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UPDATED: JANUARY 2012

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OTHER ELIGIBILITY REQUIREMENTS APPLICATION, CERTIFICATION AND RENEWAL

FACILITATED ENROLLERS

Description: Facilitated enrollers (FEs) assist applicants in the completion of the application. This assistance includes the following:

• Providing application assistance including: o seeing, copying and/or recording information about documents that verify eligibility requirements such as original identity and citizenship documents; o assisting in the completion of the application and o assisting in the collection of various documentation items; • Screening the family for the appropriate program; • Submitting the completed application, documentation and enrollment form to the local district; • Counseling the applicant on managed care plan selection, where appropriate; and • Following-up with the applicant to ensure that they complete the application process.

Policy: Effective April 1, 2010, an interview for Medicaid and FHPlus must not be required as a condition of eligibility. While an interview cannot be required, FEs are required to provide application assistance, as appropriate, to an applicant who seeks assistance in understanding the application process or with completing the application. The local district determines the applicant's eligibility for Family Health Plus, Medicaid and the Family Planning Benefit Program and is responsible for the enrollment of applicants into managed care plans as appropriate.

Persons requiring long-term care services such as nursing home care or personal care may not apply through facilitated enrollers.

References: ADMs 10 OHIP/ADM-4

01 OMM/ADM-6

INFs 10 OHIP/INF-1

GISs 11 MA/007

Interpretation: When an FE meets with an applicant or authorized representative and provides application assistance, the FE will receive and submit the application to the appropriate LDSS. In this situation, the FE must submit the application to the LDSS for an eligibility determination within 15 days. If upon agreement between an FE or health plan and (MRG)