WAG 03-06-05-g: Review of Exception

PM 03-06-05-g.

Once an exception is approved, it continues until a review is completed, even if the review date is past. The Family Community Resource Center may start a review before the due date if they become aware of a change that may affect the exception. Code E, Exception Review, appears on the PAL for the month prior to the review month (4-digit date) listed with code 683 EXCPT. It appears as overdue 2 months after the code 683 date and every other month thereafter until the date is revised or code 683 is removed.

When code E appears or a change occurs, take the following action:

1. (FCRC) Review the case and determine if there has been a significant change since the exception was originally approved or last reviewed.
2. (FCRC) If the client has failed to cooperate with an intensive program or approved education program, begin the reconciliation process (see WAG 03-13-04).
   1. If reconciliation is successful, wait until the case appears on the PAL to do an exception review.
   2. If reconciliation is unsuccessful, impose an activity sanction (WAG 03-13-05) and complete an exception review right away.
3. (FCRC) Obtain whatever information and verification are needed to determine if the same or any other exception reason applies.
   1. When the client is unable to provide 3rd party verification (such as Form 183A or medical documents), assist the client in obtaining it. Use the procedures in WAG 02-07-02-b regarding 3rd party verification. As long as the client is cooperating, the exception continues past the review month. Keep BPD informed of your progress in obtaining the information.

      Example: Ms. N has an exception due to care of her son. The review is due in March 2003. The Family Community Resource Center contacts Ms. N in February 2003 to review the family situation. Ms. N says she is still caring for her son and asks for help to get the medical information from her son's doctor. The doctor fails to return Form 183A by cut-off for March 2003, and the Family Community Resource Center informs BPD of the reason for the delay.

      The Family Community Resource Center submits Form 183A to CAU when it is finally received. The Family Community Resource Center completes Form 4692 when they receive the CAU decision and forwards all information to BPD. The exception continues throughout this process. The exception ends only if the Exception Committee decides the family no longer qualifies. The family then receives the 3-month extension. 

   2. If the client fails to provide available information or cooperate with 3rd party verification or the reason for exception no longer exists, the Family Community Resource Center explains the situation on Form 4692.
4. (FCRC) Complete a new Form 4692; enter the 4-digit date the review is due, add any new case information, and make a recommendation.
5. (FCRC) Obtain the signature of the Family Community Resource Center administrator or their designee.
6. (FCRC) Send the new Form 4692 and verifications to BPD.
7. (BPD) Presents the case to the Exception Committee. Enters the decision and, if applicable, the next review date on the new Form 4692 and faxes it back to the Family Community Resource Center with a cover memorandum.
8. (FCRC) Take appropriate action based on the review decision. Follow the instructions in the cover memorandum.
   1. If the exception continues:
      • Enter the new 4-digit review date with Item 80 code 683 EXCPT, indicating when the next exception review is needed. When the code 683 date is at least 2 months after the effective month, the case no longer appears on the PAL with code E. The date entered cannot be more than 12 months after the effective month.
      • If the exception reason changes, change the exception code in Item 60.
   2. If the exception ends:
      • Notify the client by completing and sending Your Time Limit Exception Ends (Form 4699).
      • Immediately remove the Item 60 exception code (by entering a dash over it) and Item 80 code 683. The case will no longer appear on the PAL with code E.
      • Meet with the client and revise the RSP. Add activities and steps designed to help the family become self-supporting within 3 months.
9. (System) When exception ends, automatically provides a 3-month extension of TANF benefits.
10. (FCRC) Follow policy for the applicable sanction level if a sanctioned client wants to cooperate during the extension.

    NOTE: The client may file another exception request if they again participate in the program. However, if the exception is approved and they have a 2nd or 3rd level sanction, they must serve all 3 months before full benefits can be restored.

    Example: Ms. C has an exception due to participation in a substance abuse program. Program staff notify the Family Community Resource Center that Ms. C stopped coming to meetings. Family Community Resource Center sends Form 2846 to Ms. C scheduling a reconciliation meeting on 08/01/02. Ms. C fails to attend the meeting and does not contact the Family Community Resource Center to have it rescheduled. On 08/05/02, Family Community Resource Center imposes an activity requirement sanction effective 09/02. (Ms. C previously had a sanction for child support, so it is a 2nd level sanction.)

    Family Community Resource Center also completes Form 4692 on 08/05/02, with the new information regarding Ms. C's noncooperation. They send it to BPD with a copy of Form 2846.

    On 08/14/02, the Exception Committee determines Ms. C is no longer eligible for an exception. BPD notifies the Family Community Resource Center via Form 4692 and cover memorandum. The Family Community Resource Center sends Form 4699 and removes the exception code and Item 80 code 683 effective 09/02. The system enters Item 80 code 687 with date 09/02; the extension period is 09/02 - 11/02.

    When Ms. C receives her reduced benefits on 09/03/02, she contacts the Family Community Resource Center. She states she will cooperate with the substance abuse program and wants to have her benefits restored. Family Community Resource Center helps her complete an Exception Request (Form 4691) and an Agreement to Cooperate (Form 3180) that requires her to attend meetings for 2 weeks to prove cooperation. Family Community Resource Center faxes Form 4691 to BPD.

    Ms. C fulfills the agreement, as verified by program staff. Family Community Resource Center uses TA 31/TAR 51 to change the Item 80 code 176 sanction reason code to 00 effective 10/02. On 09/20/02, Family Community Resource Center completes Form 4692 and faxes it to BPD with a copy of Form 3180 and the verification from program staff.

    The Exception Committee approves the exception on 10/02/02. Family Community Resource Center enters the exception coding effective 11/02. Entry of the exception coding automatically removes the extension code. The client's benefits are reduced by the sanction until 12/02. 

11. (FCRC) When the exception ends because the client failed to cooperate, there is no break in assistance if the client files a timely appeal or cooperates within 10 workdays of the beginning of the extension period and the exception is approved.