See policy memorandum dated 10/03/13 Verifications for Medical Programs.
See Medical Morsel dated 04/01/14 Electronic Verifications for Medical Programs.
If the applicant does not bring all of the required verification to the eligibility interview, give them a 2nd written notice that lists what is still needed. Allow 10 calendar days to receive the verification. Write the last day verification can be received on the notice. If the 10th day is not a workday, the last day is the first workday following the 10th calendar day.
When there is no eligibility interview because the person is applying only for medical and the application process cannot be completed without more information from the client, give them a deadline to contact the FCRC to provide the necessary information. Document the information needed and the deadline date in case notes. After the client contacts the FCRC to provide the necessary information and verifications are still needed, send a written notice that lists what is still needed. Allow 10 calendar days to receive the verification. Write the last day verification can be received on the notice. If the 10th day is not a workday, the last day is the first workday following the 10th calendar day.
If the verification must be obtained from a third party, tell the applicant that the application cannot be approved without the verification. Make sure they understand this. Make sure the notice tells them what to do if they do not get the verification from the third party by the last day. In this instance, the notice must tell the applicant to show DHS a copy of the written request to the third party if verifications are not received by the last day.
For Nursing Facility (NF), Supported Living Program (SLP) and Department on Aging (DoA) Community Care Program (CCP) Applicants and Clients
For persons residing in a facility, always send a copy of HFS 267LTC to the facility.
The nursing facility or supported living program facility does not need to be authorized as an approved representative to receive a copy of the 267LTC.
When the person requests more time to obtain requested verifications, grant a 30 day extension. A second 30 day extension may be granted, upon request, if needed.
Whenever an extension is granted send HFS 267LTC to the applicant/client and a copy to the facility where the person lives, if applicable.
Simplified Processing for Determining Income and Resource Eligibility for Medical Benefits
Apply this policy when determining eligibility at initial application, at redetermination and when changes are reported. This policy applies to Community and Long Term Supports and Services (LTSS) applicants and clients.
- Accept receipt of Supplemental Security Income (SSI) as verification of financial eligibility for both income and resources for individuals who are receiving SSI.
- Accept receipt of SSI as verification of financial eligibility for individuals who were receiving SSI when they were admitted to a nursing facility.
- Accept the individual's current written statement declaring that their resources are below the resource standard for the program, unless questionable, when their verified income is at or below 100% Federal Poverty Level (FPL).