Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE
Subchapter 2 - APPLICANTS
Section 17-1711.1-11 - Application counselors

Universal Citation: HI Admin Rules 17-1711.1-11

Current through November, 2024

(a) The department shall provide assistance to any individual seeking help with the medical assistance application or annual redetermination process in person, over the telephone, and online, in a manner that is accessible to individuals with disabilities and those who are limited English proficient, consistent with subsections 17-1711.1-2(b),(c) and (d).

(b) The department may choose to designate organizations, subject to certification by the department or designee to provide assistance to an individual with the application or redetermination process, to include but not be limited to:

(1) Completion or submission of an application or redetermination form for medical assistance;

(2) Interaction with the department on the status of the application or redetermination;

(3) Assistance with responses to the department; and

(4) Case management following the initial approval and subsequent redeterminations in compliance with all federal requirements.

(c) Application counselors shall not sign forms or receive notices on behalf of the individual unless the individual appoints the application counselor as the individual's authorized representative under section 17-1711.1-12.

(d) The application counselor must be:

(1) Authorized and registered by the department or its designee to provide assistance at application and subsequent redeterminations;

(2) Authorized by the applicant to function as an application counselor on their behalf;

(3) Effectively trained in eligibility and benefit rules and regulations for all medical assistance and insurance affordability programs operated in the State; and

(4) Trained in and subject to applicable federal and State laws and regulations regarding safeguarding and confidentiality of information and conflicts of interest.

(e) Should the department elect to certify application counselors, the department shall establish:

(1) A designated web portal for the exclusive use by certified application counselors for purposes of providing assistance under this section;

(2) A secure mechanism to ensure that certified application counselors are able to perform only those activities for which they are certified; and

(3) Procedures to ensure that an individual applying for medical assistance:
(A) Is informed of the functions and responsibilities of a certified application counselor; and

(B) Is able to authorize an application counselor to receive confidential information about the individual related to the individual's application for or annual redetermination of Medicaid.

(f) Services provided by a certified application counselor shall be free of charge.

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