Family Healthcare (FAMIS)

0945.015.00 FSD COUNTY OFFICE RESPONSIBILITY

It is the responsibility of the FSD county office to:

  1. Designate a member of the staff to be a liaison with the Qualified Provider(s) in the county.  This liaison provides technical assistance to the QP who experiences problems with eligibility determinations and serves as a contact for the QP on specific cases.
  2. Review QP-1 forms and TEMP cards (QO-2) received in the county office.  If necessary  information is missing from the form, call the QP liaison to obtain it.

    If the QP has made errors in determining income eligibility or the dates on the TEMP card are incorrect, the county TEMP liaison immediately discusses these problems with the SP designated staff.

  3. For TEMP eligibles, enter the information from TEMP eligibility determinations into the system via the ITMP transaction within one (1) working day of receipt.  See ITMP instructions under the heading “B. ITMP System”.
  4. For Temp eligibles, set up a case record with the TEMP information.  Label the record with the type of assistance P, the DCN, and the temporary number.  Maintain the county office copy of the QP-1 in this file with a cover sheet labeled “TEMP Section”.  File copies of any QP-2 cards of IM-29(TEMP) letters issued in this section, also.

    If the claimant subsequently applies for MC+, incorporate the TEMP section into the MC+ case record.

    If the claimant does not subsequently apply for assistance, maintain this case record for five years following the ending eligibility date.

    Local FSD office procedures must ensure that TEMP case records are readily available for review by intake caseworkers when TEMP claimants apply for MC+.

    There are two ways to identify TEMP eligible women at the application interview:

    1. Screening on IPAR prior to the application interview may indicate TEMP eligibility.  Provide this information to the worker prior to the interview.
    2. TEMP eligible women are identified if they present a current TEMP identification card (QP-2).
  5. When the TEMP eligible woman applies for MC+ in the same month as the TEMP determination (or before), take no action regarding TEMP eligibility.  A TEMP Authorization Letter (IM-29TEMP) is unnecessary, because the woman has a QP-2 good through the end of the following month.  The system tracks the MC+ application in relation to the TEMP eligibility period.
  6. When the TEMP eligible woman applies for MC+ in the last month of TEMP eligibility, give her an IM-29(TEMP) to extend TEMP coverage to 15 days from the date of application.  For example, a TEMP eligible woman, whose TEMP eligibility expires August 31, applies for MC+ on August 20.  Give her an IM-29(TEMP) with coverage from September 1 through September 4, 1991.  (September 4 is the 15th day of her MC+ application.)

    EXCEPTION:  If you know at the time of application that the woman is not eligible for MC+, do not give her an IM-29(TEMP) letter.  If you do not give her a letter, you must reject her application before the end of the TEMP eligibility period.

    When the MC+ is entered via IAPP, the system automatically extends TEMP coverage to the 15th day of the MC+ application.

  7. If there is no action taken on the MC+ application by the last day of TEMP eligibility, there is an automatic extension of TEMP coverage.

    This process occurs only if a MC+ is not acted upon within 15 days, or by the end of the TEMP eligibility period, whichever is later.  It should not happen frequently.

    When an application for MC+ is pending for a TEMP eligible woman, the system tracks the application in relation to the TEMP eligibility.  On the last day of TEMP eligibility, if a MC+ application is pending, the system generates a message to the worker on the print subsystem.  The message states, “Make a decision on the above Medicaid application today, or send a letter extending TEMP eligibility to MM/DD/YY”.  If you are unable to make an eligibility decision on the date of this message, send an IM-29(TEMP) letter to extend TEMP eligibility seven additional days.  (The seventh day is listed on the message.)  If no action is taken on the MC+ application on the date of the message, the system extends TEMP eligibility seven days.

    Every seven days, this process is repeated until the MC+ application is completed.  Every time the extension message is generated, the worker must send an IM-29(TEMP) or complete the application that day.

    NOTE:  Be sure to mail the IM-29(TEMP) the same day as the extension message, so the woman has continuous proof of TEMP coverage.

  8. For TEMP denials, do not enter in ITMP and do not set up case records.  Counties are required to report statistical information on these cases to State Office.  Keep all denial QP-1 forms in one file and prepare to submit information regarding these cases to State Office upon request.