State of Wisconsin Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

22-03 Version of 25.5 Valid Signature

25.5.1 Valid Signature Introduction

The applicant, A request for BadgerCare Plus coverage. The request must be on the Department's or Federally-facilitated Marketplace’s application, registration form or account transfer (from Federally-facilitated Marketplace) and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process.their representative (see below), or the applicant's caretaker relative must sign one of the following (using their own signature):

1. The paper applicationA request for BadgerCare Plus coverage. The request must be on the Department's application or registration form and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. form
2. The signature page of the Application Summary, either over the phone, electronically, or with a handwritten signature
3. The ACCESS application form with an electronic signature
4. The online or paper Application for Health Coverage & Help Paying Costs from the Federally-Facilitated Marketplace

25.5.1.1 Signatures from Representatives

The following people can sign the application with their own name on behalf of the applicant:

1. Guardian

When an application is submitted with a signature of someone claiming to be the applicant’s guardian, obtain a copy of the document that designates the signer of the application as the guardian. From the documents provided, ensure that the individual claiming to be the applicant’s guardian can file an application on the applicant's behalf.

When someone has been designated as one of the following, only the guardian, not the applicant, may sign the application or appoint an authorized representative:

1. Guardian of the estate
2. Guardian of the person and the estate
3. Guardian in general

If the applicant only has a legal guardian of the person, the guardian may sign the application since they are acting responsibly for an incompetent or incapacitated person. However, a legal guardian of the person can't appoint an authorized representative. The applicant must be the one to appoint an authorized representative if they choose to have one.

The applicant may appoint their guardian of the person to be the authorized representative. If the guardian of the person has been appointed the authorized representative by the applicant, the guardian may sign the application as the authorized representative.

2. Conservator (Wis. Stat. 54.76(2)) 

A conservator is a person who is appointed by a court at an individual’s request under Wis. Stat. 54.76(2) to manage the estate of the individual. When an application is submitted with a signature of someone claiming to be the applicant’s conservator, a copy of the document that designates the signer of the application as the conservator is required.

The conservator is not required to sign the application, though they are able to sign on behalf of the applicant. If an applicant has a conservator, the applicant can still sign the application on their own behalf.

3. Authorized Representative

The applicant may authorize someone to represent them. An authorized representative can be an individual or an organization (see Section 34.1 Authorized Representatives). If the applicant needs to appoint an authorized representative when applying by telephone or in person, instruct the applicant to complete the Appoint, Change, or Remove an Authorization of Representative form (Person F-10126A or Organization F-10126B). When appointing an authorized representative, someone other than the authorized representative must witness the applicant’s signature. If the applicant signs with a mark, two witness signatures are required.

The authorized representative is not required to sign the application, though they are able to sign on behalf of the applicant. If an applicant has an authorized representative, the applicant can still sign the application on their own behalf.  

4. Durable Power of Attorney (Wis. Stat. ch. 244)

A durable power of attorney is a person to whom the applicant has given power of attorney authority and agrees that the authority will continue even if the applicant later becomes disabled or otherwise incapacitated. Only a durable power of attorney for finances (may also be known as a durable power of attorney for finances and property) is considered to be the power of attorney for the purposes of providing a valid signature on the application.

When a submitted application is signed by someone claiming to be the applicant’s durable power of attorney for finances, workers must do both of the following:

1. Obtain a copy of the document the applicant used to designate the signer of the application as the durable power of attorney for finances.
2. Review the document for a reference that indicates the power of attorney for finances authority continues notwithstanding any subsequent disability or incapacity of the applicant.

Do not consider the application properly signed unless both of the above conditions are met. An individual's durable power of attorney for finances may appoint an authorized representative for purposes of making a health care application if authorized on the Durable Power of Attorney for Finances form (F-00036).

The Durable Power of Attorney for Finances form will specify what authority is granted. The appointment of a durable power of attorney for finances does not prevent an applicant from filing their own application for BadgerCare Plus, nor does it prevent the applicant from granting authority to someone else to apply for public assistance on their behalf.

5. Someone acting responsibly for an incompetent or incapacitated person

Example 1

Carl is in a coma in the hospital. Marco, a nurse who works at the hospital, can apply for health care on Carl’s behalf.

6. A superintendent of a state mental health institute or center for the developmentally disabled

7. A warden or warden's designee

A warden or warden's designee for an inmate of a state correctional institution who is a hospital inpatient for more than 24 hours.

8. The superintendent of a county psychiatric institution

The superintendent of a county psychiatric institution may sign an application for a resident of the institution provided that the county social or human services director has delegated to them (in writing) the authority to sign and witness applications for residents of the institution. Retain a copy of this written authorization. The social or human services director may end the delegation when there’s reason to believe that the delegated authority is not being carried out properly.

25.5.2 Witnessing the Signature

The signatures of two witnesses are required when the application is signed with a mark.

An agency staff person is not required to witness the signature of a mail-in, online or telephone application.

Note	This does not affect the State of Wisconsin’s ability to prosecute for fraud nor does it prevent the BadgerCare Plus program from recovering benefits provided incorrectly due to an applicant or member’s misstatement or omission of fact.

25.5.3 Telephone Signature Requirements

Telephonic signatures are valid forms of signatures for BadgerCare Plus. To collect a valid telephonic signature:

1. Create an audio recording of the following:
   1. Key information provided by the household during the telephone interview
   2. Signature statement that includes:
      1. Release of information
      2. Attestation to the identity of individual signing the application
      3. Attestation to the accuracy and completeness of information provided
      4. Rights and responsibilities
2. Store the audio recording in the ECFElectronic Case File.
3. Send the applicant or member a written summary of the information provided during the interview. Include a cover letter that outlines the applicant or member’s responsibility to review the information provided and notify the agency within ten calendar days if any errors are noted.
4. Store a copy of the written summary and cover letter in the ECF.

Note	Applications that are submitted through ACCESS or transferred from the Marketplace are signed electronically, so an additional signature (telephone or physical) is not needed.

25.5.4 Valid Signature on the Federally-Facilitated Marketplace Application

Agencies should accept the signature on the FFM application for all individuals on that application and create companion cases for adult children without obtaining a separate signature or application. Workers should reference the original FFM ACCESS application in case comments on the companion case. This policy is for FFM applications only. Current policies for non-FFM applications requiring an adult child to apply separately are still valid.

Because the BadgerCare Plus-specific rights and responsibilities information is not provided when a person applies for health care through the FFM, a summary must be sent to the applicant once the application is processed. No additional signature is required.

Note	Referrals from the FFM may include households with individuals whose eligibility may not be able to be determined on one case.

 

Example 1

Victoria and Timothy are married and filing taxes jointly. They are claiming Casey, their 24-year-old son, as a tax dependent. Victoria signs and submits an application to the FFM for health care for herself, Timothy, and Casey. The FFM assesses that they are potentially eligible for BadgerCare Plus and transfers the application to the agency. Although Casey is included in the health care request, his BadgerCare Plus eligibility cannot be determined on his parents’ CARES case. The worker must set up a separate case for Casey. No additional signature or application is required for Casey’s health care request.

 

Example 2

Darrell is filing taxes and claiming Carmen, his 22-year-old niece, as a tax dependent. Darrell signs and submits an application to the FFM for health care for Carmen. The FFM assesses that she is potentially eligible for BadgerCare Plus and transfers the application to the agency. The worker must set up a separate CARES case for Carmen. No additional signature or application is required for Carmen’s health care request.

Tax dependents living outside the home will not be included in the health care request for their tax filer’s household. A separate application is required to determine eligibility for a tax dependent living outside the home.

25.5.5 Electronic Signatures

In general, electronic signatures are valid signatures for documents requiring applicant or member signatures. Electronic signatures may appear typed or printed and may vary depending on the software used to collect the signature. Accept the electronic signature as a valid signature and process the document accordingly.

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The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.

Publication Number: P-10171