Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: REGINALD E. McELHANNON, ACTING DIRECTOR
SUBJECT: PRESUMPTIVE ELIGIBILITY (PE) FORM REVISIONS FOR MAGI
FORM REVISION #33
PE-2 WORKSHEET
PE-2 Worksheet Instructions
PE-3
PE-3TEMP
DISCUSSION:
The purpose of this memorandum is to share revisions to the following three (3) Presumptive Eligibility (PE) forms:
- Qualified Entity Presumptive Eligibility Determination Worksheet (PE-2 Worksheet)
- Clarification of:
- What can be provided if DCN for head of household or applicant cannot be located;
- Calculation of Household Size
- Questions A-G
- Addition of checkboxes for PE Programs
- Clarification of:
- MO HealthNet Presumptive Eligibility Authorization (PE-3) and MO HealthNet TEMP/SMHB-PE Authorization (PE-3TEMP)
- Addition of check boxes indicating for what program each individual is eligible
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
RM/df