Page 2020

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 95 Chapter 24 Long Term Care

• Assigning the case to a Worker. The Worker issues a DFA-6 to the client or his authorized representative to obtain any verification required to determine ongoing eligibility after the 30-day presumptive eligibility period. The DFA-6 has a 10-day time limit with the exception of spenddown cases. • Assuring that a decision regarding ongoing eligibility is made within the 30-day presumptive period, once the required verification is received. All ICF/IID applicants, other than those already admitted to and living in a certified facility, must apply for admission to the ICF/IID facility. • The staff at the ICF/IID facility may use the DFA-ICF/MR-1 to presumptively determine medical and financial eligibility. When this is done, the procedures discussed above are followed; or • When the application for ICF/IID is made using the DFA-2 or DFA-MA-1, and, thus no presumptive decision is made by the case management agency ICF/IID admission committee, the application is processed using SSI-Related Medicaid processing time limits. Eligibility is redetermined once a year and no interview is required.

NOTE: When the applicant’s eligibility for, or enrollment in, this program is pending, he must not be refused the right to apply for any or all Division of Family Assistance (DFA) programs.

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Page 2020

Official source

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 95 Chapter 24 Long Term Care

• Assigning the case to a Worker. The Worker issues a DFA-6 to the client or his authorized representative to obtain any verification required to determine ongoing eligibility after the 30-day presumptive eligibility period. The DFA-6 has a 10-day time limit with the exception of spenddown cases. • Assuring that a decision regarding ongoing eligibility is made within the 30-day presumptive period, once the required verification is received. All ICF/IID applicants, other than those already admitted to and living in a certified facility, must apply for admission to the ICF/IID facility. • The staff at the ICF/IID facility may use the DFA-ICF/MR-1 to presumptively determine medical and financial eligibility. When this is done, the procedures discussed above are followed; or • When the application for ICF/IID is made using the DFA-2 or DFA-MA-1, and, thus no presumptive decision is made by the case management agency ICF/IID admission committee, the application is processed using SSI-Related Medicaid processing time limits. Eligibility is redetermined once a year and no interview is required.

NOTE: When the applicant’s eligibility for, or enrollment in, this program is pending, he must not be refused the right to apply for any or all Division of Family Assistance (DFA) programs.