Category: 2020

FROM:   KIM EVANS, DIRECTOR

SUBJECT:   MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) RETIREMENT USER GUIDE CORRECTION

DISCUSSION:

Income Maintenance Memo #87 announced a change to how retirement accounts are counted for MHABD resource determinations.

A user guide was mentioned in that memo. An error was discovered on the user guide. This has been corrected and the corrected version has been posted and is attached to this memo.

The user guide incorrectly stated that an account available only for hardship reasons was considered accessible. This has been updated to reflect current policy. An account that is available only due to a hardship, is NOT an available resource.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

ATTACHMENTS:

• Retirement User guide

FROM:   KIM EVANS, DIRECTOR

SUBJECT:   CORRECTION ON CHIP AFFORDABILITY CALCULATOR

MANUAL REVISION #57
Appendix G

DISCUSSION:

Due to an error on the file for the Affordability Calculator, a revised version is now in the MAGI Manual.  Please delete any previous version you have downloaded and use the new version.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Remove any previous versions of the Affordability Calculator from your computer.

KE/df

FROM:   KIM EVANS, DIRECTOR

SUBJECT:    APPROVING MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) NURSING HOME CARE ON A DATE OTHER THAN THE DATE OF ADMISSION TO ALLOW PARTICIPANT TO DEPLETE RESOURCES BELOW THE RESOURCE LIMIT

DISCUSSION:

It is sometimes necessary to approve Nursing Home (vendor) Care on a date other than the date the participant was admitted to the facility. For example, this may be necessary if the individual has resources in excess of the program limit when they enter the facility, and then spends the resources down below the program resource limit.

EXAMPLE: Mr. Jacobs entered a nursing facility on August 5, 2019. He applied for vendor care on August 10, 2019. His resources were above the program limit. He stays at the facility as a private pay resident for his care until his resources are reduced below the program limit. Based on the cost of care and verified payment to the facility, his resources will fall below the resource limit effective September 15, 2019.
If eligibility is allowed to begin September 1, the facility would refund his private pay funds, causing his resources to again exceed the resource limit.

To avoid this cycle, eligibility for vendor coverage, in this example should not begin prior to September 15, 2019. This will be accomplished by entering the date his resources first fall below the program limit in the Payment Start Dt (Lev 2 Scrn) field on the Facility and Placement Information Details (FMJ5) screen in FAMIS.

Enter a comment to explain the reason for the date and how the date was determined.

The Facility and Placement Information Details (FMJ5) screen has been updated to allow entry of future dates. FAMIS will now accept future dates as far in the future as the first day of the last month that will be included in the current eligibility determination.

EXAMPLE: Eligibility determination (EDRES) completed October 1st will include October, November, and December. December 1, or earlier may be entered as the Payment Start Dt.

When an EDRES is completed, FAMIS will propose MHNS or MHSD for the days in the month prior to the date the resources were actually reduced below the limit, followed by vendor for the date the resources are first below the limit through the end of the month.

It is appropriate to allow the MHNS or MHSD to approve for the days of the month prior to the reduction of resources because the participant is eligible for the entire month in which their resources are below the limit.

1030.000.05 RESOURCES FALL BELOW LIMIT IN MONTH OF APPLICATION

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/vb

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  2020 MO HEALTHNET OUTREACH PROJECT WITH DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION, LICENSED CHILDCARE PROVIDERS, AND FAMILY SUPPORT DIVISION

DISCUSSION:

Senate Bill 583 (2010) requires the Department of Social Services (DSS) to collaborate with the Department of Elementary and Secondary Education (DESE) and licensed childcare providers in an effort to reach the uninsured children of Missouri.

Each year, to comply with Senate Bill 583, FSD provides DESE and licensed childcare providers with a flyer that informs parents how to apply:

• Online at https://mydss.mo.gov/. Please send an email to MHNPolicy@dss.mo.gov with subject line “SCHOOL” or “Facility Outreach” to let us know to watch for your application. 
• By telephone at 1-855-373-9994. When speaking with a representative please tell them this is a “School Application” or “Facility Outreach Application”.
• Request an application from 1-855-FSD-INFO (1-855-373-4636). Please write “SCHOOL” or “Facility Outreach” at the top of the application.
• Print an application online at http://dss.mo.gov/fsd/formsmanual/pdf/im-1ssl.pdf. Please write “SCHOOL” or “Facility Outreach” at the top of the application. 

The attached fliers will be distributed to schools and childcare facilities:

• Two for DESE – one in English and one in Spanish
• One for Childcare Facilities in English

FSD is required to track these applications for reporting.  Each MAGI office, Resource Center and Customer Service Center is asked to document the receipt of these applications on the attached spreadsheets.  School and Facility Outreach spreadsheets should be kept separate.  Management should enter all information onto appropriate spreadsheet and submit monthly to Cole.MHNPolicy@dss.mo.gov.

NECESSARY ACTIONS:

• Review this memorandum with appropriate staff.
• Offices should begin tracking immediately and submitting documentation on the first week of each month.

ATTACHMENTS:

• Spreadsheet for “School” application documentation
• School Outreach flyer in English
• School Outreach flyer in Spanish
• Spreadsheet for “Facility Outreach” application documentation
• Facility Outreach flyer

KE/df

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) AUTHORIZED REPRESENTATIVE FAMIS ENHANCEMENT

DISCUSSION:

This is the sixth in a series of enhancements in the FAMIS system to provide current information to the Authorized Representative (AR) as well as the MHABD participant. Previous enhancements were introduced in the following memos:

IM-77 November 14, 2016 introduced the first notices to be automatically sent to the MHABD AR.

IM-35 April 24, 2017 introduced the next notices to be automatically sent to the MHABD AR.

2017 IM Memorandum #89 dated July 11, 2017 introduced more notices to be automatically sent to the MHABD AR.

IM-165 December 27, 2017 introduced additional notices to the AR.

IM-137 August 30, 2019 introduced the functionality to enter shared AR’s for couple case.

Effective July 26, 2020 FAMIS will introduce enhancements to the Select ADM Authorized Representative (FMNH/SELADMAR) and MHABD Representative Detail (FMNG) screens. 

NOTE: Authorized representatives for Food Stamp (FS), Child Care (CC), and Temporary Assistance (TA) cases will continue to be entered and updated on the Representative List (FMJ1/AUTHREP) and Representative Detail (FMJG) screens in FAMIS.

Enhancements include:

• When an AR is entered using the directory on the Select Resource (FMFB/RESOURCE) screen, any changes made to that resources’ name, address, phone number, or fax number in the resource directory will be automatically updated on the AR screens the same day (FMNH/FMNG).
  • Refer to Email Memo IM-30, dated 05/20/2020 if a resource needs to be updated.
• Only AR’s with no end date will show in the display count. The F17=PRVREP and F20=NXTREP keys that are used to flow between active AR’s will no longer be displayed on an AR with an end date entered.
• When staff flow through the AR’s using the F17=PRVREP and F20=NXTREP keys only the AR’s with no end date will be displayed.
• The Application Only (APO) role will be allowed for add a category and add a person applications.
  • NOTE: For add a person requests the AR must be entered on the MHABD Representative Detail (FMNG) screens for the individual being added.  The AR with an Application Only (APO) role can be a shared AR with the head of household and will show on the head of households AR screen also. 
• The Application Only (APO) role will be allowed for rejected applications when a hearing has been requested. A Y must be entered in the Hearing Requested field on the MHABD Representative Detail (FMNG) screen in order for the APO role to be allowed on a rejected application.
• When an eligibility unit member no longer wants to share an AR with their spouse, the Authrep Shared Flag and Both Signed fields must be changed to N. The shared AR entry will be end dated and the system will update the MHABD Representative Detail (FMNG) screen for the individual who wishes for the AR to continue.  All comments on the original AR entry will be included.
• When a shared, primary AR is entered staff will no longer receive a message to review the primary designation for spouse when the spouse has not requested coverage.
  • The system does not create a copy of the shared AR screen for the spouse when the spouse has not requested coverage.
• The system will no longer require that one AR be listed as primary before allowing an AR to be ended.
• When a primary AR is ended, if a new primary is not designated, the system will use a hierarchy to set a default primary AR. An AR set as primary using the default method will have a D displayed in the Primary field.
  • When a new primary is added the default AR’s primary code will be changed to N.
  • The hierarchy is as follows:
    • Attorney (ATT)
    • Legal Guardian/Conservator (LGC)
    • Legal Guardian (LGN)
    • Conservator (CON)
    • Department of Mental Health (DMH)
    • Outside Agency (OA)
    • Authorized Representative (ARP)
  • The Name and Organization fields will be locked after the overnight batch process. If these fields need to be updated later you will need to end date the current, obsolete AR and enter a new AR.
    • If a new AR entry is made, enter an end date on the obsolete AR entry.
  • AR’s with a Release of Information role (ARI representative type and RLS representative role) will have an end date of one year automatically entered. This end date can be updated to reflect the date entered on the Authorization for Release of Medical/Health Information- Nursing Facilities, In-Home Nursing Care Providers, and Other Providers of Medical Services (IM-6NF) form or when AR status is revoked.   

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• At each contact or the annual reinvestigation, review Authorized Representative screens to ensure information is correct and current.

KE/vb/rr/plh

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  QUALIFIED MEDICARE BENEFICIARY (QMB) AND FAMILY MO HEALTHNET COVERAGE (MAGI)

MANUAL REVISION #55

0865.020.10

DISCUSSION:

The purpose of this memorandum is to advise staff of updates to the 0865.020.10 Filing a QMB Application section of the MO HealthNet for the Aged, Blind and Disabled manual. The following has been added:

• Eligible participants are able to receive QMB and Family MO HealthNet at the same time. These individuals are not required to receive MO HealthNet for the Aged, Blind and Disabled (MHABD) coverage.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

KE/nw

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATES TO THE MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) MANUAL REGARDING CHANGES IN CIRCUMSTANCE

MANUAL REVISION #54

0840.010.00

0840.010.35                              

0855.010.00

DISCUSSION:

A new section has been added to the Changes in Circumstance section of the MHABD manual.  Policy regarding coverage changes between the Spend Down and Ticket to Work programs is discussed in MHABD manual section 0840.010.35 Change in Coverage- Spend Down and Ticket to Work.

The Spend Down-Ticket to Work Comparison Guide has been created to aid staff members when communicating these coverage options with participants.

Coverage can only be changed if the participant has not met their Spend Down or paid in their Spend Down or Ticket to Work premium. 

When authorizing a change in coverage for a month there is an open Spend Down or Ticket to Work invoice email the Premium Payments Unit to request the invoice(s) for the specific month(s) be closed.  Send email to: MHD.PremiumPayments@dss.mo.gov with the following information:

• Subject line “Invoice needs closed”
• DCN
• Month(s) with open invoices that need to be closed.

MHABD Manual Sections 0840.010.00 Changes in Circumstance and 0855.010.00 Application Processing Procedures (TWHA) have been revised to include information covered in MHABD manual section 0840.010.35 Change in Coverage- Spend Down and Ticket to Work.

ATTACHMENT:

Spend Down-Ticket to Work Comparison Guide

NECESSARY ACTION:

• Review the memorandum and manual revisions with appropriate staff.

KE/rr