If entering an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), determine if the participant is medically certified for the ICF/IID level of care (see 0815.030.00 Vendor Surplus Computation):
- If the claimant is medically certified, make the appropriate change in the eligibility system on screen FACPLACE (FMJ5).
- If the claimant is not medically certified:
- The eligibility system will send an Advance Notice of Adverse Action advising the participant that s/he is no longer eligible for vendor payments effective with the date s/he left the previous vendor facility.
- Follow procedures in 0815.070.10 Vendor Facility to Private Home, Not Receiving HCB to determine eligibility for MO HealthNet for the Aged, Blind, and Disabled (MHABD) Spend Down/Non-Spend Down coverage.