0810.000.00 MO HealthNet Coverage

IM-55 June 2, 2023

Family Support Division (FSD) is responsible for:

1. Determining the individual’s MO HealthNet (MHN) eligibility.
2. Making referrals to Division of Senior and Disability Services (DSDS) staff for the individual’s assessment for services.
3. Processing referrals from DSDS for MHN applications.
4. Communicating with DSDS staff regarding:
   • the joint application process
   • any changes in circumstances

Requests for Personal Care Services may originate through any of the following sources:

• individual/family
• physician
• hospital
• long-term care facility
• DSDS staff
• other

When FSD staff receive a request for Personal Care Services, from any of the above sources, FSD staff will:

1. Verify the individual’s current Title XIX status:

1. 1. If the individual is currently Title XIX eligible, staff will notify DSDS staff of current Title XIX eligibility dates by using the Referral for Services form (IM-54) or by verbal confirmation.
   2. If the individual is not currently Title XIX eligible, FSD staff will:
      • Take an MHN application.
      • If the request was from a source other than DSDS staff, notify DSDS staff of the request for Personal Care Services, by sending an IM-54, indicating Title XIX eligibility determination in process and Personal Care Services requested.

1.  
2. Complete the eligibility determination; and
3. Notify DSDS staff of Title XIX eligibility or ineligibility. On approvals, beginning and ending Title XIX dates must be reported to DSDS staff, for Title XIX billing purposes. The IM-54 or a copy of the approval or rejection letter may be used as the vehicle for notifying DSDS staff. FSD staff will keep DSDS staff informed of any change in circumstance affecting the participant’s Title XIX eligibility, on an ongoing basis, including the results of annual renewals and any changes in Title XIX eligibility dates.