Sec. 07.02.04.04. Application for Service

A. Each individual wishing to do so shall be assured the opportunity to apply for services without delay. The application may be filed by the applicant himself or his authorized representative, or, where the applicant is incompetent or incapacitated, someone acting responsibly for him including agency staff. Any person who fraudulently obtains, attempts to obtain, or aids another person in fraudulently obtaining services to which he is not entitled, may be subject to prosecution.

B. The local department shall inform the applicants for and recipients of a social services program about the eligibility requirements and their rights and obligations under the program.

C. Applicants for services based on income eligibility requirements shall sign an application form prescribed by the agency. The applicant shall:

(1) Declare under the penalty of welfare fraud that true, correct, and complete information is provided;

(2) Acknowledge that the possibility of selection as part of a State review of eligibility may require documentation of income;

(3) Acknowledge the right to withdraw the application at any time; and

(4) Acknowledge that the information of the application and any State review will be strictly confidential.

D. Applicants for adoption, foster home approval, day care registration, single parent services, family planning services, voluntary foster care, and voluntary protective services for adults or children shall sign a statement prescribed by the Social Services Administration. The applicant's statement shall:

(1) Declare under the penalty of perjury that true, correct, and complete information is provided; and

(2) Acknowledge the right to withdraw the application at any time.

E. A recipient of involuntary foster care or involuntary protective services for adults or children shall be requested to sign a statement prescribed by the Social Services Administration. If he refuses, the service is to be provided with the notation in the case record that he did not wish to sign the statement and the date that the case came to the attention of the local department of social services.

F. For family planning services, the case record shall contain the written request of the client acknowledging the voluntary nature of the service.

G. For protective services to adults or to children, the case record shall describe the circumstance of actual or potential abuse, neglect, or exploitation of a child or adult.

H. For information and referral, a signed application by the client is not required.

I. A signed application is not necessary for services for which eligibility is determined on a group basis. Participation by an individual in this service is considered a request for services.