Date:  Tuesday, 14 July 1998
To:  TANF.HELPDESK
From: TANF.POLICY
Subject: Miscellaneous Question (TANF)
The following question was asked during our policy training session  for frontline staff:
Substance Abuse counseling and mental health treatment are both listed on the PRP.  Under what circumstances can a case manager require a client to seek and obtain treatment?  Now that treatment and/or counseling can be supported as a secondary activity, does this coincide with or override the PRP?  When would treatment/counseling be on the PRP?  When would it be on the PWP?  Should it be on both?  If the A/R does not agree with the case manager's opinion, what should be done?
RESPONSE:  If the worker has knowledge that an individual is enrolled in a mental health or substance abuse program, the worker will check that item on the PRP.  The individual will be expected to continue in that program.  Failure to do so could result in a sanction.  Ideally, the county supervisor will be familiar with the programs available and will have some agreement with the provider to notify us if the individual does not follow through.  Remember that there are strict confidentiality rules and that individuals will have to sign releases so that the provider can share information with us.
If an individual is not enrolled in a  program, but the worker has reason to believe that the individual needs treatment, the worker DOES NOT enroll the individual.  If there is an obvious need for the individual to be in treatment, the worker will refer him or her to the proper professional for evaluation.  That professional will determine the need for treatment and will enroll the person in a treatment program if it is necessary and if a program is available.  We can follow up to make sure the individual keeps the referral appointment.  If the individual is enrolled in a program, we can follow up to ensure he or she attends.  Failure to keep the referral appointment or failure to participate once enrolled can lead to sanction.  Again, the county supervisor should have an agreement with the provider of the treatment program so we will be notified if the individual does not keep the referral appointment or does not participate in the treatment program.
For example, if a client is turned down for a job or loses a job because he or she tests positive for drugs, there may be a need for treatment.  Our workers are NOT trained drug or substance abuse counselors and can't really establish the need for treatment.  Instead, the worker will refer the client to the local MH/MR/SA office for evaluation.  You will check "participate in substance abuse counseling/treatment" on the PRP.  At this point, the expectation is that the client will keep this first evaluation appointment.  If the SA counselor determines the client needs treatment and enrolls the client in a program, our expectation is that the client will attend and participate in the program.  If there is also a work requirement and a PWP, treatment becomes part of the PWP since substance abuse is a major barrier to finding and maintaining employment.
Another example:  A client comes in to complete a review appointment.  The client smells of alcohol.  We do not require the client to enroll in AA.   Instead, we refer this person to a substance abuse counselor.
Obviously, close cooperation and communication with the service providers in your community will be required.  Support services are available whether the counseling/treatment is a PRP or PWP requirement or both.
Yes, treatment and counseling can only be supported as a secondary activity.  If the treatment is a part of a work plan then the work plan takes precedence over the PRP.  If there is failure to comply, you can only impose one sanction even if  treatment is on the PRP and the PWP.     We hope this information provides answers to your questions.  Please let us know if you need more information.
--------------------------------------(   END OF LETTER   )-----------------------------------------------
PF   1=Help   2=Exit   3=Return   4=Query   5=Action   7=Backward   8=Forward          EMC0000