04 – Change in Circumstances in FAMIS

Tools #

• FAMIS Fastpath Reference List
• Authorizing an Action
• SNAP Unclear Information Flowchart

Guidance #

FSD team members have ten days after learning about a change to determine if any additional verification/information is needed and to request it from the EU.

Non-MAGI:

• Non-MAGI households must report changes affecting eligibility factors within ten (10) calendar days of the change. When the change is obtaining employment or a change in rate of pay, the change date is the date of the first paycheck or first paycheck with the changed rate of pay.
• Enter all new or changed information into FAMIS and evaluate the impact on eligibility
  • • If the change is reported timely and would result in increased coverage or a better benefit, the change is effective the month of the report.
    • If the change is not reported within ten calendar days and would result in an increase in coverage, the change is effective the month of report, not the month in which the change occurred.
    • If the change results in eligibility for more than one Non-MAGI coverage (such as Spend Down to TWHA or SLMB2), decisions regarding coverage must be made by the participant or the Authorized Rep. If the participant requests to be switched to the other program, do not require a new application and complete an eligibility determination as an ex parte (which means without contacting the participant).
    • If the action results in decreased coverage (including increase in Spend Down), an Advanced Notice of Adverse Action is required and the change becomes effective no later than the month following the month the change is reported unless an invoice has already been sent for the following month. In that case, the change becomes effective the second month. Example: If a participant’s income increases 10/10, Adverse Action expires 10/20, the November invoice would have been sent out on 10/1. Therefore, the increase in Spend Down is not affected until December with the new invoice and new Spend Down amount.
    • If the action results in no longer meeting eligibility, explore eligibility MAGI and AEG in MEDES. Register a MAGI application in MEDES using the most recent information from the participant’s Non-MAGI case and process to determine eligibility.

SNAP:

• SNAP households are required to report certain changes by the tenth day of the month, following the month in which the change occurred.
• The only changes which are required to be reported are:

1. 1. 1. Gross monthly income exceeds 130% of poverty
      2. Reduction in the number of hours worked by ABAWD individuals
      3. Lottery or gambling winnings equal to or greater than the current resource limit for elderly/disabled households or more in a single game.
         • Note: See 13.5.8 SNAP Lottery and Gambling Winnings for additional information.

• During a certification period, changes may be reported by the household, an outside source or an automated report. Even if information is verified upon receipt, it can still be considered unclear if additional verification/information is needed to act on the change.
• The agency must request clarification and/or verification (if applicable) of reported changes in household circumstances for unclear information if the information is:
  • • Information is less than 60 days old from the date of receipt and is required to be reported by the household, or
    • Significantly conflicting with information reported at the time of application and approved certification, enough to bring the household’s eligibility into question, or
    • A match with a participant data matching system is received
      • • Note: This information must be handled differently from other unclear information. Refer to 13.2 Information from Certain Data Matches in the FSD Policy Manual

TA:

• Temporary Assistance participants must report changes in circumstances within ten (10) days.
• Enter all new or changed information into FAMIS and evaluate the impact on eligibility.
  • • Any grant decrease becomes effective the month following the month of change or the month following expiration of the notice of adverse action.
    • Any grant increase becomes effective no later than the month following the month the change is reported.
    • When monthly income decreases by $50 or more, a deficiency payment is made for the month in which the change is reported.

Step 1: Fastpath to all applicable screens to complete the change #

See FAMIS Fastpath Reference List for assistance in locating screen fastpaths.

Address Change #

Screen Help

ADDRESS/FM0A

ADRES/FM1G

FAMIS Participant Search/PRSNSRCH

Guidance

• • The residential (physical) address must be a valid Missouri address. (FAMIS organizes applications and cases by residential address. Exceptions to using the residential address on SCMBR are: Safe At Home and a Post Office Box when the residential address is a battered women’s shelter.)
    • • Note: SNAP: When a new address is reported, contact the household by phone to obtain the new shelter expense information. If expenses have changed, end date the existing expenses for the prior month, add the new expenses current month with CS as the verification code and authorize the new case actions. If telephone contact is unsuccessful, complete the same steps as stated above except entering $0 in the amount field and leave the verification code blank. Pend the case for shelter expenses and send an FA-325 to request the updated shelter expense amounts.
  • The participant must reside in Missouri with the intent to remain in the state. Residents in certain public institutions are not eligible on this factor.
    • • Note: SNAP: Intent to remain in the state is NOT required
      • Note: Vendor:
        • • For single individuals who live in a nursing facility, the residential address is that of the nursing facility with living arrangement code ‘Nursing Home’ (NH).
          • For a married couple when one spouse is institutionalized, the address of the community spouse is the residential address (Living Arrangement type RA.) The nursing home address is captured on the Facility and Placement Information Details screen.
          • For a married couple when both reside in the same institution, and for single individuals, the facility address is the residential address and the living arrangement type ‘Nursing Home/Residential Care’ (NH) is used.
          • For a married couple with spouses residing in separate institutions, the address of the FSD county office where the couple originally resided is used as the residential address with a living arrangement type ‘Nursing Home/Residential Care’ (NH). Each spouse’s facility address is captured on the Person Detail screen, so that they may receive correspondence.
          • The Authorized Representative’s mailing address is captured on the Representative Detail screen. The case remains in the claimant(s)’ county of residence even when the Authorized Representative’s address is in another county.
  • The applicant’s declaration of residency is discussed later during the controlled flow of the application process and is entered on the RESIDENT screen.
    • • Note: SNAP: Enter the verification code on Application Detail (FM13) and document the verification by adding a comment to the Food Stamp Eligibility Unit Member Role (EUMEMROL/FM3Z) screen.

Verification

Follow FCR steps to verify.

• Can we get it?
  • • MODL
    • IMES
    • IIVE
    • LIHEAP
• If customer needs to provide verification, common verifications are:
  • • Unexpired driver’s license with current address
    • Rent or mortgage receipts
    • Lease
    • Utility bills
    • Any mail with current address

Comment

Comment on program specific EUMEMROL/FM3Z when a new address is reported and entered into FAMIS

• • The name of the person who reported the new address
  • The date and how the address was reported
  • The new address
  • How the address was verified, if it was
  • SNAP: Obtain new shelter expense information or request it if not initially provided and the participant cannot be reached by phone

MHABD couple cases, record on MHABD EUMEMROL/FM3Z who lives where, by name, when there is a community spouse and an institutionalized spouse

Adding/Removing Person from Supercase/EU #

Screen Help

INHOME

Verification

• • Accept CS unless questionable, however;
  • CC- for whom Temporary Assistance has been requested. This is due to current FAMIS functionality. TA policy states CS is acceptable unless questionable.
  • GS- Accurint Statement – Accurint for Government Eligibility information is used and additional information or verification is needed.  GS will prompt FA325 to be generated.
  • GC- Accurint Confirmation – Uses GC if no additional verification is needed after accessing Accurint for Government Eligibility or updates GS to GC after the additional information or verification is received from the participant

Comment

Comment on program specific EUMEMROL/FM3Z when adding/removing persons to existing Supercase and household/EUs

• • Identify by name, the person who is adding or removing another participant
  • Record your decisions:
    • • If not being added to a household/EU, explain why based on policy
      • If being adding to a household/EU
        • • Record if they wanted to be added, and if not why the person is mandatory per policy for that program

End Dating Resource for Non-MAGI (Excluding Vendor/Supplemental Nursing Care) #

End Dating SMI Premium on MEDEXP Due to QMB/SLMB approval #

Incarceration for MO HealthNet Participants #

Guidance

People who are incarcerated have a unique eligibility situation.

FAMIS generates a Notice of Match Results (NOMR/FA-601) for possible incarcerated participants during the controlled flow.

Note: Staff must review available electronic sources for prisoner information at application and recertification.  On IIVE (SVES-Wire Third Party Query Response), a message will appear on the bottom, right-hand corner of the screen if prisoner information is available.

Step 2: Complete EDRES #

After changes are made, complete a new Eligibility Determination Resolution following Authorizing an Action guide.

Step 3: Request Verification #

Evaluate the specific change to determine appropriate verification needed (if applicable). Request verification via FA-325 or IM-31A allowing participants 10 days to comply.

Step 4: Comment #