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FAMILY INDEPENDENCE ADMINISTRATION Matthew Brune, Executive Deputy Commissioner James K. Whelan, Deputy Commissioner Policy, Procedures, and Training Stephen Fisher, Assistant Deputy Commissioner Office of Procedures POLICY BULLETIN #14-56-OPE (This Policy Bulletin Obsoletes PD#10-21-OPE and PB #13-57-OPE) CLOSING OF THE INTENSIVE SERVICES CENTER (#71) May 29, 2014 This procedure can now be accessed on the FIAweb. Subtopic(s): Forms, MIS, Notices The purpose of this policy bulletin is to inform all staff that effective the close of business on May 30, 2014, the Intensive Services Center (Center #71) will cease operations. All cases have been manually transferred to their responsible home centers based on the zip code associated with the case. As a result of the Intensive Services Center closing, the following forms are now obsolete because the intended program no longer exists: Notice of Transfer to Intensive Services Center (EXP-78PP) Appointment Notice (W-140WW) Appointment Notice (W-140WW (S)) Management Information Systems (MIS) will send the Notice of Change of Center (M-55) letter to all participants affected by the closing of the Intensive Services Center. The M-55 letter informs the participants of their new center location and phone number. Samples of the notices are attached. Effective close of business May 30, 2014 Related Item: CD #14-15 HAVE QUESTIONS ABOUT THIS PROCEDURE? Call 718-557-1313 then press 3 at the prompt followed by 1 or send an e-mail to FIA Call Center Fax or fax to: (917) 639-0298 Distribution: X

PB #14-56-OPE Attachments: Please use Print on Demand to obtain copies of forms. M-55 Notice of Change of Center EXP-78PP Notice of Transfer to Intensive Services Center (Obsolete) W-140WW Appointment Notice (Obsolete) W-140WW (S) Appointment Notice (Spanish ) (Obsolete) FIA Policy, Procedures, and Training 2 Office of Procedures

Form M-55 Rev. 10/20/08 Return Address (stamp or write in a box) Case Name: Case Number: Caseload: Center: Telephone Number: Notice of Change of Center Dear Sir/Madam: Upon receipt of this notice, your case will be serviced by the Center listed on the top left corner of this notice. If there is any change in your situation, or you need to call the Center, please use the telephone number provided above. Keep This Notice. REMEMBER TO SAFEGUARD YOUR ELECTRONIC BENEFIT TRANSFER (EBT) CARD AND PIN NUMBER AT ALL TIMES. THE HUMAN RESOURCES ADMINISTRATION (HRA) WILL NEVER ASK YOU FOR YOUR PIN NUMBER. YOU SHOULD NEVER GIVE OUT YOUR SOCIAL SECURITY NUMBER OR OTHER PERSONAL INFORMATION. IF YOUR CASH ASSISTANCE AND/OR FOOD STAMP BENEFITS HAVE BEEN STOLEN, PLEASE CONTACT THE BUREAU OF FRAUD INVESTIGATION AT (212) 274-5030. Aviso de Cambio de Centro Estimado Señor (a): Al recibir este aviso, su caso será atendido por el Centro listado en la esquina superior del lado izquierdo de este aviso. Si ocurre cualquier cambio en su situación, o necesita llamar al Centro, favor de utilizar el número de teléfono provisto más arriba. Guarde Este Aviso. RECUERDE PROTEGER EN TODO MOMENTO SU TARJETA DE TRANSFERENCIA ELECTRÓNICA DE BENEFICIOS (EBT) Y SU NÚMERO DE INFORMACIÓN PERSONAL (PIN). LA ADMINISTRACIÓN DE RECURSOS HUMANOS (HRA) NUNCA LE PEDIRÁ SU NÚMERO PIN. USTED NUNCA DEBE DAR SU NÚMERO DE SEGURO SOCIAL U OTROS DATOS PERSONALES. SI SUS BENEFICIOS DE ASISTENCIA EN EFECTIVO Y/O CUPONES PARA ALIMENTOS HAN SIDO ROBADOS, FAVOR DE COMUNICARSE CON LA OFICINA DE INVESTIGACIÓN DE FRAUDE (BUREAU OF FRAUD INVESTIGATION BFI) AL (212) 274-5030.

Form EXP-78PP (page 1) Rev. 6/13/13 Case Number: Case Name: Notice of Transfer to Intensive Services Center This letter is to inform you that your case is being transferred to the Intensive Services Center on. This Center, which is located at 109 East 16th Street in Manhattan, is designed to service individuals who have been sanctioned for not cooperating with employment requirements. Our records indicate you or someone in your household is sanctioned. The Intensive Services Center will have programs available to help you obtain employment, once you agree to comply with employment requirements. We will refer you to a program that best meets your employment needs. If you have questions about your sanction, staff at the Center will be able to assist you. If you successfully participate in and comply with an employment program for a period of time, your benefits will be restored and your case will be transferred to another Job Center, where you can continue your progress toward employment. We will contact you when it is time for your first appointment at the Intensive Services Center. If you have an emergency before then, or if you have a disability, mental health or learning problem that makes it difficult for you to get to this new location, please call the HRA Infoline at (718) 557-1399. We look forward to assisting you in gaining self sufficiency. (Vea al Dorso)

Human Resources Administration Family Independence Administration Form EXP-78PP (page 2) Rev. 6/13/13 Fecha: Número del Caso: Nombre del Caso: Aviso de Traslado al Centro de Servicios Intensivos Por la presente le informamos de que su caso se trasladará al Centro de Servicios Intensivos el. Este Centro, ubicado en el 109 East 16th Street en Manhattan, fue establecido para brindar servicios a personas que han sido sancionadas por no cooperar con los requisitos de trabajo. Según nuestros archivos, usted o alguien en su hogar es sancionado. Tan pronto usted acuerde cumplir los requisitos de trabajo, podrá participar en los programas disponibles en el Centro de Servicios Intensivos, los cuales le ayudarán a conseguir empleo. Le enviaremos al programa que mejor satisfaga sus necesidades de empleo. Si tiene alguna pregunta respecto a su sanción, el personal del Centro le podrá asistir. Si usted participa en y cumple con un programa de empleo satisfactoriamente por un determinado período, se le restituirán sus beneficios y su caso será trasladado a otro Centro de Trabajo, en donde pueda continuar sus esfuerzos para conseguir empleo. Nosotros nos comunicaremos con usted cuando le toque su primera cita con el Centro de Servicios Intensivos. Si se le presenta una emergencia antes de dicha cita, o si usted tiene un problema físico, mental, o de aprendizaje que le dificulte trasladarse a este nuevo local, favor de llamar a la Línea Informativa de la HRA (Infoline) al (718) 557-1399. Con gusto le ayudaremos a lograr la autosuficiencia. (See Reverse)

W-140WW LLF 6/1/10 Case Number: Case Name: Center: Caseload Action Code: Appointment Notice We have scheduled a case eligibility review appointment to discuss how you have been managing on a reduced budget after you were sanctioned from Cash Assistance. At the eligibility review, you will need to explain how your household is meeting its expenses since you were sanctioned. We may also ask other questions regarding your household circumstances, including your income, and resources. At this meeting we would also like to discuss with you participating in work activities. Your failure to do so in the past resulted in your sanction. We can also work together to resolve any issues you may have and help you to comply with the Cash Assistance employment requirements. Appointment Time: Telephone: Address: City: State: Zip: This is a mandatory eligibility appointment. Failure to keep this appointment without a good reason may result in the closing of your Cash Assistance case. The authority for reviewing Cash Assistance eligibility as necessary is 18 NYCRR 351.2 and 351.21. If you are working, you must bring proof of your income such as recent pay stubs or a letter from your employer when you report. Other forms of proof can be accepted if these are not readily available. If you are receiving child care benefits and fail to keep this appointment without a good reason, these benefits could be terminated. If you are unable to report for this mandatory eligibility appointment, you must provide a good reason why you are unable to report at the time mentioned above. You must be able to provide proof of any reason you give for not reporting for this eligibility appointment. Some good cause reasons for not reporting to your case eligibility review appointment: you have a physical or mental condition which prevents compliance; your failure to comply is directly attributable to a social services district error; or other unexpected circumstances beyond your control exist, which prevent you from being reasonably expected to comply with an eligibility requirement. If you are unable to report to your eligibility review appointment, you must contact the telephone number listed above so that appropriate arrangements can be made to accommodate you. If you have a physical, mental health or learning problem that makes it difficult for you to travel to our location, or meet other HRA requirements, you have a right to ask HRA for help. This is called a reasonable accommodation. If you need help, you can call. If you asked for help and think you did not get the help you needed, you can file a complaint. To file a complaint, you can write to: ADA Compliance Officer, Office of Legal Affairs, 180 Water Street, 17th Floor, New York, NY 10038, or fax your complaint to (212) 331-4465. You are in sanction status. If you are now willing to comply, you can let your Worker know at this appointment or at any other time.

W-140WW (S) LLF 6/1/10 Fecha: Número del Caso: Nombre del Caso: Centro: Unidad de Casos: Aviso de Cita Hemos programado una cita de revisión de elegibilidad de caso para discutir cómo usted ha logrado administrarse con un presupuesto reducido, después que se sancionó su Asistencia en Efectivo. En la cita de revisión de elegibilidad, usted tendrá que explicar cómo su hogar a reunido lo suficiente para sus gastos desde que usted fue sancionado(a). Además, es posible que le hagamos otras preguntas sobre las circunstancias en su hogar, incluyendo su ingreso y recursos. Durante esta cita nos gustaría platicar con usted sobre la participación en un programa de actividades. El incumplimiento de esto en el pasado resultó en su sanción. Además, podemos trabajar juntos para resolver cualquier asunto que usted pueda tener y ayudarla cumplir con los requisitos de empleo de Asistencia en Efectivo. Fecha de la Cita: Hora: Teléfono: Dirección: Ciudad: Estado: Código Postal: Esta cita de elegibilidad es obligatoria. El no cumplir con esta cita sin razón justificada puede resultar en el cierre de su caso de asistencia en efectivo. La autoridad para la revisión de Elegibilidad para Asistencia en Efectivo como necesario es 18 NYCRR 351.2 y 351.21. Si usted recibe beneficios de cuidado infantil y no cumple esta cita, estos beneficios podrían terminarse. Si usted trabaja, tiene que traer comprobante de su ingreso como talones de paga recientes o una carta de parte de su empleador. Otros tipos de comprobante se pueden aceptar si los antedichos no están disponibles. Si usted no puede presentarse a su cita de revisión de elegibilidad, tiene que dar una razón justificada por no poder presentarse a la hora mencionada más arriba. Tiene que poder proporcionar comprobantes para cualquier razón que usted dé por no presentarse a esta cita de elegibilidad. Algunas razones justificadas de no presentarse a su cita de revisión de elegibilidad: el solicitante o participante tiene una condición física o mental que le impide el cumplimiento. el incumplimiento del solicitante o participante es directamente atribuible a un error por parte del distrito de servicios sociales; o existen otras circunstancias inesperadas, ajenas a la voluntad del solicitante/participante, por las que no resulta razonable esperar que el solicitante/participante cumpla con algún requisito de elegibilidad. Si usted no puede presentarse a su cita de revisión de elegibilidad tiene que llamar al número de teléfono listado más arriba para que se hagan los arreglos convenientes para usted. Si tiene un problema físico, mental o de aprendizaje que le dificulta transportarse a nuestro local o cumplir otros requisitos de HRA, usted tiene derecho de pedirle ayuda a la HRA. Esto se conoce como arreglo razonable. Si necesita ayuda, puede llamar al. Si usted pidió ayuda y cree que no la recibió, puede presentar una queja. Para ello puede escribir a: ADA Compliance Officer, Office of Legal Affairs, 180 Water Street, 17th Floor, New York, NY 10038, o faxear su queja al (212) 331-4465. Usted esta en estado de sanción. Si usted ahora esta dispuesto a cumplir, puede dejárselo saber a su trabajador en esta cita o en cualquier otro momento