MO HealthNet for the Aged, Blind, and Disabled

If a participant age 22 to 65 leaves the vendor facility and enters the State Hospital (General Medical and Surgical or Psychiatric Sections):

1. Record the information at the Eligibility Unit Member Role/EUMEMROL/FM3Z screen in FAMIS.
2. Contact the resource investigator at the facility to establish:
   1. anticipated length of stay and/or possible date of release
   2. plans for placement and/or living arrangements upon release
3. If plans have been made for the participant’s release:
   1. set a priority to follow up on the participant’s planned date of release
   2. take necessary action, based on the participant’s living arrangements at the time of release from the State Hospital.
4. If no plans have been made for the claimant’s release, set a priority to follow up in 21 days.
   1. If participant is still residing in the facility and no plans have been made for his/her release, change the claimant’s level of care to T (Title XIX only).
   2. Send the participant , legal guardian or relative, and the nursing facility, the notification letter of action taken (IM-33). Advise the claimant that s/he is ineligible for vendor payments.
   3. Complete an MA determination as if the participant were in his/her own home.