3140 Self-Sufficiency Agreement - The written Self-Sufficiency Agreement (SSA) between the agency and the client details the activities and services utilized by the client to accomplish the plan.

 

All activities and services beyond the initial assignment are determined based upon the SSA. This SSA is developed after assessment information has been gathered. The SSA is signed by the client; however, failure to obtain a signature does not invalidate the Agreement. Refusal to sign the SSA is considered non-compliance only after the individual fails to comply with activities established in the SSA. The client needs to be involved in the planning of updates to the agreement but signatures are not required. It is acceptable for the SSA to be handwritten. The worker should discuss this Agreement with the client. Both the client and worker should sign the agreement.

 

A minor client and his/her caretaker or other adult in the family group who is receiving assistance on behalf of the minor (see 2220) must both sign the minor's Self-Sufficiency Agreement unless the minor has been emancipated.

 

The Self-Sufficiency Agreement can be found in Appendix E-8.  If this form is not used, the Self-Sufficiency Agreement must include: client name, date, long term goal, short term goal, client action steps and due dates, agency action steps and due dates.

 

  1. TANF- A Self-Sufficiency Agreement form can be found in Appendix E-8.  If this form is not used, the Self-Sufficiency Agreement must include: client name, date, client’s specific and measurable actions with begin dates and due dates, the number of hours per week the client is expected to participate, specific and measurable actions for the career navigator and due dates.


    Note: A minor client and  their caretaker or other adult in the family group who is receiving assistance on behalf of the minor (see 2220) must both sign the minor's Self-Sufficiency Agreement unless the minor has been emancipated.

  2. E & T- The Self-Sufficiency Agreement can be found in Appendix E-7 The Self-Sufficiency Agreement must include: client name, date, client’s specific and measurable actions with begin dates and due dates, the number of hours per week the client is expected to participate, specific and measurable actions for the career navigator and due dates.

    The Self-Sufficiency Agreement must inform the client of the weekly/monthly requirements to meet Food Assistance E&T participation and ABAWD requirements. The Self-Sufficiency Agreement must inform client of what needs to be done to gain exemption from ABAWD requirements.

  3. GOALS- A Self-Sufficiency Agreement form can be found in Appendix E-9.  If this form is not used, the Self-Sufficiency Agreement must include: client name, date, client’s specific and measurable actions with begin dates and due dates, the number of hours per week the client is expected to participate, specific and measurable actions for the career navigator and due dates.