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SA policy requires that an application for SA (SA) be made in the applicant’s county of residence. The definition for county of residence for SA is found in SA 3250, Residence. Applicants or their representatives may appear at the county DSS where they are currently residing in an SA facility or at a county that is convenient for the representative to apply. The a/r must not be required to travel to the county of residence. An application taken by an income maintenance caseworker (IMC) at a DSS outside of the individual’s county of residence is a courtesy application.
NC law requires that an application shall be allowed without delay or on the same day the applicant appears at the county department. When it is discovered that an individual is a resident of another county by SA definition, the county must follow the procedures listed below.
Each DSS must have a designated contact person for courtesy applications. The contact for the
county taking the courtesy application will assure that the correct procedure is followed. The county of residence contact will approve the acceptance of the courtesy application and follow through on its completion. Prior to beginning the application process, the county in which the individual or his representative appears must verify with the contact person in the county of residence that a courtesy application will be accepted.
If the county of residence agrees to accept the application, staff at the DSS where the a/r presented to apply, will complete the courtesy application process, ensuring that information is accurate, legible, and thorough. A thorough application includes the items listed under B. Procedures, below.
It is the county of residence’s discretion whether to allow a courtesy application interview to be completed by another county DSS. If the county of residence does not wish to allow a courtesy application to be taken by the county where the applicant/representative has presented, the county of residence must determine how the applicant can apply without delay.
1. An applicant appears at his/her local county DSS to make application for SA. (Usually this is the DSS in the county where the SA facility is located but could also be where the applicant’s representative lives).
2. Local county DSS staff begins the application process, determining county of residence.
3. If it is determined that the county DSS taking the application is not in the county residence, staff will notify their agency’s appointed contact person. The agency appointed contact is the staff person responsible for assuring that the agency’s courtesy applications procedures are followed.
4. The contact person will immediately phone the contact person at the DSS in the applicant’s county of residence to request permission to take the SA application. The contact person should document name and phone number of the staff contact giving permission and give his/her name and phone number, as well as that of staff taking the application, to the county of residence DSS.
5. Staff completes the application process, ensuring that information is accurate, legible, and thorough. A thorough application includes, but is not limited to:
a. DAAS-8190-NS, Special Assistance Workbook for Non-SSI Recipients, or DAAS-8190-S, Special Assistance Workbook for SSI Recipients, with complete name, address, and contact number for applicant and/or representative;
b. DMA-5094, Notice of Your Right to Apply for Benefits
c. DSS-8124, Application Processing Form;
d. DSS-3431, Request for Financial Information;
e. General Consent;
f. Income Information;
g. Resource Information;
h. Tax check information (including parents’ names, spouse’s name(s), spouse’s parents’ names);
i. All other available online verifications (IMS, SOLQ, ESC, FSIS, DOT).
j. DMA-5097, Request for Information (which must include the request for FL-2/MR-2);
Note: If a disability determination is necessary or being requested, refer to MA-2525, Disability.
k. Complete all necessary computer matches.
6. It is recommended that the contact person review the completed courtesy application information and approve it prior to forwarding the application to the county of residence. The contact person should sign the application as reviewed when it meets courtesy application standards.
7. The completed, thorough, and legible application will be faxed to the DSS in the applicant’s county of residence within 24 hours or one work day, if the application date falls on day before a weekend or holiday and mailed via USPS or state courier within 2 work days. Notify the contact person at the applicant’s county of residence that the application has been mailed. Be sure to maintain a copy of the information in the event that the information is lost or destroyed in the mailing process.
8. Within two workdays of receipt, mail any additional information that is received to the county of residence.
9. The date of application is the date the application form or base document was signed by the individual.
10. The county of residence must:
a. Document the initial contact from the county taking the application.
b. Acknowledge receipt of the application in writing.
c. Process the application following SA procedures.
d. Maintain the case.
11. If the county of residence will not accept the courtesy application, notify the individual or his representative that he must file the application in the county of residence. Provide the individual or representative with the office address and phone number of the DSS agency in the county of residence. The county of residence must determine how the applicant can apply without delay on the same day that the individual presents to the DSS.
12. If after taking the application, the DSS learns that the applicant is a resident of another county, the DSS with the open application must process the application.
Once the application is approved, clearly document the now ongoing recipient’s SA case file with verification of correct county of residence. Reference SA 3250, Residence, II. B. Call the designated contact person in the recipient’s correct county of residence to facilitate reassignment of the now ongoing case to the correct county of residence. Follow procedures in EIS 3500, County Transfers for Active Cases to transfer/reassign the case to the correct county.
The county of residence should use the DSS-2216 to request the records of the application or active case.
A suggested form to notify the recipient of the change in the county DSS which will be maintaining the case is provided in DAAS-3001 Notice of County of Residence Reassignment/Transfer.
13. If the county DSS discovers that for an active, ongoing case, the SA recipient is a resident of another county, clearly document the recipient’s SA case file with verification of correct county of residence. Reference SA 3250, Residence, II. B. Call the designated contact person in the correct county of residence to facilitate reassignment of the active SA case. Follow procedures in EIS 3500, County Transfers for Active Cases to transfer/reassign the case to the correct county.
The county of residence should use the DSS-2216 to request the records of the application or active case.
14. If an applicant applies in more than one North Carolina county, the county of legal residence will process the application protecting the first date of application.
15. In the event there is a dispute between counties concerning the above procedures, contact the SA Program Representatives through the listserv at specialassistance@dhhs.nc.gov.
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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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