Form 08TA011E "Drug Screen Requirements Acknowledgment" - Oklahoma

What Is Form 08TA011E?

This is a legal form that was released by the Oklahoma Department of Human Services - a government authority operating within Oklahoma. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2022;
  • The latest edition provided by the Oklahoma Department of Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 08TA011E by clicking the link below or browse more documents and templates provided by the Oklahoma Department of Human Services.

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Download Form 08TA011E "Drug Screen Requirements Acknowledgment" - Oklahoma

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Drug Screen Requirements
Acknowledgment
Date
Case name
Case #
County #
Supervisor #
Worker #
Drug Screen Requirements
Per Section 230.52 of Title 56 of the Oklahoma Statutes, adult parents or needy caretakers who
apply for Temporary Assistance for Needy Families (TANF) cash assistance are required to be
screened for illegal use of a controlled substance or substances. The minimum drug screening
includes a Substance Abuse Subtle Screening Inventory (SASSI).
I understand that:
if my SASSI assessment results indicate that there is a high probability that I may be using
illegal substances or the assessment results are invalid or indicate I am highly defensive, I will
be referred for a chemical drug screen as part of the Oklahoma Temporary Assistance for
Needy Families (TANF) eligibility determination process.
if my substance abuse screening is positive for an illegal substance(s), I will be ineligible to be
included in the TANF benefit; however, if all other factors of eligibility are met, my children
may still be eligible for Child Only TANF. If I am determined ineligible as a result of a positive
screen for illegal use of a controlled substance or substances, I am not eligible for TANF
benefits until:
six months after the date I was determined ineligible when I complied with a substance
abuse treatment plan;
one year after the date I was determined ineligible; or
three years after the date I was determined ineligible for the second or subsequent
time.
if I have a valid Oklahoma Medical Marijuana Card that was issued before the date of my drug
screen and tetrahydrocannabinol (THC) is detected, this will not be considered positive for an
illegal substance. However, if my drug screen is positive for THC and I do not possess an
Oklahoma Medical Marijuana card that was issued before the date of the drug screening, it
will be counted as a positive screen. In this instance, my needs will not be included in the
TANF case.
if I have an Oklahoma Medical Marijuana Card, I must present it to my worker and testing
facility for validation purposes prior to the drug screening. If I test positive for THC and failed
to provide my card to my worker and testing facility before the drug testing, my drug test will
be considered as a positive screen.
I can withdraw my application at any time before or after the SASSI is completed without
penalty. However, if I wait to withdraw my application until after the chemical drug screen is
initiated, my application will be denied, and if I screen positive for an illegal substance(s), the
penalty described in this form will apply. If I choose to withdraw my application, I may reapply
at another time.
08TA011E
7/1/2022
Page 1 of 2
Drug Screen Requirements
Acknowledgment
Date
Case name
Case #
County #
Supervisor #
Worker #
Drug Screen Requirements
Per Section 230.52 of Title 56 of the Oklahoma Statutes, adult parents or needy caretakers who
apply for Temporary Assistance for Needy Families (TANF) cash assistance are required to be
screened for illegal use of a controlled substance or substances. The minimum drug screening
includes a Substance Abuse Subtle Screening Inventory (SASSI).
I understand that:
if my SASSI assessment results indicate that there is a high probability that I may be using
illegal substances or the assessment results are invalid or indicate I am highly defensive, I will
be referred for a chemical drug screen as part of the Oklahoma Temporary Assistance for
Needy Families (TANF) eligibility determination process.
if my substance abuse screening is positive for an illegal substance(s), I will be ineligible to be
included in the TANF benefit; however, if all other factors of eligibility are met, my children
may still be eligible for Child Only TANF. If I am determined ineligible as a result of a positive
screen for illegal use of a controlled substance or substances, I am not eligible for TANF
benefits until:
six months after the date I was determined ineligible when I complied with a substance
abuse treatment plan;
one year after the date I was determined ineligible; or
three years after the date I was determined ineligible for the second or subsequent
time.
if I have a valid Oklahoma Medical Marijuana Card that was issued before the date of my drug
screen and tetrahydrocannabinol (THC) is detected, this will not be considered positive for an
illegal substance. However, if my drug screen is positive for THC and I do not possess an
Oklahoma Medical Marijuana card that was issued before the date of the drug screening, it
will be counted as a positive screen. In this instance, my needs will not be included in the
TANF case.
if I have an Oklahoma Medical Marijuana Card, I must present it to my worker and testing
facility for validation purposes prior to the drug screening. If I test positive for THC and failed
to provide my card to my worker and testing facility before the drug testing, my drug test will
be considered as a positive screen.
I can withdraw my application at any time before or after the SASSI is completed without
penalty. However, if I wait to withdraw my application until after the chemical drug screen is
initiated, my application will be denied, and if I screen positive for an illegal substance(s), the
penalty described in this form will apply. If I choose to withdraw my application, I may reapply
at another time.
08TA011E
7/1/2022
Page 1 of 2
Signature
By signing this form, I acknowledge that I understand the above information.
Applicant signature
Date
08TA011E
7/1/2022
Page 2 of 2
Page of 2