Provider Notice Issued 04/23/2020

Temporary Guidelines to allow designated Assisters to assist clients telephonically during the COVID-19 emergency

HFS is grateful for the important work that community agencies do to support people in need of medical, nutrition and cash benefits by helping them apply for benefits, set up and use Manage My Case (MMC) through the State’s online Application for Benefits Eligibility (ABE).

The authority to assist someone under these temporary guidelines is limited to MEDICAL BENEFITS done by the following entities, hereafter referred to collectively as “Assisters”:

·         Staff at Illinois Enrollment Assister agencies: defined as agencies certified by the federal or state government as Navigators, Assisters, and Certified Application Counselors (CACs)

·         Medicaid Presumptive Eligibility (MPE) providers, local health departments and All Kids Application Agents (AKAAs); and

·         Staff working with Illinois Department on Aging (IDOA) programs, specifically: Senior Health Insurance Program (SHIP), the Long-term Care Ombudsman, and Care Coordination Units.

Typically, assistance happens face-to-face because a client signature is required. However, during the COVID-19 emergency, face-to-face interactions are not possible. To allow these agencies to continue to help clients, HFS is allowing telephonic assistance under the following circumstances:

1.    The client is on the phone providing the information to the Assister.

2.    The Assister reads the disclaimer and the client gives verbal consent authorizing the Assister to submit, on behalf of the client: an application (regular or MPE), renewal, or other action through MMC, or a Request for State ID Proofing.

3.    The Assister must complete and include the attached Model ABE Assister Consent Form for Assistance by Phone with any allowable submissions made on behalf of the client.

4.    Prior to signing the application, MMC submission or request for State ID proofing on behalf of the client, the Assister must read the Rights and Responsibilities on the form to the client and receive an affirmative verbal consent that the client understands and agrees with them.

5.    The attached Model ABE Assister Consent Form for Assistance by Phone must be: 1) on the letterhead of the Assister’s organization, 2) signed and dated by the Assister, and 3) uploaded as part of the application, redetermination, MPE application, MMC submission - under “other” (with a note in comments) and included with the Request for Manual ID proofing. The Assister must keep a copy in their records and make it available to the State upon request.

Note: The attached Consent Form is limited in scope to that outlined above and is for one-time use. This consent does NOT give an Assister the authority of an Authorized Representative.

***If an applicant is interested in applying for SNAP and does not currently receive benefits, Assisters should complete a paper application from the DHS website, leave the signature line blank, and fax the application to the State’s Central Scanning Unit. If an applicant has an existing case, they can add a program to their case using Manage My Case in https://ABE.Illinois.gov. Finally, applicants can apply for medical, SNAP and Cash benefits by calling the ABE customer call center at: 1-800-843-6154.

For questions about these Guidelines, email HFS.ABEPartnerPortal@Illinois.gov

           [Must be on Organization’s Letterhead]

Model ABE Assister Consent Form for Assistance by Phone

For use by authorized Assister Agencies submitting the following through ABE or by mail (ID proofing Request form), on a client’s behalf : an application for medical benefits, a Medicaid Presumptive Eligibility (MPE) application, a renewal or other submission through Manage My Case (MMC), or a Request for State ID Proofing through the mail.

Client’s Name: ___________________________ Client’s Phone Number:____________________

Assister’s Name: _________________________________ Phone Number ____________________

Name of Assister’s Organization: _______________________________________________________

Address of Assister’s Organization: _____________________________________________________

Type of Assistance Being Provided (check all that apply):

D Application through ABE (medical only)

Tracking # _______________________

D MPE Application through ABE

Tracking # _______________________

D Renewal of  medical  Benefits Transaction # _____________________

Attestation

D Submissions through Manage My Case in

ABE

Transaction # _______________________

D Request for State Identity  Proofing Date Mailed _____________________

I, ____________________________________attest that _______________________________

(Assister’s name)                                                                      (Client’s name)

is requesting help completing the actions indicated above and consented on _________________

(date)

at_______________ to accept my assistance. I attest that, before starting my assistance, I read the

(time)

below Consent and Attestation statements to the client. 

 Prior to submitting any information in ABE, I confirm that I reviewed the information with the client and read the Rights and Responsibilities associated with the action being performed in ABE to the client and client gave verbal agreement that they (circle one)                Agree              Disagree.

Consent:  By requesting and accepting assistance from me,____________________________ ,

(Assister’s name)

you____________________________ understand that as the applicant or client, you alone are

(Client name)

responsible for the accuracy of the information you are providing to me. I am responsible for submitting on your behalf the information you provide.

Attestation:  As someone assisting you, I_____________________________ agree to adhere to all

(Assister’s name)

regulations relating to confidentiality of information and will use the information provided

solely for the purpose of submitting, on your behalf, an application for benefits, an MPE application, a benefit renewal or other submission through MMC in ABE, or a Request for State ID Proofing. I am not responsible for receiving or submitting any additional information to the State related to the help I provide today unless you request additional assistance and sign a new ABE Assister Consent Form for Assistance by Phone. 

Assister’s Printed Name

Assister’s signature                                                                  Date Signed