PAA Section 300 Technical Eligibility Revised 1011 Sh
User Manual: 300 Technical Eligibility revised 1011
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DEPARTMENT OF HUMAN RESOURCES FAMILY INVESTMENT ADMINISTRATION TECHNICAL ELIGIBILITY 300.1 PUBLIC ASSISTANCE TO ADULTS MANUAL Section 300 07.03.07.03 Eligibility Criteria To be eligible for PAA in any month, an individual has to be: A. A resident of Maryland B. Receiving Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), or other cash benefits, or not receiving them through no fault of their own. C. Living in an Assisted Living program, a CARE home or in a DHMH Rehabilitative Residence. D. Meeting the requirements for income and resources described in Chapter 500 on Financial Eligibility. 300.2 Residency To qualify for PAA an individual has to be: A. A resident of Maryland B. A resident who resides in Maryland voluntarily and expects to stay here permanently. A recipient does not lose his resident status if he or she leaves the State for a limited period of time with intent to return. C. Living in an Assisted Living program, CARE Home or DHMH Rehabilitative Residence. D. .A recipient, who leaves the State to visit friends or relatives or to transact business and returns to his or her usual place of residence when the purpose of the visit is accomplished, remains a resident of Maryland. E. Do not pay PAA to an individual who has been absent from the state for more than thirty days. 300.3 Persons in Institutions A. Assistance may not be paid to an individual in a public or private institution for mental illness or to a resident of a public institution. B. A public institution is a facility that provides shelter or care to two or more individuals and operates under the management of a federal, state or local government agency. Revised 10/11 1 DEPARTMENT OF HUMAN RESOURCES FAMILY INVESTMENT ADMINISTRATION TECHNICAL ELIGIBILITY PUBLIC ASSISTANCE TO ADULTS MANUAL Section 300 07.03.07.03 C. A resident of a public institution is an individual living in a public institution and planning to remain there or is confined there by a court commitment. A person is not considered a resident under the following conditions: 1. Has a definite plan to leave during the current month or following month. For example, if an individual is in an institution on April 1, but plans to be discharged and enter a CARE home placement during the same month, the application can be taken on April 1. 2. Is attending a public education or vocational institution where he is receiving training and it is necessary for him to live in the institution for the duration of the training. 3. Is conditionally released from a public mental hospital and lives in the community where he does not have to abide by the rules and regulations of the hospital. He may be receiving help and guidance from hospital (usually on an outpatient basis) which is part of the treatment of his condition. Note: A customer returning to a state or private medical facility as a continuum of their care plan for a period less than 30 days is not considered institutionalized and retains PAA eligibility. 300.4 Application for SSI/SSDI A. Individuals who are not receiving SSI or SSDI must apply for these benefits as a condition of eligibility, and provide written verification of application. B. An individual is eligible for PAA while the application for other benefits is pending. C. After the application for other benefits has been denied if the denial is through no fault of the applicant, the customer should be advised to reapply for SSI or SSDI if his condition worsens. 300.5 Interim Reimbursement Agreement A. Each Assisted Living and CARE home (Project Home) applicant who is not already receiving SSI must sign the DHR/FIA 340 Interim Reimbursement Agreement. B. This form authorizes the Social Security Administration (SSA) to reimburse the local department from the customer’s lump sum benefit payment for PAA payments made during the period in which SSI eligibility was being determined. Revised 10/11 2 DEPARTMENT OF HUMAN RESOURCES FAMILY INVESTMENT ADMINISTRATION TECHNICAL ELIGIBILITY PUBLIC ASSISTANCE TO ADULTS MANUAL Section 300 07.03.07.03 C. Explain to the customer the requirement to sign the Authorization for Reimbursement of Interim Assistance (DHR/FIA 340) form to receive State benefits. D. If the customer has filed a claim with SSA, SVES or SDX shows an application filing date or a date indicating when the customer filed an appeal or a decision is pending. E. SDX or SVES also provides information about the Interim Assistance Reimbursement or IAR: 1. In SDX , check screen 2 for the IAR code; 2. In SVES, check screen 6 for the IAR Reimbursement code F. Below is a listing for the meaning of the number codes for the IAR and IAR Reimbursement fields in SDX and SVES: ¾ 0 = Essential person record. Applicant did not authorize reimbursement ¾ 1 = Total payment amount is being sent or was sent to a locality ¾ 2 = Part of the payment amount is being or was sent to a locality ¾ 3 = Reimbursement is not being made. Applicant is ineligible, or a retroactive payment is not due. ¾ 4 = Reimbursable assistance case is pending or denied ¾ 5 = Reimbursable check was returned Note: If a number from 1 to 5 is entered, do not have the customer sign a new 340. G. If there is a 0 entered, review and complete the DHR/FIA 340 and obtain the customer’s signature, and: 1. Give the Goldenrod copy to the customer; 2. Batch the Yellow copy to your LDSS finance office; 3. Retain the Pink and White copy in the permanent section of the case record, and 4. Enter the date the customer signed the 340 form in the IAR date field on the DEM2 screen. Note: The 340 form is sent to SSA via a system download. Do not send a copy to SSA. Revised 10/11 3 DEPARTMENT OF HUMAN RESOURCES FAMILY INVESTMENT ADMINISTRATION TECHNICAL ELIGIBILITY 300.6 PUBLIC ASSISTANCE TO ADULTS MANUAL Section 300 07.03.07.03 Living in an Assisted Living, CARE Home or Rehabilitative Residence To receive PAA an individual must have been certified for a licensed assisted living program, a CARE home, or a Department of Health and Mental Hygiene (DHMH) rehabilitative residence. A. Assisted Living means care given to an aged or disabled individual in a licensed protective environment. 1. DHMH licenses assisted living programs, COMAR 10.07.03. 2. Room, board, housekeeping and laundry services are provided. 3. Verification of need is documented on the PAA Disability Certification Form (DHR/FIA 4350). B. The Certified Adult Residential Environment (CARE) home, formerly known as Project Home, provides an alternative to institutional care for disabled adults. 1. CARE homes provide a supportive housing arrangement, help in reaching community resources, and protective oversight. 2. DHR’s Social Service Administration certifies CARE Homes. 3. Types of CARE Homes a. A private home that is the residence of the provider and serves a maximum of three residents. b. Supervised homes that is not the provider’s residence but may have live-in staff and serves no more than three residents. c. Group homes that may be the provider’s residence, have live-in staff and serves four to eight residents. C. DHMH Rehabilitative Residences are supervised apartments for disabled adults who have been recently discharged from state psychiatric hospitals. ¾ DHMH contracts with providers for supportive housing and community rehabilitative services for the residents. Revised 10/11 4
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