*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***

Chapter 07 - Applications

Effective:  June 1, 2012

07.15.20 - Minnesota Community Application Agent (MNCAA) Program

Archived:  June 1, 2016 (Previous Versions)

Minnesota Community Application Agent (MNCAA) Program

The Minnesota Community Application Agent (MNCAA) Program helps people enroll in Minnesota Health Care Programs (MHCP) by providing outreach and application assistance via participating community organizations. People can go to any participating organization that serves residents of the county where the applicant lives. A list of participating organizations is available on the DHS website. This list changes on a regular basis. For questions, contact the MNCAA Resource Center at 651-431-4448 or 866-468-6648.

Outreach Levels.

Level I.

Level II.

Level III.

MNCAA Resource Center at DHS.

Submitting MNCAA-Assisted Applications.

Date of Application for MNCAA-Assisted Applications.

Complete MNCAA-Assisted Applications.

MNCAA Resource Center Action.

Processing Agency Action.

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Outreach Organization Levels

There are three levels of health care outreach participation. Community organizations can choose their participation level.

Level I

Level I organizations contract with DHS to assist people applying for MHCP.

Some Level I organizations may be eligible to receive a $25 bonus for each applicant they assist who is successfully enrolled in MHCP. Organization staff members who assist with applications must be certified by DHS as an agent by completing one day of training.

Level I sites are contracted to:

n  identify potential health care enrollees,

n  assist potentially eligible enrollees to apply for MHCP,

n  assist applicants with obtaining documentation needed to determine health care eligibility,

n  offer use of fax and copy services, and

n  follow up as needed until an eligibility determination is reached.

Level II

Level II outreach organizations provide materials and referrals for application assistance to people they encounter who may be uninsured. Some Level II organizations may choose to assist with the application process but usually do not assist with the entire process.

Level III

Level III outreach organizations help raise awareness in the community but do not assist with applications. They provide information about Minnesota Health Care Programs through events in the community, health fairs and group presentations.

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MNCAA Resource Center

The MNCAA Resource Center, located at DHS, provides direct assistance to agents during the application process. Additionally, Resource Center staff will answer questions and provide assistance to:

l  Level I and Level II outreach organizations.

l  MinnesotaCare and county workers regarding cases submitted by agents.

Contact the MNCAA Resource Center at 651-431-4448 or 866-468-6648 for assistance.

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Submitting MNCAA-Assisted Applications

Agents may assist with an application for MHCP by using the Combined Application Form (CAF) (DHS-5223), the Minnesota Health Care Programs Application (HCAPP) (DHS-3417) or ApplyMN. In addition to the application, the agent will fax the following to the MNCAA Resource Center:  the Cover Sheet for MNCAA Contractors (DHS-5336), Permission to Share Information with Agencies Assisting with Applications (DHS-5337), and verifications needed for determining health care eligibility. The MNCAA must fax the application to the resource center no later than 25 days from the date of application.

Agents who assist applicants with a CAF that includes a request for cash or food support will immediately fax the CAF and available documents to the county agency in which the applicant resides. Applicants may choose to take or mail the CAF to the county agency themselves.

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Date of Application for MNCAA-Assisted Applications

ApplyMN applications are electronically date-stamped upon submittal. The date and time of submittal appear in the "Date Received" field. For more information, see Date of Application.

Agents using paper applications have the ability to set the date of application for health care. However, agents who assist with a CAF cannot set the date of application for cash or food support. The date of application for these programs is the date the county agency receives the application. The agent will inform cash or food support applicants that these benefits cannot begin until the county agency receives the CAF.

Upon receipt of a signed HCAPP or CAF that contains at least the applicant’s name and address, the agent stamps the application with their three-digit MNCAA ID number and enters the date they received the application in the ”Date received” box on the application. If the agent is working with a hospital or other health care providers who set the date of application via the Request to Apply for Minnesota Health Care Programs (DHS-3417B), a copy of this form, if available, will accompany the application.

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Complete MNCAA-Assisted Applications

A complete application for MNCAA submission purposes meets different criteria than a complete application for purposes of determining health care eligibility. A MNCAA-assisted application is considered complete for submission purposes when the following verifications, if applicable, are included with the application:

l  Identity.

l  Citizenship - If proof is not available, the completed Authorization to Request Birth Records (DHS-4841) should be included.  

l  Immigration status.

l  Pregnancy.

l  Income.

l  Assets.

Agents will also include a signed Permission to Share Information with Agencies Assisting with Applications (DHS-5337) with the application, unless the applicant chooses not to sign the form.

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MNCAA Resource Center Action

Upon receipt of a MNCAA-assisted HCAPP or CAF, Resource Center staff will review the application to determine if:

l  the application is complete according to MNCAA completion criteria. The Resource Center will contact the agent to attempt to obtain missing proofs.

l  there is an existing application or current health care eligibility. If an application is pending or current eligibility exists, a Resource Center staff person will note this for the processing agency.

The Resource Center will send a fax to the processing agency within one working day of receipt of an application at the Resource Center. The Resource Center will include in the fax:

l  the MNCAA application fax cover sheet,

l  the application,

l  all verifications, and

l  the status of missing verifications.

Additional verifications, other documents and information sent to the Resource Center after an application has been forwarded to the processing agency will also be faxed to the processing agency.

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Processing Agency Action

Process MNCAA-assisted applications according to current application processing standards.

l  Communication with an agent can occur only if the applicant has either:

n  signed the Permission to Share Information with Agencies Assisting with Applications (DHS-5337), or

n  submitted an approved release of information form.

Agencies may contact the agent to clarify information provided on the application or the agent may contact the processing agency to obtain information regarding the status of an application. Agencies may also refer an agent to the Resource Center for assistance.

l  Enter the date of application as either the date the agent entered in the ”Date Received” box on the HCAPP or CAF, or enter the date that appears in the "Date Received" field for an ApplyMN application. If a Request to Apply for Minnesota Health Care Programs (DHS-3417B) is on file or included, use whichever date is earlier. If a pending or approved application exists with a later application date than the MNCAA-assisted application date, correct the application date to indicate the earlier date and determine or redetermine eligibility as appropriate.

n  Contact the TSS Help Desk at 651-431-4100 or 800-383-7987 for assistance in correcting the MAXIS application date.

Note: The MAXIS application date cannot be changed if a notice has been generated. This includes SPEC/MEMOs, pending and approval notices. Enter case notes to indicate the reason for the discrepancy in MAXIS and change the eligibility begin date and application date on the approved RELG span in MMIS.

n  Document in MMIS case notes the correct application date for MinnesotaCare. MMIS will not allow a change to the ”APPL RECD DT” field on RCIN.

l  Enter the three-digit MNCAA ID as the referral source code in the ”Referral Source” field on the RCAD screen in MMIS. For information on completing application referral source information on MAXIS, see the following POLI/TEMP sections:  

"MNCAA Organizations"

n  Application Referral Source - Part 1 (TE02.07.437).

n  Application Referral Source - Part 2 (TE02.07.437.01).

n  Application Referral Source - Part 3 (TE02.07.437.02).

l  Send requests for missing information and verification directly to the applicant. A request for missing information and verifications must be sent to the applicant to satisfy health care notification requirements even if the agent has been contacted for the missing information and verifications.

l  Enter detailed case notes regarding the status of a MNCAA-assisted application. Include the following information for all MNCAA-assisted applications as follows:

n  MNCAA Application Received:

m Include receipt of Release of Information forms, with whom the release allows exchange of information and what information can be released.

m Document what verifications or information has been requested of the applicant and the date the request was made.

m Use standard case note procedures to document additional information.

n  MNCAA Verifications Received:

m Document the type of verification received and date received.

m Use standard case note procedures to document additional information.

n  MNCAA Resource Center Contact:  Document additional information provided by the Resource Center.

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