135.3 Exemptions from RESET Enrollment

 

An individual may be exempt from participation in RESET if they are:  

55 Pa. Code § 165.21

An individual is required to cooperate in providing needed information and verification regarding exempt status.

 55 Pa. Code § 165.22

There are both state and federal level exemptions for work participation requirements. State exemptions impact the Work Participation Rate (WPR). Federal exemptions have no impact on WPR. For more information about the WPR see Section 135.1 The Road to Economic Self-Sufficiency Through Employment and Training.

 


 ETP Code

Exemption

Verification Required

Duration

State or Federal

51

Under Age 18 and enrolled full-time in school

Client statement unless questionable. School may be contacted to verify child participation if necessary.

Until individual turns 18

Federal

52

Newborn Exemption

Review accrued time spent as ETP 52 in eCIS history screens.

For 12 months in a lifetime

Federal

53

Physical or Mental Disability

PA 635

Temporary or Permanent

State

54

TANF Parent Caregiver to Disabled Family Member living in the home

PA 1820

Must be reviewed by the CAO every 12 months at renewal

Federal

 

The CAO will:

The CAO will not:

 

135.31 Medical Exemption (ETP Status code 53)

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. See Supplemental Handbook Section 820.5, The DAP Process the Eligibility Worker.  Individuals who are cooperating with the  SSA eligibility process do not require additional disability verification and are considered exempt until such time as they:

A physician, licensed psychologist, psychiatrist, 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. The PA 635 must be used for TANF for disability verification. See Section 129.31, Verification of Incapacity for TANF.

 55 Pa. Code § 165.22

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 able to participate in employment and training activities for some hours, the individual’s enrollment status is mandatory with good cause. See Section 135.4, Good Cause.

135.311 Obtaining Verification For Medical Exemption

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 from the date indicated on the form.

NOTE: If the individual has not yet established a medical exemption, and you have granted good cause 53 to have the PA 635 completed, ensure the return date on the form coincides with the good cause review date entered in eCIS. See Section 135.4, Good Cause.

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 (HS 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, secure email, 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 they fail 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.

 

Reviewing the Completed PA 635 for RESET

If the medical provider indicates on the PA 635 that the individual is/has:

Then the individual is:

The CAO will:

Employable (Section II Block #1)

Mandatory to participate in Employment and Training (E&T) if no other good cause reason or exemption is indicated or demonstrated by the individual.

 

Explain RESET requirements to the individual.

Complete or update a job readiness assessment and Agreement of Mutual Responsibility (AMR). See Chapter 107, The Agreement of Mutual Responsibility.

 

Use ETP Code 60.

Refer to the appropriate E&T program. See Section 135.1 The Road to Economic Self-Sufficiency Through Employment and Training

Limited Employability (Section II Block #2)

Mandatory to participate in E&T with good cause for the hours the individual is unable to participate each week as indicated on the PA 635.

Explain RESET requirements to the individual.

 

Complete or update a job readiness assessment and AMR. See Chapter 107, The Agreement of Mutual Responsibility.

 

Use ETP Code 60 with Good Cause code 53. See Section 135.4 Good Cause

 

Refer to the appropriate E&T program.

 

In some cases, a DAP referral may be appropriate. See Supplemental Handbook Section 820.5, The DAP Process the Eligibility Worker.

Temporary Incapacity (Section II Block #3)

Exempt for the period indicated on the PA 635.

Discuss the benefits and ability of volunteering to participate in E&T while exempt. See Section 135.5 Volunteering to Participate in RESET.

 

Complete or update a job readiness assessment and AMR. See Chapter 107, The Agreement of Mutual Responsibility.

 

Enter a review date on the eCIS Disability screen.

 

Use ETP Code 53.

 

If the individual is expected to be incapacitated for a period of more than 12 consecutive months, a DAP referral may be appropriate. See Supplemental Handbook Section 820.5, The DAP Process the Eligibility Worker.

Permanent Incapacity (Section II Block #4)

Exempt

Discuss the benefits and ability of volunteering to participate in E&T while exempt. See Section 135.5 Volunteering to Participate in RESET.

 

Complete or update a job readiness assessment and AMR. See Chapter 107, The Agreement of Mutual Responsibility.

 

Enter a review date on the eCIS Disability screen.

 

Use ETP Code 53.

 

Must refer to DAP. See Supplemental Handbook Section 820.5, The DAP Process the Eligibility Worker.

 

135.312  When to Review Medical Exemption

The CAO will review a medical exemption:

 55 Pa. Code § 165.21

 

 

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)

If an individual is exempt and enrolls in an approved education or training program, including but not limited to, the Office of Vocational Rehabilitation (OVR) or other rehabilitation agency, the individual may volunteer for RESET, and may receive special allowances. See Section 135.5 Volunteering to Participate in RESET and Section 135.6 Special Allowances for Supportive Services.

Participating in employment or an E&T program does not automatically mean the individual is no longer disabled. If the CAO has reason to believe the individual’s medical status is questionable the CAO may request verification of the status of the disability. See Section 129.31, Verification of Incapacity.

Individuals referred to and cooperating with the DAP process 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 The Medical Exemption and Section 129.31, Verification of Incapacity.

Additional disability verification is not required while the RSDI/SSI application process is pending. The individual must continue to appeal any unfavorable Social Security Administration (SSA) decision at all levels until denied at the final appeal level. See OPS 19-04-02, SSA Change to Appeals and OPS 18-03-02, DAP Changes.

NOTE: If an individual is denied for SSA benefits at the final appeal level, this does not mean the disability is automatically ended. A new PA 635 should be requested, and the DAP worker must refer the individual to the Medical Review Team (MRT) to review for an ongoing disability. While the MRT decision is pending, the individual continues to be coded as ETP 53 for RESET.

135.32 Newborn Exemption (ETP Status Code 52)

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.  

55 Pa. Code § 165.21(c)(4)

The 12- month count begins the date the individual tells the caseworker that they want to take the exemption and ends when:

 

Any newborn exemption time used during a month counts as a whole month used.

EXAMPLE: A single TANF parent informs the CAO that their child was born on January 15th and  they wish 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:  A single TANF parent informs the CAO that their child was born on January 15th and they wish to take the newborn exemption. On April 25th they inform the CAO that they want 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. The single TANF parent 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:

Individuals who chose to take the exemption may volunteer to pursue education, job skills training, or work activities.

NOTE: The newborn exemption is only for a single, custodial parent. If consideration is requested for a newborn in a two-parent household good cause should be reviewed. See Section 135.4, Good Cause.

135.33 Under Age 18 Exemption (ETP Status Code 51)

An individual under 18 years of age pursuing a high school diploma or General Equivalency Degree/High School Equivalency (GED/HSE) is exempt unless the individual is married or the single minor head of household.

Any program that will grant a high school diploma or equivalent 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 (PDE).

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 if enrollment status is questionable.

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.

NOTE: High school students will not have their activity hours tracked. For high school students who are 18 years old that have an active Project Enrollment screen please enter the Indicator Tracking Code 74.  This tracking code will be used to identify TANF eligible children age 18 and currently enrolled in high school, to include students on summer vacation who expect to re-enroll in high school for the next regular term.  Using this code will properly remove these students from the Zero Hour Alert that is issued on the 11th of the month.

Individuals who are under 18 years of age and pass the GED/HSE exam will be required to participate in other work or work-related activities after they pass the exam even if they have not yet received the actual 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:

If the individual under 18 years of age willfully and without good cause fails to participate in one of the above, they may be subject to sanction. In this instance, only the individual under 18 years of age is subject to sanction. See Section 135.7, Non-Compliance with RESET Requirements.

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 or suspended from school and plans to return after the expulsion or suspension period, educational alternatives may be used to satisfy compulsory attendance requirements during the expulsion or suspension period.

Educational alternatives include:

 

 

135.34 Caring for a Disabled Family Member (ETP Status Code 54)

A TANF parent providing care for a disabled family member living in the home is exempt from work participation requirements 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 TANF 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.

NOTE: A TANF parent may qualify for caregiver exemption regardless of whether the disabled family member attends school on a full-time basis.

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. See Section 135.4, Good Cause.

Review ETP 54 at each renewal.

An exempt caregiver may volunteer to participate in an approved E&T activity and receive subsidized child care, if they are employed or has an activity indicated on an open ETP Project Enrollment screen. See Section 135.5 Volunteering to Participate in RESET.

 

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.

 

REVIEWING THE CAREGIVER REVIEW FORM (PA 1820) FOR FEDERAL EXEMPTION:

1.     The CAO will ensure the fields of the PA 1820 have been completed appropriately. The caregiver must describe in detail what they do to care for the disabled family member living in their home.

2.     The third section must be completed by a licensed medical provider.

3.     The CAO must ensure the disabled family member lives in the same home as the TANF parent requesting the caregiver exemption.

4.     The continued need for the caregiver exemption should be reviewed every 12 months at renewal; this does not mean a new PA 1820 is required if the diagnosis is not likely to change or improve. Review the most recent PA 1820 in the record, and if necessary, consult a DAP worker, if you are uncertain if a new PA 1820 is required.

NOTE: Only TANF parents are eligible to request and receive a caregiver exemption. If the specified relative is not a TANF parent, good cause should be explored if they are needed in the home to provide care for a disabled child or adult living in their home. See Section 135.4, Good Cause.

 

 

 

Updated September 21, 2021, replacing July 19, 2013,