323 FAMILY/DOMESTIC VIOLENCE OPTIONS (FVO) SR 16-12 Dated 06/16

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Families receiving or applying for Financial Assistance to Needy Families (FANF) financial assistance that include an individual who is or has been a victim of family/domestic violence, may request certain accommodations* in FANF or the New Hampshire Employment Program (NHEP) called Family Violence Options (FVO). FVOs may include:

 · an exemption from the 60-month lifetime limit on receipt of FANF. Note that an assessment is also required when an individual requests this FVO;

 · being excused from NHEP participation requirements. Note that an assessment is also required when an individual requests this FVO; and

 · a waiver of child support cooperation requirements. Note that the individual must complete DFA Form 754B, Good Cause Claim for Non-Cooperation with Child Support, as well if requesting this FVO, but an assessment is not required when an individual requests this FVO.

Definition of Family/Domestic Violence

The term "family/domestic violence" has the same meaning as "battered or subjected to extreme cruelty," and is defined as having been subjected to any of the following:

 · physical acts that resulted in or threatened to result in physical injury to the individual;

 · sexual abuse;

 · sexual activity involving a dependent child;

 · being forced as the caretaker relative of a dependent child to engage in nonconsensual sexual acts or activities;

 · threats of, or attempts at, physical or sexual abuse;

 · mental abuse; or

 · neglect or deprivation of medical care.

Family/Domestic Violence Standardized Procedures and Documentation

The individual requesting an FVO must complete DFA Form 754C, Request for Family/Domestic Violence Option, and provide any of the following documentation:

 · court, medical, criminal, child protective services, social services, psychological or law enforcement records;

 · a written statement from a public or private social agency;

 · a written statement from a public or private social agency providing family/domestic violence services; or

 · sworn statements from individuals, other than family members, knowledgeable of the circumstances.

Exception: If the individual requesting an FVO is unable to obtain the documentation listed above, the individual may sign the section on DFA Form 754C indicating that they or a family member are or have been a victim of family/domestic violence and that compliance with program requirements would:

 · make it more difficult for the family to escape the family/domestic violence;

 · unfairly penalize the family who is or has been victimized by such violence; or

 · put the family at further risk of family/domestic violence.

An FVO assessment is required in addition to DFA Form 754C when an individual requests:

 · an extension of the 60-month lifetime limit on FANF financial assistance; or

 · accommodations in NHEP.

False information provided on DFA Form 754C will result in the denial of the Family Violence Option request and is referred to the Office of Special Investigations (OSI) for fraud investigation if the individual received FANF financial assistance based upon the false information.

If the individual is to be referred to the AIU for a required FVO assessment, then while still with the client, the Family Services Specialist (FSS) or NHEP Employment Counselor Specialist (ECS) must contact the Assessment and Intervention Unit (AIU) at 1-800-852-3345 ext 9322 or 271-9322 to schedule the client for an FVO assessment. The AIU Counselor can speak directly with the client to schedule an appointment.

If the staff person reaches the AIU answering machine leave a message on the machine with the client’s name, case number, RID number, and a safe phone number at which a return call to the client can be made.

Regardless of whether or not AIU was contacted during the interview, follow up with an email to the mailbox FVO Community Referrals.

If it is not safe to call the client, inform the client it is their responsibility to contact the AIU within 2 business days.

If the staff person or the individual requesting the FVO does not make contact with an AIU Counselor to schedule this required FVO assessment, the FSS or NHEP ECS must notify the client that:

 · the client is responsible for contacting the AIU at the number above within 2 business days to schedule this assessment; and

 · failure to schedule and participate in this assessment will result in an automatic denial of the hardship request or *accommodations  in NHEP.

Specific Requirements

An individual may request *accommodations in NHEP based upon family/domestic violence provided the individual making the FVO request:

 · follows the Family/Domestic Violence Standardized Procedures and Documentation above for documenting and verifying a claim based upon family/domestic violence;

 · participates in an individualized FVO assessment with an AIU Counselor; and

 · develops an individualized service plan.

References: He-W 602.08(c)(1); He-W 602.10(a)(1); He-W 606.31(b); He-W 637.18(c); 45 CFR 260.50-260.55; 42 USC 602(a)(7); 42 USC 608(a)(7)(C)(iii)