Individual who is pregnant or parenting Copy of child‘s birth certificate Baptismal record Observation of pregnancy status Doctor‘s note confirming pregnancy Self-certification (Participant identifies status and signs and dates paperwork) Individual with a disability Letter from a Vocational Rehabilitation Agency, such as Maryland Division of Rehabilitation Services (DORS) verifying An individual with: (A) a physical or mental impairment that substantially limits one or more major life activities of such disability individual; (B) a record of such an impairment; or (C) being Letter from Maryland Department of Health regarded as having such an impairment (as described in the and Mental Hygiene (DHMH) Behavioral Americans with Disabilities Act § 12102 (3) Health Administration (BHA), Administrative Services Organization, or another Core Service Agency attesting that the individual receives specialty services within the Public Health System Developmental Disabilities Administration (DDA) certificate for long term supports Social Security Administration disability records Statement or Diagnosis from a PhD, MD, Licensed Clinical Social Worker (LCSW) or other licensed clinical professional School records (Individualized Education Plan, 504 Plan, exit documents or other documentation stating disability) Workers Compensation records Veterans Administration letter/records Temporary Disability Assistance Program approval letter Public Assistance to Adults (PAA) approval letter Self-certification (Participant identifies status and signs and dates paperwork) Low-income individual Alimony Agreement Applicant Statement An individual who— (i) receives, or in the past 6 months has Award letter from veteran‘s administration received, or is a member of a family that is receiving or in the Bank statements past 6 months has received, assistance through the Compensation award letter supplemental nutrition assistance program established under Court award letter the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.), the program of block grants to States for temporary assistance for Pension statement needy families program under part A of title IV of the Social Employer statement/contact Security Act (42 U.S.C. 601 et seq.), or the supplemental Family or business financial records security income program established under title XVI of the Social Security Act (42 U.S.C. 1381 et seq.), or State or local Housing authority verification income-based public assistance; (ii) is in a family with total Pay family income that does not exceed the higher of—(I)the Public Assistance records poverty line; or (II) 70 percent of the lower living standard income level; (iii) is a homeless individual (as defined in
Individual who is pregnant or parenting Copy of child‘s birth certificate Baptismal record Observation of pregnancy status Doctor‘s note confirming pregnancy Self-certification (Participant identifies status and signs and dates paperwork) Individual with a disability An individual with: (A) a physical or mental impairment that substantially limits one or more major life activities of such individual; (B) a record of such an impairment; or (C) being regarded as having such an impairment (as described in the Americans with Disabilities Act § 12102 (3) Letter from a Vocational Rehabilitation Agency, such as Maryland Division of Rehabilitation Services (DORS) verifying disability Letter from Maryland Department of Health and Mental Hygiene (DHMH) Behavioral Health Administration (BHA), Administrative Services Organization, or another Core Service Agency attesting that the individual receives specialty services within the Public Health System Developmental Disabilities Administration (DDA) certificate for long term supports Social Security Administration disability records Statement or Diagnosis from a PhD, MD, Licensed Clinical Social Worker (LCSW) or other licensed clinical professional School records (Individualized Education Plan, 504 Plan, exit documents or other documentation stating disability) Workers Compensation records Veterans Administration letter/records Temporary Disability Assistance Program approval letter Public Assistance to Adults (PAA) approval letter Self-certification (Participant identifies status and signs and dates paperwork) Low-income individual An individual who— (i) receives, or in the past 6 months has received, or is a member of a family that is receiving or in the past 6 months has received, assistance through the supplemental nutrition assistance program established under the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.), the program of block grants to States for temporary assistance for needy families program under part A of title IV of the Social Security Act (42 U.S.C. 601 et seq.), or the supplemental security income program established under title XVI of the Social Security Act (42 U.S.C. 1381 et seq.), or State or local income-based public assistance; (ii) is in a family with total family income that does not exceed the higher of—(I)the poverty line; or (II) 70 percent of the lower living standard income level; (iii) is a homeless individual (as defined in Alimony Agreement Applicant Statement Award letter from veteran‘s administration Bank statements Compensation award letter Court award letter Pension statement Employer statement/contact Family or business financial records Housing authority verification Pay Public Assistance records
Client-Records-Managment-Policy-2018.docx