SR 12-15 Dated 03/12

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases the following revised forms and their associated instructions:

·   DFA Form 754B, Good Cause Claim for Non-Cooperation with Child Support, and its Spanish translation, DFA Form 754B(Sp); and

·   DFA Form 780, Good Cause Decision Sheet.

Revisions to the forms, but primarily the instructions to the forms, incorporate improved processes for sharing information between the Division of Family Assistance (DFA) and Division of Child Support Services (DCSS) due to the expansion of the Electronic Document Imaging management process to DCSS.

DESCRIPTION OF REVISIONS MADE TO FORMS

DFA Form 754B, Good Cause Claim for Non-Cooperation with Child Support, is used as follows:

·   DFA: As the Temporary Assistance to Needy Families (TANF) applicant or recipient’s official statement regarding whether they will or will not be making a good cause claim for non-cooperation with child support requirements.

·   DCSS: Upon receipt of DFA Form 754B, DCSS suspends all child support activity until a final decision has been made on the good cause claim by DFA.

There are no changes in how DFA Form 754B will be used with TANF clients. However, DFA Form 754B will no longer be printed as a 3-PART, no-carbon-required (NCR) form. Due to the availability of Electronic Document Imaging in all District Offices and the expansion of the process to DCSS staff, NCRs are no longer required. Instead, when using the new version of the form, Family Services Specialists (FSS) or DCSS workers will scan the form once it is completed, and then provide the original to the applicant for the applicant’s records.

Once the completed DFA Form 754B is scanned, the enhanced shared document process "releases" the DCSS Form 725, Application for Child Support Services, DFA Form 754B, and any other scanned documents associated with Child Support services to "OnBase," the DCSS electronic case management system. New HEIGHTS will share information with OnBase as the shared documents are released. Other scanned information associated with Child Support Services that will be electronically shared with OnBase, other than DCSS Form 725 and DFA Form 754B, may include:

·   DCSS Form S637, Safeguard Request;

·   DFA Form 754C, Request for Family/Domestic Violence Option;

·   DFA Form 780, Good Cause Decision Sheet;

·   the child’s birth certificate; and

·   the TANF client’s family/domestic violence (FDV) statement.

Along with the scanned documents, the Recipient Identification (RID) number and District Office fields will be autopopulated in the appropriate OnBase fields and the Master Index table, using NECSES Member and the RID number link. Each morning, OnBase will list any new information that has been electronically sent from New HEIGHTS.

The Spanish version of this form, DFA Form 754B(Sp), and the instructions for DFA Form 754B were updated accordingly. The Bosnian version of this form will be released under separate cover.

DFA Form 780, Good Cause Decision Sheet, was previously used as follows:

·   By DFA to inform DCSS of the results of a good cause determination for non-cooperation with child support requirements, and to provide other information necessary for the good cause reports.

·   By DCSS to inform DFA that the good cause determination had been reviewed and then to notify DFA whether or not DCSS concurred with DFA’s decision based upon the supporting documentation supplied by DFA and documentation and information available to DCSS.

DFA Form 780, Good Cause Decision Sheet, has been revised as follows:

·   DFA no longer needs to supply DFA Form 780 for DCSS’ signed approval of DFA’s decision on the good cause request. DCSS initiated this alteration in the good cause decision process because DCSS indicated that DCSS and DFA have consistently agreed on the decisions DFA makes, and the additional step of requiring a DCSS signature on the decisions is therefore no longer needed. As such, the DCSS section was removed from DFA Form 780.

·   Additionally, DFA Form 780 will no longer be printed as a 3-PART, NCR form. Due to the availability of Electronic Document Imaging in all District Offices and the expansion of the process to DCSS staff, NCRs are no longer required. Instead, when using the new version of the form, FSS will scan the form once it is completed, and then prepare, scan, and send DFA Form 781, Good Cause Claim/FVO Decision, to the TANF client per current policy. DCSS workers will be notified of the decision on DFA Form 780 via the shared document process described in the description above in the changes to DFA Form 754B.

Instructions for DFA Form 780 were updated accordingly.

All workers should continue to use the old versions of DFA Form 754B, DFA Form 754B(Sp) and DFA Form 780 until the supply is exhausted. FSS, however, no longer need to send DFA Form 780 to DCSS as of the release of this SR. The new English versions of DFA Form 754B and DFA Form 780 will be printed when the current supply is depleted and can be reordered using the Quarterly Forms Order (QFO), per usual process. When more DFA Form 754B(Sp) are needed, contact the Policy Development Unit. The Bosnian translation of DFA Form 754B will be released under separate cover.

POLICY MANUAL REVISIONS

Revised Family Assistance Manual Topics

Section 311.17  Good Cause for Non-Cooperation

Section 311.23  Good Cause: Notifying the Division of Child Support Services (DCSS)

IMPLEMENTATION

District Offices and DCSS staff are to continue to use the old versions of DFA Form 754B, DFA Form 754B(Sp), and DFA Form 780 until their supply is exhausted. FSS, however, no longer need to send DFA Form 780 to DCSS as of the release of this SR. The new English versions of DFA Form 754B and DFA Form 780 will be printed when the current supply is depleted and can be reordered using the QFO, per usual process. When more DFA Form 754B(Sp) are needed, contact the Policy Development Unit.

CLIENT NOTIFICATION

No special client notification is planned or needed.

TRAINING

No special training is planned or needed.

FORMS MANUAL POSTING INSTRUCTIONS

*The process changes described in this SR were originally going to be released in SR 11-47 and a small supply of the form was printed under this original SR number, with no subsequent release of the SR. Once the supply of this interim version of the form is depleted, the final version of DFA Form 754B released in this SR, DFA SR 12-15, will be printed. All currently available versions of DFA Form 754B are valid and must be acted upon accordingly.

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the SR has been posted to the On-line manual.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective April 30, 2012. Additionally, this SR will be distributed under separate cover to all internal hard copy holders of the Forms and Family Assistance Manuals.

DFA/JBV:s