| TO: | ALL COUNTY OFFICES |
| FROM: | JANEL R. LUCK, DIRECTOR |
| SUBJECT: | LEGACY JANUARY 2008 INCREASE IN VETERAN'S ADMINISTRATION (VA) BENEFITS |
DISCUSSION:
The Veteran's Administration (VA) increased benefits by 2.3% to persons who receive widow, children, and veteran pension benefits and to persons who receive service connected compensation. The increase begins with the January 2008 checks. The Veteran's Administration (VA) Cost of Living Adjustment will be completed the weekend of December 8, 2007. Legacy will be completing an adjustment on all MO HealthNet for the Aged, Blind, and Disabled (MHABD) spenddown, non spenddown, and vendor cases; Supplemental Nursing Care (SNC) cash cases; Supplemental Aid to the Blind (SAB) cash cases; Home and Community Based (HCB) Services cases; and Missouri Children with Developmental Disabilities (MOCDD) Waiver cases that include an individual in the assistance group receiving VA benefits.
For applications approved after the mass adjustment, verify the new VA amount. If the new amount is unavailable and the old amount of VA benefits has been verified, multiply the old amount by 1.023 to arrive at the approximate new amount of benefits.
State Office will complete the adjustment as follows:
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send the adverse action or adjustment notice;
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adjust or close the case; and
- provide a listing of cases for counties.
NOTE: No paper reports or notices will be produced for counties. These documents will be on MOBIUS.
County staff must handle the case when:
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a hearing is requested within the 10-day adverse action period; and/or
- the case is listed for review.
Refer to specific instructions later in this memorandum.
Cases Which Are Mass-Adjusted
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“M” type of assistance cases with a “T” level of care.
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Vendor cases, including those with allotments.
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Supplemental Nursing Care (SNC) cash cases, type of assistance “N”, “R”, and “F” with payee level of care “W”, “X”, “P”, “V”, “Y” or “B”, or any GR (SSI/SP) cases. If ineligible for the cash grant, the cash grant will be closed but the level of care will be changed to a “T”.
- SAB cash cases and conversion cases using AB criteria.
How Cases Are Mass-Adjusted
The computer program identifies participants that receive VA, based upon entries in field 25 and field 14 F of IMU5. The VA increase is added to the gross and net income figures (fields 34 and 41), and a new deficit or surplus amount is calculated for field 35. If the increase appears to cause ineligibility based on a surplus of income, some cases are closed with an adverse action notice sent to the participant and other cases are listed for review by the Eligibility Specialist.
If no VA amount appears in field 14F, but there is VA income included in the gross income in field 41 based upon the code entered in field 25, the total new amount of VA will be added to the income in fields 41 and 34, because the system cannot tell that the figure in field 41 includes VA. For these cases, the Eligibility Specialist must make the correct adjustment by entering the new amount of VA in fields 14F, 34, and 41. The Eligibility Specialist must also send the IM-80 to reduce the grant.
NOTE: MA spenddown cases are adjusted by changing the surplus amount in Field 36. The increased spenddown amount will be for February 2008 as January invoices have already been sent.
Vendor cases are adjusted by changing the surplus amount the participant must pay the nursing home. The system generates a notice of adjustment to the nursing home in addition to the participant notice.
Cases will be adjusted by applying the 2.3% increase to the VA amount shown in 14F. For these cases, if the amount in 14F is wrong, the adjustment will be wrong. The Eligibility Specialist is responsible for correcting 14F and any other affected figures.
No IM-5 turnarounds will be produced for this adjustment. These cases will appear on a report titled “Cases Adjusted.” County offices can access this report on MOBIUS. In some instances, case information is incomplete or incorrect, or otherwise cannot be mass adjusted or updated. Counties must review these cases manually, using the MOBIUS lists. Each case listed includes a caption to identify why the case could not be adjusted. Review these listed cases and manually adjust if necessary. For example, if the expense figures for a Supplemental Aid to the Blind case is not the maximum grant amount for household size, the computer program cannot make the correct computations from an incorrect expense figure and the case cannot be adjusted.
For all types of assistance, cases that will not be adjusted include:
- Cases with assistance group members who do not have VA listed in field 14F.
Listing of Cases Not Adjusted by State Office which Need Action by County Staff
There is one list of cases not adjusted:
- Cases Needing Review for Adjustment.
Cases Adjusted-Review for Further Action
Also included on the listing of cases adjusted are the following situations, which require Eligibility Specialist review to determine if further adjustment is needed. Individuals appearing on this listing with “Not Included” captions must be reviewed for necessary action.
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Supplemental Nursing Care Case Adjusted
An individual losing cash eligibility was adjusted and changed to a “T” level of care. Review these cases to see if the individual is eligible for another type of assistance and take necessary action.
NOTE: Review all cases listed in MOBIUS for manual adjustment and make necessary changes.
Hearings on Computer Adjusted Cases
The adverse action notices generated by the mass adjustment will be dated December 10, 2007. The participant has until December 20, 2007, to request a hearing and have benefits restored to pre-adjustment levels.
If the participant requests a hearing on or before December 20, 2007, complete an IMU5 transaction to cancel the computer adjustment (i.e., cancel-close a closed case, restore a grant, etc.) and follow usual hearing procedures. Immediately print a copy of the computer generated IM-80, available on MOBIUS.
If the participant does not request a hearing on or before December 20, 2007, no further case action is necessary.
Listing of Cases Adjusted
Cases that are mass-adjusted are included on one of several listings in MOBIUS.
“Not Included” on the “Cases Adjusted” list requires action. All others are for informational purposes.
- Cases Adjusted
This list is sorted by county, load, and program. The participants are listed alphabetically within program. The date of any IM-80 generated by the system for this adjustment appears in the upper right corner of the listing.
NOTE: All cases appearing with a caption of “Not Included” for any individual MUST be reviewed for necessary action by the county.
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Captions
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Not Included - This caption indicates that the individual is not included in the case budget, and therefore has no affect on the adjustment computations. However, these individuals must be reviewed by the county for necessary action. Identifying information also appears on the listing for these individuals.
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CLOSE - The case was closed in the mass adjustment.
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NO CHG - The mass adjustment resulted in no change to the case.
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DECR - The grant was decreased in the mass adjustment.
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Surp Inc - The surplus was increased in the mass adjustment.
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Surp Inc/Allot - The surplus was increased for an allotment case in the mass adjustment.
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Surp Dec/Allot - The surplus was decreased for an allotment case in the mass adjustment.
- $90 VA- nursing home recipient who receives $90 or less in VA.
Surplus Changes as a Result of VA Increases
Each vendor nursing home or institution receives a listing of its residents with VA. This list shows the case number, case name, old surplus amount and new surplus amount. The list includes a letter to the administrator of the nursing home.
Use the IM-62 to notify the vendor of any correction in the January surplus amount or to supply the January 2008 surplus amount for any participant with VA who is not on the vendor's listing.
Use normal procedures for changing surplus amounts when an error is discovered:
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For increases, the effective date is the month following the expiration of the IM-80 or the signing of the IM-80A and
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For decreases, the effective date is the month following the month of the report or discovery.
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Cases Bypassed
The county is not required to act on bypassed cases. They will not be adjusted or listed. The following cases will be bypassed during the mass adjustment:
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Refugee cases (because none currently receive VA);
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Presumptive Eligibility for Children;
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Darling cases-These are “M” type of assistance cases identified by an “M” indicator in Field 27 of IMU5;
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QMB-only cases (“Q” type of assistance)( because there are none currently receiving VA);
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SLMB-only cases (“L” type of assistance) )( because there are none currently receiving VA); and
- BCCT.
Notices to Participants
Adverse action notices and notices of adjustment will be generated by the system and mailed to participants. The following are samples of the notices being sent to participants. These are attached for informational purposes only. For hearing requests, access the copy of the notice sent to the participant in MOBIUS. To view examples of the notices, click on the appropriate link(s) below:
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Increase in Surplus Amount (Cases with N, I, D, or K Level of Care) No L Level of Care Individuals
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Increase in Surplus Amount (Cases with D, I, K, or N Level of Care) With L Level of Care Individuals
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No Change or a Decrease in Surplus but an Increase in Participant's or L Level Individuals OASDI
- SNC and SAB with Levels of Care V, W, X, Y, B, or P (May Include Decreases and Closings)
Food Stamps and Temporary Assistance Mass Adjustments
Instructions for handling Food Stamp and Temporary Assistance cases are covered in a separate memorandum.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Review cases and adjust manually as needed.