SR 23-33 Dated 12/23

STATE OF NEW HAMPSHIRE

DEPARTMENT OF HEALTH & HUMAN SERVICES - Bureau of family assistance (bfa)

INTER-DEPARTMENT COMMUNICATION

SUMMARY

This Supervisory Release (SR) releases updates to BFA Form 785, Hardship Extension Requests.

POLICY

No policy is being changed by the release of this SR.

NEW HEIGHTS & NH EASY SYSTEMS PROCEDURES

New HEIGHTS will have the revised batchable BFA Form 785, Hardship Extension Requests, along with its newly translated Spanish version available by January 2023.

NH Easy will also have BFA Form 785, Hardship Extension Requests, along with its newly translated Spanish version available in its “Forms” section by January 2023.

DESCRIPTION OF REVISIONS MADE TO FORMS

The following changes have been made to BFA Forms:

§  BFA Form 785, Hardship Extension Requests

-   Updated Assessment and Intervention Unit’s (AIU) toll free phone number extension;

-   Added a question asking the client if they completed the form alone or if they received help, with a signature line for the person to print and sign their name that assisted them; and

-   Now available in Spanish.

§  BFA Form 785(i), Hardship Extension Requests

-   Minor editorial changes.

Place an order through the DHHS Warehouse/Logistics via the District Office’s Quarterly Forms Order (QFO) when a supply of the new version(s) are needed.

The new version of BFA Form 785, Hardship Extension Requests as well the new Spanish translated version will also be available electronically on the DHHS website at http://www.dhhs.nh.gov/forms-documents-0 and NH EASY Gateway to Services at https://nheasy.nh.gov/#/forms.

BFA Forms Form 785, Hardship Extension Requests,BFA Form 785(Sp), Hardship Extension Requests, and the associated instructions will also be available internally, for Department staff only, on the N:\ drive upon release of this SR.

POLICY MANUAL REVISIONS

Family Assistance Manual Topics

Part 323                   FAMILY DOMESTIC VIOLENCE OPTIONS (FVO)

Section 808.09        Referral to NHEP

IMPLEMENTATION

The current paper version of BFA Form 785, Hardship Extension Requests, will be used until the supply is exhausted, at which point the new paper version can be ordered.  Upon sending the paper version of BFA Form 785 to the client, manually correct AIU’s extension number from ext. 9322 to ext. 19322.

CLIENT NOTIFICATION

No special client notification is planned or needed.

TRAINING

No special training is planned or needed.

FORMS 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 Online Manuals.

DISTRIBUTION

This SR will be distributed according to the electronic distribution list for BFA policy releases. This SR, will be available for agency staff in the Online Manual Library, and for public access on the Internet at https://www.dhhs.nh.gov/sr_htm/sr.htm, effective January 1, 2024.

BFA:rs