134.03 Specified Hardship Criteria SR 09-20, 07/09(FAM-A)

If a FANF assistance group meets more than one hardship criterion, it must choose which criterion is to be considered for the hardship exemption request.

All hardships must be verified in the manner noted for each criterion in this section.

Criteria Available to all FANF Cases:

1. Lack of Adequate Child Care

A hardship extension may be granted due to an inability to find adequate child care, provided the client has made a good faith effort to do so. See Section 808.31, Compliance Requirements, for a definition of adequate child care.

Required Verification:

• The individual must provide a written statement specifying when the individual last had an adequate child care provider, when and why that provider was lost, and how the individual has either not been able to find a child care provider or that the only child care available does not provide care that is adequate. The statement must list the providers contacted, dates contacted, and the reason the provider was inadequate; and

• If an NHEP participant, the individual’s assigned Employment Counselor Specialist (ECS) must document the individual’s past experience with child care providers and what efforts the individual has made to find adequate providers in the past.

2. Loss of Employment

A hardship extension may be granted due to loss of employment provided the unemployed adult:

• has applied for unemployment compensation (UC) benefits;

• is actively seeking employment; and

• did not voluntarily quit, refuse to accept a suitable job offer, or get fired without good cause as described in PART 315, VOLUNTARY QUIT.

Required Verification:

A statement from the unemployed adult detailing the efforts that have been made to get a job which includes the names of the employers contacted and the dates contacted, and:

• a copy of the "Determination on Claim for Unemployment Benefits" (Form NHUS1016) from New Hampshire Employment Security (NHES); or

• a signed statement from the local NHES office verifying an application has been filed for unemployment benefits.

3. Life-threatening Circumstance or Emergency Situation

A hardship extension may be granted to cases that are experiencing life-threatening circumstances or an emergency situation, as noted below:

• natural disasters such as floods, fires, hurricanes, and earthquakes;

• eviction, homelessness, loss of owned residence, arson, theft of clothing, food, or money;

• medical emergencies or serious illness of an assistance group member or of a person for whom an assistance group member is legally liable under state law to support;

• discontinuance of utilities or heat, or unsafe or unhealthy living conditions;

• peril to the physical or mental well-being of a child; or

• any other circumstance considered life-threatening by the DFA supervisor.

Required Verification: Any reasonable documentation that substantiates that life-threatening circumstances or an emergency situation exists. Examples of reasonable documentation include, but are not limited to, the following: a police report, insurance claim, eviction or mortgage foreclosure notice, shut-off notice, doctor’s statement, emergency room bill, a signed and dated written demand for rent for an actual or pending eviction, a notice that the town is condemning the home the individual lives in, or a Health Department notice.

4. Medical Condition of the Individual Submitting the Hardship Request

A hardship extension may be granted to cases in which an adult is unable to participate or has limited participation in any NHEP work program activity due to their own physical or mental condition.

Exception: Before being granted a second hardship extension based upon long-term disability, the individual must first apply for disability benefits. See FAM 317, DEVELOPING POTENTIAL SOURCES OF INCOME.

Required Verification: Form 752a, Authorization for Release of Protected Health Information, which allows the healthcare provider to share information with Department staff, including contract staff, and Form 752(State Office), Physician/Clinician Statement of Capabilities, completed by a medical doctor or clinician that provides information about the individual’s condition, states how long the condition will last, and indicates why the condition prevents the individual from working or participating in any NHEP activities.

A new Form 752(State Office) is required if the current verification on file is more than 4 months old, or a more recent form indicates that the individual’s medical condition will end before the beginning of the extension period.

Although the Hardship Review Committee retains the authority to approve or deny a hardship extension request, all individuals requesting an extension due to a medical condition are referred to the *TANF Program Analyst for assessment*.

5. Medical Condition of A Relative, Assistance Group Member or Spouse

A hardship extension may be granted to cases in which an adult is unable to participate or has limited participation in any NHEP work program activity due to a physical or mental condition of a relative, assistance group member, or spouse. The adult must provide care to the individual, who resides in the same household, due to that individual’s illness, incapacity, or disability. There must also be no alternative care available or feasible for the relative, assistance group member, or spouse.

Exception: When a hardship extension has been granted due to the individual caring for a disabled relative, assistance group member, or spouse, and the individual subsequently requests an extension for this same reason, the Hardship Extension Review Committee will review the request to determine if the family’s circumstances warrant a recommendation that it be permanently exempted from NHEP work requirements. If the Committee makes this recommendation, and the individual agrees, the case will be transferred to the Family Assistance Program (FAP). Since individuals participating in FAP are permanently exempted from closure due to the 60-month time limit, the individual will no longer have to request a hardship extension to continue to receive FANF financial assistance.

Required Verification: Form 752a, Authorization for Release of Protected Health Information, which allows the healthcare provider to share information with Department staff, including contract staff, and Form 752HH(State Office), Physician/Clinician Statement of Necessary Patient Care for a Household Member, completed by a medical doctor or clinician that provides information about the relative’s, assistance group member’s, or spouse’s condition, states how long it will last, and indicates why that prevents the individual applying for the extension from working or participating in any NHEP activities.

A new Form 752HH(State Office) is required if the current verification on file is more than 4 months old, or a more recent form indicates that the relative’s, assistance group member’s, or spouse’s medical condition will end before the beginning of the extension period.

Although the Hardship Review Committee retains the authority to approve or deny a hardship extension request, all individuals requesting an extension due to the medical condition of a relative, assistance group member, or spouse are referred to the *TANF Program Analyst for assessment*.

6. Learning Disability

A hardship extension may be granted due to a learning disability of an adult family member.

Required Verification:

A signed statement from a licensed psychologist or a state certified education professional licensed to certify the existence of a learning disability, indicating that the individual currently has a learning disability and the expected treatment outcome. This signed statement must include a plan that identifies:

• the steps and timeframes necessary to help the individual meet the employment-related goals that are included in the individual’s NHEP Employment Plan (EP), if the individual has an EP; or

• the specific steps and timeframes the individual needs to meet to become employable and self-sufficient, if the individual does not have a current EP.

7. Participation in a Substance Abuse or Mental Health Program

A hardship extension may be granted due to an adult family member’s participation in a substance abuse program or mental health program that prevents or limits participation in NHEP work program activities.

Required Verification: A statement from the program director or an official program representative indicating:

• that the individual is participating in a structured mental health/drug or alcohol program and that participation in the program prevents or limits participation in NHEP work program activities;

• the kinds of NHEP activities the individual can participate in while enrolled in the program;

• the amount of time the individual can spend on NHEP activities while enrolled in the program; and

• the length of time the individual is expected to be in the program, the number of hours per day the individual is involved in the program, and the expected end date of the program.

8. Family/Domestic Violence

A hardship extension may be granted to an assistance group that includes an individual who is or has been a victim of family or domestic violence. Victims of domestic violence must participate in an assessment interview with a person who is trained in domestic violence and develop an individualized service plan.

Required Verification:

• Completed Form 754C, Request for Family/Domestic Violence Option, and submission of corroborative evidence that verifies the domestic violence claim. See FAM PART 323, FAMILY/DOMESTIC VIOLENCE OPTIONS (FVO), for examples of corroborative evidence; and

• participation in a mandatory assessment interview with a person skilled in family or domestic violence.

Criteria Available Only to Certain NHEP Assistance Groups

9. In Compliance with NHEP Participation Requirements (Open FANF AG’s Only)

A hardship extension may be granted to AG’s whose FANF financial assistance is open at month 60 or during an extension if all AG members mandatory for participation in NHEP work activities are currently in compliance with NHEP work program requirements. All mandatory adults in the open FANF assistance group must, at the time the extension is to begin:

• be complying with his or her Employment and Plan;

• be participating in an approved NHEP activity;

• not be sanctioned for failure to meet NHEP work program requirements;

• not be disqualified from receiving FANF financial assistance due to commission of an Intentional Program Violation at the time the 60-month time limit is reached; and

• meet all eligibility requirements for FANF financial assistance.

Required Verification: NHEP Employment Counselor Specialists (ECS) will verify compliance as part of the hardship extension review process.

10. Working 30 hours a week (Available Only to AG’s Previously Closed Due to Time Limits and Now Reapplying for FANF)

FANF cases that have been closed either due to reaching the 60-month time limit or the end of a 6-month extension period may subsequently qualify for a hardship extension if the adult who has already received at least 60 months of FANF, is working 30 or more hours a week in unsubsidized employment and the case is otherwise FANF eligible.

Required Verification: Documentation of the hours of employment, and, if requested by the Family Services Specialist (FSS), proof that the wages are not subsidized.

11. Family Does Not Meet Any Specified Hardship Criteria (Available Only to AG’s Previously Closed Due to Time Limits and Now Reapplying for FANF)

FANF AG’s that have been closed either due to reaching the 60-month time limit or the end of an extension period and that do not meet any of the hardship criteria specified in this section may request an extension based on a unique hardship condition, and have the request reviewed, provided they were in compliance with all NHEP work program and FANF eligibility requirements when the previous eligibility ended. All adults in the pending assistance group also must:

• not have voluntarily quit or refused suitable employment without good cause within 60 days of the request for an extension; and

• currently meet all eligibility requirements for FANF.

Required Verification:

• a detailed explanation on Form 785 of the reason for the extension request; and

• appropriate verification, as determined by the Hardship Review Committee, of the circumstances being presented as constituting a hardship.

In addition:

• the ECS must provide a statement on Form 785 indicating that the adult case member was in compliance with NHEP work program requirements if the member was a mandatory or voluntary NHEP participant when the most recent period of eligibility ended due to time limit policy; and

• FSS must indicate on Form 785 that the applicant had not voluntarily quit or refused employment or been disqualified for intentional program violation.

Special Situation Hardship Criteria

An "across-the-board" hardship extension may be granted:

• if New Hampshire Employment Security has determined that the state:

- is eligible for the federal/state cooperative extended benefit program pursuant to the Federal-State Extended Benefit Unemployment Compensation Act of 1970 or any other temporary federal supplemental unemployment benefit program in effect in the state; or

- has a statewide unemployment rate of 7%; and

• to families living in an area designated by the United States Department of Labor as a labor surplus area.

Required Verification: DFA State office will track and monitor these criteria and notify District Offices when any of these conditions are met and also when the circumstances above are no longer present.