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MISSISSIPPI

[NON-FINANCIAL CRITERIA: TANF WORK PROGRAM]

Revised 10-01- exempt from the TWP for another reason will not be required to sign the Agreement until the work status changes to a mandatory (NE) or an exempt volunteer (EV) referral. However, the individual may choose to claim this exemption instead of another exemption for which he/she is qualified if substance abuse treatment is needed. If the referral to the TWP occurs at a time other than a regular case review, the Agreement may be completed at the orientation appointment. The worker will be responsible for coordinating this arrangement with the case manager to assure that the Agreement is signed prior to beginning participation in the TANF Work Program. Requesting an Exemption When the TANF applicant or recipient requests an exemption to obtain treatment for substance abuse and the MDHS-EA-336 has been signed, the worker will provide forms MDHS-EA336A, Substance Abuse Treatment Recommendation, and MDHS-EA-336B Substance Abuse Treatment Plan to the individual requesting the exemption. In order to ensure compliance with the Health Insurance Portability and Accountability Act of 1996, the client is to be given a MDHS-EA-933, Notice of Privacy Practices. Signatures should be obtained on a MDHS-EA902, HIPAA Authorization for Release of Information and a MDHS-EA-903, HIPAA Authorization for Release of Information by the Mississippi Department of Human Services. The MDHS-EA336A and MDHS-EA-336B must be completed by the primary care provider (PCP) or Mental Health Office. The Worker must complete the recipient’s identifying information and get the individual’s signature on the forms authorizing the release of information by the service provider. The worker must also complete the MDHS-EA-332, Report of Social Information, taking care to record the individual’s statements about his substance abuse problem and how this limits his/her ability to work or care for his family. A copy of the MDHS-EA-332 should be attached to the MDHS- EA336A. The recommended plan and social information are not submitted for Medical Review approval unless the exemption request later becomes a request for an incapacity determination. It is the responsibility of the individual requesting an exemption to make an appointment with his/her primary care provider to discuss his substance abuse disorder and develop a treatment plan for rehabilitation. The PCP may refer the individual to the local Mental Health Office or

3909 Volume III | Chapter 3