MEMORANDUM

DISCUSSION:

Effective October 12, 2009, the implementation of the Adult programs in FAMIS requires changes and additions to the following screens. These changes will be visible to staff statewide, regardless of whether or not the county or Eligibility Unit (EU) has been converted to FAMIS.

• Supercase Member Relationships (FM0F or RELINFO) screen
• Application Request (FM0G or REQUEST) screen
• MO HealthNet Application Detail (FM17) screen
• Income (FMX0) screen
• Disabled (FMMX or DISABLED) screen
• Liquid Resource (FMW0), Personal Property (FMW2), Real Property (FMW4), and Vehicle (FMW3) screens
• Health Insurance Detail (FMXY) screen
• Supercase Eligibility Unit Summary (FM30) screen

Supercase Member Relationships (FM0F or RELINFO) screen

Relationships between Eligibility Unit (EU) members are captured on the Supercase Member Relationships (FM0F or RELINFO) screen. A "Begin Dt" field for both Family and Legal relationship is added to the Supercase Member Relationships (FM0F or RELINFO) screen. The date a relationship begins is important for the Adult programs. Eligibility, transfer of property, and division of assets determinations are affected if the correct date is not entered. The Supercase Member Relationships (FM0F or RELINFO) screen displays in the controlled flow for all Adult MO HealthNet (ADM) applications and is viewable in Maintenance Mode. Relationship information can be updated on the Relationship Detail (FMA4 or RELATION) screen. The "Begin Dt" field defaults to the current date if a date is not entered in this field.

Application Request (FM0G or REQUEST) screen

"MA" is entered in the "PGM" field on the Application Request (FM0G or REQUEST) screen for Adult MO HealthNet applications. A new subprogram code, "ADM" (Adult MO HealthNet) is added for the Adult programs and is entered in the "Sub Pgm Class" field on the Application Request (FM0G or REQUEST) screen. The "Delay Code" and "Due Date" fields on the Application Request (FM0G or REQUEST) screen do not display results for Adult MO HealthNet applications. Due dates and delay codes are accessed from the MO HealthNet Application Detail (FM17) screen.

MO HealthNet Application Detail (FM17) screen

The MO HealthNet Application Detail (FM17) screen below displays for Adult MO HealthNet applications. The "Options for Benefit Requested" section is updated for Adult MO HealthNet applications. Enter "M" in the "Benefit Requested" field if an individual requests benefits under the MO HealthNet for the Aged, Blind, and Disabled (MHABD) spenddown/non spenddown, Vendor, HCB, Ticket to Work Health Assurance (TWHA), or Supplemental Nursing Care (SNC) programs. Enter "B" in this field if an individual requests Supplemental Aid to the Blind (SAB) or Blind Pension (BP) benefits.

NOTE: If a "B" is entered and the participant is not eligible for SAB or BP benefits, eligibility for MHABD spenddown/non spenddown, Vendor, HCB, TWHA, and SNC is explored. It is not necessary to change the entry on the Application Detail (FM17) screen. Eligibility for Qualified Medicare Beneficiary (QMB) and Supplemental Low Income Medicare Beneficiary (SLMB) programs is explored for any individual with an "M' or "B" entered in the "Benefit Requested" field.

Enter an "N" in the "Benefit Requested" field if an individual is not requesting benefits for themselves but is required to be included in the EU.

NOTE: An "N" must be entered for a spouse as well as any minor children or dependents living with a Community Spouse for which an Institutionalized Spouse wishes to make an allotment.

Enter an "E" in the "Benefit Requested" field if the individual should be excluded.

Income (FMX0) screen

A "Taxes Withheld" field is added to the Income (FMX0) screen to capture information for the Ticket to Work Health Assurance (TWHA) program. A "Y" is entered in this field if an individual has earnings from employment or self-employment and Medicare and Social Security taxes are withheld from their income. Self-employed persons must provide proof of payment of Medicare and Social Security taxes for income to be considered earned. Self employed individuals must provide copies of their tax records to verify taxes withheld or if it is a new self employment enterprise, they must provide business records (i.e. business ledgers or gross profit statements) showing the taxes are being withheld for Social Security and Medicare. Enter "N" for all income types not withholding Medicare and Social Security taxes.

Disabled (FMMX or DISABLED) screen

The function key F15=MRTINFO is added to the Disabled (FMMX or DISABLED) screen. This is used to view the Medical Review Team (MRT) screens in FAMIS.

Liquid Resource (FMW0), Personal Property (FMW2), Real Property (FMW4), and Vehicle (FMW3) screens

An "MHABD Excl Rsn" field is added to the Liquid Resource (FMW0), Personal Property (FMW2), Real Property (FMW4), and Vehicle (FMW3) screens. This field is used for resources that are excluded from the Adult MO HealthNet eligibility determination, but not excluded for the Temporary Assistance or Food Stamp programs. If there is a code entered in this field the system excludes the entire resource when determining eligibility for any Adult MO HealthNet program. Do not enter an exclusion reason in this field unless the entire resource is excluded. If only a portion of the resource is excluded enter the amount that is excluded in the "Excluded Amount" field and the system counts the remainder as an available resource. The Liquid Resource (FMW0) screen is pictured below.

Health Insurance Detail (FMXY) screen

A "Disregard Amount" field is added to the Health Insurance Detail (FMXY) screen. Entry in this field allows a disregard of assets in determining MHABD eligibility for individuals who received benefits from a qualified long-term care partnership policy. The disregard amount is the amount the insurance carrier verifies as paid to or on behalf of the individual as of the month of application.

Supercase Eligibility Unit Summary (FM30) screen

The Supercase Eligibility Unit Summary (FM30) screen is used to display eligibility results for all programs in FAMIS. Certain fields and function keys are dynamic based upon the program. The Supercase Eligibility Unit Summary (FM30) screen displays the technical eligibility and assistance group (AG) results for Adult MO HealthNet programs. The financial resource (Res) and income eligibility determination (Inc) columns display as "N/A" (Not Applicable). This is because the resource and income determination is done at the AG level for MO HealthNet for Adult programs instead of at the Eligibility Unit (EU) level as it is in other programs. A new column "AG RSLT" is added for Adult MO HealthNet programs. A new function key F6=MHABD is added for Adult MO HealthNet programs to allow the eligibility specialist to view the technical, resource, and budget summary results for the AG. To view the AG results for a particular month type "S" in the SEL column and press F6=MHABD.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.

SS