| Administrative Letter 18-03 Important: Systematic Alien Verification for Entitlements (SAVE) Paperless Verification Processing | Administrative Letter | pdf | 186 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Administrative Letter No. 09-07 – Economic Recovery Payment’s Effect on Special Assistance Adult Care Home (SA/ACH) and Special Assistance In-Home (SA/IH) Eligibility (Economic recovery payments were made only in 2009 and were no longer excluded as a resource after March 1, 2010) | Administrative Letter | pdf | 16 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 13-07 – Instructions for Special Assistance In-Home Approvals for Individuals with Verified Supported Housing Slots | Administrative Letter | pdf | 101 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Administrative Letter No. 13-11 – Electronic Benefit Issuance | Administrative Letter | pdf | 98 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 13-11 – Electronic Benefit Issuance | Administrative Letter | pdf | 98 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Administrative Letter No. 14-02 – Effect of 2014 Social Security Cost of Living Adjustment and New 2014 Federal Poverty Level on SA/IH Cases | Administrative Letter | pdf | 113 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Administrative Letter No. 14-04, Revised Timeframe for Replacement of Special Assistance Checks | Administrative Letter | pdf | 25 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 14-11 Addendum , Appropriations Act of 2014: Policy for Resources for SA IH | Administrative Letter | pdf | 24 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Administrative Letter No. 14-11 Addendum, Appropriations Act of 2014: Policy for Resources for SA IH | Administrative Letter | pdf | 24 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 14-11, Appropriations Act of 2014: Changes to the Special Assistance Program | Administrative Letter | pdf | 20 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 14-13, Social Security Cost-of-Living Adjustment (COLA 2015) and VA Cost-of- Living Adjustment (COLA 2015) for Special Assistance (SA) in a Facility | Administrative Letter | pdf | 60 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 15-07, Special Assistance Redeterminations/Recertifications Amended | Administrative Letter | pdf | 39 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 17-03, Social Security Cost-of-Living Adjustment (COLA) and VA COLA for Special Assistance In-Home (SA_IH)Beneficiaries | Administrative Letter | pdf | 31 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 17-03, Social Security Cost-of-Living Adjustment (COLA)and VA COLA for Special Assistance In-Home (SA-IH) Beneficiaries | Administrative Letter | pdf | 31 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Administrative Letter No. 17-08, Social Security Cost-of-Living Adjustment (COLA 2018) and VA Cost-of-Living Adjustment (COLA 2018) for Special Assistance (SA) in a Facility | Administrative Letter | pdf | 288 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 18-02 Social Security Cost-of-Living (COLA 2018) and Veteran’s Assistance (VA) Cost-of-Living Adjustment for Special Assistance In-Home (SA-IH) Beneficiaries | Administrative Letter | pdf | 112 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Administrative Letter No. 18-08, Social Security Cost-of-Living Adjustment (COLA 2019) and VA Cost-of-Living Adjustment (COLA 2019 for Special Assistance (SA) in a Facility. | Administrative Letter | pdf | 852 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 19-03, Social Security Cost-of-Living Adjustment (COLA 2019) and VA Cost-of-Living Adjustment for Special Assistance In-Home (SA-IH) Beneficiaries. | Administrative Letter | pdf | 453 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. 19-10, Social Security Cost-of-Living Adjustment (COLA 2020) and VA Cost-of-Living Adjustment for Special Assistance In-Home (SA-IH) Beneficiaries | Administrative Letter | pdf | 32 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. DAAS 16-12 COLA 2017 | Administrative Letter | pdf | 39 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. DAAS-07-10 – Social Security Administration Data Access | Administrative Letter | pdf | 24 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. DAAS-07-16 РVeteran’s Affairs Match | Administrative Letter | pdf | 547 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. DAAS-07-20 – Interstate Match | Administrative Letter | pdf | 274 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. DAAS-08-04 – Economic Stimulus Act Payments (Stimulus payments were received in 2008 only) | Administrative Letter | pdf | 81 KB | | social-services special-assistance | administrative-letter |
| Administrative Letter No. DAAS-08-15 – Applying the 2009 Social Security Cost of Living Adjustment (COLA) Disregard to Special Assistance In-Home (SA/IH) Cases Only | Administrative Letter | pdf | 49 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Appendix G SAIH Slot Request Form | Form | pdf | 15 KB | | social-services special-assistance special-assistance-in-home-program | form |
| CHANGE NO: 01-06, VERIFICATION OF CITIZENSHIP AND IDENTITY FOR SPECIAL ASSISTANCE | Change Notice | pdf | 48 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 01-07, SPECIAL ASSISTANCE ADULT PROGRAM MANUAL UPDATES | Change Notice | pdf | 48 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 02-02, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATE | Change Notice | pdf | 23 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 02-03, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATES | Change Notice | doc | 34 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 02-07, SPECIAL ASSISTANCE ADULT PROGRAM MANUAL UPDATES | Change Notice | pdf | 26 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 03-02, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATES | Change Notice | pdf | 15 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 04-02, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATES | Change Notice | pdf | 15 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 05-02, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATES | Change Notice | pdf | 11 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 06-02, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATES | Change Notice | pdf | 9 KB | | social-services special-assistance | change-notice |
| CHANGE NO: 07-02, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATES | Change Notice | pdf | 10 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 01-04, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATES | Change Notice | pdf | 29 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 01-08, SPECIAL ASSISTANCE FOR ADULTS PROGRAM MANUAL UPDATES | Change Notice | pdf | 46 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 01-09, SPECIAL ASSISTANCE FOR ADULTS (SA/ACH) PROGRAM MANUAL UPDATES | Change Notice | pdf | 36 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 01-10, SPECIAL ASSISTANCE FOR ADULTS PROGRAM MANUAL UPDATES | Change Notice | pdf | 46 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 01-11, FIGURE CHANGE TO FORM AND CLARIFICATIONS | Change Notice | pdf | 36 KB | | social-services special-assistance | change-notice |
| CHANGE No. 01-12, Federal Poverty Guidelines | Change Notice | pdf | 26 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE NO. 01-13, SSI 2013 FEDERAL BENEFIT RATE (FBR) UPDATES IN THE SPECIAL ASSISTANCE MANUAL | Change Notice | pdf | 31 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 01-15, SA MANUAL | Change Notice | pdf | 21 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 01-2017, SA ELIGIBILITY MANUAL AND FORM REVISIONS | Change Notice | pdf | 20 KB | | social-services special-assistance | change-notice |
| CHANGE No. 02-06 | Change Notice | pdf | 42 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE NO. 02-08, SPECIAL ASSISTANCE FOR ADULTS PROGRAM MANUAL UPDATES | Change Notice | pdf | 29 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 02-09, SPECIAL ASSISTANCE FOR ADULTS PROGRAM MANUAL UPDATES – RESOURCES | Change Notice | pdf | 37 KB | | social-services special-assistance | change-notice |
| CHANGE No. 02-10, Special Assistance for Adults In-Home (SA/IH) Program Manual Updates | Change Notice | pdf | 27 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE No. 02-11, Federal Poverty Guidelines | Change Notice | pdf | 27 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE NO. 02-12, CONVERSION OF FIGURES TO FORMS | Change Notice | pdf | 40 KB | | social-services special-assistance | change-notice |
| CHANGE No. 02-13, Federal Poverty Level UPDATE TO SA-IH MANUAL | Change Notice | doc | 32 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE NO. 02-14, SPECIAL ASSISTANCE TO THE CERTAIN DISABLED (SCD) | Change Notice | pdf | 20 KB | | social-services special-assistance | change-notice |
| CHANGE No. 02-2017: State/County Special Assistance In-Home (Eligibility) | Change Notice | pdf | 19 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE NO. 03-08, SPECIAL ASSISTANCE FOR ADULTS PROGRAM MANUAL UPDATES | Change Notice | pdf | 54 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 03-10, SPECIAL ASSISTANCE FOR ADULTS PROGRAM MANUAL UPDATES | Change Notice | pdf | 27 KB | | social-services special-assistance | change-notice |
| CHANGE No. 03-11 Removal Of SA-5600 and SA-5700 | Change Notice | pdf | 22 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE No. 03-12: Changes in the SA/IH PROGRAM | Change Notice | pdf | 39 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE NO. 03-14, RESIDENCY REQUIREMENT CHANGES | Change Notice | pdf | 53 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 03-2017, SA ELIGIBILITY REDETERMINATIONS | Change Notice | pdf | 86 KB | | social-services special-assistance | change-notice |
| CHANGE No. 04-08, Special Assistance In-Home Program Manual Updates | Change Notice | pdf | 33 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE NO. 04-10, SPECIAL ASSISTANCE PROGRAM MANUAL UPDATES | Change Notice | pdf | 70 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 04-11, SA-3110 FIGURES TO FORMS | Change Notice | pdf | 29 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 04-2017, SA APPLICATION PROCESS | Change Notice | pdf | 127 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 05-10, SPECIAL REVIEW CODES AND OVERPAYMENT RECOUPMENT ADJUSTMENT REQUESTS | Change Notice | pdf | 36 KB | | social-services special-assistance | change-notice |
| CHANGE NO. 05-11, SSI 2012 FEDERAL BENEFIT RATE (FBR) UPDATES IN THE SPECIAL ASSISTANCE MANUAL | Change Notice | pdf | 30 KB | | social-services special-assistance | change-notice |
| CHANGE No. 06-10, Special Review Codes | Change Notice | pdf | 38 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE No. 06-11, SSI 2012 Federal Benefit Rate (FBR) Updates in the Special Assistance In-Home Manual | Change Notice | pdf | 25 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| CHANGE No. 1-14: 2014 FPL and IEM | Change Notice | pdf | 24 KB | | social-services special-assistance special-assistance-in-home-program | change-notice |
| DAAS 20201 Special Assistance Second Party Review Form APPLICATIONS | Form | docx | 34 KB | | social-services special-assistance | form |
| DAAS 20202 Special Assistance Second Party Review Form RECERTIFICATIONS | Form | docx | 32 KB | | social-services special-assistance | form |
| DAAS ADMINISTRATIVE LETTER NO: 13-02 DMA ADMINISTRATIVE LETTER NO: 01-13, MEDICAID TERMINATION FOR ALL SPECIAL ASSISTANCE BENEFICIARIES IN AN INSTITUTION FOR MENTAL DISEASE (IMD) | Administrative Letter | pdf | 230 KB | | social-services special-assistance | administrative-letter |
| DAAS ADMINISTRATIVE LETTER NO. 09-24, CITIZENSHIP DOCUMENTATION, DMA ADMINISTRATIVE LETTER NO. 08-09, ECONOMIC AND FAMILY SERVICES EFS_WF_AL-11-2009 | Administrative Letter | pdf | 426 KB | | social-services special-assistance | administrative-letter |
| DHHS-AS-0011 Adult and Family Service Plan HW | Form | docx | 44 KB | | adult-protective-services adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DHHS-AS-0011_Adult_and_Family_Service_Plan _Elec | Form | docx | 48 KB | | adult-protective-services adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DHHS-AS-0016 Consent for Release of Information HW | Form | docx | 38 KB | | adult-protective-services adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DHHS-AS-6222 Adult Service Contact Activity Log HW 2024 | Form | docx | 17 KB | | adult-protective-services adult-services general-adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DHHS-AS-6222 Adult Services Contact Activity Log Elec 2024 | Form | docx | 26 KB | | adult-protective-services adult-services general-adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DHHS-AS-6223 Interim or Quarterly Review Elec 2024 | Form | pdf | 110 KB | | adult-protective-services adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DHHS-AS-6223 Interim or Quarterly Review HW 2024 | Form | docx | 26 KB | | adult-protective-services adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DHHS-AS-6225: SAIH Program Assessment Electronic | Form | docx | 140 KB | | social-services special-assistance | form |
| DHHS-AS-6226 Case Closing Summary Elec 3.2024 | Form | docx | 26 KB | | adult-protective-services adult-services general-adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DHHS-AS-6226 Case Closing Summary HW 3 2024 | Form | docx | 21 KB | | adult-protective-services adult-services general-adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DMA ADMINISTRATIVE LETTER NO: 03-10, DSS ADMINISTRATIVE LETTER PERFORMANCE MANAGEMENT/REPORTING AND EVALUATION MANAGEMENT PM-REM-AL-02-10, DAAS ADMINISTRATIVE LETTER NO: 10-07 | Administrative Letter | pdf | 32 KB | | social-services special-assistance | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO: 07-10, DSS ADMINISTRATIVE LETTER PERFORMANCE MANAGEMENT/REPORTING AND EVALUATION MANAGEMENT PM-REM-AL-07-10, DAAS ADMINISTRATIVE LETTER NO: 10-14, AUTHORIZED REPRESENTATIVE SCREEN | Administrative Letter | pdf | 9 MB | | social-services special-assistance | administrative-letter |
| DMA ADMINISTRATIVE LETTER NO. 08-09, DAAS ADMINISTRATIVE LETTER NO. 09-24 ECONOMIC AND FAMILY SERVICES EFS_WF_AL-11-2009 ADDENDUM 1, (CITIZENSHIP DOCUMENTATION) | Administrative Letter | pdf | 46 KB | | social-services special-assistance | administrative-letter |
| DSS ADMINISTRATIVE LETTER PERFORMANCE MANAGEMENT/REPORTING AND EVALUATION MANAGEMENT PM-REM-AL-06-10, DMA ADMINISTRATIVE LETTER NO: 05-10, DAAS ADMINISTRATIVE LETTER NO: 10-11 | Administrative Letter | pdf | 223 KB | | social-services special-assistance | administrative-letter |
| DSS_5027_SIS_Client_Entry_Form | Form | pdf | 1,014 KB | | adult-protective-services adult-services general-adult-services guardianship special-assistance-in-home-case-management social-services special-assistance | form |
| DSS-0031 SAIH Program Interagency Referral Form | Form | pdf | 230 KB | | social-services special-assistance | form |
| DSS-0033: Appendix E, Supplement 1 | Form | pdf | 133 KB | | social-services special-assistance | form |
| DSS-0034: Appendix E, Supplement 2 | Form | pdf | 107 KB | | social-services special-assistance | form |
| DSS-20221: SA Recertification Budget Sheet | Form | pdf | 321 KB | | social-services special-assistance | form |
| DSS-3000 Appointment Follow-up Letter Regarding SA Assistance Request | Form | pdf | 56 KB | | social-services special-assistance | form |
| DSS-3001: Notice of County of Residence Reassignment/Transfer | Form | pdf | 30 KB | | social-services special-assistance | form |
| DSS-3001sp Notificación sobre reasignación o transferencia | Form | pdf | 32 KB | | social-services spanish special-assistance forms-in-other-languages | form |
| DSS-3002 Agreement to Sell | Form | pdf | 73 KB | | social-services special-assistance | form |
| DSS-3002sp Compromiso de venta | Form | pdf | 75 KB | | social-services spanish special-assistance forms-in-other-languages | form |
| DSS-3003 Important Information About Your Special Assistance and Your Resources | Form | pdf | 22 KB | | social-services special-assistance | form |
| DSS-3004 Referral to SSA for Waiver or Reduction of Overpayment Recoupment | Form | pdf | 57 KB | | social-services special-assistance | form |
| DSS-3005 Documentation Regarding Continuation of Special Assistance When the LOC Is Upgraded, But No Bed Is Available | Form | pdf | 53 KB | | social-services special-assistance | form |
| DSS-3006 Medical Care Special / Medical Expense Form | Form | pdf | 57 KB | | social-services special-assistance | form |
| DSS-8190 SSI/Non-SSI Application Workbook | Form | pdf | 800 KB | | social-services special-assistance | form |
| DSS-8190A SSI/Non-SSI Application Workbook Appendix A | Form | pdf | 118 KB | | social-services special-assistance | form |
| DSS-8191 Special Assistance Re-enrollment Information Notice | Form | pdf | 554 KB | | social-services special-assistance | form |
| EIS 1061 XPTR Report Distribution System | Manual | pdf | 148 KB | | sa-eligibility-information-system-eis social-services special-assistance | manual |
| EIS 1105 State Data Exchange (SDX) | Manual | pdf | 293 KB | | sa-eligibility-information-system-eis social-services special-assistance | manual |
| EIS 4000 Appendix D – Special Assistance Codes | Manual | pdf | 93 KB | | sa-eligibility-information-system-eis social-services special-assistance | manual |
| Performance Management/Reporting and Evaluation Management, PM-REM AL-02-2013, DMA ADMINISTRATIVE LETTER NO: 03-2013, DAAS ADMINISTRATIVE LETTER NO: 2013-05, DSS ECONOMIC AND FAMILY SERVICES ADMINISTRATIVE LETTER NO: 03-2013, DCDEE ADMINISTRATIVE LETTER NO: 01-2013, ONLINE VERIFICATION (OLV) ENHANCEMENTS | Administrative Letter | pdf | 291 KB | | social-services special-assistance | administrative-letter |
| SAIH CASE MANAGEMENT MANUAL CHANGE NOTICE | Change Notice | pdf | 253 KB | | social-services special-assistance | change-notice |
| Special Assistance Administrative Letter No. 17-08 Social Security Cost-of-Living Adjustment (COLA 2018) and VA Cost-of-Living Adjustment (COLA 2018) for Special Assistance (SA) in a Facility | Administrative Letter | pdf | 288 KB | | social-services special-assistance special-assistance-in-home-program | administrative-letter |
| Special Assistance In Home Program Manual | Manual | pdf | 626 KB | | social-services special-assistance special-assistance-in-home-program | manual |
| Special Assistance Manual | Manual | pdf | 3 MB | | sa-manual social-services special-assistance | manual |
| State/County Special Assistance In-Home Case Management Manual | Manual | pdf | 1 MB | | social-services special-assistance special-assistance-in-home-case-management | manual |
