Case Types
Emergency Assistance
Restrictions
Child Support
Required Forms
100

These case types are 100% federally funded.

What are case types 11, 12, & 19?

100

These are the 3 emergency assistance case types.

What is EAF, EAA, & ESNA?

100

The shelter restriction code used to restrict the full shelter on a case type 11.

What is code 'E'?

100

Two consequences for failure to comply with the Support Collection Unit.

What is an IV-D sanction & loss of Medicaid?

100

The 2 forms required for individuals applying for Safety Net Assistance?

What are the Repay Agreement and Assignment of Wages?

200

These case types are state & locally funded.

What are case types 16, 17, & 18?

200

The number of months that EAF & ESNA can pay shelter arrears.

What is 6 months?

200

The agency's policy when permission is not given by the client to place their shelter or utilities on direct voucher.

What is restricting the shelter or utility allowances?

200

An individual can claim this if they feel they can't cooperate with child support requirements.  

What is good case?

200

The form that is signed by a client to give permission to place their shelter or utilities on direct voucher.

What is LDSS-4580 - Request for Voluntary Restricted Payments?

300

This case type has a 60-month time limit.

What is case type 11?

300

This emergency case type requires a full repayment agreement on an eviction payment.

What is ESNA?

300

This code is entered on the budget when placing the fuel bill on direct voucher.

What is code 'X'?

300

This needs to be established if both parents aren't listed on the birth certificate.  

What is paternity? 

300

The form that an Examiner must complete individually with all applying adults (18+) to determine a specific barrier to self-sufficiency at intake and recert.  

What is the Drug & Alcohol Screening form.    (LDSS-4571)
400

This case type has a 24-month time limit.

What is case type 16?

400

The amount of months that DSS can pay for utility arrears.

What is 4 months?

400

When placing the electric non-heating account on full voucher, this amount needs to be entered on the budget.

What is the monthly billing amount?

400

The portion of assigned child support paid to a client, in addition to the TA grant, is called this.  

What is the Support Pass-Through?

400

The form an Examiner MUST complete when requesting verification from a client. 

What is the Documentation Requirements form (LDSS-2642)?

500

The family case type when an adult is required to participate in drug and alcohol treatment, coded employment code 63.

What is case type 12?

500

This emergency case type requires a 6-month guarantee when paying utility arrears but is not eligible for ongoing cash assistance.

What is EAA?

500

The are the 2 types of direct voucher for utilities.

What is full bill and subject-to-limit?

500

The TA grant is reduced by this percentage for each adult that fails to cooperate with SCU requirement. 

What is 25%?

500

This form MUST be issued the date of application if an immediate or emergency need is indicated on the application.  

What is the Action Taken on Your Request for Assistance to Meet an Immediate Need or a Special Allowance (AKA - Immediate Needs notice) (LDSS-4002). 

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