Sec.17b-616-20. Elements of the application

(a) The Family Support Program application shall include, but is not limited to, the following information:

(1) Nature of the child's disabling condition;

(2) A statement of the diagnosis and medical needs signed by the child's health care professional; including verification that the child does not have mental retardation;

(3) Verification of Income: wage stubs for the last six (6) weeks, and a complete copy of the I.R.S. Federal Income Tax Return for the previous calendar year; and

(4) Expected use of the family grant including information as to the ongoing extraordinary financial expenses.

(b) The Department shall conduct a social study in order to evaluate the home and family situation and to determine eligibility. The elements of the social study shall include but not be limited to: family members and relationships, description of the child with a disability, financial information and a description of the home environment.

(Effective November 30, 1995)