Submittal of a signed paper application, an on-line application, or a telephonic application shall be considered a request for assistance. See 1411.5 for signature requirements.
Based on the provisions of 4310, an application shall include all persons who are required to be in the assistance plan. A new application is not required to add additional household members to existing programs.
Intake may be limited to providing the application form unless the applicant makes an additional request. If there is an intake interview, it must provide the applicant an opportunity to state his request and explain his situation and enable the agency to provide the applicant with needed information or to refer him to other staff members or other agencies for the help requested.
The application form together with the eligibility worker's records (if any), the necessary forms (budgets, notices of action, narratives, etc.), and any required verification must substantiate eligibility or ineligibility.
At the time of application processing, each month shall be viewed separately in determining eligibility or ineligibility. For example, if an application is filed in July but processed in August, ineligibility in August shall not affect the eligibility determination for the month of July.
Application and Additional Information can be requested from the Clearinghouse or any Outstationed Worker site. An application can be filed in person, by mail, by fax, or electronically online. The following application forms are in use:
NOTE: Online applications are received through the KDHE-DHCF Customer Self-Service Portal (CSSP).
When an application is requested, the agency shall help the household identify their medical needs and assure that the individual receives the appropriate application. The individual shall be encouraged to file the application the same day – in person, by fax, or electronically online. See 1411.2 below for the application date of an online application. An application shall be mailed to the household the same day the request is received.
If the applicant household is homeless and they have no physical street address to list, the application shall be so noted and accepted by the agency.
For ongoing recipients who have completed an application form and who subsequently request additional assistance and for situations in which an additional program is added to a pending application based on a client's request, the following provisions shall apply:
The date of receipt by the agency of a validly signed application is considered the application date for establishing initial eligibility and for processing purposes. While the applicant is directed to both sign and date the application, the date provided by the applicant (or authorized representative) on the application does not determine the application date (see also 1411.5).
A paper application that is received through the mail or physically delivered to agency personnel on agency premises shall be considered received that date. An application that is received through a drop box, mail slot, or other such manner at the opening of the business day shall be considered that day, even if the application was deposited prior to that date.
An application received by the agency via email or fax is deemed an original application and is considered received on the date on the time stamp if received by 5:00pm on a business day. If the application is received after 5:00pm on a business day or on the weekend or a holiday, the application is the next following business day.
When an applicant files an application form that is not intended for the medical coverage requested, additional information may be requested, but the application date is the date the application is received by the agency. Completion of the appropriate form is not required to establish the application date for the coverage requested.
NOTE: Date-stamping of a paper application by someone other than agency of agency contracted personnel does not constitute a date of receipt for application purposes.
The entire application shall be returned to allow the applicant to review his/her answers prior to certifying under penalty of perjury that all answers are correct and complete to the best of their knowledge. A cover letter must be attached to the returned application explaining the need to sign the application and return to the agency for processing.
If the originally unsigned application is returned with a valid signature, the application date for processing purposes is the date the returned application is received by the agency if received on a business day. If the application is received on the weekend or a holiday, the application date is the next following business day.
NOTE: Neither an online nor telephonic application may be submitted without a signature. Therefore, there should never be an online or telephonic application received without a signature. The signature may be invalid (see subsection (6) below), but there should always be a signature.
When an application with an invalid signature has been received by the agency, the application (or a copy of the application for online applications) shall be returned to the applicant with instructions to either verify the authority of the person who signed the application or to sign the application in their own name (if legally competent to do so).
If verification of authority to sign the application or if the application with the applicant’s own signature is timely received by the agency per 1321 (3), the application date for this application is determined by the following:
This provision also applies where someone other than the applicant, who is verified to act on behalf of the applicant according to 2111 (2)(a), signs and timely returns the application to the agency.
NOTE: If the application indicates that the person signing the application has authority to apply on behalf of the applicant (such as a person holding a Durable Power of Attorney or is a guardian or conservator of the applicant), but no verification has been provided at the time of application, the process described in this section does not apply. In that instance, the signature is initially considered valid, and the agency shall send a request for information to provide verification of the authority.
This provision also applies where someone other than the applicant, who is verified to act on behalf of the applicant according to 2111 (2)(a), signs and timely returns the application to the agency.
If verification of authority to sign the application or if the application with the applicant’s own signature (or of someone who can act on behalf of the applicant) is not timely received, the application shall be denied due to an invalid signature based on the date the application was originally received.
The program(s) requested shall be registered using the date of receipt of the application as the application date for those programs only. Any subsequent request for other programs by the applicant shall be registered with an application date based on the date of request for the additional program(s).
NOTE: An online application may not be submitted without a program request. Therefore, there should never be an online application received without a program request.
An individual in need or by another person able to act in the individual's behalf may submit an application for assistance. See 2110. If the applicant or his representative signs by mark, the names and addresses of two witnesses are required. Obtaining the signatures of all persons in the family group who are requesting assistance and able to act in their own behalf per 2110 is encouraged but cannot be required.
General hospitals are generally not regarded as a licensed facility for this purpose unless approved. However, KDHE policy may approve exceptions on a case-by-case basis.
Complete applications will be forwarded to the Clearinghouse for processing. All information pertinent to eligibility and known by institutional staff will be communicated to the Clearinghouse. When the institution acts as an employer to the patient, institutional personnel will be responsible for reporting all earnings to the Clearinghouse.
The form must include an authorization for care from KDHE as well as an effective date for care.
All documents are located on the KDHE Eligibility Policy website.
In addition, the plan will also include the anticipated date of discharge, documentation that the individual has been referred to Social Security to make application for SSI or SSDI benefits, the individual's address and living arrangement following discharge, and an ongoing treatment plan.
The assigned worker shall have at least five working days advance notice to carry out the eligibility functions. Upon receipt of the approved discharge plan, the worker will need to ascertain the current eligibility status of the individual.
In such instances, the inmate can sign the application as of the date of completion and the application can be filed with the Clearinghouse where the facility is located. The application must be part of the approved discharge plan for the inmate. Designated Clearinghouse staff shall be responsible for coordinating submission and processing of these applications. Discharge planning staff at each correctional facility are responsible for initiating a release plan which incorporates a completed and signed application for benefits, if appropriate, as well as all supporting documentation for the application. If application is made for medical assistance benefits, the guidelines provided for MediKan Reintegration cases in item (4) above are applicable. This includes completion of the ES-3903 and completion of necessary forms and referrals as well as all medical records obtained by the facility regarding the person's disability.
The application shall be registered in KEES at the time of receipt. However, the application is not valid until the release date. As such, the application registration date shall be changed to reflect the release date at the time of release and application processing time frames (including expedited benefits) will be based on that date.
The agency shall make an eligibility determination and issue benefits within 30 days following the date of the applicant's release from the institution. If, for any reason, the agency is not notified on a timely basis of the applicant's release date, the agency shall determine benefits based on the date of release.
Assistance shall be determined based on the living arrangement the person is residing in upon release. Assistance for the individual shall be prorated for the first month of assistance based on the date of application/discharge.
The household may voluntarily withdraw its application at any time. The agency shall document in the case file the reason for withdrawal, if any was stated by the household, and that contact was made with the household to confirm the withdrawal. The household shall be advised of its right to reapply at any time subsequent to withdrawal.
As noted in 1411, an application or review form must be signed to be considered a valid request for assistance. The signature must be both valid (see 1411.2 (6)) and acceptable. An acceptable signature is one which meets the following requirements.
A signature provided in the wrong place in most instances shall not disqualify the application as long as the signature is both valid and acceptable. This applies to signatures provided on either the signature page or the medical representative authorization page of the application.
NOTE: While it is not required that the signature be on the correct signature line, it does need to indicate an agreement/authorization of the items preceding the signature section on the signature page, i.e., the rights and responsibilities section of the application or review form.
When the signature has been determined to be unacceptable, an attempt to contact the applicant should be made to confirm the identity of the person who signed the application. If it is confirmed that the applicant (or authorized representative) signed the application, the signature shall be considered acceptable.
Based on this process, the verbal signature shall always be deemed to be acceptable. However, if it is later verified that the person who provided the verbal signature was not the applicant (or authorized representative), the signature is considered to be a forgery, and thus an invalid signature, see 1411.2 (6).
If the application does not contain an acceptable signature, follow the process described in 1411.2 (6) for invalid signatures.
NOTE: While the applicant (or authorized representative) is directed to both sign and date the application, failure to date the application (or provide an incorrect date) does not invalid the signature or the application. As long as an acceptable signature has been provided, the signature requirement has been met. See 1411.2.
All applications shall be approved or denied on a timely basis except when a determination of eligibility cannot be made within the required period due to the failure of the applicant or a collateral to provide required information. Written notice must be given the applicant by the end of the required period giving the reason(s) for the delay. The approval of an application from a non-citizen who is otherwise eligible may not be delayed beyond the timely processing time frame due solely to the fact that no INS response to a request for verification of immigration status has been received.
Timely action is defined as follows: