When a Client Appeals a TANF Sanction Based on VIEW Non-Compliance . . .

1. When a Client Appeals a TANF Sanction Based on VIEW Non-Compliance . . . What Happens Next? Fall BPRO Conference 2014

2. The Successful VIEW SanctionAppeal • The successful VIEW sanction appeal is built from the very first contact with the client by the TANF worker and the VIEW worker. • Always follow TANF and VIEW guidance and contact your regional TANF/VIEW consultant with guidance questions; • Always make sure the participant understands VIEW program requirements, what constitutes non-compliance, and what it means to be sanctioned; • Always document assignments, non-compliance, contacts with the participant (and attempts to contact) regarding non-compliance, and the reason negative action is being taken against the TANF case.

3. Non-Compliance with VIEW Requirements • A VIEW sanction is the suspension of a household’s entire TANF grant for VIEW program noncompliance. • All TANF and TANF-UP recipients who are determined mandatory or who volunteer for the VIEW Program and who have signed an Agreement of Personal Responsibility are subject to sanction if they fail to participate without good cause. • Before a VIEW worker refers a VIEW participant for a TANF sanction, the processes described in the Sanctions section of VIEW guidance at 1000.20, A, must be completed.

4. Non-Compliance with VIEW Requirements • Attempt to contact the client by phone to encourage participation, explore good cause, and/or notify the client of a possible sanction. • Document the case record that the contact was made or attempted. • Good cause will exist if: • The participant's inability to fulfill program requirements is due to circumstances outside her control; • Acceptable child care is not available, or; • Accepting employment would result in a net loss of cash income for the assistance unit.

5. Non-Compliance with VIEW Requirements • If the ESW determines from the contact that the participant did not have good cause for non-compliance, or if the ESW is unable to contact the client verbally, the ESW must take action to begin the sanction process. • The ESW completes the VIEW Non-Compliance Checklist, and the VIEW supervisor reviews the circumstances and signs the form if she agrees the sanction is appropriate. • The supervisor must not approve the sanction unless the participant has been offered screening for disabilities, reasonable accommodations have been provided if needed, and the agency has attempted to notify the client verbally regarding the reason for the sanction.

6. Non-Compliance with VIEW Requirements • The ESW is responsible for telling the EW to impose the sanction and which sanction to impose (1st, 2nd , 3rd, etc.). • Even though the information goes over as an alert to the EW when the ESW enters the sanction referral into ESPAS, a written communication form from the ESW to the EW is still required. • The EW must impose the sanction effective the first of the month following the month in which the ANPA is sent, allowing for the 10-day advance notice requirement.

7. Advance Notice Requirements • Based on agency procedures, the ESW will either send the client the VIEW Notice of Sanction/ Termination or the Advance Notice of Proposed Action within 3 business days of the missed appointment. • Alternately, the ESW will immediately notify the EW who will send the ANPA within 3 business days of receipt of the notification. • Regardless of who completes the ANPA, the manual reference for the action is 901.6, since it is the TANF grant (not the VIEW case) that is being sanctioned. • The ANPA must indicate the reason for the sanction and the duration of the sanction.

8. Advance Notice Requirements • Refer to Broadcast 5044 dated 07-10-08. • Every Notice of Action must contain enough specific information to enable individuals to understand why the action is being taken and to decide if they agree or disagree with the action. • Providing specific information in the notice will improve communication, help to identify obvious errors, and reduce phone calls from clients. • Notices must also cite the specific regulation or state policy that supports the action taken. Referring to an entire policy manual or a chapter of the manual is not sufficient.

9. Advance Notice Requirements • Examples of specific information: • “Failed to comply with VIEW requirements” is insufficient because it does not describe the individual’s action or inaction that led to the sanction. Instead, the notice should state “You missed your September 1, 2014, appointment with the VIEW worker.” • “Failed to turn in Job Search forms.” should be written as “Failed to verify participation in Job Search assignment.”. The reason for the sanction referral is not that they did not turn in the forms, but that (by not turning in the forms) they failed to verify that they participated as required.

10. Sanctioning VIEW Volunteers • The 12-month trial period for volunteers who wish to participate in VIEW was eliminated with TANF Transmittal 55, effective 10-01-14. • Volunteers may still participate to the extent funding is available but will give up their exemptions and become mandatory participants subject to all program requirements and penalties for non-cooperation. • If the TANF case closes and the individual reapplies, her new exempt or mandatory status will be determined as part of the eligibility process. • If the client’s previous exemption was for a temporary medical condition (V5), or for caring for a disabled household member (V7), she must secure a new medical at reapplication if she states she is unable to participate in VIEW for either of those reasons.

11. Non-Compliance with VIEW Requirements • The VIEW case record must contain: • Correspondence advising the participant of the scheduled interview, when the sanction is for failure to report for assessment, reassessment, a job interview, or other required interview; • The Activity and Service Plan showing the details of the assignment, when the sanction is for failure to complete an assigned activity; • The contact log documenting all contacts with the participant, and; • A copy of the communication form sent to the EW to sanction the case.

12. Best Practices – TANF • Explain the requirements of the VIEW Program and the related supportive services to all applicants/recipients at application and redetermination. • Don’t refer a recipient to VIEW before an exemption ends. • When sending the ANPA, include the details about the reason for sanction from the communication form received from the ESW. (Send the communication form back and ask for the details if necessary.) • Use manual reference 901.6 on the ANPA, and always give 10 days advance notice.

13. Best Practices – TANF • If it can be established that the participant actually became exempt during the time she was required to participate, and verification is received before the effective date of the sanction, the sanction should not be imposed. • If the participant who has been referred for a first sanction obtains and verifies full-time employment (at least 30 hours per week for at least minimum wage) prior to the effective date of the proposed sanction, the sanction should not be imposed. • Both of these situations must be communicated to the ESW in writing.

14. Best Practices – VIEW • Always follow verbal reschedules up with a written appointment notice, even if the appointment is made for the following day. • Always list the details of the current assignment on the Activity and Service Plan and discuss the requirement to contact the VIEW worker if unable to complete the assignment for any reason, including the need for supportive services not identified at the assessment/reassessment. • Always document the contact log about reschedules, the participant’s reasons for failure to participate as assigned, and unsuccessful attempts to contact the participant to discuss the VIEW case.

15. Best Practices – VIEW • Always attempt to make phone or personal contact before imposing the sanction to explain the circumstances of the sanction and document the case record about the contact/attempt to contact and the results. • Always have the VIEW supervisor review and sign the VIEW Non-Compliance checklist before advising the EW to impose the sanction. • Give detailed information about the reason for sanction on the communication form to the EW so that she can include the details on the ANPA.

16. Avoiding the Appeal Process,When Possible • Offer the client the opportunity to have an agency conference to try to discuss the issues before the hearing process. • Make sure the client knows that this conference will not delay or replace the hearing process. • Make sure the client doesn’t feel like she is being bullied or ganged up on. • Even if this conference leads to resolution, the fair hearing must be held unless the client withdraws her appeal in writing.

17. The Right to Appeal • The TANF State Plan and the Code of Virginia provide the opportunity for a fair hearing to individuals affected by the administration of the public assistance programs. • Virginia Code establishes the right of any individual to appeal and receive a fair hearing before the State agency because he is aggrieved by any agency action affecting his receipt of assistance.

18. The Right to Appeal • Every applicant shall be informed orally and in writing of the circumstances under which he has a right to a fair hearing, of the method by which he may obtain a hearing, and of the right to be represented by others or to represent himself. • Every recipient shall be informed orally and in writing at the time any action is taken that affects his receipt of benefits of the circumstances under which he has a right to a fair hearing, of the method by which he may obtain a hearing, and of the right to be represented by others or to represent himself. • The local agency must inform clients orally that if they have a disability that limits their ability to file an appeal, they are entitled to help from the local agency in filing the appeal.

19. Advance Notice of Proposed Action • The Goldberg v. Kelly decision of the United States Supreme Court requires that in cases of any proposed reduction, termination, or suspension of assistance payments, written advance notice of the proposed action must be mailed to the recipient at least 10 days before the action is taken. • The date the advance notice is postmarked is not included in the computation of the 10 days.

20. Continued Benefits During the Appeal Process • If a hearing request is received prior to the effective date of any proposed reduction in benefits, assistance must be continued in the original amount without interruption until a hearing decision is rendered, unless the recipient submits in writing a statement indicating his desire to refuse such assistance. • In the event the hearing decision is adverse to the recipient, benefits continued in the original amount during the appeal are subject to recovery. • The agency is not required to provide additional notice before taking action based on the appeal decision.

21. Continued Benefits During the Appeal Process • Exception: TANF assistance granted during the appeal of a VIEW sanction for a client who has not yet received 24 months of assistance is not considered an overpayment when the hearing decision is adverse to the recipient. • The unsuccessful appeal simply delays the imposition of the VIEW sanction and the consequent loss of benefits to the household. • Months which accrued on the VIEW clock during the appeal process remain on the VIEW clock. • Any benefits issued beyond the 24th month are an overpayment and must be recouped.

22. Request for a Fair Hearing Procedures • A fair hearing may be requested orally or in writing by a claimant or by a person acting as his authorized representative (such as a relative, friend, or attorney). • If a household makes an oral request for a hearing, the local agency must complete the procedures necessary to start the hearing process. • The Notice of Appeal must be made available to the household to facilitate appeal requests, but completion of this form by the household is not required if a clear expression for a hearing has been made by some other method. • Local agencies must help the claimant submit and process the request, and prepare the case, if needed.

23. Request for a Fair Hearing Procedures • Upon receipt of the hearing request, the hearing officer will acknowledge the request by letter to the claimant and his representative (if known.), and the local agency against which the appeal is filed. • The hearing officer will send a Local Agency Validation form to the local agency to determine whether or not the appeal was filed timely. • Within 5 days the local agency will complete and return the validation form to the hearing officer , and if the appeal request was filed timely, then the hearing will proceed. • The requirement of filing within the 30-day time limit is met if the request for appeal is received in the state or local agency, or postmarked, by the end of the 31st day following the date of the agency’s notice.

24. Appeal Summary of Facts • For every validated appeal, the local agency shall prepare an Appeal Summary of Facts to be forwarded to the hearing officer no fewer than 7 days prior to the hearing. • All statements made should be factual and phrased in a way not objectionable to the claimant. • The Summary of Facts must be prepared jointly by eligibility staff and employment services staff to ensure that both TANF eligibility and VIEW participation issues are stated in the summary.

25. The Summary of Facts Includes: • Identifying Information • Name and address of local agency • Names of TANF and VIEW supervisors, eligibility worker, and employment services worker • Name, address, and case number of claimant • Persons included in the assistance unit, including names, dates of birth, and relationship to claimant • Other persons in the household, including names and relationship to claimant. • Date of Request and Reason for Appeal • Quoting claimant's own words in requesting a hearing.

26. The Summary of Facts Includes: • Statement of Agency Action • The ESW must state the VIEW requirement that the claimant was obligated to complete and how and when she failed to complete it. Provide specific information including dates of contact. • The EW must state the dates of the relevant actions, the reason for the agency’s action, and facts that specifically relate to the policy/guidance underlying the agency’s action. • Include any other information that is relevant to the action and/or issues of the appeal, for instance, the claimant’s concerns or disagreements that were discussed during the time that the action took place. • State whether assistance is continuing during the appeal process in the amount authorized immediately prior to the adverse action.

27. The Appeal Summary of Facts Includes: • Policy/Guidance Provisions • Either list the manual citations and state the basis for the agency’s actions, based on the citation, or; • Print out the pages and mark the relevant section(s). • Documentation • Include all relevant documents relating to the action being appealed. • They will vary based on the specific facts of the case, but may include: • VIEW appointment letters • Activity and Service Plans • Attendance sheets.

28. The Appeal Summary of Facts Is a Very Important Document • Both the EW and the ESW have a role in preparing this document. • Do not leave anything for the hearing office to infer. • Write as though the reader is not familiar with the facts of the case or with program policy and procedures. • Give all information, and quote all guidance references to support the reason the action was taken. • The narrative should be a logical, chronological sequence of events, including an explanation of the reason(s) the sanction was imposed.

29. Finally, • The Summary of Facts must be signed by the person completing the Summary and the local agency director. • Send copies of the Summary of Facts and all supporting documentation to both the hearing officer and the claimant at least 7 days prior to the date of the hearing. • Appeals are generally conducted at the local agency, with the hearing officer teleconferenced in. • The decision of the hearing officer will be final and binding once mailed to the appellant and the local agency. • An appeal may be withdrawn in writing by the claimant or by his representative • An appeal is considered abandoned if neither the claimant nor his representative appears. (Home office will send a 10-day show cause letter.)

30. The Successful VIEW SanctionAppeal • Remember: • The successful VIEW sanction appeal is built from the very first contact with the client by the TANF worker and the VIEW worker. • Always follow TANF and VIEW guidance and make sure the participant knows the requirements; • Always document assignments and negative actions in the case record; • Always offer the client an agency conference after an appeal has been filed to make sure the client understands program requirements and the reason negative action is being taken against her case; • Always write the Summary of Facts with input from both the EW and the ESW; • Always have TANF and VIEW staff at the hearing.

31. Good Luck! Questions?