PAA Section 200 Application Revised 1011

User Manual: 200 Application revised 1011

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DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 1
200.1 Application Process
The application process for Public Assistance to Adults (PAA) follows the
procedures outlined in COMAR 07.03.01, Application for Public Assistance.
A. Allow an individual requesting PAA or on whose behalf a request is made the
opportunity to apply.
B. Because of age or incapacitation, many PAA applicants will be unable to come to
the agency and apply in person.
C. Family members, personal representatives, or operators of facilities or their staff
may request PAA on behalf of an applicant.
D. Give applicants or their representative information about PAA program coverage
and about their rights and responsibilities.
E. PAA applicants or their representatives apply in the local department of social
services in the jurisdiction of intended residence.
F. In cases involving release from the hospital into a facility, the application may be
accepted and eligibility determined prior to the individual’s release (if all
information and verification required for eligibility determination are available).
1. The first grant may be issued to the hospital provided all needed verifications
have been received and eligibility has been established. This will enable the
individual to have sufficient funds to pay for his care in the community.
2. All subsequent checks must be mailed to the community address.
G. Family Investment case managers must make every effort to protect the interests
of a PAA applicant and help the customer to work through the application
process. Hospital social workers and case managers can provide assistance in
obtaining required verifications.
H. An individual may file an application for PAA, whether potentially eligible or not.
I. An individual applying for PAA may choose any person during any aspect of the
application process to assist him/her.
1. Applicants who do not speak English or have limited English proficiency must
have access to an interpreter. The local department is responsible for
providing an interpreter. The interpreter may be:
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 2
a. A local department staff member;
b. An individual designated by the applicant, or
c. An individual outside the agency who is proficient in the customer’s
language.
2. An interpreter cannot be a minor child.
200.2 Application Form
The applicant files for assistance on forms specified by the local department and
approved by DHR.
A. The application process starts with an application containing, at a minimum, the
applicant’s name, address, and signature (or signature of the applicant’s
authorized representative).
B. The LDSS may use either the DHR/FIA CARES 9711 Request for Assistance
Form or the CARES generated ARF after the case is screened.
1. A local department staff member stamps the date the 9711 is received to
record the filing date, and
2. The filing date must be recorded if the minimum information is completed, but
the local department can have applicants complete all the information on the
ARF.
C. Generate the rest of the application from the data entered into CARES during the
interview. Have the customer sign the 9707 Rights and Responsibility document.
D. The applicant signs the system generated application at the end of the interview.
¾ DHR captures voter registration information and provides all
applicants/recipients an opportunity to complete a voter registration form.
E. The local department may also use a paper application package, the DHR/FIA
CARES 9702 Eligibility Determination Document for One Person and a 9707
Rights and Responsibility Form
Note: Use the Paper Application Package when CARES is not available.
F. Accept all applications during the local department’s normal business hours.
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 3
G. The basic components of the application process are the same in each local
department, but the forms and sequence may differ. Basic forms are:
1. A signed and completed application from the customer/representative.
(Either a system generated eligibility determination document (EDD), or a
paper application (DHR/FIA 9702 or 9701)
2. The Consent for Release of Information form (DHR/FIA 704)
3. The Public Assistance Disability Certification form (DHR/FIA 4350)
4. The Authorization to Give Information form (DHR/SSA 220), if needed
H. The application must include a statement of the type of care:
1. Assisted living,
2. CARE home, or
3. Rehabilitative residence.
I. For CARE homes the application must include the level of care required:
1. Level A – minimal supervision;
2. Level B – moderate supervision;
3. Level C – extensive supervision, or
4. Level D – specialized and intensive supervision.
200.3 Face-to-Face Interview
If possible, the individual applying for PAA should be interviewed face to face.
A. The local department may waive the requirement for a face-to-face interview
because of the applicant’s physical or mental condition.
B. A hospital case manager (or other person knowledgeable about the applicant’s
physical or mental condition) may advise the FIA worker that a customer cannot
participate in a face-to face interview.
C. Applicant interviews may be on the day the application is filed.
D. If same day service is not possible, offer the first appointment on the next
available business day.
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 4
E. The applicant, an authorized representative, or someone acting responsibly for
the applicant when that person is physically or mentally incapacitated signs the
application under penalty of perjury.
200.4 Verification of Information
A. The case manager must verify the following PAA eligibility factors:
1. Countable income
a. Verify application has been made for all potential sources of income
b. Verify that the applicant is not receiving Social Security, SSI, or other cash
benefits through no fault of his or her own.
c. The receipt and amount of SSI may be verified via the State Verification
Exchange System (SVES), the State On-Line Query (SOLQ) or the State
Data Exchange (SDX). The SDX also contains information on the
amounts and sources of beneficiary’s income other than SSI.
Note: Provide narration when excluding income to support the exclusion.
2. Countable assets
3. Social Security Number
4. Immigration status of noncitizens
• Use SAVE to verify status of each noncitizen
• Send immigrants without current documentation to INS
• Do not make direct contact with INS unless specifically requested to do so
by the immigrant and all regular sources of verification have been
exhausted
B. The case manager may require verification for questionable information.
C. Give the customer verification requests in writing.
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 5
D. The case manager, during the interview:
1. Specifies what verification is needed
2. Discusses ways to obtain the verification
3. Discusses acceptable optional verifications
4. Sets a deadline to return verification, giving at least 10 days, and
5. Confirms that the customer can obtain the verification
E. The applicant or customer is responsible for obtaining verification
1. The case manager assists in obtaining the necessary verification if the
individual is:
a. Physically or mentally incapable of meeting the requirement, or
b. Lacks the resources to meet the requirement, and
c. Needs the case manager’s assistance to meet the deadline
2. The case manager will not limit acceptable proof to a specific document when
an eligibility factor can be verified in more than one way.
200.5 Medical Assistance
A. All PAA recipients are automatically eligible for Medical Assistance. Certification
is made in the Federal category regardless of whether the individual is receiving
SSI.
B. Medical Assistance begins the first day of the month that the customer is
determined eligible for the PAA grant.
200.6 Medicare Part B Coverage
A. Disabled customers may also be eligible for Supplementary Medical Insurance
Benefits (SMIB), also known as Part B of Medicare.
B. This program carries with it a premium per month and is administered by the
Social Security Administration (SSA).
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 6
C. The State pays the premium for Medical Assistance recipients. This is known as
the State Buy-In program.
D. For the most part, disabled customers who also receive Social Security are
eligible for SMIB and Buy-In within two years of the onset of their disability.
200.7 Assistance Unit
A. A PAA assistance unit always consists of one person.
B. When a married couple applies for PAA, establish two separate cases.
200.8 Non-Discrimination
A. A local department may not discriminate against any applicant or customer of
Family Investment programs on the grounds of:
1. Race
2. Color
3. National origin
4. Gender
5. Age
6. Marital status
7. Mental or physical disability
8. Religious or political affiliation
B. Based on the grounds listed in A, the local department may not:
1. Deny benefits and services;
2. Subject an individual to segregation or separate treatment;
3. Restrict the individual from any advantage or benefit of the program, or
4. Treat the individual differently in determining if eligibility requirements are
met.
C. An individual may file a written complaint setting forth the circumstances of
alleged discrimination with any of the following:
1. Secretary of DHR
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 7
2. Equal Opportunity Officer of DHR
D. DHR investigates promptly and informs the complainant of its findings within 60
days.
E. The case manager will:
1. Tell customers about their right not to be discriminated against and include
this information during the application and recertification process
2. Assist applicants and customers who want to file a complaint of
discrimination.
200.9 Confidential Nature of Records
A. Safeguard information about applicants and customers, keeping it confidential
unless disclosure of the information is specifically permitted.
1. Local departments must have written procedures for maintenance of case
files and the removal and return of information to case files.
2. Safeguard information from other state or federal agencies in accordance with
procedures established by the local department or the State.
3. When information can be disclosed, the individual receiving the information
must also agree to keep it confidential and use the information only for the
intended purpose.
4. When information cannot be disclosed, the local department or State agency
cannot acknowledge whether any records exist or whether the individual is
known to the agency.
B. The case manager gets the consent of the applicant or customer to request
verification from an outside source, unless it is needed for administrative
purposes such as fraud or overpayment documentation.
1. Inform the applicant, orally and with specific review of Form 9707 or the
attachment to application forms, that a signature on the application:
a. Includes consent for the local department to obtain information from other
sources.
b. Allows the local department to use social security numbers to match the
records of other agencies, organizations, and businesses.
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 8
2. Limit all requests for information to those that are needed to determine
eligibility.
Note: Some agencies, businesses, and organizations may require a consent
form specific to themselves before releasing information. When this occurs,
obtain the customer’s specific written consent or refer the individual to the
outside source to give consent.
200.10 Information Release Without Consent
A. Information may be released without the individual’s consent in the following
circumstances:
1. There is a court order
a. A subpoena is not a court order
b. If a subpoena is received:
i. Contact the local department’s attorney, or if not available, DHR’s
Office of the Attorney General at 410-767-7726
ii. The attorney will:
• Determine if Article § 88A , Annotated Code of Maryland, allows
disclosure without a court order
• Call the courts and request permission not to comply
• Request a court order if required
• Advise Family Investment staff of the decision and any required
actions
2. Local, State, or Federal officials are pursuing an investigation of any program
violation.
3. Local, State, or Federal officials or employees require the information for the
administration of the program.
4. A volunteer or contractor of a State or Federal agency, who has signed a
written agreement to abide by State and Federal confidentiality laws and
regulations, requires the information for administration of the program.
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 9
5. A Federal, State or local law enforcement officer presents the name and
social security number of a fugitive felon along with an arrest warrant that
establishes the individual as a fugitive felon.
200.11 Case Transfer
A. Transfer a case when the family moves from:
1. One county to another within Maryland, or
2. One district office to another within a county or within Baltimore City
B. Customers are responsible for notifying the case manager of the customer’s
intent to move to another jurisdiction prior to the actual move.
C. The clearinghouse worker:
1. Sends a message to the receiving jurisdiction of the pending case transfer.
2. Keys in the new local department or district office on CARES.
3. Completes the case transfer when appropriate.
D. Prior to transferring a case, supervisors, lead workers, or an agency designated
reviewer MUST:
1. Complete an assessment of the case readiness for transfer, including
documentation and narration that supports the eligibility decision.
2. Assure that, to the extent possible, all outstanding work is done prior to the
transfer.
3. Review each case to be transferred for:
a. Outstanding alerts – process, if possible, or transfer
¾ Alerts assigned to the IRN# (Client ID#) must be manually transferred
to the new case manager. Those that are assigned to the AU# will
transfer with the case.
b. Date the next recertification is due.
c. An INITIATED recertification on CARES – TRY to complete recertifications
already initiated on CARES before transferring.
DEPARTMENT OF HUMAN RESOURCES
FAMILY INVESTMENT ADMINISTRATION PUBLIC ASSISTANCE
TO ADULTS MANUAL
07.03.01.00
07.03.07.03
APPLICATION Section 200
07.03.07.15
Revised 10/11 10
¾ Retain automated scheduling of recertification appointments. To
achieve this, it is necessary to transfer a case regardless of where it is
in the cycle.
4. Make sure the new address is entered into CARES
E. The paper record, with the Case Record Transfer Form attached to the front, is
sent by certified mail to the new jurisdiction within 5 working days of the CARES
transfer.
F. The designated person in the receiving agency must review the case for:
1. Any outstanding alerts
2. Date the next recertification is due
3. A recertification that has been initiated, but not completed
G. If a customer moves and notifies the new agency office without having notified
the prior office, the new agency is responsible for taking action to provide
services
1. May include contacting the former jurisdiction
2. Call the CARES Help Desk for technical assistance if needed
H. If the PAA recipient moves into a living arrangement other than another licensed
Assisted Living home, certified CARE home or Rehabilitative Residence, close
the case.

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