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Effective: October 1, 2008 |
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03.50.15ar4 - Legal Factors for GAMC (Archive) |
Archived: June 1, 2011 |
People may be ineligible for General Assistance Medical Care (GAMC) if they have engaged in certain criminal activities. People must answer questions about the following criminal activities at the time of application:
1. Drug Felony Convictions.
2. Fraudulent Statements about Residence.
3. Fleeing Felony Convictions.
4. Violating Parole, Probation or Supervised Release.
This section explains how to collect information about these criminal activities and under what circumstances these criminal activities will make an applicant ineligible for GAMC.
Fraudulent Statements About Residence.
Violating Parole, Probation or Supervised Release.
Each health care applicant who qualifies for GAMC must answer questions about certain criminal activities before eligibility may be approved. The questions must be answered within 10 days or within the application processing period, whichever is longer. GAMC applicants are only required to answer these questions at application. Do not require clients to respond to the questions at renewal.
Applicants must answer these questions in writing. The Health Care Application (HCAPP) (DHS-3417) does not include the required questions. Therefore, GAMC applicants applying with a HCAPP must also complete the Required Questions for GAMC (DHS-3423). The Combined Application Form (CAF) (DHS-5223) includes the required questions. GAMC applicants who apply with a CAF do not need to complete an additional form.
Note: The wording and order of the questions on DHS-3423 and the CAF may be different.
A person convicted of a drug felony on or after July 1, 1997, is ineligible for GAMC for five years from the date of completion of the terms of the court-ordered sentence, unless the person meets any of the following conditions:
l Participates in a drug treatment program.
l Has successfully completed a drug treatment program.
l Has been assessed as not needing a drug treatment program.
If the applicant answers positively on DHS-3423 or the CAF to a previous conviction of a drug felony, determine if the applicant meets one of the conditions that will allow eligibility. Follow inconsistent information policy if the county agency has other information that an applicant has been convicted of a drug felony.
People who meet one of the above conditions are eligible for GAMC if they meet all other eligibility requirements. However, the convicted person is subject to random drug testing as a condition of eligibility. DHS suggests that county agencies coordinate efforts with local probation or court services to establish procedures and share costs of random drug testing for these clients.
If the client fails a drug test, or a probation officer or other official entity informs the county that the client has failed a drug test, the client is ineligible for assistance for five years beginning the first of the month following the month of the positive test result for an illegal controlled substance.
Note: A subsequent drug conviction while receiving assistance results in ineligibility for the convicted person beginning the month after the date of conviction, and continuing for five years after completion of sentence.
Note: Do not disqualify other household members because of the GAMC applicant's ineligibility. Continue to deem the ineligible member's income and assets.
Fraudulent Statements About Residence
A person convicted of making a fraudulent statement about his or her place of residence in order to receive medical assistance simultaneously from two or more states is ineligible for GAMC for ten years beginning on the date of the conviction.
If the applicant answers positively on DHS-3423 or the CAF to a previous conviction of this crime, determine the date of conviction and calculate the ineligibility period. Follow inconsistent information policy if the county agency has other information that an applicant has been convicted of this crime.
Note: Do not disqualify other household members because of the GAMC applicant's ineligibility. Continue to deem the ineligible member's income and assets.
A person currently fleeing prosecution, custody, or confinement after being convicted of a felony is ineligible for GAMC until he or she provides documentation that the issue has been resolved.
Deny eligibility if the applicant answers on DHS-3423 or the CAF that he or she is a fleeing felon. Follow inconsistent information policy if the county agency has other reliable verified documentation that the client is a fleeing felon.
Note: Do not disqualify other household members because of the GAMC applicant's ineligibility. Continue to deem the ineligible member's income and assets.
Violating Parole, Probation or Supervised Release
A person currently in violation of a condition of probation, parole, or supervised release is ineligible for GAMC until he or she provides documentation that they are no longer in violation.
Deny eligibility if the applicant answers on DHS-3423 or the CAF that they are in violation. Follow inconsistent information policy if the county agency has other information that the client is in violation.
Note: Do not disqualify other household members because of the GAMC applicant's ineligibility. Continue to deem the ineligible member's income and assets.