SR 12-19 Dated 11/12

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This SR releases policy related to the issuance of financial assistance benefits to the following groups:

·   Financial Assistance to Needy Families (FANF) and State Supplement Program (SSP) financial assistance applicants and recipients; and

·   Guardians, Conservators, and Protective Payees.

FANF and SSP financial assistance applicants and recipients can now opt to have their financial assistance benefits issued via Electronic Funds Transfer (EFT) or Electronic Benefits Transfer (EBT). Formerly, EFT was the primary method for FANF and SSP financial assistance benefit issuance. This policy change was made at the request of DFA Management Team, in response to feedback received from Field Operations and the Bureau of Welfare to Work.

Formerly, guardians, conservators, and protective payees were allowed to choose paper check as their client’s FANF or SSP financial assistance benefit issuance method. The Department is no longer issuing paper checks. Guardians, conservators and protective payees must choose to have their client’s FANF or SSP financial assistance benefits issued via EFT or EBT.

As a result of this change to allow FANF and SSP applicants and recipients a choice in the method of their cash assistance benefit issuance, new electronic DFA Form 706, Information Needed to Process Electronic Funds Transfer (EFT), was created to collect bank account information from FANF and SSP applicants/recipients who do not have their bank account information with them at the time they are in contact with the Family Services Specialist (FSS). This form can be used to obtain bank account information from non-NHEP-related vendors as well. Instructions for this form were created accordingly.

New electronic Form NHEP251, NHEP Provider Enrollment, was developed to replace the electronic test version Form NHEP251T, Provider Enrollment (Test Version). Form NHEP251 is designed to enroll NHEP providers only, as this enrollment process occurs in the Bridges system and is processed by the Data Management Unit (DMU). New Form NHEP251 now includes a section to collect bank account information for NHEP providers who wish to receive payment via EFT. Instructions for this form were updated accordingly.

BACKGROUND

The change to allow clients a choice in their cash benefit issuance method is primarily due to feedback from Field Operations and the Bureau of Welfare to Work that mandating the issuance of financial assistance payments to a client’s bank account via EFT exposes many low-income clients to high bank fees due to overdraft or minimum balance bank policies. Bank fees applied to the client’s account are then potentially diminishing the client’s monthly FANF or SSP cash grant received from the Department. Formerly, EFT was the primary method for FANF and SSP financial assistance benefit issuance because it was determined to be more cost effective for the State.

In keeping with the Department-wide initiative to move toward a more financially and environmentally responsible paperless system, DFA is eliminating the paper checks issued to EA vendors, guardians, conservators, and protective payees. The Department expects to achieve significant savings in administrative costs through this change.

POLICY

FANF and SSP cash benefits may be issued via EFT or EBT. The FANF or SSP casehead chooses which benefit issuance method to use.

Guardians, conservators, and protective payees have the option of receiving financial assistance benefits on behalf of their clients via EBT or EFT.

DESCRIPTION OF NEW ELECTRONIC DFA FORM 706

DFA Form 706, Information Needed to Process Electronic Funds Transfer (EFT), is a single sheet, one-sided, document that has been created to collect banking information from clients and non-NHEP-related vendors/providers for EFT benefit issuance. Because it is expected that this form will only need to be used on rare occasions, it is being released as an electronic form. The form can also be used to switch bank accounts for EFT benefit issuance. This form replaces DFA Form EFT-V/P, Information Required to Process Electronic Funds Transfer (EFT) – Vendor/Provider.

Electronic DFA Form 706 collects the following information needed to process EFT:

·   the client’s/vendor’s name;

·   the client’s case number (If a vendor is filing out this form, this line can be left blank);

·   the bank name;

·   the name as it appears on the bank account;

·   the bank account number;

·   the bank routing number;

·   the bank account type, checking or savings;

·   the signature and printed name of the individual completing the form; and

·   the date the form is completed.

Electronic DFA Form 706 is NOT required for a client to choose EFT as their benefit issuance method. If the applicant or recipient has the bank information required to process EFT (which includes the routing number for the individual’s account, the individual’s account number, and the Bank name) readily available when in contact with the FSS, electronic DFA Form 706 is not needed. The information can be immediately entered into New HEIGHTS on the "Electronic Funds Transfer" screen or the "Vendor Details" tab. This form only needs to be used when the individual does not have the needed banking information readily available and/or New HEIGHTS is unavailable.

New electronic DFA Form 706 is not retained in the case record. It can be destroyed as soon as the information is entered into New HEIGHTS. Instructions for this new form were created accordingly. Note: This form cannot be used in lieu of providing account balance information, which is still required verification for all cash assistance programs.

Note: DFA Form 706 both replaces and expands upon DFA Form EFT-V/P. This means that where formerly DFA Form EFT-V/P was used only with non-NHEP-related vendors and providers (such as landlords or utility companies working with the Department through the Emergency Assistance Program) when New HEIGHTS was inoperative and/or the New HEIGHTS-generated AE0006, Vendor Enrollment, could not be accessed, it is now also used by clients, as needed, when the client’s EFT information cannot be readily entered directly into New HEIGHTS. Use new electronic DFA Form 706 as follows:

·   For non-NHEP-related vendors and providers:

1. Use DFA Form 706 with vendors/providers only when New HEIGHTS is unavailable and/or the AE0006 cannot be generated.

2. If DFA Form 706 must be used with a vendor/provider who is currently enrolled with the Department because the vendor/provider needs to change the EFT account information they have provided to the Department, send DFA Form 706 to the vendor/provider.

3. If DFA Form 706 must be used with a new vendor/provider who is not enrolled with the Department, and the worker cannot access New HEIGHTS so that the AE0006 can be generated, send DFA Form 706 to the vendor/provider along with Form AW-9, Alternate W-9 Form-CIS.

·   For clients:

1. Use DFA Form 706 with clients only when New HEIGHTS is unavailable or the client does not have the needed EFT banking information readily available.

2. If DFA Form 706 must be used, provide DFA Form 706 to the client along with a District Office-specific Central Scanning Unit business reply envelope.

New electronic DFA Form 706 will be transmitted to each District Office with the electronic release of this SR. Contact Linda White at 271-9474 with any questions related to transferring the electronic version of this form to your PC. Electronic DFA Form 706 can be used immediately upon receipt and as instructed in this SR. Any DFA Form EFT/VP on hand can be recycled. A Certificate of Destruction has been included with this SR. There are no plans to translate DFA Form 706 at this time.

DESCRIPTION OF NEW ELECTRONIC FORM NHEP251

Form NHEP251, NHEP Provider Enrollment, is a single sheet, double-sided, electronic document used to:

·   enroll NHEP providers of goods and services, such as child care registration fees, education and training fees, employment related fees, books, supplies, job tools, work clothing, uniforms, automobile repairs and other authorized services, with the Department, so that the NHEP provider can receive payments from DHHS; and

·   report NHEP provider changes, such as changes of address, incorporation, provider name, or bank account information.

NHEP Employment Counselor Specialists (ECS) provide the electronic Form NHEP251 to NHEP providers. The NHEP provider completes Form NHEP251 and returns it to the Data Management Unit (DMU). DMU then enters the information from Form NHEP251 into the Bridges system.

This form replaces the electronic test version Form NHEP251T, Provider Enrollment (Test Version), released via email from the Welfare to Work Bureau Chief to ECS on August 05, 2011. As of the release of this SR, any Form NHEP251T on hand can be recycled. A Certificate of Destruction has been included with this SR.

With the input of DMU and DHHS Finance, the following changes have been made to electronic Form NHEP251:

·   A section has been added for the NHEP provider to enter bank account information for the purpose of receiving payment via EFT. (Note: This form cannot be rejected if the provider does not include bank account information.) This EFT-related section includes fields for the following information:

- Account holder name;

- Bank name and address;

- Account number and routing number; and

- A check box for the appropriate account type: checking, or savings.

·   The ECS name and District Office has been moved to the top of the form.

·   Transaction type (new, change, or terminate) no longer includes the A, C, or X code. DMU and DHHS Finance have indicated that these codes are now outdated.

·   Instructions for the NHEP provider to return the form to DMU, and DMU’s address, have been included at the top of the form.

·   Instructions to return Form NHEP251 along with a voided check or deposit slip have been included on the form at the request of DMU.

·   A signature line and signature date have been included to be completed by the NHEP provider, along with the following disclaimer: I certify that I have read and understand the instructions for this form. My signature authorizes payments to be sent to the designated account above.

·   More spaces have been added for those NHEP providers who have multiple Bridges Resource Identification numbers.

·   Child Care-Contracted, Child Care-Licensed, and Child Care-Unlicensed check boxes have been removed from the Services Provided section as this form is only used for child care registration fees. The Child Development Bureau (CDB) has their own CDB form to enroll child care providers with the Department.

·   The Local and State Office Use Only section has been removed. DMU and DHHS Finance have indicated that this section is no longer needed.

·   Instructions for the NHEP provider on how to fill out the Form NHEP251, located on the back of the form, have been updated to include instruction for the Bank Account section.

·   Instructions on the back of the Form NHEP251 now include the following disclaimers related to EFT:

- Access To Account – Once the direct deposit is completed, any questions regarding access to funds are between the payee and the bank. All inquiries and liabilities regarding access to funds must be addressed to the bank. DHHS is not responsible for any fees charged to you by your bank.

- False Statements or Fraudulent Claims - State law provides a fine of not more than $2,000 or imprisonment for not more than one (1) year or both for giving false information in connection with making a written or electronic false statement that the party does not believe to be true (NH RSA 651:2 and 641:3).

Instructions for electronic Form NHEP251 have been updated accordingly and now include:

·   Instructions for DMU to email the ECS to notify them that the NHEP provider enrollment is complete; and

·   DMU now retains Form NHEP251 for 3 years from the date of completion, and it is no longer retained in the NHEP case file.

Use new electronic Form NHEP251 as follows:

·   The standing stock of current and older versions of test version Form NHEP251T must be recycled and/or destroyed. A Certificate of Destruction has been included with this SR.

·   Form NHEP251 will be transmitted to each District Office with the electronic release of this SR. Contact Linda White at 271-9474 with any questions related to transferring the electronic version of this form to your PC. Form NHEP251 can be used immediately upon receipt and as instructed in this SR.

·   The New HEIGHTS-generated WP0013, Provider Enrollment Packet, is associated with new Form NHEP251. Until changes in New HEIGHTS can be made to align the WP0013 with the changes to Form NHEP251 released in this SR, ECS must suppress the WP0013 and instead mail the following to new NHEP providers:

- Form NHEP251;

- Form AW-9L, Request for W-9 Information; and

- Form AW-9, Alternate W-9 Form-CIS.

District Office staff will be notified under separate cover and at a later date when New HEIGHTS has made all needed changes to the WP0013.

IMPLEMENTATION

The policy released in this SR is effective upon release.

However, until New HEIGHTS system changes can be put into place:

·   FANF and SSP financial assistance recipients must be prompted to choose between EFT or EBT to implement the policy changes as stated above. If the casehead chooses EFT and does not provide the information needed to issue benefits via EFT, or the bank account information the casehead provides results in a failed EFT transfer, as indicated via the New HEIGHTS Reports/DO Daily Reports EFT Benefit/Prenote Failure Report (NB1700RA), workers must manually select EBT for the case. "Paper check" must not be selected from the payment option dropdown box.

·   "Paper check" must not be selected from the payment option dropdown box on the "Benefit Issuance" screen for cases involving guardians, conservators, and protective payees. Only EFT or EBT may be chosen. Cases with assigned public guardians including Tri-County Cap, Monadnock Developmental Services, Pathways, Community Bridges, and Northern Human Services, are being converted to EFT at the State Office level. The agencies who have converted to EFT will be sending the new electronic DFA Form 706 along with the application for any new clients.

·   ECS must suppress the generation of the WP0013 and instead mail the following to new NHEP providers:

- Form NHEP251;

- Form AW-9L, Request for W-9 Information; and

- Form AW-9, Alternate W-9 Form-CIS.

Form implementation is as follows:

·   Electronic DFA Form 706 and electronic Form NHEP251, both transmitted to each District Office with the electronic release of this SR, can be used immediately upon receipt and as instructed in this SR. The forms can also be accessed by DHHS employees via the Family Services database in Lotus Notes. Contact Linda White at 271-9474 with any questions related to transferring the electronic versions of these forms to your PC.

·   Recycle all versions of DFA Form EFT/VP and Form NHEP251T on hand. A Certificate of Destruction has been included below.

RELATED REVISION MADE TO DFA FORM 800A

DFA Form 800A, DFA Programs & Services Guide, also required text changes to incorporate the revised policy released in this SR. See DFA SR 12-04 dated July 2012 for more information about the text changes to DFA Form 800A.

POLICY MANUAL REVISIONS

Revised Family Assistance Manual Topics

PART 615  BENEFITS: DETERMINATION, FREQUENCY, AND ISSUANCE

PART 707  ISSUING FINANCIAL ASSISTANCE BENEFITS

PART 831   PAYMENT TO NHEP PROVIDERS

PART 929   PROVIDER QUALIFICATIONS FOR NH CHILD CARE SCHOLARSHIP

Revised Adult Assistance Manual Topics

PART 115   VENDOR PAYEES

Section 617.01  Assistance Payments: Determination, Frequency, and Issuance

PART 705  ISSUING BENEFITS

CLIENT NOTIFICATION

Notification of the changes to He-W 671.02 and He-W 671.04 to support the elimination of paper checks to guardians, conservators, and protective payees, and the option for cash applicants and recipients to chose between EFT and EBT, was published in the NH Rulemaking Register, Office of Legislative Services, on April 26, 2012. A public hearing on the amended Administrative Rules was held on May 17, 2012.

The Office of Public Guardian, working with State Office, has had all their financial assistance benefit recipients successful switched to EFT as of August 21, 2012. State Office will be working with other public guardian agencies to switch them over to EFT as well.

At a later date, notification will be sent to guardians, conservators, and protective payees that paper checks will no longer be issued. District Offices will be alerted of this mailing under separate cover prior to the notification occurring.

TRAINING

No special training is planned or needed.

FORMS MANUAL POSTING INSTRUCTIONS

DISPOSITION

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

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 December 31, 2012. Additionally, this SR, and printed pages with posting instructions, will be distributed under separate cover to all internal hard copy holders of the Family Assistance, Adult Assistance, and Forms Manuals.

DFA/LRB:s