IM-93 AUTOMATIC SECOND REQUEST FOR INFORMATION (FA-325) ELIMINATED FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP), TEMPORARY ASSISTANCE (TA), AND MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) APPLICATIONS

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  AUTOMATIC SECOND REQUEST FOR INFORMATION (FA-325) ELIMINATED FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP), TEMPORARY ASSISTANCE (TA), AND MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) APPLICATIONS

MANUAL REVISION #
0105.045.00
0110.000.00

 

DISCUSSION:

Eligibility system updates were completed on 09/05/2021 to no longer automatically send a second Request for Information (FA-325) on SNAP, TA, and MHABD applications. The General Information section of the Income Maintenance (IM) Manual has been updated to reflect this change.

Applicants will be mailed one initial request during the application process. Staff must send a second FA-325 in the following situations:

  • The applicant provided part, but not all, of the information requested on the original FA325,
  • The applicant has provided the information requested but it is insufficient to be used in determining eligibility, or
  • The applicant has shown a good faith effort in obtaining the information but has requested more time.

When sending a second FA-325 is necessary, all requests should be clear enough for the applicant to determine exactly what is needed or why previously submitted information is insufficient.

A second FA-325 is not required and should not be sent in the following situations:

  • The applicant does not respond to the initial FA-325.
  • The applicant returns information, but it is not what was requested.
    • Example: Pay stubs are requested from the applicant. The applicant does not return pay stubs but instead provides a rent receipt.

NOTE: Information requiring staff to send two FA-325s, in all situations, before rejecting an MHABD application (in IM Memorandum #158 dated 12/14/2017) is now obsolete.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/nw

IM-91 SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) UPDATED IM-160 AND IM-161 FORMS WITH IM-160 INSTRUCTIONS AND MANUAL UPDATE

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) UPDATED IM-160 AND IM-161 FORMS WITH IM-160 INSTRUCTIONS AND MANUAL UPDATE

MANUAL REVISIONS:

1145.015.00

FORM REVISION #

IM-160
IM-160 INSTRUCTIONS
IM-161

 

DISCUSSION:

The Advance Notice of Your Administrative Disqualification Hearing (IM-160) and Waiver of Administrative Hearing Disqualification Consent Agreement (IM-161) forms have been converted into fillable PDF forms. The instructions for the IM-160 and policy regarding Disqualification Penalties have been updated to clarify language.

The revised forms are currently available in the IM Forms Manual.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Destroy all previous paper versions of the IM-160 and IM-161 and immediately begin using the updated versions.

 

KE/mm

IM-88 INTERNAL USE ONLY FORMS REMOVED FROM PUBLIC DEPARTMENT OF SOCIAL SERVICES (DSS) FORMS MANUAL AND MOVED TO THE INCOME MAINTENANCE (IM) FORMS MANUAL

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  INTERNAL USE ONLY FORMS REMOVED FROM PUBLIC DEPARTMENT OF SOCIAL SERVICES (DSS) FORMS MANUAL AND MOVED TO THE INCOME MAINTENANCE (IM) FORMS MANUAL

 

DISCUSSION:

The DSS Manuals Forms Manual (public site) is intended to be used primarily by the public. The purpose is to assist participants and community partners who help participants with applying for and maintaining assistance from the Family Support Division (FSD).

The DSS Manuals Forms Manual (public site) has been updated to remove forms that are for internal use only. This includes many forms that staff complete and send to participants, as well as forms that are for field processing only and should not be accessible to participants.

The forms listed below are now available to staff only in the FSD Intranet Forms Manual (internal site).

 

Internal Use Only forms removed from the DSS Manuals Forms Manual:

BCC-1

BCCT Temporary Medicaid Authorization

CARS-3

Demand Letter for Overissuance

CARS-3

Out State Demand Letter (OTSTAT)

CARS-3-AE

Agency Error

CARS-3-IHE

Inadvertent Household Error (SPV-N)

CARS-3-IHE-H

Inadvertent Household Error Suspected Program Violation (SPV-Y)

CTYINFO

County Information Template (IM Forms)

FA-351

Child Care Provider Health and Safety Information

FA-352

Child Care Invoicing And Payment Information

FA-402

Letter for FA-402’s Returned After 90 Days

FA-700

Confidentiality Agreement

FA-701

FAMIS User Request

FA-702

Request for Access to FAMIS Information

FA-703

Access or Revocation of Profile to a FAMIS User Granted by Central Security Administrator

FSD/DBH

Coversheet

FSD/WIU

Tracking Sheet

IM-115

Request for Food Stamp Household Report

IM-14

Request for Interpretation of Policy

IM-145 OTH

Change Report Form

IM-16

Communication Transmittal

IM-16 Log

Child Support TA Sanction Request

IM-204

Returned Check Register

IM-206

Check Transmittal

IM-210 MHN

Report of MHN Quality Control Review

IM-29

MAGI

IM-29

Medicaid Eligibility Authorization

IM-29 OPE

Out-of-Pocket Expenses

IM-29 SPDN

Notification of Spend Down Coverage

IM-30A

MA Spend Down Worksheet

IM-30B

Surplus Computation Worksheet

IM-31

Appointment Letter

IM-311Q

QC Referral For Contact/Sanction

IM-31A

Request for Information

IM-31A

Request for Information Electronic

IM-31A

Request for Information – Spanish

IM-31A SHMB

Request for Information Show Me Healthy Babies

IM-31M

Notification of Missed Interview

IM-31Q

Notice Of Contact Requested

IM-31SPDN

Spend Down Notification

IM-32DIV

Temporary Assistance Diversion Approval Notice

IM-32MAGI

Approval Notice

IM-32MAWD

Notice of Case Action

IM-32SMHB

Action Notice – SMHB

IM-32SPDN

Notice of Approval for Medical Assistance Spend Down

IM-33

Notice of Case Action

IM-33A

Notice of Temporary Assistance/Food Stamp Case Action

IM-33MAGI

MAGI Notice of Case Action

IM-33MAGI

MAGI Notice of Case Action – Spanish

IM-33MHF

MO HealthNet for Families Notice of Action

IM-33TMH-R

Transitional MO HealthNet Quarterly Report

IM-360A

Extension or Closing Summary

IM-363

Notice of Temporary Assistance Extension for Hardship Action

IM-365

EMCIA Cover Sheet

IM-39

Request For Employment Security Information – Outside State Of Missouri

IM-39A

Request For Public Assistance Information – Outside The State Of Missouri

IM-41TA

TANF Months Used

IM-54

Referral for Services

IM-54A

Home and Community Based Services Referral/Assessment

IM-58

Transitional MO HealthNet Suspension Notice

IM-61

Social Information Summary

IM-62

Notice of Eligibility for Nursing Facility/Other Vendor

IM-62 PEME

Notice Of Post Eligibility Medical Expense Reduction In Surplus

IM-62 PEME-NFA

PEME Facility Notification – Approval

IM-62 PEME-NFD

PEME Facility Notification – Denial

IM-63 HWD

MO HealthNet Undue Hardship Waiver Decision

IM-63 HWN

MO HealthNet Undue Hardship Waiver Letter

IM-63 HWR

MO HealthNet Undue Hardship Waiver Request

IM-66 MAN

Medical Appointment Notification

IM-66 MAR

Medical Appointment Notification – Authorized Representative

IM-66 MRN

Medical Appointment Reschedule Notification

IM-66 MRR

Medical Appointment Reschedule Notification – Authorized Representative

IM-6EBT

Authorization for Release of Information

IM-76

Social Security Referral Request

IM-80

Adverse Action Notice

IM-80PRE

Pre-Closing Notice

IM-80SPDN

Non-spend down to spend down Adverse Action Notice

IM-80TMH

Adverse Action Notice

IM-82A

Notice of Vendor Termination

IM-89

Agency Representative Food Stamp Hearing Control Log

IM-90

Withdrawal of Request for Hearing

IM-90A

Agency Action Rescinded

IM-90B

Agency Action Withdrawn Participant Notification

IM-94A

Family Child Care Provider Notice of Registration (Appr/Rej)

IM-94B

Parental Notice of Family Child Care Provider Registration (Appr/Rej)

Menu

Adds Menu Items for IM Forms to MS Word

MO 580-2421

Family Care Safety Registration  – Child Care And Elder-Care Worker Registration

MRT Checklist

MRT Checklist

PE-1

SSL Application

PE-2

Worksheet

PE-3

PE Auth

PE-3

TEMP SMHB

WRKRINFO

Worker Information Template

 

SSI/SSDI Transition Letter

 

SSI/SSDI Transition Letter – Spanish

 

Signature Request Letter

 

Internal Inspections Report/Field Office

 

IRS Notice Log

 

Research and Evaluation Request

 

Standard Visitor Log

 

DHSS Referral Letter

 

DHSS Referral Letter-Spend Down

 

Application for Other Benefits letter

 

MO HealthNet Spend Down Discussion Checklist

 

Temporary Assistance Diversion Transmittal Form

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Update saved links.

 

KE/cj

IM-84 MILEAGE REIMBURSEMENT RATE INCREASE FOR ALL INCOME MAINTANENCE (IM) PROGRAMS

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  MILEAGE REIMBURSEMENT RATE INCREASE FOR ALL INCOME MAINTANENCE (IM) PROGRAMS

MANUAL REVISION #
APPENDIX J

 

DISCUSSION:

The state mileage rate used to calculate expenses for all IM programs increased from $.43 per mile to $.49 per mile effective 07/01/2021. Use the rate of $.49 per mile when calculating mileage expenses.

Eligibility system updates were completed on 07/21/2021 to reflect the rate increase. Appendix J of the MO HealthNet for the Aged, Blind and Disabled manual has been updated to reflect the change.

Note: Final approval for the increased rate was received after July benefits were created. Affected cases have been adjusted to reflect this change for July 2021 and notices will be generated.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/nw

IM-82 SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) IM-210 FORM AND INSTRUCTIONS REVISED

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) IM-210 FORM AND INSTRUCTIONS REVISED

FORM REVISION #
Report of SNAP Quality Control Review (IM-210)
Instructions for Completing the IM-210

 

DISCUSSION:

The Report of SNAP Quality Control Review form (IM-210) and Instructions have been updated. The updated form revises Food Stamps to SNAP, job title terms and time frames. The revised form is currently available in the IM Forms Manual.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Destroy all previous paper versions of the IM-210 and immediately begin using this version.

 

KE/mm

IM-81 RESUME SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) RECERTIFICATION INTERVIEWS

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  RESUME SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) RECERTIFICATION INTERVIEWS

 

DISCUSSION:

The Food and Nutrition Services (FNS) option to waive SNAP recertification interviews has ended. SNAP recertification interviews resumed August 1, 2021.

NOTE:  Continue to waive recertification interviews for households in which all adult (18 and over) members are disabled or elderly, no household member has earned income, and there are no changes in circumstances. Use the SNAP Recertification Interview Decision Chart when determining if an interview is necessary.

Recertification applications that are pending when interviews resume (received prior to August 1, 2021) will be waived.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/ks

IM-79 EXPIRATION OF COVID-19 VERIFICATION FLEXIBILITIES FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP), TEMPORARY ASSISTANCE (TA) AND CHILD CARE (CC)

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  EXPIRATION OF COVID-19 VERIFICATION FLEXIBILITIES FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP), TEMPORARY ASSISTANCE (TA) AND CHILD CARE (CC)

 

DISCUSSION:

During COVID-19 staff were allowed to provide flexibilities while working with participants to obtain verifications introduced in memo, IM-22 COVID-19 Verification for Food Stamps (FS), Temporary Assistance (TA) and Child Care (CC), dated 3/27/2020.

Beginning August 1, 2021, participants will be required to meet verification eligibility requirements as flexibilities will no longer be adequate when determining eligibility.

Discontinue using Collateral Contact (CC) to prevent cases from pending for verification that was not easily obtained. Instead, process requests for verifications and pending verifications according to pre-COVID-19 requirements.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/ks

IM-78 OBSOLETE FORMS REMOVED FROM DEPARTMENT OF SOCIAL SERVICES (DSS) FORMS MANUAL AND INCOME MAINTENANCE (IM) FORMS MANUAL

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  OBSOLETE FORMS REMOVED FROM DEPARTMENT OF SOCIAL SERVICES (DSS) FORMS MANUAL AND INCOME MAINTENANCE (IM) FORMS MANUAL

 

DISCUSSION:

The DSS Manuals IM Forms Manual (public site) and FSD Intranet IM Forms Manual (internal site) have both been updated to remove forms that are obsolete and no longer to be used by Family Support Division (FSD) staff.

Obsolete forms that were removed:

DOI-1 

Referral for Investigation

IM-1

Application for Benefits

IM-2

Application for Benefits

IM-2

Mod Adult Adult Supplement – Spanish

IM-209

Case Reading Form

IM-23

Client Services Postcard

IM-2C

Expenses of Producing Income – Spanish

IM-2U

Eligibility Recording Form

IM-30C

Explanation of Financial Eligibility

IM-30IBCA

Income Maintenance Budget (IBCA)

IM-31A MC+

MC+ Request for Information

IM-32MC

MC+ Approval Notice (Non-premium groups)

IM-32MPW

MC+ for Pregnant Women Approval Notice

IM-32PRM

MC+ Approval Notice (Premium Group)

IM-32QMB

Notice of Approval

IM-32SLMB

Notice of Approval

IM-33A

Notice of Temporary Assistance/Food Stamp Case Action

IM-33MAF

MAF Notice of Case Action

IM-33MC

MC+ Notice of Denial

IM-33MCC

MC+ Notice of Action

IM-34

Change of Status Summary

IM-35

Identification Data Form

IM-36

Vital Statistics Form

IM-37

Insurance Form

IM-38

IM-2 Recording Worksheet

IM-3A

Reinvestigation Notice

IM-4 MA

Information about your Medical Assistance

IM-42

Inter-county Transfer

IM-42A

County Transfer Letter

IM-80MC

MC+ Advance Action Notice

PC-1

Presumptive Eligibility Determination

PC-2

MO HealthNet for Kids Presumptive Eligibility Determination

SPNDDOWN

Spend Down Calculation Document

 

Audit Document Request Form

 

Flow Chart for Pregnant Women Applications

 

Affidavit of Disaster Loss

 

Case Manager Performance Plan

 

Case Worker Performance Plan

 

Program Improvement Plan

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Discontinue use of any forms shown.
  • Discard any unused forms shown if paper copies are being stored.

 

KE/cj

IM-77 COMMON LAW MARRIAGE UPDATE FOR ALL INCOME MAINTENANCE PROGRAMS

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  COMMON LAW MARRIAGE UPDATE FOR ALL INCOME MAINTENANCE PROGRAMS

MANUAL REVISION #
1100.010.00
1105.015.04.15
0205.025.00
1805.030.10.07
1013.000.00

 

DISCUSSION:

If a common law marriage was established in another state, each partner is considered a spouse in Missouri. Common law marriages cannot be initiated in Missouri.

EXAMPLE: Edward and Ana state they are common law spouses. Their marriage began in Kansas, where common law marriages can be established. Consider them spouses for eligibility purposes.

The following manual sections have been updated or created to reflect this information:

Child Care will continue to follow Temporary Assistance policy for specified relatives. Refer to 2010.010.00 Relationship of the Applicant to the Child for more information.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Send questions regarding common law marriages through normal supervisory channels.

 

KE/ers

IM-76 TAX CREDIT CHANGES RESULTING FROM THE AMERICAN RESCUE PLAN ACT (ARPA) OF 2021

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  TAX CREDIT CHANGES RESULTING FROM THE AMERICAN RESCUE PLAN ACT (ARPA) OF 2021

 

DISCUSSION:

The ARPA modified the provisions of several commonly used tax credits. Most of the changes are in effect only for 2021. The following tax credits are refundable, meaning the credit amount can be paid directly to the tax filer if his/her tax liability is $0.

 

Child Tax Credit (CTC) Earned Income Credit (EIC) Child and Dependent Care Credit
A credit increase to $3600 for qualifying children ages 0-5; $3000 for children ages 6 through 17. The minimum age to qualify for the EIC is lowered to 19 and the maximum age is removed. The maximum amount of this credit increased to $6000 for one child and $16,000 for two or more children.
One-half of the estimated CTC amount is payable to parents in advance monthly payments starting in July 2021; the other half will be issued as part of 2021 tax refunds. The maximum income for an earner without children is increased to $9820.  
Tax filers will be able to opt out of the advance monthly payments. Some married filers may be treated as unmarried filers in certain circumstances.  

 

Do not count advance monthly payments or lump sum refunds of a refundable tax credit as income or a resource for Income Maintenance programs. For programs that consider resources, count tax credit funds remaining after 12 months as a resource.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/ers