| TO: | ALL COUNTY OFFICES |
| FROM: | JANEL R. LUCK, DIRECTOR |
| SUBJECT: | FAMILY HEALTHCARE PROGRAMS: COST OF LIVING ADJUSTMENTS (COLA); MANUAL REVISION #6: 0905.012.80 0920.010.35.20, 0925.010.25.20 |
DISCUSSION:
Senate Bill 577 (2007) amended Section 208.153 RSMo to authorize the disregard of annual Social Security Cost of Living Adjustment (COLA) increases for the Family Healthcare programs until the next Federal Poverty Level (FPL) adjustment. COLA increases for all participants receiving Social Security Administration (SSA) and Supplemental Security Income (SSI) are disregarded until the yearly FPL adjustments. COLA income increases for participants receiving Veterans Administration (VA) and Railroad Retirement (RR) continue to be adjusted yearly in January.
The Family Healthcare programs that will not be mass adjusted for participants receiving SSA and SSI income in January are:
- MO HealthNet for Families (MHF)
- MO HealthNet for Kids (MHK)
- MO HealthNet for Pregnant Women (MPW)
- MO HealthNet for Newborns (MHN)
- Transitional MO HealthNet (TMH)
- Extended Women's Health Services (EWHS).
FAMIS MASS ADJUSTMENTS FOR JANUARY 2008
Individuals in Eligibility Units (EUs) that receive SSA and/or SSI will have their COLA increase noted on their individual income screens for the budget month of January 2008. FAMIS will not complete an eligibility determination for Family Healthcare (FAM in FAMIS) EUs with the SSA and/or SSI increase, as the increase is being disregarded. FAMIS will continue to disregard this increase for Family Healthcare programs until the annual FPL mass adjustments.
Individuals in all EUs that receive VA and/or RR will have their COLA increase noted on their individual income screens for the month of January AND were mass adjusted the weekend of December 8, 2007.
SSA/SSI MANUAL INCOME ENTRIES MADE AFTER MASS ADJUSTMENT
SSA and SSI incomes for individuals in any FAMIS EU (Family Healthcare, Child Care, Food Stamps and Temporary Assistance) entered after the adjustment must include the pre-COLA adjusted amount for December 2007 and the COLA adjusted amount for January 2008. FAMIS is disregarding the COLA amount entered for January's income for the Family Healthcare programs, and including it for all other FAMIS programs.
Example 1: Applications Made After COLA Mass Adjustment (December 8, 2007)
On February 8, 2008, Ms. Woods applies for Food Stamps and MO HealthNet for Kids (MHK) benefits for her son, James. Ms. Woods has been receiving Social Security Disability Income (SSDI) for five years. Her son James has been receiving SSI for two years.
Enter Ms. Woods' and James' pre-COLA adjusted SSDI/SSI income for the month of December 2007. Enter their COLA adjusted SSDI/SSI income for the budget month of January 2008, as well as their current budget month. The Food Stamp EU eligibility determination budgets the current (COLA adjusted) SSDI/SSI amounts, and the MO HealthNet for Kids eligibility determination budgets the pre-COLA adjusted SSDI/SSI amounts.
Example 2: Active EUs with Participants that Begin Receiving SSA/SSI Between COLA and FPL Mass Adjustments
The Heather family is active in FAMIS, receiving MO HealthNet for Families (MHF) and Food Stamp benefits. The family reports that daughter Joey begins receiving SSI February 1, 2008. Budget the SSI being received for the month of February 2008.
Food Stamp EUs subject to simplified reporting rules are required to report changes as described in section 1140.005.00 Definition of Simplified Reporting. Act upon changes reported following policy in section 1140.005.20 Changes Not Required to be Reported by Simplified Reporting Eligibility Unit.
Example 3: Exploring Prior Quarter for Family Healthcare Applications Taken After the FPL Adjustments
On March 15, 2008, Ms. Johnston applies for MO HealthNet for Pregnant Women (MPW). She requests prior quarter coverage for her pregnancy. Ms. Johnston has been receiving SSDI for several years. Enter SSDI received for December 2007 and the COLA adjusted income for the month of January 2008.
FAMILY HEALTHCARE PROGRAMS NOT FULLY CONVERTED
Family Healthcare EUs that are on the Manual Conversion list or have not been through the initial conversion controlled flow AND have no other active FAMIS EU's (i.e. Food Stamps, Temporary Assistance, etc.) will not have updated SSA and/or SSI income. When going through the conversion flow with a Family Healthcare EU, the actual income being received the month of conversion to FAMIS needs to be budgeted for that month (refer to Income Maintenance Memo IM-59 dated June 22, 2007, regarding CHIP Premium conversion EUs). Enter the SSA/SSI/VA/RR pre-COLA adjusted income for December 2007 budget month and the SSA/SSI/VA/RR COLA adjusted incomes for January 2008 budget month.
NOTE: Check FAMIS screen FM40/EULOG for the status date of the “CNVT” action to determine the month of FAMIS conversion.
NECESSARY ACTION:
Do not enter SSA/SSI income for December for individuals who begin receiving SSA/SSI after December 2007.
Contact Income Maintenance Program and Policy Unit for SSA/SSI individuals with special circumstances.
- Review this memorandum with appropriate staff.