Effective July 1, 2016, the maximum grant for SAB and BP increases from $711 to $728. A Family Assistance Management Information System (FAMIS) mass adjustment was completed the weekend of June 11, 2016.
This memorandum discusses the following:
- ELIGIBILITY UNITES (EUS) IN THE CONTROLLED FLOW
- CONFLICT OF ACTIONS
- OTHER ACTIONS
- FAIR HEARING REQUEST
ELIGIBILITY UNITS (EUS) IN THE CONTROLLED FLOW
If an eligibility unit (EU) with existing SAB/BP income is in the FAMIS controlled flow, the SAB/BP grant amount will not be adjusted. These cases will appear on the "Cases Not Adjusted/Error" Report and will not be adjusted by the system until the controlled flow is completed. Priority attention must be given to this listing as participant's SAB/BP grant amount will be incorrect beginning July 1, 2016.
When the case is taken through the flow a July 2016 budget and subsequent budget months must be entered, FAMIS will then calculate the deficiency or retroactive SAB/BP grant amount and issue those payments to the participant. To check for deficiency or retroactive SAB/BP payment issuance after the overnight batch process, view the Payment History (PAYHIST/FM5F) screen.
NOTE: Deficiency (DEF) payments are issued if the month for which they are intended has passed; retroactive (RTO) payments are issued if the month for which they are intended is the current month.
CONFLICT OF ACTIONS
FAMIS adjusts the income on EUs with a pending adverse action at the time of the mass adjustment. This results in a conflict of actions because one adverse action must be completed or voided before the new action can be taken. The eligibility specialist receives the alert "OUTSTANDING ELIGIBILITY DETERMINATION". The conflict must be resolved by the eligibility specialist.
Access the Action Resolution (ACTRES/ FM5O) screen and void the pending adverse action. Refer to the user guide Changing an Adverse Action Status for instructions. After voiding the adverse action, access the Eligibility Determination Resolution (EDRES/ FM3Y) screen, run a new eligibility determination, and authorize the new adverse action. FAMIS will produce an Adverse Action Notice (FA510) or a MO HealthNet Adverse Action Notice (FA410) and take action when the notice has expired.
For eligibility determinations completed on or before June 11, 2016, FAMIS will use the previous SAB/BP grant amount for the budget months through June 2016. For eligibility determinations completed June 11, 2016 or after, FAMIS will use the previous SAB/BP grant amount for budget months through June 2016 and use the new SAB/BP grant amount for the month of July 2016 and ongoing.
A Claimant Action Notice (FA150) is sent for the following types of cases during the mass adjustment, notifying them of the July 2016 change of benefits:
- all Child Care cases adjusted;
- all Temporary Assistance cases adjusted;
- all Food Stamps case adjusted.
No action notice is being sent for Food Stamps, Family Healthcare or Temporary Assistance cases that result in no change (NOCH) in benefits due to the SAB/BP mass adjustment.
A MO HealthNet Adverse Action Notice (FA410) will be sent for Family Healthcare cases that result in a change in benefits due to the SAB/BP adjustment. A MO HealthNet Action Notice (FA450) will be sent once the adverse action notice expires.
An Adult MO HealthNet Adverse Action Notice (FA420) will be sent for Adult MO HealthNet cases that result in a change in benefits due to the SAB/BP adjustment. An Adult MO HealthNet Benefit Notice (FA460) will be sent once the adverse action notice expires.
FAIR HEARING REQUEST
If the EU requests a fair hearing, send the request to the Hearings Unit the same day. It is important to send all Agency evidence to the Hearings Unit as soon as possible. All available evidence should be sent to the Hearings Unit with the original request for hearing. Do not wait until a few days before the hearing to send the evidence.
For budget adjustments or closings, evidence includes, but is not limited to:
- MO HealthNet Pre-Closing Notice (FA411)
- Adverse Action Notice (FA510; FA410; or FA420)
- TA/MA/FS Review History Screen (FM57) screen print
- Action Notice (FA150; FA450; or FA460)
- Comments Screens
- Manual sections/legal references
- Budget Summary (FM4A, FM4D, FM4H, FM4K) screen for applicable months if the change/closing is due to income
- Adult MO HealthNet AG Budget Summary (FMD8) screen (Adult MO HealthNet only)
- Detail screens of budget entries, as applicable:
- Income Summary Detail (FM33)
- Assistance Group Details (FM4E) (Family Healthcare only)
- ADM AG Income Summary Detail (FMDE) screen (Adult MO HealthNet only)
- Expense Summary (FM34)
- ADM AG Expense Summary (FMDF) screen (Adult MO HealthNet only)
- Income (FMX0) screen
- Income Amount (FMX3) screen
- Shelter Expense (FMXK) screen
- Utility Expense Standard (FMXJ) screen
- Court Ordered Expense (FMXL) screen
- Dependent Care Expenses (FMXM) screen
- Medical Expense (FMXA) screen
- Financial Resource Detail Summary for applicable months if the change/closing is due to resources
Provide a copy of the evidence to the EU asking for the hearing, and their legal representative and schedule a pre-hearing conference. If the EU designates an attorney or authorized representative for the hearing, send a copy of all notices and evidence for the hearing to the EU and the designated individual.
Please note that if verification of child support income was from a Missouri Automated Child Support System (MACSS) screen, the verification should be requested from child support staff for the hearing. They can provide a print-out that contains the same information that can be presented as evidence. If the local office cannot get this information, contact the Program and Policy Unit for assistance. Do not go to hearing and state that the verification cannot be supplied because the screen cannot be printed, as the FSD has access to this information.
- Review this memorandum with appropriate staff.