Intake Procedures & Information

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Intake Procedures

Please note that there are two steps that must be completed to access Case Management services. 

1. The State of Florida requires that you must be verified ELIGIBLE TO APPLY for services. The State eligibility process is described   in detail on page two. 

2.  You must complete the Case Management Intake paperwork. 

ASAP Case Management Intake Process

 (Pinellas County Residents only) 
 

1. Call ASAP office

 St. Petersburg office:  727-328-3260        3050 1st Ave South. St. Petersburg

 Clearwater office:  727-449-2437               1214 Cleveland Street. Clearwater

Inform receptionist/volunteer that you want to apply for case management services

•  ASAP staff will explain intake process and complete a short intake form. The intake form includes an assessment of client needs to determine if client needs expedited intake.  

• ASAP staff will schedule appointment to complete case management intake. 

• ASAP staff and client will discuss clients’ immediate needs and, if community resources are available, CM will refer client to community provider(s) per identified needs.  Client is responsible for scheduling appointment(s) with providers.   Staff will assist as needed.  

If client has not completed or scheduled an appointment for Part B Eligibility, staff will schedule an appointment with the Ryan White Eligibility Specialist and explain documentation required for Eligibility Specialist (please see below). 

Florida Department of Health Eligibility Requirements for Patient Care Programs

What are the eligibility requirements?

• You have to be HIV positive.

• You must be living in Florida.

• You cannot be receiving the same services from Medicaid, Project AIDS Care or Insurance.

• You have to be low-income - at or below 400% of the Federal Poverty Level (FPL).

 What required documentation do I need? 

1.  Proof of HIV Status- Original or copy of an HIV Laboratory Test which shows your HIV Status – Must be confirmatory test such as Western Blot.  Do Not Bring a Doctor’s Statement.

2.  Living in Florida. Bring Photo ID if possible.

• Drivers License
• Florida ID Card
• Utility Bill (In your name)
• If homeless, discuss documentation requirements with staff

• Medicaid Card

• Medicare Card

• Project AIDS Care Eligibility Notice

• Insurance Policy

• Public Assistance Program Award or Denial Letters 

• Veterans Administration and Other Documents which apply.

4.  Bring all that apply to show your Income, Cash & Items of Value, such as :

• Bank & Savings Statements

• Military & Earnings Statement

• Rental & Other Income

• If Self Employed–1040 Form

• Public Assistance Award or Denial Letters 
 

Clients must be willing to cooperate with eligibility staff during the eligibility process and sign and comply with the Rights and Responsibilities (See next page to review Rights and Responsibilities and guidelines for Re-Determination and Continued Eligibility).

 
When will I start receiving services? 

Eligibility staff will give you an eligibility confirmation letter after your application is processed and approved. You will be asked to choose a case management agency to help you determine all of your needs. 

CLIENTS REFERRED FOR CASE MANAGEMENT SERVICES MUST SCHEDULE AN APPOINTMENT TO COMPLETE THE CASE MANAGEMENT INTAKE PAPERWORK.

 ELIGIBILITY APPLICATION - RIGHTS AND RESPONSIBILITIES

(Must be signed by applicant) 

I understand that I am responsible for giving truthful and correct information on this application and during the application process to the best of my knowledge and failure to be truthful may prevent or delay a determination of eligibility to receive services.   

I understand if I knowingly give information that is not true or withhold information and receive services that I am not eligible to receive, I may be lawfully punished and have to pay the Department of Health back for services.   

I understand the information I provide may be verified, which may include computer matching and the information I give about my income may be checked.

I understand that the information will be kept confidential in accordance with Florida and Federal law. 

I understand not all services I am eligible to receive may be available, accessible or funded, and I may not meet specific Program Qualifications for some programs.

I understand that at any time during the application process I can be denied eligibility if my actions are uncooperative, disruptive of office procedures, threatening or hostile towards staff. 

I understand the Department of Health, eligibility staff cannot discriminate because of race, color, sex, age, disability, religion, nationality or political beliefs. 

I understand I have the right to ask for a Fair Hearing if I think the decision on my case was unfair or incorrect.

Re-Determination and Continued Eligibility

 (1) Eligibility of an existing client is re-determined every six months or at shorter intervals if the client's income and other eligibility factors change before the 6-month period.

 (2) The client must report any change in his/her situation, which will impact his/her eligibility status to the eligibility staff no later than 10 days after it is known.

 (3) A client can be determined ineligible to receive services for the following reasons:

              (a) A client is no longer living in Florida.

            (b) A client is eligible to receive services or is participating in local, state or federal programs where the same type service is provided.

              (c) A client is no longer considered low-income.

              (d) A client has not complied with the Rights and Responsibilities in the application.