Family Support Division (FSD) staff have the responsibility of requesting necessary verification and recording information in the electronic record that clearly documents all eligibility requirements for a program are met, or that one or more requirements are not met and ineligibility exists.
Individuals applying for or receiving assistance have the responsibility to provide information or access to the information needed for determining eligibility, both initially and on a continuing basis.
If the participant signs a release form for FSD to have access to the information needed for determining eligibility, but the source will not provide the information requested to FSD, requires payment for the response, or requires a company specific form, inform the participant that they must obtain the information from the source directly. It is the participant’s, authorized representative’s, and/or legal representative’s responsibility to provide FSD with all information regarding the household’s income and circumstances at the time of the initial application and ongoing to determine eligibility. It is FSD staff’s responsibility to inform the participant what information is needed. Ensure the Request for Information (FA-325 or IM-31A) form clearly identifies the documentation that must be provided.
An applicant must be given at least ten days to supply necessary information per request. A MO HealthNet (MHN) application may be rejected after the initial Request for Information (FA-325 or IM-31A) has expired. A second FA-325 must be sent in the following situations:
- The applicant provided part, but not all, of the information requested on the original FA-325
- 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
If an MHN application is rejected prior to the actual due date of the application for failure to provide verification or failure to cooperate, and then all of the requested information is received on or prior to the due date of the application, the application should be cancel rejected and processed using the original date without requiring that the applicant submit a new application document.
For active cases, if the participant refuses or fails to provide the necessary information to establish continuing eligibility within ten days, authorize an adverse action to close in the eligibility system, or send an Adverse Action Notice form to close.
Questionable Documentation or Other Verification
FSD is not required to accept documentation or verification if it appears to be inaccurate, incomplete, inconsistent, inauthentic, or not true. If the participant provides documentation or other verification that is questionable, send a Request for Information form (FA-325 or IM-31A) requesting the clarifying or additional information needed. Allow ten days for the participant to provide the information needed to determine eligibility. If the requested information is not received or does not resolve the discrepancy, authorize the rejection or adverse action to close the case for failure to cooperate.
If FSD staff learn of information affecting the eligibility determination, which was not disclosed at the time of the application and was not a change in circumstances, allow the participant up to the application due date to provide needed verification. If the necessary information needed to determine eligibility is not received by the due date, authorize the rejection for failure to cooperate. Do not exceed the application processing time frames. See MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual section, 0804.005.00 MHABD Application Timeframes.
Any case action can be challenged in a hearing so there must be a rational, reasonable explanation for taking action, such as closing or rejecting a case, based on the information provided or not provided. Staff must be able to explain, based on logic and facts, not on conjecture, prejudice, or emotion, why the documentation was questionable and the application was denied.