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NYS Office of Temporary and Disability Assistance- TA and SNAP Employment Policy Manual

Appendix A- Page 2 Rev. 3/2022 Agreement with Worksite Sponsor Agency Following is a copy of a model agreement districts may use as a guide for establishing worksite agreements with organizations that will provide work experience placements. This model incorporates all statutory and regulatory requirements governing work experience assignments. Any agreement used by the district should ensure that all such requirements are met. Districts may wish to include additional information in their worksite agreement to specify how such requirements are met or to address local concerns. Agreement with Worksite Sponsor Agency THIS AGREEMENT, made the __ day of _________________ , 20__ , by and between ________________ in THE COUNTY OF ____________________, having its offices at _________________________, hereinafter designated the "social services district", and (Name and Address of Sponsor)

hereinafter designated the "sponsor." WHEREAS, the social services district is charged with receiving and administering federal Temporary Assistance for Needy Families (TANF) funds, state Safety Net Assistance funds and Supplemental Nutrition Assistance Program (SNAP) Employment and Training (SNAP E&T) funds to be used for work activities in accordance with State Social Services Law and its implementing regulations. TANF activities must be in accordance with the state plan filed with the U.S. Department of Health and Human Services under Title IV-A of the Social Security Act. The social services district may use federal and state funds for work activities as authorized under the TANF Program, the state- administered Safety Net Assistance Program, and the SNAP E&T program to provide for the establishment of work experience projects, including any work experience that is part of a community service program, for persons in receipt of TANF, Safety Net Assistance and/or SNAP benefits. Such projects may include the performance of work experience activities in the public sector or non-profit sector, including activities associated with refurbishing publicly assisted housing. Work experience projects also may include the operation of an activity of a governmental unit, a non- profit agency, or an institution, pursuant to an agreement with the social services district in accordance with state regulations; and WHEREAS, the sponsor is a state or federal government institution, a municipality, a public agency, or a public or private nonprofit entity desiring to provide work experience activities for recipients of TANF, Safety Net Assistance, and/or SNAP benefits under an agreement complying with such provision of law and regulations. NOW, THEREFORE, it is agreed as follows: