2000 - GENERAL ELIGIBILITY REQUIREMENTS

 

This section describes non-financial eligibility requirements which are common to all programs as well as those general program criteria specific to each. Assistance can only be provided when all applicable requirements have been met for a particular program.

 

2100 REQUIREMENTS COMMON TO ALL OR MOST PROGRAMS

 

2110 Act in Own Behalf - The client must be legally capable of acting in his or her own behalf.

 

2111Adults

 

  1. Legally Incapacitated – Legally incapacitated adults are not eligible to receive assistance unless such assistance is applied for by a guardian or conservator.

  2. Not Legally Incapacitated – For medical applications, the spouse, personal representative (as defined in 1522), person with a durable power of attorney (for financial decisions), or representative payee for Social Security benefits may apply on behalf of an adult who has not been determined legally incapacitated.

    For any other individual to apply, a signed written authorization from the person for whom they are applying must be obtained. The medical representative authorization section on the ES-3100.1 application form may be used for this purpose and must be signed by the adult and at least one witness. The designated medical representative shall act in the place of the individual for whom they are applying. The medical representative shall receive copies of all notices and is responsible for completing review forms and reporting changes.

    The medical representative should be someone who is trusted and knowledgeable about the individual’s circumstances and needs, including their income, resources and household situation. Except in very limited circumstances, it would not be appropriate to appoint or accept a medical representative who has little or no prior experience with the individual. This would include those whose primary interest is in collecting on outstanding medical bills rather than in fully representing the interests and needs of the applicant for medical assistance.

    In rare instances where the individual is unable to file their own application and obtaining a written consent is not possible, the application shall be accepted and a referral completed to Social Services to have a guardian or conservator appointed if appropriate. For example, an individual may have been in an automobile accident and is in a coma. The application would not be denied or delayed because an appropriate person is not available to file.

    When someone other than the individual is acting in their behalf, all notices must still be sent to the applicant/recipient in addition to the authorized representative.

  3. Facilitators – An individual may grant limited authority to a person who is assisting in the medical application process. This individual would not be a medical representative, but could share and receive information concerning the case depending on the scope of authority granted. This individual would not be responsible for completing review forms or reporting changes. Their role would be confined to helping the individual with the application process.

 

2112 Minors
 

  1.  Minors can act in their own behalf and receive assistance only under one of the following circumstances:
     

    1. A court has emancipated the minor by bestowing the rights of majority upon the minor. Such an individual is legally an adult.
       

    2. The minor is age 16 or 17 and is or has been married.
       

    3. There is no caretaker exercising parental control over the child or willing to assume parental control and one of the following circumstances exist:
       

      1. The parents of the minor are institutionalized per 4140.
         

      2. The minor has no parent who is living or whose whereabouts is known.
         

      3. The health and safety of the minor has or would be jeopardized by remaining in the household with the minor's parents or other caretakers. Such status must be documented by an independent source such as social services, law enforcement, religious authorities or a battered person's shelter.

        If local arrangements are made between EES and Children and Family Services (CFS), a referral may be made to CFS for assistance in determining the status of the minor's parents or other caretakers and any health and safety issues that would exist in such living arrangements. The determination of a minor's ability to act in own behalf under this provision must be approved by the EES Program Administrator or designee and documented in the case record.
         

    4. The minor is placed into independent living by SRS (If the minor's needs are being met by CFS or a foster care contractor, the minor may only apply on behalf of his/her child).
       

    5. The minor enters an approved transitional living program, such as MINK.
       

    6. The minor enters Job Corps or another approved adult-supervised living arrangement, and the EES Program Administrator or designee, on a case-by-case basis, determines it is in the best interests of the minor to allow the minor to apply in his or her own behalf. This decision must be documented in the case record.

      Once a minor approved to act in his or her own behalf leaves the group living arrangement, the EES Program Administrator or designee must determine if it continues to be in the minor's best interests to act on his or her own behalf and document the decision in the case record.

      The EES Program Administrator's approval is required only if the minor does not qualify to act in his or her own behalf based on one of the categories in a through (e) above.
       

  2. Minors who are unable to act in their own behalf are not eligible to receive assistance unless such assistance is applied for by a person meeting one of the following criteria:
     

    1. All programs Except Medical


      1. A parent or caretaker (as defined in 2220, 2221, 2222, and 2223). This includes an adult mandatory filing unit member in the situations noted in 2220.
         
      2. An adult household member (Food Stamps Only).
         
      3. A personal representative as defined in 1522 (General Assistance Only).

    2. For Medical only -
       
      1. A court-appointed legal guardian, custodian, or conservator.

      2. A representative payee for the minor’s Social Security benefits.

      4. A responsible adult, with whom the child resides, who meets the definition of a caretaker according to 2110.

      5. A responsible adult, with whom the child resides, who does not meet any of the above criteria can apply for the minor child if they are appointed as the authorized agent by the minor’s parent or legal guardian. This authorization is only for purposes of application and maintenance of the minor child’s medical assistance case with the Kansas Health Policy Authority and SRS. A completed ES-3108 - Appointment of Authorized Agent for Minor must be on record. This authorization is time-limited and a new authorization form is required at each certification.

      6. If the child’s parent or legal guardian cannot be located to assign an authorized agent, the relationship of the responsible adult to the child must be confirmed or substantiated. An individual’s statement and two corroborative pieces of evidence shall meet the burden of proof unless there is an independent reasonable basis to doubt the veracity of the statement. Corroborative evidence may include but is not limited to a written statement from a public or private licensed social agency, clergy, attorney, school official, medical provider, or other professional.

        This confirmation is time-limited. New verification is required at each certification.


    An individual who meets one of the medical assistance only criteria may also request prior medical coverage for the child. This is true even if the individual did not meet the criteria or was not living with the child during the prior medical period. However, eligibility shall be determined based upon the child's situation in the month (see 4300 - Assistance Planning).

    Note:  Anytime a minor’s health, safety, or current medical condition is judged to be at risk, a referral to Children and Family Services would be appropriate.





  3. Facilitators (Medical Only) - An individual may grant limited authority to a person who is assisting in the medical application process. This individual would not be a medical representative, but could share and receive information concerning the case depending on the scope of authority granted. This individual would not be responsible for completing review forms or reporting changes. Their role would be confined to helping the individual with the application process.