(a)The department shall develop an application and reapplication form for the determination of a resident’s eligibility for the program. An applicant, or a guardian or custodian of an applicant, may apply or reapply on behalf of the applicant and the applicant’s spouse and children.
(b)The application shall, at a minimum, do all of the following:
(1)Specify the information that an applicant or the applicant’s representative must include in the application.
(2)Require that the applicant, or the applicant’s guardian or custodian, attest that the information provided in the application is accurate to the best knowledge and belief of the applicant or the applicant’s guardian or custodian.
(3)Specify that the application fee due upon submission of the applicable form is ten dollars ($10) a
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(a)
The department shall develop an application and reapplication form for the determination of a resident’s eligibility for the program. An applicant, or a guardian or custodian of an applicant, may apply or reapply on behalf of the applicant and the applicant’s spouse and children.
(b)
The application shall, at a minimum, do all of the following:
(1)
Specify the information that an applicant or the applicant’s representative must include in the application.
(2)
Require that the applicant, or the applicant’s guardian or custodian, attest that the information provided in the application is accurate to the best knowledge and belief of the applicant or the applicant’s guardian or custodian.
(3)
Specify that the application fee due upon submission of the applicable form is ten dollars ($10) annually.
(c)
In assessing the income requirement for eligibility, the department shall use the income information reported on the application and not require additional documentation.
(d)
An application may be completed at any pharmacy, physician office, or clinic participating in the program through an Internet Web site or call center staffed by trained operators approved by the department. A pharmacy, physician’s office, clinic, or nonprofit community organization that completes the application may keep the application fee as reimbursement for its processing costs. If it is determined that the applicant is already enrolled in the program, the fee shall be returned to the applicant and the applicant shall be informed of his or her current status as a program participant.
(e)
The department shall utilize a secure electronic application process that can be used by a pharmacy, physician’s office, or clinic, by an Internet Web site, by a call center staffed by trained operators, by a nonprofit community organization, or through the third-party vendor to enroll applicants in the program.
(f)
During the department’s normal working hours, the department shall make a determination of eligibility within 24 hours of receipt by the program of a completed application. The department shall mail the program participant an identification card no later than seven days after eligibility has been determined.
(g)
For applications submitted through a pharmacy, the department may issue a participant identification number for eligible applicants to the pharmacy for immediate access to the California Discount Prescription Drug Program.
(h)
Any program participant that has been determined to be eligible shall be enrolled for 12 months or until the program participant notifies the department of an intent to end enrollment.
(i)
The department shall notify a program participant of termination of enrollment 30 days prior to the termination.
(j)
A person shall be required to apply pursuant to this section for each 12-month period of eligibility.