Notice of Requirement to Cooperate and Right to Claim Good Cause for Refusal to Cooperate in Child Support Enforcement and Third Party Resource Requirements
Your help in the child support enforcement process may be of
value to you and your child because it may result in:
·
finding the absent parent
·
legally establishing your child’s paternity
·
receipt of child support payments that may give you
more money than if you receive TANF
·
acquisition of private health insurance through the
absent parent, and
·
acquisition of rights
to future Social Security, veterans or other government benefits.
The law requires you to help the Division of Family and
Children Services (DFCS) and the Office of Child Support Services (OCSS) get
any support owed to you and the children for whom TANF is requested, unless you
have good cause for not helping.
In helping DFCS or OCSS, you must do one or more of the
following:
·
Name the absent parent of any child for whom you are
requesting TANF and/or Medicaid.
·
Provide information to help find the absent parent.
·
Help determine who the legal father is if your child
was born out of wedlock.
·
Agree to have a blood test if the person you name as
the father denies paternity.
·
Help the state get money owed to you and/or the child
who receives TANF.
·
Provide information about medical insurance the
absent parent has on your child.
You must come to the DFCS office, OCSS or court to sign
papers or provide needed information.
You may have good cause for not wanting to help OCSS collect
child support or medical coverage for your child. You may not have to help if you believe
helping is not in your child’s best interest, and if you can prove it. If you want to claim good cause, you must
tell your worker. You can do this at any
time.
·
You will not be eligible to receive TANF for yourself
and your child.
·
Your child may still be eligible for Medicaid.
You may claim good cause for any of the following reasons:
·
Your help may cause serious physical or emotional
harm to your child or to you.
·
The child was born as a result of rape or incest.
·
Court proceedings are underway for adoption of the
child.
·
An agency is helping you to decide whether to place
the child for adoption.
To Prove Good Cause, You Must
·
give DFCS
information it needs to decide if you have good cause for not helping. If you fear physical harm and cannot get proof,
DFCS may still be able to make a good cause determination.
·
give proof to
DFCS within 20 days of claiming good cause.
DFCS will give you more time only if you have trouble getting proof.
DFCS may excuse you from helping based on the information
you provide. Or, DFCS may ask you to
provide more information. DFCS will not
contact the absent parent without telling you.
NOTE: If you are applying for TANF, you will not be
approved until you give DFCS proof of your claim of good cause or the
information DFCS needs to investigate your claim.
Form 138 (Rev. 12/2008)
EXAMPLES
OF PROOF OF GOOD CAUSE
·
birth certificate, medical or law enforcement records
showing that the child was born as a result of rape or incest
·
court or other legal documents showing that adoption
proceedings have begun
·
court, medical, criminal, child protective services,
social services, psychological or law enforcement records showing that the
absent parent may hurt you or the child
·
medical records or written statements from a mental
health professional showing the history and current status of your and/or the
child’s emotional health
·
a written statement from a public or private agency
showing you are being helped to decide whether to give your child up for
adoption
·
sworn statements from friends, neighbors, clergy,
social workers, or medical professionals who know why you have good cause.
If you need help in getting any of the documents, ask your
worker.
If you receive TANF, you
give the state of
If you receive TANF and the absent
parent pays child support through the Office of Child Support Services (OCSS),
you probably will NOT receive the full amount of the child support
payment. Instead, you may receive a
“gap” payment. All child support paid by
an absent parent, which is in excess of the "gap" amount, is retained
by OCSS and is used to pay back the TANF funds that you have received. Your TANF case manager can explain gap
budgeting and the payment procedures to you.
If your TANF case is
closed, child support payments will be sent to you up to the amount of the
absent parent’s current monthly obligation.
Any child support amount paid over the current obligation will be kept
by the state to repay past TANF grants received by you. Once the past TANF grants are repaid, you
will be sent all child support paid by the absent parent.
If your TANF case is
closed and then reopened, any child support back payments due you will
be assigned to the State up to the amount of all TANF money you have ever
received. When the Unreimbursed Public
Assistance (UPA) is repaid, then you will start receiving any back payments
owed to you.
If
you receive child support payments to which you are not entitled, you may have
to repay the state. The state will
notify you of the amount of the overpayment and the timeframe for repayment.
OCSS may review the DFCS good cause decision in your case.
If you request a hearing about the decision, OCSS may participate in the
hearing.
If you have good cause for not helping, OCSS will not try to
establish paternity or collect child support.
I have read this notice about my rights to claim good cause
and not helping to establish paternity or to collect child support from the
absent parent.
_________________________________________________________
Signature
of Applicant/Recipient
__________________________________________
Date
I have provided the TANF or Medicaid applicant/recipient
with a copy of this notice.
_________________________________________________________
Signature of Case Manager
__________________________________________
Date
Form 138 (Rev.12/2008) Reverse