Kansas Economic and Employment Services Manual
2000 General Eligibility
10-17
2000 - GENERAL ELIGIBILITY
REQUIREMENTS
This section describes non-financial eligibility requirements which
are common to all programs as well as those general program criteria specific
to each. Assistance can only be provided when all applicable requirements
have been met for a particular program.
2100 REQUIREMENTS COMMON
TO ALL OR MOST PROGRAMS
2110 Act in Own
Behalf - In order to apply for assistance, the individual must
be legally capable of acting in his or her own behalf. For medical only,
see also 1411.3 (6) concerning applications
received through the Health Insurance Marketplace.
2111 Adults - An adult for application purposes
is defined as anyone 18 years of age or older. An adult’s capacity to
act in their own behalf determines whether or not they are allowed to
apply for assistance.
- Legally Incapacitated -
Legally incapacitated adults are not eligible to receive assistance
unless such assistance is applied for by a guardian or conservator.
A legally incapacitated adult shall be defined as any adult who is
impaired both physically and mentally by reason of mental illness,
mental deficiency, physical illness or disability to the extent that
he or she is unable to understand or communicate responsible decisions
concerning his or her person, or to the extent the adult cannot effectively
manage or apply his or her estate to necessary ends for whom a guardian
or conservator has been appointed by the court.
- Not Legally Incapacitated -
For medical applications, any adult who has not been determined to
be legally incapacitated as described in subsection 1. above is presumed
to be able to act in their own behalf. A competent adult may apply
for assistance for himself or herself.
- The following additional individuals may apply on behalf of
a competent adult without requiring authorization from the adult:
- The spouse of the adult (see 4312(1)).
- The partner
of the adult with whom there is a mutual child (including
an unborn child).
- A tax filer who claims (or intends to claim) the adult
as a dependent on his or her federal tax return.
- A person with a durable power of attorney (for financial
decisions) for the adult.
- The representative payee for Social Security benefits for
the adult.
- For an individual other than the adult or those listed in subsection
(a) above to apply, the individual must be appointed by the adult
as his or her medical representative. A signed written authorization
from the person for whom they are applying must be obtained. The
medical representative authorization section on the application
form may be used for this purpose and must be signed by the adult
and at least one witness. The designated medical representative
shall act in the place of the individual for whom they are applying.
The medical representative shall receive copies of all notices
and is responsible for completing review forms and reporting changes.
The medical representative should be someone who is trusted and
knowledgeable about the adult’s circumstances and needs, including
his or her income, resources and household situation. Except in
very limited circumstances, it would not be appropriate to appoint
or accept a medical representative who has little or no prior
experience with the individual. This would include those whose
primary interest is in collecting on outstanding medical bills
rather than in fully representing the interests and needs of the
applicant for medical assistance.
- In rare instances where the adult is unable to file his or
her own application and obtaining a written consent is not possible,
the application shall be accepted and a referral completed to
Social Services to have a guardian or conservator appointed if
appropriate. For example, an individual may have been in an automobile
accident and is in a coma. The application would not be denied
or delayed because an appropriate person is not available to file.
When someone other than the adult is acting in his or her behalf, all
notices must still be sent to the applicant/recipient in addition to the
authorized representative.
- Facilitators - An individual
may grant limited authority to a person who is assisting in the medical
application process. This individual would not be a medical representative
and may not apply on behalf nor sign an application for the adult, or request a fair hearing on behalf of the adult. They may share and receive information concerning the case depending
on the scope of authority granted. This individual would not be responsible
for completing review forms or reporting changes. Their role would
be confined to helping the individual with the application process.
2112 Minors - A minor for application purposes
is anyone under 18 years of age. A minor’s capacity to act in his or her
own behalf determines whether or not he or she is allowed to apply for
assistance.
A minor is presumed to be
legally incapable of acting in his or her behalf and therefore may
not apply for himself or herself. However, a minor can act in his
or her own behalf and receive assistance only under one of the following
circumstances:
A court has emancipated the
minor by bestowing the rights of majority upon the minor. Such
an individual is legally an adult.
The minor is age 16 or 17 and
is or has been married.
There is no caretaker exercising
parental control over the child or willing to assume parental
control and one of the following circumstances exist:
The parents of the minor
are institutionalized per 4140.
The minor has no parent
who is living or whose whereabouts is known.
The health and safety of
the minor has or would be jeopardized by remaining in the
household with the minor's parents or other caretakers. Such
status must be documented by an independent source such as
social services, law enforcement, religious authorities or
a battered person's shelter.
If local arrangements are made between EES and Prevention and
Protection Services (PPS), a referral may be made to PPS for
assistance in determining the status of the minor's parents
or other caretakers and any health and safety issues that
would exist in such living arrangements. The determination
of a minor's ability to act in own behalf under this provision
must be approved by the EES Program Administrator or designee
and documented in the case record.
The minor is placed into independent
living by DCF. In situations where the minor’s needs are being
met by PPS or a foster care contractor, the minor can not apply
for his/her own needs but may apply on behalf of his/her child
providing the child resides with the minor and is not in DCF custody.
The minor enters an approved
transitional living program, such as MINK.
The minor enters Job Corps or
another approved adult-supervised living arrangement, and the
EES Program Administrator or designee, on a case-by-case basis,
determines it is in the best interests of the minor to allow the
minor to apply in his or her own behalf. This decision must be
documented in the case record.
Once a minor approved to act in his or her own behalf leaves the
group living arrangement, the EES Program Administrator or designee
must determine if it continues to be in the minor's best interests
to act on his or her own behalf and document the decision in the
case record.
The EES Program Administrator's approval is required only if the
minor does not qualify to act in his or her own behalf based on
one of the categories in a through (e) above.
Minors who are unable to act in
their own behalf are not eligible to receive assistance unless such
assistance is applied for by a person meeting one of the following
criteria:
- All programs
Except Medical
- A parent or caretaker (as defined in 2220,
2221, 2222,
and 2223). This includes
an adult mandatory filing unit member in the situations noted
in 2220.
- An adult household member (Food Assistance Only).
- For Medical only
-
- A court-appointed legal guardian, custodian, or conservator.
- A representative payee for the minor's Social Security
benefits.
- A responsible adult, with whom the child resides, who meets
the definition of a caretaker according to 2220.
- An adult with whom the minor resides and who claims,
or intends to claim, the minor as a dependent on his or
her federal income tax return.
- A responsible adult, with whom the child resides, who
does not meet any of the above criteria can apply for
the minor child if they are appointed as the authorized
agent by the minor's parent or legal guardian. This authorization
is only for purposes of application and maintenance of
the minor child's medical assistance case with the KDHE
and DCF. A completed ES-3108 - Appointment of Authorized
Agent for Minor must be on record. This authorization
is time-limited and a new authorization form is required
at each certification.
- If the child's parent or legal guardian cannot be located
to assign an authorized agent, the relationship of the
responsible adult to the child must be confirmed or substantiated.
An individual's statement and two corroborative pieces
of evidence shall meet the burden of proof unless there
is an independent reasonable basis to doubt the veracity
of the statement. Corroborative evidence may include but
is not limited to a written statement from a public or
private licensed social agency, clergy, attorney, school
official, medical provider, or other professional.
This confirmation is time-limited. New verification
is required at each certification.
An individual who meets one of the medical assistance only criteria
may also request prior medical coverage for the child. This is true
even if the individual did not meet the criteria or was not living
with the child during the prior medical period. However, eligibility
shall be determined based upon the child's situation in the month
(see 4300 - Assistance Planning).
Note: Anytime
a minor's health, safety, or current medical condition is judged to
be at risk, a referral to Prevention and Protection Services would
be appropriate.
- Facilitators (Medical Only)
- An individual may grant limited authority to a person who is assisting
in the medical application process. This individual would not be a
medical representative and may not apply on behalf nor sign an application
for the minor, or request a fair hearing on behalf of the minor. They may share and receive information concerning the
case depending on the scope of authority granted. This individual
would not be responsible for completing review forms or reporting
changes. Their role would be confined to helping the individual with
the application process.