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VIRGINIA DEPARTMENT OF SOCIAL SERVICES EXPEDITED SERVICE CHECKLIST

10/24 VOLUME V, PART XXIV, PAGE 41

EXPEDITED SERVICE CHECKLIST

FORM NUMBER - 032-03-0718

PURPOSE OF FORM - To assist in screening households for entitlement to expedited services.

USE OF FORM - May be used for a new application, reapplication or a late recertification to identify households eligible for expedited service processing.

NUMBER OF COPIES - One.

DISPOSITION OF FORM - File in the case record.

INSTRUCTIONS FOR PREPARATION OF FORM - Obtain information on the left side of the form from the applicant or application. The applicant, BPS, screener, volunteer, or anyone else designated by the local department of social services, may complete the left side of form.

Local department of social services personnel must complete the "Agency Use Section." The form identifies each of the ways a household could be eligible for expedited service. If a household is entitled to expedited service, the BPS must conduct an interview, determine eligibility, and authorize benefits, if eligible, within the expedited service processing period.

NOTE: This form will assist in screening households for expedited services. Local departments that use appointment systems for interviews must screen all applicants to ensure that those entitled to expedited service receive appointments and delivered benefits within expedited period. Agencies that interview clients on a walk-in, daily basis may not necessarily need to use this checklist since determination for expedited service can occur during the interview.

TRANSMITTAL #35