1400 Application Process, Case Disposition, and Written notice of Case Action

 

1410 Application Process

 

1411 General Information - Submittal of a signed paper application or an on-line application shall be considered a request for assistance. Ineligibility for cash assistance does not automatically render the applicant ineligible for other programs. For food assistance and cash purposes, a face-to-face or telephone interview is required at the time of application (See 1412.4)

 

Based on the provisions of 4000, 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 EES 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 effect the eligibility determination for the month of July.

 

Use of the Eligibility Documentation Log, ES-3113A, is optional for each TAF and food assistance application processed. The items listed on this form are considered to be the minimum documentation required for each application/review processed, and if the ES-3113A is not used, the items listed on this form must be documented in the case file either in the narrative or on a locally developed form.

 

Expedited food assistance service shall be provided to households in immediate need. See 1415.1. Expedited medical eligibility shall also be provided to all pregnant women who apply for cash or medical assistance. Refer to KFMAM 1407.

 

An application for food assistance benefits can be filed at any Social Security Administration (SSA) Office for those households in which all members of the food assistance household are either applying for or receiving SSI benefits. For convenience, the application process for joint processing (SSA-SRS) has been separated from regular SRS application processing. The application process for households applying at the SSA office is discussed in 1417.

 

1411.1 How to Apply - Applicable to All Programs - Application forms can be requested from any local SRS office or SRS access site. An application can be filed in person, through an authorized representative (for food assistance), by mail, or electronically by fax or computer. See also 1411.5 regarding Universal Access.

 

NOTE: Effective May 1, 2009, applicants cannot apply for General Assistance or Medicaid via the online application. The online application Welcome page provides links to the paper applications for these programs. All persons applying for TAF online shall be made aware of the medical programs and offered either the appropriate ES-3100 or the Healthwave application.

 

When an application is requested, the local office shall help the household identify their service needs and assure that the applicant receives all necessary applications. For example, applying for food assistance benefits should be encouraged if the person expresses concerns which indicate that the household does not have enough food. When an application is requested, the local office shall encourage the household to file an application that same day. This can be done in person or electronically by fax or by using the on-line application. (See 1411.2 for the application date of an online application). If none of these alternatives work for the household, an application shall be mailed to the household the same day the request is received.

 

NOTE: If the applicant household is homeless and they have no street address to list, the application shall be so noted and accepted by the agency.

 

For ongoing recipients who have completed the ES-3100 or ES-3100.1 and who subsequently apply for additional assistance under a different program (e.g., a food assistance recipient who requests cash assistance) and for situations in which an additional program is added to a pending ES-3100 or ES-3100.1 application based on a client's request, the following provisions shall apply:

 

NOTE: The provisions below are not applicable to instances in which the agency initiates the new program, e.g., closing TAF but continuing medical for a pregnant woman, and in instances when a TAF applicant/recipient or food assistance work program participant verbally requests child care subsidy, will be in transition from JO  to EM child care. See 1413 (5).

 

  1. If the new program (including the EM child care) is requested within the month following the month of application, or in the first month of the new review period, neither an application, signature, nor interview is required (assuming an interview has already occurred for the open program). The date of proration for these types of requests shall be the date the request is first received, either orally or in writing, by the agency. See 7401.
     

  2. If the new program is requested after the month following the month of application or after the first month of the review period, an application and interview (if applicable) are required.
     

  3. If a request is made for a new medical program after the month following the month of application or after the first month of the new review period and there are less than six months left in the current review period, an application is required.
     

  4. If a request is made for cash assistance while in extended medical or transitional medical status, an application, and interview are required if the original cash review period has expired.

1411.2 Application Date - The date of receipt in a local SRS Service Center or the HealthWave Clearinghouse (for some Medicaid programs) of a signed paper application is considered the application date for establishing initial eligibility. Giving a signed paper application to an SRS worker during a face-to-face interview at an off-site location, such as during a home visit or at an SRS Access Point, shall also establish the date of application.

For an on-line application (which is electronically signed), the date the application is submitted on-line shall be considered the application date if received before 5:00 pm (or closing time) when submitted on a business day. If the application is submitted after 5 pm (or closing time) on a business day, weekend or holiday, the application date is the first business day following the weekend or holiday. A weekend is defined as starting at 5:00 pm on Friday evening until Sunday at 11:59 pm. Staff shall note the date discrepancy and reason (after 5 pm on a business day, weekend or holiday) in the case file.

All signed applications shall be date-stamped the date of receipt in the SRS office.

The application date for applications received with no indication of the programs being requested is the date the application is received in the local SRS office. Immediate contact with the applicant must be made to determine which programs are being requested. The programs requested shall be registered using the date of receipt 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 [See 7401(10)].

Example 1:

An individual files an application for assistance on June 1, but fails to indicate on the form which programs he/she is requesting. The agency contacts the applicant on June 3 to determine he/she is requesting cash, medical, and food assistance. Those programs are registered with an application date of June 1.

Example 2:

An application for food assistance is received on March 2. During the face-to-face interview on March 5, the applicant also requests TAF and child care assistance. These additional programs are registered with an application date of March 5.

NOTE: Paper applications that are received either through the mail or left at the office that are not signed by the applicant are to be returned to the applicant for signature. The entire application must 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 application explaining the need to sign the application and to return it to the office for processing.

Applicants can return page 1 of the ES-3100 or ES-3100.1 and establish the filing date as long as page 1 contains the applicant's name, address, and signature. The application must be completed, however, to determine eligibility.
 

NOTE: Date-stamping of an application by an SRS Access Point does not constitute a date of receipt for application process. 

For information regarding a faxed or copied application form see 1212.2.

1411.3 Who May File - An application for assistance shall be made by the individual in need or by another person able to act in the individual's behalf. See 1523, 2110 and 2220. 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.

 

  1. Filing on Behalf of a Deceased Person - For medical, an application may be made on behalf of a deceased person by any responsible person. Application must be made in the month of death or within the three following months.

    Refer to 2320 for applications related to the funeral program.

    The most recent application/redetermination form will suffice as an application for funeral assistance. Information on that form shall be compared with any updated information supplied by persons having knowledge of the family's or deceased person's resources. Although a case is open for the deceased, and payment for the funeral can be made on that program, a separate determination of eligibility for funeral assistance is required.
     

  2. Filing for Institutionalized Individuals (Not applicable to the GA Reintegration Program or Food Assistance Program) - When possible, all necessary information and signed forms will be obtained by institutional personnel. Parents, spouses, guardians/conservators and others who may apply on behalf of the individual per 2110 must always be given the opportunity to apply on behalf of an institutionalized person not able to act in his own behalf. If institutionalized personnel are unable to obtain an application from the patient or any of the above individuals, the administrator of a licensed facility may apply on behalf of the patient. For minor children, if the length of stay will not exceed 30 days so that parental income and assets are considered, hospital staff are not be able to complete the application process. General hospitals are not regarded as a licensed facility for this purpose.

    Complete applications will be forwarded to the SRS office for processing.

     

    All information pertinent to eligibility and known by institutional staff will be communicated to the local office. When the institution acts as an employer to the patient, institutional personnel will be responsible for reporting all earnings to the local SRS office.
     

    Generally the local SRS office where the institution is located will process new applications. (See 1411.5 regarding Universal Access.) However, when appropriate, the local office shall determine whether the individual is currently included on an open cash or medical case before processing. If the individual is included on a currently open case, the application shall be denied. The referral and a copy of the application shall be sent to the current county where the appropriate case action will be taken to certify eligibility to the institution. (See 9200 (ICT).) For individuals who currently have an unmet spenddown, the institution should be notified as no FFP can be claimed until the spenddown is met. Medical expenses incurred at the institution shall be considered toward the unmet spenddown and eligibility certified when the spenddown is met.
     

  3. Filing for Individuals Requesting Tuberculosis Coverage - For persons KDHE determines to be in need of treatment for TB (per 2692)  who  are not eligible for regular medical coverage, the Certification of Need for  TB Treatment (ES-3100.3) is normally used for application.

    The form must include an authorization for care from KDHE as well as an effective date for care.
     

  4. Filing for Individuals Qualifying for the GA Reintegration Program - Discharged staff have the responsibility for initiating a discharge plan for persons being discharged from Medicaid approved psychiatric hospitals, the Larned State Security Program, and the Larned Correctional Mental Health Facility (Central Unit). For GA Reintegration (GAR) program purposes, an approved discharge or release plan shall include: 

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 and that they have been provided with a copy of the ES-3902, Presumptive Medical Disability Determination Brochure, the individual's address and living arrangement following discharge, and an ongoing treatment plan.

The EESR worker shall have at least five working days advance notice to carry out the eligibility functions. (See 2314.) Upon receipt of the approved discharge plan, the EESR worker will need to ascertain the current eligibility status of the individual.

  1. Filing for Individuals Being Released from State Correctional Institutions - Discharge staff at the 9 State Correctional Facilities may begin the application process for potentially eligible inmates up to 30 days prior to their release. The correctional facilities are El Dorado(Central, North, and Toronto Unit), Ellsworth, Hutchinson (Central, East, and South Units), Lansing (Central, East and Osawatomie Units), Larned (Central and West Units), Norton (Central and Stakton Units), Topeka, Wichita Work Release Facility, and Winfield.

 

In such instances, the inmate can sign the application as of the date of completion and the application can be filed with the local SRS service center where the facility is located. The application must be part of the approved discharge plan for the inmate. Designated SRS staff in each Region 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 and/or General Assistance benefits, the guidelines provided for GA Reintegration cases in item (4) above are applicable. This includes completion of the  ES-3903, Presumptive Medical Disability Determination Questionnaire, 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 KAECSES 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. Where applicable, a face to face interview must also be conducted after the person has been released.

 

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. See also the provisions of KEESM 1417 regarding Food Assistance and processing of SSA applications for inmates of public institutions.
 

Assistance shall be determined based on the living arrangement the person is residing in upon release. For cash purposes, the shelter standard for the county of placement shall be used in establishing the need standard for persons placed in independent living arrangements. Assistance for the individual shall be prorated for the first month of assistance based on the date of application/discharge.
 

1411.4 Withdrawing the Application - 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.

 

1411.5 Universal Access - Although an application is normally made in the county of residence, an individual or family can apply for and receive benefits in an area other than where they live. The SRS service center where the application is filed shall inform the consumer of the possible options, considerations, and consequences of having the case processed and managed from a service center other than the service center which would ordinarily serve residents of that county. If the consumer chooses to have benefits and services established and maintained in the service center where originally filed, the service center shall process the application and, if approved, manage the case unless there is a good reason not to. The individual would usually be expected to access all like services from the same service center except where such services need to be accessed from different locations.

 

The ability to be served in an area other than where the person normally resides may be appropriate when:

 

 

Being served in another service center would not be appropriate where the individual is shopping for better services or a different worker, to avoid negative consequences such as a work penalty, or where court jurisdiction does not allow the case to be handled in a different Region.

 

If an application is mailed or left at a county office that will not be responsible for processing the application, the office shall mail the application to the appropriate office on the same day, or forward it the next day by any means to insure the application arrives the day it is forwarded (such as FAX). However, as noted above, applications for Medicaid poverty level or HealthWave XXI coverage for children will usually be mailed to the HealthWave Clearinghouse.

 

1411.6 Registration of Applications – Applications for all programs that are not entitled to expedited benefits, must be registered within two business days of the date of application (see 1411.2). Applications that are entitled to expedited benefits must be registered within one business day of the date of application. For example a non-expedited online application is submitted on a Saturday. The application date is Monday, and the application must be registered by close of business on Wednesday. Or a non-expedited online application is received submitted on the Wednesday before Thanksgiving. The application date is the following Monday and the application must be registered by close of business on Wednesday. For expedited, the same policy applies except the agency has only one day to register the application. So, an expedited application submitted online on a Saturday must be registered by close of business on Monday. Or an expedited paper application is received on a Friday and it must be registered by close of business on Monday.

Applications received without a benefit program request must be registered within two business days of the date the agency determines the programs for which the customer is applying. Applications that are entitled to expedited benefits must be registered within one business day of the date the agency determines the programs for which the customer is applying. See 1411.2.