Page 35

Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M01 October 2013 Subchapter Subject Page ending with Page M0120 MEDICAL ASSISTANCE APPLICATION M0120.200 3

3. No Individual authorized to sign If the applicant is unable to sign the application and does not have an attorney in fact, authorized representative, or family substitute representative, the applicant’s inability to sign the application must be verified. Verification is by a written statement from the applicant’s doctor that says that the applicant is not able to sign the MA application because of the applicant’s diagnosis or condition. Follow these procedures: a. Determine if anyone has begun the process to have a guardian or conservator appointed for the applicant. b. If action has been initiated to obtain a guardian for the applicant, meaning a court guardianship hearing is scheduled on the court docket, request verification that the action is on the court docket. Give 10 days for this verification to be provided. If the verification is provided within the 10 day period, continue to pend the application until the guardian or conservator is appointed. If the application pends for 45 days, send written notice to the applicant to extend the pending application.

Once the guardian/conservator has been appointed, request verification of the appointment and that the application be signed by the guardian or conservator. Retain a copy of the application and mail the original application to the guardian/conservator. Allow 10 days for the signed application and guardian/conservator papers to be returned. If the application form and guardian/conservator papers are not returned to the agency by the specified date, deny the application because it is invalid. c. If guardianship/conservator procedures have not begun or have not been verified as being on the court docket, refer the applicant to Adult Protective Services (APS) in the local agency.

If the report to APS meets all criteria for a valid report, an investigation will be conducted to learn whether protective services are needed and, if so, what services are needed. The protective services identified will be provided or arranged by APS.

Continue to pend the application until the APS investigation is completed. If the completed APS investigation concludes that guardianship proceedings will not be initiated, the application must be signed by the applicant, or the applicant must sign a statement designating an authorized representative. Give the applicant 10 working days to return the signed application to the agency.

d. If the application form is not signed by the applicant or the authorized representative and returned to the agency by the specified date, deny the application because it is invalid.