The caseworker must explain:
Responsibilities both for the person and for the CAO assisting the person.
Right to appeal and have a fair hearing.
Good cause.
Penalties for noncompliance with eligibility requirements.
Both the person and caseworker must initial and date the bottom of each page to acknowledge that all information on these pages was discussed and reviewed thoroughly with the individual.
The caseworker must follow these guidelines when completing the AMR's “Plan for Supporting Myself and My Family:”
Make sure the AMR is readable. Printing is easier to read. Use a pen, not a pencil, or complete the form on Docushare.
Make sure the AMR is in a language the person can understand. This may require the use of a translator so the person can read the AMR.
Follow the language and questions in each section to assist in engaging a conversation with the person when discussing goals and responsibilities.
The caseworker must enter the following information on the AMR:
The person's line number in the case records.
The person’s full name.
The case record number and county code.
The phone number where the person can be reached.
The date the AMR is completed.
The following information should be completed by the caseworker and reviewed with the person signing the AMR:
Number of Cash days:_____
Highest level of education completed:_____
Birthdate of youngest child:_____
Paid Work Experience weeks completed:_____
Allowable Community Service hours per week:_____
The person must list a long term goal and the first steps in obtaining their goal. Persons with education or training goals will usually have an education goal plus a long term job related goal.
Examples:
Long term goal: "To get my registered nurse (RN) license".
First steps: "To successfully completed the fall semester at Harrisburg Area Community College (HACC)".
Explain to the person that the long term goal is for the person or family to become economically secure without Cash Assistance. The best way to do that is through a job or continued education. Discuss with the person his or her plan for achieving this goal.
There may be more than one goal.
A goal may relate to employment or other activities to progress toward economic security.
Goals are not the same for everyone. They are based on the person’s situation and possible barriers that may need addressed.
Goals are jointly agreed on by the caseworker and the person.
Goals are the person’s, not the caseworker's.
Goals should be reasonable and attainable.
Earn a bachelor’s degree in social work and become a social worker.
Get a job as a nurse’s aide.
Continue to attend school, making satisfactory progress as defined by the college.
Finish my GED.
In the “Barriers to Goal Achievement ” the caseworker must complete the Job Readiness Assessment checklist (see CAH 135.11, RESET Enrollment Status) to identify barriers and criteria to determine the appropriate RESET participation project referral. The CAO assessment should include the questions listed below. The participation requirement will be based on how the client answers the Job Readiness Assessment questions. See Job Readiness Assessment Guide.
CAO should include any barriers that may prevent an individual's ability to participate in an activity or that the person chooses to disclose.
Examples:
Full or partial mental or physical disabilities.
Domestic violence.
Substance abuse.
Children with disabilities or serious health problems.
Homelessness.
Criminal history.
Limited English proficiency.
NOTE: When domestic violence is a barrier, to ensure confidentiality, the caseworker must never note it on the AMR, but instead be referred to as "supportive services". He or she must document the circumstances and information about domestic violence in the case comment.
If a TANF program requirement has been waived because the person cannot safely apply for support or participate in work activities, the AMR must show that a waiver of that requirement has been granted. Again, no reference to “domestic violence” should be made on the AMR, even if it was the reason for the waiver. Although recipients may self-attest on the PA 1747, a referral to DV services can assist the individual in addressing the situation effectively. The caseworker must note the reason for the waiver in the case comment.
Serious health problems, such as HIV/AIDS, drug or alcohol addiction, and mental health issues, may be barriers to employment. The caseworker must not note the specific condition on the AMR. Instead, he or she must simply note that there is a serious, chronic, or acute medical condition and record specific information about the medical condition in the case comment.
The caseworker must do the following:
Consider barriers that the person must overcome, and use the person’s strengths to decide on the most appropriate activities.
Always address barriers, such as language, with the person.
Develop a plan, such as “Take ESL classes,” to help the person reduce the barrier’s effect on the goal of becoming self-supporting. Any steps the person takes to improve his or her situation are steps in the right direction. The person’s participation is critical.
In the "Employment & Training Status" section, the caseworker must indicate the person's employment and training status by checking the appropriate box:
Mandatory: The person is subject to work (RESET) requirements.
Exempt: The person is not subject to work requirements because of an exemption.
The “Participation Status” section must show that the CAO reviewed the good cause and exemptions status of each mandatory person. The caseworker must check the appropriate box provided whether good cause or an exemption is approved, denied, or not applicable.
Caseworkers should provide the reason for the good cause or exemption determination and any barriers having an impact on the person's ability to work or participate in an activity.
The “Agency Assistance and Referrals” section must include a list of all supportive services that are provided to the person plus any referrals made to other appropriate community agencies or organizations to address the barriers listed in AMR Section "Barriers to Goal Achievement".
Examples of supportive services:
Child care---- list the address and phone number of the local area Early Learning Resource Center (ELRC).
Transportation
Clothing
Book allowances
NOTE: The AMR must include a statement that the person is required to provide a receipt within 14 days of receiving Special Allowance (SPAL) money for supportive services.
Examples of community agencies:
Counseling programs
Housing assistance
Children’s services
The caseworker must include actions to be taken by the person to address or eliminate each barrier identified on the AMR.
The plan to address barriers should be in clear, meaningful steps and very specific. If something is not agreed to on the AMR, the individual cannot be cited or sanctioned for not doing it.
Example: If a person is on probation or parole or is subject to payment of fines and costs, this section should state that the person must comply with probation or parole terms or with an approved payment plan for fines and costs.
Appropriate AMR text: "Continue making payments to the court for outstanding fines and costs until the amount is paid in full".
In cases of domestic violence, appropriate text would be: " Referred to supportive services" for confidentiality reasons.
When a serious health problem exists, and the person is receiving treatment for it, an appropriate AMR statement would be: "Continue to follow treatment plan prescribed by your doctor".
If the person is a candidate for SSI or SSDI benefits and referred to the Disability Advocacy Program (DAP), the caseworker must include that information in this section and write that the person must apply with Social Security, keep all appointments and agree to appeal the decision if the SSI or SSDI application is denied for medical reasons. The caseworker must explain to the person that the DAP advocate will help with the appeal process.
See Supplemental Handbook, Chapter 820, Section 820.64.
If good cause or an exemption is denied or not applicable in the AMR Section "Participation Status", the "Participation Activities" section must be completed with the specific activities or employment the person agrees to and the number of core and non-core hours per week the person is required to participate in a program or activity.
Core activities are required for all individuals who are mandatory to participate in RESET.
Non- core activities are available if additional hours are needed to meet the minimum work requirement after the required core activity hours are met or when all opportunities to participate in a countable core activity have been exhausted or are not available.
See Cash Handbook Chapter 135.2 Employment and Training Activities.
The activities or employment should relate to the person's long term goal and first steps written in AMR Section "Goals".
The AMR must include name, address, and phone number of the program or activity. In addition, list the specific date and time the person should report to the program or activity.
Example: if the long term goal and first steps is to become an RN, the participation requirements should read
What: KEYS- Attend college classes for RN degree.
Where: HACC, 1 HACC Drive, Harrisburg, Pa 17110 (717) 780-2400
When: Report to classes Monday, September 1, 2014
Hours: MWF 8-12 and TTh 1-5
You must participate 20 core hours per week and 0 non-core hours per week.
This section is divided into two sections, for situations where the person is participating in two activities.
NOTE: The caseworker must write the number of hours the person is required to participate in each program or activity.
If the person chooses employment, the caseworker must enter work-related activities in the first section. Entries in this section should focus on job search activities. If appropriate, the caseworker must enter the number of hours the person is working.
Activities may include those related to education and training.
After completing this section, the caseworker must review the "Your Rights" and "Good Cause" statement with the person.
After AMR Section: "Participation Activities" and "Your Rights" and "Good Cause" statements, the caseworker must enter the following:
His or her name and phone number (or the appropriate caseworker's name and phone number).
A date the person is expected to report to the CAO on the status of the plan.
The date should be no later than the next renewal. The caseworker must let the person know that this progress report is very important.
Both the person and the caseworker must sign, date and initial page 3, the agreement statement of the AMR in the spaces provided below AMR Section: "Participation Activities" and must initial and date pages 1, 2, and 4 to verify that they have discussed and agreed on the AMR plan.
NOTE: The AMR is not a valid agreement without the appropriate signatures.
The caseworker must make sure the person reads and understands the agreement statement to the left of the signature lines at the bottom of page 3.
The AMR is a mutual agreement and should reflect what is agreeable to both the person and the caseworker. Advise the person that the AMR may be revised and updated as necessary to reflect any changes in circumstances. The person may ask that the AMR be revised and updated a necessary.
When completing an AMR for child-only cases, including kinship caregivers, the caseworker must remember that an adult caretaker who is not receiving Cash Assistance is not subject to RESET requirements. The AMR is completed for the benefit of the child rather than the adult. Below are guidelines for how to complete an AMR for a child-only case:
AMR Section, “Goals,” must show goals that benefit the child. For example, a long-term goal might be “To make sure the child completes his/her education.” First steps might be “To attend teachers’ conferences and school activities as needed.”
AMR Section, "Barriers to Goal Achievement", must be completed if the child is mandatory and subject to the RESET requirements. The caseworker should use the Job Readiness Assessment checklist (See CAH 135.11 RESET Enrollment Status) to identify barriers and criteria to determine the RESET program participation requirement and project referral
AMR Section “Employment and Training Status,” must reflect the employment and training status of the child, not of the adult caregiver. The child is exempt if he or she is under age 18 and working toward a high school diploma or GED. If the school-age child is not in school working toward a high school diploma or GED, the caseworker must review the employment and training status to determine whether the child is mandatory or exempt. The adult is not considered in the employment and training status review, because he or she is not subject to the RESET requirements. An exception is a currently sanctioned adult.
AMR Section, “Participation Status,” must show that the CAO reviewed the good cause status and exemption of a mandatory budget group member that is subject to the RESET requirements. The caseworker must check the appropriate box provided whether good cause or an exemption is approved denied, or not applicable and the reason for the good cause or exemption.
AMR Section, “Agency Assistance and Referrals,” must include a list of all supportive services that are provided to a mandatory child plus any referrals made to other appropriate community agencies or organizations to address the barriers listed in AMR Section: "Barriers to Goal Achievement" in order to meet the RESET requirements.
AMR Section, "Participation Activities", is not applicable in a child-only/kinship caregiver case. The caseworker must write "Child-only case, not applicable" in this section. The exceptions to this are a child who is not RESET exempt or an adult who is currently sanctioned. The caseworker must review RESET requirements.
This section must reflect actions to be taken for the benefit and well-being of the child. The adult has responsibilities to the child, such as making sure the child attends school every day and keeping all doctor appointments and immunizations current. These responsibilities are considered "family responsibilities" and should be listed in this section.
Determining eligibility for Extended TANF requires a partial renewal, including a new AMR or an update to an existing AMR.
The AMR must specify an eligibility track and the reason the adult head of household or spouse qualifies for that track. The AMR must be detailed and specific to the adult’s circumstances. For Extended TANF eligibility procedures, see Cash Assistance Handbook Chapter 176, Section 176.32.
NOTE: It is not necessary to keep track of day counts on an AMR for Extended TANF adults. Extended TANF does not have a time limit.
In some circumstances, a new or updated AMR may be completed by telephone interview for the partial renewal. In a telephone interview, the caseworker must:
Explain to the adult the reason a new or updated AMR is necessary;
Narrate the reason in case comments; and
Send a copy of the updated or new AMR to the recipient.
The recipient must initial or sign the AMR and return it to the CAO within 30 days of the date of the CAO signature.
As circumstances change, a recipient may qualify for Extended TANF under another eligibility track. Any changes between tracks require a partial renewal, including a new or updated AMR.
The CAO must distribute the AMR as follows:
Original copy of the AMR to the person.
One complete copy with signatures should be scanned and attached to the record.
NOTE: This includes any AMR updated and sent to the individual for signature and return. An AMR mailed to the individual must be completed, signed and dated and returned within 30 days from the date of the CAO signature on the AMR. A signature is required to verify that the individual is complying with all AMR activities.
One copy for the Service Delivery Area (SDA) for persons who are participating in a contracted program.
One copy for the Employment and Training Unit (optional).
An individual with Limited English Proficiency (LEP) should be provided two copies of the AMR, one in English and one in the preferred language of the person. The English copy may be needed for E&T contractors or others who assist the person, as well as for the CAO. Both AMRs should be scanned and attached to the record. Please note that currently there are translations of the AMR template in Spanish, Russian, Vietnamese, Chinese, Nepali, Swahili, Arabic, French, Ukrainian, Haitian-Creole, Dari, Pashto, and Cambodian.
OPS040604 Additional Information on Limited English Proficiency (LEP) (Linked April 23, 2013)
If an existing AMR is updated, the CAO must give the person a copy of the updated AMR.
Case comment entries should state that the AMR was completed, explain the plan for the person to report, and include any other information to help with follow-up. It is not necessary to repeat the activities and tasks listed on the AMR.
After the AMR is completed, the CAO must make sure that future case comment entries:
Track the progress of the person;
Note when follow-up contacts occur;
Note that changes or additions to the plan were made; and
Clearly establish any basis for adverse action if the person fails to participate in the activities listed on the AMR.
Updated October 3, 2023; Replacing November 27, 2019