Special Assistance SA-3110 APPLICATION PROCESS

Re-issued 11/01/11

I. INITIAL CONTACT

A. Participation in the Application Process

In addition to allowing an individual to place his/her own application for Special Assistance (SA) allow an authorized representative to apply for SA on behalf of an individual. If a representative is making the application, it is preferable (though not required) that the representative has some knowledge of the individual’s situation.

Note: Throughout SA policy any references to the applicant or the recipient also always apply to the applicant’s/recipient’s (a/r’s) authorized representative.

1. Although an individual can ask anyone to apply for assistance on his/her behalf, in order for a representative to receive the same benefits notices as the a/r he/she must be an authorized representative.

2. An authorized representative is any individual who is legally authorized or designated in writing by the a/r to act on behalf of the applicant/recipient.

The IMC must enter the demographics of the authorized representative (including name and address) in EIS at application disposition or for ongoing case any changes in the Authorized Representative information.

Each type of Authorized Representative is identified by an indicator code in EIS. They are listed below in hierarchy order followed by the correct EIS indicator code, “A” being first in the hierarchy of preference and on down to “H”, the lowest in the hierarchy of preference. See DAAS Administrative Letter 10-14 for further instructions.

a. Legal guardian (includes DSS with custody or guardianship): Code ‘A’ in EIS

b. Power of attorney (POA); Code ‘B’ in EIS

c. Health care power of attorney; Code ‘C’ in EIS

d. Department of Social Services (placement responsibility only); Code ‘D’ in EIS

e. Spouse (Not separated); Code ‘E’ in EIS

f. Parent (For children under 21); Code ‘F’ in EIS

g. Authorized representative (An individual designated in writing by the applicant/recipient to assist with eligibility issues and who can have access to the information in the case file.); Code ‘G” in EIS.

h. Authorized representative as designated by SSA on SDX; Code ‘H’ in EIS

Example of Order of Hierarchy: John has a legal Guardian. He also has a spouse. The legal guardian would be the choice to key in EIS as the authorized representative.

3. Request a written statement by the applicant/recipient (a/r) from any non-relative who is applying on behalf of an individual authorizing the non-relative to act as his authorized representative. Do not refuse to take or deny the application if the statement is unavailable at application. If the statement is unavailable at application, request the statement as additional information. If the applicant is unable to write an authorization, document the reason in the case record.

4. Any time an application is being made by someone on the individual’s behalf, the following questions should be addressed during the interview. Document questions and responses in the SA case file:

a. Why is the individual not applying for himself?

b. Does the applicant have a legal power of attorney or guardian appointed by the Clerk of Superior Court?

(1) Guardianship – Appointed by Clerk of Superior Court

Guardianship is the legal relationship where an individual’s authority to make decisions is replaced with the authority of another (the guardian) when the Clerk of Superior Court finds the individual no longer capable of making decisions for himself. In North Carolina, the laws concerning guardianship are found in NC General Statute 35A.

See SA-3000, Definitions, for an explanation of the various types of guardianship. For further information, see the Division of Aging and Adult Services website regarding guardianship.

(2) Power of Attorney – Appointed by the Competent Adult

Power of Attorney (POA) is an official document by which a competent person (adult) appoints another competent person or persons to assist in managing affairs of the person making the appointment. The scope of the POA’s authority may be broad or narrow as specified in the official document. Both general and durable POA’s serve as attorneys-in-fact to act in legal matters. The POA ends when the person who made the POA appointment dies, or as a competent adult, revokes the POA authority. See SA-3000, Definitions, for an explanation of the different types of POA.

c. If applicant has a POA or guardian as described above:

(1) Document the POA or legal guardian’s name, address and phone number.

(2) Obtain a copy of the legal guardianship or POA appointment and file the document in the SA case file.

(3) Include the guardian or POA on all case correspondence.

(4) The guardian or POA may designate a representative to apply on behalf of the applicant

d. If the SA applicant does not have an appointed POA nor a court appointed guardian, document the name, address, or telephone number of the family member or other individual acting as representative of the applicant. Document the relationship of the acting representative to the applicant. Update this information in the SA case file at each review or change in situation. The applicant is not required to have a legally appointed decision maker in order to apply for SA.

e. Is the individual able to be interviewed by the Income Maintenance Caseworker either via the telephone or a home visit? If not, why not?

f. Is the individual able to sign the “Release of Information” form himself? If not, why not?

g. Explain to a representative(s) who is not the applicant’s legally appointed guardian or POA that information regarding the application and/or ongoing case cannot be released to the acting representative without written authorization by the applicant.

If the representative holds the applicant/recipient's legal POA or legal guardianship, he/she can sign the consent for release of information form for a/r.

5. Complete the DMA-5093, Daily Reception Log For Medical and Financial Assistance. Include the individual’s name, address, date, purpose of the visit, and outcome of the visit.

B. Explaining the Relationship of Special Assistance to the Federal SSI Program

1. Explain to each applicant that the SA program is a state supplement to the federal SSI program. If the applicant’s income is less than the federal benefit rate (FBR) for SSI, the individual is required to apply for SSI. (The FBR is the basic standard used in computing the amount of Federal SSI benefits for individuals and couples. The FBR is increased annually to reflect increases in the cost of living.)

2. Each applicant for SA must be informed that he/she must apply for all benefits to which the applicant may be entitled, including receiving the maximum benefit for which the applicant is eligible. This includes, but is not limited to SSI.