410 IAC 3.2-2-6 County department responsibilities in application process

Sec. 6. (a) The county department shall accept and act on all applications, signed by an applicant, except as provided in section 4 of this rule and 410 IAC 3.2-4-1. (b) The county department shall be responsible for assisting in the completion of the application form and for all other activity necessary to determine whether the child is financially eligible or ineligible for services under the CSHCN program. The county department shall submit to the state department of health its recommendations concerning the financial eligibility or ineligibility of the child. (c) To assist in the completion of the application process, the county department shall do the following: (1) Accept applications for the CSHCN program in accordance with section 1 of this rule. (2) Explain the information that the applicant needs to supply the county department. (3) Assist the child and family in completing the CSHCN and Medicaid applications. (4) Explain the available CSHCN program health care and care coordination services. (5) Inform families that they are required to inform the county department or state department of health of significant changes in financial circumstances or of a change of address. (6) Explain the eligibility requirements. (7) Explain the appeals process. (8) Verify the child's age by reviewing the child's birth certificate. (9) Verify the child's residency by reviewing at least one (1) of the following: (A) Rent or property payment receipts. (B) Utility records. (C) City directory. (D) Voter's registration. (E) Driver's license. (F) Federal income tax returns. (10) Explain any other information provided or requested by the director. (11) Document the type of services that the applicant is requesting. (12) Document the child's medical problem according to the applicant. (13) Document the name of the physician or other provider, including hospitals or emergency departments, that last examined the child and the date and location of the most recent physical examination. (14) Document health insurance information in accordance with 410 IAC 3.2-5-1. (d) Except as provided in section 4 of this rule and 410 IAC 3.2-4-1, the county department shall act on all applications and forward all applications to the state department of health within thirty (30) calendar days of the date of application. (e) The county department shall recommend denial of an application for one (1) or more of the following reasons, including, but not limited to: (1) Voluntary withdrawal by the applicant. (2) Location of the child or family is unknown. (3) Failure of the child or family to cooperate in the processing of the application. (4) For a child not enrolled as of December 31, 1992, the child or the child's family is financially ineligible for the CSHCN program. (5) Child or the child's family fails or refuses to apply for the Medicaid program in accordance with section 4 of this rule. (f) The county department shall forward to the state department of health, within thirty (30) calendar days of the date of application, the recommendation to deny an application. The county department shall include written documentation to substantiate the recommended decision.