103-2          REQUEST FOR SERVICE  

A completed and signed request for service application is considered an identifiable application. When DPA Division of Public Assistance receives a request for service, the request must be registered on EIS Eligibility Information System to protect the benefit start date. Certain situations when cases are registered as requests for service include the following:

• An applicant comes in to a DPA Division of Public Assistance office and cannot stay to complete the entire application. The applicant may complete and sign page A of the GEN 50 B Application for Services and submit it as a request for service application.

• A recertification or review (GEN 72 Eligibility Review Form) is received after the month following the end of the certification period. This is considered a request for services.

• A recipient submits a GEN 72 Eligibility Review Form to recertify for a specific program and requests to add another program to their case. The request is considered a request for service.

103-2 A.     REGISTERING AND FILING REQUEST FOR SERVICE APPLICATIONS

When an applicant submits a request for service using page A of the GEN 50 B Application for Services, the rest of the GEN 50 B Application for Services is given back to the applicant to complete. Staff must date stamp the request for service application with the date of receipt, and register it on EIS Eligibility Information System. Date stamping the request for service application protects the date the applicant initially expressed the need for having their eligibility considered.

When a recipient submits a GEN 72 Eligibility Review Form after the month following the end of the certification period, the GEN 72 Eligibility Review Form must be registered as a request for service. A GEN 50 B Application for Services must be completed before DPA Division of Public Assistance can authorize benefits for the recipient.

For example:

If certification ends in October, the month following the end of certification period is November. Any GEN 72 Eligibility Review Form received in November is considered late recertification. However, any GEN 72 Eligibility Review Form received after November must be registered as a request for service.

When a recipient submits a GEN 72 Eligibility Review Form and requests to add another program to their case, the request must be registered as a request for service. A GEN 50 B Application for Services must be completed before DPA Division of Public Assistance can authorize benefits for the recipient.

To register the request, staff must use the appropriate code:

• RA  - Temporary Assistance
   

• RF  - Food Stamps
   

• RM - Medicaid
   

• RP - Adult Public Assistance

• RG - Chronic and Acute Medical Assistance
   

• RR - General Assistance

103-2 B.     NOTICE AND INTERVIEW REQUIREMENT

DPA Division of Public Assistance will notify applicants who submit a request for service application of the interview requirement. Staff must send the N000 (APPLICATION RECEIVED - INTERVIEW NEEDED) notice the same day the request for service application is registered on EIS Eligibility Information System . The N000 notice informs the applicant of the receipt of their application, a reminder to complete the entire application packet, and the requirement to attend an interview.  

Note:  

The Food Stamp program has specific and time-sensitive requirements for scheduling interviews and notifying clients about missed interviews.  See Food Stamp manual section 601-3.

103-2 C.     APPLICANT FAILS TO COMPLETE THE APPLICATION PROCESS

If an applicant fails to attend an interview and complete the application process, their application will be denied 30 calendar days after the application filing date (the application filing date is counted as zero). EIS Eligibility Information System will automatically deny the application and send the appropriate denial notice based on the programs the applicant requested to receive.

103-2 D.     STORING REQUEST FOR SERVICE APPLICATIONS

Request for service applications are often stored in a file created specifically for request for service applications. This file is organized by month and the request for service is filed the month it is received in the DPA Division of Public Assistance office. In certain circumstances, the request for service application is pulled from the monthly file and filed either in the two, four or six-part folder. Follow the procedures below in determining when a request for service application is pulled from the monthly file:

1. Applicant completes the application process and a case file exists or is created

If an applicant completes the entire application packet and attends an interview, pull the applicant’s request for service from the monthly file. Match the request for service application with the completed application packet and file accordingly in the case file (existing or new). Refer to MS 103-1 for additional guidelines on organizing case files.

2. Applicant fails to complete the application process

If the applicant does not complete the entire application packet and fails to attend an interview, determine if there is an existing case file for the applicant.

If a case file exists, pull the request for service application and match it with the current case file. Place the document in the appropriate section. Refer to MS 103-1 for additional guidelines on organizing case files.

If there is no existing case file, leave the request for service in the monthly file created specifically for storing request for service applications.

103-2 E.     RETAINING AND DESTROYING REQUEST FOR SERVICE APPLICATIONS

Request for service monthly files will remain in the office for a three-year period. It is not necessary to archive request for service monthly files. After the three-year period is over, the files may be destroyed or shredded.