Md. Code Regs. 10.09.11.04

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.11.04 - Application

A. The local health department or the local department of social services shall determine eligibility for pregnant women and children.

B. The local health department or the local department of social services shall give oral or written information about the eligibility requirements, coverage, scope, and related services of the Maryland Children's Health Program, and an individual's rights and obligations under the Program, to any individual requesting this information.

C. The local health department or the local department of social services shall make the application form available without delay to an individual requesting one.

D. A resident temporarily absent from the State but intending to return may apply for assistance by mail to the local health department or the local department of social services in the jurisdiction in which the resident's home is located. The individual shall demonstrate the individual's continued residency in the State and shall meet all technical and financial requirements in order to be determined eligible.

E. Application Filing and Signature Requirements.

(1) An individual who wishes to apply for the Maryland Children's Health Program under this chapter shall submit a written and signed application form to the local health department or the local department of social services in the jurisdiction in which the individual's residence is located. An applicant is responsible for completing the application but may be assisted in the completion by an individual of the applicant's choice.

(2) For the purpose of establishing only the date of application, the applicant, or a person acting on behalf of the applicant, shall sign the application form.

(3) For the purpose of establishing eligibility of a pregnant or postpartum woman of any age, the applicant shall sign the application form.

(4) For the purpose of establishing eligibility of a child applicant who is neither pregnant nor postpartum, a parent or stepparent living with the child shall complete and sign the application form. If the child does not live with a parent, an authorized representative who is 21 years old or older shall complete and sign the application form.

F. The date of application shall be the date on which a written, signed application is received by the local health department or the local department of social services. The application may be mailed or hand delivered to the local health department or it may be hand delivered to the local department of social services.

G. An individual who has filed an application may voluntarily withdraw that application but the application form remains the property of the local health department of the local department or social services and the withdrawal does not affect the periods under consideration specified under §H of this regulation.

H. Period Under Consideration. The local health department or the local department of social services shall establish a period under consideration based on the date of application established under §F of this regulation. For both a pregnant or postpartum woman and a child, the period under consideration is the 12-month period beginning with the month of application.

I. Processing Applications-Time Limitations.

(1) When an application is filed at the local health department, a decision shall be made promptly but not later than 10 days from the date of application. When an application is filed at the local department of social services, a decision shall be made promptly, but not later than 30 days from the date of application.

(2) The time standards specified in §I(1) of this regulation cover the period from the date of application to the date the local health department or the local department of social services mails notice of its decision to the applicant.

(3) The local health department or the local department of social services shall inform the applicant in writing of the missing information needed to determine eligibility, and the applicable time limit of 10 or 30 days.

(4) When an applicant fails to complete the application form or to provide the required information needed to determine eligibility within the 10 or 30 day limit provided under §I(1) of this regulation, the applicant shall be determined ineligible.

(5) If an applicant is determined ineligible for the current period under consideration due to a technical factor, the application shall be disposed of and the application date may not be retained. If the applicant reapplies, a new period under consideration shall be established based on the date the new application is filed.

(6) Reactivation of an Application Following a Decision of Ineligibility.

(a) A request for current eligibility following the rejection of an application for failure to provide required information or verifications is considered a reactivation of the appropriate earlier application if the request is filed within 6 months of the earlier application.

(b) The reactivation period applies to the earliest rejected application for which the period under consideration has not expired.

(c) The applicant may establish eligibility at any time during the reactivation period.

J. Required Information.

(1) The information needed to determine eligibility for the Maryland Children's Health Program, including an applicant's earned and unearned income, shall be accepted, without written documentation, by the local health department or the local department of social services.

(2) Written verification of the income of a parent or spouse whose income is considered in determining the eligibility of the applicant shall be required if the parent or spouse does not submit a social security number.

(3) Written verification of any factor of eligibility shall be required if the eligibility worker determines that the applicant's statements are inconsistent with other available information.

Md. Code Regs. 10.09.11.04

Regulations .04 adopted as an emergency provision effective July 1, 1998 (25:15 Md. R. 1182); adopted permanently effective November 30, 1998 (25:24 Md. R. 1773)
Regulations .04 amended as an emergency provision effective July 1, 2001 (28:14 Md. R. 1319); amended permanently October 29, 2001 (28:21 Md. R. 1856)
Regulation .04I amended effective June 21, 2004 (31:12 Md. R. 911)