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Wisconsin Department of Health and Family Services Obsolete Medicaid Eligibility Handbook For the current MEH, see http://www.emhandbooks.wi.gov/meh-ebd/ For the current BC Plus Handbook, see http://www.emhandbooks.wi.gov/bcplus/ |
2.1.5.2.1 Women, Infants, and Children ( WIC ) Referral
Make an eligibility decision for each completed application filed in your agency.
Once the client has completed the application process, complete the following using CARES Client Assistance for Re-employment & Economic Support and the appropriate policy documents:
Determine each person's eligibility.
Document case actions and circumstances in CARES case comments.
Notify the client on a CARES notice of decision or a manual positive or negative notice regarding his/her eligibility.
If a Supplemental Security Income Income is anything you receive in cash or in kind that you can use to meet your needs for food, clothing, and shelter. ( SSI ) applicant/recipient or authorized representative submits an application at both the SSA and IM Agency, provide a notice of decision for each IM Agency application.
A signed application form is an application for assistance. Applications are recorded as applications and must be formally disposed (IMM, Ch. I, Part A, 28.0.0). Withdrawing an application ends the application process already begun. Withdrawal does not negate the fact that the application was filed.
Only the applicant can decide to voluntarily withdraw an application. Some examples of when this might occur include:
Relatives are voluntarily willing to support.
The applicant does not wish to comply with one or more requirements.
The applicant knows s/he is not eligible.
Have the client complete a Voluntarily Declining Aid form ( DWSW 2233 ) . Withdraw the case in CARES. This establishes an official date of application for determining any potential divestment of assets.
When you determine a group is eligible:
Approve the application for those MA subprograms in which the eligibility requirements have been met, or process a ( HCF 10110, formerly DES 3070 ) when an eligibility decision is made manually.
Notify the client on a CARES-generated Notice of Decision or Positive Notice ( HCF 16015 ) of the benefits for each program approved.
File in the case record a copy of all forms completed and sent that are not in the CARES history file.
Whenever you approve MA to a group including a woman who is pregnant or recently gave birth or a child under five years old:
Refer the group to your local Special Supplemental Food Program for Pregnant Women, Infants, and Children ( WIC ) Program.
CARES-generated notices will provide such a referral notice automatically.
When you provide a manual positive notice to the MA group, include the following statement:
"If someone in your household is pregnant, breastfeeding, has recently given birth or is under age five, you should be aware that for these persons a Special Supplemental Food Program for Pregnant Women, Infants, and Children ( WIC ) exists in your area. If you are interested, please call (insert your local WIC project's name here) at (insert your local WIC project's phone number here).
Provide the group with the WIC program pamphlet.
Obtain copies of the pamphlet from your local program office of the Department of Health and Family Services, Division of Public Health.
An ineligible person may be eligible if s/he applies for MA on his/her own behalf on a separate application. Therefore, it is important to remember that a finding of "not eligible" in some instances may only mean "not eligible" as part of this application.
When you determine a group is ineligible:
Deny the application for those subprograms for which eligibility requirements have not been met.
Deny the application when the client does not provide information necessary for a determination.
Notify the client on a CARES Notice of Decision or Negative Notice ( HCF 16001 ), of each program for which s/he is not eligible.
File, in the case record, the information on which the denial is based and a copy of the notice sent if not in CARES.
Send the applicant a CARES Notice of Decision or both a Positive (HCF 16015) and a Negative (HCF 16001) Notice when any of the following occurs:
The client is found eligible for a program and ineligible for another.
The client is found eligible for a program and is discontinued from another.
The application is approved, but a person in the group is denied.
Any other approval and denial combination.
This page last updated in Release Number : 04-03
Release Date: 08/02/04
Effective Date: 08/02/04
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