Current through Register Vol. 54, No. 44, November 2, 2024
(a)
Origin
of an application. The following shall apply to the initiation of an
application:
(1) The application process will
begin when a person indicates to the County Office by any action that he wants
his MA eligibility determined.
(2)
An application may be made prior to the need for service or at the time the
need for service arises.
(3) An
application will not be accepted on behalf of a person who has died, in
accordance with §
123.82 (relating to
definitions).
(4) An application
for MA may be made in person, by letter or by telephone.
(5) If because of illness, infirmity or a
physical or mental handicap a person is unable to apply for himself, a
relative, a friend or official of the institution or agency providing the
service may apply on behalf of the applicant.
(6) If the applicant has a guardian or other
legal representative, that person shall be expected to apply on behalf of the
applicant if he is available to do so.
(7) Regardless of the way an application for
MA is made, the county office will follow it up promptly with appropriate
action to decide whether or not the applicant is eligible.
(b)
Place of application.
The place of application shall conform with the following:
(1) Normally, application is made to the
county office in the county of residence. However, if the care is being
furnished in another county, application may be made in that county.
(2) If the person is not a resident of the
county in which application is being made, the completed application forms will
be sent to the county of residence, which will complete the determination of
eligibility. A person who is institutionalized for other than inpatient
hospital care will be considered a resident of the county in which the
institution is located.
(3) If a
resident is out of this Commonwealth and a request is received, the necessary
forms will be sent for completion to the institution providing the care and,
upon their return, eligibility will be determined and disposition
made.
(c)
Personal interview required. A personal interview with an
applicant is required. The required interview will be held within 60 days from
the date the application, Form PA 743 is received in the County Assistance
Office. Pending the interview, MA may be authorized for no more than 60 days on
the basis of the information in the application, as set forth in §
127.84(Reserved).
At the time of the personal interview, a Form PA-743R will be completed by the
County Assistance Office worker and signed by the applicant. If information
gained at the personal interview for Page 1, Form PA-743R, differs from the
information on Page 1, Form PA 743 taken at application, the clerical unit must
submit the new information to the Bureau of Data Processing via Form
PA-743RE.
(d)
Purposes of
the interview. The purposes of the interview are as follows:
(1) Review and evaluate the application form
for accuracy and completeness.
(2)
Inform the applicant of additional information or substantiating information
needed to determine eligibility or category.
(3) Explain to the applicant his rights and
responsibilities and obtain the signature of the applicant on the Form PA-743S
(Rights and Responsibilities).
(4)
Inform the applicant of the medical services available to him.
(5) Discuss with the applicant any other
information or regulations that are pertinent to his situation.
(6) Witness the signature of the
client.
(7) Complete a Form PA-743R
and obtain the signature of the client on it.
(e)
Disposing of an
application. Applications will be disposed of as follows:
(1) Applications will be promptly acted upon
and eligibility will be determined as quickly as possible, preferably within at
least 30 days from the date of application appearing on the Form PA 743. If
circumstances are such that the County Office is unable to make a decision
within the 30 day period, it may extend this period on condition that the
applicant is advised, by letter, of the reasons for the delay, the date he may
expect a decision, and his right to a fair hearing if he believes the delay is
unjustified.
(2) The application
process will end, and the application be disposed of, when one of the following
has taken place:
(i) The applicant is found to
be eligible.
(ii) The applicant is
found to be ineligible.
(iii) The
applicant withdraws or fails to complete the application.
(3) However, after the applicant has sworn to
and signed the affidavit, and service under the program has been received, the
application may not be withdrawn. The worker will record the decision and the
supporting evidence in the case record.
