Division of Family and Economic Security, Bureau of Working Families

Emergency Assistance Manual

1.2.2 Completing the Emergency Assistance Application

Individuals can submit a completed EAEAEmergency Assistance application to the W-2W-2Wisconsin Works agency using one of the following: 

  • The ACCESS A client facing web portal that provides self-service, case specific information regarding an individual’s FoodShare, Medicaid, Wisconsin Shares, Wisconsin Works (W-2), and Job Access Loan benefits, including program eligibility information.web portal; or
  • The Emergency Assistance Application form (DCF-F-DWSP2010-E).

For applications received using Form DCF-F-DWSP2010-E, the W-2 agency must date stamp the completed EA application on the date it is received by the agency. This date is used as the application date, even if the applicant signed the application on a different day. 

For applications received via ACCESS, the application date is determined in ACCESS based on the time and date of application submittal. 

An EA application is considered complete when it has all of the following: 

  • A legible name; 
  • An address, if available;
  • A reason for the emergency;   
  • A signature by the applicant or their representative (see 1.2.2.1); and 
  • Been completed to the best of the applicant’s ability. 

An EA worker must complete any missing information on the EA application with information provided by the applicant. Any information added or updated by the W-2 agency must be clearly explained in EA comments in WWPWWPWisconsin Work Programs.  
 
If Form DCF-F-DWSP2010-E is submitted, the W-2 agency must scan and store all pages of the application in ECFECFElectronic Case File or place a copy in the paper file. (See 4.4.3) 

1.2.2.1 Applicant Signatures

A valid signature from the applicant or their representative is required for an application to be considered complete. (See 1.2.2)

The EA worker must review each of the assurance statements from Form DCF-F-DWSP2010-E with all applicants during the required meeting (see 1.3.3), regardless of how they sign the application. This ensures that the applicant has an opportunity to ask for clarification of each item prior to signing.  

W-2 agencies must provide all applicants the option to choose one of the following signature methods:  

  • Written signature: The applicant physically signs Form DCF-F-DWSP2010-E.  
  • Electronic signature: The applicant electronically signs Form DCF-F-DWSP2010-E via an electronic signature software.  
  • Telephonic signature: The applicant telephonically signs Form DCF-F-DWSP2010-E during a recorded call.  
    • EA workers must read aloud the EA application to record the agreement being made between the EA worker and the applicant. Additionally, the EA worker must read aloud the language that is in the telephonic signature display in Genesys. The Telephonic Signature Interaction ID generated in Genesys must be documented on the signature line and in EA comments in WWP. 
  • ACCESS signature: The applicant signs the application in ACCESS A client facing web portal that provides self-service, case specific information regarding an individual’s FoodShare, Medicaid, Wisconsin Shares, Wisconsin Works (W-2), and Job Access Loan benefits, including program eligibility information.to submit a completed EA application.