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Customers identified in this section may not be able to gather proof needed for the eligibility process and may need extra help.
The state worker will make reasonable efforts to obtain proof on behalf of the customer when the customer is unable to cooperate with the application process because the customer:
· Is Homeless,
· Has a physical or mental impairment, or
· Is Incapacitated.
When a customer is incapacitated, a Physician’s Statement of Incapacity (DE-217) may be needed to help get information to approve eligibility. For example, it may be needed to authorize release of financial or medical information to the Agency.
Customers may be referred to a Public Fiduciary when there is no one with the authority to manage the customer’s affairs or willing to help in the application process.
See Public Fiduciary Referral Examples
Term |
Definition |
Homeless |
A person who does not have a fixed residence. For example: · A public or private place not meant for human habitation; · A supervised shelter designed to provide temporary shelter to homeless persons. · A half-way house or similar place that provides temporary residence. · A room provided rent free in another person’s home for 90 days or less. · A place not designed, or ordinarily used, for sleeping. This includes places like a car, bus station, hallway, park, or sidewalk. |
Incapacitated |
A person who is physically and/or mentally unable to apply for Medical Assistance for him or herself and is unable to authorize someone in writing to act as a representative. · Incapacity is not an issue if the person is represented by: · Court appointed legal guardian or conservator; · Someone previously appointed by customer as a durable general power of attorney (POA) and the POA is still valid; · Someone previously appointed by the person as an Authorized Representative and the Authorized Representative form is still valid; · For customer’s under age 18, a natural or adoptive parent; · Spouse, unless divorced or legally separated; or · An adult who is in the customer’s MAGI Budget Group (MA602D). |
Program |
Legal Authorities |
All programs except QMB and KidsCare |
42 CFR 435.914 R9-22-1407 R9-22-1501(D) R9-28-401.01 |