- TO:
- ALL FAMILY SUPPORT DIVISION OFFICES
- FROM:
- JULIE GIBSON, DIRECTOR
- SUBJECT:
- CLARIFICATION OF REFERRAL PROCESS FOR HOME AND COMMUNITY BASED SERVICES
DISCUSSION:
The purpose of this memorandum is to provide clarification of the referral process for Home and Community Based Waiver Services (HCB) to the Department of Health and Senior Services (DHSS) Division of Senior and Disability Services (DSDS).
Income Maintenance memorandum IM- 25 Home and Community Based Services Referral Process and Form (IM-54A) Revisions, dated April 8, 2015 introduced the revised Home and Community Based Referral (IM-54A) form and referral process.
When to Send the IM-54A to DSDS
Send the IM-54A to DSDS, when the participant is:
- Approved for MO HealthNet spend down (MHSD) or non-spend down (MHNS), and
- Found to meet the HCB eligibility factors outlined in Income Maintenance manual section 0820.000.00 ELIGIBILITY BASED ON RECEIPT OF HCB WAIVER SERVICES.
Send the IM-54A to DSDS, when the individual is:
- Ineligible for MHSD or MHNS only due to excess resources, but potentially eligible for HCB after a division of assets, and
- Found to meet other basic HCB eligibility factors.
- Mark “Potential HCB Eligibility/Paper Referral Process” on the IM-54 in section designated “Participant Referred to DSDS/Designee for.”
Do not send an IM-54A to DSDS, when the individual does not meet the HCB eligibility factors. Do not refer individuals who:
- Are under age 65, or under age 63 when disabled.
- Has no need of HCB services
- Has income which exceeds the HCB income limit
Self-Referral to DSDS
If contacted by a MHSD or MHNS participant determined ineligible for HCB by the FSD, who needs in-home services, advise the individual to request services directly from DSDS. Self-referrals for Home and Community Based Services to DSDS can be completed by calling 866-835-3505.
DSDS Reassessment
DSDS reassesses eligibility for HCB annually. DSDS will notify FSD when an active HCB participant is found ineligible based on the new assessment. Upon receipt of the IM-54A indicating ineligibility for HCB waiver services, FSD will begin the process to end HCB coverage and explore eligibility for MHNS or MHSD.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
JG/vb