Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: FORMS ADDED TO IM FORMS MANUAL TO VERIFY VETERAN’S ADMINISTRATION (VA) INCOME FOR VENDOR PARTICIPANTS
FORM REVISION #07 – FA-312 VA Vendor, FA-313 VA Vendor Letter
When a participant is receiving VA income and enters a vendor facility, their income may or may not change depending on what type of VA income they are receiving.
Regional Nursing Home offices can send a release form to the participant to sign so that staff may contact VA directly to verify any changes in income that occurred due to the participant entering a vendor facility.
Forms were added to the IM Forms Manual to assist staff with collecting this information. Veterans Administration Verification (Vendor) form (FA-312 VA Vendor) is the release form for the participant to sign. VA Letter (FA-313 VA Vendor Letter) is available for staff to send to the participant to request the signed release and explain why FSD needs to contact VA.
- Review this memorandum with appropriate staff.