Publications

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• Reinstate vs Regrant

• Report of Admission or Discharge Rated Housing Facility/Residential Care Home W - 265

  Form W-265 is used by the Rated Housing Facility/Residential Care Home to notify the Department (1) when an individual is admitted to the home or facility, (2) when an individual is discharged from the home or facility (regardless of whether the discharge is temporary or permanent) and (3) when there is a change in discharge status from temporary to permanent.

• SAGA Application for Payment of Funeral and Burial Expenses W-1053

  SAGA Application for Payment of Funeral and Burial Expenses.

• Self-Employment Income Verification Form W-38

  Self-Employment Income Verification Form.

• Self-Employment Income Verification Form W-38S - Versión en Español

  Self-Employment Income Verification Form (W-38S) - Versión en Español

• SNAP ABAWD Work Requirement Medical Report W-1210

  SNAP ABAWD Work Requirement Medical Report.

• Special Information about Healthcare Tax Form--IRS Form 1095-B

  Enrollees in the HUSKY Health program will soon be receiving a new tax form in the mail. This is the ‘IRS Form 1095-B,’ required by federal law to help you prepare your federal tax return.

• spndown

• Standing Up for Children: Child Support Services (infographic)

  Stronger Families, Brighter Futures.

• State Plans

  These plans describe Connecticut’s programs that furnish financial assistance and services to needy families in a manner to fulfill the purposes of the Temporary Assistance for Needy Families (TANF) program.

• TANF Caseload Reduction Report Request for Comments

  Pursuant to federal regulations at 45 CFR § 261.40 et seq., the Connecticut Department of Social Services is seeking public review and comment on the methodology and the case number estimates used in its Temporary Assistance for Needy Families (TANF) Caseload Reduction Report to calculate the state’s TANF Work Participation Rate for Federal Fiscal Year 2020.

• Therapeutic Diet Request W-351

  Therapeutic Diet Request.

• Vendor Direct Deposit Form W-260

  Vendor Direct Deposit Form

• W-1216

  Supplemental Nutrition Assistance Program (SNAP) Computation Sheet

• W-1532

  Supervisory Review for Justification of PCA for Overnight and Live-In Services