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26.3.4 Work Requirement Exemption If serious mental or physical illness or hospitalization that causes the member to be temporarily unable to work or participate in the HEC program, the work requirement can be suspended for up to six months. The IM agency may grant up to two non-consecutive work requirement exemptions (up to six months each) within any three-year period. The member must contact the IM agency to request the exemption using the Medicaid Purchase Plan (MAPP) Work Requirement Exemption (F-10127) form. The agency may grant a work requirement exemption if the MAPP member: • Has been enrolled in MAPP for at least six months and has paid any applicable premiums prior to the request of an exemption. • Is expected to be able to return to work within the next six months. • Provides a doctor’s statement as proof of the mental or physical health-related hardship making them unable to work or participate in the Health and Employment Counseling program. • Has not already been granted two exemptions in the past three years. The MAPP member must continue to pay all applicable premiums during the work requirement exemption period or have an approved temporary premium waiver. DHS may also grant a temporary waiver of the work requirement for good cause. Example 1 A MAPP member who has already been granted two work requirement exemptions by the IM agency within the last three years has a car accident and will be unable to work for three months. The agency cannot grant a third exemption but can refer the request to DHS for consideration. If a work exemption request is denied, the member has appeal rights in accordance with the Medicaid program. In the last month of an exemption, the agency must send a notice to the member indicating the date the work requirement exemption will end and any steps the member must take to continue MAPP eligibility. 26.3.5 Health and Employment Counseling Program Health and Employment Counseling (HEC) is a pre-employment program for MAPP members who are not employed but are looking for work. HEC participation is one way to meet the MAPP work requirement. Individuals enrolled in or applying for MAPP who are interested in HEC can call 866-278- 6440 to learn more about the program. HEC participation can occur for up to nine months with one three-month extension, for a total of 12 months.

Members can re-enroll in HEC to meet the eligibility criteria for MAPP. HEC participation is limited to twice within a five-year period, and there must be six months between any two HEC participation periods. 26.3.5.1 Health and Employment Counseling Processing MAPP applicants or members interested in enrolling in HEC are required to complete and submit a HEC Application (F-00004). Applications may be printed from the Department of Health Services’ website at: https://www.dhs.wisconsin.gov/employment-skills/hec-faq.htm. Applicants can also contact their local agency to request a HEC application be mailed to them. The applicant can complete the