Application Process
Confidentiality
Because the PAGC acts on behalf of the client, an “Authorization to Release Information” (CSF 13) is NOT required.
Responsibilities of the Public Administrator/Guardian/Conservator
The PAGC’s responsibilities include:
- Submitting a completed application packet for each person for whom GA is requested.
Note: The date that is stamped on the packet by the GA office will be the GA application date.
The following on-line form must be completed and signed by the Public Guardian/Conservator:
- “Responsibilities of Public Guardian/Conservators or Applicant/Beneficiary Representative” (DHCS 7068) for persons applying for combined GA and Medi-Cal programs.
Note: The “Eligibility Worker/Public Guardian Communication Form” (SCD 1294) is to be used for communication between EW and Public Guardian/Conservator regarding the client’s GA eligibility. This may include, but is not limited to:
- Requesting information or verification.
- Reporting changes, (e.g., change of address, dismissal of conservatorship, death of client).
- Completing an SSI application, including having the following forms completed:
- “Referral To/From Social Security” (SCD169) date stamped, completed and signed off by the Social Security Administration) on all conserved applicants PRIOR to submitting the application packet.
- “Authorization for Reimbursement of Interim Assistance Initial Payment or Initial Post eligibility Payment” (SSP 14).
Note: The PAGC must follow through on all SSI appeal levels.
- Completing the “Application for Cash Aid, Food Stamps, and/or Medi-Cal”(SAWS 1), and “Disability Determination Service Division” (DDSD) forms on all potentially Medi-Cal eligible applicants.
- Applying for disability benefits (State Disability Insurance [SDI] or private insurance) if potential eligibility exists. A written statement from the DPG/I is acceptable verification that this requirement has been met.
- Applying for Veteran (VA) benefits if potential eligibility exists and providing a copy of the “Veterans Benefits Verification And Referral” (CW 5).
- Reporting within ten (10) days any changes in work, income, property, address, when any benefit has been applied for (e.g., SSI/SSP or any of the above listed benefits), dismissal of conservatorship and death of client. The EW must be contacted if more time is needed to provide proof of changes.
Responsibilities of Eligibility Staff
The Social Services Agency (SSA) will provide the PAGC office with a supply of all mandated SSA forms. Upon receipt of an application packet from the PAGC office, the application will be ID’d by clerical and processed accordingly. [Refer to "PAGC Application Process" in the DEBS BP].
Related Topics
Public Administrator/Guardian/Conservator