1.4.6  Required W-2 Forms and Publications During the Application Process

Form

Description

W-2 Benefits and Services Offered at Wisconsin Works Agencies (11890-P)

This brochure describes the benefits and services available at the W-2 agency in one page and must be given to every individual who requests assistance of any kind.

W-2 agencies must have this brochure available at all office locations. At a minimum, W-2 agencies should supply greeters, receptionists, and resource specialists with this brochure to give to individuals they interact with.

What to Bring With You (2372-P)

This publication describes types of documentation an applicant may need to provide to verify specific information needed to determine W-2 eligibility and must be given to the applicant at the time they inquire about W-2. Similar information is provided 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. for online applicants. This publication is also used by Medicaid/BadgerCare Plus programs, FoodShare, Child Care, and CTSCaretaker Supplement.

W-2 Rights and Responsibilities (398-P)

This brochure outlines a participant’s rights and responsibilities when participating in W-2 and RCARefugee Cash Assistance programs. This brochure must be provided to participants and reviewed during the application process. Applicants must initial the signature page of the CWW Application Summary acknowledging they received this brochure.

Wisconsin Works (W-2) Participation Agreement (10755)

This form outlines participation requirements of a W-2 participant. During the application process, the FEPFinancial and Employment Planner must provide this form to the applicant and thoroughly review it. The agency worker, applicant, and all adults in the W-2 Group must sign this form. The agency must give the participant a signed copy of the PAParticipation Agreement and scan the original into ECFElectronic Case File.

This form may be reviewed again during EPEmployability Plan  updates and W-2 reviews. W-2 agencies should review the PA with participants unclear on a participation requirement explained in the PA.

Good Cause Notice (5600-P)

This publication must be given to all W-2 applicants when they apply for W-2 and documented in CWW case comments.

For applicants who applied in ACCESS, the W-2 agency does not have to provide the physical publication; applicants read and indicate their understanding in ACCESS.

The Good Cause Notice must also be provided physically to participants and documented in CWW case comments:

·        When a child is added to the W-2 Group An adult custodial parent, all dependent children with respect to whom the individual is a legal custodial parent and all minor children with respect to whom the adult individual’s dependent child is a custodial parent. W-2 Group includes any non-marital co-parent or any spouse of the individual who resides in the same household as the individual and any minor children with respect to whom the spouse or non-marital co-parent is a custodial parent. W-2 Group does not include any person who is receiving cash benefits under a county relief block grant program. This is also referred to as the W-2 Assistance Group (W-2 AG);

·        When a parent leaves the W-2 Group;

·        At reapplication for continued benefits; and

·        If a participant disclose a circumstance that may meet the CSChild Support good cause criteria (See 15.6.1).

See section 15.6.1 for more information on the good cause notice language in ACCESS. For other relevant CS-related forms and publications, see Chapter 15.

Notice of Assignment:  Child Support, Family Support, Maintenance, And Medical Support (2477)

All W-2 applicants must receive this form. Applicants being referred to the local CSAChild Support Agency, or applicants already receiving services from the local CSA, must sign the Notice of Assignment form acknowledging the assignment of child support or an understanding of how child support payments are assigned if they begin receiving child support payments while receiving W-2 services. (See 15.1.3) A signed copy of this notice must be scanned into ECF.  

Domestic Violence Brochure (2614-P)

The Domestic Violence Brochure must be provided at the appointment with the RS or when an applicant who submitted an ACCESS application interviews with the FEP. If the appointment with the FEP is virtual, the FEP must provide an electronic copy of the brochure during the intake appointment.

For safety reasons, it is important that W-2 agency staff point out the brochure so that the applicant can decide if it is safe to keep. Including the brochure in a stack of other papers may put an individual at risk if they are unaware of it.

TANF Electronic Benefit Transfer Transaction Restrictions Flyer (2947-P)

The TANFTemporary Assistance for Needy Families Temporary Assistance for Needy Families EBTElectronic Benefit Transfer Restrictions Flyer must be provided to all W-2 applicants during the application process and at eligibility reviews. The flyer identifies specific merchant locations where TANF funded assistance cannot be accessed and specifies types of electronic benefit transfer transactions that are prohibited.