Category: IM Memo

IM-121 FORM REVISIONS COMPLETED FOR ADMINISTRATIVE DISQUALIFICATION HEARING FORMS

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  FORM REVISIONS COMPLETED FOR ADMINISTRATIVE DISQUALIFICATION HEARING FORMS

FORM REVISION #

IM-160 (INSTRUCTIONS)
IM-160P
IM-161 (INSTRUCTIONS)
IM-161A

 

DISCUSSION:

Form revisions were completed for forms that are used by Income Maintenance (IM) staff and by the Administrative Hearings Unit (AHU) for participants requiring an Administrative Disqualification Hearing.

Advance Notice of Your Administrative Disqualification Hearing (IM-160) was updated for formatting and to add information for the participant regarding the purpose of the hearing.

Waiver of Administrative Hearing Disqualification Consent Agreement (IM-161) was updated for formatting.

The instructions for the IM-160 and IM-161 were updated. These forms and instructions are now available to staff only in the FSD Intranet IM Forms Manual.

Withdrawal of Waiver of Administrative Hearing Disqualification Consent Agreement (IM-161A) was updated for formatting and published as a fillable PDF. The IM-161A is available to participants, advocates, and staff in the DSS Manuals IM Forms Manual.

A new form packet Administrative Disqualification Packet (IM-160P) has been added for staff use to the IM Forms Manual. This form contains linked versions of the IM-160, IM-161, and IM-161A.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using the IM-160, IM-161, and IM-161 with revision dates of 10/2021.
  • Discard any out of date forms.
  •  

KE/cj

IM-120 TERMINOLOGY UPDATE TO THE ELIGIBILITY SYSTEM AND MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAM MANUALS

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  TERMINOLOGY UPDATE TO THE ELIGIBILITY SYSTEM AND MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAM MANUALS

MANUAL REVISION #

0525.010.05
0525.010.10
0630.015.25
0805.020.05
0810.035.10
0815.000.10
0815.020.10
0815.025.00
0815.040.00
0815.065.00
0815.075.10
0815.075.10.05
0815.075.10.10
0815.075.15
0955.020.00
1015.010.05

 

DISCUSSION:

Effective November 28, 2021, MHABD program manuals and the eligibility system will reflect the proper terminology when referencing Individuals with Intellectual Disabilities (IID). The eligibility system and MHABD policy manuals will no longer reference Mental Retardation or Institute for Mental Retardation.

 

Eligibility system changes

  • The MHABD interview driver question will now to be read as:

“Is any applicant in a Skilled Nursing Facility, Intermediate Care Facility, Residential Care Facility, Intermediate Care Facility for Individuals with Intellectual Disabilities, Mental Health Center, Psychiatric Hospital or State Rehab Center?”

  • The Facility and Placement Information Details (FMJ5) screen now has the following codes:
    • Type Code: IMR- ICF for Indivs w/Intellectual Disabilities
    • Type of Bed Code: IMR- ICF for Indivs w/Intellectual Disabilities
    • DA-124A/B Level of Care: IMR- ICF for Indivs w/Intellectual Disabilities

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/nw

IM-119 EMERGENCY MO HEALTHNET FOR INELIGIBLE ALIENS (EMCIA) FORMS UPDATE

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  EMERGENCY MO HEALTHNET FOR INELIGIBLE ALIENS (EMCIA) FORMS UPDATE

FORM REVISION #

IM-365
IM-365D

 

DISCUSSION:

Updates have been made to forms used for EMCIA determinations.

The Emergency MO HealthNet for Ineligible Aliens (IM-365) form was updated to add MO HealthNet Adult Expansion Group (AEG), update contact information for the Medical Review Team (MRT) Processing Center, allow additional dates of service (up to 6), and change to PDF format.

The Emergency MO HealthNet for Ineligible Aliens Determination (IM-365D) was created to document the MRT physician’s determination of qualified coverage dates for EMCIA emergency medical conditions as outlined in Section 1903(v) of the Social Security Act.

These forms are available for staff use in the FSD Intranet Income Maintenance (IM) Forms Manual.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Use the forms with the revision date of 10/2021.
  • Discard any forms with older revision dates.

 

KE/cj

IM-118 ADDITIONAL UPDATES TO NATIONAL VOTER REGISTRATION (NVR) MANUAL

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  ADDITIONAL UPDATES TO NATIONAL VOTER REGISTRATION (NVR) MANUAL

MANUAL REVISION #

2100.000.00
2100.010.00
2100.020.00
2100.020.10
2100.020.20
2100.020.40
2100.020.50
2100.020.60
2100.020.70
2100.030.00
2100.040.00
2100.050.00
2100.060.00

 

DISCUSSION:

Additional changes have been made to the NVR Manual to update terminology used throughout the manual. There have been no changes to NVR requirements or procedures.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/rr

IM-117 PRIOR QUARTER (PQ) UPDATES TO THE FAMILY MO HEALTHNET (MAGI) AND MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAM MANUALS

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  PRIOR QUARTER (PQ) UPDATES TO THE FAMILY MO HEALTHNET (MAGI) AND MO HEALTHNET FOR THE AGED, BLIND, AND DISABLED (MHABD) PROGRAM MANUALS

MANUAL REVISION #

0420.000.00
0515.005.00
0620.005.00
0810.015.00
0810.015.05
0810.015.10
0815.045.00
0815.050.05
1030.035.40
1810.030.10
1830.020.00
1850.030.00
1865.030.10

 

DISCUSSION:

Updated policy information regarding PQ requests have been made to the MAGI and MHABD program manuals. Individuals may apply or reapply for PQ for up to one year after the application date. They may apply for PQ in person, by telephone, or in writing.

The PQ months must be the three consecutive months prior to the date of application.

EXAMPLE: Ms. B applied and was approved for MHABD in May 2021. In August 2021, Ms. B contacted FSD stating she had outstanding medical bills from March 2021. Ms. B can apply for PQ because it has not been over a year since she submitted her initial application for MHABD.

Note: Adult Expansion Group (AEG) PQ coverage shall not start prior to the implementation month of July 2021.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/kg

IM-116 FORM REVISIONS COMPLETED FOR HEARING WITHDRAWAL FORMS

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  FORM REVISIONS COMPLETED FOR HEARING WITHDRAWAL FORMS

FORM REVISION #
IM-90 (INSTRUCTIONS)
IM-90A (INSTRUCTIONS)
IM-90B (INSTRUCTIONS)

 

DISCUSSION:

Form revisions were completed for hearing withdrawal forms that are used by Income Maintenance (IM) staff. These forms were changed to reflect updated terminology and for improved formatting. All forms are available as fillable PDF documents. The forms and corresponding instructions were added for staff use to the IM Forms Manual.

Policy regarding administrative hearings has NOT changed.

Withdrawal of Request for Hearing (IM-90) may be completed by Family Support Division (FSD) staff by phone or in person while working with participants.

Agency Action Rescinded (IM-90A) is to be completed by the FSD agency witness assigned to the requested hearing. This form is sent to the Administrative Hearings Unit to rescind a hearing.

Agency Action Withdrawn Participant Notification (IM-90B) is to be completed by the FSD agency witness assigned to the requested hearing. This form is sent to the participant to notify them that the agency has rescinded the action and the hearing has been cancelled.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using IM-90, IM-90A, and IM-90B forms with revision date of 10/2021 immediately.
  • Discard any forms with older revision dates.

 

KE/cj

IM-115 INTRODUCING INFORMATION ACCESSED FROM KANSAS DEPARTMENT OF LABOR (IM-39K) FORM

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  INTRODUCING INFORMATION ACCESSED FROM KANSAS DEPARTMENT OF LABOR (IM-39K) FORM

FORM REVISION #
IM-39K

 

DISCUSSION:

A new form, Information Accessed from Kansas Department of Labor (IM-39K), has been created to collect Kansas unemployment income information. When a participant declares Kansas unemployment income, staff will submit a Request for Employment Security Information – Outside State of Missouri (IM-39) by email:

A specialized unit accesses the Kansas Department of Labor (KDOL) interface and completes the IM-39K with all relevant and available information. Screen shots of the KDOL interface will not be added as these are not allowed in the electronic case file.

The specialized unit will send the IM-39K to the staff member who requested the Kansas unemployment information. Processing staff will enter the information in the eligibility system and add the IM-39K to the electronic case file.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/cj

IM-113 UPDATES TO REQUEST FOR EMPLOYMENT SECURITY INFORMATION – OUTSIDE STATE OF MISSOURI (IM-39) AND INSTRUCTIONS

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  UPDATES TO REQUEST FOR EMPLOYMENT SECURITY INFORMATION – OUTSIDE STATE OF MISSOURI (IM-39) AND INSTRUCTIONS

FORM REVISION #
IM-39
Instructions

 

DISCUSSION:

The Request for Employment Security Information – Outside State of Missouri (IM-39) has been updated to simplify the form, provide updated return options for the receiving state, and convert the form to PDF format for easier accessibility.

The IM-39 Form Instructions have been updated to reflect the changes made to the IM-39.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/cj

IM-112 AFGHAN HUMANITARIAN PAROLEE UPDATES FOR ALL PROGRAMS

Posted on

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  AFGHAN HUMANITARIAN PAROLEE UPDATES FOR ALL PROGRAMS

 

DISCUSSION:

Due to updated guidance individuals with an immigration status of Humanitarian Parolee are now considered Qualified Non-Citizens and are not subject to the five-year waiting period for MO HealthNet (MHN), Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance (TA) and Child Care (CC).

Humanitarian Parolees are treated like those with Special Immigrant Visas (SIVs) and are eligible for benefits. Policy guidance regarding Afghan Humanitarian Parolees contained in Email Memorandum #53 Afghan Parolees or Special Immigrant Visa (SIV) Updates for All Programs is now obsolete.

Afghan Humanitarian Parolees:

  • Will have form I-94 noting Humanitarian Parolee- SQ4, SQ5, CQ1, CQ2, CQ3, OAR, PAR Class of Admission (COA);
  • Foreign passport with Department of Homeland Security/U.S. Customs and Borders (DHS/CBP) admission stamp noting Operation Allies Welcome (OAW);
  • Foreign passport with DHS/CBP with a stamp admitting them with an SQ1, SQ2, SQ3, SQ6, SQ7, or SQ8 COA; or
  • Foreign passport with DHS/CBP admission stamp noting Parolee (DT).

NOTE: Applications received for Afghan SI Parolees, Humanitarian Parolees (also known as Afghan non-SI Parolees), Afghan SI CPRs, and Afghan SI LPRs must be sent to the FSD Refugee Unit at: FSDREFUGEE@ip.sp.mo.gov. Special entry is required to allow this population to be coded correctly. Do not process these applications.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.

 

KE/kg