MEMORANDUM

DISCUSSION:

Effective the weekend of February 11, 2012 additional MHABD programs were moved to FAMIS. These programs include Supplemental Aid to the Blind Vendor, Section 1619, MO HealthNet for Disabled Children, MO HealthNet Vendor for Children and Missouri Children with Developmental Disabilities (MOCDD) Waiver cases. Applications requests for any of the above programs must be entered in FAMIS as of Tuesday, February 14, 2012.

Active cases in the Legacy system will not be converted until the weekend of February 18, 2012. Follow instructions in the Conversion of MHABD Deferred Programs memo to insure those cases are correctly converted.

Supplemental Aid to the Blind (SAB) Vendor

Enter as an ADM case on the request screen. Enter B in the Benefit requested blank on the Application Detail screen (FM17). Complete the controlled flow, answering the SAB/BP questions. Enter information on the Facility and Placement Information (FACPLACE or FMJ4) screen.

The outcome will show SABVENDOR on the Assistance Group Worksheet (FMDB).

NOTE: Entries on the Disabled (DISABLED or FMMX) screen will be the type of disability that the individual qualifies for, BLD (BLIND) is not a valid code for this program.

Individuals Qualifying Under Section 1619 of the Social Security Act

When individuals have 1619 A or B status, eligibility specialists will make an entry of S19 on the Disabled (DISABLED or FMMX) screen to identify which type of MHABD coverage is recommended for the individual. When participants with 1619 coverage are added to supercases where a spouse is currently receiving another type of MHABD coverage, the 1619 participant will be added to the active case following the steps outlined in FAMIS User Guide Adding a Member to the Supercase and/or Eligibility Unit.

NOTE: Individuals applying for MHABD prior quarter coverage in Missouri after receiving coverage under section 1619 in a different state will require the eligibility specialist to make entries on the Received Out of State (RECOUTST or FMMW) screen in maintenance mode after completing the controlled flow.

EXAMPLE: Mr. Jones applies for MHABD 1619 coverage on February 2012 and requests prior quarter coverage. The Eligibility Specialist (ES) has determined that he is eligible for 1619 coverage in Missouri effective November 2011, due to his receipt of 1619 coverage in Illinois in October 2011. The Received Out of State screen does not allow an entry of more than three months prior to the current application month during the controlled flow, so the ES will complete the controlled flow, then prior to doing the eligibility determination the ES will fast path to the Received Out of State (RECOUTST or FMMW) screen and add 10/2011 as a month that the participant received benefits and Illinois (IL) as the state.

MO HealthNet for Disabled Children (MHDC)

Parents and siblings of the disabled child should be included in the supercase (SC). Failure to add all siblings will result in incorrect deeming. Establish and verify relationships as needed. If parent(s) are known to FAMIS, information from the parent's case such as, income, birth, residency, SSN's, citizenship verification for the child, and disabled codes will populate the child's MHDC case/application.

FAMIS will determine the assistance group based on relationships and will deem the parent's income to the disabled child. Parent's resources, with some exceptions (401K's, etc.), are deemed to the disabled child's case and count in entirety. Enter the appropriate disability code for the disabled child on the DISABLED (FMMX) screen.

MO HealthNet Vendor for Children

For children placed in a facility accredited by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), make entries on the Facility Placement (FACPLACE or FMJ4) screen, depending on the type of facility and bed where the child resides. For children in JCAHO, the Facility Placement screen includes an entry field for the IM-71and the date of receipt.

NOTE: Children in vendor facilities may need to have eligibility determined based on different EU members by changing the selections on the Application Request Detail (FM17) screen. The eligibility specialist will first take the application through the controlled flow with all EU members. Then, if an optional member has been included who causes ineligibility, the eligibility specialist will change the status of the optional member to excluded, and complete the controlled flow based on the updated eligibility unit.

Missouri Children with Developmental Disabilities (MOCDD) Waiver

Children on the Missouri Children with Developmental Disabilities (MOCDD) or Sarah Lopez Waiver will be entered into FAMIS under their own name, with their parents entered as excluded household members. The ES will complete the controlled flow answering all questions for the MOCDD child. FAMIS determines a participant's eligibility for MOCDD coverage based on entries on the Missouri Children with Developmental Disabilities Info (MOCDD or FMJ8) screen. This screen is currently not in the controlled flow, so access this screen in maintenance mode prior to entering the controlled flow, or upon completion of the controlled flow, by typing FMJ8 or MOCDD on the FAMIS command line. Upon completion of required data on the Missouri Children with Developmental Disabilities Info (MOCDD or FMJ8) screen, complete either the controlled flow or an eligibility resolution (EDRES), and review coverage recommendations. Refer to FAMIS User Guide Adding MOCDD Coverage for more information on entering MOCDD coverage in FAMIS.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Begin entering applications for SAB Vendor, Section 1619, MHDC, MO HealthNet for Vendor Children, and MOCDD in FAMIS effective Tuesday, February 14, 2012.

KS/TM/DH