32.03.04.21

.21 Determination of Eligibility to Receive Services.

A. An individual who wants to apply to be a participant in the Program shall file an application with the provider from which the individual wants to receive services. The Department shall provide an application form that individuals applying for the Program shall use.

B. Upon receipt of an application to receive services, the provider shall determine if the applicant meets the requirements of Regulation .20 of this chapter.

C. To determine whether an applicant meets the requirements of §A(4) and (5) of Regulation .20 of this chapter, a provider shall assess the applicant's functional abilities using an assessment form approved by the Department or arrange for an assessment through the Maryland Department of Health's Adult Evaluation and Review Services program. Unless more frequent evaluation is warranted, a reassessment to determine whether the applicant still meets the requirements of §A(4) and (5) of Regulation .20 of this chapter shall be conducted every 2 years using either the Adult Evaluation and Review Services program or an assessment form approved by the Department.

D. If a provider determines an applicant is eligible to receive services and if sufficient financial resources are available through participant's payments, State subsidies, or other sources to cover the cost of providing the congregate housing services needed by the applicant, the provider shall:

(1) Accept the applicant as a participant if the applicant has a signed lease for an apartment in the facility; or

(2) Place the applicant's name on a waiting list if the applicant does not have a signed lease for an apartment in the facility.

E. If a provider determines an applicant is eligible to receive services, but there are not sufficient financial resources available to cover the cost of providing the services needed, the provider shall place the applicant's name on a waiting list for subsidies.

F. If a provider determines that an applicant is ineligible for services, the provider shall notify the applicant in writing of the determination within 10 days after making the determination. The provider shall send a copy of the written determination immediately to the Department by mail and by fax machine.

G. A denial of eligibility notice issued under §F of this regulation shall include:

(1) The determination;

(2) The reason for denial;

(3) The specific regulation supporting the denial; and

(4) Information about other resources in the community that may be able to assist the applicant.