10-020.A Welfare-to-Work (WTW) Exemptions
Upon the approval of CalWORKs (CW) benefits, all aided adults are required to be referred and registered to participate in Welfare-to-Work (WTW) activities, per CPG 10-005.B, unless the Human Services Specialist (HSS) determines that an individual meets exemption criteria.
An individual may request an exemption from participation in Welfare-to-Work (WTW) activities by submitting a CalWORKs Exemption Request Form (CW 2186A), as provided by the HSS or Employment Case Manager (ECM).
The ECM may also make a recommendation to exempt an individual from WTW participation when:
· A participant is unable to continue participation; or
· A Good Cause excuse per CPG 10-020.B extends beyond 30 days.
Under these circumstances, the ECM will provide all available information to the HSS to support their recommendation to exempt the individual from WTW participation.
It is the HSS’ responsibility to:
· Consider input received from the ECM, if applicable;
· Make the final determination to approve or deny the exemption, following processing timeframes outlined in CPG 10-005.J;
· Notify the individual of the final decision via the CalWORKs Exemption Determination (CW 2186B);
· Enter and/or remove the individual’s exempt or nonexempt registration status in CalWIN per How To #237; and
· Communicate with the ECM and Child Care worker, if applicable, when a change is made to an individual’s registration status.
An individual may qualify for an exemption from WTW participation under the following criteria:
Care of a Child Exemption
The care of a child exemption may be given when a parent or other relative has primary responsibility for providing care to a child 12 weeks of age or under.
New Young Child Exemption
The new young child exemption is a once-in-a-lifetime exemption that may be given when an individual is a primary caretaker for a child age 23 months or younger. This exemption will only be given at the individual’s request, as documented per their completed CalWORKs Exemption Request Form (CW 2186A).
The HSS and ECM will discuss the availability of the new young child exemption with any individual who meets the criterion for this exemption, including how his/her decision to use the exemption now or in the future will affect his/her eligibility to benefits and services.
The occurrence and outcome of each new young child discussion will be documented in CalWIN case comments, and may occur during, but are not limited to, the following circumstances:
· Initial CalWORKs intake interview;
· WTW orientation/appraisal appointment,
· Annual CalWORKs redetermination, and/or
· Subsequent contacts with the individual that involve reviewing WTW registration status.
Once an individual receives this exemption and it is ended for any reason, it may not be given again even if the child has not yet reached 24 months. The exemption is considered to have ended when the case closes for any reason.
NOTE: When CalWORKs eligibility is restored per CPG 40-125.B or a previous discontinuance is rescinded, the new young child exemption may continue to be given unless exemption criteria are no longer met.
When documenting the outcome in CalWIN case comments, the HSS/ECM will select the appropriate record from the drop-down menu from the type field:
NEW YOUNG CHILD CASE COMMENT TYPE
TRANSITIONING FROM A AB X4 4 TEMPORARY EXEMPTION
An individual who is exempt under the AB X4 4 temporary young child exemption as of December 31, 2012 should not be offered the new young child exemption until he/she is in the reengagement process, are described in CPG 10-001 I. and CPG 10-001 J..
Refer to CPG 11-001.E for New Young Child Exemption Questions and Answers.
For two-parent households, only one parent (the primary caretaker) at a time may qualify for an exemption based on providing care for a young child. The other parent will be required to participate in WTW unless he/she meets other exemption criteria.
When the primary responsibility for providing care for a child changes, only the parent who has primary caretaking responsibility will qualify for the exemption if eligible to either of the following:
· Care of a child exemption (per CPG 10-020.A.3); or
· New young child exemption (per CPG 10-020.A.4).
NOTE: Effective January 1, 2013, AB X4 4 temporary exemptions can no longer be transferred between parents in a two-parent household.
SWAPPING THE NEW YOUNG CHILD EXEMPTION
Parents in the same household may swap the new young child exemption only once. After a parent has used this exemption, he/she will not qualify for it again, regardless of the number of months for which the exemption was received.
If a parent has used the new young child exemption, and later moves to a new Assistance Unit (AU), he/she will not qualify to use the exemption again.
EXEMPTIONS AND AID CODES
In a two-parent household, if both parents are considered employable, the Assistance Unit (AU) receives CalWORKs under the aid code 35.
If one parent becomes exempt, both parents are no longer considered employable and the aid code changes to 30.
When the exemption ends, the CalWORKs aid code changes to 35 effective the first of the month following the end date of the exemption.
Please refer to CPG 10-001.D for WTW participation requirements.
Medical Verification (CW 61)
Medical documentation is required to be provided before the HSS can make a final determination to approve a WTW exemption based on any of the following:
· Caring for an ill or incapacitated household member; and
· Pregnancy - Temporary Incapacity.
Note: A household member who is receiving SSI/SSP does not automatically exempt a recipient from participating in WTW.
In order for the documentation to be considered “acceptable,” certain conditions must be met. The medical documentation must:
· Verify that an individual’s ability to be regularly employed or to participate in WTW activities is impaired by either his/her own medical condition or that of a household member.
· Be signed by a licensed doctor. As defined by the California Department of Social Services (CDSS) a “licensed doctor” means a health care professional who is licensed by a State to diagnose and treat physical and mental impairments that can affect an individual’s ability to work or participate in WTW activities, which includes, but is not limited to, doctors of medicine, osteopathy, chiropractic, and licensed/certified psychologists.
NOTE: Medical verification may be provided by a doctor practicing/licensed outside of California. In these instances, staff will need to clarify that the doctor maintains a valid license issued by a U.S. state.
· Contain the expected duration and extent to which the disability impairs employment and indicate that the individual is actively seeking appropriate treatment for the disability, as verified by a doctor.
MEDICAL VERIFICATION FORMS
When an exemption based on a medical condition is requested, the HSS or ECM will provide the individual with the Authorization to Release Medical Information (CW 61 Coversheet and CW 61).
If the CW 61 does not contain sufficient information regarding the medical condition, the HSS or ECM will provide the following supplemental medical verification forms:
1. Physical Capacities (CW 61A); and/or
2. Mental Capacities (CW 61B).
The CW 61A and/or CW 61B may be used by the HSS and/or ECM to:
· Obtain additional medical information needed to establish if a basis for exemption exists; or
· Determine if there are any limitations that may affect the individual’s participation in certain types of WTW activities.
The ECM may provide the doctor with a description of the individual’s assigned or planned WTW activities and/or participation hours in the top portion of the CW 61A and CW 61B.
NOTE: Since the CW 61A and CW 61B are supplemental forms, they do not contain any section to allow authorization to release medical information. Therefore a CW 61 Coversheet and CW 61 must always be included with the CW 61A and CW 61B.
An individual will be exempt from WTW effective the date the individual meets exemption criteria, including the receipt of all required verifications. If the individual is sanctioned for noncompliance with WTW requirements, the sanction will be temporarily suspended while the exemption is in place. Once the exemption ends, the sanction will resume.
NOTE: The AB X4 4 temporary exemption will automatically cure a sanction for noncompliance with WTW requirements.
EXEMPTIONS BASED ON A MEDICAL CONDITION
An individual must disclose if he/she has an existing medical condition that may limit or exempt him/her from WTW participation.
When an individual who has had the opportunity to disclose an existing medical condition, but fails to do so in a timely manner, the exemption will be given effective upon the receipt date of the CW 61 or other approved medical verification, regardless of the onset date of the medical condition as indicated on the verification.
An exemption from WTW participation will end effective the last day that an individual meets exemption criteria. The individual will be referred and registered to WTW effective the following day, unless other exemption criteria are met.
When an individual is no longer eligible to an exemption, the HSS will:
· Update the exemption status in CalWIN per How To #237; and
· Refer and register the individual to WTW per How To #248.
See CPG 10-020.A.12 for information regarding reviewing exemptions based on a medical condition.
CalWORKs applicants and recipients are required to apply for any unconditionally available income as outlined in CPG 44-100.C.
The HSS must refer the individual to the Social Security Administration (SSA) to apply for Social Security Disability Insurance (SSDI) benefits if the following is identified:
· A physical, mental or emotional disorder that exempts the recipient from WTW and is expected to last 12 months or more; or
· Medical documentation of a disorder that has lasted or is expected to last over 12 months and exempts the recipient from WTW activities.
Effective August 1, 2003, an exempt CalWORKs recipient whose exemption status is based on a medical condition, either his/her own medical condition or that of a household member, will no longer be allowed to voluntarily participate in WTW unless he/she provides verification releasing him/her to return to work or participate in WTW activities.
Before being allowed to voluntarily participate in WTW, an exempt individual must provide medical verification that:
· Meets criteria outlined in CPG 10-020.A.6;
· Indicates that he/she is able to work or participate in WTW activities; and
· Indicates the number of hours that he/she is able to participate.
Under certain circumstances, the individual may provide documentation to verify that he/she is no longer:
· Required to provide care for a child who is a dependent/ward of the court; or
· Caring for an ill or incapacitated household member or that another person has taken over that responsibility.
An exempt individual will be allowed to volunteer for any number of hours as permitted by their medical verification.
NOTE: If new medical verification indicates that the exempt individual is able to meet the WTW participation hours required per CPG 10-001.D, even with limited physical or mental capacity, then the individual’s exemption status will end. The individual will be required to participate in WTW and the ECM must work with the individual to modify their WTW plan as appropriate.
The ECM will determine the number of hours that an exempt individual may participate in WTW activities, based on the medical verification provided. Exempt volunteers may be assigned to appropriate WTW activities as per CPG 10-005.H; however, weekly participation hour requirements (CPG 10-001.D) do not apply.
If an exempt volunteer fails to participate in a scheduled WTW activity, the ECM and HSS will take action in accordance with CPG 10-025.H.
SELF-INITIATED PROGRAMS (SIPs)
The sequence of WTW activities defined in CPG 10-005 also applies to exempt volunteers and includes making Self-Initiated Program (SIP) determinations. In order to qualify for a SIP, the individual must be enrolled in a qualifying program prior to the initial appraisal, regardless of the individual’s exemption status, per CPG 10-015.A.
ENDING VOLUNTARY WTW PARTICIPATION
If an exempt volunteer is no longer able to participate in WTW, the ECM will:
· Discontinue the individual from the activity and the Supportive Services with timely notification;
· Alert the HSS to update the individual’s WTW registration status in CalWIN per How To #237; and
· Send the Child Care Communication Form (27-128) to the appropriate Child Care staff to notify them of the individual’s change in WTW registration status.
WTW exemptions are required to be periodically reviewed to determine if:
· The medical condition or other basis for the exemption has changed;
· The individual continues to seek medical treatment; per CPG 10-020.A.6, and
· Resources are available to help the recipient overcome any barriers which impair his/her participation in WTW.
Exemption reviews will be performed by the HSS at least annually during the CalWORKs redetermination; however, the HSS and/or ECM may review an individual’s exemption status more frequently, as needed.
REVIEWING EXEMPTIONS BASED ON A MEDICAL CONDITION
An individual may request an exemption based on a medical condition at any time and will be given the opportunity to provide verification as outlined in CPG 10-020.A.6. The exemption will be reviewed as follows:
NOTE: The HSS or ECM may request medical verification at any time if there is reason to believe that there has been a change in the individual’s condition that may affect his/her exemption status.
See CPG 10-020.A.8 for establishing exemption end dates.
The following table shows how each exemption category, as described in CPG 10-020.A.2, affects the TANF 60-Month, CalWORKs 48-Month Time on Aid (TOA), and WTW 24-Month Clocks:
See CPG 15-100.A for additional information regarding the TANF 60-Month and CalWORKs 48-Month Clocks.