PA 635 may also be used to verify incapacity to determine deprivation due to incapacity in a two-parent household See Section 129.31, Verification of Incapacity.
When the CAO is waiting for the return of the PA 635, or if the PA 635 indicates an individual is capable of participating in employment and training activities for some hours, the individual’s enrollment status is mandatory with good cause. See Section 135.4, Good Cause.
The CAO will:
1. Complete the CAO address, case record identification information and the individual’s contact information on the top of page one of the PA 635.
2. Indicate a return date of no more than 30 days.
3. Indicate the required participation hours for this individual in Section II.
4. Instruct the individual to take the PA 635 to his or her medical provider.
5. Have the individual sign an Authorization for Use or Disclosure of Personal Information (PW 1815) to accompany the PA 635.
6. Provide a stamped envelope addressed to the CAO for the physician’s office to return the completed form within 30 days from the date indicated on the form.
NOTE: The medical provider may return the completed form to the CAO via mail or secure fax. The PA 635 may only be emailed to the CAO if the sender has a DHS-secured CWOPA email account.
An individual is considered mandatory for RESET if he or she fails to verify exempt status within 30 days of the date indicated on the form, unless the individual has cooperated and verification is pending from a third party.
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If the medical provider indicates on the PA 635 that the individual: |
Then the individual is: |
Then the CAO will: |
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Is Employable (Section II Block #1) |
Mandatory to participate in Employment and Training (E&T) ( ETP Status Code 60) |
Explain E&T options and requirements to the individual. Refer to the appropriate activity Complete an AMR outlining the activity requirements and hours of participation Update the case narrative. |
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Has limited Employability (Section II block #2), and can participate in employment or training less than hours required per week
The medical professional is asked to create a treatment plan for individuals who have limited employability or are temporarily incapacitated
NOTE: If block #1 or #2 indicates that accommodations are needed for employment or training, the contractor will review and consider how the accommodations can be met. |
Mandatory to participate in E&T with good cause for the hours the individual is unable to participate (ETP Status Code 60 and Good Cause Code 53) |
Indicate the E&T program and number of participation hours on the Agreement of Mutual Responsibility (AMR. See Chapter 107, The Agreement of Mutual Responsibility.
Fax the AMR and the PA 635 to the contractor (when applicable).
Refer the individual to an E&T program by entering a Project Code and Project ID on the ETP Project Enrollment screen in the electronic Client Information System (eCIS). Enter Activity Code(s) on the ETP Project Enrollment screen in eCIS for non contracted or self-initiated programs.
Enter Good Cause Code 53 and the number of GC hours on the ETP Project Enrollment screen in eCIS when the individual is unable to participate for the required number of hours. OR Remove the Good Cause Code 53, if the Good Cause no longer applies. NOTE: In some cases a DAP referral may be appropriate. See Supplemental Handbook Section 820.5, The DAP Process the Eligibility Worker. |
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Has a Temporary Incapacity (Section II Block #3), and can not participate in any form of employment or training activity
The medical professional is asked to create a treatment plan for individuals who have limited employability or are temporarily incapacitated.
OR Is Permanently disabled (Section II Block #4) |
Exempt for the period of time indicated on the PA 635 (ETP Status Code 53) OR Exempt (ETP Status Code 53) |
Update the Individual Non-Fin Questions screen in eCIS with a “Y”- disabled, and ETP Status Code 53.
Enter a review date on the Disability screen in eCIS.
Update the AMR and case narrative.
Explain the benefits of participating in the Maximizing Participation Project (MPP). Note: MPP is only available in Philadelphia.
Update the ETP Project Enrollment screen in eCIS, if applicable.
Refer to the DAP. See Supplemental Handbook Chapter 820, Disability Advocacy Program. |
The CAO will review a medical exemption:
When a change is reported that would affect the individual’s exemption status. The CAO may request an updated PA 635.
At reapplication. A new PA 635 may not be required unless the medical exemption will expire within the next 30 days.
When system alert 056 is received, indicating that an individual's temporary incapacity is ending:
The CAO will schedule a partial redetermination to update the individual's employability status. At the scheduled appointment the CAO will update the AMR, discuss available RESET options and refer the individual to the appropriate E & T activity. If during the partial redetermination interview, the individual indicates that their temporary incapacity continues, the CAO will give them a new PA 635 to be completed and returned to the CAO within 30 days.
OPS 13-01-03 Procedure Change for TANF Recipients with Temporary Incapacity (ETP 53) (Linked July 19, 2013)
The CAO may also require the individual to submit to an independent examination as a condition of receiving assistance if:
55 Pa. Code § 165.21(c)(1)(iv)
The disability is not obvious.
The individual participates in MPP (Philadelphia only).
If an individual is exempt and enrolls in an approved education or training program, including but not limited to, the Office of Vocational Rehabilitation or other rehabilitation agency, the individual may volunteer for RESET, and may receive special allowances. See Sections 135.5 and 135.6.
Entry into employment or an E &T program does not automatically mean the individual is no longer disabled. However, if the CAO suspects the individual’s medical status has changed, the CAO may request verification of the status of the disability.
Once the CADISB Disability screen in eCIS is completed for an individual with a physical or mental disability, the system will generate an alert 30 days prior to the end date of the disability.
When system alert 056 is received the CAO will follow the procedure above.
Individuals referred to DAP are considered exempt until a final eligibility determination for Retirement, Survivors, Disability Insurance (RSDI) or Supplemental Security Income (SSI) is made. If the individual is denied RSDI or SSI, the individual’s exempt status must be reviewed. See Section 135.31.
Disability verification is not required while the RSDI/SSI application process is pending.
A single custodial parent, in a one-parent household, caring for a child under the age of 12 months may be exempt. This exemption is limited to a maximum of 12 months in the parent’s lifetime. The months do not need to be consecutive and the child is not required to be on TANF.
The 12- month count begins the date the individual tells the caseworker that he or she wants to take the exemption and ends when:
The parent has used his or her 12-month lifetime limit;
No later than the last day on the month prior to the child's first birthday; or
The parent chooses to stop taking the exemption.
Any newborn exemption time used during a month counts as a whole month used.
EXAMPLE: Ms. B informs the CAO that her child was born on January 15th and she wishes to take the newborn exemption. The ETP status code 52 is entered into eCIS. January counts as one month toward the 12-month lifetime limit. The 12-month time-limit for the newborn exemption ends on December 31st because the child turns one in the month of January.
An individual with a child under one may choose not to take some or all of this exemption due to the lifetime 12-month time limit.
If the individual has not used the full 12-month exemption, the remaining months of the lifetime limit may be used for subsequent births or adoptions.
EXAMPLE: Ms. B informs the CAO that her child was born on January 15th and she wishes to take the newborn exemption. On April 25th she informs the CAO that she wants to stop taking the newborn exemption and look for employment. January counts as one month and April also counts as one month used toward the 12-month life-time limit. Ms. B has eight months of the newborn exemption available to use for subsequent births or adoptions.
Once this 12-month limit has been fully used, even if it was used in another state, an individual may not receive it again. The CAO must review the individual’s history including:
The current case record;
Previous case records;
The eCIS narrative;
The CQINDA history screen in eCIS;
The CQPREN screen history in eCIS to look for good cause given to the parent in a two-parent household who is caring for a child under 12 months of age; and
If applicable, contact the other state for information about any newborn exemption time already used.
Individuals who chose to take the exemption may volunteer to pursue education, job skills training, or work activities.
An individual under 18 years of age pursuing a high school diploma or GED is exempt, unless the individual is married or the single head of household.
Any program that will grant a high school diploma is considered an appropriate school. This includes cyber charter schools and special education for students who have an Individualized Education Program (IEP) with supervised education or vocational training approved by the authorities of the school district or by the Pennsylvania Department of Education.
A parent or caretaker’s statement that a child under 18 is attending school is acceptable verification to establish a child’s exemption from RESET program requirements unless there is contradictory or conflicting evidence. Statements from school officials about school attendance can serve as verification of enrollment.
Individuals not enrolled in school at application or renewal will have 30 days to verify participation in high school or a program leading to a certificate of high school equivalency.
If an individual enrolls in high school or a program leading to a certificate of high school equivalency during the summer recess or any other scheduled break, the enrollment is acceptable until the educational program begins. The parent or caretaker must give verification of participation when the program begins .
Individuals who pass the GED exam will be required to participate in work activities during the period of time between when they pass the exam and when they actually receive the certificate of high school equivalency.
Individuals under age 18 who cease to participate in a program leading to a certificate of high school equivalency lose their exemption and must be enrolled in RESET. In these cases:
An AMR must be completed with the individual and signed by the parent/caretaker when the individual does not meet the criteria for signing his or her own AMR See section 107.2.
The AMR must list the individual’s responsibility to participate in one or more of the following:
Education leading to a high school diploma or certificate of high school equivalency;
An approved work activity; or
30 hours per week of work.
If the individual under 18 years of age willfully and without good cause fails to participate in one of the above, he or she may be subject to sanction. In this instance only the individual under 18 years of age is subject to sanction. See Section 135.7.
Once the child becomes enrolled in RESET, the child remains enrolled but may again become exempt from participation if the child returns to school or enrolls in a GED program.
If a student is expelled from school and plans to return after the expulsion period, educational alternatives may be used to satisfy compulsory attendance requirements during the expulsion period.
Educational alternatives include:
Enrollment in a non-public school licensed or registered by the Department of Education;
Tutoring approved by the district superintendent and conducted by a properly qualified private tutor;
Home education by the parent which meets Pennsylvania’s Home Education law;
Enrollment of a 15 or 16 year old in an approved, accredited private trade or business school; or
Enrollment of a senior high school student prior to graduation in an approved college.
A TANF parent providing care for a disabled family member living in the home is exempt when documentation to support the need for the disabled family member to have a caregiver is provided.
To meet the medical documentation requirement, the Caregiver Review Form (PA 1820) must be used.
A parent may also be exempt if their child with disabilities receives full-time instruction in the home AND a parent is required to be present.
A TANF grandparent who is the specified relative of a disabled child living in the home does not qualify for this exemption, but may be granted good cause.
Review ETP 54 at each renewal.
Individuals who are no longer eligible for ETP 54 should be encouraged to begin participation as soon as arrangements can be made for the disabled family member, but no later than four weeks from the date of the renewal interview.
Update the AMR and refer the individual to an appropriate program.
An exempt caregiver may volunteer to participate in an approved E&T activity and receive subsidized child care, if he or she is employed or has an activity indicated on an open ETP Project Enrollment screen.
COMPLETING THE CAREGIVER REVIEW FORM (PA 1820):
1. The CAO will complete the first section of the form including caregiver's name, address and record number.
2. The caregiver must complete the second section of the form.
3. The third section of the form must be completed by a licensed medical provider familiar with the medical or psychological needs of the individual with the disability.
4. The completed form must be maintained in the case record for a period of six years from the date it is created or from the date it was last in effect, whichever is later.
Reissued July 19, 2013, replacing April 11, 2013,