HAR §17-1711.1-11
HAR §17-1711.1-11. Application counselors
Cite as Haw. Code R. § 17-1711.1-11
(a) The
department shall provide assistance to any individual
seeking help with the medical assistance application
or annual redetermination process in person, over the
telephone, and online, in a manner that is accessible
to individuals with disabilities and those who are
limited English proficient, consistent with
subsections 17-1711.1-2(b),(c) and (d).
(b) The department may choose to designate
organizations, subject to certification by the
department or designee to provide assistance to an
individual with the application or redetermination
process, to include but not be limited to:
(1) Completion or submission of an application
or redetermination form for medical
assistance;
(2) Interaction with the department on the
status of the application or
redetermination;
(3) Assistance with responses to the department;
and
(4) Case management following the initial
approval and subsequent redeterminations in
compliance with all federal requirements.
(c) Application counselors shall not sign forms
or receive notices on behalf of the individual unless
the individual appoints the application counselor as
the individual’s authorized representative under
section 17-1711.1-12.
(d) The application counselor must be:
(1) Authorized and registered by the department
or its designee to provide assistance at
application and subsequent redeterminations;
(2) Authorized by the applicant to function as
an application counselor on their behalf;
(3) Effectively trained in eligibility and
benefit rules and regulations for all
UNOFFICIAL
1711.1-6
medical assistance and insurance
affordability programs operated in the
State; and
(4) Trained in and subject to applicable federal
and State laws and regulations regarding
safeguarding and confidentiality of
information and conflicts of interest.
(e) Should the department elect to certify
application counselors, the department shall
establish:
(1) A designated web portal for the exclusive
use by certified application counselors for
purposes of providing assistance under this
section;
(2) A secure mechanism to ensure that certified
application counselors are able to perform
only those activities for which they are
certified; and
(3) Procedures to ensure that an individual
applying for medical assistance:
(A) Is informed of the functions and
responsibilities of a certified
application counselor; and
(B) Is able to authorize an application
counselor to receive confidential
information about the individual
related to the individual’s application
for or annual redetermination of
Medicaid.
(f) Services provided by a certified application
counselor shall be free of charge.
[Eff 09/30/13] (Auth: HRS §346-14; 42 C.F.R.
§435.908) (Imp: HRS §346-29, 42 C.F.R. §435.908)