SR 24-09 Dated 03/24

 

STATE OF NEW HAMPSHIRE

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

INTER-DEPARTMENT COMMUNICATION

 

FROM THE OFFICE OF:

Administrator IV of Bureau of Family Assistance (BFA) Debra E. Sorli

BFA SIGNATURE DATE:

March 25, 2024

AT (OFFICE):

Bureau of Family Assistance

TO:

All BFA Staff

All BES Staff

SUBJECT:

Obsoletion of BFA Forms and Updates to the Family Assistance Manual (FAM)

EFFECTIVE DATE:

Upon Receipt

 

SUMMARY

This Supervisory Release (SR) releases updates to the Family Assistance Manual (FAM) and also releases the obsoletion of DFA Form 797 and 797(i), Eligibility Narrative and DFA Form 261 and 261(i), Financial Assistance to Needy List (FANF) Interview Checklist.

 

NEW HEIGHTS & NH EASY SYSTEMS PROCEDURES

There are no changes to the New HEIGHTS system or NH EASY Gateway to Services.

 

DESCRIPTION OF REVISIONS MADE TO FORMS

The following changes have been made to DFA Forms:

·          DFA Form 797 and 797(i), Eligibility Narrative

-    Obsoleted

 

·          DFA Form 261 and 261(i), Financial Assistance to Needy List (FANF) Interview Checklist

-    Obsoleted

 

POLICY MANUAL REVISIONS

Family Assistance Manual Topics

Section 127.05   Notifications During the Initial Interview

§  New page

Part 803            NHEP PARTICIPANT NOTIFICATION

§  Previously called NOTIFICATIONS AT APPLICATION

Part 805            NOTIFICATIONS AT REDETERMINATION

§  Deleting

 

IMPLEMENTATION

This policy is effective upon release of this SR. All paper versions of DFA Form 797, Eligibility Narrative, and DFA 261, Financial Assistance to Needy Families (FANF) Interview Checklist, and their coordinating instruction pages must be recycled immediately. A Certificate of Destruction has been included with this SR.

 

CLIENT NOTIFICATION

No special client notification is planned or needed.

 

FORMS INSTRUCTIONS

Remove and Destroy

Insert/Replace

 

DFA Form 797, Eligibility Narrative,

DFA SR 83-114

1 singled sided sheet

None

DFA Form 797(i), Instructions for Eligibility Narrative,

DFA SR 83-114

1 single sided sheet

None

DFA Form 261, Financial Assistance to Needy Families (FANF) Interview Checklist,

DFA SR 11-30

1 single sided sheet

None

DFA Form 261(i), Instructions for Financial Assistance to Needy Families (FANF) Interview Checklist,

DFA SR 10-17

1 Single sided sheet

None

 

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, and revised Online Manuals, 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 May 25, 2024.

 

BFA:rs

 

CERTIFICATE OF DESTRUCTION

I certify that all copies of DFA Form 797, Eligibility Narrative, DFA 261, Financial Assistance to Needy Families (FANF) Interview Checklist, and their coordinating instruction pages have been destroyed.

District Office Administrative Supervisor:   _________________________________________

District Office:   ______________________________________________________________

 

 

Return this certificate to the BFA Policy Unit, 129 Pleasant St, Brown Bldg, 3rd Floor, Concord, NH 03301, after the instructions in the SR have been carried out.