December 1973 Eligibility Requirements Manual

1020.010.00 Patients in a Medical Institution

While the law disqualifies persons who are inmates of certain public institutions from receiving assistance, there is an exception for persons who are ‘patients’ in public medical institutions. Regulation 13 CSR 40-2.080(3) defines ‘patient’, and regulation 13 CSR 40-2.080(4) defines ‘public medical institution’.

The following criteria are applied when determining eligibility for patients in public medical institutions:

  1. The definitions of ‘patient’ and ‘public medical institution’, as set forth in regulations 13 CSR 40-2.080(3) and 13 CSR 40-2.080(4) respectively, must both be applied when determining eligibility.
  2. Persons residing in public institutions that are not medical institutions are not eligible to receive assistance.  Institutions such as jails and county farms do not meet the requirements of regulation 13 CSR 40-2.080 (4).
  3. Section 208.151 of the law states:  ‘The following needy persons shall be eligible to receive medical assistance….  (4) All persons who would be determined to be eligible for old age assistance benefits, permanent and total disability benefits, or aid to the blind benefits under the eligibility standards in effect December 31, 1973, or less restrictive standards as established by rule of the Family Support Division, who are sixty-five years of age or over and are patients in state institutions for mental diseases or tuberculosis. Persons age 65 or older in the certified sections of Fulton State Hospital, St. Joseph State Hospital, Nevada State Hospital, Farmington State Hospital, St. Louis State Hospital, Western Missouri Mental Health Center in Kansas City, Mid-Missouri Mental Health Center in Columbia, and Malcolm Bliss Mental Health Center in St. Louis meet the ‘institutional residence’ eligibility requirement. Individuals under 65 in State Mental Hospitals or the Missouri State Rehabilitation Center, who meet the eligibility criteria for Medical Assistance as if living in their own homes, are entitled to General Medical and Surgical Services benefits.
  4. To determine if an institution conforms to the definition of public medical institution as stated in Regulation 13 CSR 40-2.080(4), submit to the State Office a brief description (summary)of the institution as pertains to the criteria listed in sections A. and B. of Regulation 13 CSR 40-2.080(4). Submit a summary for each institution in the county that possibly meets this definition; however, only one summary per institution is required unless the institution should initiate a major change in function or organization.  The advice and facilities of the Department of Health (DOH) are available to FSD whenever necessary in determining whether an institution meets the legal definition of a public medical institution.