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Job Aid: Request for Past Paid Public Assistance
Overview
This job aid lists the steps needed to complete a Past Paid Public Assistance request from Child Support.
Refer to admin letter April 10, 2015.
Policy Note: The Work First worker will receive a DSS 4746 from the Child Support Services with section I
completed. The Work First worker must complete section II of this form within two days.
Step-by-Step Instructions
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Conduct a Person Search using the child’s CNDS.
Navigate to the Care and Protection tab.
Click the Cash Assistance Product Delivery Case reference number hyperlink.
On each Cash Assistance Product Delivery Case, click on the Financials tab and document each
payment for the requested time frame on the DSS 4746 form.
5. Calculate the payment. Total each monthly payment and divide by the number of children in the
AU. The example below shows the November 2014 payment history ($236.00) with 2 children in
the AU. Therefore, the total amount of $236.00 is divided by 2 and the payment amount is
$118.00.
6. Document the PPPA request on the latest opened Income Support case under the Case Details tab
in the Notes folder. (If none of the Income Support cases are open, document the most recent
closed Income Support Case.)
7. Sign and return the DSS 4746 to the Child Support Services via inter office mail or another secured
method to ensure confidentiality when transmitting these forms.
Reminder: A child support referral must first be completed on each Cash Assistance and Medical
Assistance case. Refer to IV-D Referrals for Medical Assistance, Cash Assistance and MAGI Cases Job Aid.
Job Aid – Request for Past Paid Public Assistance – 4/1/2015
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