2111 Adults

An adult for application purposes is defined as anyone 18 years of age or older. An adult’s capacity to act in their own behalf determines whether or not they are allowed to apply for assistance.

Legally Incapacitated - Legally incapacitated adults are not eligible to receive assistance unless such assistance is applied for by a: A legally incapacitated adult shall be defined as any adult who is impaired both physically and mentally by reason of mental illness, mental deficiency, physical illness or disability to the extent that he or she is unable to understand or communicate responsible decisions concerning his or her person, or to the extent the adult cannot effectively manage or apply his or her estate to necessary ends for whom a guardian or conservator has been appointed by the court. Guardian or Conservator. Medical Representative Representative Payee for Social Security A tax filer who claims (or intends to claim) the adult as a dependent on his or her federal tax return.

Not Legally Incapacitated - A competent adult may apply for assistance for himself or herself. Any adult who has not been determined to be legally incapacitated as described in subsection 1. above is presumed to be able to act in their own behalf. Act in own behalf is further defined as being able to perform all activities that a consumer would perform for themselves, including the ability to appoint an additional Medical Representative or Facilitator. The following additional individuals may apply on behalf of a competent adult without requiring authorization from the adult: The partner of the adult with whom there is a mutual child (including an unborn child). The spouse of the adult (see 4312(1) ). A tax filer who claims (or intends to claim) the adult as a dependent on his or her federal tax return. A person with a durable power of attorney (for financial decisions) for the adult. The representative payee for Social Security benefits for the adult. For an individual other than the adult or those listed in subsection (a) above to apply, the individual must be appointed by the adult as his or her medical representative. A signed written authorization from the person for whom they are applying must be obtained. The KC-6100, Medical Representative Authorization Form or medical representative authorization section on the application form may be used for this purpose and must be signed by the adult. Two witness signatures are required if the applicant/recipient signs with a mark. Attorneys representing the consumer must provide a statement on the attorney’s letterhead indicating they are representing the consumer in their Kansas Medicaid matter. The designated medical representative(s) shall act in the place of the individual for whom they are applying. The medical representative(s) shall receive copies of all notices and is responsible for completing review forms and reporting changes. Once appointed, the medical representative(s) shall have authority to act on behalf of the consumer until revoked or the medical representative passes away. The medical representative should be someone who is trusted and knowledgeable about the adult’s circumstances and needs, including his or her income, resources and household situation. Except in very limited circumstances, it would not be appropriate to appoint or accept a medical representative who has little or no prior experience with the individual. This would include those whose primary interest is in collecting on outstanding medical bills rather than in fully representing the interests and needs of the applicant for medical assistance. In rare instances where the adult is unable to file his or her own application and obtaining a written consent is not possible, the application shall be accepted, and a referral completed to Adult Protective Services (APS) to have a guardian or conservator appointed if appropriate. For example, an individual may have been in an automobile accident and is in a coma. The application would not be denied or delayed because an appropriate person is not available to file. When someone other than the adult is acting in his or her behalf, all notices must still be sent to the applicant/recipient in addition to the authorized representative.

Facilitators - An individual may grant limited authority to a person who is assisting in the medical application process. This individual would not be a medical representative and may not apply on behalf nor sign an application for the adult or request a fair hearing on behalf of the adult. They may share and receive information concerning the case depending on the scope of authority granted. This individual would not be responsible for completing review forms or reporting changes. Their role would be confined to helping the individual with the application process. A signed written authorization from the person for whom they are assisting must be obtained. The KC-6200, Facilitator Authorization Form or Facilitator authorization section on the paper application form may be used for this purpose and must be signed by the adult. Two witness signatures are required if the applicant/recipient signs with a mark. For Facilitators, the length of appointment is dependent on the form used to appoint. KC-6200 form - Six months from date of signature or through the application period, whichever is later unless a specific date of expiration is provided by the individual. If a specific date of expiration is listed which exceeds six months, the appointment shall last through the date specified or twelve months from the date the form is signed, whichever is shorter. Facilitator form within the KanCare paper application – Through the end of the application period. NOTE : The application period is the month following the month of eligibility determination.

Release of Protected Health Information Form – An individual may grant a specific person or organization to share and receive information concerning the case. This does not give authority to act on behalf of the adult or request a fair hearing on behalf of the adult. A signed written authorization from the person for whom they are requesting to share or receive information must be obtained. KC-6110, The Release of Protected Health Information form may be used for this purpose and must be signed by the adult. The length of appointment shall be the date entered on line 8 of the form, or 12 months, whichever is shorter.