Written Agreement (CW 86)

Before an account can be designated as “restricted,” the caretaker relative must sign an “Agreement — Restricted Account” (CW 86) which sets forth the requirements, restrictions and penalties of having such an account. A CW 86 is required for each restricted account established by the AU.

The recipient must be advised to first retain resources close to the property limit to pay for any unexpected expenses or emergencies BEFORE they enter into a written agreement.

Because the CW 86 is a binding agreement, it must be thoroughly reviewed with the recipient, prior to signing. By signing the CW 86, the recipient certifies that they understand the terms which establish, maintain, and end a restricted account as well as the specific consequences (a penalty period) for failing to meet required timeframes.

CW 86 Coversheet

When the recipient has requested a restricted account, one copy of the CW 86 Coversheet must be given to the recipient, and a copy imaged into the case record for documentation purposes.

CW 86 Instructions

When the recipient has requested a restricted account and has been given the CW 86 Coversheet, these procedures must be followed:

  1. EW
    1. Reviews the cover sheet with the recipient, giving a copy to that individual and imaging a copy into the case record.
  2. Client & EW
    1. Completes Section A:
      1. Each item in this section must be reviewed with and initialed by the caretaker relative. The EW must witness the recipient's signature.
      2. If this is a joint account, the other person listed on the account must sign the CW 86.
    2. Completes Section B, which instructs the recipient to:
      1. Provides information about the account,
      2. Provides proof of the account, and
      3. Signs, dates and returns the original to the EW within 30-calendar days after the caretaker relative signs the agreement.
  3. EW  
    1. Creates a Reminder in CalSAWS for 30-calendar days to check on status of CW 86.
    2. Documents in the “County Use Only” section the date the original agreement was returned and approved, or that the agreement was terminated and the reason why. Give one copy to the recipient.
    3. Images the returned original documents into case record if received timely. OR Terminates the agreement if the AU fails to return a completed original CW 86 with proof of the account, within the 30 days.

CW 86 Completion

When the recipient is ready to complete the CW 86, the following timeframes apply:

IF THEN...
Only Section A is completed, Review, with the recipient, the instructions in Section B which allow 30-calendar days to return the agreement.
Give the recipient the original and one copy of the CW 86, and image copy into the case record.
When the recipient returns with Section B completed with proof of the account, image the original into the case record and give the recipient a copy.
Section A & B are completed at the same time Image the original copy of the CW 86 into the case record, and give the recipient a copy.

Termination of Written Agreement

[EAS 42-213(p)]

The written agreement for restricted accounts terminates when any one of the following occurs:

  • The AU is discontinued from CalWORKs.
  • The restricted account is closed.
  • The AU does not provide timely verification of the account information.
  • State or federal law changes the conditions, or no longer permits, these restricted accounts.
  • The recipient requests termination of the restricted account. A period of ineligibility could result based upon the balance in the restricted account.

Related Topics

Rule

Account Information

Qualifying and Nonqualifying Withdrawal

Good Cause