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 TANF 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-DCF) has been separated from regular DCF 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 DCF office, DCF access site, or KDHE-DHCF Outstationed Worker site. An application can be filed in person, through an authorized representative (for Food Assistance), by mail, by fax, or electronically online. See also 1411.5 regarding Universal Access. DCF has one paper application form for food assistance, TANF (including Refugee) and Child Care. The revised (10-13) ES-3100 is now titled “Application for Benefits”. All requests for medical assistance must now be made on KDHE-DHCF forms as follows:


The revised ES-3100 has space for 4 persons in a household. If the household is applying for more than 4 persons, they should complete the ES-3100 Addendum – Additional Persons. Each page (front and back) contains questions for 2 persons.


Both DCF and KDHE-DHCF offer online applications. The DCF online application allows an individual to apply for the Food Assistance, Temporary Assistance for Needy Families (TANF), and Child Care programs. The KDHE-DHCF online application allows an individual to apply for the medical assistance programs.

NOTE: Online applications for medical assistance received through the KDHE-DHCF Customer Self-Service Portal (CSSP) will be routed to either DCF or KDHE-DHCF (or both) for processing depending on the type(s) of assistance requested.

When an application is requested, the local DCF office shall help the household identify their service needs and assure that the individual receives all necessary applications. For example, an individual expressing concerns about not having enough food should be encouraged to apply for food assistance benefits. 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.

 

NOTE: 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 the ES-3100 application form and who subsequently request 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 application based on a client's request, the following provisions shall apply:

 

  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, a new application, signature, or interview is not required (assuming an interview has already occurred for the open program). The date of proration shall be the date the additional 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, a new application and interview (if applicable) are required.
     

  3. If a request is made for a new medical program on an open medical assistance case, additional information may be requested, but a new application is not required..
     

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

  5. No new application is required if the agency initiates the new program, such as adding QMB coverage to an open Medically Needy (MN) case, or when transitioning JO Child Care to EM, or where a TANF work program participant verbally requests Child Care Subsidy.

1411.2 Application Date - The date of receipt of a signed paper application in a DCF Service Center or Outstationed Worker site is considered the application date for establishing initial eligibility.


All signed applications shall be date-stamped the date received in the DCF Service Center or the Outstation Worker site.

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

NOTE: Date-stamping of an application by non-agency personnel does not constitute a date of receipt for application purposes.


  1. Online applications – The following rules apply in determining the application date for an online application:

    1. DCF online application – The date the online application (which is electronically signed) submitted through DCF is received shall be considered the application date if it is received before 5:00 pm (or closing time) when submitted on a business day. If the application is submitted after 5:00 pm (or closing time) on a business day, weekend, or holiday, the application date is the next following business day.

    2. KDHE-DHCF online application – The date the online application (which is electronically signed by the applicant or legal representative) submitted through KDHE-DHCF shall be considered the application date if submitted on a business day. If the application is submitted on a weekend or holiday, the application date is the next following business day.

      If the application is submitted by an individual with no legal relationship to the applicant, the application date is the date the “Medical Representative Authorization” or “Signature Page” form is received. If neither of these two (2) forms is received within 30 days of the date the online application was received, the application is void. For the DCF online application, a weekend is defined as starting at 5:00 pm on Friday evening until 11:59 pm on Sunday. For the KDHE-DHCF online application, a weekend is defined as Saturday and Sunday. Staff shall make a notation of the date discrepancy (after 5:00 pm on a business day, weekend, or holiday) in the case file.

  2. Applications with no program request – The application date for a paper application received with no indication of the program(s) being requested is the date the application is received in the local DCF office or Outstation Worker site. 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 TANF and Child Care assistance. These additional programs are registered with an application date of March 5.

  1. Unsigned applications – Paper applications that are received either through the mail or left at DCF the office, KanCare Clearinghouse, or Outstationed Worker site that are not signed by the applicant or legal representative are to be returned to the applicant for signature. 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 application explaining the need to sign the application and to return it to the appropriate office for processing.

    Applicants can return page 3 of the ES-3100 and establish the filing date as long as that page contains the applicant's name, address, and signature. The application must be completed and submitted, however, to determine eligibility.
     

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.
     

  2. Filing for Institutionalized Individuals (Not applicable to the MediKan 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 DCF 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 DCF office.
     

    Generally the local DCF 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 MediKan 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 MediKan Reintegration program purposes, an approved discharge or release plan shall include:
    • a copy of the ES-3903, Presumptive Medical Disability Determination Questionnaire;

    • one copy of the ES-3904, HIPAA compliant Authorization to Disclose Information to Kansas Health Policy Authority;

    • a completed ES-3901, Presumptive Medical Disability Team Referral; and

    • a completed and signed application form or a referral to the Economic/Employment Support Reintegration (EESR) worker in the local DCF office where the hospital or prison is located so that an application can be taken.

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 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 a maximum of 90 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 and East Units), Larned (Central and West Units), Norton, 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 DCF service center where the facility is located. The application must be part of the approved discharge plan for the inmate. Designated DCF 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 assistance benefits, the guidelines provided for MediKan 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.

  2. Filing for Individuals through the Health Insurance Marketplace – Individuals may apply for medical assistance through the Health Insurance Marketplace. The Marketplace application allows any adult member of the tax household to apply for any and all other members of the tax household. Should the agency receive an application via account transfer from the Marketplace, it shall be accepted and processed even if the individual filing the application does not meet the requirements of 2110 and subsections.

 

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.

 

However, when an a TANF applicant has been requested to submit to suspicion-based drug testing for TANF, a request for withdrawal or case closure to avoid a drug test, does not override a drug test request. Explanation of consequences of the drug test failure is required. See KEESM 2660. This does not apply to food assistance.

 

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 DCF service center where the application is filed shall inform the client 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 client 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 Title 21 coverage for children will usually be mailed to the KanCare 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 client 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 client is applying. See 1411.2.