OBSOLETE POLICY CHIP MANUAL |
Effective: July 1, 2011
Persons who are eligible for CHIP have the right to receive correct and timely benefits. They have the right to receive proper notice if there is a change in the benefits for which they qualify. In most situations, this means the notice must be written, adequately explain the action, and sent in a timely manner. (See section 803 for more rules about notices.)
In addition, all people have the right to:
Apply for CHIP. Any enrollee, who needs help from a DWS Associate or the state eligibility agency, has the right to receive that help.
A child living on his own may apply on his own behalf.
Be treated with dignity, courtesy and respect. This includes, but is not limited to being addressed as Mr., Mrs., Ms., or Miss; being told the name of any worker they contact; and being told clearly and courteously (verbally and in writing) which verifications and information he or she must provide.
Receive information about:
Programs and benefits: Enrollees have a right to receive information about medical programs including Medicaid and the Children's Health Insurance Program. It also includes information about the benefits of those programs.
Rights and responsibilities: This includes what the enrollee agrees to when signing the application as well as agency responsibilities. The enrollee also has a right to an explanation of the agreements he makes when signing the application form.
Requirements of the program: Enrollees have the right to information about their own eligibility as well as the proofs on which we based an eligibility action. This means enrollees can see information in their case files that was used to determine their eligibility. Anyone can look at a copy of the policy manual for any programs.
CHIP
Voter Registration Information: Enrollees have the right to receive information about how to register to vote. All applicants will be asked if they wish to register to vote. If the enrollee chooses to register to vote at application or review, complete voter registration form VOT-80. Each time an enrollee reports a change of address on a form, he or she will again be given an opportunity to complete a voter registration form. If the enrollee chooses to register to vote when reporting an address change, have the enrollee complete form VOT-81. If the enrollee has questions regarding the voting process, where to vote, etc., refer to form VOT-PM-82. Staff will assist enrollees to complete the forms in the same manner as staff would assist in completing an application for benefits. At no time will staff encourage enrollees not to register to vote, to join a particular political party, or to vote in a particular manner. Staff will tell enrollees that the decision about registering to vote will not affect their eligibility for CHIP.
Look at information in their case record that the eligibility agency uses to make an eligibility determination.
Protections Guaranteed under the Constitution and Law:
Non-discrimination: It is illegal to discriminate on the basis of race, religion, sex, age, national origin, political beliefs or disabling conditions. (Age of a child may affect eligibility for CHIP and/or certain Medicaid programs. However, these distinctions do not affect a person's right to apply for assistance.) Questions about ethnic background are for statistical purposes only.
Home Visits: If you must visit an applicant or enrollee after working hours, make an appointment. Do NOT enter an enrollee's home without his permission.
Due Process Rights:
Written notice: The enrollee has the right to be told in writing the reason for actions taken by the department which deny, reduce, or terminate his benefits, or when an application is approved. (See Section 803 for more information about time requirements for notices.)
The eligibility agency cannot close or take an adverse action without providing 10-day advance notice. This includes action taken regarding reviews and case changes. (See section 803-1 for exceptions to the advance notice requirements.)
Review of Decisions: The enrollee may request an agency conference to talk about his case. He may request a fair hearing any time he does not agree with an action on his case. (See Sections 120-1 and 120-2 for rules about agency conferences and fair hearings.)