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Public Assistance
Shawnda O'Brien, Director of Public Assistance
Shawnda O'Brien


Applications for Public Assistance

Use the links below to apply.

Mail, fax, drop off, or email your application to the nearest local office.

Copies of applications are available at local offices, and we can mail one to you if asked.

An electronic application is not available for programs other than MAGI (income-based) Medicaid at this time.

Medicaid Applicants please note:

  • Income-based Medicaid applicants are encouraged to apply at This is the fastest way to see if you’re covered.
  • Older age or disability Medicaid applicants should only use the following (paper) application at this time:

Application for Services

(for most assistance programs)
Other Applications
Review or Recertification
  • The Eligibility Review Form (GEN-72) can be used for most programs. The division sends a prefilled review application form with the standard recertification or review notice.
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