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A. Inform the applicant that his/her Social Security number(s) will be used to match information with other agencies such as the Internal Revenue Service and SSA. Further explain that the Social Security number will be used for the ESC/UI match. Inform the applicant that matches will be done unless withdrawal of the application is requested. Obtain applicant’s signature on the DMA-5001 Notice on the Use of Social Security Numbers.
B. Request the applicant to sign a release of information. Only the applicant, the applicant’s legal guardian or the applicant’s duly appointed POA can legally sign the consent form. If a legal guardian or an appointed POA is signing for the applicant, they must sign the applicant’s name followed by their own name. Refer to DSS-6969, Consent for Release of Information for a suggested form.
C. Explain to the applicant that it is the county's responsibility to use collateral sources to substantiate or verify all necessary information to establish eligibility. An exception would be when a close relative instead of the county must verify state residency. See SA-3250, Residence, II. Collateral sources of information include knowledgeable individuals, business organizations, public records, and documentary evidence.
D. Inform the applicant that name(s) of collaterals, such as landlords, employers, and others with the knowledge of the applicant’s situation must be provided. If the applicant denies permission to contact necessary collaterals, the application shall be denied due to failure to cooperate in establishing eligibility.
E. Explain that a caseworker may visit the applicant’s residence or SA facility if necessary to verify eligibility requirements.
F. Explain Carolina ACCESS, the managed health care program for Medicaid and North Carolina Health Choice (NCHC) recipients. The county dss must either enroll recipients in Carolina ACCESS or exempt recipients at application, redetermination or any time a recipient contacts the agency to request a change in CA enrollment status. Refer to MA-2425, Community Care of North Carolina/Carolina Access (CCNC/CA) for instructions.
G. Explain that SSI payments and any other income the applicant receives will be considered in computing SA payments.
H. Completing the FL-2/MR-2:
Explain that SA facility placement is based on need as indicated by medical information and recommended level of on the FL-2 or MR-2 or on the Assessment Type of the FL-2e.
If the FL-2/MR-2 form has not been completed and presented to the caseworker in the intake interview, give a blank form to the applicant for completion by the applicant’s physician (MD), physician assistant (PA), or nurse practitioner (NP). See SA-3100 Eligibility, for complete instructions regarding the FL-2/MR-2 requirement
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office.
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