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A-2130 Division of Welfare and Supportive Services PERSONAL RESPONSIBILITY PLAN Eligibility and Payments Manual PRP Forms MTL 13/05 13 Nov 01 Child-Only Assessment/Personal Responsibility Form

The Child-Only Assessment/Personal Responsibility Form 2037-WA is a two (2) page form used to establish a PRP for TANF households with no “work-eligible” members.

Eligibility staff must review Form 2037-WA each time TANF eligibility is reviewed. If the PRP has not expired and there are no changes of circumstances, staff must document that the PRP was reviewed and is still current. If the PRP has expired, or will expire prior to the next scheduled TANF eligibility review, a new PRP form must be completed by eligibility staff. If a change in circumstances is found prior to TANF eligibility review, the PRP must be amended by eligibility staff within 10 days of the reported change.

2140 PRP DEVELOPMENT The PRP must be developed and personalized based on the household’s unique circumstances. A participant’s strengths, interests, work experience/skills, employment barriers and other issues are identified through the assessment process and serve as a foundation for the PRP.

The case manager facilitates development of the PRP in collaboration with the participant and documents the plan on Form 2538-WA. To be effective, it is crucial the participant be allowed to take ownership of the plan by having input regarding the goals, tasks and time frames being established.

At a minimum, the plan will:

● Identify the household’s barriers (issues) to achieving economic independence; ● Outline the specific steps (tasks) to be taken by the participant, to achieve economic independence; ● Document the negotiated time frames by which each task will be completed; ● List how the Division plans to support the participant’s efforts; ● Document the children’s immunization and education status and encourage the caretaker to keep the children’s immunizations current and support school attendance and academic progress; ● Address the monitoring and verification requirements for each work activity per established policy; and ● Provide specific contact information for whom the participant must contact if they are unable to fulfill responsibilities listed on the PRP.