MEMORANDUM

DISCUSSION:

In January 2012, all Social Security Administration (SSA), Supplemental Security Income (SSI), Veterans Administration (VA), and Railroad Retirement (RR) participants will receive a 3.6% cost of living adjustment (COLA). A mass adjustment of Missouri Children with Developmental Disabilities (MOCDD) Waiver, 1619, Refugee, Presumptive Eligibility for Children, M. Darling, MO HealthNet for Disabled Children (MHDC), Supplemental Aid to the Blind vendor, and BCCT cases with SSA, SSI, VA, and/or RR income will occur the weekend of December 10, 2011.

For applications approved after the mass adjustment, verify the new SSA, SSI, VA, or RR amount. If the new amount is unavailable and the old amount of SSA, SSI, VA, or RR benefits has been verified, multiply the old amount by 1.036 to arrive at the new amount of benefits.

State Office will complete the adjustment as follows:

• send the adverse action or adjustment notice;
• 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:

• 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

• “M” type of assistance cases with a “T” level of care.
• SAB Vendor cases and conversion cases using AB criteria.

How Cases Are Mass-Adjusted

The computer program identifies participants who receive VA, based upon entries in field 14F 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.

Cases will be adjusted by applying the 3.6% increase to the VA amount shown in 14F. For these cases, if the amount in 14F is incorrect, the adjustment will be incorrect. The Eligibility Specialist is responsible for correcting 14F and any other affected figures.

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.

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 all types of assistance, cases that will not be adjusted include:

• Cases with assistance group members who do not have SSA, SSI, VA, or RR. 

Listing of Cases Not Adjusted by State Office which Need Action by County Staff

There is one report of cases not adjusted:

• Cases Needing Review for Adjustment.

Cases Adjusted-Review for Further Action

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, 2011. The participant has until December 21, 2011, to request a hearing and have benefits restored to pre-adjustment levels.

If the participant requests a hearing on or before December 21, 2011, 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 21, 2011, 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.

• Captions Defined
  • 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.
  • CLOSE - The case was closed in the mass adjustment.
  • NO CHG - The mass adjustment resulted in no change to the case.
  • DECR - The grant was decreased in the mass adjustment.
  • Surp Inc - The surplus was increased in the mass adjustment.
  • Surp Inc/Allot - The surplus was increased for an allotment case in the mass adjustment.
  • 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 SSA, SSI, VA or RR

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 2012 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:

• For increases, the effective date is the month following the expiration of the IM-80 or the signing of the IM-80A and
• For decreases, the effective date is the month following the month of the report or discovery.

See the online manual 0815.000.00 for more information.

Notices to Participants

Adverse action notices and notices of adjustment will be generated by the system and mailed to participants. For hearing requests, access the copy of the notice sent to the participant in MOBIUS.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Review cases and adjust manually as needed.

TM/