Maximizing Participation Project _MPP_ by chenmeixiu

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									Maximizing Participation Project (MPP)
  County Assistance Office (CAO)

                Guidelines


         (Excluding Philadelphia County)




                                           July, 2010
                                                 Table of Contents


A. MPP Overview

B. MPP Eligibility Criteria

   1. Volunteer Participants (Pre-60 Month)
   2. Mandatory Participants (Post-60 Month – Extended TANF)
   3. Ongoing Eligibility

C. Operating MPP at the CAO

   1.    MPP Team Development
   2.    Interviews
   3.    Recruiting Volunteers (Pre – 60 Month)
   4.    Enrollment (Pre – 60 Month and Post – 60 Month)
   5.    Medical History Profile Report
   6.    MPP Team Meetings
   7.    Service Plans
   8.    Payment for Needed Services
   9.    Special Allowances
   10.   Work Ready – Supported Work Component
   11.   Working Participants in MPP
   12.   MPP Transition Component
   13.   Transporting MPP Participants to Appointments
   14.   Time Limits in MPP
   15.   MPP Hourly Requirements
   16.   Medical Assessment Form (MAF) – PA 635
   17.   Ongoing CAO Responsibilities
   18.   MPP Case Record Requirements
   19.   Confidentiality
   20.   Release of Information
   21.   Limited English Proficiency (LEP)
   22.   Suspected Child Abuse
   23.   Domestic Violence
   24.   Social Security
   25.   Reasons for Termination
   26.   Inter-county Transfers

D. Work Capacity Assessment (WCA)

   1.    WCA Overview
   2.    WCA Referral Process
   3.    WCA Contractor Responsibilities
   4.    WCA Completion
   5.    WCA Non-Cooperation
   6.    WCA Data Entry
   7.    Copying Cost for Medical Records

E. MPP Vendor Payments

   1.    Overview
   2.    Eligibility
   3.    Authorization of Vendor Payment
   4.    Adding New Vendors to the MPP Vendor File
   5.    Back Debts and Phone Policy
   6.    Possible Payment Sources
   7.    Processing Returned, Replacement, Overpayment, and Underpayment Vendor Payments



                                                           2                               July, 2010
F. Client Information System (CIS) Data Entry Procedures

   1.    Overview
   2.    Activity Codes
   3.    Project Termination Codes
   4.    Referral Rejection Codes

G. Attachments

   1.    MPP Coordinators Contact List
   2.    Pennsylvania Office of Mental Health and Substance Abuse Services (OMHSAS) Agencies Contact List
   3.    MPP Medical and Social History (PA1718)
   4.    Provider Authorization for Services Form (PA 1719)
   5.    Authorization for Release of Information Form (PA 1723) and (PA 1723-S)
   6.    MPP Enrollment Form (PA1724)
   7.    TANF Work Activity Summary and Case Synopsis (PA1725)
   8.    MPP Service Plan (PA 1726) and (PA 1726-S)
   9.    Introductory Letter to OVR Providers (PA 1730)
   10.   Professional Service Invoice for Photocopy/Postage Costs (PA 1748)
   11.   Work Capacity Assessment Transmittal Form (PA 1749)
   12.   Letter of Explanation and Request for Information (PA 1751)
   13.   MPP Termination Form (PA 1757)
   14.   MPP Vendor Addition Form
   15.   MPP Vendor Payment Checklist
   16.   Vendor Payment Request for Back Bills and Telephone Services Form
   17.   MPP Vendor Payment Adjustment Form
   18.   Pennsylvania Coalition Against Domestic Violence Subcontractors Contact List
   19.   Participant Statement for Use of a Volunteer Interpreter
   20.   Data Warehouse Registration Form
   21.   Medical History Profile Report Desk Reference Guide
   22.   Medical History Profile User Guide
   23.   Report of Suspected Child Abuse Form (CY 47)
   24.   Confidential Facsimile Message
   25.   Sample MPP Vendor Table
   26.   Pennsylvania Office of Vocational Rehabilitation (OVR) Contact List
   27.   Pennsylvania OVR Related Acronyms




                                                         3                                         July, 2010
A. MPP OVERVIEW
   MPP is an Employment and Training (E&T) Program that provides services to TANF and Extended TANF
   individuals who have been identified as having:

         a physical or mental disability as determined by a Medical Assessment Form (MAF) (PA 635); or
         multiple barriers to participation and have demonstrated a pattern of being terminated from E&T
          programs due to these barriers.

   MPP focuses on the needs and barriers of the entire family. The primary goal of MPP is to help clients secure
   and retain employment by providing services and encouragement that will help the client and household
   members remediate or stabilize barriers that may hinder them from achieving self-sufficiency. This is
   accomplished through appropriate assessment(s)/evaluation(s), services, and activities.

   A team centered approach is used in collaboration with private and public health and social services agencies.
   The MPP Worker is the MPP Team leader and is responsible to coordinate, schedule, and participate in ongoing
   MPP Team meetings.

   Additionally, the MPP Worker and Team will:

         Focus on what the participants’ strengths are and the positive, rather than just the barrier(s);
         Identify and use the motivations that participants bring with them to promote work and education;
         Help participants learn problem solving skills so they can help themselves; and
         Build plans with participants that promote ownership and commitment.


B. MPP ELIGIBILITY CRITERIA

   1. Volunteer Participants (Pre-60 Month)
      TANF clients may volunteer for MPP if they have:

             a physical or mental disability as determined by a Medical Assessment Form (MAF) (PA 635) (These
              clients are identified on CIS with an ETP Program Status Code of 53 (Exempt)); or
             multiple barriers to participation and have demonstrated a pattern of being terminated from E&T
              programs due to these barriers (These clients are identified on CIS with an ETP Program Status
              Code of 60 (Mandatory RESET)).

   2. Mandatory Participants (Post-60 Month – Extended TANF)
      Clients are required to meet Extended TANF (E-TANF) requirements in order for their cash assistance to
      continue beyond the 60 month limit. Clients can meet the E-TANF track requirement by participating in MPP
      if they have:

             a physical or mental disability as determined by a Medical Assessment Form (MAF) (PA 635) (These
              clients are identified on CIS with an ETP Program Status Code of 53 (Exempt)); or

             multiple barriers to participation and have demonstrated a pattern of being terminated from E&T
              programs due to these barriers (These clients are identified on CIS with an ETP Program Status
              Code of 60 (Mandatory RESET)).

   3. Ongoing Eligibility
      Pre-60 month TANF clients who are exempt (ETP code 53) due to a temporary or permanent disability may
      continue to volunteer to participate in MPP, or if a Post-60 month TANF client (ETP code 53), to participate
      in the MPP track of E-TANF. Pre-60 month TANF clients, who are exempt (ETP code 53), remain eligible
      for TANF if they do not participate in MPP services or activities. Clients who are exempt (ETP code 53) are
      not subject to sanction regardless of their MPP participation.

      If a client who is mandatory to participate (ETP code 60) agrees to participate in MPP, failure to participate
      without good cause may result in a sanction for Pre-60 month TANF clients, or case closure for Post - 60

                                                         4                                          July, 2010
     month TANF clients. CAOs will follow all procedures related to compliance review, determining good cause,
     and sanctioning for Pre - 60 month TANF clients, or closing a case for Post-60 month TANF clients (see
     Cash Assistance Handbook, Chapters 135.7 and 135.8).

     If a Post – 60 month Extended TANF client does not comply with MPP requirements, without good cause,
     the entire family is ineligible for Extended TANF benefits. Extended TANF benefits may be reinstated as
     soon as the client cooperates with MPP or another appropriate Extended TANF track.

     Please also see Section C – 16 regarding Medical Assessment Forms.


C. OPERATING MPP AT THE CAO

  1. MPP Team Development
     Based on the barriers identified and/or suspected, results of the participant’s Medical and Social History
     Form (PA 1718) (Attachment 3) and other relevant information, the MPP Worker will identify the appropriate
     MPP Team members and providers needed to determine what services will best assist the participant.

     MPP Team members may include professionals from:

            Mental Health (MH) agencies;
            Drug and Alcohol (D&A) agencies;
            Office of Vocational Rehabilitation (OVR);
            Domestic violence agencies;
            Crisis Intervention agencies;
            Children and youth social services agencies;
            Disability Advocacy Program (DAP) Worker or other RESET Workers;
            Special needs coordinators, managed care agencies, and behavioral health agencies;
            Housing agencies;
            Juvenile probation offices;
            School District if the participant's individual circumstances warrant their involvement; and
            Any other social service, community, and medical assistance agencies based on the participant’s
             individual needs.

     Only professionals related to the participant’s individual case may be in attendance at MPP Team meetings.
     Most commonly, the MPP Team will include professionals from mental health, drug and alcohol, and OVR
     agencies.

  2. Interviews
     Interviews will be face-to-face and private between the CAO Worker/MPP Worker and the client. However,
     the client may choose to bring an advocate or other person to the interview if the MPP Worker and/or MPP
     Team determine that it is appropriate. Interviews will be held in a confidential location.

  3. Recruiting Volunteers (Pre-60 Month)
     The CAO or MPP Worker will ask appropriate clients to volunteer to participate in MPP. If the client chooses
     to volunteer for MPP, the CAO or MPP Worker will:

            Complete the TANF Work Activity Summary and Case Synopsis (PA 1725) (Attachment 7)
            Update the AMR indicating enrollment in MPP;
            Data enter the client’s referral information (see Section F); and
            Proceed with the Enrollment process below.

  4. Enrollment (Pre-60 Month and Post-60 Month)
     When a referral is received, the MPP Worker will conduct a case record review to become familiar with the
     client’s background and situation. The MPP Worker will obtain and review the information below:

            Case narratives

                                                      5                                          July, 2010
          AMRs
          Current and past MAFs
          Medical information, including physician, clinic, and hospital records
          Assessments and evaluations (Physical, psychological, and functional capacity)
          Medical History Profile Report (Please see Section C - 5 for further details)
          DAP history
          Work history
          Family and Social History
          Information regarding the client’s current and past participation in E&T programs
          Educational activities and the outcome of those experiences
          Information regarding services the participant is currently receiving from other agencies/providers
          Any valuable input from previous caseworkers
          Any other pertinent information.

   The MPP Worker will then schedule and conduct an Enrollment Interview with the client.             During the
   Enrollment Interview, the MPP Worker will:

          Explain Extended TANF and MPP policies and requirements, including hourly requirements.
          Explain the MPP Worker’s and Team’s responsibilities, including tracking participant progress.
          Complete the MPP Enrollment Form (PA 1724), (Attachment 6).
          Data enter the participant’s enrollment information in CIS (see Section F).
          Review the completed TANF Work Activity Summary and Case Synopsis (PA 1725) (Attachment 7).
          Discuss the participant’s exemption situation.
          Discuss the circumstances regarding the participant’s termination from contracted programs and/or
           other employment or training activities. Contracted program information is available on request from
           the Contractor, if not already in the case record.
          Explain to the participant that the Medical and Social History Form(PA 1718) (Attachment 3)
           questions are intended to help identify any health, education, work, family and legal, housing, or
           transportation related issues, and that the information shared will be confidential.
          Complete the Medical and Social History (PA 1718) (Attachment 3) with the participant.
          Complete the Authorization for Release of Information Form (1723) (Attachment 5).

           NOTE: A new Medical and Social History Form (PA 1718) (Attachment 3) and/or Authorization for
                 Release of Information Form(s)(PA 1723) (Attachment 5) are not necessary if the participant
                 has been terminated from MPP and returns within 60 days.

   If the participant is hesitant about completing the Medical and Social History Form (PA 1718) (Attachment
   3) and/or the Authorization for Release of Information Form (PA 1723) (Attachment 5) at the time of the
   enrollment interview, the participant may enroll in the program but must complete the Medical and Social
   History Form (PA 1718) (Attachment 3) and Authorization for Release of Information Form (PA 1723)
   (Attachment 5) within 30 days of enrollment. In such an instance, the Service Plan (PA 1726) (Attachment
   8) will be developed based on currently available information.

   The participant’s circumstances may not be discussed with any other agency or MPP Team Member until
   the appropriate Authorization for Release of Information Form (PA 1723) (Attachment 5) is signed.

   If the participant does not complete the Medical and Social History Form (PA 1718) (Attachment 3) and/or
   the Authorization for Release of Information Form within 30 days of enrollment, the participant will be
   ineligible to continue participating in MPP. The participant may re-enroll in MPP once they agree to
   complete the form(s).

   NOTE: The MPP Worker will conduct one face-to-face meeting with the participant weekly during the
         enrollment period and the first month of participation. The enrollment period is defined as the time
         between referral and actual completion of the Service Plan (PA 1726) (Attachment 8).

5. Medical History Profile Report

                                                     6                                            July, 2010
   The report contains a history of the medical benefits provided to a client with Medicaid eligibility for a set
   period of time, including the name and addresses of inpatient hospitals, physicians, prescriptions, etc. This
   will help to identify situations or other medical concerns that may have gone unaddressed. The information
   received from these reports is confidential and should not be shared outside the MPP Team, WCA
   Contractor or DAP Worker.

   It is not mandatory to request a Medical History Profile Report for Pre-60 month MPP participants. The CAO
   may request a Medical History Profile Report for any MPP participants when the MPP Team feels that it
   would be beneficial.

   It is mandatory to request a Medical History Profile Report for all Post – 60 month - Extended TANF - MPP
   participants, as this is a component in the Work Capacity Assessment (WCA) Transmittal Package to be
   sent to the Work Capacity Assessment (WCA) Contractor (See Section D for more details).

   MPP staff is required to register for a license with the Data Warehouse by completing the online registration
   form at http://km/pgm/asp/training/DWregistration.asp. MPP staff who do not have access to this web page
   must register by completing the Data Warehouse Registration Form (Attachment 20). Requestors should
   then email the completed form to their immediate supervisor. Supervisors must include their name and
   email address on the form and email the form to ra-impromptu@state.pa.us. CAO staff will receive an email
   from the Office of Information Systems to confirm that they have been approved for access to the Medical
   History Profile Report.

   Please see OPS Memo 041002 for further details and procedures to extract the report.

   Please see the Medical History Profile Report Desk Reference Guide (Attachment 21) and Medical History
   Profile User Guide (Attachment 22) for further assistance.

6. MPP Team Meetings
   The MPP Worker and Team will meet and review all of the information that the MPP Worker previously
   reviewed which is listed in Section C – 4. The MPP Worker and Team will also review any additional
   information, including the following:

         Medical and Social History Form (PA 1718) (Attachment 3)
         Authorization for Release of Information Forms (PA 1723) (Attachment 5)
         TANF Work Activity Summary and Case Synopsis Form (PA 1725) (Attachment 7).

   The first MPP Team meeting should not include the participant, unless the MPP Team determines that it
   would be in the participant’s best interest to attend.

   The MPP Team members will make recommendations on appropriate services, activities, and supports.
   Appropriate services and activities may include:

         Drug and alcohol assessment and treatment;
         Learning disability assessment and treatment;
         Mental health assessment and treatment;
         Domestic violence services;
         Medical assessment and treatment;
         Work Capacity Assessment (WCA) – for Post-60 Month - Extended TANF clients mostly;
         Housing services;
         Child advocacy for delinquency assistance;
         Involvement in a child’s school activities or appointments;
         Office of Vocational Rehabilitation (OVR) services;
         Literacy services;
         GED classes;
         Child related services, such as parenting classes and health care education;
         Current services the participant is already receiving if the MPP Team agrees with them; and
         Any other services or activities necessary to achieve the goals.

                                                     7                                           July, 2010
   Ongoing MPP Team meetings will be held once a month, at a minimum. In the interest of time, some
   discussions with MPP Team members may occur over the phone; however, a face-to-face MPP Team
   meeting must occur minimally on a monthly basis.

   The MPP Worker will include the participant in the meetings. If the MPP Worker and Team feel it would be
   in a participant’s best interest to not be in attendance at a particular meeting, then this can be done. In such
   instances, documentation regarding the reason must be kept in the MPP Case Record.

   Assessments
   In most cases, an assessment or evaluation will be included in the Service Plan (PA 1726) (Attachment 8),
   unless the participant has recently had an in-depth assessment or evaluation or is currently in treatment.

   The MPP Worker and/or MPP Team will discuss the barriers and recommendations, noted on the
   assessment(s) reports, with the participant, as deemed appropriate and in the participant’s and household
   members’ best interest. The MPP Worker, MPP Team, and assessment(s) provider will determine what is
   appropriate information to discuss with the participant. In some instances, it may be best for the
   assessment(s) provider(s) to discuss the assessment(s) results with the participant instead of the MPP
   Worker or MPP Team.

   Due to the sensitive content of the assessment(s), the CAO will not release a copy of an assessment(s)
   report(s) to the participant. Instead, with the participant's consent, a copy of the report(s) may be sent to the
   participant's treating physician(s) or Primary Care Physician (PCP), who is better qualified to interpret the
   medical findings in the assessment(s).

   The MPP Worker, MPP Team, and participant will then determine together what steps to take next.
   Anything additional should be added to the Service Plan (PA 1726) (Attachment 8).

   Assessments for other household members may be completed but must be first approved by BETP. In such
   instances, the MPP Worker will follow the procedures outlined in Section E – MPP Vendor Payments.

   Second Opinions
   If the results of an assessment or other medical services are in conflict with the information contained on the
   Medicaid forms or other documented medical information, a second opinion may be obtained.

   The MPP Team, in consultation with the participant, will develop a Service Plan (PA 1726) (Attachment 8)
   based on information contained in one or both sets of assessments or evaluation.

   Please see Section D - 2 for details regarding WCA re-referrals.

7. Service Plans
   A Service Plan (PA 1726) (Attachment 8) will be developed to address the needs of the participant and the
   household. It will contain all recommended services, activities and supports, and will address all barriers
   and concerns.

   Once the MPP Team has developed and signed a Service Plan (PA 1726) (Attachment 8), the MPP Worker
   will schedule a face-to-face meeting with the participant to review the Service Plan (PA 1726) (Attachment 8)
   and recommendations. The MPP Team Member(s) may be part of the meeting. The Service Plan (PA
   1726) (Attachment 8) will include the participant’s input and suggestions, if the MPP Team agrees that they
   are in accordance with the goals.

   NOTE: In instances where the MPP Worker and/or MPP Team feels that the participant or household
         member(s) has an urgent or life-threatening need for particular services, the MPP Worker and Team
         will arrange for the services immediately and prior to receiving any assessment results.

           Examples of an urgent need would include existing medical treatment or services that the participant
           is currently receiving, as well as mental health and/or drug and alcohol treatment.


                                                      8                                            July, 2010
   Service Plans (PA 1726) (Attachment 8), and revised Service Plans, must include the following:

          Information regarding appropriate Authorization for Release of Information Form(s) (PA 1723)
           (Attachment 5)
          All services, activities, and supports and specific information about each including dates, times and
           locations
          Signatures of the participant and MPP Worker and Team members.

   The participant’s parental and other responsibilities should be considered when completing the Service Plan
   (PA 1726) (Attachment 8) and included as part of it. The Service Plan (PA 1726) (Attachment 8) can not
   conflict with any other agency Service Plan (PA 1726) (Attachment 8) that the participant may have already.

   In order to remain enrolled in MPP, the participant must agree to the terms of the Service Plan (PA 1726)
   (Attachment 8) and sign it within 30 days of the completion of the Medical and Social History Form (PA
   1718) (Attachment 3. Participants who have not done so will be terminated from the program if good cause
   does not exist. The compliance process must be completed with the participant, first, to determine if good
   cause exists, prior to terminating from MPP. Should there be a valid reason why a Service Plan (PA 1726)
   (Attachment 8) is not agreed to and signed by the participant within 30 days, the MPP Worker may leave the
   MPP case open and document the reasoning in the MPP Case Record.

   If the MPP Worker and the participant made changes in the Service Plan (PA 1726) (Attachment 8), the
   MPP Worker will update the appropriate MPP Team Member(s) by telephone and have the appropriate MPP
   Team Member(s) initial and date the changes at the next MPP Team meeting.

   Service Plan (PA 1726) (Attachment 8) will be revised to address barriers identified as a result of completed
   assessments and other services and activities. The appropriate MPP Team Member(s)’s input will be
   included in the revision.

   Copies of the Service Plan (PA 1726) (Attachment 8) and AMR will be given to the participant and each
   MPP Team Member.

       NOTE:      When documenting domestic violence services on the Service Plan (PA 1726) (Attachment
                  8) and AMR, do not write the words “domestic violence”. Instead use the words “referred for
                  services”. This is to help ensure the participant’s and children’s safety. If an abuser has
                  access to any indicator that domestic violence was discussed, it increases the danger to the
                  participant and/or the children.

                  Do not include any details, or names of the domestic violence service providers, or anything
                  else, on the Service Plan (PA 1726) (Attachment 8) or AMR.

8. Payment for Needed Services
   To determine the method of payment for needed services, the MPP Worker must first determine if:

          The services are covered through the participant’s existing medical coverage;
          The requested services have limits in terms of number of times received or the number of times a
           participant may receive the service in a given time period;
          The participant has exceeded the limits associated with the service; and
          The needed services are available in the participant’s area.

   Fee for Service (FFS)
    For medical services that are provided under Medicaid covered FFS, the MPP Worker should contact the
   Medicaid Headquarters representative if there is a question whether the services are covered and available
   to the participant.

   Managed Care Organization (MCO)
   For services that are provided through a MCO, the MPP Worker will contact the MCO to determine if the
   services are covered and available to the participant. The MCO Special Needs Coordinator will also be able
   to assist the MPP Worker in locating providers in the participant’s area.
                                                    9                                           July, 2010
   Mental Health, Mental Retardation, and Drug and Alcohol Services
   If it is determined that the participant would benefit from mental health, mental retardation and/or drug and
   alcohol type services, the MPP Worker will:

          Discuss the needed services with the Mental Health, Mental Retardation, and/or Drug and Alcohol
           MPP Team Member and/or the MCO representative (in HealthChoices counties) who will review the
           request and indicate what services are available, what the approved costs are for the services, and
           assist in recommending providers who might be able to provide these services. The client may be
           seen by mental health and drug and alcohol providers that are not associated with the local MH/MR
           and D/A county agency;

          Mental health, mental retardation, and drug and alcohol services will be paid either through the
           Managed Care agreement process or, in areas where Managed Care is not available, will be
           reimbursed at the Headquarters level as funds have been provided to the Office of Mental Health
           and Substance Abuse Services (OMHSAS) for this purpose.

          Learning disability services may be available through partnering agencies or other resources. If not,
           they may be purchased using the MPP Vendor Payment System. The Mental Health/Mental
           Retardation Team Representative should be able to provide direction to the Mental Retardation
           agency counterpart who can assist with these assessments.

   MPP Vendor Payments
   If the services are needed due to a physical condition, the condition should be discussed with the OVR
   Team Member who will be able to provide advice and service recommendations. If the services are not
   covered under the participant’s existing medical coverage or any other manner, the OVR member will tell the
   MPP Worker whether the needed services are available to the participant through OVR or a MPP Vendor
   Payment to an OVR provider.

   If needed services are not covered by the participant’s existing medical coverage, OVR, or OVR provider, or
   in any other manner, a MPP Vendor Addition request can be made to BETP to add the vendor to the MPP
   Vendor Table. Please see Section E, MPP Vendor Payments, for details.

9. Special Allowances
   Participants who participate in MPP will be eligible to receive the same support services as participants who
   participate in other AMR approved RESET activities and as indicated in the Cash Assistance Handbook,
   Chapters 135 and 183. These include but are not limited to needed transportation and child care
   allowances that are associated with services or activities listed on their Service Plan (PA 1726) (Attachment
   8).

   When assisting individuals with transportation to MPP related activities, the CAO should first consider
   services provided by the Medical Assistance Transportation Program (MATP) (see 138.411 to review
   eligibility for this program and to see a list of MATP providers by county).

   If the MPP activity is not covered by MATP or the individual is otherwise ineligible to receive assistance
   through MATP, the CAO will consider eligibility for a medical transportation allowance under reason code
   200 (see 138.412 for eligibility criteria for medical transportation allowances). Please note that medical
   transportation allowances are issued at .12/mile.

   If the MPP activity is excluded from eligibility for a medical transportation allowance, the CAO will determine
   if the participant is eligible for an E&T transportation allowance under reason code 250/850.

   NOTE: When authorizing an allowance for MPP related activities, the CAOs must consider the same
         eligibility criteria as for any other E&T activity, including if the activity is approved on the MPP service
         plan, if there are other less costly or more practical alternatives and if the allowance is required to
         enable participation in the activity.


                                                      10                                            July, 2010
   Completion of the SPAL Verification Form and the Self-Reliance Checklist is also required.



   NOTE: A MPP participant, who is hospitalized or enters a residential drug and alcohol
         rehabilitation/treatment program, would continue in MPP as long as they remain TANF eligible and if
         the rehabilitation/treatment program is considered to be part of the approved plan for MPP.

           During this period, a participant will be eligible to receive the same special allowances as other
           clients who participate in AMR approved RESET activities.

           Please see EPP 449135 and EPP 489135 for more details.

10. Work Ready (WR) – Supported Work Component (SWC)
    MPP participants who need the support of a ramp-up to employment can be referred to the WR – SWC for
    Employment and Training activities.

   The MPP Worker and Team should determine if the participant is ready to increase activity hours because
   they have resolved or stabilized their barriers sufficiently, or have minimal barriers, and do not require
   extensive interventions.

   Please keep in mind that in order for the MPP participant to participate in the WR – SWC, the MPP case,
   project code B, and any activities associated with MPP must be closed on CSPREN and CSIETP
   respectively. This will allow for a referral to be completed for the new employment and training provider. A
   client cannot be enrolled in MPP and also the WR – SWC. The MPP Team will assess whether or not the
   MPP participant has progressed enough to be closed out of MPP and enrolled in WR – SWC.

   When referring a participant to the WR - SWC, a copy of the participant’s Service Plan (PA 1726)
   (Attachment 8) should be sent with the referral to the WR – SWC case manager. An Authorization for
   Release of Information Form (PA 1723) (Attachment 5), must be signed by the participant in order to send
   the Service Plan (PA 1726) (Attachment 8) and to release any information to the WR – SWC case manager.

11. Working Participants in MPP
    If an MPP participant gets a job while participating and TANF remains open, the CAO should not close the
    MPP project until the MPP Team has met to determine if the participant is still in need of MPP services while
    employed. If the MPP Team determines that the participant is still in need of MPP services the Service Plan
    (PA 1726) (Attachment 8) should be revised to include the employment.

   If the MPP Team determines that an MPP participant is no longer in need of MPP services then the
   participant will be terminated from MPP and referral made to the next appropriate employment and training
   program.

   If an MPP participant gets a job and TANF closes, then the participant can participate in the MPP Transition
   Component. Please see Section C - 12 for details regarding the MPP Transition Component.

   NOTE: The amount of hours the participant is working, alone, does not determine whether or not the MPP
         case should be closed. For example, the MPP case is not closed based on the participant working
         20 hours a week, alone.

12. MPP Transition Component
    The transition component is designed to assist participants, who are terminated from MPP due to
    employment or obtaining SSI, successfully transition to their next step in life.

   Case management services will continue with face-to-face contact a minimum of once every two weeks.
   The MPP Worker will continue to assist the participant in remaining connected with any needed services and
   help prepare them to manage their household without MPP involvement.


                                                     11                                          July, 2010
   Eligible Participants
   Participants must be referred or actively participating in MPP at the time of the cash closing, due to
   employment or obtaining SSI, in order to participate in the MPP Transition Component.

   Eligibility Period
   Participants remain eligible for the transition component for a maximum of 90 days.

   Please see OPS 040706 for further details, including details regarding Special Allowances and System
   Requirements during the transition period.

13. Transporting MPP Participants to Appointments
    Providing transportation is not a requirement of the MPP Worker or CAO.

   The Office of General Counsel (OGC) and Labor Relations Section (LRS) officials concluded that CAO
   Workers may transport MPP and DAP participants to meetings and appointments when necessary.
   However, the use of a State owned vehicle must be used if one is available, and activities must be limited to
   those while acting within the scope of employment.

   Please see EPP 579135 for more details and for information regarding CAO and MPP Worker liability.

14. Time Limits in MPP
    Participants can participate in MPP up to 24 months. If the MPP Team feels that more time in MPP is
    needed, the MPP Worker can make an Exception Request to BETP. An Exception Request must be
    approved by BETP and should be forwarded to BETP by calling 717-787-1302 or by faxing 717-787-4106.

   Please keep in mind that not all participants will require 24 months. The 24 month limit in MPP is not a
   lifetime limit, however, that does not mean a re-enrolled client should necessarily need 24 months per MPP
   enrollment. The MPP Worker and Team will evaluate each participant’s individual circumstances and
   determine the number of months the individual can participate when re-enrolling in MPP.

15. MPP Hourly Requirements
    The hourly requirement will begin once the following items are completed:

          Medical and Social History Form (PA 1718) (Attachment 3);
          Authorization for Release of Information Form (PA 1723) (Attachment 5);
          Any needed assessment(s) and results received; and
          Service Plan (PA 1726) (Attachment 8), including any assessment(s) recommendations.

   The participant must participate an average of 20 hours per week, unless the participant’s individual
   circumstance and the MPP Team recommends less than 20 hours per week. However, this reduction should
   not go below 5 hours per week.

   Hours of participation may include the time it takes to travel to and from services and activities included on
   the Service Plan (PA 1726) (Attachment 8). In some cases, these hours might also include the time spent in
   telephone contact with the CAO or MPP Worker and/or other professionals related to the MPP case.
   Information regarding these hours will be documented on the Service Plan (PA 1726) (Attachment 8) and
   data entered on CSIETP.

   MPP Workers are encouraged to contact participants prior to their scheduled appointments to encourage
   their attendance and after their appointments to offer continuing support and assistance, as needed.

   Participants who, without good cause, repeatedly fail to comply with the terms of their Service Plan (PA
   1726) (Attachment 8) and/or their hourly requirements may be terminated from the program. CAO
   intervention and outreach is required and must be documented in the case record before termination occurs.
   If the participant is terminated from MPP, a MPP Termination Form (PA 1757) (Attachment 13) must be
   completed.


                                                    12                                           July, 2010
16. Medical Assessment Form (MAF) – PA 635

   Pre-60 Month TANF Participants
   If a MAF expires during participation in MPP, the CAO will request an updated MAF. If the participant is
   determined to have full or limited employability, the participant may choose to continue to participate in MPP
   or to be referred to another E&T program. If the participant chooses to remain enrolled in MPP, failure to
   participate without good cause may result in sanction.

   NOTE: A WCA, normally completed for Post-60 month Extended TANF/MPP participants, can be completed
         for a Pre-60 month TANF/MPP participant in place of a MAF, as long as the participant is part of this
         decision making process and chooses to complete a WCA instead of a MAF.

   Post-60 Month Extended TANF Participants
   If a MAF expires during participation in MPP for a Post-60 month Extended TANF participant, a new MAF is
   not required. In most instances, a WCA is completed for a Post-60 month Extended TANF participant. The
   WCA takes precedence over all MAFs for the length of the temporary disability that is listed on the WCA.

   If the MPP Team or participant disagrees with the WCA results or recommendations, a second WCA may be
   completed by different WCA Contractor providers. Should the MPP Team not agree with either of the
   WCAs, the MPP Team may choose to have a MAF completed and the MAF would take precedence for the
   length of time noted, but this should only happen in rare occasions.

   NOTE: Please refer to Section – D for more details regarding the WCA.

   NOTE: Please refer to Section C – 23 for more details regarding the MAF and domestic violence.

17. Ongoing CAO Responsibilities
    The MPP Worker will:

         Contact the participant, minimally once a week or more often if appropriate and needed, in order to
          offer encouragement, answer questions, and assist with obtaining services and supports. Individual
          face-to-face contact will be maintained on at least a monthly basis.
         Assist the participant to keep appointment for services and follow-through with the Service Plan (PA
          1726) (Attachment 8).
         Contact participant to discuss reasons appointments were not kept or services were not accessed or
          received.
         Provide the participant with information on available services.
         Contact agencies on the participant’s behalf.
         Accompany the participant to their appointment if requested and as CAO resources allow.
         Monitor the participant’s progress with service providers.
         Meet with appropriate MPP Team members, at least once a month, to review progress/assessment
          results.
         Revise Service Plan (PA 1726) (Attachment 8) as needed.
         Issue or facilitate the issuance of support services allowances for which the participant is eligible and
          not currently receiving.

18. MPP Case Record Requirements

   The MPP Worker will create a confidential MPP Case Record. All MPP case information should be kept in
   this record separate from the CAO Case Record information. The MPP Case Record should be kept in a
   secure and confidential location with limited accessibility. Clerical Workers and other CAO staff not
   associated with the MPP case should not have access to the MPP Case Record or narrative.

   All potential MPP client and enrolled MPP participant information such as medical conditions, treatment,
   medications, and other sensitive information must be kept as handwritten narrative in the MPP Case Record
   only. Additionally, all MPP Team meeting and service provider discussions and outcomes will be recorded
   in the MPP Case Record.
                                                    13                                            July, 2010
The following should be documented in the MPP Case Record narrative:

      date, time, and location of all MPP related contacts;
      purpose and outcome of all MPP related contacts;
      participant’s demeanor;
      improvements;
      any setbacks encountered;
      any problems or deterioration in the participant’s conditions or circumstances;
      solutions offered and the participant’s responses;
      services and supports requested or provided
      whether or not any follow-up is needed; and
      any other relevant information.

The MPP Case Record narrative must not be included in the CIS narrative. The narrative in CIS should be
the minimum necessary information that is needed by others who view the narrative. This would include:

      date and time of contact.
      MPP Team meeting to discuss case and/or develop Service Plan (PA 1726) (Attachment 8).
      Authorization of special allowances.

The MPP Case Record will contain all applicable copies of the following:

      Separate MPP case narrative
      Identifying information
      AMR
      TANF Work Activity Summary and Case Synopsis (PA 1725) (Attachment 7 )
      Medical documentation
      MAF PA 635 and/or other medical verification forms
      DAP information
      Medical History Profile Report
      WCA Transmittal Package, except CIS screens
      WCA results
      Assessment results
      Medical and Social History Form (PA 1718) (Attachment 3)
      Authorization for Release of Information Form (PA 1723) (Attachment 5)
      Names, agency affiliations and phone numbers of the MPP Team members and partnering agencies
      List of the agencies represented at each MPP Team meeting
      Documentation of the participant’s weekly hours of participation
      Service Plans (PA 1726) (Attachment 8)
      Provider Authorization for Services Form PA (1719) (Attachment 4) and appropriate invoicing
       information
      OVR-type vendor payment approval, denial, verification of receipt of services, and payment notices
      Support services approval notices, denial notices, verification of receipt of services and payment
       notices
      MPP Vendor Payments information and related forms
      Progress reviews obtained from each Service Provider at least monthly
      Information on the participant’s length of time in the program
      MPP Termination form (PA 1757) (Attachment 13) and termination information including the date,
       reason and documentation/justification related to the termination
      Any other relevant information.

The following items may be kept in electronic format as long as the CAO has the ability to print the
document on demand, otherwise it must be kept in paper format:

      Written correspondences sent to or relating to the participant;
                                                 14                                      July, 2010
           Documentation of phone calls/other contacts made to or on behalf of the participant.

    If the CAO chooses to keep any of the above two bulleted items in electronic format, the CAO will print it and
    provide it to BETP during BETP – MPP monitoring visits, for all records to be reviewed.

    All documentation with the participant’s signature must be kept in paper format.

19. Confidentiality
    All participants must be assured that the personal data they provide will be confidential.

    Participant information obtained from the participant or other sources will be kept confidential. It will only be
    released upon the participant’s written approval, obtained on DPW approved Authorization for Release of
    Information Forms (PA 1723) (Attachment 5), and only for the purpose specified by the participant.

    When the client's MPP case is closed and the CAO case record is forwarded to the appropriate Worker, the
    separate MPP Case Record should be stored in the same manner as the CAO has established for the
    storage of confidential case files.

    To comply with the Health Insurance Portability and Accountability Act (HIPAA), the privacy regulations at 45
    CFR, Sections 160-504 and 164.530 indicate that all Personal Health Information should be retained for a
    period of 7 years. Since the majority of MPP information is considered Personal Health Information, all MPP
    information should be kept for a period of 7 years, after which the information should be shredded.

20. Release of Information

    Authorization for Release of Information Form (PA 1723)
    For confidentiality reasons, all consultations with outside agencies must be preceded by a signed MPP
    Authorization for Release of Information Form(s) (PA 1723) (Attachment 5) that the participant has signed
    and dated. The Authorization for Release of Information Form(s) (PA 1723) (Attachment 5) must be specific
    to the participant and the agency with which information will be shared. No blanket release forms will be
    permitted. The form must have a begin and end date clearly indicated on the form. The end date on the
    form may not exceed twelve months from the date the participant signed the form. If the participant remains
    in MPP for more than twelve months, new Authorization for Release of Information Form(s) (PA 1723)
    (Attachment 5) must be signed by the participant in order for information to be shared with appropriate MPP
    Team member(s) or with other professionals.

    Release of Confidential Medical Information
    Please see OPS Memo 030414 regarding further details regarding the release of confidential medical
    information and HIPAA requirements.

    Children and Youth Social Services Agencies
    Please see EPP 446135 regarding the release of Children and Youth Social Services Agencies information.

    Requests for Medical Information from Bureau of Disability Determination (BDD), the Social Security
    Administration (SSA) or the Participant's Attorney
    MPP and DAP Workers often receive requests from a participant's attorney and/or the BDD or SSA for
    copies of Medical Assessment forms (PA 635), and any other medical information that may be part of the
    CAO file. This information is requested to help determine the client’s eligibility for SSI.

    The MPP Worker will provide the information. Assessments will be provided once completed.

    NOTE: If a participant’s attorney requests the information, and if the WCA is not yet fully completed, the
          WCA will still be sent to the participant’s attorney as long as there is a completed and signed
          Authorization for Release of Information form (PA 1723) (Attachment 5).

    The MPP Worker, WCA Contractor, and DAP Worker will work collaboratively to ensure that complete
    information is provided.


                                                      15                                            July, 2010
    A copy of the request will be included in the WCA Summary Results Package and documented
    appropriately.

21. Limited English Proficiency (LEP)
    Each CAO should facilitate the provision of adequate interpretive services for all MPP services and
    activities. If other outside options are not available the CAO may request addition of an interpretive service
    provider to the MPP Vendor File. Please see Section E for details regarding the MPP Vendor Payment
    process.

    If the participant chooses to use their own interpreter, the interpreter must adhere to the Volunteer
    Interpreter Guidelines. The MPP Worker will review the Volunteer Interpreter Guidelines with the Volunteer
    Interpreter and the participant before any signatures are obtained. The interpreter must complete the
    statements of proficiency and responsibilities. The participant must complete the “Participant Statement for
    Use of a Volunteer Interpreter” attachment (Attachment 19).

    The CAO can not use participants or other family or household members as interpreters for other
    participants.

22. Suspected Child Abuse
    The Child Protective Services Law (CPSL) (23 Pa.C.S., Chapter 63) defines child abuse as harm to a child
    under 18 years of age that results from a caregiver or family dysfunction. Types of child abuse include
    serious physical injury, sexual abuse or exploitation, serious mental injury, serious physical neglect, and
    imminent risk.

    Every CAO employee is required to give an immediate verbal report to the Executive Director or Designee
    when the CAO employee suspects that a child is a victim of child abuse. It is not the CAO employee’s
    responsibility to determine whether or not abuse actually occurred or what type of abuse occurred. It is
    merely the CAO employee’s responsibility to report suspected child abuse.

    The Executive Director or Designee must call ChildLine (800-932-0313) and report all suspected child abuse
    immediately after receiving a report, and do so without determining if the report is valid. The Executive
    Director or Designee must provide ChildLine with all known information. The Executive Director or Designee
    must inform the reporter when the call is made, and complete a Report of Suspected Child Abuse (CY47)
    (Attachment 23) and forward to the county Children and Youth Social Services Agency in the county where
    the alleged abuse occurred.

    A summary of the action should be placed in the CAO case record, but is removed to ensure confidentiality
    when the record is reviewed by anyone other than a CAO employee.

23. Domestic Violence
    All victims of domestic violence must be assured that the personal data they provide will be confidential.
    This is of critical importance to domestic violence victims since their physical well-being or life may be
    endangered should their whereabouts become known to the abuser.

    The CAO should be prepared to make referrals to domestic violence service providers by offering hotline
    numbers, brochures, and information about domestic violence. This may include CAO brochures, CAO
    palm cards, or local domestic violence providers’ brochures.

    It must always be the participant's choice to take any materials with domestic violence references
    printed or written on them. Extreme discretion is advised before any materials referencing domestic
    violence are left with the participant in the CAO, participant’s home, or anywhere. This could be a safety
    concern to the participant. If an abuser has access to any indicator that domestic violence was discussed, it
    increases the danger to the participant and/or the children. And for these same reasons, the CAO will never
    mail materials, with information referencing domestic violence, to the participant's home.

    If the CAO provides a participant with a telephone number for services related to domestic violence, the
    CAO will never include the name, address, or any other identifying information related to the service provider


                                                     16                                           July, 2010
    on paper. One possible suggestion would be to write only the telephone number on the back of the CAO
    Worker’s business card.

    Domestic violence materials should be available in waiting rooms and ladies’ restrooms, at the CAO, so
    participants may choose to pick up materials. Please see the Cash Assistance Handbook (CAH), Chapter
    108, Appendix A for further details regarding brochures and forms.

    Please see CAH, Chapter 108.101 regarding non-disclosure requirements.

    Please see CAH, Chapter 108.102 regarding the use of an alternate address.

    Please see Section D – 3 regarding the Work Capacity Assessment (WCA).

    Medical Assessment Form (MAF) – PA 635 regarding Domestic Violence
    If a MAF is returned for an Extended TANF client who is in the Domestic Violence (DV) Track #1, the client
    may remain in this track, with an ETP Code 53, as long as necessary. However, the client may choose to
    volunteer for MPP. In some cases, the client may benefit more from being in the MPP Track #2, however, a
    very careful examination of the client’s situation and family’s safety should be done first to determine which
    track would be best for that particular client and family. Local domestic violence agencies can assist the
    participant in making this track choice. If the client chooses to volunteer for MPP, the client would remain
    coded as Program Status Code 09, B Project and Good Cause Code 58 would be opened on CQPREN, and
    Tracking Exemption (TE) Code 31 would be entered. Please refer to OPS 021002, Implementation
    Instructions for the Extended TANF Program, and D1640, CIS System Modifications for CATIME & CATEXT
    (page 2, CATEXT).

24. Social Security

    Pending SSI Approval
    Some participants, who are seeking SSI, progress enough in their Service Plan (PA 1726) (Attachment 8)
    that their only goal is to await a SSI decision. In such cases, MPP might no longer be appropriate. The
    MPP Worker and MPP Team should determine if the participant:

          Has a long-term disability and has progressed enough in their Service Plan (PA 1726) (Attachment
           8) that their only goal is to await their SSI decision and ongoing MPP may no longer be appropriate.
          Is awaiting their initial or appeal SSI decision.
          Does not need continued MPP Team follow-up and does not have serious barriers or issues needing
           resolution.

    If a participant has been connected with all necessary services, barriers are resolved or appropriately
    stabilized, does not need continued MPP Team follow-up, and now only is awaiting a decision from Social
    Security, it is appropriate for the client to be terminated in MPP using Termination code J (Pending SSI
    Approval), and enrolled in Project A with a Sub-project code 24 on CQPREN. The participant would then be
    entered in the Deferral Track, TE code 34. There is no current time limit regarding the amount of time in the
    Deferral Track. These participants will be transitioned to a Disability Advocacy Program (DAP) or ongoing
    caseload to be determined by the CAO.

    Individuals referred to DAP, who are cooperating with the SSA and the eligibility process, are considered
    exempt until the final eligibility determination for RSDI or SSI is made. This includes all appeal processes
    that fall within the final eligibility determination process.

    Extended TANF Clients in Deferral Track (TE 34)
    The Deferral Track (TE 34) requires follow up at least every 90 days, and although current policy states that
    the client must be referred back to MPP after 180 days in the Deferral Track, BETP is waiving that policy for
    these clients pending regulations changes. If the CAO learns that the client was denied SSI after the final
    eligibility determination, the CAO will change the client’s ETP code to 60, enter GC code 53 on CSPREN for
    the client, and will give the client a MAF to be completed.



                                                     17                                           July, 2010
    If the MAF is returned to the CAO and the client is exempt, then the CAO will change the ETP code from 60
    to 53 and will remove the GC code 53 from CSPREN. The CAO will then meet with the client and determine
    what the most beneficial track is. If MPP is determined to be the best track, then the CAO will enter a B
    project referral on CSPREN.

    If the MAF is returned to the CAO and the client is not exempt, then the CAO will remove the client’s GC
    code 53. The CAO may give the client a second MAF to be completed if the CAO feels that a second
    opinion is needed. If this is done, then the CAO may re-enter the GC code 53 until the MAF is completed
    and returned to the CAO.

    Compassionate Allowances Program
    Social Security has an initiative called the Compassionate Allowances Program. This is a program that will
    expedite applications for disability for conditions that are so severe that a two-year wait for Social Security
    Disability (SSD) is considered unreasonable.

    There is an initial list of 50 conditions that meet these Compassionate Allowances criteria. Others may be
    added in the near future. The link for the complete list:
    http://www.socialsecurity.gov/compassionateallowances/conditions.htm

    The MPP Worker will assist participants and household members with this expedited process if he or she
    meets one of these criteria diagnoses and has applied for SSD.

25. Reasons for Termination
    Participants may be terminated from MPP for the following reasons:

       Failure, without good cause, to appear for the enrollment interview and two rescheduled interviews
        within 30 days of referral.

       Failure, without good cause, to complete a Medical and Social History Form (PA 1718) (Attachment 3)
        and/or Authorization for Release of Information Form (PA 1723) (Attachment 5) within 30 days of
        enrollment.

       Failure, without good cause, to agree to terms of the Service Plan (PA 1726) (Attachment 8) within 30
        days of the completion of the Medical and Social History Form (PA 1718) (Attachment 3).

       Repeated Failure, without good cause, to participate with the agreed-upon Service Plan (PA 1726)
        (Attachment 8). (This will be determined on a case-by-case basis and may be defined differently for
        each individual based on the participant’s situation and the type of barriers encountered.)

       Failure, without good cause, to attend an appointment with a partner agency. The number of times the
        participant may miss an appointment before being terminated will depend on individual circumstances
        and good cause determination. A participant, who without good cause, repeatedly fails to comply with
        MPP, may be terminated from the Project until such time as they are willing to comply. The CAO will
        make the good cause determination with input from partnering agencies if applicable.

       Failure, without good cause, to comply with the WCA requirements.

       Failure, without good cause, to provide an updated MAF, as explained in Section C – 16.

       Resolution and/or appropriate stabilization of all barriers. This will be mutually agreed upon by the
        participant and MPP Team members. Appropriate documentation must be included in the MPP case
        record.

       Pending SSI approval.

       Receiving SSI (participant may still do the MPP Transition Component).


                                                      18                                           July, 2010
        Obtaining employment, resulting in TANF case closing (participant may still do the MPP Transition
         Component).

         NOTE: The CAO should not terminate an MPP participant until the CAO Worker has verification that the
               participant reported to work and began employment and has received his or her first pay.

        Termination in attempt to better meet the participant’s needs through a different employment and
         training program.

        Reaching the 24-month time limit in MPP and an extension is not determined to be appropriate.

        Reasons beyond the CAO’s control:

             o   claiming one year exemption after giving birth
             o   receiving unemployment compensation benefits that close the participant’s TANF case
             o   participant voluntarily closes his or her TANF grant
             o   participant moves out of the county or state
             o   passing away of the participant
             o   full-time entrance into a substance abuse treatment facility, expected to last more than 30 days,
                 and the MPP Worker is not able to or it is not appropriate to continue to work with the participant
                 regarding his or her Service Plan (PA 1726) (Attachment 8); and
             o   incarceration of the participant that is expected to last more than 30 days.

     Prior to terminating a participant from MPP due to non-compliance with MPP requirements, the MPP Worker
     will complete the compliance review process with the participant to determine if good cause existed. If good
     cause exists, the MPP case will remain open. If good cause does not exist, the MPP Team must review the
     situation(s) and agree to terminate the participant from MPP before terminating.

     Appropriate documentation of intervention and measures taken to keep the participant engaged in MPP will
     be noted in the participant’s MPP and CAO Case Records. The CAO Executive Director or a designee must
     approve, in writing, all terminations that occur for this reason.

     Pre-60 month exempt (ETP code 53) participants may withdraw without any consequence. However, Pre-
     60 month exempt participants who drop out and have not exhausted their Time Out will have the Time Out
     end dated unless they are eligible for Time Out under another basis. Please keep in mind that for Post-60
     month participants, Extended TANF eligibility hinges on MPP participation.

     If the participant is terminated from MPP, a MPP Termination Form (PA 1757)(Attachment 13), must be
     completed within five days of termination. The completed copy of the MPP Termination Form (PA 1757)
     (Attachment 13) must be kept in the participant’s MPP Case Record and shared with all MPP Team
     members and any agencies listed on the participant’s Service Plan (PA 1726) (Attachment 8).

     MPP Workers are reminded to discontinue Time Out for exempt participants who are terminated from MPP
     unless they qualify for Time Out under other criteria.

  26. Inter-County Transfers
      A pre-60 month participant who moves to another county must volunteer for MPP in the new county. A post-
      60 month participant who meets the MPP track criteria is required to enroll in MPP or another track if
      appropriate, in order to continue their TANF eligibility and receive Extended TANF at the new CAO.

     Please see EPP 478135 for details regarding the inter-county transfer process and MPP participants.


D. WORK CAPACITY ASSESSMENT (WCA)

  1. WCA Overview



                                                       19                                           July, 2010
   The goal of a WCA is to evaluate the participant’s health condition, employment potential, and determine
   what services may help the participant with overcoming or stabilizing a barrier(s). It is conducted by a
   medical services agency, contracted by DPW.

   The WCA is required for those clients who meet the Extended TANF - MPP criteria, unless the client was
   referred to MPP before Extended TANF was authorized.

   The WCA may be completed for an individual that was referred to MPP before Extended TANF was
   authorized, if it is deemed appropriate by the MPP Team, the client agrees to it, and will assist the
   participant in stabilizing their barrier(s) or with attaining Social Security benefits.

   The WCA will consist of an assessment of all documentation received from the CAO and client’s treating
   physician(s) and can include any combination of the following assessments:

      Independent Medical Examination (IME);
      Psychological Examination (IPE);
      Functional Capacity Evaluation (FCE); and
      An assessment of all documentation received by the WCA Contractor. This will include the results of the
       assessments and other available information and documentation provided by the MPP Worker and the
       participant’s Treating Physician(s). The WCA Contractor will use this assessment to create the WCA
       Summary Results.

   The MPP Team will use the WCA Summary Results in conjunction with professional advice from the MPP
   Team members, input from the participant and other available data, to develop the Service Plan (PA 1726)
   (Attachment 8).

2. WCA Referral Process

   Initial WCA Interview
   The MPP Worker will meet with the participant to explain the process and complete the necessary forms. In
   most cases, this will occur during the MPP Enrollment Interview for Post-60 month participants. The MPP
   Worker will:

      Explain the WCA process to the participant;
      Provide the participant with the name and phone number of the WCA Contractor and MPP Worker;
      Send an Information Packet to each of the participant’s treating physicians. The MPP Worker may also
       send an Information Packet to former treating physicians if the MPP Worker and Team feel that it may
       be beneficial. The MPP Worker will complete the following forms with the participant and include them
       in the Physicians Information Packet:

       o   Authorization for Release of Information Form(s) (PA 1723) (Attachment 5), to allow transfer of
           information from the participant’s treating physician(s) to the WCA Contractor (2 copies).
           Additionally, in order for specific information to be included in the WCA written assessment reports,
           which are sent from the WCA Contractor to the MPP Worker, an Authorization for Release of
           Information Form (PA 1723) (Attachment 5) must be completed and signed giving permission to
           release the specific information back to the MPP Worker;

       o   Letter of Explanation and Request for Information Form (PA 1751) (Attachment 12). This form
           explains the WCA process and requests that copies of the participant’s medical records be sent to
           the WCA Contractor; and

       o   Professional Service Invoice for Photocopy/Postage Costs (PA 1748) (Attachment 10). This form
           offers reimbursement for photocopy and postage costs incurred in sending medical records to the
           WCA Contractor.

           NOTE: Photocopy fees and postage costs incurred in sending medical records to the WCA
                 Contractor will be invoiced and paid by the WCA Contractor.

                                                    20                                          July, 2010
        The Professional Service Invoice for Photocopy/Postage Costs (PA 1748) (Attachment 10) will be
        returned to the WCA Contractor by the treating physician(s) if reimbursement is requested for
        photocopying expenses related to copying fees associated with the participant’s medical records
        and/or postage costs. The treating physician(s) will also indicate his desire to be included in the
        diagnostic testing process on the Professional Service Invoice for Photocopy/Postage Costs (PA
        1748) (Attachment 10).

    o   A 9½ “x 12½” document envelope addressed to the WCA Contractor. This envelope will be used by
        the treating physician to send the participant’s medical records and information to the WCA
        Contractor. The CAO will include this envelope with the packet of information created for each
        physician.

It is recommended that the CAO create labels with the WCA Contractor’s name and address to use on the
Professional Service Invoice for Photocopy/Postage Costs form (PA 1748) (Attachment 10), the Letter of
Explanation and Request for Information form (PA 1751) (Attachment 12), and the document envelope
included in the treating physician’s information packet.

To ensure that the WCA Contractor has the most current phone number for the participant, the MPP Worker
will ask the participant for a current phone number where he or she can be reached, and write it at the top of
the WCA Transmittal Form (PA 1749) (Attachment 11).

A Service Plan (PA 1726) (Attachment 8) will be developed, if one isn’t already, to determine what services
and activities the participant should pursue during the time the participant is enrolled in the WCA process.
Please follow Section C – 7 regarding the development of the Service Plan (PA 1726) (Attachment 8).

Creating a WCA Referral
The MPP Worker will create a WCA Referral Package to provide to the WCA Contractor via Priority Mail.
Copies of the following documents, except where otherwise noted, will be included in the WCA Referral
Package, as appropriate:

   Medical and Social History Forms (PA 1718) (Attachment 3)
   Assessment results
   MPP Case Record narratives
   Pertinent case narrative entries; actual copies of the narrative and/or printouts from CQCCOM
   DAP referral forms (PA 731)
   Medical information contained in the DAP file (open or closed)
   Medical History Profile Report
   AMR Forms (PA 1661)
   Employability Assessment Forms (PA 1663 and PA 1664)
   Medical Assessment Forms (PA 635)
   Health Sustaining Medications Forms (PA 1671)
   Report of Physical/Medical Examination Forms (PA 586)
   Authorization for Release of Information Forms (PA 1723) (Attachment 5) Original and one copy
    included in the packet of information sent to each treating physician
   MPP Enrollment Form (PA 1724) (Attachment 6)
   TANF Work Activity Summary and Case Synopsis Form (PA 1725) (Attachment 7)
   The WCA Transmittal Form (PA 1749) (Attachment 11). The transmittal form is used as a cover sheet to
    collect and transfer information from the CAO to the WCA Contractor.
   Letter of Explanation and Request for Information Form (PA 1751) (Attachment 12), original sent with
    the client to give to each treating physician.
   Professional Service Invoice for Photocopy/Postage Cost Form (PA 1748) (Attachment 10), original sent
    with the client to each treating physician.
   Any other information that may be helpful.

The MPP Worker will make a CSPREN Sub Project referral, using Sub Project Code 41, to the WCA
Contractor at the same time the WCA transmittal and supporting documentation is sent to the WCA
Contractor. Please see Section D – 6 for CIS data entry details.
                                                 21                                           July, 2010
If the MPP Team determines that a certain aspect of the WCA is not needed, such as the medical evaluation
or psychological evaluation, the MPP Worker will inform the WCA Contractor of this recommendation. If the
WCA Contractor disagrees with the MPP Team’s recommendations, then the WCA Contractor should
discuss this with the MPP Worker and/or MPP Team and determine what is best for the participant.

WCA Re-Referrals regarding WCAs closed by the WCA Contractor
If a participant is terminated by the WCA Contractor and the MPP Team elects to re-refer the client for a
second WCA, within 90 days of the first WCA referral, the MPP Worker must review the previously
completed Medical and Social History Form (PA 1718) (Attachment 3) with the participant to determine if
there have been any changes in the participant’s circumstances. If no changes are noted, the MPP Worker
will have the participant add a second signature and date to the original Medical and Social History Form
(PA 1718) (Attachment 3). The CAO will then create a WCA referral on CIS and send the WCA Transmittal
form indicating in bold letters that this is a re-referral and the date of the new referral.

If additional documentation is available, that was not provided when the original WCA Referral Package was
sent, the MPP Worker will include this documentation with the revised WCA Transmittal form and Medical
and Social History Form (PA 1718) (Attachment 3), and send it via Priority Mail to the WCA Contractor.

WCA Re-Referrals regarding Participants who do not agree with the WCA Summary Results
If the participant disagrees with the WCA Summary Results, the participant can be re-referred to the WCA
Contractor for a second WCA.

Re-evaluating Temporary Disabilities at the WCA Re-evaluation Date
The CAO may refer the participant back to the WCA contractor, at the re-evaluation date, to re-evaluate the
temporary disability and any other alleged disabilities, but it is not required. When the WCA Contractor
completes a WCA and determines that an Extended TANF - MPP participant is temporarily disabled, the
WCA Contractor includes the expected length of the temporary disability and a re-evaluation date on the
WCA Summary Results page and on the WCA Summary Report. The MPP Team will determine what may
be most helpful for the participant with consideration of the participant’s on-going treatment and services. If
the MPP Team determines that a re-evaluation would be helpful, another WCA can be recommended
instead of a MAF. A MAF may be used if the MPP Team determines it to be best. The following actions
should take place when the returning MAF states:

 “Employable” for 20 or 30 hours per week (with or without accommodation)
    o The MPP Team and participant will determine what E&T program/track would be most helpful and
       appropriate.
   o   The participant may choose to continue to participate in MPP or to be referred to another E&T
       program.
   o   Change the participant’s ETP status code if needed.

   If the participant chooses to be referred to another E&T program then:
   o Discuss the change in E&T requirements with the participant.
   o Terminate enrollment in MPP.
   o MPP case manager should convey the need for continuation of services with CAO caseworker
        responsible for changing the client’s AMR.
   o Complete an AMR to identify the change in program and participation requirements.
   o Refer the client to the appropriate E&T program.

 "Limited Eligibility"
    o The MPP Team and participant will determine what E&T program/track would be most helpful and
       appropriate.
   o   The participant may choose to continue to participate in MPP or to be referred to another E&T
       program.
   o   Change the participant’s ETP status code if needed.

   If the participant chooses to be referred to another E&T program then:
   o Discuss the change in E&T requirements with the participant.

                                                  22                                           July, 2010
       o   Terminate enrollment in MPP.
       o   MPP case manager should convey the need for continuation of services with CAO caseworker
           responsible for changing the client’s AMR.
       o   Complete an AMR to identify the change in program and participation requirements.
       o   Refer the client to the appropriate E&T program.

    “Temporary Disability”
       ○ The MPP participant remains eligible for MPP.
       ○ Individuals with a disability of 12 consecutive months or more should also be referred to DAP.

    “Permanent Disability”
       o Client should be pursuing Social Security Disability/SSI with the assistance of a DAP worker.
       o If the client has been connected with all necessary services, barriers are resolved or stable, and now
           only awaiting a decision from Social Security, it is appropriate for the client to be terminated in MPP
           and enrolled in an A project, with a subproject 24, and in Deferral Track. Individuals referred to
           DAP, who are cooperating with the SSA and the eligibility process, are considered exempt until the
           final eligibility determination for SSDI or SSI is made. This would include all appeal processes that
           fall within the “final eligibility determination” process.

   CQDISB screen on CIS should be updated to reflect either the WCA re-evaluation date or MAF date, based
   on the assessment tool that is used. At the review date on CIS, the MPP Team will determine the next
   review date, up to but no more than six months from the previous review date, unless the participant was
   determined permanently disabled. A permanent disability does not require a future review date. If
   determined to be permanently disabled, the DAP worker should assist the participant in pursuing SSI/SSDI.

3. WCA Contractor Responsibilities
   If the WCA Contractor does not receive the WCA Transmittal Package from the CAO within five days of
   receipt of the WCA referral on the Commonwealth Workforce Development System (CWDS), the WCA
   Contractor will follow up by contacting the CAO – MPP Worker.

   When the WCA Contractor receives the WCA Transmittal Form (Attachment 11) and documentation from
   the MPP Worker, the WCA Contractor will:

      Make at least two phone calls to the participant’s Treating Physician(s) in an attempt to obtain
       documentation initially requested by the participant using the WCA Letter of Explanation and Request for
       Information Form (PA 1751) (Attachment 12). If this information has not been received from the
       participant’s Treating Physician(s), the WCA Contractor must have an Authorization for Release of
       Information Form (PA 1723) (Attachment 5) signed by the participant and provided by the MPP Worker
       in the WCA Transmittal Package, before attempting to obtain this documentation. Attempts will be
       recorded on the WCA Transmittal Form (PA 1749) (Attachment 11) and also data entered on CWDS;

       NOTE: If the MPP Worker has provided appropriate Authorization for Release of Information Forms
             signed by the participant, the WCA Contractor will photocopy medical records received from the
             participant’s Treating Physician(s), and send them to the MPP Worker, for use in developing a
             Service Plan (PA 1726) (Attachment 8).

      Conduct a review of documentation received from the MPP Worker and the participant’s Treating
       Physician(s). If the WCA Contractor is unable to reach the Treating Physician(s) or the substantiating
       documentation is not received within 30 days of WCA referral, the WCA Contractor will continue the
       WCA Process, without the use of this information;
      Determine the type of evaluations needed based on the information that has been received;
      Schedule the appropriate assessment(s) with appropriate physician(s) by using the following steps:

       ○   Create an Appointment Letter in CWDS using standardized text, and sent via U.S. Mail to the
           participant’s address;
       ○   Notify the participant of this appointment, in writing, at least seven days prior to the appointment
           date, in addition to making attempts to reach the participant by phone;

                                                     23                                           July, 2010
    ○   Place a phone call to and/or send an email to the MPP Worker to advise of participant’s
        assessment/evaluation appointment date and time.

    The WCA Contractor will send the MPP Worker a copy of each appointment letter to enable them to
    offer any special allowances the participant may need in order to ensure attendance at the WCA
    assessment(s)/evaluation(s).

    The physician must be located not more than two hours or 100 miles away from the participant’s
    residence, one-way.

    If the participant does not keep, or is unable to attend the scheduled appointment, it can be rescheduled
    by the WCA Contractor one time. If the participant fails to show for the second appointment, the WCA
    referral is terminated for non-cooperation. If the WCA referral is terminated for non-cooperation, prior to
    completion of the WCA process, the MPP Team must evaluate the circumstances surrounding the WCA
    termination and determine if the participant should also be terminated from MPP.

   Perform assessment(s) which may include but is not limited to the following assessments:
    ○ Physical capacities, accomplished via an IME;
    ○ Mental capacities; accomplished via an IPE;
    ○ Functional capacities, accomplished via a FCE; and
    ○ An assessment of the participant’s capacity to work with or without appropriate accommodations.

   Provide the physician(s)’ opinions regarding:
    o Diagnostic testing, services, treatments, or accommodations that is necessary in order for the WCA
       to be completed and for the individual to move toward self-sufficiency.

        If the participant’s Treating Physician(s) has indicated a desire to be involved in the diagnostic
        testing process on the Letter of Explanation and Request for Information (PA 1751) (Attachment 12),
        the WCA Contractor will contact the Treating Physician(s) to assess if they choose to be involved in
        the scheduling of the diagnostic testing;

    o   Referrals for additional diagnostic testing, if needed; and
    o   Recommendations regarding participation in employment and training programs and necessary
        treatment, activities or accommodations.

   Compile the WCA Summary Results;

    The WCA Summary Results will:
    ○ Provide information on the participant’s capacity to work;
    ○ Verify any barrier(s) that are hindering the participant’s ability to work;
    ○ Specify any services, activities, and/or accommodations that might improve the participant’s capacity
       to work;
    ○ Determine if the participant is able to work without limitations;
    ○ Determine if the participant is a potential candidate for SSI/SSDI; and
    ○ Discuss possible changes in the participant’s diagnosis and prognosis.

   Send a results package to the MPP Worker within one week of receipt of the material provided by the
    physician(s) performing the assessment(s). The WCA Summary Results Package will include results of
    all assessments completed and all supporting documentation from the MPP Worker, Treating
    Physician(s); and
   Data enter WCA Outcome Code on CWDS. Please see Section D – 6 for further details.

The physician(s) who is conducting the assessment(s) will complete a report, based on the assessment(s),
and will send it to the WCA Contractor.

If a participant has attended one or more assessments, but not all, and the WCA Contractor is able to
determine that the participant has a severe impairment, or is temporarily impaired, the WCA Contractor will
make note of the missed medical appointment but will complete the WCA Summary Narrative listing barriers
                                                  24                                           July, 2010
     to employment and recommendations to alleviate those barriers. In situations like these, the WCA is
     considered complete and is not required to be re-referred. If additional assessments are needed in the
     future, they can be obtained through the MPP Vendor Payment System.


     Domestic Violence Disclosure during a WCA
     Please see EPP 481135 regarding procedures to follow when a participant shares domestic violence
     information during the WCA process and regarding the WCA Contractor sharing such disclosed information
     with the MPP Worker. Please see Section C – 23 for more details and regarding how to give domestic
     violence information to participants safely.

4.   WCA Completion
     The WCA Summary Results can be shared with the MPP Team members if the appropriate consents have
     been signed, granting permission by the participant to share the information with the team. However, even
     with the participant's permission to share, in keeping with HIPAA regulations, the report must be collected at
     the conclusion of the meeting and must not be taken outside of the CAO.

     Due to the sensitive content of the assessment(s)/evaluation(s) obtained through the WCA, the CAO will not
     release a copy of the WCA Summary Results or Report to the participant. Instead, with the participant's
     consent, a copy of the WCA Summary Results may be sent to the participant's treating physician(s) or
     Primary Care Physician (PCP), who is better qualified to interpret the medical findings in the assessments.

     The MPP Worker and MPP Team should discuss the barriers and recommendations noted on the WCA
     Summary form with the participant, as deemed appropriate and in the participant’s and family’s best interest.

     The MPP Team and participant will revise the Service Plan (PA 1726) (Attachment 8) as needed using data
     from the WCA Summary Results and recommendations, supporting documentation, Medical and Social
     History Form (PA 1718) (Attachment 3), and all other relevant information. The WCA Summary Results and
     recommendations are intended to assist the MPP Team in the development of the Service Plan (PA 1726)
     (Attachment 8), but are not determinative of the outcome of the MPP process. If the MPP Team agrees that
     a certain WCA Summary Results recommendation is not in the best interest of the participant, the
     recommendation does not need to be included in the Service Plan (PA 1726) (Attachment 8).

     If the participant disagrees with the WCA Summary Results, the participant can be re-referred to the WCA
     Contractor for a second WCA. The CAO will then data enter another sub-project referral to the WCA
     Contractor.

     If the participant disagrees with the WCA Summary Results and refuses to cooperate with the referral for a
     second WCA and/or develop a revised Service Plan (PA 1726) (Attachment 8) incorporating the WCA
     Summary Results, the CAO may terminate enrollment in MPP after completing the compliance review
     process and if good cause does not exist. If good cause does not exist, the CAO will then determine if the
     client still qualifies for Extended TANF under the MPP track or any other Extended TANF track. If the client
     does not qualify for Extended TANF, the CAO will send a 162A (Advance Notice) to close Extended TANF
     benefits. The client may appeal this decision, and may also reapply for benefits at any time.

     If a second WCA is requested and completed, the Service Plan (PA 1726) (Attachment 8) may include a
     combination of recommendations made in the first and second WCA.

     WCA Precedence
     The WCA takes precedence over all MAFs for the length of the temporary disability that is listed on the
     WCA. If the MPP Team or participant disagrees with the WCA results or recommendations, a second WCA
     may be completed by different WCA Contractor providers. Should the MPP Team not agree with either of
     the WCAs, the MPP Team may choose to have a MAF completed and the MAF would take precedence for
     the length of time noted, but this should only happen in rare occasions.

     Supported Work Participants
     If a participant is terminated from MPP and referred to Supported Work, based on the findings of a WCA,
     and the then client has a MAF completed while in Supported Work that shows the client is temporarily or

                                                      25                                           July, 2010
   permanently disabled, the client would not be eligible for MPP if the length of the disability listed in the WCA
   still applies.

   NOTE: If the Supported Work Contractor determines that the client is not appropriate for Supported Work
         and would be better served through MPP, then the Supported Work Contractor and MPP Worker
         should discuss the concerns. The MPP Worker should then discuss the concerns with the MPP
         Team. If both the Supported Work Contractor and MPP Team agree that MPP is best for the
         participant, then the participant may be terminated from Supported Work and referred back to MPP.

   If the length of the disability listed in the WCA has expired, then the client can be re-enrolled in MPP and the
   MPP Team will determine if another WCA would be helpful or not.

5. WCA Non-Cooperation
   If a participant does not take the information packet containing an Authorization for Release of Information
   Form (1723) (Attachment 5), Letter of Explanation and Request for Information Form (PA1751) (Attachment
   12), and Professional Invoice for Photocopy/Postage Costs Form (PA 1748) (Attachment 10) to his or her
   Treating Physician(s), there is no penalty. The WCA Contractor is required to make attempts to secure this
   information from the Treating Physician(s).

   If the participant fails to cooperate with the WCA component or with other MPP requirements, the MPP
   Worker will review supporting information from the WCA Contractor and will complete the compliance review
   process with the participant to determine if the participant has good cause for not cooperating. The MPP
   Worker will then conduct a meeting with the MPP Team to decide whether or not it would be appropriate to
   terminate the participant from MPP, if good cause does not exist. The MPP Worker and Team must exhaust
   all possible strategies to engage the participant in MPP and to assist the participant with achieving the
   Service Plan (PA 1726) (Attachment 8) goals, prior to terminating from MPP.

   If the decision is made to terminate the participant from MPP, the CAO will terminate the participant’s
   enrollment in CIS. The CAO will review the participant’s eligibility for Extended TANF benefits. If not eligible
   for Extended TANF, the CAO will send an Advance Notice of Adverse Action (PA 162A) to the participant to
   close Extended TANF benefits. The participant may appeal this decision and may also reapply for benefits
   at any time. Extended TANF participants who fail to cooperate with the WCA or with MPP are not subject to
   RESET sanction.

   If a Post - 60 month participant fails to cooperate with MPP or is approved for SSI/OASDI after the WCA
   referral has occurred, but before the WCA is completed, both the MPP project and the WCA referral should
   be terminated if good cause does not exist when completing the compliance review process. In order to do
   this, the MPP Worker will call the WCA Contractor, notify them of the non-cooperation or receipt of SSI, and
   ask the WCA Contractor to terminate the WCA enrollment so that the participant can be terminated from
   MPP.

6. WCA Data Entry
   The participant data related to referral, participation, and outcomes will be collected on CIS.

   The MPP Worker will complete the following CIS screens:

      CSPREN

       o   Enter Sub-Project Code 41 without a begin date.
       o
           NOTE: This will generate a referral to the WCA Contractor via CWDS. The begin date will be
                 refreshed from the date the Contractor enters on CWDS. Likewise, the WCA will be ended
                 on CWDS and the end date will be displayed on CIS on CQPREN along with an Outcome
                 code.

      CSIETP

       o   Open appropriate activities and appropriate begin dates;
                                                      26                                             July, 2010
    o     Enter expected hours;
    o     Enter actual hours of participation; and
    o     Update as necessary or required.

WCA Outcome Codes
The WCA Contractor will enter one of the following Outcomes Codes on CWDS to identify the outcome of
the WCA. The entry on CWDS will thus transfer to CIS – CQPREN.

   M - Able to work Full Time with No Limitations. No barriers to prevent employment.
   N - Severe Impairment, not able to work - would be an excellent candidate for SSI/SSDI.
   O - Temporary Impairment or Incapable of Sustained Employment due to barriers that may be
    addressed with appropriate interventions.
        o Expected length of disability ____________
          o   Re-evaluation should take place on/after this date: ___/___/___
   P – Able to work up to _____ hours per _____ with the following accommodations, treatments, or
    services, and consideration of the barriers listed below.
   U – Significant Impairment due to significant barriers that may not be amenable to intervention –
    potential candidate for SSI/SSDI.

Incomplete WCA Outcome Codes:
 Q - Participant failed to show for 2 apts: (circle) IME/FCE/Psych Eval/Diagnostic Test
 R - Participant was approved for SSI/SSDI
 S - WCA closing requested by MPP or WCA Coordinator (reason if known __________)
 6 - Extended TANF MPP criteria terminated (CAO entered)

CWDS Inquiry
There are 13 screens in CWDS related to the WCA. The CAO may view the progress of the WCA through
an inquiry in CWDS.

The WCA screens are:

    1.    WCA Sub-Project New Referral Screen;
    2.    WCA Sub-Project Enrollment Screen;
    3.    WCA Sub-Project Closed Project Screen;
    4.    WCA CAO Documentation List Screen;
    5.    WCA Physician Documentation Info Screen;
    6.    WCA Physician Documentation Data Screen;
    7.    WCA Physician Documentation History Screen;
    8.    WCA IME Schedule Screen;
    9.    WCA Appointment Letter Screen (not available for CWDS inquiry);
    10.   WCA Diagnostic Procedure Screen;
    11.   WCA Diagnostic Procedure Results Screen;
    12.   WCA Summary Results And Close Screen; and
    13.   Clocks Screen.

The WCA Contractor will use the CWDS screens to:

         Accept or reject the participant on their New Referrals list by entering a sub-project begin date or
          referral rejection code whichever is appropriate;
         Enter documentation received from the CAO;
         Enter documentation received from the participant’s Treating Physician(s);
         Enter assessment scheduling data;
         Create an appointment letter for the assessment (if needed);
         Refer the participant for any necessary diagnostic testing and record the procedure code and the
          amount of the test (DPW approval required for any test over $1000);
         Enter diagnostic testing results; and

                                                     27                                       July, 2010
            Enter appropriate Outcome Code and narrative.

     CWDS Reports
     WCA Reports are on CWDS. WCA Reports can be sorted by all sub-projects or by a specific sub-project.
     The WCA project will be labeled as B9999, indicating the WCA Contractor, on the sort drop down for
     reports.

  7. Copying Cost for Medical Records
     Reimbursement is given to offset the fees incurred by physicians to send medical records to the WCA
     Contractor and to the MPP Worker. The dollar amount allowed for reimbursement of photocopy costs is
     updated annually with an effective date of January. The dollar amount change is announced every
     December in the PA Bulletin.

     Please see EPP 495135 for more details and to learn how to obtain these yearly changes.

     NOTE: Costs are not reimbursable for medical records related to SSI applicants, and therefore are not
           reimbursable through DAP. Medicaid providers are required through their provider agreement to
           provide medical documentation free of charge. DAP staff should inform providers of this
           requirement in their provider agreement.


E. MPP VENDOR PAYMENTS

  1. Overview
     Services authorized through the MPP Vendor Payment System are intended to resolve or stabilize the
     barriers that are preventing the participant from moving forward and complying with their Service Plan (PA
     1726) (Attachment 8).

     The MPP Vendor Payment System is commonly used to pay for psychological evaluations, medical
     assessments, vocational testing and skills training programs. Occasionally, there are non-traditional
     services or items, such as reconditioned appliances, eyeglasses, hearing aids, hearing examinations, weight
     loss, exercise and wellness programs that may be requested for approval from BETP Headquarters to assist
     the participant to reach self-sufficiency.

     The MPP Worker must have exhausted all other avenues of funding before the payment can be made with
     MPP funds.

     The CAO is able to issue vendor payments to OVR vendors listed on the CIS - MPP Vendor Table. Please
     see Attachment 25 for a sample of the MPP Vendor Table. The MPP vendor will appear on the MPP
     Vendor Table only once even though they may provide multiple services.

  Payments made on behalf of MPP participants for MPP services will be made directly to the provider.

  Payment amounts are pre-established by OVR and are in accordance with OVR Agreement Letters.

  2. Eligibility
     Participants must be actively participating in all of the activities that are listed on their Service Plan (PA
     1726) (Attachment 8), and the activities must be moving the participant towards self-sufficiency.

     The MPP Worker must have verification that the cost of the service is comparable to costs charged by two
     other providers, unless the provider already has an agreeable service fee with OVR.

     Services cannot be available through the participant’s Medicaid coverage, or through other available
     resources.

  3. Authorization of Vendor Payment



                                                       28                                          July, 2010
If the recommended services are available through the participant’s Medicaid coverage, or through other
available resources, that method of payment must be used. If the services are not otherwise available, the
MPP Worker will:

   Discuss the participant’s suspected barriers with the OVR Team member. The OVR Team member will
    review the relevant material and recommend appropriate services, fee amounts and providers that may
    be used to provide the services.

    The MPP Worker and OVR Team member will use the MPP Vendor Table to verify a provider name,
    address, contact person, telephone number and detailed provider information.

    Provider information on the MPP Vendor Table can be obtained by using any of the following methods:
       o “CQVENR” – to access the entire list of vendors;
       o “CQVENR/CO #” - to access a list of multiple vendors in a particular county;
       o “CQVENR/VENDOR # or Federal Tax ID#” - to directly access a particular single vendor.

   Meet with the participant and discuss the recommendation(s) and providers available. If multiple
    providers exist, the participant may choose. Participants may be referred to providers outside their
    county of residence.

   Complete the Introductory Letter for Providers (PA 1730) (Attachment 9) with participant.

   Complete the Provider Authorization for Services Form (PA 1719) (Attachment 4) with participant. This
    information is obtained from the MPP Vendor Table. The information must be entered exactly as it is on
    the MPP Vendor Table.

   Complete an Authorization for Release of Information Form (PA 1723)(Attachment 5) with participant.

   Contact the provider and schedule the first appointment between participant and provider, if deemed
    necessary, and list the total service units (hours), per unit amount, and total service fee authorized for
    services.

   Explain to the provider and the participant that, in order for the provider to be paid, missed appointments
    may only be rescheduled by the MPP Worker.

   Mail the following to the provider:
       o Introductory Letter for Providers Form (PA 1730) (Attachment 9), attached to two provider copies
            of the Provider of Authorization for Services Form (PA 1719) (Attachment 4).
       o Authorization for Release of Information Form (PA 1723) (Attachment 5).

Prior to authorizing a vendor payment to a provider, the following must occur:

   Participant has received the service;
   Provider has signed, completed and returned the original (white) copy of the Provider Authorization for
    Services (PA 1719) (Attachment 4), along with an invoice for services rendered, and a written
    evaluation or report about the results of the participant’s treatment or service; and
   MPP Worker has compared the above information to the CAO copy of the Provider Authorization for
    Services (PA 1719) (Attachment 4) in order to verify that the provider has provided the authorized
    services.

    NOTE: The provider may use the Provider Authorization for Services (PA 1719) (Attachment 4) to
          cancel a service that was previously authorized or recommend changes and additions to
          participant services.

The following process will be followed to authorize a vendor payment to the provider:



                                                  29                                            July, 2010
      MPP Vendor Payment Reason Code 371 will be used. Reason Code 372 can only be issued as a
       Central Issuance;
      Each check, for the same "From–Through" period, issued will be limited to $1,500. If the services
       received exceed $1,500, multiple checks can be issued;
      Vendor payments will be issued in a timely manner and in compliance with DPW regulations regarding
       the issuance of these allowances/payments; and
      Data enter appropriate information on CCCOTI.

4. Adding New Vendors to the MPP Vendor Table and the MPP Vendor Services Table
   New vendors can be added to the MPP Vendor Table if a needed service is not offered on the MPP Vendor
   Table. However, all requests must first receive approval by BETP before payment is authorized.

   The MPP Worker will fax the following completed information to BETP at 717-787-4106, to request approval
   to add the vendor to the MPP Vendor Table:

      The MPP Vendor Addition Form (Attachment 14);
      The MPP Vendor Payment Checklist (Attachment 15); and
      A copy of the most recent Service Plan (PA 1726) (Attachment 8).

   BETP will review the request for approval and notify the MPP Worker of the decision. Each request is
   considered individually, based on the MPP participant's situation. A vendor may become a permanent
   addition to the MPP Vendor Table or may be authorized for a one-time. If approved, BETP will enter the
   vendor on the MPP Vendor Table.

5. Back Debts and Phone Policy
   The CAO can help MPP participants with certain back debt expenses under certain circumstances. This
   includes but is not limited to payments for housing, utilities, or other services that are necessary for the
   participant’s compliance with his or her Service Plan (PA 1726) (Attachment 8) requirements. Like a regular
   MPP Vendor Payment, the MPP Worker must have exhausted all other avenues of funding before the
   payment can be made with MPP funds.

   The MPP Worker will first:

      Determine if the participant persistently has expenses in excess of their income;
      Discuss developing budget habits; and
      If deemed necessary by the MPP Team, refer the participant to a credit counseling service who will
       assist in establishing a plan in working with the creditors.

   If this does not resolve the problem, the CAO may forward a request for a vendor payment to BETP for
   review and possible approval of a payment. The following must be faxed to BETP at 717-787-4106:

      The Vendor Payment Request for Back Bills and Telephone Service Form (Attachment 16);
      The MPP Vendor Addition Form (Attachment 14);
      The MPP Vendor Payment Checklist (Attachment 15);
      A written statement or copy of the delinquent bill; and
      A copy of the most recent Service Plan (PA 1726) (Attachment 8).

   In addition, the CAO will use procedures outlined in Section E – 3.

   Payments for this purpose will not exceed a lifetime maximum of $1,000 and will be approved only if not
   otherwise reimbursable through existing resources such as special allowances, Medicaid payments or other
   community resources at no cost to the participant.

   Should the debt exceed this lifetime limit, the participant must be able to pay the difference between the
   MPP vendor payment amount and the amount of the debt. It is important that the participant provide
   verification to the MPP Worker as to how they will be able to provide payment for the difference and even
   more important, how he/she plans to prevent this from becoming a recurring situation.

                                                    30                                         July, 2010
   As part of the eligibility requirement for the approval of a MPP vendor payment for back debt payments,
   participants are required to participate in credit counseling. It is the MPP Worker’s responsibility to ensure
   that the credit counseling results in a practical and fiscally plausible budget. Further debt management
   classes participation is required if recommended by the MPP Team.

   If a credit counselor provides a budget plan, the MPP Worker should evaluate whether or not it appears that
   the participant will be able to pay future expenses. Participants must be able to pay all future bills as part of
   the back debt vendor payment eligibility.

   The above process will also be followed when there is a need to assist participants with telephone
   expenses. Once approved, the CAO may issue a vendor payment up to $25 a month for up to 6 months.
   This is intended to cover a phone card or minimum basic telephone service for up to 6 months. The MPP
   Team must work with the participant on developing a long-term plan that will assist the participant in meeting
   the telephone expense once the 6-month limit is exhausted.

   The MPP Worker will contact the participant's local phone company regarding Lifeline Service, Lifeline 150
   Service, Link-Up-America, UTAP Program and any other services available to assist people with their phone
   bills, and obtain necessary application forms. The MPP Worker will assist the participant in completing
   these forms, as needed, and help to facilitate approval of these services for eligible participants.

   Verizon may be able to provide a brochure, “Getting and Keeping your Phone Service Connected”, for
   details on the above phone programs.

6. Possible Payment Resources
   Below is a list of community resources:

      Pennsylvania Public Utility Commission – includes information to assist people with utility service
       payments.
       http://www.puc.state.pa.us
      Pennsylvania Utility Choice – includes information to assist people with utility service payments.

           o   Electric
                          http://www.puc.state.pa.us/utilitychoice/lowincomeprograms.aspx?ut=ec

           o   Natural Gas
                       http://www.puc.state.pa.us/utilitychoice/lowincomeprograms.aspx?ut=nc

           o   Telephone
                      http://www.puc.state.pa.us/utilitychoice/lowincomeprograms.aspx?ut=tc

      $1 Energy Fund – can assist with utility payments such as electric, gas, and water – 1-800-683-7036 or
       http://www.dollarenergy.org/services/hardship.asp
      HEAR NOW – can assist with hearing aids – 1-800-328-8602 Ext. 2358 www.sotheworldmayhear.org
      Pennsylvania Initiative on Assistive Technology – may loan equipment – 1-877-722-8536
      Salvation Army – may be able to assist with furniture articles
      Center for Independent Living – http://www.pcil.net/index.htm
      Benevolent & Protective Order of Elks of the USA – each association may have its own major project.
       These include help with people with disabilities – http://www.elks.org
      ModestNeeds.Org – www.modestneeds.org - offers different small grants for emergency type situations.
       Should a participant be eligible, it should not affect their benefits.

7. Processing Returned, Replacement, Overpayment, and Underpayment Vendor Payments
   The following procedures will be followed for returned vendor payment checks, replacement vendor payment
   checks, overpayments, and underpayments.

   Returned

                                                      31                                           July, 2010
If the CAO receives a returned vendor payment check; the CAO will:

   Complete a CIS on-line inquiry to verify when the payment was authorized and to whom the payment
    was issued;
   Determine the circumstances and reasons surrounding the returned check; and
   Determine whether or not the reimbursement is a Commonwealth of Pennsylvania Treasury issued
    check or a personal check or money order written by the provider or any other check not Commonwealth
    of Pennsylvania Treasury issued.

If the reimbursement is a Commonwealth of Pennsylvania Treasury issued check, the CAO will send both
the returned check and the MPP Vendor Payment Adjustment Form (Attachment 17) within ten days of
receipt to:

           State Treasury Department
           P.O. Box 3047
           Room 113, Finance Building
           Comptrollers Office
           Harrisburg, Pennsylvania 17105-3047

If the reimbursement is a personal check or money order written by the provider or any other check (not
Commonwealth of Pennsylvania Treasury issued), the CAO will send both the returned check and the MPP
Vendor Payment Adjustment Form (Attachment 17) within ten days of receipt to:

           Commonwealth of Pennsylvania
           Public Health and Human Services Comptroller Office
           Attn: General Accounting
           P.O. Box 2675
           Harrisburg, Pennsylvania 17105-2675

Copies of all returned Commonwealth of Pennsylvania Treasury checks, personal checks or money orders
and supportive documentation must be kept in the MPP Case Record.

Replacement
If a vendor reports that they did not receive a vendor payment, the CAO will:

       Complete a CIS on-line inquiry to verify if and when a payment was authorized and to whom the
        payment was issued;
       Complete a MPP Vendor Payment Adjustment Form (Attachment 17), check the block for
        Replacement Investigation; and
       Send MPP Vendor Payment Adjustment Form (Attachment 17) to the State Treasury Department
        address above.

The State Treasury Department will investigate the issued vendor check and notify the CAO contact person
of the findings.

If the State Treasury Department finds the vendor check is still outstanding and the check is voided after 30
days from the issued date, the CAO will:

   Reissue a replacement vendor check to the provider using the same “From-Through” period information
    as the original vendor check and entering MPP Vendor Refund Reason Code 372 on CCCOTI screen.

Overpayment
If a vendor reports that they received a vendor payment check that exceeds the service invoice amount, the
CAO will:

   Complete a CIS on-line inquiry to verify the vendor payment amount authorized and to whom the
    payment was issued.

                                                 32                                          July, 2010
         Compare the amount issued with the original Provider Authorization for Services (PA 1719) (Attachment
          4) and service invoice.
         Contact the vendor requesting them to send a refund check to the CAO, pay to the order of
          “Commonwealth of Pennsylvania”, for the total amount of the overpayment.
         Complete a MPP Vendor Payment Adjustment Form (Attachment 17), checking the block for
          Overpayment, noting the amount returned and appropriate information.
         The CAO contact person will sign the completed form and attach the vendor overpayment refund check.
         Forward the MPP Vendor Payment Adjustment Form (Attachment 17) and overpayment refund check to
          the Comptroller’s Office at the address below:

                  Commonwealth of Pennsylvania
                  Public Health and Human Services Comptroller’s Office
                  Attn: General Accounting
                  P.O. Box 2675
                  Harrisburg, Pennsylvania 17105-2675

      Underpayment
      If a vendor reports that they received a vendor payment check that is less than the service invoice amount,
      the CAO will:

         Complete a CIS on-line inquiry to verify the vendor payment amount authorized and to whom the
          payment was issued.

         Compare the amount issued with the original Provider Authorization for Services (PA 1719) (Attachment
          4) and the service invoice.

         Complete a MPP Vendor Payment Adjustment Form (Attachment 17), checking the block for
          Underpayment, noting the amount requested and appropriate information.

         Contact the vendor directing them to cash the original vendor payment check and provide another
          written invoice to the CAO requesting an additional vendor payment for the total amount of the
          underpayment.

         After receiving service invoice from the vendor, issue a vendor payment check for the total amount of the
          underpayment using the same “From-Through” period information of the original vendor check and
          entering MPP Project Vendor Payment Reason Code 371 on CCCOTI screen.


F. Client Information System (CIS) Data Entry Procedures

   1. Overview
      The participant data related to referral, enrollment, activities and hours of participation will be collected on
      CIS. The CAO is responsible to complete timely and accurate data entry in CIS. Data entry will be
      considered timely if entered within five days of the activity.

      The MPP Worker will complete the following CIS screens:

         CSPREN;

              o   Open Project B (MPP);
              o   Enter the project begin date; and
              o   Update as necessary or required.

         CSIETP; and

              o       Open appropriate activities and appropriate begin dates;
              o       Enter expected hours;

                                                         33                                           July, 2010
           o       Enter actual hours of participation; and
           o       Update as necessary or required.

      CACOMP
       When Time Out is granted for Pre – 60 month participants:

           o   Enter Program Status Code of 06;
           o   Enter Tracking Exemption (TE) Code 75;
           o   Send PA 162C to the participant; and
           o   The TANF Clock Stops on the next payment date whose deadline can be met.

2. Activity Codes
   Activity codes will be used to track what the MPP participant is doing at any specific time. Activity codes will
   be data entered on the CSIETP screen. Multiple activity codes can be entered at the same time, however
   the activity codes in CIS and the activities listed on the Service Plan (PA 1726) (Attachment 8) must agree.

   Participation hours should be entered after the participant actually attends the service or activity. This will
   prevent months of data storage for appointments the participant rescheduled or for other reasons the
   participant did not attend.

   Below are activity codes that may be used with MPP.

          Code 6 – Providing child care for a community service participant;
          Code 11 – English as a Second Language (ESL) - as part of a skills training or job search plan;
          Code 12 – Adult Basic Education/Literacy (ABE) - remedial education to increase literacy/numeracy
           levels as part of a skills training or job search plan; Code 13 – General Equivalency
           Diploma(GED)/High School - Preparation for GED as part of a skills training or job search plan;
          Code 14 – TANF/PA Community College - TANF clients who are enrolled in a community college in
           PA;
          Code 16 – TANF Post Secondary - TANF clients enrolled in two or four year college (other than a
           PA Community College) or Community College outside PA;
          Code 17 – Move-Up Literacy - Pennsylvania Department of Education intensive literacy education
           for TANF clients;
          Code 20 – Community Service - Non-paid work at a federal, state or local government or a non-profit
           organization;
          Code 23 – Subsidized Employment - Full or part time employment with a wage subsidy provided by
           the contractor for a set period of time;
          Code 24 – Skill/Vocational Training - Vocational and technical training which provides specific
           occupational skills needed in the current job market;
          Code 26 – Paid Work Experience - Subsidized employment of not more than six months duration
           which is combined with classroom study or other training program;
          Code 33 – Unsubsidized Employment - Employment in private or public sector that results in income
           that is not subsidized;
          Code 42 – Job Search/Prep Training and ongoing job search for non-WSC enrollees – time limited;
          Code 46 – Contracted Job Development/Job Placement - Intensive job search/job development
           using techniques, such as letters, phone calls, visits, surveys, etc.;
          Code 51 – Vocational Work Experience – DPW-funded work experience which is directly related to
           an individual's field of study during enrollment in a vocational or post-secondary education; and
          Code 99 – Barrier Remediation/Removal

   Most MPP hours will be captured under activity code 99 (Barrier Remediation/Removal). The following
   service and activity hours will be recorded on CIS under activity code 99:

         Medical and Social History Form (PA 1718) (Attachment 3) completed (should include all time
          participant spends completing the form);
         Service Plan (PA 1726) (Attachment 8) development (should include all time participant spends
          developing Service Plan (PA 1726) (Attachment 8));

                                                      34                                           July, 2010
           Assessment/Evaluation;
           Learning disability services;
           Drug and alcohol services;
           Mental health services;
           Mental retardation services;
           Domestic violence services;
           Rape crisis services;
           Medical services;
           Housing and homeless services;
           Children and family services;
           OVR services;
           MPP related work activities;
           Legal services (should be used for participants who need to attend probation or attorney meetings,
            court appearances and other legal services. Participation hours should be entered after verification
            is obtained that the participant actually attended these meetings); and
           Any other services or activities that are listed on the Service Plan (PA 1726) (Attachment 8) should
            also be data entered on CSIETP.

  3. Project Termination Codes
     Project termination codes will be used to determine why the participant is no longer enrolled in MPP. Project
     termination codes will be data entered on the CSPREN and CSIETP screens.

     The following project termination codes may be used with MPP:

             Code 1 – Employment 20 hours/week or greater;
             Code 2 – Income from OJT/Work Experience;
             Code 3 – Withdraws or terminates without Good Cause;
             Code 4 – Withdraws or terminates with Good Cause;
             Code 7 – Other;
             Code 8 – Employment, 30 hours/week or greater;
             Code E – Completed – barrier resolved (MPP)
             Code G – Terminated – barrier not resolved (MPP)
             Code J – Terminated – SSI pending approval;
             Code K – Project terminated in CIS/CWDS open;
             Code R – Expiration of 45 day hold period;
             Code W – Terminated – recommend SPOC or WIA related program referral; and
             Code X – Terminated – recommend referral to KEYS

  4. Project Referral Rejection Codes
     Referral rejection codes will be used to track the reason a participant’s referral to MPP is terminated prior to
     enrollment. These codes will be data entered on CSPREN.

     The following project referral rejection codes may be used with MPP:

             Code 1 – Failed to report;
             Code 2 – Refused to cooperate;
             Code 5 – Other;
             Code 7 – Withdrawals from MPP;
             Code K – Project terminated in CIS/CWDS open; and
             Code T – Referred in error

G. ATTACHMENTS

  1. MPP Coordinators Contact List
  2. Pennsylvania Office of Mental Health and Substance Abuse Services (OMHSAS) Agencies Contact List
  3. MPP Medical and Social History (PA1718)

                                                        35                                           July, 2010
4.    Provider Authorization for Services FoRM (PA 1719)
5.    Authorization for Release of Information Form (PA 1723) AND (PA 1723-S)
6.    MPP Enrollment Form (PA1724)
7.    TANF W ORK ACTIVITY SUMMARY AND CASE SYNOPSIS (PA1725)
8.    MPP Service Plan (PA 1726) AND (PA 1726-S)
9.    Introductory Letter to OVR Providers (PA 1730)
10.   Professional Service Invoice for Photocopy/Postage Costs (PA 1748)
11.   Work Capacity Assessment Transmittal Form (PA 1749)
12.   Letter of Explanation and Request for Information (PA 1751)
13.   MPP Termination Form (PA 1757)
14.   MPP Vendor Addition Form
15.   MPP Vendor Payment Checklist
16.   Vendor Payment Request for Back Bills and Telephone Services Form
17.   MPP Vendor Payment Adjustment Form
18.   Pennsylvania Coalition Against Domestic Violence Subcontractors Contact List
19.   Participant Statement for Use of a Volunteer Interpreter
20.   Data Warehouse Registration Form
21.   Medical History Profile Report Desk Reference Guide
22.   Medical History Profile User Guide
23.   Report of Suspected Child Abuse Form (CY 47)
24.   Confidential Facsimile Message
25.   Sample MPP Vendor Table
26.   Pennsylvania Office of Vocational Rehabilitation (OVR) Contact List
27.   OVR Related Acronyms




                                                     36                              July, 2010

								
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