1.2.2 Completing the Emergency Assistance Application

1.2.2.1 Applicant Signatures

The W-2 agency must provide an opportunity to complete an Emergency Assistance (EA) application to all persons who request EA. If EA is requested in person or over the phone, the W-2 agency must provide applicants the opportunity to complete and sign the EA application on the same day as the request or inquiry. (See 1.2.2.1).

Applicants can submit an EA application by submitting a completed Emergency Assistance (EA) Application (2010) to the W-2 agency or by submitting the application in the ACCESS web portal. The W-2 agency must date stamp the completed EA application on the date it is received by the agency, which is used as the application date. 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:

1.             A legible name;

2.             An address, if available;

3.             A reason for the emergency;  

4.             A signature by the applicant or their representative (see 1.2.2.1); and

5.             Been completed to the best of the applicant’s ability.

The applicant, or that person’s representative, must complete the Emergency Assistance (EA) Application (2010) or the online ACCESS application to the best of his or her ability. A W-2 agency worker must complete any missing information from 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 WWP.

During the meeting with the applicant, a W-2 agency worker must review each of the assurance statements in the Emergency Assistance (EA) Application (2010) with the applicant to ensure that the applicant has an opportunity to ask for clarification of each item.

Applicants applying in ACCESS have the option to schedule the required meeting in ACCESS or directly with their local W-2 agency. If an applicant does not schedule an appointment in ACCESS, the W-2 agency must contact the applicant within one working day of the application date to continue the application process. (See 1.3.2.1)

The W-2 agency must scan and store all pages of each application in ECF or place a copy in the paper file if an Emergency Assistance (EA) Application (2010) is submitted. (See 4.4.3)

 

1.2.2.1 Applicant Signatures

A valid signature is required for an application to be considered complete. (See 1.2.2)

EA application signatures from the applicant can be obtained one of four ways below. W-2 agencies must provide the option to sign the application in whichever acceptable signature method the applicant prefers.

1. Written signature: The applicant physically signs the Emergency Assistance (EA) Application (2010)

2. Electronic signature: The applicant electronically signs the Emergency Assistance (EA) Application (2010) via an electronic signature software.

3. Telephonic signature: The applicant telephonically signs the Emergency Assistance (EA) Application (2010)  during a recorded call.

FEPs must read the EA application in order to record the agreement being made between the FEP and the applicant. Additionally, the FEP must read 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 PIN comments.

4. ACCESS signature: The applicant signs the application to submit a completed EA application in ACCESS.

The W-2 agency worker must review the assurance statements with all applicants during the meeting, regardless of how the application signature was obtained.

 

History: Release 23-01; Release 22-04; Release 21-04; Release 21-03; Release 21-01; Release 20-01.