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COMBINED MANUAL

ISSUE DATE 12/2014

MFIP ILL/INCAPACITATED EXTENSION CATEGORY

0011.33.09

MFIP: See 0011.30 (60-Month Lifetime Limit) for an explanation of the 60-month lifetime limit and exceptions. See 0011.33 (MFIP Hardship Extensions) for an explanation of the requirements for hardship extensions. Also see 0011.33.03 (MFIP Employed Extension Category), 0011.33.06 (MFIP Hard to Employ Extension Category).

Counties may extend MFIP benefits for participants requesting extension under the ill/incapacitated category after 60 months when documentation is not available by the 60th month. Participants must cooperate with efforts to obtain the documentation and they may be responsible for an overpayment if they are later determined to not qualify for an extension. Also see 0011.30.03 (MFIP Transition Period). Participants with an ill/incapacitated extension are considered Family Stabilization Services (FSS) participants and ARE REQUIRED to develop an FSS Employment Plan and follow FSS requirements.

The following are the “ill or incapacitated” extension categories:

● Participants who are ill, injured, or incapacitated may be extended if there is professional certification of an illness, injury, or incapacity that is expected to last more than 30 days which severely limits the participant’s ability to obtain or maintain suitable employment. NOTE: Consider a participant to have met the employment related criteria for this category if the qualified professional determines that the participant’s condition prevents him/her from working 20 or more hours per week.

Participants who are pregnant may be extended under the ill or incapacitated category if there is a medical professional’s statement verifying that they are unable to work due to a medical condition, other than pregnancy, and the condition is expected to last for more than 30 days. The extension under ill or incapacitated lasts only as long as the illness or incapacity lasts.

Participants in this category are considered Family Stabilization Services participants and must develop an FSS Employment Plan (FSS EP). The FSS EP must include the treatment recommendations of the health care provider certifying the illness, injury, or incapacity. The extension may end for caregivers who do not follow treatment recommendations without good cause. See 0028.18 (Good Cause for Non-Compliance--MFIP/DWP). Good cause may be granted when the nature of a caregiver’s disability interferes with follow through on treatment recommendations.

● Participants who are needed in the home must provide verification that they are needed to provide care for another member of the assistance unit, a relative in the household, or a foster child in the household who has a professionally certified illness or incapacity that is expected to continue for more than 30 days. The verification of an illness/injury/incapacity must state that the participant is needed in the home to provide care, but it does not have to include the extent to which the participant is needed in the home. Participants in this category are considered FSS participants and are not expected to work.

● Participants with a child or an adult in the household who meets the special medical criteria for home care services or a home and community based waiver services program, severe emotional disturbance, or serious and persistent mental illness. Those meeting the special medical criteria must be receiving or eligible to receive these services or programs. Participants in this category are considered FSS participants and presumed to be unable to work. See 0011.36 (Special Medical Criteria).

If the participant’s health care provider cannot or will not provide the information needed to determine if the participant is eligible for a hardship extension, obtain a release of information from the participant authorizing you to contact the health care provider. Explain to the health care provider that this information is needed to determine if the participant is eligible for a hardship extension. If the health care provider still does not respond, contact the consumer representative at the health plan. If the health plan does not respond, contact DHS Health Care Purchasing Division, at 651-431-2478. Indicate which health plan you have contacted.

DWP, SNAP, MSA, GA, GRH: No provisions.