109.01 Filing an Application (MAM-A)

SR 14-08 Dated 01/14

Previous Policy

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Applications can be submitted:

• online via the NH EASY website or through the Federally Facilitated Marketplace (FFM);

• in-person at the District Office (DO);

• via mail; or

• over the phone.

The official Filing Date for applications is:

• the date when the application is completed and received by the DO, if the completed application is received by the DO during business hours on a day that the DO is open for business.

• the next day the DO is open for business, if the completed application is received after hours or on a day when the DO is closed for business; or

• the date the FFM electronically transfers the application to NH, regardless of whether or not the DO is open for business.

If required by the program, personal eligibility interviews are in person at the DO or, if approved by the DO Supervisor, by telephone. MAGI-related medical assistance groups are not required to participate in an interview.

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A completed application must, at minimum, contain the applicants:

• name;

• address; and

• signature, or the signature of an authorized representative acting on behalf of the applicant.

Individuals have the right to file an application on the same day they contact the District Office.

Exceptions:

• When a resident of an institution applies for assistance prior to leaving the institution, the filing date of the application is the date the applicant is released from the institution.

• For individuals applying for MA at New Hampshire Hospital or any federally qualified health clinic or other agency or outreach site authorized to assist individuals with filing an application, the time frames begin from the date the application is filed at the facility.

Support Staff Process

Direct individuals to the NH EASY website or the DHHS website to apply for assistance, or provide the individual with DFA Form 800, Application for Assistance, upon request. If the paper DFA Form 800 is provided:

• Assist the applicant in completing the form, if requested.

• When the individual returns the application, review to ensure the application is complete as described above, and then date stamp the application.

• Complete the "Agency Use Only" section on the back of the first page (the Coversheet) of the DFA Form 800, indicating the date the application was received.

• Review the application for eligibility for expedited Food Stamp benefits. All individuals potentially eligible for expedited Food Stamp benefits are interviewed on the same day that the application is filed. If the applicant cannot be interviewed on the date of application, schedule a personal or phone interview for the next business day or when it is otherwise convenient for the applicant.

• For all other individuals, schedule the individual for an eligibility interview by completing Client Registration (CR) in New HEIGHTS and using the "Schedule Individuals" screen. Do not initiate or print Form 800H, also known as the HAF, at the conclusion of CR. Write a note on DFA Form 797, Eligibility Narrative, to notify the FSS that CR has been completed.

• Give the DFA Form 800 Coversheet plus New HEIGHTS-generated letter CS0002, Schedule Initial Interview, DFA Form 800A, DFA Program and Services Guide, and all other applicable forms to the individual.

• Create an electronic case file for the individual.

Filing of an Application Received in the Wrong DO

If an application is mailed to the wrong District Office (DO), date stamp it and forward it to the appropriate DO on the same day that it was received, unless it meets the criteria for expedited Food Stamp benefits. If information on the application indicates the household is eligible for expedited benefits, process the Food Stamp portion of the application immediately.

If an individual contacts the wrong DO, give the individual the address and telephone number of the correct DO, and offer the individual the opportunity to complete an application that same day.

If the individual hand-delivers an application to the wrong DO, schedule an appointment for the correct DO and forward the application to that office. Give the individual the address and telephone number of the correct DO, with the CS0002 indicating the time of the individuals appointment in the correct office.

Special Procedures for Applications Filed by Mail

Once a mailed DFA Form 800 is received in the DO, support staff review all the information on the application and complete the "agency staff only" boxes on the application. Most applicants will then be scheduled for the next available interview appointment. However, the following applications are not immediately scheduled for an interview:

• applications containing information indicating potential eligibility for Expedited Food Stamp benefits. These applications are given to the Supervisor for review once the support staff determines potential eligibility. If the Supervisor confirms the potential eligibility, support staff calls the applicant to schedule an interview for the next business day, or another day convenient to the applicant. If the applicant cannot be reached by phone, an interview is scheduled no sooner than 5 business days from the date of application; and

• applications containing information indicating no potential eligibility for any DFA assistance program or service requested. These applications are given to the Supervisor for review as well. If the Supervisor confirms that there is no potential eligibility for all assistance requested on DFA Form 800, or DFA Form 800MA, the DFA worker may deny all assistance requested without an interview.

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References: He-W 601.01(n) & (p), He-W 601.03(a), He-W 602.03, RSA 167:8,I, 7 CFR 273.2(b)(3), 42 CFR 435.907, 42 CFR 435.911, 42 CFR 435.1200(e), 45 CFR 206:10(a)(1) & (b)(1)-(3)